Why were these risk assessment tools developed?
All children deserve scientifically informed assessment procedures that will improve their ability to develop and lead happy, healthy and pro-social lives. Based on decades of experience serving young children displaying antisocial behaviour, we observed a notable gap between the vast scientific literature on risk factors related to later-life antisocial outcomes and the ability to apply this information during routine clinical practice. The EARL was developed to bridge this divide under the rubric of Structured Professional Judgment (SPJ) so that a) at-risk children could benefit from scientifically informed assessments, b) to increase transparency in the assessment of such children, and c) to advance scientific work in risk factor research.
How were the EARLs developed?
The Child Development Institute (CDI), were the first to develop a comprehensive psychosocial SPJ clinical risk assessment framework, specifically focused on young children with behavioural problems. The first scheme for boys was created and published in 1998 as the Early Assessment Risk List – V1 Consultation Edition (EARL-20B V1; Augimeri, Webster, Koegl, & Levene; 1998). Two years later, after further development, Version 2 was published, Early Assessment Risk List for Boys – V1 Consultation Edition (EARL-20B; Augimeri et al., 2001). A parallel scheme for girls was created concurrently and published as Early Assessment Risk List for Girls (EARL-21G; Levene et al., 2001).
The latest revision of the EARL was published in 2021 (EARL-V3; Augimeri et al., 2021). While retaining all the key principles of the previous assessments, the items have been updated according to the latest scientific research, and accordingly, also place a greater focus on how culture and ethnicity may affect risk factors. Similarly, based on the currently available literature and clinical expertise, the previous boys’ and girls’ tools have been combined into one, with gender considerations highlighted within each item. To ensure the applicability of the tool, cultural risk assessment experts and gender experts were heavily involved in the revision process. This ensures that the tool is more inclusive while still highlighting important societal considerations around gender.
Within what settings and for which populations should the EARLs be used?
The tools were originally developed for boys and girls between the ages of 6 and 11 who are thought to be at risk for engaging in future antisocial behaviour. Most often, children will be referred to community-based mental-health services by their caregivers or their school. While children’s-mental health settings are the most frequent organisations to use the tool, the EARL can also be used in a range of settings including the school system, medical settings, child protection, police and youth justice services, private practice, and other community-based organizations.
Can the EARLs help with intervention planning as well as with risk management?
Yes. In fact, we argue that persons who use the EARL tool to identify risk have an ethical obligation to do something about it. This is one of the benefits of using a structured clinical risk assessment device. We view each item or risk factor as a starting point from where additional assessment, and ultimately, risk management can begin. The EARLs can greatly assist in the formulation of treatment plans and goal setting with parents. In the latest edition of the tool, a section titles Suggested Risk Management Strategies is included, which maps each risk factors to a set of suggested strategies to mitigate that risk. These suggestions may act as a starting point to aid professionals with treatment planning. However, we stress that the practitioner is the best source of knowledge about the help and resources for each child that is available in their community.
What is the format of the EARLs?
The EARl-V3 contains 21 risk factors that are organized under three broad sections: Child, Family, and Barriers to Treatment. Each Item is rated on a three-point scale (0-1-2; not present, possibly present, present) where a higher score represents greater risk. Each risk factor includes a literature review of the background of the risk factor and how it relates to antisocial behaviour, highlighting considerations for gender and culture throughout. Each risk factor then includes examples of risks and accompanying coding instructions for that risk factor. Ratings are organized on a “Summary Sheet” which allows assessors to render numeric (0-1-2) ratings and red flag factors that are particularly concerning through the use of a “Critical Risk” checkbox. The Summary Sheet also provides an “Overall Clinical Risk Judgment" rating that allows assessors to assign a global assessment of risk, followed by their treatment recommendations.
How much time does it take to administer the EARL?
The answer to this question depends on the amount of information one has prior to conducting the assessment. We encourage users of the tool to gather as much information as possible that is relevant to child's antisocial behavior. In addition to other sources, information from case conferences, child and parent interviews, psychological reports, school assessments, standardized clinical measures should be considered. Once this is done, an assessment can be typically performed in about 20-45 minutes.
Who is qualified to use the EARLs?
We state up front in each of the EARL manuals that the schemes are to be used only "by clinicians and professionals experienced in working with high-risk boys and/or girls under the age of twelve who have severe antisocial difficulties." With the requisite experience, each manual can be used successfully across a variety of domains and disciplines including children's mental health, child protection, medicine, education, law enforcement, community health, psychiatry, psychology and social work. Although not required, training is highly encouraged above and beyond a full reading and understanding of the manuals.
What training is available?
For an overview of training opportunities, please visit Training Options
How do I order the EARLs?
Click here to purchase the EARLs Training Options