The Development of a Screening Tool for Childcare Professionals to Detect and Refer Infant and Toddler Maltreatment and Trauma: A Tale of Four Countries

Abstract

Child maltreatment is considered a pressing social question, compromising the present and future mental and physical health of one in four children in Europe. While children younger than three years of age are especially vulnerable, few screening instruments are available for the detection of risk in this age group. The purpose of this research was to develop a screening tool for childcare professionals working in public and private daycare settings to support them in the early identification and referral of infants and toddlers exposed to emotional and physical abuse and neglect by primary caregivers, to be used in different settings across four European countries: Belgium, Italy, Latvia, and Hungary. Method: A stratified process was used to create the screening tool: We started by using Living lab methodology to co-create the screening tool with its final users, which was followed by testing the tool with a total of 120 childcare professionals from the four participating countries. Results: During the Living Lab phase, a screening tool with three layers was developed. The initial layer includes five “red flags” that signal particular concern and require immediate action. The second layer is a quick screener with twelve items focused on four areas: neglect of basic needs, delays in development, unusual behaviors, and interaction with caregivers. The third layer is an in-depth questionnaire that aids in formalizing a thorough observation of twenty-five items within the same four areas as the quick screener. After a one-day training session, 120 childcare professionals caring for children aged 0–3 from four countries assessed the screening tool and their overall training experience. Childcare professionals reported great satisfaction with the three-layered structure, which made the tool versatile, and agreed on its content, which was considered helpful in the daycare setting for the regular evaluation of the behavior of children and their primary caregivers, thus improving the early observation of change from the normal behavior of the infant or toddler. Conclusion: The three-layered screening tool was reported as feasible, practical, and with great content validity by childcare professionals working in four European countries.

Care When It Counts: Establishing Trauma-Sensitive Care as a Preventative Approach for 0–3-Year-Old Children Suffering from Trauma and Chronic Stress

“…Participants were 10–15 professional caregivers (end-users, i.e., childcare professionals but also pediatricians and health visitors), parents and policy members from Belgium (Living lab 1) and Hungary (Living lab 2). The other two project partners from Italy and Latvia organized two living labs independently from Belgium and Hungary because they focused on another topic, namely detecting and referring child maltreatment and trauma [ 25 ]. A convenience sample of 10–15 participants was composed within the region of the researcher’s workplace.…”

Domestic Violence Victimization Risk Assessment in Children and Adolescents: A Systematic Review

“…Risk assessments and interventions have increasingly been used for the mitigation and eradication of domestic violence victimization (Baird and Wagner 2000;Sani and Lopes 2018). Risk assessment guides teams in making critical decisions within limited timeframes for child protection in healthcare services (Baird and Wagner 2000;Kearney et al 2023), e.g., identifying, at an early stage, families at high risk of child maltreatment (Bisagno et al 2023;van der Put et al 2017). Predicting the onset of abuse can be better achieved through an actuarial assessment (using criteria and structured measures) than through clinical assessment (Baird and Wagner 2000;van der Put et al 2017).…”