Reporting and identifying child physical abuse: How well are we doing?

Abstract

Entry into the child protection system in the US begins with a child maltreatment report. Some evidence suggests that report source and child age are related to report outcomes, but there has been no national study of these relationships. The purpose of this secondary data analysis was to describe the distribution of report sources for child physical abuse (CPA), and examine whether (a) the source of a report and (b) child age contribute to the likelihood of substantiation of the reported abuse. Multilevel logistic regressions were conducted using a US national sample of 204,414 children investigated for CPA in 2013 in a dataset obtained from the National Child Abuse and Neglect Data System. Results showed that fewer than one in seven children reported for CPA were confirmed victims of abuse. Professionally mandated reporters initiated the majority of CPA reports, and their reports were more likely to be substantiated compared with nonprofessionals. However, reports made by even the most accurate professional group (legal/law enforcement) had only a 26% chance of substantiation, and some professional groups had a lower likelihood of substantiation than nonprofessionals. Reports made by professionals were less likely to be substantiated as child age increased. More research is warranted to develop and test the effectiveness of training programs to improve CPA reporting and identification.

How do States Inform Nurses of Their Policies for Mandatory Reporting of Child Maltreatment?

“…A universal mandate raises the question about whether every state resident needs to be trained to understand the state definition of child maltreatment and what it means to be a mandated reporter. Because all residents do not receive specific training to recognize child maltreatment as legally defined in their state, there is concern that a universal mandate produces more reports to be investigated, but not greater child safety (Ho et al, 2017; Krase & DeLong-Hamilton, 2015). By contrast, nearly 65% of states, including Washington, DC (n = 33) list specific professionals who are mandated to report suspected child maltreatment or face a penalty.…”

“…Nine states also invoke the mandate to make a child maltreatment report based upon a judgment of probable future harm, even if there is no current observation of injury, or the harm is not imminent (Mudrick & Smith, 2017). With this variation, studies of nurses’ understanding of mandatory reporting obligations have noted the need to understand the specific definitions and policies of their state (Davidov et al, 2012; Ho et al, 2017; Merrick & Latzman, 2014).…”

“…If nurses are knowledgeable about the evidentiary standards, reporting, and the investigative processes, appropriate cases are brought to the attention of authorities, potentially preventing harm to children through a failure to report or an unnecessary report (Merrick & Latzman, 2014; Raz, 2020). Ho et al (2017) found that among reports filed by medical personnel, which includes nurses, only 22% of cases investigated were likely to be substantiated, indicating that under the state's criteria sufficient evidence of child abuse or neglect was found. From this, they emphasize the importance of state-specific understanding of what constitutes child abuse and the needed evidence.…”

Rate of orthopedic resident and medical student recognition of nonaccidental trauma: a pilot study

“…Increased public awareness of child abuse, along with a lack of training for mandated reporters may result in over-reporting child abuse [15,16]. Most child protection laws require mandated reporters to report any case of suspected abuse to CYPS [4,[17][18][19][20]. Levi et al [18] reported significant variability among pediatricians' level of interpreting and understanding of reasonable suspicion for abuse.…”

“…Sharma et al [21] reported that radiology residency programs may be deficient in teaching residents to accurately recognize child abuse. Ho et al [4] stated that reports made by legal and law enforcement agencies had only a 26% chance of substantiation. They also found professional cohorts such as teachers/educators had only a marginally higher substantiation from child abuse reports than nonprofessional cohorts such as parents or relatives (13.7% versus 9.8%).…”