Assessment instruments for at-risk children and youth: a systematic mapping review
We carried out a systematic mapping review on research on tools designed to give a better understanding of the child’s or youth’s need for help.
In the field of child welfare in Norway today, different assessment tools are used to map the individual situations of at-risk children and youth. The tools are designed to give a better understanding of the child’s or youth’s need for help, as well as support decisions about further interventions. The Norwegian Directorate for Children, Youth and Family Affairs (Bufdir) has a responsibility to assist the Child Welfare Services with updated information on relevant assessment tools with good psychometric properties and hence commissioned a review on this topic.
We carried out a systematic mapping review of systematic reviews, i.e. a presentation of the existing research. Because there are too many published primary studies of mapping tools on a variety of relevant areas we could not summarize them. After consultation with the commissioner Bufdir we therefore included only systematic reviews.
- We included 12 systematic reviews of high or moderat methodological quality. The systematic reviews considered 405 studies that appraised 163 unique mapping tools
- In the results we presented 37 unique mapping tools and some of these look like they have evidence for good psychometric properties
- The 37 tools map ADHD (Attention Deficit Hyperactivity Disorder), behavioural problems, general mental health, parent-child interaction, suicide risk, social skills, substance use problems, being subject to abuse, and young children’s development
- We did not identify any tools that map crime, quality of life, family problems or risk factors in general
There are a number of reliable assessment tools to map the situation of at-risk children and youth. We note that our systematic review does not provide a complete account of all relevant tools, as it is a mapping review of existing systematic reviews.
In the field of child welfare in Norway today, different assessment tools are used to map the individual situations of at-risk children and youth. The tools are designed to give to a better understanding of the child’s or youth’s need for help, as well as support the decisions about further interventions. The Norwegian Directorate for Children, Youth and Family Affairs (Bufdir) has a responsibility to assist the Child Welfare Services with updated information on relevant assessment tools with good psychometric properties and hence commissioned a review on this topic. The mapping tools described in this systematic mapping review are meant to be used by child welfare workers who not necessarily are trained as specialists. The tools are designed to map the need for intervention, alternatively, the need for further mapping and examination.
The research questions are as follows:
- Which existing mapping tools can be useful in order to assess the need for help in children and youth in contact with Child Welfare Services?
- What is the evidence for these tools’ psychometric properties?
Relevant fields of topic were mental health (from attachment to mental problems), quality of life, resilience, substance use, crime, family problems, and various risk factors.
We carried out a systematic mapping review of systematic reviews, in accordance with the methods literature on mapping reviews and the Methods Handbook of the Division for Health Services, Norwegian Institute of Public Health. Mapping reviews primarily give an overview of the research on a topic, and do not usually appraise quality of included studies or synthesise the data.
In January 2019 we carried out the first systematic literature search from which we identified almost 100.000 primary studies. Given these unmanageable search results, in consultation with the commissioner Bufdir, we decided to limit the search to systematic reviews. A new literature search for systematic reviews published after year 2000 was carried out in February 2019.
Two researchers, independent of each other, screened all the titles and abstracts, and subsequently all the possibly relevant reviews in fulltext, in order to assess relevance according to the inclusion criteria. Next, two researchers examined the possibly relevant reviews to decide whether they were systematic reviews (i.e. explicit inclusion criteria, a systematic literature search and quality appraisal of the included studies). Finally, two researchers appraised the quality of the systematic reviews with the Division for Health Services’ checklist and only included reviews of high or moderate methodological quality.
The included reviews had examined a large number of mapping tools, so we chose to present in more detail the tools that the review authors draw the attention to. Two researchers extracted data from the included systematic reviews as well as the included mapping tools. The extracted data was checked for correctness and completeness by other researchers. The reviews and the tools are sorted and presented in several ways in this mapping overview, in text and tables.
We identified 12 systematic reviews of high or moderate methodological quality. These reviews assessed 163 unique mapping tools. We present the 37 tools that the review authors emphasized or that were the only tools the review assessed. All the 163 mapping tools are listed in appendices, sorted by theme and by alphabet.
Two tools that map ADHD (Attention Deficit Hyperactivity Disorder) were highlighted. The tools had uncertain psychometric properties and showed also that ethnicity influenced the teachers’ evaluations of ADHD symptoms in the child or young person.
One tool that map behavioural problems was highlighted. This tool was especially designed for African-American youth, and the tool showed good psychometric properties.
General mental health
Eight tools were highlighted. These tools map general health in children and youth. Four of the tools showed acceptable to good psychometric properties, but for the others the evidence was more uncertain.
The tools map interaction between parents and young children. Five tools were highlighted, but only one tool was considered to have good psychometric properties.
Risk of suicide
One tool was highlighted. This tool maps risk for suicide among young people and show high sensitivity but uncertain evidence.
Three tools were highlighted. The tools map social skills or competencies in children and young people. All three showed good psychometric properties.
Substance use problems
Two very brief tools were highlighted. Both tools map substance use problems among young people and showed good capacities for quickly identifying possible problems.
Twelve tools were highlighted. The tools map experiences with physical, psychological or sexual abuse or neglect, and they are all considered to have acceptable psychometric properties. One tool was considered to have good psychometric properties.
Three tools were highlighted that map young children’s physical and psychological development. Two tools showed good psychometric properties but all three had somewhat uncertain evidence.
The 12 included systematic reviews highlighted 37 tools that all map the needs of children and young people on relevant areas of life. In the areas of general mental health, parent-child interaction, social skills and abuse we found several tools that in the reviews were considered to have good psychometric properties and sound evidence. Only four of the 11 tools that Bufdir were particularly interested in, were identified in the search. Further, we did not find any systematic reviews of acceptable methodological quality that had considered the thematic areas resilience, family problems, crime or risk factors in general.
Limitations of this mapping review
This review is a systematic mapping review and not a full systematic review. Moreover, we have only included research that is already systematically summarised and of acceptable methodological quality. This presents some limitations. We might have missed entire thematic areas or individual tools. Being a mapping review, we might also have missed details on the tools or the primary studies and we have not appraised the quality ourselves or run the analyses.
We have identified a number of mapping tools on several thematic areas, and some of the tools look like they have evidence for good psychometric properties. It is possible to take a closer look at them in order to consider their relevance for use in Norway.