Detection of Problematic Substance Use in the Child Welfare System: A Comparison of Self-Report and Caseworker Report

Abstract

Using a national sample of American families investigated for child maltreatment, this article compares parental self-report on the Alcohol Use Disorders Identification Test and Drug Abuse Screening Test measures to caseworker report of problematic alcohol and drug use at investigation. Data in this article are from child welfare caseworkers and a subset of parents surveyed in the National Survey of Child and Adolescent Well-Being II—primary caregivers (most often the biological mother) whose child remained in the home following investigation (n = 4,009). Caseworkers identified problematic alcohol use in only 17.7% of the parents who self-reported problematic alcohol use and problematic drug use in 37.6% of the parents who self-reported problematic drug use. Sensitivity and specificity for the detection of problematic alcohol use were 21.5% and 94.8%, respectively, and 65.3% and 83.7% for problematic drug use, respectively. After controlling for the other variables in the model, an allegation of substance use reduced the odds of caseworker detection of problematic alcohol use being consistent with parent self-report (odds ratio [OR] = 0.45, p <.001).