Differences between Screening and Assessment

Evidence-Based or Validated Tools

Matching Youth to Services

There are a variety of validated risk screening and assessment tools that can be used by the court to determine a youth’s risk of reoffending. Risk assessment instruments (often referred to as risk-needs assessments) also provide information that can be used to determine potential interventions that may prevent further delinquent behavior. These screening and assessment tools (also referred to as structured decision-making, or SDM) should guide juvenile system decisions. Probation officers should use screening and assessment tools to prepare disposition recommendations for the juvenile court judge and to design effective case plans for the youth they serve.

Using risk screening and assessment tools:

  • Introduces greater consistency and equity to the decision-making process;
  • Focuses limited system resources on the highest risk offenders, while reducing the unnecessary use of secure detention, residential treatment, and correctional placements;
  • Ensures that decisions are based both on concerns for community safety and concerns about the youth’s needs that relate to delinquent behavior and necessary treatment interventions;
  • Provides a mechanism to facilitate linking youth with the types of programs that are most appropriate to their offense, level of risk to reoffend, needs, and strengths; and
  • Provides a standardized method of important data collection that can provide the prevalence of some problem areas across youth so resources can be planned accordingly.

Differences between Screening and Assessment

While the terms screening and assessment are often used interchangeable they actually are very different. In addition, the terms have both legal and clinical meanings and justice involved youth may receive both legal and clinical screening and assessment.

Screening refers to a short tool that can be administered with little to no training. A risk screening tool can provide the court with the information regarding a youth’s risk for reoffending but will not provide any information about why the youth is at risk of reoffending. A clinical screening tool may provide the court (or treatment provider) with information regarding the likelihood of a substance use or mental health disorder (depending on the tool used). In either case, a screening tool will provide the juvenile court with information that can be used to determine if further assessment is warranted.

Assessment tools are generally much longer than screening tools and should be administered by someone who has been trained in their use. And as with screening tools, assessments have both a legal and clinical definition. A legal assessment is concerned with identifying dynamic risk factors that may influence whether a youth continues to commit delinquent acts (criminogenic needs), which provides direction as to the targets for the youth’s interventions. A clinical assessment is designed to determine the extent of a substance abuse or mental health problem and provide information regarding level of care or service placement. It should be noted that there is overlap in the type of questions and domains that legal and clinical assessments investigate, but the methods, purposes, and impact on delinquent behaviors differ.

Evidence-Based or Validated Tools

In the context of screening and assessment tools, validity refers to the extent an instrument actually measures what it claims to measure. Establishing validity is an ongoing and complex process that requires the involvement of a trained researcher familiar with test theory, psychometrics, scale development, and validation methodology. In selecting screening and assessment tools, it is important to determine if the tool has undergone rigorous development and review. But, selecting and using a validated tool isn’t enough.

An important part of validity has to do with standardization. A tool has been developed to be used in a specific way. If it is not, that can invalidate the results. For example, if the manual states that the items of the risk assessment tool are to be rated based on an interview with the youth in addition to collateral information, but the user only conducts an interview with the youth and does not obtain collateral information, then the process is invalid. For another example, if a self-report questionnaire is intended to be filled out by a youth on his/her own, but the user instead reads the questions to the youth and circles the answers based on what the youth says aloud, this is not an evidence-based method. This is because if research has shown a tool to have good validity when used in a specific way, it is unknown whether the tool will remain valid if used differently.

Applying an evidence-based approach to the risk assessment process seeks to improve the chances for a meaningful judgment about the future risk that a case poses. When considering the use of standardized risk screening and assessment, it is essential that juvenile courts build in a set of policies and procedures for using these instruments. These policies and procedures should include 1) an overview of the validated tools used; 2) a description of when and who will administer each tool; and 3) a description of how the information will be used to inform decision making. These policies and procedures should further include mechanisms for administrative overrides, both mandatory and discretionary. Mandatory overrides reflect policy positions. For example, a juvenile court may decide that any youth using a firearm will be placed in secure detention. Discretionary overrides, which generally require supervisory approval, allow for unique or mitigating circumstances that may not be captured by the validated tool.

It is by having a robust series of policies and procedures, combined with continuous quality assurance and supervisory oversight, for using validated screening and assessment tools that courts can rely on the objective legitimacy of the data and can subsequently feel confident in the decisions made as a result.

Matching Youth to Services

The ideal outcome of evidence-based risk assessment is linking the needs of youth with proper services that meet their criminogenic needs. First, youth at the highest overall level of risk for reoffending should receive the most intensive services, and those with the least risk should receive the least intensive. Second, good matching between criminogenic needs and the nature of the services that youth are provided has been shown to be considerably more important in reducing reoffending and improving public safety than merely providing “more” services. In fact, mandating the youth’s participation in too many services can have unintended negative consequences (e.g., inability to attend all services because of time or transportation obstacles). Probation officers should perform a “reality check” when designing case plan services to ensure that youth aren’t overloaded – no more than two to three services at any given time is recommended.

Matching services to youths risk/needs requires a systematic process. One approach some agencies have used is to create a Service Referral Matrix that categorizes services according to a low, moderate, or high level of intensity within each criminogenic need area. The criminogenic need areas are dictated by the risk assessment tool in place. Commonly these areas include aggression, substance abuse, family problems, school/educational needs, antisocial peer associations, and antisocial attitudes or disruptive behaviors. As risk or need increases, the matrix reflects an increased intensity of services that would be appropriate for referral. Thus the matrix can be used to identify proper services based on the individual youth’s criminogenic need areas (guides selection of the type of service) and level of risk for reoffending (relates to the necessary intensity of the service).

Screening and Assessment for Mental Health, Trauma, and Substance Abuse

While not primary drivers of immediate criminogenic activity, the juvenile court would be remiss not to address underlying conditions that could lead to negative life outcomes including long-term justice system involvement.

A substantial body of research also shows that the prevalence of childhood abuse, neglect, and other trauma among delinquent populations is substantially greater than in the general population. The reasons for the high prevalence are complicated and difficult to disentangle. For some youth, traumatic experiences and mental health issues may be connected to further delinquent behavior and for others it will not.

Youth with mental health issues or histories of abuse, neglect, and other traumatic experiences may require targeted and intensive intervention, particularly if these issues interfere with their ability to benefit from other interventions that target their criminogenic needs. Screening for these important factors should occur early in the juvenile court process, but clinical assessment from a trained professional is essential to establish the severity of the mental health issues and a potential connection to delinquent behavior. Serious substance abuse issues are well-documented risk factors for continued delinquent behavior that require effective intervention. It is important to note that information a youth reveals during the assessment process should not be used against her or him at trial. Otherwise, the youth will not likely disclose important information related to immediate needs.

It is important to recognize that criminogenic need and behavioral health conditions (i.e. mental health, substance abuse, and trauma) can interact in complex ways. It is important to identify and address the presence of each but to not make a priori assumptions as to how one might affect the other. This is best done by identifying the levels of concern or risk in each domain and thoughtfully assessing how each domain impacts the others. It is well worth considering if a given mental health condition, traumatic stress or substance abuse may or may not be driving the delinquent behavior. This is especially worth considering, given that the bulk of persons with significant mental health concerns do not commit crime and are in fact more likely to be victims of crime. Some hypothetical examples of the complex situations are as follows:

  • A youth with a significant mood disorder might be arrested for violent outbursts at home. When this youth is treated with the appropriate medication the outbursts subside. This example typifies the need for behavioral health diversion programs with minimal juvenile justice system involvement in for some youth.
  • A youth with diagnosed mental health conditions, a severe trauma history, and significant gang involvement might be arrested for burglary and armed robbery as part of organized gang activities. This youth also shows high criminogenic needs in the areas of aggression, antisocial attitudes, and antisocial peer associations. Certainly the diagnosed behavioral health and trauma concerns should be treated. However, it is not a given that successful treatment would lead to reduction in the risk to reoffend in and of itself. Interventions used to address criminogenic needs would be needed to specifically target the risk of reoffending. In turn treating the behavioral health needs might assist a youth to better engage in this traditional programming to address the risk of re-offense. This example typifies the need for a strong collaborative approach involving intensive interventions in the juvenile justice and mental health systems. It is also likely that the juvenile justice interventions will be the most crucial to reduce the risk of re-offense.

In summary, thorough screening and assessment leads to a comprehensive intervention that address the various need areas and there interactions.

For more information about the use of research based risk assessment tools and mental health screening tools used in each state, visit http://www.jjgps.org/juvenile-justice-services#evidence-based-practices?tabId=2&view=risk-instruments