Sexual risk assessment tool in the child welfare system developed
Children in the welfare system are particularly vulnerable to commercial sexual exploitation of children (CSEC) according to a 2013 U.S. House of Representatives Ways and Means hearing, but few practical screening tools currently exist to identify victims and those at risk for sexual exploitation, according to an interdisciplinary team of Penn State researchers. "Most of the screening measures that exist are quite broad and geared towards sex trafficking of young adults and adults, and we found that there wasn't an effective assessment tool looking at children, particularly those who have been involved in the child welfare system," said Carlomagno Panlilio, assistant professor of education and Social Science Research Institute (SSRI) co-funded faculty member. Abuse can happen anywhere, but there tends to be a higher victimization risk for children in welfare because of prior abuse and an absence of stable caregivers, according to the researchers. "Our study is the first to examine risk factors for CSEC using a large, nationally representative sample of both male and female youth whose families were investigated by Child Welfare Services," the researchers report in a special issue of Child Abuse and Neglect. The researchers, who are developing an evaluation tool, are part of the Child Maltreatment Solutions Network at Penn State. Funded by both Penn State and the National Institutes of Health, the network's goal is to raise public awareness about the scope and gravity of child maltreatment through efficient translation of evidence-based research and by partnering with community providers and public policy leaders at the local, state, and federal levels. Panlilio and his colleagues used 2,244 children's responses, a representative sample of both males and females, obtained from the National Survey of Child and Adolescent Well-Being study, which surveyed children and families that had been investigated by Child Protective Services. They used a statistical model to examine the underlying range of risk for childhood sexual exploitation based on how the children answered survey questions. Within this process, choosing a response that affirms the question would signal an indication of risk. For example, when asked about whether the child felt suicidal, the child could choose the response "I do not think about killing myself" or "I want to kill myself." Questions like this, on a broad variety of subjects, make up the assessment survey. Additionally, the model allowed researchers to test whether certain items can discriminate between children who are higher or lower in this range of risk. For example, if an item is considered to discriminate well, then children with a low risk of CSEC would have a smaller chance of affirming a particular question. This study was an initial exploratory attempt to examine potentially useful items to use in a screening measure, which was based on prior studies and a strong theoretical model. "Before we engaged in developing a potential instrument, we wanted to see how the items would perform on a large-scale data set," said Panlilio. This psychological measurement approach would enable the researchers to create an effective assessment that can potentially reveal which children in the welfare system are at risk for commercial sexual exploitation, and could serve as the first step towards prevention of the exploitation of maltreated children. "We started with 11 predictors based on our review of previous literature, and what we found surprising was that some of these questions were not performing well," said Panlilio. "The items were unable to discriminate the presence or absence for the severity of risk." For example, a question included in previous assessment models created by other researchers asks, "When I'm with a caregiver, I feel unhappy. How true is this?" "If they (children) are in foster care, they are probably not happy with their caregiver," said Panlilio. "Questions like this don't necessarily indicate a risk of sexual exploitation." Such questions were excluded from the final model that Panlilio's research team created. The final model used seven rather than 11 items. The researchers also tested how the response rate to certain questions differed based on gender. Their results indicate a high severity risk of sexual exploitation for males who answered positively to questions about drug or alcohol use, a previous runaway incident, suicidality, and exposure to severe violence. "We want to understand if the severity of risk is different for boys and girls," said Panlilio. Previous models solely focused on female victims of sexual exploitation. "This is the first step in instrument development regarding how we can begin to identify specific risk indicators for children who have the potential to be sexually exploited in the welfare system," said Panlilio. "In the future, we would like to collaborate with others and test the items in a sample of the population." Other Penn State researchers on the paper include SSRI co-funds Sheridan Miyamoto, assistant professor of nursing; Sarah Font, assistant professor of sociology; and Hannah Schreier, assistant professor of biobehavioral health. The Eunice Kennedy Shriver National Institute of Child Health and Human Development supported this work.