Early Assessment of the Risk of Child Maltreatment Within Preventive Youth Healthcare: An Evaluation of the Discriminative Ability of the GIZ Needs Assessment

ABSTRACT

This study examined the discriminative ability of the GIZ tool—a needs assessment methodology—to distinguish between levels of subsequent child protection activities, used as a proxy for child maltreatment, within Dutch Preventive Youth Healthcare (PYH). Two tools were evaluated: (1) the GIZ‐triangle, a global screening of strengths and care needs across three domains, and (2) the GIZ‐matrix, a detailed screening across 10 domains. Additionally, the study explored whether the discriminative ability of the GIZ‐matrix could be improved by developing an actuarial module, where conclusions are algorithmically determined based on risk factors. Secondary analyses were performed on 36,989 GIZ assessments, linked to Statistics Netherlands data on child protection activities over a 5‐year follow‐up period. Discriminative ability was assessed using area under the receiver characteristics curve (AUC) values. Results showed moderate discriminative ability: AUC = 0.681 for the GIZ‐triangle and AUC = 0.698 for the GIZ‐matrix. The discriminative ability of the GIZ‐matrix improved significantly with the actuarial sum score (AUC = 0.776, large effect). The results show the suitability of the GIZ methodology to distinguish between families with and without later child protection activities, as a proxy for child maltreatment. The actuarial module is a valuable addition to support professionals in their decision process to provide services to families.