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Structured Decision Making ® (SDM ) System Overview Presented by Deirdre O’Connor, Children's Research Center Structured Decision Making ® and SDM ® Registered in the U.S. Patent and Trademark Office. SDM® Systems. Comprehensive case management Structured critical decision points

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Structured Decision Making® (SDM) SystemOverviewPresented by Deirdre O’Connor,Children's Research CenterStructured Decision Making® and SDM®Registered in the U.S. Patent and Trademark Office

sdm systems
SDM® Systems
  • Comprehensive case management
  • Structured critical decision points
  • Research- and evidence-based assessments
sdm systems3
SDM® Systems
  • Adult corrections
  • Juvenile justice
  • Child protection
  • Foster care placement support
  • Adult protection
  • Economic self-sufficiency (TANF)

“Risk assessment establishes a foundation for virtually everything we do in the child protection system. A meaningful and consistent tool is essential for all of us to do our job properly. [The SDM system] clearly provides us with that tool.”

Judge Michael Nash,

Presiding Judge of the Los Angeles Juvenile Court

reduce subsequent harm outcomes for all cases in study 12 month follow up
Reduce Subsequent Harm:Outcomes for All Cases in Study, 12-month Follow-up

The Michigan Department of Social Services Risk-based Structured Decision Making System: An Evaluation of Its Impact on Child Protection Services Cases, 1995

cmc evaluation results from florida revocation rates community control admissions n 45 346
CMC Evaluation Results From Florida Revocation Rates, Community Control Admissions (N = 45,346)

Florida Department of Corrections Research and Data Analysis: Leininger, “Effectiveness of Client Management Classification,” December 1998

expedite permanency recent research in los angeles county
Expedite Permanency:Recent Research in Los Angeles County

Median Time to Reunification in Months

39% Decrease

improve decision making
Improve Decision Making

All information

Information learned

Information needed for decision at hand


SDM® Assessments:

Graduated Sanctions for Juvenile Justice

  • Detention screening
  • Risk classification/supervision levels
  • Strengths/needs for case planning
  • Disposition recommendations
  • Reassessment of risk and needs
  • Institutional placement decisions
  • Release/transition decisions

Structuring Critical Decisions

in Child Protective Services

Is it child abuse/neglect (CA/N)?

Screening criteria


How quickly do we need to respond?

Response priority

Is the child safe?

Safety assessment

What is the likelihood of future maltreatment?

Investigation/ Assessment

Initial risk assessment

What should the service plan focus on?

Family strengths and needs assessment

Risk reassessment

Reunification reassessment

Family strengths and needs reassessments

Should the case remain open or be closed?


consistency reliability
Consistency (Reliability)

Sample: Four independent ratings of 80 cases.

Child Abuse and Neglect: Improving Consistency in Decision Making, 1997

accuracy validity
Accuracy (Validity)

(n = 138)

(n = 442)

(n = 202)

(n = 475)

(n = 304)

(n = 541)

(n = 231)

(n = 130)

(n = 250)

Sample: Four independent ratings of 80 cases.

Child Abuse and Neglect: Improving Consistency in Decision Making, 1997

validity in juvenile justice recidivism by risk classification
Validity in Juvenile Justice:Recidivism by Risk Classification

Percentage of Youth With Subsequent Delinquent Adjudication

Within 15 Months

targeting resources reduces risk
Targeting Resources Reduces Risk

(n = 562)

(n = 347)

(n = 79)

(n = 105)

(n = 89)

(n = 48)

Wisconsin Urban Caucus, 1998

the sdm system as part of a family c entered practice framework
The SDM® System as Part of a Family-centered Practice Framework
  • Tools do not make decisions; people do.
  • Research and structured tools combine with clinical judgment and experience to support decision making.
  • Should be integrated within the context of solution-focused, family-centered practice.
sdm implementation in louisiana
SDM® Implementation in Louisiana
  • Fall 2007 OCS workgroups modified:
  • SDM initial risk assessment
    • In-home risk reassessment
    • Out-of-home reunification reassessment
  • January 2008 Training for OCS supervisors and trainers
  • July 2008 All parish offices trained and using SDM assessments
  • August 2009 Initial risk assessment integrated into ACESS,

completed on all investigations

  • January 2010 Screening and response time assessment field-tested
  • June 2010 Screening and response time assessment implementation statewide
louisiana sdm assessments
Louisiana SDM® Assessments
  • Screening and response time assessment
  • Initial risk assessment
  • In-home risk reassessment
  • Reunification reassessment

Integrated into

Focus on Four initiative

screening and response time assessment28
Screening and Response Time Assessment
  • Structuring decision to improve consistency
  • No change in statutes or policy
    • Elements of child abuse or neglect report
    • Specific allegations
    • Response times
  • Change in documentation
  • Change in decision-making process
  • Expected increase in alternative response assessments
initial risk assessment
Initial Risk Assessment

Is this a family that needs ongoing support/intervention?

actuarial risk assessment
Actuarial Risk Assessment
  • A statistical procedure for estimating the probability that a “critical” event will occur.
  • In the auto insurance industry, the critical event is a car accident involving a driver insured by the agency. Among breast cancer patients, the critical event is recurrence of cancer.
  • In this case, the critical event is the likelihood of future child maltreatment.
risk level by initial safety assessment
Risk Level by Initial Safety Assessment

N = 69,567

2008 California Combined Report

california risk study results
California Risk Study Results

N = 2,511 investigations conducted in 1995, followed for two years.

California Risk Assessment Validation: A Retrospective Study, 1998

informing decisions and targeting resources
Informing Decisions and Targeting Resources
  • Risk classifies families by likelihood of subsequent abuse/neglect.
  • High and very high risk families are significantly more likely to experience subsequent maltreatment.
  • Using risk to decide whether to provide services, and the intensity of services, can reduce repeat maltreatment.
risk level vs substantiation
Risk Level vs. Substantiation

(N = 110)

(N = 360)

(N = 146)

(N = 58)

(N = 84)

(N = 173)

(N = 365)

(N = 154)

N = 1,450

New Mexico, 1997


SDM® Case Open/Close Guidelines

*Moderate and low risk cases with unresolved safety issues should always be transferred

for ongoing services.

risk reassessment41
Risk Reassessment
  • What is the new risk level?
    • Research-based items with strongest relationship to outcomes
    • Assessment of progress
    • New incidents
  • Should case continue to receive services or be closed?
  • If services continue, what level of services should be provided?
reunification reassessment43
Reunification Reassessment
  • Reduce time to stable, long-term care arrangement
  • Achieve reunification whenever it is safe to do so
New Foster Care Cases With a Return Home Goal:Achievement of Stable, Long-term Care Arrangement15 Months After Entering Foster Care

Care Arrangement Outcomes

(N = 885)

(N = 1,222)

Michigan Foster Care Evaluation, 2002

reentry for children returned home
Reentry for Children Returned Home

(N = 263)

(N = 236)

(N = 131)

(N = 311)

Michigan Foster Care Evaluation Addendum, 2002

reunification reassessment46
Reunification Reassessment

Is risk low or moderate?

Should we continue reunification services?

Should we pursue another long-term care goal?



Is visitation adequate?




Is the child safe or conditionally safe?




For more information, please contact:

Deirdre O’Connor, Senior Researcher

Children’s Research Center