The Child Abuse Risk Evaluation Dutch Version (CARE-NL): A retrospective validation study

Abstract

The Child Abuse Risk Evaluation–Dutch version (CARE-NL) is a structured professional guideline for assessing the risk of all types of child abuse. The CARE-NL comprises 18 risk factors: eight Parental characteristics, three Parent-Child interaction factors, five Family factors, one Child vulnerability factor, and an extra factor for child sexual abuse risk. We examined interrater reliability and predictive accuracy of the instrument in a retrospective study at Advice and Reporting Centers on Child Abuse (ARCCA) in The Netherlands. The ARCCA files contained limited information on Parental risk factors, while parental characteristics, such as mental disorder and substance abuse, are the most important risk factors for (repeated) child abuse. On the other hand, the majority of the files included ample information on child and family characteristics. The CARE-NL could be reliably coded by trained raters and the predictive accuracy for out-of-home placement (AUC =.73) and placement of the child under court supervision (AUC =.78), at two years follow-up, was adequate. Use of the CARE-NL ensures that the assessment of the risk of child abuse focuses on the most important, empirically based risk factors in a structured and coherent way.