Enhancing Detection of Child Maltreatment and Neglect: An Evaluation of Psychological Tools Adapted for Schools

This study evaluates the diagnostic accuracy of scalable early detection tools that schools can use to identify child maltreatment. Child maltreatment, with severe consequences for children's wellbeing, remains difficult to detect due to underreporting, stigma, and the limits of existing tools. We conducted a cross-sectional study of over 1,000 students in five schools in Buenos Aires and Cordoba, Argentina, implementing three scalable tools projective drawings (Kinetic Family and Person in the Rain), the Piers-Harris Self-Concept Scale, and a teacher's checklist against comprehensive psychological assessments as the reference standard. Results show that approximately 35% of the children in the sample exhibited signs of maltreatment or neglect. Each of the tools demonstrated a precision rate of over 50%, with the combination of projective drawings and teacher's checklist achieving up to 76% precision. The overall sensitivity was 36.8%, significantly enhancing detection rates compared to existing school processes. These findings indicate that early detection tools can significantly enhance identification of maltreatment and hold potential for broader implementation, though they should complement rather than replace comprehensive psychological evaluations.