Predictive Modeling

Potential Application in Prevention Services


      In 2012, the New Zealand Government announced a proposal to introduce predictive risk models (PRMs) to help professionals identify and assess children at risk of abuse or neglect as part of a preventive early intervention strategy, subject to further feasibility study and trialing. The purpose of this study is to examine technical feasibility and predictive validity of the proposal, focusing on a PRM that would draw on population-wide linked administrative data to identify newborn children who are at high priority for intensive preventive services.


      Data analysis was conducted in 2013 based on data collected in 2000–2012. A PRM was developed using data for children born in 2010 and externally validated for children born in 2007, examining outcomes to age 5 years.


      Performance of the PRM in predicting administratively recorded substantiations of maltreatment was good compared to the performance of other tools reviewed in the literature, both overall, and for indigenous Māori children.


      Some, but not all, of the children who go on to have recorded substantiations of maltreatment could be identified early using PRMs. PRMs should be considered as a potential complement to, rather than a replacement for, professional judgment. Trials are needed to establish whether risks can be mitigated and PRMs can make a positive contribution to frontline practice, engagement in preventive services, and outcomes for children. Deciding whether to proceed to trial requires balancing a range of considerations, including ethical and privacy risks and the risk of compounding surveillance bias.
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      1. New Zealand Government. White Paper for Vulnerable Children, Volume II. 2012.

        • Vaithianathan R.
        • Maloney T.
        • Putnam-Hornstein E.
        • Jiang N.
        Children in the public benefit system at risk of maltreatment: Identification via predictive modeling.
        Am J Prev Med. 2013; 45: 354-359
        • Panattoni L.E.
        • Vaithianathan R.
        • Ashton T.
        • Lewis G.H.
        Predictive risk modeling in Health: options for New Zealand and Australia.
        Aust Health Rev. 2011; 35: 41-51
        • Putnam-Hornstein E.
        • Needell B.
        Predictors of child welfare contact between birth and age 5: an examination of California’s 2002 birth cohort.
        Child Youth Serv Rev. 2011; 33: 2400-2407
        • Schwartz I.M.
        • Jones P.
        • Schwartz D.
        • Obradovic Z.
        Improving social work through the use of technology and advanced research methods.
        in: Lindsey D. Shlonsky A. Child Welfare Research. Oxford University Press, New York2008
        • Wu S.
        • Ma C.
        • Carter R.
        • et al.
        Risk factors for infant maltreatment: a population-based study.
        Child Abuse Negl. 2004; 28: 1253-1264
        • Putnam-Hornstein E.
        • Wood J.N.
        • Fluke J.
        • Yoshioka-Maxwell A.
        • Berger R.P.
        Preventing severe and fatal child maltreatment: making the case for the expanded use and integration of data.
        Child Welfare. 2013; 92: 59-75
      2. National Ethics Advisory Committee. Sharing identifiable health information for use in predictive risk modelling research: advice to the Minister of Health. 2013.

        • Ministry of Social Development.
        Children’s Contact with Ministry of Social Development Services.
        Ministry of Social Development, Wellington2012
        • Runyan D.
        • Wattam C.
        • Ikeda R.
        • Hassan F.
        • Ramiro L.
        Child abuse and neglect by parents and caregivers.
        in: Krug E. Dahlberg L.L. Mercy J.A. Zwi A.B. Lozano R. World Report on Violence and Health. WHO, Geneva2002
      3. Child Youth and Family. Children at Increased Risk of Death From Maltreatment and Strategies for Prevention. Wellington: Ministry of Social Development; 2006.

        • Kerslake Hendricks A.
        • Stevens K.
        Safety of Subsequent Children—International Literature Review.
        Families Commission, Wellington2012
        • Perry B.
        Household Incomes in New Zealand: Trends in Indicators of Inequality and Hardship 1982-2012.
        Ministry of Social Development, Wellington2013
        • Perry B.
        Non-income Measures of Material Wellbeing and Hardship: First Results From the 2008 New Zealand Living Standards Survey, With International Comparisons.
        Ministry of Social Development, Wellington2009
        • Baumann D.J.
        • Dalgleish L.
        • Fluke J.
        • Kern H.D.
        The Decision Making Ecology.
        American Humane Association, Washington, DC2011
        • Wulczyn F.
        • Gibbons R.
        • Snowden L.
        • Lery B.
        Poverty, social disadvantage, and the black/white placement gap.
        Child Youth Serv Rev. 2013; 35: 65-74
        • Leventhal J.
        Can child maltreatment be predicted during the perinatal period: evidence from longitudinal cohort studies?.
        J Reprod Infant Psychol. 1988; 6: 139-161
        • Drake B.
        Unraveling “unsubstantiated.”.
        Child Maltreat. 1996; 1: 261-271
        • Hussey G.
        • Marshall J.
        • English D.
        • et al.
        Defining maltreatment according to substantiation: distinction without a difference?.
        Child Abuse Negl. 2005; 29: 479-492
        • Fluke J.
        Allegory of the cave: on the theme of substantiation.
        Child Maltreat. 2009; 14: 69-72
        • Mansell J.
        • Ota R.
        • Erasmus R.
        • Marks K.
        Reframing child protection: a response to a constant crisis of confidence in child protection.
        Child Youth Serv Rev. 2011; 33: 2076-2086
        • Munro E.
        The Munro Review of Child Protection: Final Report, a Child-Centred System.
        The Stationery Office, Department for Education, London2011
        • Gilbert R.
        • Widom C.S.
        • Browne K.
        • Fergusson D.
        • Webb E.
        Burden and consequences of child maltreatment in high-income countries.
        Lancet. 2009; 373: 68-81
        • Harcourt B.E.
        Against Prediction: Profiling, Policing, and Punishing in an Actuarial Age.
        University of Chicago Press, Chicago2006
        • Drake B.
        • Jolley J.
        • Lanier P.
        • Fluke J.
        • Barth R.
        • Jonson-Reid M.
        Racial bias in child protection? A comparison of competing explanations using national data.
        Pediatrics. 2011; 127: 471-478
        • Putnam-Hornstein E.
        Preventable injury deaths: a population-based proxy of child maltreatment risk.
        Public Health Rep. 2012; 127: 163-172
        • Putnam-Hornstein E.
        • Needell B.
        • King B.
        • Johnson-Motoyama M.
        Racial and ethnic disparities: a population-based examination of risk factors for involvement with child protective services.
        Child Abuse Negl. 2013; 37: 33-46
        • Fluke J.
        • Shusterman G.
        • Hollinshead D.
        • Yuan Y.T.
        Longitudinal analysis of repeated child abuse reporting and victimization: multistate analysis of associated factors.
        Child Maltreat. 2008; 13: 76-88
        • Peters R.
        • Barlow J.
        Systematic review of instruments designed to predict child maltreatment during the antenatal and postnatal periods.
        Child Abuse Rev. 2003; 12: 416-439
        • Nelson H.D.
        • Selph S.
        • Bougatsos C.
        • Blazina I.
        Behavioral Interventions and Counseling to Prevent Child Abuse and Neglect: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation.
        Agency for Healthcare Research and Quality, Rockville, MD2013
        • Moyer V.A.
        Primary care interventions to prevent child maltreatment: U.S. Preventive Service Task Force Recommendation Statement.
        Ann Intern Med. 2013; 159: 289-297
        • MacMillan H.L.
        • Wathen C.N.
        • Barlow J.
        • Fergusson D.M.
        • Leventhal J.M.
        Interventions to prevent child maltreatment and associated impairment.
        Lancet. 2009; 373: 250-266
        • Fergusson D.
        • Boden J.
        • Horwood J.
        Early Start Evaluation Report: Nine Year Follow-Up.
        Ministry of Social Development, Wellington2012
        • Dubowitz H.
        • Feigelman S.
        • Lane W.
        • Kim J.
        Pediatric primary care to help prevent child maltreatment: the Safe Environment for Every Kid (SEEK) model.
        Pediatrics. 2009; 123: 858-864
        • Dubowitz H.
        • Lane W.G.
        • Semiatin J.N.
        • Magder L.S.
        The SEEK model of pediatric primary care: can child maltreatment be prevented in a low-risk population?.
        Acad Pediatr. 2012; 12: 259-268
        • Daro D.
        • Dodge K.
        Creating community responsibility for child protection: possibilities and challenges.
        Future Child. 2009; 19: 67-93
        • Mersky J.P.
        • Topitzes J.D.
        • Reynolds A.J.
        Maltreatment prevention through early childhood intervention: a confirmatory evaluation of the Chicago Child–Parent Center preschool program.
        Child Youth Serv Rev. 2011; 33: 1454-1463
        • Cooper E.
        • Wharewera-Mika J.
        Māori Child Maltreatment: A Literature Review Report.
        Te Kahui Mana Ririki, Auckland2009
        • Cram F.
        Safety of Subsequent Children—Māori Children and Whānau: A Review of Selected Literature.
        Families Commission, Wellington2012
        • Durie M.
        • Cooper R.
        • Snively S.
        • Grennell D.
        • Tuaine N.
        Whānau Ora: Report of the Taskforce on Whānau-Centred Initiatives.
        Ministry of Social Development, Wellington2010
        • Durie M.
        Whānau Ora Fact Sheet: Paenga-whāwhā / April 2013.
        Te Puni Kökiri, Wellington2013
        • Boulton A.
        • Tamehana J.
        • Brannelly T.
        Whānau-centred health and social service delivery in New Zealand: the challenges to, and opportunities for, innovation.
        MAI J. 2013; 2: 18-32
        • Sturrock F.
        • Gray D.
        The Incredible Years Pilot Study Evaluation Report.
        Ministry of Social Development, Wellington2013
        • Putnam-Hornstein E.
        • Needell B.
        • Rhodes A.E.
        Understanding risk and protective factors for child maltreatment: the value of integrated, population-based data.
        Child Abuse Negl. 2013; 37: 116-119
        • Brownell M.D.
        • Jutte D.P.
        Administrative data linkage as a tool for child maltreatment research.
        Child Abuse Negl. 2013; 37: 120-124
        • Gilbert R.
        • Fluke J.
        • O’Donnell M.
        • et al.
        Child maltreatment: variation in trends and policies in six developed countries.
        Lancet. 2011; 379: 758-772