REPORTING CHILD ABUSE AND NEGLECT

Pediatric abusive head trauma is a form of child abuse, and all fifty states have statutes that mandate reporting of suspected child abuse and neglect for certain professionals. Familiarity with state laws will ensure that providers report to the appropriate agency within the required time frame. Some states have provided the option of making such a report through the Internet. Information on specific state laws is provided by the Children’s Bureau of the Administration for Children and Families, U.S. Department of Health and Human Services.

(For state-by-state information on mandated reporting, see “Child Welfare Information Gateway” in the “Resources” section at the end of this course.)

Who Must Report Abuse?

Anyone may report suspected child abuse at any time and is encouraged to do so. Such reports are typically confidential and may be made anonymously by members of the public.

Approximately 47 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the Virgin Islands designate professions whose members are mandated by law to report child maltreatment. There are three states (Indiana, New Jersey, and Wyoming) that do not enumerate specific professions as mandated reporters but require all persons to report.

Individuals designated as mandatory reporters typically have frequent contact with children. The professionals most commonly mandated to report across the states include the following:

  • Social workers
  • Teachers, principals, and other school personnel
  • Physicians, nurses, and other healthcare workers
  • Counselors, therapists, and other mental health professionals
  • Childcare providers
  • Medical examiners or coroners
  • Law enforcement officers

It is important that all professionals be informed of the laws that pertain to the jurisdiction of their own practice (CWIG, 2019).

What Situations Require That a Report Be Made?

Although the circumstances under which a mandatory reporter must make a report vary from state to state, typically a report must be made when the reporter has reasonable cause to suspect that a child whom the reporter sees in his or her professional capacity is abused or maltreated. In some states, the mandatory reporter must report even if the information is third-hand or is not obtained in their professional capacity. If the professional has knowledge of or observes a child being subjected to conditions that would reasonably result in harm to the child, a report must also be made (CWIG, 2019).

REASONABLE CAUSE

There can be “reasonable cause” to suspect that a child is abused or maltreated if, considering the physical evidence observed or told about, and based on the reporter’s own training and experience, it is possible that the injury or condition was caused by neglect or by nonaccidental means.

Certainty is not required. The reporter need not be certain that the injury or condition was caused by neglect or by nonaccidental means. The reporter need only be able to entertain the possibility that it could have been neglect or nonaccidental in order to possess the necessary “reasonable cause.” It is enough for the mandated reporter to distrust or doubt what is personally observed or told about the injury or condition.

In child abuse cases, many factors can and should be considered in the formation of that doubt or distrust. Physical and behavioral indicators may also help form a reasonable basis of suspicion. Although these indicators are not diagnostic criteria of child abuse, neglect, or maltreatment, they illustrate important patterns that may be recorded in the written report when relevant.

How Is a Report Made?

In most jurisdictions, a telephone report should be made as soon as possible and then should be followed by a written report. States provide standardized forms for this purpose, typically available online at the website of the relevant community agency (CPS, Department of Children and Family Services, etc.).

Most healthcare facilities also have policies and procedures in place regarding the reporting of suspected child abuse. Healthcare professionals must know what guidelines are in place at their place of employment as well as state mandates.

At the time of an oral telephone report, frequently to a state-subsidized 800 number, a CPS specialist will typically request the following information:

  • The condition of the child
  • Names and addresses of the child and parents or other person responsible for care
  • Location of the child at the time of the report
  • Child’s age, gender, and race
  • Nature and extent of the child’s injuries, abuse, or maltreatment, including any evidence of prior injuries, abuse, or maltreatment to the child or its siblings
  • Name of the person or persons suspected to be responsible for causing the injury, abuse, or maltreatment (“subject of the report”)
  • Family composition
  • Any special needs or medications
  • Whether an interpreter is needed
  • Source of the report
  • Person making the report and where reachable
  • Actions taken by the reporting source, including taking of photographs or X-rays, removal or keeping of the child, or notifying the medical examiner or coroner
  • Any additional information that may be helpful, including if there are any other children in the home

A reporter is not required to know all of the above information in making a report; therefore, lack of complete information does not prohibit a person from reporting. However, information necessary to locate a child is crucial.

Consequences for Failing to Report

Nearly every state enacts penalties, in the form of a fine or imprisonment, for mandatory reporters who fail to report suspected child abuse or neglect. In addition, mandated reporters can be held liable by civil systems for intentionally failing to make a report of suspected abuse that was encountered while acting in their professional capacity (CWIG, 2015b).

Failure to report also leads to more serious consequences for the child and family. CPS cannot act until child abuse is identified and reported—that is, services cannot be offered to the family nor can the child be protected from further suffering.

INEQUITY AND IMPLICIT BIAS IN CHILD WELFARE

Research indicates the presence of race- and poverty-related disparities and disproportionality in the child welfare system related to reporting, foster care placements, and the termination of parental rights decisions. Several factors may explain these findings, including:

  • Correlation between poverty and maltreatment
  • Visibility or exposure bias
  • Limited access to services
  • Geographic restrictions
  • Child welfare professionals knowingly or unknowingly letting personal biases impact their actions or decisions

Thus, it is important that healthcare professionals be aware of their own biases when working with families and when assessing for and reporting suspected abuse.

Biases may come in two forms:

  • Explicit biases include overt acts of discrimination, racism, and prejudice. Explicit bias is easier to identify; people are typically aware of the explicit biases they may possess because it is a conscious bias.
  • Implicit biases include unconscious attitudes and beliefs that can produce discriminatory behaviors. Everyone has implicit biases, but they can be more difficult to assess because they are unconscious.

(Ellis, 2019)