Teachers' recognition and reporting of child abuse: a factorial survey

OBJECTIVE: The major aim of this study was to determine the effect of characteristics of the case, the teacher, and the organizational setting on recognition and reporting of child abuse. METHOD: A factorial survey design was employed in which a probability sample of teachers (N = 480) responded to vignettes in which case characteristics were systematically manipulated. RESULTS: Analysis using OLS regression showed that case characteristics alone accounted for 50.30% of the variance in recognition and 51.08% of the variance in reporting: the strongest effects were from type and seriousness of abuse, positive behavior of the victim and positive psychology of the perpetrator. The inclusion of variables describing the teachers and the school explained only a very small additional proportion of the variance in teacher's responses. CONCLUSIONS: Teachers responses to child abuse are relatively unbiased by either the extraneous characteristics of the perpetrator or victim, the responding teacher, or the school setting. The findings do not appear to support the problem of "overreporting." There is evidence for "underreporting," particularly in less serious cases involving physical and emotional abuse. Teachers are undeterred by the many problems and fears that may accompany a report of child abuse to Child Protective Services. Teachers use discretion in reporting abuse they recognize.     

Child care workers' knowledge about reporting suspected child sexual abuse.

As reports of the sexual abuse of preschool-aged children increase and the number of children in day care expands, it is important to recognize child care workers as potentially important resource persons for sexually abused preschoolers. Although they are potential resources for abused children, they may fail to report suspected abuse if they do not know their legal responsibilities and their rights and protections under the law. The purpose of this study was to determine child care workers' knowledge about their reporting rights and responsibilities. Relative to child sexual abuse experts, day care personnel knew significantly less about the procedures for reporting suspected abuse and their protection under the law. Suggestions for improving child care workers' knowledge about reporting suspected sexual abuse cases are provided.     

Interdisciplinary collaboration needed in obtaining high-quality medical information in child abuse investigations

BackgroundDespite reporting legislation, healthcare providers (HCPs) do not always report and collaborate in cases of suspected child abuse. Recognizing this leaves children at risk, the Wisconsin Child Abuse Network (WI CAN) sought to understand barriers to mandated reporting and collaboration with child abuse investigators.ObjectiveThe purpose of the study was to investigate barriers for professionals in providing and obtaining high-quality medical information in child abuse investigations.Participants and settingParticipants included five discipline-specific focus groups: HCPs, child protective services (CPS), law enforcement, lawyers, and judges. All professionals had been directly involved in Wisconsin child abuse cases.MethodsThis qualitative study consisted of discipline-specific focus groups, directed by open-ended interview questions. Data analysis was completed through the narrative inquiry methodology.ResultsBarriers to providing and obtaining high-quality medical information in child abuse investigations were both discipline-specific and universal amongst all groups. Discipline-specific barriers included: HCPs’ discomfort with uncertainty; CPS’ perception of disrespect and mistrust by HCPs; law enforcement’s concerns with HCPs’ overstepping professional boundaries; lawyers’ concern of HCPs’ discomfort with court proceedings; and judges’ perception of a lack of understanding between all disciplines. Universal barriers included: value of high-quality medical information in child abuse investigations, burden of time and money; unequal resources between counties; a need for protocols, and a need for interdisciplinary collaboration.ConclusionFindings from this study suggest several ways to address identified barriers. Possible interventions include equalizing resources between urban and rural counties (specifically financial resources and access to child abuse experts); protocolizing reporting and investigations; and, increasing interprofessional education.     

How teachers define and respond to child abuse: The distinction between theoretical and reportable cases

Teachers are considered to be among those who are well-placed for the detection and prevention of child abuse. Yet little attention has been given to the definitions teachers use in deciding which cases to process. The paper draws on a larger study of Ontario women teachers. Information from 264 elementary teachers and 47 principals was collected in three phases: exploratory interviews, a survey, and focused interviews. A key part of the survey involved 10 vignettes designed to determine how teachers define abuse, how much experience they have had in dealing with such situations, and what action they took in each case. The findings demonstrated that teachers included a broad range of behaviors in their own “theoretical” definitions, but preferred informal intervention over formal reporting. Although there is no statistical relationship between definitions and reporting, it seems clear that the decision to report involves the interplay of definitions, institutional response, and teachers' experiences with a range of reactions and personal trials. Reporting is also complicated by teachers' disciplinary role, by their concerns for establishing reasonable grounds, and by the perception that some cases can be handled more effectively by the school, without the intervention of Child Protection Services (CPS).     

Teachers' attitudes toward and knowledge of child maltreatment

OBJECTIVE: The purpose of this study was to determine teachers' self-reported knowledge of the signs and symptoms of child maltreatment, reporting procedures, legal issues surrounding child abuse and their attitudes toward corporal punishment. In addition, a factor analysis was performed on the Educators and Child Abuse Questionnaire (ECAQ) (Kenny, 2001a). METHOD: Two hundred teachers, who work in the southeast region of the US in a large, ethnically diverse school system, were administered the ECAQ which contains questions on knowledge concerning: (1) signs and symptoms of child abuse, (2) laws, and (3) procedures for reporting child abuse as well as number of reports filed. RESULTS: Most teachers reported being unaware of the signs and symptoms of child maltreatment, as well as reporting procedures. They also felt administration would not be supportive and were in disagreement with their legal role as mandated reporters. The ECAQ was found to be a reliable measure with four factors: (1) Awareness of signs and symptoms of child abuse, (2) Knowledge of reporting procedures, (3) Attitudes toward discipline, and (4) Seriousness of child abuse. CONCLUSIONS: In general, teachers reported a lack of awareness of the signs of child abuse and reporting procedures, which may affect their ability to report cases of suspected abuse. There is a need for standardized training in child maltreatment for all teachers as well as clear, concise institutional guidelines for reporting child abuse and support for teachers confronted with suspected victims.     

Worker judgements of seriousness about and reporting of suspected child maltreatment.

OBJECTIVE: This study examined the relationship between judgements about the seriousness of incidents of suspected maltreatment and the reporting of those incidents. METHOD: Eighty-six graduate social work students were given 12 vignettes depicting problematic parental behaviors. Students were asked to rate each vignette according to how serious they perceived the parental behavior to be with "1" being "not serious" and "7" being "very serious." Students were also asked to indicate whether or not they would report the incident to child protective services. Data were analyzed by case and by individual. RESULTS: All 12 vignettes were serious with mean incident ratings ranging from a low of 6.0 to a high of 6.9. However, not all incidents were reported with similar frequency. Only incidents that were collectively very serious were reported by nearly all respondents (Spearman rank order correlation coefficient = .94). Among worker characteristics, the worker's judgement of seriousness was the only predictor of reporting. CONCLUSION: The results suggest that beginning human service workers are unsure of their legal responsibility to report suspected maltreatment. The results also point to a need for closer collaboration between mandated reporters and child protective services.     

Factors associated with nurses' intention to report child abuse: a national survey of Taiwanese nurses

OBJECTIVE: The objectives were to determine the experiences of Taiwanese nurses with a new child abuse reporting law and to assess attitudinal correlates of nurses' intention to report. METHOD: A stratified quota sampling technique was used to select registered nurses working in pediatric, psychiatric and emergency care units in Taiwan. A total of 1400 (return rate 88%) questionnaires from 1617 nurses were used. The questionnaire includes demographic information, attitudes toward and knowledge of child abuse and reporting laws, and eight vignettes of child abuse. RESULTS:Most nurses (86%) said they had never reported a child abuse case; 21% said they had failed to report a suspected case of child abuse. Most (80%) had never had any child abuse education. About 75% felt their nursing education and in-service training was inadequate or absent. Most had an inadequate knowledge of the reporting law (mean score: 60% correct). Nurses only answered 17-43% of the law-related questions correctly. The majority accepted the professional responsibility to report. There were some differences among pediatric, psychiatric and emergency care nurses. In general, these Taiwanese nurses had negative attitudes toward corporal punishment and toward parents who abuse their children. The study also identified a variety of attitudes related to intention to report relevant to the Theory of Planned Behavior. CONCLUSIONS:Nurses accept responsibility for reporting but they believe their professional preparation for reporting is inadequate. There is a strong need for in-service and pre-service education about child abuse among nurses in Taiwan.     

Australian undergraduate primary school student‐teachers’ responses to child sexual abuse and its mandatory reporting

This study aims to understand how primary school teachers, as mandatory reporters of child sexual abuse, are responding to child sexual abuse and its mandatory reporting, even though many teachers do not receive a compulsory course in Child Protection and its legal requirements in their pre‐service university training. A cohort of 81 Australian final fourth‐year Bachelor of Education (Primary) student‐teachers was asked about four aspects of it. Qualitative data gathered from these student‐teachers’ questionnaires provide important insights into their knowledge of child sexual abuse; their knowledge of Department of Education policy on it; their professional competence in mandatory reporting of it; and their recommended educational and professional training in it. The results show that all of these student‐teachers feel inadequately prepared to address child sexual abuse and mandatory reporting in schools, being unaware of both knowledge of it and the Department’s policy, even though many recognise the gravity of sexual abuse for the child survivor and the need, and seriousness, of child protection. Finally, these student‐teachers all want better training about these issues during their four‐year degree. In conclusion, these results, and some recommendations, may provide a guide for curriculum planners to design compulsory and appropriate pre‐service university courses to enhance student‐teachers’ knowledge, skills and competencies about child sexual abuse and its mandatory reporting.     

General population norms about child abuse and neglect and associations with childhood experiences

BACKGROUND: A variety of definitions of child abuse and neglect exist. However, little is known about norms in the general population as to what constitutes child abuse and neglect or how perceived norms may be related to personal experiences. METHODS: We conducted a random-digit-dialed telephone survey of 504 Washington State adults. Respondents were asked whether they believed each of 34 behaviors, identified in focus groups as possibly physically, sexually or emotionally abusive or neglectful, constituted abuse or neglect. Then, they were asked whether they had experienced 33 of the behaviors. RESULTS: Five of the six behaviors with the highest levels of consensus were for sexual abuse, whereas only one emotionally abusive behavior had a high level of consensus (95% agreement). Consensus that spanking constituted abuse increased with severity. Those respondents who reported experiencing a particular behavior were significantly less likely to believe the behavior abusive for 11 of the 33 behaviors and more likely to believe the behavior abusive for two of the behaviors. Where comparisons were possible, there was a high level of consensus that behaviors identified as abusive in Child Protective Service operational definitions constituted abuse. CONCLUSIONS: Self-reported childhood experiences were associated with perceived norms about child abuse. A better understanding of community norms about child abuse and neglect may be helpful in communicating with the public or allow for better targeting of educational messages through the media, parenting education classes, and so forth.     

Countertransference and failure to report child abuse and neglect

Though every state has laws requiring the report of suspected child abuse and neglect, failure to report remains a significant problem. Review of previous research on failure to report suggests that the reporters' anxieties about disrupting their relationship with the child's family as well as the reporters' gender, experience, and training affect willingness to report. Countertransference fear, guilt, shame, and sympathy are discussed as a basis for understanding the reporter's anxieties. We suggest that countertransference issues should be addressed in the training and ongoing practice of mandated reporters. The following mechanisms are offered to deal with this issue in training and practice: (1) teaching professionals about how countertransference reactions may arise during the reporting process (this training may include the use of risk management groups for private practitioners); (2) identification of a community child abuse expert for consultation; and (3) educating child protection workers about psychodynamics aspects of case management.     

Pediatricians' knowledge, attitudes and experience regarding child maltreatment in Kuwait

OBJECTIVES: This cross-sectional survey was conducted to evaluate the awareness and actual professional experience of pediatricians in Kuwait regarding child maltreatment, a topic rarely explored in this part of the world. METHODS: Data were obtained from all pediatricians in public hospitals with pediatric emergency services using a structured detailed self-completed questionnaire. RESULTS: The experience of child neglect was more common than that of child abuse in the clinical practice of surveyed pediatricians. Fifty percent of 117 pediatricians (69% of all eligible) reported having encountered at least 1 case of abuse and up to 3 cases of neglect in the past year. Women and younger doctors more commonly recognized hypothetical situations as maltreatment, and believed child abuse and neglect as being common or very common in Kuwait. Other demographic or professional variables did not affect recognition of maltreatment. Participants would most likely alert social workers about suspected maltreatment cases. More than 80% did not know whether there is a legal obligation to report or which legal authorities should receive reports of suspected cases. DISCUSSION AND CONCLUSIONS: National ethical guidelines regarding reporting suspected cases of maltreatment must be established. Laws protecting maltreated children and reporting physicians must be immediately enacted. Additional training is required to help pediatricians, especially expatriates from other cultures, to diagnose with certainty cases of child maltreatment in their practice in Kuwait.     

Three models of child abuse consultations: A qualitative study of inpatient child abuse consultation notes

Child abuse pediatricians have multiple roles in caring for abused children, including prevention, diagnosis, treatment, and, when needed, expert legal opinion. The child physical abuse consultation differs from the traditional medical consultation in that it has medical, investigative and legal audiences, all of whom have different information needs. How child abuse pediatricians approach their cases and how they document their initial inpatient consultations that will be used by such a diverse audience is currently unexplored. We used content analysis to examine 37 child physical abuse consultation notes from a national sample of child abuse pediatricians in order to understand physicians’ approaches to these consultations. Three commonly used models of child physical abuse consultation were identified in the data that we named the base model, the investigative model, and the family-dynamic model. While model types overlap, each is distinguished by key features including the approach used to gather information, the information recorded, and the language used in documentation. The base model most closely mirrors the traditional medical approach; the investigative model concentrates on triangulation of sources of information; and, the family-dynamic model concentrates on physician perceptions of family relationships. The three models of consultations for child physical abuse mirror the areas of child abuse pediatrics: diagnostic, forensic and therapeutic. These models are considered in relationship to best practice from other medical specialties with forensic components.     

Overreporting and underreporting of child abuse: teachers' use of professional discretion

OBJECTIVE: According to mandatory reporting laws for professionals, the relationship between initial recognition that a child may have been abused and the subsequent reporting of that suspected case of child abuse to the responsible agency would, at first glance, appear to be clear. However, this relationship has developed into one of the major social policy controversies of the recent past. Our major goal is to present research findings that address this social policy debate concerning the problems of underreporting and overreporting, focusing specifically on teachers. METHOD: A factorial survey design, that combines the advantages of the factorial experiment with those of surveys, was employed in a probability sample of teachers (N=480) who responded to vignettes in which case characteristics were systematically manipulated. Teachers responded with judgments about whether the vignette was child abuse and the likelihood that they would report this suspected case. Characteristics of the teachers and their work setting (school) were also measured. RESULTS: When comparing the teachers' recognition and reporting scores, we found that they gave the same score for 63% of the vignettes they judged, gave higher reporting than recognition scores (overreporting) for 4% of the vignettes, and gave higher recognition than reporting scores (underreporting) for 33% of the vignettes. Discrepancies between recognition and reporting (over and under reporting) were related to characteristics of the case, teacher, and school where the teacher was employed. CONCLUSIONS: Teachers in our Ohio sample evidence the use of professional discretion in making judgments about the recognition and reporting of child abuse and do not appear to make these judgments with equal certainty. Their use of discretion is more likely to result in underreporting than overreporting.     

Attributions and discipline history as predictors of child abuse potential and future discipline practices

OBJECTIVES: We attempted to identify factors that can be applied in primary and secondary prevention programs and expand the understanding of why those who were not abused may engage in abusive behavior. The purpose of this research was to explore how young adults' attributions of whether they deserved their childhood discipline, as well as their abuse history, relate to physical child abuse potential and their discipline plans for their future children. METHOD: A sample of 140 non-parent college students were asked to report on their discipline history, perceptions of that discipline, child abuse potential, and expected discipline practices. An age range of 18-20 was targeted for multiple reasons, including the suitability of these young adults for primary and secondary prevention programs. RESULTS: Analyses revealed that both physical child abuse potential and future discipline practices were independently predicted by respondents' belief that they deserved their discipline in conjunction with the harshness of their childhood discipline. DISCUSSION: These results suggest that the attributions of self-blame held by young adults about their discipline experiences are significant for increasing physical abuse potential regardless of whether the individual reports a history of abuse.     

Listening to Children: A study of child and family services

This paper reports on child data generated in a pilot project of the ACCESS Study of Child and Family Services , an investigation of the degree to which child and family services meet user needs within local communities. Based on theoretical perspectives drawn from social capital theories, the pilot study was undertaken by a partnership of local early childhood services within the precinct of Queensland University of Technology, Brisbane (Australia) and included two childcare centres, two kindergartens/ preschools, one playgroup and one primary school. Seventy-six children aged 3-8 years were asked, in informal conversations with their caregivers, to comment on their experiences in the service and to consider possible advice they might give to children coming into the service. Theoretical perspectives from the sociology of childhood are used to examine children's accounts of their lived experience in early childhood services.     

Getting evidence into action to tackle institutional child abuse

The Australian Royal Commission into Institutional Responses to Child Sexual Abuse is an example of a government response to survivors’ demands to address the harm they suffered. It is also a major response by a national government to improve child safety in the future. Facing up to child abuse is difficult and in other countries similar inquiries have suffered delays and derailing. This commentary uses an evidence-to-action lens to explore why clear evidence of child sexual abuse may be ignored and side-lined. It argues that where evidence challenges the powerful, is surprising and shocking, or undercuts current institutional and policy arrangements, then that evidence is likely to be ignored, undermined or refuted – all factors which are present in the case of historical institutional child sexual abuse.     

Why is sexual abuse declining? A survey of state child protection administrators.

OBJECTIVES: Cases of substantiated sexual abuse have declined approximately 39% nationwide from 1992 to 1999, according to estimates from the National Child Abuse and Neglect Data System (NCANDS). Despite the dramatic nature of the decline, little discussion of the trend has occurred at either the national or the state level. Aims of the research were to: (1) gather state-level information about possible sources of the sexual abuse decline, (2) identify child protection trends that might be contributing to the decline, and (3) assess the level of awareness of the decline in state child protection offices. METHODS: Telephone interviews were conducted with child protection administrators in 43 states. RESULTS: More than half of the officials in states with large declines were unaware of any discussion of the declines within their agency or in the public at large within their state. State officials cited a diverse array of possible causes for the decline, including: (1) increased evidentiary requirements to substantiate cases, (2) increased caseworker caution due to new legal rights for caregivers, and (3) increasing limitations on the types of cases that agencies accept for investigation. More than half also mentioned the effectiveness of prevention programs, increased prosecution, and public awareness campaigns, implying that a portion of the decline may result from a real decline in occurrence. CONCLUSIONS: Responses from child protection officials have inherent biases, but they are useful in generating hypotheses for further study in trying to account for the decline. The results suggest that further discussion and increased analysis of child maltreatment system data are important next steps.     

A taxonomy of duties to report child sexual abuse: Legal developments offer new ways to facilitate disclosure

Background: Child sexual abuse is undisclosed for many reasons that are resistant to change. Citizens can play an important role in disclosing cases of child sexual abuse to authorities. Professionals who deal with children also play a crucial role. Office-holders in organisations have a clear responsibility to prevent cover-ups of sexual abuse. Recently, some countries have created important new legal duties for adults to disclose child sexual abuse.Objectives: This article creates a contemporary taxonomy of duties to disclose cases of child sexual abuse, and explains their nature and justification.Participants and setting: Citizens, professionals dealing with children in the course of their work, and managers of child and youth-serving organisations.Methods: Legal analysis created a taxonomy of reporting duties. Analysis of these duties from perspectives of criminal jurisprudence, public health law, children’s rights and ethics considered their justification.Results: Seven legal duties now exist, in criminal law, civil law and child protection law. Some apply to all citizens; others to managers in organisations; others to professionals dealing with children in the course of their work. All the duties are directed to early detection of cases; some are directed towards prevention; and some are focused on avoidance of institutional corruption.Conclusions: These developments represent historic progress in overcoming normally intractable barriers to disclosure of cases of child sexual abuse. New legal duties are consistent with principles from criminal jurisprudence, public health law, children’s rights and ethics. Where adopted, societies should ensure the creation and maintenance of ecological conditions in which these duties can be observed.     

Are researchers bound by child abuse reporting laws?

OBJECTIVE: To discuss issues concerning mandatory reporting of child abuse in research settings. METHOD: An overview of existing Federal and State statutes regarding mandatory reporting of child abuse is presented. A critical review of the literature addresses the following issues: (1) whether researchers have a moral duty to place the health and safety of children above concerns about confidentiality and the benefits of obtaining new knowledge; (2) whether the Certificate of Confidentiality preempts reporting requirements; (3) whether researchers who are not health professionals (such as child developmentalists, psychobiologists, neuroscientists) should be required to report; and (4) whether researchers should be required to expand their protocols to include more in-depth investigation of potential abuse. RESULTS: Existing child abuse reporting laws do not specifically designate researchers as among the category of individuals mandated to report suspected child abuse. Currently, Human Subject Protection Committees and Federal funding agencies are tending to interpret reporting laws as applying to researchers, including requiring that research subjects are informed of this responsibility in consenting procedures. It is unclear whether the Certificate of Confidentiality preempts child abuse reporting laws. CONCLUSION: The authors recommend that legislatures specifically designate researchers as mandated reporters to ensure more uniform reporting practices in research settings. For both investigators and Human Subject Protection Committees, inclusion of researchers among the categories of those mandated to report would also help address issues of immunity from civil and criminal liability for "good faith" reports that turn out to be false and injurious.     

A descriptive survey of Swedish child health nurses' awareness of abuse and neglect. I. Characteristics of the nurses

OBJECTIVE: The objectives were to assess: (1) child health nurses' identification of abuse/neglect of children of preschool age in their districts; (2) overall prevalence of abuse/neglect according to the nurses; (3) determinants of nurse identification; (4) determinants of nurse-reported district prevalences; and (5) determinants of reporting to the child protection services (CPS). METHOD: Questionnaires were mailed to about 3,000 child health centers. RESULTS: Fifty-five percent responded. Of these, 22% identified no case and 33% at least one (mostly five or fewer). The overall prevalence was 1.4%. Identification correlated with general participation rate in the county. Other determinants of identification were acquaintance with the district, large district populations, and three variables assumed to reflect a personal interest. Determinants of prevalences were small district populations, regular contacts with the social services, and two personal interest variables. With large district populations, identification increased, whereas prevalences decreased. Only 30.3% had made a report to the CPS. Regular contacts with the social services correlated with reporting. Personal interest was a determinant of the decision to report, and acquaintance with the district a determinant of reporting rate. CONCLUSIONS: Abuse and neglect did not appear as priorities for the Child Health Services. The method probably led to an underestimation of the true prevalence. Personal interest and social services contacts emerged as important determinants. However, the assumed criteria of "interest" were not validated. For effective identification, no nurse should be responsible for more than 400 to 500 children. Implications for practice and research are discussed.