Early detection of risk for maltreatment within Dutch preventive child health care: A proxy-based evaluation of the long-term predictive validity of the SPARK method

Abstract

Background: For effective prevention of child maltreatment, it is crucial that risk factors for child maltreatment are identified as early as possible. In the Dutch preventive child healthcare, the SPARK-method is used for this purpose.

Objective: The current study investigated the predictive validity of the SPARK-method for predicting child protection activities, as a proxy for child maltreatment, and whether the estimation can be improved with an actuarial module.

Participants and setting: Participants included a community sample of 1582 children of approximately 18-months-old for whom the SPARK was administered during well-child visits at home (51 %) or at the well-baby clinic (49 %).

Methods: SPARK measurements were linked to data on child protection orders and residential youth care over a 10-year follow-up period. The predictive validity was evaluated using Area Under the receiver operating characteristic Curve (AUC) values.

Results: Results showed good predictive validity for the SPARK clinical risk assessment (AUC = 0.723; large effect). The actuarial module led to a significant improvement in predictive validity (AUC = 0.802; large effect), z = 2.05, p = .04.

Conclusion: These results show that the SPARK is suitable for estimating the risk of child protection activities and that the actuarial module is a valuable addition. The SPARK can be used to support professionals in preventive child healthcare with their decision on appropriate follow-up actions.

Keywords: Child maltreatment; Child protection activities; Predictive validity; Risk assessment; SPARK method.