Risk and safety of children and youth in child protection systems: A systematic review of risk assessment instruments.

BACKGROUND

The volume of referrals concerning child abuse and neglect underscores the importance of systematic risk assessment to identify and analyse factors that increase its likelihood, enabling timely intervention (Brem & Forrester, 2023).

OBJECTIVE

This systematic review examines actuarial risk assessment instruments employed in child protection systems and identifies the specific risk factors they evaluate.

METHODS

A comprehensive search was conducted across PubMed, EBSCO, and Web of Science databases, supplemented by manual searches, following PRISMA guidelines. Methodological quality was assessed using the CCAT, and risk of bias was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. After screening 1585 records, 11 empirical studies published between 2009 and 2023 were included, covering 10 distinct risk assessment instruments applied in child welfare contexts in the United States, Spain, the Netherlands, and the United Kingdom.

RESULTS

Findings highlight five key domains of risk factors commonly assessed: demographic and socioeconomic conditions, child-specific vulnerabilities, environmental influences, caregiver and family dynamics, and prior abuse or neglect. Actuarial models demonstrated higher predictive validity and inter-rater reliability than consensus-based assessments, although their performance varied across cultural and socioeconomic contexts. Most instruments conceptualised maltreatment risk as a cumulative construct and did not consistently differentiate predictive performance by subtype (e.g., neglect, physical abuse, exposure to domestic violence). In addition, some socio-demographic predictors may reflect likelihood of child protection system involvement rather than confirmed maltreatment, requiring cautious interpretation. Overall, effective actuarial instruments integrate multiple domains, emphasise modifiable risk factors, and complement clinical judgment.

CONCLUSIONS

This review underscores the need for culturally responsive, empirically validated, and digitally accessible tools to support evidence-based decision-making and enhance child protection practices worldwide. Strengthening longitudinal validation and subtype-sensitive modelling may further improve precision and equity in risk assessment.