Decision-Making Factors in the Mandatory Reporting of Child Maltreatment

A-TEAM: An Interprofessional Approach to Mandated Reporting in the Hospital Setting

Reporting suspected child maltreatment in pediatric settings presents unique challenges. Variation in mandated reporter training may lead to discomfort and emotional dysregulation. Failure to collaborate inter-professionally potentially results in suboptimal care for vulnerable children and families. A-TEAM promotes awareness, transparency, empathy, a nonjudgmental strategy, and management by an interprofessional team when referring patients for child protective services evaluation. A faculty trained in pediatric trauma nursing led the development of A-TEAM. Integrating nursing and social work expertise protects the integrity of family-centered patient care. The A-TEAM approach may be a valuable contribution to the continuing education of pediatric health care professionals.

Potential Reporters of Suspected Child Maltreatment are Sensitive to the Amount of Evidence and the Potential Consequences of Reporting

The context of suspected maltreatment cases is likely to influence the decision of whether or not to make a formal report. Across one pilot study (N = 368) and two experiments (Exp. 1 N = 444; Exp. 2 N =416), undergraduate students and online community participants reported their anticipated actions and beliefs when confronted with evidence of child maltreatment. Participants reviewed case dossiers built from real-world child neglect cases in which increasing levels of evidence were presented and the consequences of reporting, or not reporting, the maltreatment were made salient to the adult or child. The experiments revealed a clear difficulty in deciding whether or not to report suspected maltreatment. Highlighting the impact on either the child or the adult by describing potential consequences moved participants either closer to (child-salient) or farther from (adult-salient) a formal report. Participants were also sensitive to the amount of evidence to support a suspicion of abuse, which influenced the likelihood of a formal report. This work suggests that increasing the salience of maltreatment consequences to child victims may increase the likelihood that suspected maltreatment will be reported.

Statutory Threshold Wording is Associated with Child Maltreatment Reporting

The purpose of this study was to determine whether statutory wording of child maltreatment mandated reporting legislation was associated with reporting patterns and substantiation of abuse across U.S. states and territories. Annual state averages for total referrals, referrals screened-out, referrals screened-in, referrals substantiated, and child population (all children in the U.S.; annual average = 74,457,928) were obtained from the 2010-2017 Child Maltreatment Reports. Odds ratios were calculated for: (1) two major statutory language frameworks (suspicion versus belief), (2) seven sub-categories (e.g., suspect, reasonably believe, etc.), and (3) universal mandated reporting (yes versus no). Use of suspicion (versus belief) was associated with higher rates of referrals made (OR = 1.13) and screened-in (OR = 1.13), but lower substantiation rates (OR = .92). States using universal mandated reporting (versus those who did not) had slightly lower rates of referrals (OR = .99), but higher rates of referrals screened-in (OR = 1.16) and substantiated (OR = 1.06). Differences in statutory wording are associated with variability in reports, suggesting the possibility that statutory wording is one factor involved with these differences. However, future research is needed to explore alternative contributing factors and/or explanations.