In most Australian states, legislation makes provision for professionals to report their concerns about the future welfare of an unborn child to appropriate authorities. The legislation establishes guidance for the implementation of family supports to minimize future child protection involvement. Given the legislation and the potential benefits, empirical research linking substance misuse during pregnancy and child protection involvement is relatively limited. We review 21 original studies linking substance misuse during pregnancy with child protection outcomes and the potential generalizability of results to the Australian context. The majority of studies reviewed were conducted in the USA and were mostly retrospective. Other differences between studies include sample sizes, comparison groups, study setting, participants’ ethnicity and pattern of drug use. In the postnatal literature, it is well established that child abuse is associated with a complex array of factors including partner, as well as broader family factors and yet, the studies reviewed focus upon maternal substance abuse without including the wider context. Given the available evidence‐based literature, it is difficult to come to definitive conclusions that can assist clinicians involved in frontline decision‐making for early intervention. Well‐designed research, accessible by antenatal health‐care professionals, is needed to adopt an evidence‐based approach to risk assessment in the prenatal context.
Limitations of instruments adopting consensus and actuarial approaches are well documented when assessing risk of abusive behaviour. Whilst the consensus approach is flexible and useful for structuring information, it relies upon the practitioner's ability to combine information and apply knowledge of empirical research. The actuarial approach involves a graduated probability measure in the form of a score that determines the likelihood of a particular event occurring; however, this approach focuses upon static risk factors and tends to be inflexible given its necessary reliance on nomothetic factors. A third approach, structured professional judgement comprises evidence‐based risk factors and decision‐making guidelines to inform professional judgement and standardize assessments. Instruments focus upon dynamic risk factors that assist practitioners monitor risk levels and manage risk. This approach is useful for social work practice that commonly requires ongoing risk assessments and risk management. Structured professional judgement has not been meaningfully explored in Australian child protection practice despite it being used successfully for approximately two decades for assessing a range of offending and violent behaviour. Given the complexity of child protection cases, further research on approaches to risk assessment that combine evidence‐based research, structured assessment and clinical judgement, is warranted.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.