Early detection for neglect and abuse

Does the Child Check initiative offer starting points to better assist and support children when their parents have serious mental health challenges, drug, or alcohol addiction or other serious chronic conditions? Three professionals share their insights.

‘Child Check’ is a protocol used by professionals who work with adult clients, such as (family) doctors, nurses, social workers, psychiatrists and psychologists, to help identify children at increased risk of abuse or neglect.

Successful in the Netherlands

Child Check outlines the steps professionals can take to determine the well-being of children, while treating the parent who is their patient or client. For example: if a person with an addiction comes into the emergency room, the care team can conduct an assessment to identify whether the person has children and that they are safe.

Since the implementation of the protocol in the Netherlands in 2007, the method has proven successful with a positive predictive value of 91%, substantially increasing the detection rate of child abuse in an emergency department setting.


The Court of Guardianship (CoG), in collaboration with UNICEF the Netherlands and Augeo Foundation, are working towards implementing a ‘Child Check’ protocol on Sint Maarten. In 2022, local stakeholders were informed about their possible roles within Child Check and asked for feedback on the next steps for implementation.

“After our consultations, we have learned that some organisations already do a similar ‘check’ during their work”, shares Kimberly Dort-Brown, Head of the Court of Guardianship. “However, all invitees agreed that there is room for improvement. The Child Check method will streamline how professionals working with adults (parents) can help identify child abuse or neglect cases. Once identified, we can provide the needed assistance to the children of their clients.”

In addition to early detection, Child Check ensures that parents and caregivers are supported. This holistic approach was appreciated by several stakeholders that will play a part in the implementation of Child Check.

“Child Check can help formalise and refine the way we do our assessments”

Tasheena Thomas
Director of Turning Point Foundation, centre for drug rehabilitation

“During our intake assessments, there are several questions about their family dynamics. We ask if they have children, and if yes, with whom or where they reside. This is important to check if the children are safe, and crucial for the client’s rehabilitation journey. As a drug rehabilitation facility, the whole family must be involved as much as possible. If a client has a strong network, managing and treating their addiction will be easier.

Action Plan

“We had a client with a gambling addiction. Because of this, he could not pay rent and other expenses to support his family. His child was going to school but wasn’t functioning because he wasn’t eating regularly. In this case, we will do counselling and make an action plan to ensure that the children’s basic needs are met. We also have meetings with family members separately to ensure everyone feels comfortable sharing any concerns. The Court of Guardianship will be involved if any neglect or abuse is suspected.

I think Child Check would be great to implement in Sint Maarten. The protocol focuses on the whole family dynamic to ensure that children are safe and families are supported. Child Check specialises in child protection and can help formalise and refine the way we do assessments at Turning Point.

Prevent the circle of abuse

“We should look at it this way: if we save a child, we prevent the circle of abuse from happening again. We see a similar cycle of addiction in families that have not received adequate support. Helping children as early and quickly as possible will result in a healthier and safer community.”

“For a better working relationship between various agencies dealing with families and children”

Celine Carty and Christine Regis
Social workers at the St. Maarten Medical Center

“Our role is to be the advocate for patients and patient care. An initial assessment is done when patients come in. We also do spot checks on the wards and keep in close contact with nurses and doctors. If any concern arises, we check in with the patient and see what assistance can be offered.

Substance use

“Often patients will indicate if they have any children at home. If there is any suspected neglect or abuse, we involve the Court of Guardianship. We help families by providing counselling and providing relevant guidance and referrals. Due to the limited resources on our island, creativity is essential.

One of our success stories includes a pregnant woman visiting our outpatient clinic for a check-up. During testing, the gynaecologist realised there were illicit substances in her system and alerted us. After our conversation, I assessed that she and her partner had another child at home. Despite her substance abuse, the home and her child were very well taken care of. She agreed to go to therapy, random home visits, and to random drug testing. Taking certain drugs was a coping mechanism for her during stressful times – but she recovered, and both her children are doing well.

Holistic approach

“We think Child Check would provide the opportunity for a better working relationship between various agencies dealing with families and children – a holistic approach. Of course, we must take privacy into account. However, if we can share certain information through having a program such as Child Check to create more efficiency, we can help children and families more quickly.”