National Child Abuse Prevention Month

According to the most recent Child Maltreatment Report, released by Administration for Children and Families in 2010, about 3.3 million referrals alleging child maltreatment were filed with child welfare agencies, involving 5.9 million children.

Children birth to 3 years old represented the largest group of confirmed child abuse and neglect victims. Caucasian children were victims of maltreatment in 44 percent of the cases, the most of any other race, but African American children were victimized at a higher rate. Most children (78 percent) were reported for neglect, while 18 percent suffered from physical abuse.

From all of those statistics, some could highlight a specific population most at risk, but child abuse and neglect is not specific to any one race, religion or community.

Also documented in the Child Maltreatment Report, an average of 1,560 children have died from child abuse and neglect in the United States each of the past five years. The victims vary in age, race and type of violence experienced.

As if the direct impact on children’s health, safety and well-being weren’t enough, the financial impact on the economy is staggering:

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Hunting the Predator

Justice For Life


Why the ‘Johns’ aren’t getting prosecuted – Fox…, posted with vodpod

Human trafficking is a global problem. But it’s quickly gaining local media attention as people learn how prevalent the problem is in cities such as Atlanta, Phoenix and New York, among others. Local law enforcement agencies say it is more challenging than ever to crack down on the ‘johns.’ “The issue with prosecuting buyers — or ‘johns’ as some people call them — typically they’re not known to the victim,” said Cobb County Police Detective Carol Largent. “They may not know a first name, a last name; know what they drive, where they live. They may not be able to give us any information about them.”

Read more at Elizabeth Prann’s Fox News article: Human Trafficking: Hunting the Predator.

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Child abuse, the holidays and mandated reporting

Right now we are at the height of the holiday season, full of fun, food, and festivities. However, it also includes increased stress, especially during intense family situations, and it isn’t uncommon for child abuse rates and reports to increase during this time. A recent article from Tri-Cities News in Tennessee touches on this problem of how with the holidays comes an increased pressure and strain, which often leads to an increase in exposure to violence and possibly incidence of abuse. WOWKTV 12 in Charleston, South Carolina also shares a report about domestic violence increasing over the holidays and endangering children and families. These situations demonstrate why it is so important that people are aware of what abuse is, the signs to look for, and when and where to report it.

So keeping this and the holidays in mind, we want to finish our discussion about mandated reporting by remembering why this topic is so important.

Looking back over the past couple of weeks, we:

  1. Opened with a discussion about the Penn State scandal.
  2. Looked at what mandated reporting is and who is responsible for reporting.
  3. Examined the role of reporting in systems and the barriers to reporting
  4. And finally, discussed mandated reporting in practice and its implications.

All of this is important because of the effect that abuse and neglect on children who experience it. Futures Without Violence recently highlighted the new Center for Disease Control (CDC) National Intimate Partner and Sexual Violence Survey, or NISVS. The report’s findings show that…

…on average, 24 people per minute are victims of rape, physical violence, or stalking by an intimate partner in the United States, based on a survey conducted in 2010. Over the course of a year, that equals more than 12 million women and men.

Similarly, early this week, the United Nations (UN) adopted further protocol for protection children from violence and abuse. Both of these recent developments reiterate how important it is for nations to be vigilant about understanding abuse and neglect and how they can work to clarify the definition of abuse, reporting laws, and what needs to be done to put those laws into practice. Recognizing and further addressing the problem of abuse and maltreatment shows the United States’ commitment to protecting and giving children a voice. This makes the new congressional dialogue about mandated reporting statutes even more timely.

So as we enter the New Year, we should remember the importance of protecting children against all kinds of violence. Having proper legislation in place, like mandated reporting laws, is only the beginning. The next step is to train people, raise awareness, and encourage people to embrace change.

Mandatory Reporting: Implications, Meanings, and Practice

We’ve been talking a great deal about mandated reporting the past few weeks expanding our knowledge about the topic, drilling down into some of the specifics, and thinking through some of the barriers for professionals and systems.  Now we’ve come to what the implications of that reporting might be for mandated professionals, families, individuals, and the children affected.

Since the Penn State scandal became public knowledge, there has been a firestorm of opinion and media and legislative activity across the United States. States are responding by reviewing current mandatory reporting laws and reinforcing who is responsible for reporting abuse and when they should be reporting. There is some individual outcry that everyone should be required to be a mandated reporter and others are opposed to the expansion of legislation, citing it will cause more harm than good. But, overall there is a general agreement that reporting laws are necessary but clarification is essential for them to be carried out properly.

Nancy Fagan, LCSW, a child-welfare specialist with Jewish Family and Children Services, wrote an opinion piece that reiterates the view point that everyone has a clear ethical and legal responsibility to report abuse, but that those responsibilities must be clarified and outlined.  Another writer from the Michigan CASA blog believes even more extremely that “when there is even a question or an inkling of abuse,” that you must assume that abuse is occurring until you are proven otherwise.

On the other end of the spectrum, in a November 27th opinion piece for the Hartford Courant, Joette Katz, the commissioner of Connecticut’s Department of Children and Families and former State Supreme Court Justice, said that she was against requiring everyone to become a mandated reporter. The piece cites that studies have not proven that extensive reporting laws have even helped to reduce the incidence or prosecution rate of abuse cases and in fact can increase the prevalence of spurious reports which take away from the investigation of legitimate cases being reported.

So in order to understand the implications of mandated reporting, one has to think about their own understanding about the subject. In a recent lecture on child protection laws, Margaret Lynch Professor of Community Pediatrics, King’s College, gave a lecture at the University College London on child protection laws, and as part of the lecture she provided an exercise that required participants to look at the subject of reporting from personal, public, and professional perspectives and confront their own understanding about the subject. One of the scenarios asked participants whether they would be suspicious of the idea of a father cuddling with his 11-year-old daughter in bed after she’s had a scare. Each person had a very different understanding of what should have been done or how they should have responded from a reporting perspective.

This scenario is a clear example of the implications of mandated reporting legislation. When presented with a possibly scenario of abuse, how do people respond? How do you know when it is abuse or when it’s not? In a room full of policy makers, doctors, and advocates every person had a different understanding about the presented scenario. They each would interpret legislation and guidelines differently. So do states push forward with the mindset that everyone should report if they have any reason to suspect abuse or should they follow the Commissioner’s advice for targeting reporting laws and cautioning guidelines?

A study published in Clinical Pediatrics in 2010, by Benjamin H. Levy and Kathryn Crowell, Child Abuse Experts Disagree About the Threshold for Mandated Reporting, attempted to see if setting forth guidelines for using reasonable suspicion for reporting abuse might help to create an overall threshold for the context of reporting abuse. However, they found that there really wasn’t any guidance that helped to determine the interpretation of the meaning of abuse. The study concluded that experts even showed a wide range of variation in defining that suspicion. Basically, there’s absolutely no consensus on how even experts can interpret suspicion. This and other studies also discuss that abuse investigations themselves can be just as traumatic as any suspected abuse, so there is no need to put a child through the trauma of the reporting process on an “inkling” of suspicion. This may especially be the case if everyone is a mandated reporter because they’ll start reporting anything because they’re afraid of facing penalties for not reporting.  If experts are not even clear about what reporting laws mean then it may be even more difficult for the average person to know what to look for as well.

Looking back at the exercise about child protection, we just have to keep in mind that everyone has an identity affected by their life experiences, beliefs, and culture that impact their understanding of abuse. The implications of mandated reporting laws can have a strong impact on everyone involved in the reporting process. So, this must be kept in mind as states review their laws and as people understand what abuse is and what constitutes reasonable suspicion for reporting.

While it isn’t always clear what is meant by “reasonable suspicion,” there are signs that you can look out for whether you are a practitioner, parent, teacher, or individual. Prevent Child Abuse America suggests the following:

What You Can Do: Recognize the Warning Signs


The behavior of children may signal abuse or neglect long before any change in physical appearance. Some of the signs may include:

  • Nervousness around adults
  • Aggression toward adults or other children
  • Inability to stay awake or to concentrate for extended periods
  • Sudden, dramatic changes in personality or activities
  • Unnatural interest in sex
  • Frequent or unexplained bruises or injuries
  • Low self-esteem
  • Poor hygiene

They also provide a webpage that lists the steps to report and where to actually go to report.

What you can do: Report Suspected Abuse or Neglect

In addition the following website provides some guidelines for what reporters can expect and how to respond:

If a child discloses that he or she has been abused by someone, it is important that you listen to them most of all.

•   Investigate
•   Ask leading questions (a question that suggests the answer or contains the information the questioner is looking for – That man touched you, didn’t he?)
•   Make promises
•   Notify the parents or the caretaker

•   Provide a safe environment (be comforting, welcoming, and a good listener).
•   Tell the child it was not his/her fault
•   Listen carefully
•   Document the child’s exact quotes
•   Be supportive, not judgmental
•   Know your limits
•   Tell the truth and make no promises
•   Ask ONLY four questions
•   What happened?
•   Who did this to you?
•   Where were you when this happened?
•   When did this happen?
•   Asking any additional questions may contaminate a case!

Report it!
•   Call your local law enforcement agency
•   Call your local Child Protective Services Agency
•   Call the 24-Hour Childhelp® National Child Abuse Hotline and we will connect you to the appropriate agency.

Questions that will be asked when you call

  1. The name, address and age of the child.
  2. The name and address of the child’s parent, guardian or other persons having custody of the child.
  3. The nature and extent of the abuse or neglect.
  4. Any evidence of previous incidences.
  5. Any other information which may be helpful in establishing the cause of the child’s abuse or neglect and the identity of the perpetrator.

You do not need to have all of the above information when you call to make a report, but the more accurate information you can provide, the better equipped the offices will be to assess the child’s risk.

We’ve also included some further resources below that can help reporters clarify reporting laws and some further signs that you can look for if you suspect a child might be abused:

Prevent Child Abuse America

Child Abuse and Neglect Recognizing and Preventing Child Abuse

Mandatory Reporters of Child Abuse and Neglect: Summary of State Laws

Mandated reporting: what are the barriers?

There is general public sentiment that several adults involved in the Penn State scandal should have reported what they saw or suspected. In response to the scandal, members of Congress held a hearing on December 13 to debate revisions to mandated reporting laws including discussion of making everyone a mandated reporter. However, this will not necessarily improve reporting activities. There are several questions about how to go about revising the mandated reporting requirements in effective ways that will improve the system, not just increase the number of people reporting and reports made. As mentioned on our last post, numerous barriers exist for reporters such as the fear of repercussions like day care centers losing business due to false reports, direct service workers losing their treatment alliance, pediatricians’ concerns about not having follow up with what happens after they report, and many others. In research over the past several decades, themes of these barriers have been identified as well as solutions that could help policy makers think through what policy improvements would mean, and throughout this blog we will discuss these themes in more depth.

Barriers across Systems

Vague Legal Definitions and Requirements

Definitions: Currently, definitions of abuse and who must report is based on state law. There is rising support for a consistent legal definition of abuse and standard for reporting. Universal definitions and reporting is thought to help mitigate issues with cases that cross state lines as well as provide equity and equality in who gets reported and who gets help. It also would help professionals know what is required of them in our highly mobilized society.

Requirements: Statutes vary on what type of evidence is required and what degree of suspicion must be present, leaving it up to the individual reporter to decide what he will and will not report. More specific legal definitions and requirements will provide better guidance to reporters in the situations.

Populations: The debate is between inclusive and broad legislation versus narrow and specific legislation. Many experts are aligning themselves on the narrow side because it is more feasible to train specific groups, they do not want to flood the system with false reports, and the pool of mandated reporters can always grow. They feel that a few well-trained and involved professionals are better equipped to correctly identify and deal with suspicious situations.

Lack of Training and Awareness

Content: One of the biggest barriers for professionals is concrete knowledge of what is required of them such as signs they should be looking for, what they need to report, and where to report. The legal definitions used are purposefully vague to allow reporters both the freedom and protection to report suspicions. However, this ambiguity more often confuses professionals and leaves them to interpret what abuse is and what constitutes “sufficient evidence” on their own. This has lead to inconsistencies in who and what gets reported and when. Experts hold that the best training should include specific information on what abuse is, the signs and symptoms to look for, as well as clear guidelines about what and where to report.

Dosage: The other issue with training is the duration and frequency of it. Research suggests that the best training is interactive with low dosage and high frequency. This provides the clinicians with a supportive environment as they continue to learn and hone their skills.

Resources:  The trainings described above require proper funding and time to allow the professionals to adjust to the training. Better trained professionals can improve the accuracy of reports, lessening the burden on CPS and improve the services they are able to provide.

Cross-System Collaboration and Transparency

Problems with data sharing: Each of the systems has their own individual data and privacy laws such as Health Insurance Portability and Accountability Act (HIPPA) and Child Abuse Protection and Family Educational Rights and Privacy Act (FERPA.) This makes it difficult to both identify at-risk families as well as track progress. Also, individual data does not necessarily speak to or track issues of reporting and child abuse/neglect. Through information sharing, researchers and practitioners would be better able to have a sense of the true level of abuse/neglect as well as gaps in services.

Problems with trust/transparency of CPS: Many professions cited they were dissatisfied with prior experiences with reporting and how CPS handled it. Some studies even found professionals who said it was a factor in why they did not report a suspicion. Other studies have found that professionals may simply not report because they feel they are best able to handle a situation since they have an established relationship with the child and the family already. CPS, on the other hand, is struggling to keep up with the reports, investigations, and follow up services for their families. One solution that would help both systems could be to increase other systems’ involvement with the investigation process. This would both utilize the relationships already established with the child and their families as well as provide more context and history to the investigation. It would also help relieve some of CPS burden and increase the feedback loop for professionals on reports they have made.

Barriers within Systems:

As noted above, there are several barriers that cross all the systems, but there are also barriers within each individual system. Each system has its own unique viewpoint and lens of situations but also its own barriers. For example, teachers can report a child they see every day, but they may not report because they feel they can help the child and if they report, the child may be placed out of their district. However, emergency room doctors are there at the point of crisis and are able to help ensure the immediate safety of the child, but have little knowledge of the patient’s history or influence on their future.

Early Education/School Systems

Teachers and school staff have a unique role to play in detecting potential situations of abuse and neglect. Since children are present consistently at school – or inconsistently, which could be a red flag – school personnel are able to see behavioral changes or trends in children. This sense of longevity helps provide a strong evidence base for potential abuse/neglect cases. However, barriers include large class sizes, heavy testing requirements, and lack of training in both reporting methods and signs/symptoms of abuse/neglect.

Social Workers/Psychologists

Direct practice professionals often have the most firsthand testimony of instances of abuse/neglect. This is because clients are encouraged to open up and talk about issues they are experiencing in their lives. However, this client-clinician bond can only happen when trust is established, and. to report on that abuse could break professional-client privilege and potentially halt the healing process. Another concern many clinicians express is that it will make the situation worse and/or further traumatize the person if the situation is not dealt with appropriately.

Pediatricians/Nurses/Health Professionals

The medical profession has the trust of families and exposure to physical symptoms of abuse, often at the point of crisis. This enables them to both identify patterns as well as secure the immediate safety of children. However, it also leaves them in a hard spot because it is difficult to distinguish the cause of injuries, especially in crisis settings such as the ER. When only seeing the child at the point of crisis and without an accurate and complete medical history, a doctor may miss signs and patterns of abuse and neglect. Also, they often have very strict interpretation of evidence and are reluctant to report anything that cannot be firmly proven.

To Wrap Up…

As mandatory reporting statues are reviewed, policymakers need to keep in mind all of these barriers in the context of the larger picture. One way to do this is to use research to guide decision-making. As highlighted in expert testimony from Frank Cervone, Executive Director of the Support Center for Child Advocates in Philadelphia, at the congressional hearing, there are valuable lessons to be learned from the many innovative approaches states have taken in dealing with mandatory reporting. He went on to advocate for careful study of the research on best models of policy, system collaboration, and treatment interventions. This way the laws enacted will be thoughtful responses that will both improve the system and better meet the needs of children and their families instead of being a reactionary policy.


For further information into the proposed bill, go to

For further information about barriers and solutions:

Background and Basics of Mandated Reporting

As noted on Friday, mandated reporting laws have been in existence since around the 1960s in the United States, a requirement for states that want to receive money from the Child Abuse Prevention and Treatment Act (CAPTA). These laws were supposed to  encourage reporting to help Child Protective Services (CPS) protect vulnerable children from abuse and/or unhealthy living situations in their state. Because of this, many states decided to mandate specific groups of professionals to report, people they felt would be the best equipped to identify abused and neglected children.  And with that mandate some states outline legal consequences for failing to report.

However, as illustrated by the Penn State scandal, mandatory reporting laws are now more seen as a way to enforce and police reporting activities or failing to report. These conflicting ideas result in a variety of barriers for mandated reporters encountering suspicious situations.

A Reporting “How to”

Researchers Warner and Hansen characterize reporting activities in four phases:  assessment and evaluation of the situation, identification of suspected abuse, reporting to authorities, and validations of suspicions. (Influence of Case and Professional…, Hasen et al) The very basics are highlighted in the chart below.


Generally,  verbal reports are made to one of three entities – the state’s reporting hotline, the state’s child protective services agency, or law enforcement. A verbal report must be followed up by a written report and then the case is entered into the state database.

Whether or not the case is substantiated – meaning evidence of maltreatment was found – the report will stay in the database for a designated period of time (specific to each state).

Next, the state’s child protection agency will investigate the situation. The case will be ruled one of three ways: unfounded, meaning there was no evidence of maltreatment; indicated, meaning it is likely that maltreatment has occurred; or substantiated, meaning sufficient evidence of maltreatment was found. If the report of abuse is substantiated and/or indicated, a case will be opened and a caseworker assigned to the family. If the case is unfounded or indicated, referrals to voluntary community-based services are provided and the report remains in the system for the specified period of time.

This process is the general flow, no matter where the reporting happens. Anything more specific is dictated by the individual state’s legislation.

State Mandates

In order to get Title IV money (CAPTA), states are required to produce their own specific mandated reporting laws to further define who must report, what must be reported, and how to report. The major differences between states are who is a mandated reporter, what degree of abuse are they to report on, and timing of abuse (whether only past abuse or threat of future harm).

In general, state’s definitions of mandated reporting falls into three categories based on the degree of knowledge the mandated reporter needs to have to report: believe, suspect, know. Let’s look at each a little more in-depth:

1. Eighteen states have belief-based mandates, the broadest of legal definitions for what a mandated reporter is supposed to report. If the mandated reporter has any reason to believe there is abuse going on, they are required to report. The benefits of this is encouraging reporting of any situation in the best interest of the child. However, more often than not this leads to both under- and over-reporting since there are no guidelines for what defines abuse.

2. Thirteen states employ the suspected-based mandates, which is based on the idea that mandated reporters judge a suspicious situation against some sort of professional standards to decide whether or not the situation needs to be reported. This type of law seeks to mitigate biases or inappropriate personal lenses by applying professional lenses to dictate reporting activities. However, like the belief-based laws, professionals often find this definition too vague and it leads to individual interpretations of laws, abuse, and professional conduct.

3. Sixteen states have knowledge-based mandates, which use the very legal terms of evidence and knowledge to dictate reporters’ responsibility. This allows the most legal protection for mandated reporters; however, they still remain suspiciously vague about what kind of evidence and how much is needed to know that abuse is taking place. This can also lead to underreporting.

(The other 3 states have laws that do not fit into these three “degree” categories.)

Another difference between states is who must report. Currently, 18 states have universal laws, which means that everyone is a mandated reporter. Several others, including Congress, have bills before their legislative bodies to make everyone a mandated reporter. The other states mandate those who are child-serving jobs. The most common professions according to the National Child Welfare Gateway  are medical staff and doctors, teachers and school personnel, and social workers. Other states include day care providers, community center workers, coaches, and others.

And lastly, “timing” of abuse mandated to report differs among states. Some states require an actual instance of abuse or neglect to be suspected to trigger reporting where as some states push for more inclusive laws to include “future threat of harm” as a prevention measure. This gets into the idea of the purpose of mandated reporting laws – whether they are to prevent and protect or just protect. The positives and negatives of the current laws will be discussed further on this blog later this week.

As can be seen above, each of the mandates presents its own set of barriers and unintended consequences. The general response since the Penn State scandal broke is to push lawmakers to amend policies to include the most people as reporters and broadest interpretations of abuse as possible. However, many experts are now cautioning this approach as broad laws have been found to increase confusion of professionals about what is required of them as well as under-reporting since there is no clear guidance or training provided to professionals and especially to the general public. Also, there are concerns about what false reports can do to vulnerable families and children.

The best laws are those that answer the following questions in clear specific language:

– Who is required to report?

– What type of abuse and neglect are reportable?

– What level of suspicion is acceptable and how is this expressed?

– Are reporters required to report all sources of abuse or just parents/caregivers?

– Are any new types of abuse required? – poverty neglect, exposure to porn,

– Define by extent of harm  or report any occurrence

– Report only incidences of abuse or threats to future safety?

– How much time is given to make the report?

(Mandatory Reporting Legislation…Mathews and Kenny, Feb 2008, p 589)

Mandates that answer these questions equip mandated reporters to be knowledgeable about abuse and their responsibilities, feel supported in their actions, and know how to balance legal requirements and practice questions in order to help the CPS protect children. As a whole, vague legislative mandates lead professionals to feel uncertainty about specific legal requirements, fear of losing treatment alliance and other results reporting could have on their client-practitioner relationships. There is also a fear of making the situation worse such as retaliations against the child victim, and lack of faith in the child protection services ability and actions in reported cases. Later this week we will look into the barriers for mandate reporters and some of the policy recommendations and practice solutions that are out there.


For more resources about your individual state laws, signs and symptoms of abuse, and other issues surrounding mandated reporting, please see the following resources.

Child Abuse Reporting Statues (complied by National Clearinghouse on Child Abuse and Neglect)

Child Welfare Information Gateway – Mandated Reporting publications

“Recognizing and Responding to Child Maltreatment” by Bilger et all

The Basics of Mandated Reporting

According to the Children’s Bureau annual Child Maltreatment report more than 700,000 children were reported to be mistreated in fiscal year 2009. Almost 80 percent of those children were neglected while 17 percent were physically abused and 9 percent were sexually abused. (The total equals more than 100 percent because some children experienced multiple abuses.)

Those numbers reflect reports made to child protection services agencies across the country, 52 percent of which were made by educators, law enforcement, social services and medical personnel – people mandated to do so.

Every state and Washington, D.C. has mandated reporting laws that require certain professions who work with children to report suspected child abuse.

Those professionals vary, but usually include teachers, social workers, medical and mental health professionals and child care providers, according to the Child Welfare Information Gateway.

The punishment for failing to report can be as serious as a misdemeanor.

Mandated reporter laws also describe what and where to report concerns.

For example, here in Maryland, “each health practitioner, police officer, educator or human service worker, acting in a professional capacity” are expected to report to law enforcement or child welfare agency if they suspect a child is being abused or neglected. Abuse and neglect are not specifically defined by the law.

But each state’s definitions are based on minimum standards set by federal law. Through the Federal Child Abuse Prevention and Treatment Act and the Keeping Children and Families Safe Act of 2003, child abuse and neglect is defined as:

…any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm…

The National District Attorneys’ Association has a handy list of laws for each state here. Take a look and see if you’re mandated to report, what you should report and who you report to.

Child Welfare Information Gateway: Summary of State Laws

Child Welfare Information Gateway: State Guides and Resources

National District Attorney’s Association: List of Mandated Reporting laws by state

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