Who is placing the child at risk? Exploring the assessment capabilities of child protection social workers in health related contexts

While Child Welfare assessments of children’s physical health status require Child Protection Workers (CPW) to gather information about families from collaterals, such as physicians, this data may not carry the same level of... [ view full abstract ]

While Child Welfare assessments of children’s physical health status require Child Protection Workers (CPW) to gather information about families from collaterals, such as physicians, this data may not carry the same level of granularity and insight often acquired through lengthier interactions or home visits.
Within many Child Protection Agencies (CPAs), social workers function as primary file stewards and represent the “eyes and ears” of organizations, such that information gleaned from the field to complete case histories is relied upon as key source of evidence for clinical decision-making. However, with limited medical training, should one feel confident in CPW’s capacity to effectively identify failure-to-thrive in an infant who presents as just “small-framed”? Or the possibility that white staining in an infant’s mouth could be a symptom of oral thrush and not “merely milk residue”? Or determine that a caregiver’s consistent forgetfulness about picking up a child from school is a manifestation of Alzheimer’s disease and not a symptom of “lazy parenting”?
The reliance on CPWs to make life-altering decisions in the complex lives of families may result in acts of omission by the welfare system with implications for adverse outcomes. Furthermore, gaps in the collection of health related data, particularly during the initial screening process can impede the formulation of comprehensive clinical assessments of children’s physical health status. We argue that for CPAs to effectively carry out their mandate, screening of children’s health must be approached from an Interdisciplinary Practice (IP) perspective, beginning from the front-end to the back- end of the service delivery trajectory. This approach to service delivery is an opportunity to reap the maximum benefits of IP for clients receiving child welfare services.