The ERisk Index: A Reliable and EasytoAdminister Screening Tool of Early Precursors of Likely Neglec

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The E-Risk Index A Reliable and
Easy-to-Administer Screening Tool of Early
Precursors of Likely Neglectful Behaviors

• Robin Gaines Lanzi, Sharon Landesman Ramey,
• Shannon S. Carothers Bert, Bette R. Keltner, and
• the Centers for the Prevention of Child Neglect
• Georgetown University

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Research Goals

• 1) Identify key constructs hypothesized to be
  precursors of early child neglect
• 2) Develop a screening tool for service providers
  and clinicians and then determine whether it can
  be used to predict the quality of home
  environments and mother-child interactions
• 3) Determine whether screening tool predicts
  childrens development

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Data obtained during

• Second trimester of pregnancy (including measures
  of plans related to parenting)
• Home visits when baby was 4 months old and 6
  months old
• Cell phone interviews when child was 4 to 5
  months old
• Subsequent data collection (lab and home visits,
  cell phone interviews) at 8, 12,15, 18, 24, 30,
  36 mos.

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Tools to measure early risk for neglect include

• Self-report via standardized interviews
  (multi-occasion)
• Child Abuse Potential Inventory - CAPI
  (Milner,1986)
• Parenting Style (Bavolek, 1985)
• Beck Depression Inventory (Beck, 1987)
• Parent-Child Activities (CPCN, 2000) cell phone
  interviews
• Study-specific items about responsibility and
  neglect
• Direct observations
• Parent-Child Interactions (Landry, 2000)
• HOME (Caldwell Bradley)
• Risk of Physical Neglect Indicators (CPCN, 2002)

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Research Goal 1Key Constructs Hypothesized to
be Precursors of Early Child Neglect
Resources Education Income Age/Experience Mental
Health
Recognition of Parenting Responsibilities Unwill
ing to accept new responsibilities No plans for
care
Support for Parenting Someone to turn to for
info, help,

• Parenting
• Beliefs and
• Information
• Lack of or wrong info
• about child needs
• effective practices

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Uncertain (when pregnant) about ability to
provide emotional support to children
plt.0001
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Uncertain (when pregnant) about ability to do
good job raising children
p lt.01
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Beck moderate to severe clinical depression
ratings (when pregnant)
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CAPI Unhappiness Score (when pregnant)
p lt .01
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Unwillingness to recognize and accept new
parenting responsibilities (when pregnant)
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Parenting Style Punishment Scores during
pregnancy
p lt .01
12
Parenting Style Authoritarian Scores during
pregnancy
p lt .001
13
Parenting Style Lack of Responsivity to Child
Scores during pregnancy
p lt .001
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CAPI Rigidity Scores (during pregnancy)
p lt .001
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Summary of findings about neglect precursors
during pregnancy

• Low resource mothers have higher rates of
• Maternal adjustment problems including mental
  health issues and uncertainty about ability to do
  a good job raising child and to provide emotional
  support
• Unwillingness to accept parental responsibilities
• Endorsing use of more abusive/neglectful,
  punitive, rigid, and authoritarian parenting
  practices, and less responsivity to child
• Teen mothers have highest rates of any group on
  almost all precursors

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Similar Patterns of Early Precursors of Likely
Neglectful Behaviors during 1st 6 months of
Babys Life

• With the exception that even more teen moms
  become even more unwilling to accept parental
  responsibilities when baby is 6 months old

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Unwillingness to recognize and accept new
parenting responsibilities
During Pregnancy
When Baby is 6 months old
plt.0001
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Research Goal 2
Development of a Screening Tool for Service
Providers and Clinicians
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Key Constructs Hypothesized to be Precursors of
Early Child Neglect
Resources Education Income Age/Experience Mental
Health
Recognition of Parenting Responsibilities Unwill
ing to accept new responsibilities No plans for
care
Support for Parenting Someone to turn to for
info, help,

• Parenting
• Beliefs and
• Information
• Lack of or wrong info
• about child needs
• effective practices

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Development of the 4-Item E-RISK Index Early
Precursors of Likely Neglectful Behaviors

• Certainty about ability to do a good job raising
  child
• Certainty about ability to provide emotional
  support to child
• Recognition and acceptance of new responsibility
  as a parent
• Indicate young children who feel secure often
  grow up expecting too much

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4-Item E-Risk Index Percent of Mothers with
Each Number of Risk Factors
Percent
Number of Risk Factors
plt.001
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4-Item E-Risk Index Significantly Related to
4-Month Home Environment Mother-Child
Interactions
p gt .001, p gt .05
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4-Item E-Risk Index Significantly Related to
8-Month Home Environment Mother-Child
Interactions
p gt .001, p gt .05
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4-Item E-Risk Index Significantly Related to
18-Month Home Environment Mother-Child
Interactions
p gt .001, p gt .05
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Research Goal 3
Using E-Risk Index to Predict Childrens
Development
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E-Risk Index Predicting 24-Month Child Outcomes
p gt .001, p gt .05
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Childrens 24-Month Problematic Ratings for
BAYLEY and PLS-4 Subscales
p gt .05
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Discussion
Research, Intervention,Service, and Policy
Implications
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Research, Intervention,Service, and Policy
Implications

• 4-item E-RISK Screening Tool can easily be
  adopted by clinicians, service providers, and
  interventionists to better serve and support
  parents before neglectful behaviors may occur and
  potentially adversely affect the babys
  development