After the Webinar: Risk Assessment Tools for Legally Involved Youth. Q&A with Dr. Sandra Antoniak

Webinar presenter Dr. Sandra Antoniak answered a number of your questions after her presentation, Risk Assessment Tools for Legally Involved Youth.  Here are just a few of her responses.

 

Audience Question: What does the acronym SAVRY stand for again? 

Dr. Sandra Antoniak: It’s listed on one of the slides. It is Structured Assessment of Violence Risk in Youth.

 

Audience Question: We hear a lot about resilience these days from a whole range of sources and literature reviews. How do we evaluate resilience in youth and what does that look like?  

Dr. Sandra Antoniak: That is a great question. So, resilience has many aspects, and this is a very exciting thing that people are starting to research right now. So, when you look at resilience, you want to look at perhaps such factors as cognitive flexibility, adaptability, being able to be flexible, like Chris, with the technology. Different things that would allow a young person to be able to bounce back from an adverse event. Now, some of these things are going to be internal to the child themselves, such as that all the factors I just mentioned, some of which may be external to the child. In their environment, that may be their family, their social supports, resources, school factors, educational level, engagements. But those kinds of things would allow that child to have a safety net under them that when they experienced an adverse event that they won’t necessarily be alone with it, number one. But then also number two, that they’d be able to find their way back out of it and not develop such things as depression, substance use, and even suicidality. So, resilience is a very important thing that generalizes even to communities, and on the topic of school shooters. There are now studies regarding the resilience of the communities when one of these events happened in the community. So, it’s a very human thing. And hopefully, the research in this area will be able to develop tools to evaluate for resiliency, much like we evaluate for violence. I mean, I suspect many of the protective factors that we find say, for example, listed in the SAVRY, are going to be crucial elements to resiliency.

 

Audience Question: This may be a little off-topic, but is resilience and grit the same thing?  

Dr. Sandra Antoniak: I guess it depends on what part of the country you’re from. I mean, if you can think about it you hear about true grit, you know that getting up and getting over, getting on. You know, the bootstrap, kind of, that’s what I come to mind when I think of grit. But certainly, it’s that element of mental resilience or toughness that can allow you to get through and that’s going to look different for different people. But I’d say they’re kind of in the same vein.

 

Audience Question: Have you found any callous and unemotional traits assessments?  

Dr. Sandra Antoniak: That’s a good one. I wouldn’t have to look into that, because the callous and unemotional traits in my particular world that was one that wasn’t included in the conduct disorder, but in my clinical opinion should be. But, if Tatianna, e-mail me, I can do some additional looking into those two particular factors, because they are very important. I can look into that and get back to you

 

Audience Question: How often would you recommend re-assessment for youth in residential programs? And we’re talking about youth who may have been there for years. So, how often should they be re-assessed?  

Dr. Sandra Antoniak: Oh, that’s a great question. Having worked in a residential setting, where sometimes kids would come in even grade school and then graduate, that question was placed all the time. In large part, you have to look at the assessment tool you’re using. And usually, they will give you some guidelines in there about how often you should re-assess them. So, for example, from where I was in our protocols with basically twice a year, we would run the child through, or the adolescent through their battery. If the child was progressing significantly, then we may back off to a year as appropriate once we had some feel over the course of years what their trajectory was. So, for example, if a child or an adolescent was continuing to struggle and was not progressing, we re-evaluated more often because there was always the question for staff, what are we missing? You know, what are those risk factors we’re missing that we can potentially impact and improve upon. So, it was also good feedback, not only about the adolescents but about the system taking care of that adolescent or child. Could we do better? So, it depended on what part of the course they were on. If they had several years of steady improvement and, globally, they were on an upward course, then we may back off to yearly, especially for the older adolescents. So, I would say look at the tool you’re using there should be some guideline about how often you should be re-assessing.

 

Audience Question: Why does a tool only worked up to age 18? What makes it ineffective from like 18 and beyond. And especially, going back to that case, we’re talking about where the young woman had literally just turned 18. What makes it magically stop at 18?  

Dr. Sandra Antoniak: There’s no magic. I didn’t talk about the overlay of the emotional maturity of the person you’re working with. You can have a 20-year-old who could be emotionally mature as a 12-year-old. You can have a 12-year-old, who’s probably more emotionally mature the most college kids, you know, and those are extreme exaggerations to prove a point. But there is no magic point about 18, except one, and that’s with the legal involvement and the definition legally of where that demarcation is between childhood and adulthood, and that happens to be 18 in most jurisdictions, some jurisdictions at 16. But in general, you know, in the US, it’s 18. So that’s why these groups when these tests are developed to be scientifically rigorous and paying homage to the psychologists and the MDs and everyone who’s working hard to develop these rigorous tools. That’s where their data sets are. If you use a tool outside of the appropriate data set, it’s not valid. So, if you try to go to court on that, you’re potentially open to criticism, about not being as scientifically rigorous. There’s nothing special about 18. And I completely understand your point. But unfortunately, you know, legally, that’s where, things, you know. That’s the line of demarcation.

 

Audience Question: Do you have a sense as to what percent of juvenile sex offenders are also victims themselves?  

Dr. Sandra Antoniak: Oh, that’s a great question. If I was just based on my clinical experience, and I was into residential, that also had several groups of cottages that were for sexual offenders. It depends on which category of sex offender you may be working with. And just in my clinical judgment, there are those who were re-enacting, which are the majority. You have those that were re-enacting a previous trauma, or they were not understanding maybe because of intellectual delay, or autism delay, that it was socially inappropriate sexually acting out, as opposed to the kids who are true perpetrators that would perpetrate on the other sex offenders to the point that these kids had to be removed. They were truly predatory. So, they were very much two different groups of kids in, you know, this is not scientifically rigorous, but just in my clinical experience, I would say it was about a 60 40 split where there had been some sort of trauma, or some sort of exposure to pornography or having some sort of molestation or sexually inappropriate act perpetrated upon them. And then they were acting out with it again. Would that make it into their adult life? Positive judgment, maybe not. However, these kids that were truly predatory, these children and adolescents had a very different course. But, again, this is just my clinical opinion and what I saw. The evidence base argues against that, but that was my clinical experience.

 

Audience Question: Do you know of juvenile assessment tools for issues outside the physical violence or sexual violence realm? So, for example, juveniles who participate in grand larceny or arson.  

Dr. Sandra Antoniak: That’s interesting. I have not looked at those particularly, especially the arson. My suspicion is… whoever asked that question, please e-mail me, because that’s a fascinating question, and I’ll, I will look into it and get you some resources that they’re out there. Because I’ve never specifically I’m not aware of specific tools for those other than the generalized criminal risk assessments. But I can look into it.

 

Audience Question: You mentioned the J-SOAP-II was for boys. Does that mean it’s not valid for female adolescents in the same range? 

Dr. Sandra Antoniak: That’s a really good question. And, again, if you have to go back and look at the particular guidelines for the test that you are looking at or the tool that you’re using, and if their data set is mostly for boys, then, yes, you have to use it most specifically for boys. That is where it’s most valid. Now, the issues they’re looking at, it just may be that they don’t have the data set for enough data set for females yet, to be able to generalize it. And so, I refer to this concept of generalizability a couple of different times today. And that just means that was when the test was developed, what datasets did they look like? And does that data set include the people that you are trying to evaluate? So again, there are risk factors in there and protective factors that you’re looking at in that assessment that may well generalize to girls as well. But they just don’t have that data set to say, specifically for females. You want to be very careful and circumspect.

 

Click Here to Watch a Recording of Risk Assessment Tools for Legally Involved Youth.  

 

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