# Identification of Newborns at High Risk for the Occurrence of Preventable Child Maltreatment

> **NIH NIH P50** · WASHINGTON UNIVERSITY · 2022 · $276,661

## Abstract

ABSTRACT
Childhood maltreatment (CM) has highly deleterious effects on human development and is arguably the most
influential, preventable cause of enduring psychopathology in the U.S. Infants and young children are at
particularly high risk for physical harm from abuse and neglect, comprising over 60% of all child maltreatment
fatalities. An increasing number of studies point to the ability to target prevention of CM by estimating
individual-specific risk at the time of birth, on the basis of readily-available variables in birth records. The
prospect of real-time identification of newborns at risk for CM on the basis of risk indicators available in
obstetrical settings to be able to target prevention is exciting, but empirical testing of feasibility and predictive
utility of methods are key to any systematic attempt to integrate this in U.S. obstetric or newborn clinical
services. For example, birth record indices still identify a substantial number of children who do not go on to
experience CM, making it important to attempt to optimize specificity (preserving sensitivity) with additional
brief clinical screens or administrative data predictive risk modeling prior to broad implementation. Moreover,
since screening is only as valuable as its actionability, it is important to understand whether screening results
in uptake of needed preventive intervention and, in turn, whether this decreases actual CM. In a sample of 400
families enriched for risk for future CM, we contrast the predictive utility of three types of newborn screening for
risk of future official-report of CM involving: a) birth record risk variables (BRRV) only; b) BRRV plus a brief
clinical screen for maternal mental health and substance use status, childhood trauma and/or current intimate
partner violence; and c) retrieval and analysis of a set of medical record and insurance claims variables (for
each family) based on those included in a large-scale PRM effort of a separate Capstone center project during
the study period. A RCT pilot arm of the study will explore the extent to which a brief, personalized education
protocol for the primary caregiver enhances his/her engagement in intervention over care as usual. A second
major aim of the project is to advance scientific understanding of the relationship between risk and outcome.
Despite the established association between CM and psychopathology, the associated paths and mechanisms
are still being identified, calling for more longitudinal investigation with the hope of identifying modifiable factors
that can be targeted for intervention when prevention efforts are not successful. We will first determine whether
CM report (as a primary outcome) is moderated by participation in services and/or changes in modifiable risk
factors over the first 6 months of life. Next we will explore the extent to which infant developmental outcomes
are moderated not only by CM, but by early psychobiological indices of vulnerability to its adverse
conse...

## Key facts

- **NIH application ID:** 10475106
- **Project number:** 5P50HD096719-05
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** JOHN N. CONSTANTINO
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $276,661
- **Award type:** 5
- **Project period:** 2018-09-20 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10475106

## Citation

> US National Institutes of Health, RePORTER application 10475106, Identification of Newborns at High Risk for the Occurrence of Preventable Child Maltreatment (5P50HD096719-05). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10475106. Licensed CC0.

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