Child Abuse Detection, Reporting and Treatment > Chapter 8 - Reporting Procedures

Chapter 8: Reporting Procedures

The previous chapter addressed many issues concerning mandatory reporting of child abuse and neglect. Still, there are some specific issues about reporting procedures that must be taken into account:

A) Among various personnel and staff members, who is the final shot-caller on who actually makes the report?

B) What kind of information should the report contain?

C) Is there a minimum age limit for making a report?
The different States may have differing protocols for reporting child abuse. For California, the requirement is to make a call immediately to an agency designated to receive Suspected Child Abuse Reports (SCAR), and submit the report in writing within 36 hours. Initial reports are typically made to Child Protective Services and/or law enforcement. Others to call, depending on the living situation of the children and those involved, may include probation departments, social services departments and/or Community Care Licensing. Some situations create complications of reporting, especially when the reporting party involves more than one individual. Written protocols and training become increasingly important for agencies in these situations. This includes Groups Home environments (addressed further below) and medical environments, as described in the following vignette:
Case Vignette

In a mostly-rural Western state, two pediatricians were involved in treating a five-year-old girl who had been brought to ERs and physicians a total of 302 times since birth by her natural mother. Both pediatricians treated the child for gastric complaints, intense vomiting episodes, frequent diarrhea, anorexia, failure to thrive, and general listlessness. One pediatrician began to suspect that the child was a victim of Munchausen’s Syndrome by Proxy, a condition that will be discussed later in the course in great detail. This pediatrician believed that the child’s mother was intentionally making the child ill to gain the attention and approval of medical professionals – a classic intention of Munchausen’s. The pediatrician discussed his suspicions with his fellow internal medicine pediatrician, who did not agree with these suspicions. Neither physician reported the matter to CPS. In the next six months, the child’s medical condition continued to worsen, not responding to medical treatment. She became so thin and dehydrated that her life was endangered. Finally, a pediatric nurse in the intensive care unit reported the case to CPS as a possible incident of Munchausen’s Syndrome by Proxy. Subsequent investigation revealed that the nurse’s suspicions were true; the child’s mother was arrested and convicted of aggravated child abuse. Both physicians were reprimanded by their state licensing boards and data concerning their failure to report suspected child abuse was entered into the National Practitioner’s Data Base.


This vignette illustrates several important reporting points. First, the pediatrician who initially suspected that the child was being abused should have reported the case to CPS regardless of the opinion of the disbelieving pediatrician. Reporting suspected child abuse and neglect is never a communal decision; one single mandatory reporter who, despite nay-saying from others, suspects that a child is being harmed must report the case. Conversely, the pediatrician who did not believe the child was being abused, but was informed of his colleague’s suspicions, should also have reported the case although he personally had no such suspicions. There is no medical diagnosis called “child abuse or neglect.” This is a determination that can be made only by a CPS worker or court personnel. For example, a medical diagnosis would be worded in this manner: “severe, persistent gastric distress of unknown etiology.” When this diagnosis appears over and over again for an extended period of time, it is time for a child’s physician to ask questions before that ugly word, “malpractice” is whispered. An easy way to remember this concept is by comparing it to a medical examiner’s differentiation between “manner of death” and “cause of death.” On a death certificate, the M.E. would list a child’s cause of death as “severe cranial hemorrhage” while the manner of death would be listed as either “homicide” or “accidental.”

There is no “final shot caller” as to which medical staff member should report suspicions of child abuse. In the vignette, it was the pediatric intensive care nurse who made the report; she consulted no one and required no one’s permission to make the report. As a mandatory reporter, for her to do otherwise would have been a serious ethical violation that could have resulted in the forfeiture of her license. The same would be true of a mental health technician who is not a clinician, but who conducts intake interviews and administers psychological testing. Regardless of the actions or wishes of the attending psychiatrist, this technician, like the X-Ray technician mentioned earlier, must report his/her suspicions.

When making a report of child abuse and neglect, oral or written, the reporter should give as much specific information as possible about the abuse or neglect incident(s): who was involved, when did the incidents happen, what exactly did the reporter see and/or hear, how many times did the alleged incident(s) occur, and what action, if any, has been taken on previous reports. Give the names of others to whom the suspicions were reported, such as CPS workers and healthcare providers, and law enforcement personnel. Write or say any and all information that may be even remotely helpful; let the CPS workers do their jobs and decide what is or is not relevant.

[QN.No.8.When making a report of possible child abuse or neglect:]
Another reporting issue that can arise is the age of the reporter. Can a minor report being abused or neglected, or another child whom he/she suspects is being victimized? Yes, under certain circumstances. Any child is able to tell an adult that he/she is being abused or neglected. That adult, in turn, should immediately report the case to CPS – not to the child’s parent(s). CPS workers and law enforcement personnel are adept is determining the sincerity of the child, whether the child understands what constitutes abuse and neglect, the child’s motive in making the report, and the child’s truthfulness. For example, in most states, spanking a child is not unlawful or abusive unless it is excessive as confirmed by eye-witness and/or medical reports. “Excessive” is most often defined as spanking that leaves visible marks, bruises or lacerations, and is most often caused by the use of a weapon such as a hairbrush, electrical cord, belt, or other instrument.

The best way for a mandated reporter or private citizen to learn more about reporting procedures is to read pamphlets often found in government health and children’s services offices, physicians’ offices, or on literally hundreds of Internet sites through any major search engine. Being informed is the best way to help a child; if in doubt, report!

Group Home Procedure for Child Abuse Reporting

For the safety and well-being of the students, and to protect the mission of the agency, it is important group homes have established protocols to ensure allegations of abuse are reported. Depending on the agencies you work with, a good rule of thumb to call a child abuse hotline if the allegation is toward a non-employee of the group home, and that the alleged abuse occurred at a location separate from the group home. If, however, the allegation is towards a group home staff, or a visiting parent, it may be best to call law enforcement, initially. You are also required to follow up in calls to placing agencies and community care licensing. 

Because of the extensive reporting requirements, written protocols need to be put in place as to who fills out the different reports (Suspected Child Abuse Reports, Speicail Incident Reports, etc.), and how are these alleged incidents communicated to administration. Adminstrators should be informed and make sure that all reports are completed and done correctly. It should be made clear to staff, that if they have a reasonable suspicion of abuse, they need to make the report, even if one above them on the Supervisory scale disagrees. Staff also need to know that these reports can be made confidentially, but that the group home has multiple reporting obligations, so information needs to be communicated to the administration so they can fulfill their duties.

 
Child Abuse Detection, Reporting and Treatment > Chapter 8 - Reporting Procedures
Page Last Modified On: April 18, 2015, 11:32 AM