Objective: To design and test a rapid assessment tool for predicting dysfunctional behavior of children who live in homes where their mother reports recent physical or sexual partner abuse.

Methods: A cohort analysis was completed. 300 abused mothers accessing services for partner abuse were interviewed to determine risk factors for dysfunctional behavior of their children. Mothers were asked if they had taken their child to a health care provider within the last four months as well as questions about their functioning and the behaviors of the child during the same four months.

Results: Among the 300 children living in a violent home, 81% had seen a health care provider within the preceding four months. Model testing revealed among the children classified as having the highest risk for dysfunctional behavior (predicted probability of clinical behaviors > 75%), between 82-100% of these children presented with clinical level behaviors when their mother sought services for the abuse.

Conclusions: The Rapid Assessment Triage tools offer an evidence-based, high predictability method for rapid assessment and triage of children who are most likely to have dysfunctional behaviors when their abused mothers seek services. Since 81% of the children had seen a healthcare provider within the preceding 4 months of their mother seeking services, the triage tools offer healthcare providers an opportunity to assess the risk of dysfunctional behavior of children with a mother who screens positive for abuse. To maximize child health, mothers require assessment for partner violence and assessment for dysfunctional behavior of their children.

Key Take Away Points

  • Domestic violence is common and children exposed to the violence can experience growth, developmental, and behavioral dysfunctions which can be long lasting and may permanently compromise health and well-being.
  • An evidence-based, simple to use, high predictability triage tool was derived to predict which children exposed to domestic violence are in greatest need of immediate referral and services to minimize dysfunctional behavior problems and health consequences of exposure to violence.

Author Biography

Dr. McFarlane conducts research on the health effects of violence against women and children and the effectiveness of interventions to prevent further violence. Her research has been funded by the National Center for Injury Prevention, Agency for Health Research & Quality, The National Institute of Justice, and the National Institutes of Health. Her research findings have been presented to congressional committees, cited on CNN, and used globally to set standards of care for abused women and children. In 2011 Dr. McFarlane was funded with $2.6 million dollars by the Houston Endowment to complete a 7-year study on 300 abused women and 300 children who use shelters and justice services for the first time. The safety, work, health, and functioning of the women and their children will be described to offer evidence for global policy and practice standards for the care of abused women and their children. As of 2014, Dr. McFarlane has retained 95% of this high-risk sample of abused women and their children.

Dr. Jacquelyn Pennings is a statistical analyst with expertise in modeling of large data sets to establish predictor models.

Dr. Rene Paulson is a statistical analyst who works with teams of researchers to derive research studies driven by best research methods and uses optimum statistical procedures to measure the impact of interventions.

Dr. Nina Fredland is a child and adolescent specialists who has worked in the violence prevention field for over 30 years.

Dr. Brenda Binder is a pediatric nurse practitioner and adolescent specialist who has worked in the child abuse and violence intervention field for many years.

Dr. Anne Koci is a woman's health specialists with over 25 years of experience in violence against women and the associated development of tools to measure the marginalization of abused women and health impact.

Dr. Nora Montalvo is a maternal child health specialists who works on the Texas Mexico border in shelters and violence intervention programs for abused immigrant women and their children.


The 300 women who participated in this study are acknowledged and greatly appreciated.