Child Abuse Assessment and Reporting

 

By completing this course the healthcare professional will be able to:
1.  Describe the standard for making a report of child abuse.
2.  Describe and assess the signs and symptoms of child abuse.
3.  Identify mandated reporters.
4.  Describe child abuse services privileged communications including the disclosure of the reporter’s identity.
6.  Describe intervention techniques that minimize the trauma to abuse survivors and their families.

 

Duty to Report Child Abuse

All States, the District of Columbia, the Commonwealth of Puerto Rico, and the U.S. territories of American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands have statutes identifying mandatory reporters of child maltreatment. A mandatory reporter is a person who is required by law to make a report of child maltreatment under specific circumstances. Approximately 48 States, the District of Columbia, Puerto Rico, and the territories have designated individuals, typically by professional group, who are mandated by law to report child maltreatment. Individuals typically designated as mandatory reporters have frequent contact with children. Such individuals may include:

  • Social workers
  • Marriage Family Therapist
  • Psychologists
  • Interns
  • Counselors
  • School personnel
  • Health care workers
  • Mental health professionals
  • Childcare providers
  • Medical examiners or coroners
  • Law enforcement officers

Some other professions frequently mandated across the States include commercial film or photograph processors (in 11 States and 2 territories), substance abuse counselors (in 13 States), and probation or parole officers (in 13 States). Six States (Alaska, Arizona, Arkansas, Connecticut, Illinois, and South Dakota) include domestic violence workers on the list of mandated reporters. Members of the clergy now are required to report in 25 States.

Reporting by Other Persons

Approximately 18 States and Puerto Rico require all citizens to report suspected abuse or neglect, regardless of profession. In all other States, territories, and the District of Columbia, any person is permitted to report. These voluntary reporters of abuse are often referred to as "permissive reporters."

Standards for Making a Report

The standards used to determine under what circumstances a mandatory reporter should make a report vary from State to State. Typically, a report must be made when the reporter, in his or her official capacity, suspects or has reasons to believe that a child has been abused or neglected. Another standard frequently used is when the reporter has knowledge of, or observes a child being subjected to, conditions that would reasonably result in harm to the child. Permissive reporters follow the same standards when electing to make a report.

Privileged Communications

Mandatory reporting statutes also may specify when a communication is privileged. "Privileged communications" is the statutory recognition of the right to maintain the confidentiality of communications between professionals and their clients or patients. To enable States to provide protection to maltreated children, the reporting laws in most States and territories restrict this privilege for mandated reporters. All but 5 States and Puerto Rico currently address the issue of privilege within their reporting laws, either affirming the privilege or denying it, that is, not allowing privilege to be a reason for failing to report. The physician-patient and husband-wife privileges are most commonly denied by States. The attorney-client privilege is most commonly recognized. The clergy-penitent privilege is also widely recognized, although that privilege is usually limited to confessional communications and, in some States, is denied altogether.

Inclusion of the Reporter's Name in the Report

Most States maintain toll-free telephone numbers for receiving reports of abuse or neglect. Reports may be made anonymously to most of these reporting numbers, but States find it helpful to their investigations to know the identity of reporters. Approximately 16 States, the District of Columbia, American Samoa, Guam, and the Virgin Islands currently require mandatory reporters to provide their names and contact information, either at the time of the initial oral report or as part of the written report. The laws in Connecticut, Delaware, and Washington allow child protection workers to request the name of the reporter. In Wyoming, the reporter does not have to provide his or her identity as part of the written report, but if the person takes and submits photographs or x-rays of the child, his or her name must then be provided.

Disclosure of the Reporter's Identity

All jurisdictions have provisions in statute to maintain the confidentiality of abuse and neglect records. The identity of the reporter is specifically protected from disclosure to the alleged perpetrator in 39 States, the District of Columbia, Puerto Rico, and the territories of American Samoa, Guam, and the Northern Mariana Islands. This protection is maintained even when other information from the report is being disclosed.

Release of the reporter's identity can be allowed in some jurisdictions under specific circumstances or to specific departments or officials. For example, disclosure of the reporter's identity can be ordered by the court when there is a compelling reason to disclose (in California, Mississippi, Oklahoma, Tennessee, and Guam), or upon a finding that the reporter knowingly made a false report (in Alabama, Arkansas, Connecticut, Kentucky, Louisiana, Minnesota, South Dakota, and Vermont). In some jurisdictions (California, Florida, Minnesota, Vermont, the District of Columbia, and Guam), the reporter can waive confidentiality and give consent to the release of his or her name.

Below is a state by state list which includes the following:

Mandated Reporters

Standards for Making a Report

Privileged Communications

Inclusion of the Reporter's Name in the Report

Disclosure of the Reporter's Identity

Reporting by Other Persons

Before continuing please click on the following link to verify reporting laws in your state. click here. Because laws often change be sure to stay current with the Child Abuse reporting laws in your state.

Philosophy of Child Protective Services

The basic philosophical tenets of CPS include the following:

A safe and permanent home and family is the best place for children to grow up. Every child has a right to adequate care and supervision and to be free from abuse, neglect, and exploitation. It is the responsibility of parents to see that the physical, mental, emotional, educational, and medical needs of their children are adequately met. CPS should intervene only when parents request assistance or fail, by their acts or omissions, to meet their children's basic needs and keep them safe.

Most parents want to be good parents and, when adequately supported, they have the strength and capacity to care for their children and keep them safe. Most children are best cared for in their own family. Therefore, CPS focuses on building family strengths and provides parents with the assistance needed to keep their children safe so that the family may stay together.

Families who need assistance from CPS agencies are diverse in terms of structure, culture, race, religion, economic status, beliefs, values, and lifestyles. CPS agencies and practitioners must be responsive to and respectful of these differences. Further, CPS caseworkers should build on the strengths and protective factors within families and communities. They should advocate for families and help families gain access to the services they need. Often, securing access means helping families overcome barriers rooted in poverty or discrimination, such as readily accessible transportation to services.

CPS agencies are held accountable for achieving outcomes of child safety, permanence, and family well-being. To achieve safety and permanence for children, CPS must engage families in identifying and achieving family-level outcomes that reduce the risk of further maltreatment and ameliorate the effects of maltreatment that has already occurred.

CPS efforts are most likely to succeed when clients are involved and actively participate in the process. Whatever a caseworker's role, he or she must have the ability to develop helping alliances with family members. CPS caseworkers need to work in ways that encourage clients to fully participate in assessment, case planning, and other critical decisions in CPS intervention.

When parents cannot or will not fulfill their responsibilities to protect their children, CPS has the right and obligation to intervene directly on the children's behalf. Both laws and good practice maintain that interventions should be designed to help parents protect their children and should be as unobtrusive as possible. CPS must make reasonable efforts to develop safety plans to keep children with their families whenever possible, although they may refer for juvenile or family court intervention and placement when children cannot be kept safely within their own homes. To read more about the working relationship between CPS and the court system, please refer to the user manual on working with the courts.

When children are placed in out-of-home care because their safety cannot be assured, CPS should develop a permanency plan as soon as possible. In most cases, the preferred permanency plan is to reunify children with their families. All children need continuity in their lives, so if the goal is family reunification, the plan should include frequent visits between children and their families as well as other efforts to sustain the parent-child relationship while children are in foster care. In addition, the CPS agency must immediately work with the family to change the behaviors and conditions that led to the maltreatment and necessitated placement in out-of-home care.

To best protect a child's overall well-being, agencies want to assure that children move to permanency as quickly as possible. Therefore, along with developing plans to support reunification, agencies should develop alternative plans for permanence once a child enters the CPS system. As soon as it has been determined that a child cannot be safely reunited with his or her family, CPS must implement the alternative permanency plan.

Responsibilities of Child Protective Services

According to the National Association of Public Child Welfare Administrators (NAPCWA), the mission of the child protective services (CPS) agency is to:

  • Assess the safety of children;
  • Intervene to protect children from harm;
  • Strengthen the ability of families to protect their children;
  • Provide either a reunification or an alternative, safe family for the child.

CPS is the central agency in each community that receives reports of suspected child abuse and neglect; assesses the risk to and safety of children; and provides or arranges for services to achieve safe, permanent families for children who have been abused or neglected or who are at risk of abuse or neglect. The CPS agency also facilitates community collaborations and engages formal and informal community partners to support families and protect children from abuse and neglect. To fulfill its mission, CPS must provide services, either directly or through other agencies, which are child-centered, family-focused, and culturally responsive to achieve safety, well-being, and permanency for children. When families are unable or unwilling to keep children safe, CPS petitions juvenile or family court on the child's behalf either to recommend strategies to keep children safe at home or to be placed in out-of-home care.

This chapter provides an overview of the seven stages of the CPS process, which are described in more detail throughout the manual.

Intake

CPS is responsible for receiving and evaluating reports of suspected child abuse and neglect, determines if the reported information meets the statutory and agency guidelines for child maltreatment, and judges the urgency with which the agency must respond to the report. In addition, CPS educates individuals who report allegations of child abuse or neglect (frequently referred to as "reporters") about State statutes, agency guidelines, and the roles and responsibilities of CPS.

Initial Assessment or Investigation

After receiving a report, CPS conducts an initial assessment or investigation to determine:

  • If child maltreatment occurred;
  • If the child's immediate safety is a concern and, if it is, the interventions that will ensure the child's protection while keeping the child within the family or with family members (e.g., kinship care or subsidized guardianship), if at all possible;
  • If there is a risk of future maltreatment and the level of that risk;
  • If continuing agency services are needed to address any effects of child maltreatment and to reduce the risk of future maltreatment.

The terms "assessment" and "investigation" are used interchangeably in many States and territories, but they are not synonymous. Investigation encompasses the efforts of the CPS agency to determine if abuse or neglect has occurred. Assessment goes beyond this concept to evaluate a child's safety and risk, and to determine whether and what services are needed to ameliorate or prevent child abuse and neglect...

The initial assessment or investigation is not just a fact-finding process; it establishes the tone for all future work that may take place with a particular family. During the initial assessment or investigation, CPS must determine whether child abuse and neglect occurred and can be substantiated and whether to conduct an evaluation to determine the risk of maltreatment occurring in the future. CPS also must establish rapport with family members and engage them in the intervention process.

Family Assessment

Once a determination of child abuse or neglect has been made and the child's immediate safety has been ensured, the next step is to conduct a family assessment. During this step, the caseworker engages family members in a process to understand their strengths and needs. In particular, the caseworker works with the family to:

  • Identify family strengths that can provide a foundation for change;
  • Reduce the risk of maltreatment by identifying and addressing factors that place children at risk;
  • Help children cope with the effects of maltreatment.

Since the impact of child maltreatment depends on the interaction of risk and protective factors, using an ecological developmental framework for this assessment is often appropriate

Case Planning

In order to achieve the desired programmatic outcomes of CPS (i.e., child safety, child permanency, child and family well-being), interventions must be well planned and purposeful. These outcomes are achieved through three types of plans:

  • A safety plan, which is developed whenever it is determined that the child is at risk of imminent harm;

  • A case plan, which follows the family assessment and sets forth goals and outcomes and describes how the family will work toward these outcomes;

  • A concurrent permanency plan, which identifies alternative forms of permanency and addresses both how reunification can be achieved and how legal permanency with a new family might be achieved if reunification efforts fail.

All three plans should be developed collaboratively, when possible, among the CPS caseworker, the family, and community professionals who will provide services to the family.

Service Provision

This is the stage during which the case plan is implemented. It is CPS's role to arrange, provide, and coordinate the delivery of services to children and families. When possible, the services that are selected to help families achieve goals and outcomes should be based on an appropriate match of services to goals and should use best practice principles. When needed services are not readily available or accessible, an interim or alternative plan must be made with families.

Family Progress

Assessment is an ongoing process that begins with the first client contact, continues throughout the life of the case, and should incorporate reports from other service providers. When evaluating family progress, caseworkers focus on:

  • Ensuring the child's safety;
  • Reducing the risk of maltreatment;
  • Addressing successfully any of the effects of maltreatment on the child and family;
  • Achieving the goals and tasks in the case plan;
  • Achieving family-level outcomes.

Case Closure

The process of ending the relationship between the CPS worker and the family involves a mutual review of the progress made throughout the helping relationship. Optimally, cases are closed when families have achieved their goals and the risk of maltreatment has been reduced or eliminated.

Some closings occur because the client discontinues services, and the agency does not have a sufficient basis to refer the situation to juvenile or family court. Other cases are closed, however, when families still need assistance. When this happens, the caseworker should carefully document what risks may still be present so this information is available should the family be referred to the agency at a later time. At the time of closure, workers should involve the family in a discussion about what has changed over time and what goals they may still have. When family needs are still apparent and are outside the scope of the CPS system, every effort should be made to help the family receive services through appropriate community agencies.

Intake

Intake is the first stage of the child protective services (CPS) process and is one of the most important decision-making points in the child protection system. It is the point at which reports of suspected child abuse and neglect are received. Information gathered by caseworkers is used to make decisions regarding safety (e.g., Is the child at risk of imminent harm?), risk (e.g., What is the likelihood that maltreatment will occur sometime in the future?), and the type of CPS response required. At intake, caseworkers also perform a critical public relations function by responding professionally and sensitively to the concerns raised by community professionals and citizens, and by clarifying the role of the agency regarding referrals of suspected abuse or neglect. Referrals are accepted from all sources, and each report is treated as a potential case of child maltreatment.

Intake Process

Specific guidelines for conducting the intake process vary from State to State and community to community. In general, caseworkers must:

  • Gather sufficient information from the reporter and agency records to be able to:

    Identify and locate the children and the parents or primary caregiver;
    Determine if the report meets the statutory and agency guidelines for child maltreatment;
    Assess whether the child is safe;
    Evaluate the motives of the reporter.

  • Provide support and encouragement to the reporter by:

    Explaining that the purpose of CPS is to protect children and strengthen families;
    Emphasizing the importance of reporting and explaining the process in which the report will be tracked;
    Describing the types of cases accepted by CPS as well as the types of information needed from the reporter;
    Responding sensitively to the fears and concerns of the reporter;
    Discussing the State's regulations regarding confidentiality, including the circumstances under which a reporter's identity may be revealed (e.g., if required by court action in a particular case).

  • Handle emergency situations such as:

    Calming the caller;
    Determining how to meet the immediate needs of the child and family being reported.

  • Check agency records and the State's central registry (if appropriate) to determine if the family or child is known or has been reported to the agency previously.

Gathering Information from Reporters

The more comprehensive the information provided by the reporter, the more experienced caseworkers are able to determine the appropriateness of the report for CPS intervention; whether the child is safe; and the urgency of the response needed. State and local child protection agencies have guidelines for information-gathering at intake. In general, caseworkers should obtain information on:

  • The contact information for the child and family, which helps to locate the child and family and determine if the child is at immediate risk of harm;

  • The alleged maltreatment, including type, nature, severity, chronicity, and where it occurred;

  • The child, including the child's condition and behavior, which helps in evaluating whether the child is in immediate risk of harm or danger and determining the urgency and type of the response;

  • The parent or caregiver, including their emotional and physical condition, behavior, history, view of the child, child-rearing practices, and relationships outside the family;

  • The family, including family characteristics, dynamics, and supports.

More detailed information that should be collected from the reporter within each of these areas. Although not every reporter will have all the information described, it is important to attempt to gather it to guide the investigation and ensure the appropriate decisions at intake. This may be the only opportunity the agency has to talk with the reporter.

Gathering this detailed information is essential to determine if the child is safe and how quickly contact with the family must be made to assure safety. It also enables caseworkers to identify the victim, the parent or caregiver, and the maltreater (if different from the parent or caregiver), and to determine how to locate them so that the initial assessment or investigation can be conducted. In addition, information from the reporter may identify other possible sources of information about the family and the possibility of past, current, or future abuse or neglect. Finally, it will assist the caseworker responsible for the initial assessment or investigation in planning the approach to the investigation in an accurate and effective manner.

Providing Support to Reporters

Reports of child abuse and neglect are most often initiated by telephone and may come from any number of sources. Each reporter should be given support and encouragement for making the decision to report. In addition, the reporter's fears and concerns should be elicited and addressed. These can range from fear that the family will retaliate to fear of having to testify in court.

It is often very difficult for the reporter to make the call. The telephone call usually comes after much thought has been given to the possible consequences to the child and family. More than likely, the reporter has considered that it would be easier just to do nothing or that the CPS system may not be able to help the family. It may be difficult for a reporter to think that this call will actually help the family rather than hurt it. Simple verbal reassurances or a follow-up letter that expresses the agency's gratitude to the reporter for taking the initiative to call can make the difference in the reporter's future willingness to cooperate.

Intake Information Analysis

Upon receiving a referral, the intake worker or caseworker attempts to gather as much information as possible about each family member; the family as a whole; and the nature, extent, severity, and chronicity of the alleged child maltreatment. Once the initial intake information is collected, the caseworker conducts a check of agency records or, in some States, a central registry to determine any past reports or contact with the family. Then the caseworkers must collect and analyze the information and determine if it meets the following criteria.

Statutory and Agency Guidelines

This determination is made by comparing the data collected to State law regarding the definition of child abuse and neglect and the requirements for State or county response; agency policies interpreting the laws and practice standards; agency or office customs regarding further refinement of definitions; required response times; and practical issues, such as jurisdictional authority or caseload management.

Credibility

An essential step in the intake process is determining the consistency and accuracy of the information being reported. In some locations, the intake workers take all reports and the investigator determines the credibility of the report; in other locations, the intake workers determine the credibility of the report. Sometimes caseworkers question the validity of the report suspecting it may be influenced by a contentious divorce, custody battle, or bad neighbor relationships. Regardless of suspicions about the motives of the reporter, if the allegations meet the statutory and agency guidelines, the case must be accepted.

A number of questions will help caseworkers evaluate the credibility of the report:

  • Is the reporter willing to give his or her name, address, and telephone number?
  • What is the reporter's relationship to the victim and family?
  • How well does the reporter know the family?
  • Does the reporter know of previous abuse or neglect? What has led him or her to report now?
  • How does the reporter know about the case?
  • Does the reporter stand to gain anything from reporting?
  • Has the reporter made previous unfounded reports on this family?
  • Is the reporter willing to meet with a caseworker in person if needed?
  • Does the reporter appear to be intoxicated, extremely bitter, angry, or exhibiting behavior that makes the caseworker question his or her competency?
  • Can or will the reporter refer CPS to others who know about the situation?
  • What does the reporter hope will happen as a result of the report?
  • Does the reporter fear reprisal from family?
  • Does the reporter fear self-incrimination? For example, due to substance-abusing behavior or participation in physically abusive behavior.

When an Initial Assessment or Investigation Is Warranted

One of the primary decisions in the intake process is whether or not to accept a report for a CPS investigation. This decision is based on the law, agency policy, and information about the characteristics of the case that are likely to indicate, or result in, harm to the child. The appropriateness of this decision depends on the ability of the caseworker to gather critical and accurate information about the family and the alleged maltreatment and to apply law and policy to the information gathered.

States have different criteria and tools for acceptance of the report. Some of the steps caseworkers should take in making this decision include:

  • Referring to State law. The law defines what is considered child maltreatment under State statutes. These definitions are the caseworkers' ultimate source of guidance.

  • Reviewing agency policies. Agency policies include State and local guidelines. They may have additional information regarding definitions and how to respond to different types of reports.

  • Discussing with the supervisor how these guidelines are implemented in the office. Sometimes customs develop among caseworkers or units that may not reflect agency guidelines. This often occurs as a result of many years of practice and improvisation over time. Unfortunately, these adaptations to circumstances may lead caseworkers away from carrying out their mandated responsibilities.

Whether to accept a case for initial assessment or investigation or to refer it to other community agencies depends on the following:

  • If the child appears to be at risk of harm due to circumstances other than direct parental or caregiver maltreatment, are there other agencies that can intervene quickly enough to guard the safety of the child? For example, in cases of partner abuse with the child in the home, the police are often the most appropriate first responders. CPS also may need to be involved if it is determined that there is potential for harm to the child.

  • Problems that may be more appropriately served by other agencies include parental substance abuse, parental or child physical or mental illness, developmental disability, lack of resources to meet basic needs, lack of information about appropriate parenting, lack of sufficient support systems during a crisis, lack of daycare, the child's constant truancy, or severe learning problems that do not endanger the child.

  • The circumstances that could result in imminent danger to the child should be determined, as well as whether a referral to an appropriate agency will ensure service delivery; whether the connection between appropriate services and the family is so tenuous that the child may not receive the needed intervention, thereby requiring protective intervention; or whether an initial report focused on the need for other services is masking other, more serious, dangers to the child.

This decision is based on having accurate and comprehensive information as well as the ability of the worker to assess and use the information to develop a clear picture of the situation and to apply the law and policy to the case. Agency screening tools can be helpful in making this decision.

Immediate Risk

Determining the urgency of the response to the report is essential to the safety assessment. CPS's primary concern should be to establish whether the child is safe, pending a face-to-face contact by the agency or another professional trained in assessing safety. Many States have their own criteria for response times based on the nature of the report. The criteria considered are the level of severity of the incident or the harm to the child, the person responsible for the alleged abuse or neglect, and the family's situation.

Response Time

Once it has been determined that an initial assessment or investigation is warranted, the next step is to determine the safety of the child and how quickly CPS must respond to the case. Many States have their own criteria for response times based on the nature of the maltreatment and the family situation.

The following factors generally are used by CPS agencies to distinguish between reports that require an immediate response, reports requiring a response within 24 hours, and reports that require a CPS response but do not involve immediate or continuing danger of serious harm to the child. CPS should respond immediately when:

  • The child's injury is severe or the alleged maltreatment could have resulted in serious harm—for example, shooting a gun, pushing a child down the stairs, locking a child in a small enclosed space, not providing enough food to eat over an extended period of time, or locking a toddler out of the house without supervision.

  • The child is particularly vulnerable because of age, illness, disability, or proximity to the alleged perpetrator, or the child is a danger to himself or herself, or others.

  • The behavior of the parent or caregiver, including an inability to take care of the child, is known to have caused harm or endangered the child or others. Or the behavior of the parent or caregiver is unpredictable and could result in serious harm to the child.

  • There is no person who is able and willing to act on the child's behalf in the time that is required to keep the child safe long enough for CPS to intervene within normal time frames.

  • The family is likely to flee the area with the child or abandon the child.

  • The report involves child sexual abuse, and the child continues to have contact with the alleged perpetrator.

  • The child has current physical injuries that need to be documented, such as photographing injuries or measuring bruises.

Case Examples

The caseworker must examine the total picture to evaluate if there is a clear opportunity for the child to be seriously harmed if there is no immediate intervention. To determine how quickly the agency must respond to a particular case, caseworkers must consider the factors that individually present a risk to the child, as well as any factors (such as domestic violence or substance abuse) that in combination present an even greater risk to the child. The presence of several factors and one or more combinations of factors requires an immediate response by CPS.

Case Examples

A Case Requiring an Immediate CPS Response:

A single mother who has been diagnosed as having paranoid schizophrenia is having delusions of killing her 6-month-old infant. The mother stopped taking her medication (often required when pregnant) and has been drinking heavily. The community psychiatric nurse who has been visiting the home weekly was told by the mother never to come back.

A Case Requiring a CPS Response Within 24 Hours:

A daycare provider reports a 3½-year-old child because he has bruises and welts on his buttocks. The child provides three different stories of how they occurred, none of which seem plausible. There are no previous reports of maltreatment and the daycare provider who has been caring for this child for 18 months has never seen bruises before. The daycare provider reports that the mother drops off and picks up the son. The child is very active, difficult to manage, and has attempted to hurt other children.

A Case Not Requiring a CPS Response Within 24 Hours:

During the first 3 months of school, the children of a single mother were absent over one-half of the days. When the 7-year-old girl and 10-year-old boy do come to school, they have severe body odor and dirty clothes. The school nurse treated the children for lice and scabies, and the 7-year-old falls asleep in class. The school has contacted the mother, who has not followed through with any of her commitments regarding the children.

Initial Assessment or Investigation Decisions

To make effective decisions during the initial assessment or investigation process, the CPS caseworker must have competent interviewing skills; be able to gather, organize, and analyze information; and arrive at accurate conclusions. Critical decisions that must be made at this stage of the CPS process include the following:

  • Is child maltreatment substantiated as defined by State statute or agency policy?
  • Is the child at risk of maltreatment, and what is the level of risk?
  • Is the child safe and, if not, what type of agency or community response will ensure the child's safety in the least intrusive manner?
  • If the child's safety cannot be assured within the family, what type and level of care does the child need?
  • Does the family have emergency needs that must be met?
  • Should ongoing agency services be offered to the family?

Decision Point One: Substantiating Maltreatment

The substantiation decision depends on the answers to two questions: "Is the harm to the child severe enough to constitute child maltreatment?" and "Is there sufficient evidence to support this being a case of child maltreatment?" Even in those cases lacking evidence, CPS caseworkers should still document information since unsubstantiated reports may eventually show a pattern that can be substantiated. Due to varying State regulations regarding the expungement of records, this may not be possible for all agencies.

Upon completion of the initial assessment, the caseworker must determine the disposition of the report based on State laws, agency guidelines, and the information gathered. CPS agencies use different terms for this decision—substantiated, confirmed, unsubstantiated, founded, or unfounded. To guide caseworker judgment in making the substantiation decision, each State has developed policies that outline what constitutes credible evidence that abuse or neglect has occurred. Most States have a two-tiered system: substantiated-unsubstantiated or founded-unfounded. Some States have a three-tiered system of substantiated, indicated, or unsubstantiated. The indicated classification means the caseworker has some evidence that maltreatment occurred, but not enough to substantiate the case.

At this point in the decision-making process, caseworkers should ask themselves:

  • Have I obtained enough information from the children, family, and collateral contacts to adequately reach a determination about the alleged abuse or neglect?
  • Is my decision on substantiation based upon a clear understanding of State laws and agency policies?
  • Have I assessed the need for other agency or community services when CPS intervention is not warranted?

The following sections discuss substantiation decisions for different types of maltreatment—child neglect, physical abuse, sexual abuse, and psychological maltreatment.

Determining Child Neglect

Determining child neglect is based on the answers to two questions: "Do the conditions or circumstances indicate that a child's basic needs are unmet?" and "What harm or threat of harm may have resulted?" Answering these questions requires sufficient information to assess the degree to which omissions in care have resulted in significant harm or significant risk of harm. Unlike the other forms of maltreatment, this determination may not be reached by looking at one incident; the decision often requires looking at patterns of care over time. The analysis should focus on examining how the child's basic needs are met and identifying situations that may indicate specific omissions in care that have resulted in harm or the risk of harm to the child.

Affirmative answers to the following questions may indicate that a child's physical and medical needs are unmet:

  • Have the parents or caregivers failed to provide the child with needed care for a physical injury, acute illness, physical disability, or chronic condition?
  • Have the parents or caregivers failed to provide the child with regular and ample meals that meet basic nutritional requirements, or have the parents or caregivers failed to provide the necessary rehabilitative diet to the child with particular health problems?
  • Have the parents or caregivers failed to attend to the cleanliness of the child's hair, skin, teeth, and clothes? It is difficult to determine the difference between marginal hygiene and neglect. Caseworkers should consider the chronicity, extent, and nature of the condition, as well as the impact on the child.
  • Does the child have inappropriate clothing for the weather and conditions? Caseworkers must consider the nature and extent of the conditions and the potential consequences to the child.
  • Does the home have obvious hazardous physical conditions? For example, homes with exposed wiring or easily accessible toxic substances.
  • Does the home have obvious hazardous unsanitary conditions? For example, homes with feces- or trash-covered flooring or furniture.
  • Does the child experience unstable living conditions? For example, frequent changes of residence or evictions due to the caretaker's mental illness, substance abuse, or extreme poverty?
  • Do the parents or caregivers fail to arrange for a safe substitute caregiver for the child?
  • Have the parents or caregivers abandoned the child without arranging for reasonable care and supervision? For example, have caregivers left children without information regarding their whereabouts?

While State statutes vary, most CPS professionals agree that children under the age of 8 who are left alone are being neglected. It is also agreed that children older than 12 are able to spend 1 to 2 hours alone each day. In determining whether neglect has occurred, the following issues should be considered, particularly when children are between the ages of 8 and 12:

  • The child's physical condition and mental abilities, coping capacity, maturity, competence, knowledge regarding how to respond to an emergency, and feelings about being alone.
  • Type and degree of indirect adult supervision. For example, is there an adult who is checking in on the child?
  • The length of time and frequency with which the child is left alone. Is the child being left alone all day, every day? Is he or she left alone all night?
  • The safety of the child's environment. For example, the safety of the neighborhood, access to a telephone, and safety of the home.

Determining Physical Abuse

In determining whether physical abuse occurred, the key questions to answer are "Could the injury to the child have occurred in a nonabusive manner?" and "Does the explanation given plausibly explain the physical findings?" The caseworker must gather information separately from the child, the parents, and other possible witnesses regarding the injuries. The following questions may help determine if abuse occurred:

  • Does the explanation fit the injury? For example, the explanation of a baby falling out of a crib is not consistent with the child having a spiral fracture. It is important to know the child's age and developmental capabilities to assess the plausibility of some explanations. It is also crucial to receive input from medical personnel and exams.

  • Is an explanation offered? Some caregivers may not offer an explanation, possibly due to denial or an attempt to hide abuse.

  • Is there a delay in obtaining medical care? Abusive caregivers may not immediately seek medical care for the child when it is clearly needed, possibly to deny the seriousness of the child's condition, to try to cover up the abuse, or in hope that the injury will heal on its own.

Caseworkers must also examine the nature of the injury, such as bruises or burns in the shape of an implement, e.g., a welt in the shape of a belt buckle or a cigarette burn.

Determining Sexual Abuse

In addition to the factors mentioned in determining physical abuse, the caseworker should ask the following questions to determine whether sexual abuse has occurred:

  • Who has reported that the child alleges sexual abuse? For example, caseworkers should be alert to separated or divorced parents making allegations against each other.
  • What are the qualifications of the professional reporting the physical findings? For example, if the health care providers do not routinely examine the genitalia of young children, they may mistake normal conditions for abuse or vice versa.
  • What did the child say? Did the child describe the sexual abuse in terms that are consistent with their developmental level? Can the child give details regarding the time and place of the incident?
  • When did the child make a statement or begin demonstrating behaviors suspicious of sexual abuse and symptoms causing concern? Was the child's statement spontaneous? Has the child been exposed to adult sexual acts?
  • Where does the child say the abuse took place? Is it possible for it to have occurred in that setting? Is it possible that the child is describing genital touching that is not sexual in nature? For example, bathing the child.

Determining Psychological Maltreatment

Psychological maltreatment has been given relatively little serious attention in research and practice until recently. There are many reasons for this, including problems with inadequate definitions, failure to establish cause-and-effect relationships, and the difficulty of clarifying the cumulative impact of psychological maltreatment. In order to determine if psychological maltreatment or emotional abuse occurred, caseworkers must have information on the caregiver's behavior over time and the child's behavior and condition. Caseworkers must determine whether there is a chronic behavioral pattern of psychological maltreatment, such as caregivers who place expectations on the child that are unrealistic for the child's developmental level, threaten to abandon the child, or direct continually critical and derogatory comments toward the child. There also must be indicators in the child's behavior suggestive of psychological maltreatment; however, the child's behavior alone is often insufficient to substantiate a case. Caseworkers must determine whether the child has suffered emotional abuse. The following questions may help determine if psychological maltreatment has occurred:

  • Is there an inability to learn not explained by intellectual, sensory, or health factors?
  • Is there an inability to build or maintain satisfactory interpersonal relationships with peers or adults?
  • Are there developmentally inappropriate behaviors or feelings in normal circumstances?
  • Is there a general pervasive mode of unhappiness, depression, or suicidal feelings?
  • Are there physical symptoms or fears associated with personal or school functioning, such as bedwetting or a marked lack of interest in school activities?

Demonstrating a causal connection between the caregiver's behavior and the child's behavior is often difficult to substantiate. This minimally necessitates that the caseworker observe caregiver-child interaction on several occasions, as well as be informed from other sources' observations (e.g., school personnel, relatives, and neighbors).

Decision Point Two: Assessing Risk

Risk factors are influences present in the child, the parents, the family, and the environment that may increase the likelihood that a child will be maltreated. Risk assessment involves evaluating the child and family's situation to identify and weigh the risk factors, family strengths and resources, and agency and community services. While risk assessment has been an integral part of CPS since the field's inception, the formalization of the process and decision-making, through the development of risk assessment instruments, has taken place just within the last 12 to 15 years.

This section describes risk assessment models and its key elements, the analysis of risk assessment information, special cases of risk assessment (when substance abuse or domestic violence coexist with maltreatment), and cultural factors for consideration.

Risk Assessment Models

The majority of States use risk assessment models or systems that are designed to:

  • Guide and structure decision-making;
  • Predict future harm and classify cases;
  • Aid in resource management by identifying service needs for children and families served;
  • Facilitate communication within the agency and with other community stakeholders.

Additional detail of the types of risk assessment information in each area.


Risk Assessment Information

Maltreatment

  • Caregiver actions and behaviors responsible for the maltreatment
  • Duration and frequency of the maltreatment
  • Physical and emotional manifestations in the child
  • Caregiver's attitude toward the child's condition and the assessment process
  • Caregiver's explanation of the events and effects of the maltreatment

Child

  • Age
  • Developmental level
  • Physical and psychological health
  • Temperament
  • Behavior
  • Current functioning
  • Child's explanation of events and effects, if possible and appropriate

Caregiver(s)

  • Physical and mental health
  • History
  • Current functioning
  • Coping and problem-solving capacity
  • Relationships outside of the home
  • Financial situation

Family Functioning

  • Power and issues of control within the family
  • Interactions and communications among family members
  • Interactions and connections with others outside the family
  • Quality of relationships
  • Problem-solving ability

Analysis of Risk Assessment Information

Caseworkers analyze the information collected to determine what information is significant as it relates to the risk of maltreatment. The following are suggested steps for assessing risk:

  • Organize the information by defined category (e.g., education level, stressors);
  • Determine if there is sufficient and believable information to confirm the risk factors, strengths and resources, and their interaction;
  • Use the risk model to assign significance to each of the risk factors and strengths.

The caseworker groups this information into an overall picture of the family and its dynamics and analyzes it to assess the current level of risk of maltreatment. This dictates the next steps in service provision and interaction with the family.

Risk Assessment in Cases of Substance-Abusing Families

Risk assessment in these cases also examines the extent of substance use, its impact on lifestyle, and its impact on parenting. The following scales are often used to assess risk in families where there is substance abuse:

  • Parent's commitment to recovery. This scale assesses a parent's stage of recovery, willingness to change behavior, and desire to live a life free from alcohol and other drugs.
  • Patterns of substance use. This scale assesses the parent's pattern of alcohol and other drug use—ranging from active use without regard to consequences to significant periods of abstinence.
  • Effects of substance use on child caring. This scale assesses the parent's ability to care for his or her children and meet their emotional and physical needs.
  • Effects of substance use on lifestyle. This scale assesses a parent's ability to carry out his or her everyday responsibilities and any consequences that may have for the family.
  • Support for recovery. This scale assesses parent's social network and how that network may support or interfere with recovery.

The Child Welfare League of America (CWLA) suggests some questions caseworkers can ask regarding alcohol and other drug abuse to facilitate risk assessment in these cases:

  • Do you use any drugs other than those prescribed by a physician?
  • Have you ever felt you should cut down on your drinking or drug use?
  • Has a physician ever told you to cut down or quit the use of alcohol or drugs?
  • Have people annoyed you by criticizing or complaining about your drinking or drug use?
  • Have you ever felt bad or guilty about your drinking or drug use?
  • Have you ever had a drink or drug in the morning ("eye opener") to steady your nerves or to get rid of a hangover?
  • Has your drinking or drug use caused a family, job, or legal problem?
  • When drinking or using drugs, have you had a memory loss or blackout?

Risk Assessment in Cases in Which Partner Abuse and Child Maltreatment Coexist

The following factors should be considered to assess risk in cases where partner abuse and child abuse and neglect coexist:

  • An abuser's access to the child or adult victim

  • The abuser's pattern of abuse
      -   Frequency or severity of the abuse in current and past relationships
      -   Use and presence of weapons
      -   Threats to kill the victim or other family members
      -   Stalking or abduction
      -   Past criminal record
      -   Abuse of pets
      -   Child's exposure to violence

  • The abuser's state of mind
      -   Obsession with the victim
      -   Jealousy
      -   Ignoring the negative consequences of the violence
      -   Depression or desperation

  • Individual factors that reduce the behavioral controls of either the victim or abuser
      -     Abuses alcohol or other substances
      -     Uses certain medications
      -     Suffers from psychosis or other major mental illnesses
      -     Suffers from brain damage

  • A victim, child, or abuser thinking about or planning suicide

  • An adult victim's use of physical force or emotional abuse

  • A child's use of violence

  • Situational factors
    Presence of other major stresses, such as poverty, loss of a job, or chronic illness
    Increased threat of violence when victim leaves or attempts to leave abuser
    Increased risk when abuser has ongoing or easy access to victims
    Physical inability of nonabusing parent to protect child due to assault
    Nonabusing parent's fear of leaving or inability to leave due to economic status or lack of place to go

  • Past failures of response systems (e.g., courts, law enforcement) to react appropriately.

The following are areas to assess with a child regarding partner abuse and child maltreatment:

  • Pattern of the abusive conduct. What happens when your parents (the adults) fight? Does anyone hit, shove, or push? Are serious threats made? Does anyone throw things or damage property? Has anyone used a gun or knife? When was the last big fight between your parents?

  • Impact of domestic violence on the adult victim. Has anyone been hurt or injured? Is your mom or dad afraid? How do your parents act after a bad fight? Have you ever seen the police or anyone come over because of their fights? Have you seen injuries or damaged property?

  • Impact of domestic violence on the child. Have you ever been hurt by any of their fights? What do your brothers or sisters do during fights? Are you ever afraid when your parents fight? How do you feel during a fight? After the fight? Do you worry about the violence? Do you talk to anyone about the fights? Do you feel safe at home? Have you ever felt like hurting yourself or someone else?

  • Child's protection. Where do you go during their fights? Have you tried to stop a fight? Have you ever had to take sides? In an emergency for your parent or yourself, what would you do? Who would you call? Have you ever called for help? What happened?

  • Child's knowledge of danger. Has anyone needed to go to a doctor after a fight? Do the adults use guns or knives? Do you know where the gun is? Has anyone threatened to hurt someone? What did the person say?

Cultural Factors in Risk Assessment

Caseworkers should integrate cultural sensitivity into the risk assessment process by:

  • Considering the family's cultural identification and perception of the dominant culture;
  • Inquiring about the family's experience with mainstream institutions, including CPS and other service providers in the community;
  • Assuring clarity regarding language and meanings in verbal and nonverbal communication;
  • Understanding the family's cultural values, principles of child development, child caring norms, and parenting strategies;
  • Gaining clarity regarding the family's perceptions of the responsibilities of adults and children in the extended family and community network;
  • Determining the family's perceptions of the impact of child abuse or neglect;
  • Assessing each risk factor with consideration to characteristics of the cultural or ethnic group;
  • Considering the child and family's perceptions of their response to acute and chronic stressors;
  • Explaining why a culturally accepted behavior in the family's homeland may be illegal here.

Decision Point Three: Determining Child Safety

A child is considered unsafe when he or she is at imminent risk of serious harm. Safety is an issue throughout the life of a case. The Adoption and Safe Families Act (ASFA) requires that States assess and assure a safe environment for children in birth families, out-of-home placements, and adoptive homes. It is important to remember that determining the risk of maltreatment and the child's safety are two separate decisions. Children may be at risk of harm some time in the future (risk assessment) and they may currently be safe (no threat of imminent serious harm). The following sections describe the key safety decision points, the steps for arriving at the safety decision, and the development of a safety plan.

Safety Decision Points

There are two key decision points during the initial assessment or investigation in which the child's safety is evaluated. During the first contact with the child and family, the caseworker must decide whether the child will be safe during the initial assessment or investigation. The question caseworkers must ask themselves is, "Is the child in danger right now?" Caseworkers assess current danger by searching for factors in the family situation and caregiver behavior or condition, including emotions, physical circumstances, and social contexts. Examples include: young children with serious injuries that are inconsistent with the caregiver's explanation; children in the care of people who are out of control or violent; and premeditated maltreatment or cruelty.

The second critical time for evaluating safety is at the conclusion of the initial assessment. This safety assessment follows the determination of the validity of the report and the level of risk. Caseworkers must determine:

  • Whether the child will be safe in his or her home with or without continuing CPS services;
  • Under what circumstances a case can be diverted to community partners;
  • Under what circumstances intensive, home-based services are necessary to protect a child;
  • Whether the child needs to be placed in out-of-home care.

To determine safety at this point, the caseworker uses the findings of the risk assessment. The caseworker identifies the risk factors that directly affect the safety to the child; the risk factors that are operating at a more intense, explosive, immediate, or dangerous level; or those risk factors that in combination present a more dangerous mix. The caseworker weighs the risk factors directly affecting the child's safety against the family protective factors (i.e., strengths, resiliencies, resources) to determine if the child is safe.

Steps for Arriving at the Safety Decision

The sequential steps for arriving at the safety decision include:

  1. Identifying the behaviors and conditions that increase concern for the child's safety, and considering how they affect each child in the family.
  2. Identifying the behaviors or conditions (i.e., strengths, resiliencies, resources) that may protect the child.
  3. Examining the relationship among the risk factors. When combined, do they increase concern for safety?
  4. Determining whether family members or other community partners are able to address safety concerns without CPS intervention.
  5. Considering what in-home services are needed to address the specific behaviors or conditions for each risk factor directly affecting the child's safety.
  6. Identifying who is available (CPS or other community partners) to provide the needed service or intervention in the frequency, time frame, and duration the family needs to protect the child.
  7. Evaluating the family's willingness to accept and ability to use the intervention or service at the level needed to protect the child.

If the services or interventions are not available or accessible at the level necessary to protect the child, or if the caregivers are unable or unwilling to accept the services, the caseworker should consider whether the abusive caregiver can leave home and the nonoffending caregiver can protect the child. If not, the caseworker should consider whether out-of-home care and court intervention is needed to assure the child's protection.

Development of a Safety Plan

The safety plan and the case plan have two different purposes. The interventions in the safety plan are designed to control the risk factors posing a safety threat to the child. Interventions in the case plan, however, are designed to facilitate change in the underlying conditions or contributing factors resulting in maltreatment. To control the risk factors directly affecting child safety, the safety interventions must:

  • Have a direct and immediate impact on one or more of the risk factors;
  • Be accessible and available in time and place;
  • Be in place for the duration of the threat of harm;
  • Fill the gaps in caregiver protective factors.

In identifying safety interventions and developing a safety plan, CPS caseworkers are required to make reasonable efforts to preserve or reunify families. Child safety is the most important consideration in these efforts. ASFA also states that when certain factors are present (e.g., abandonment, torture, chronic abuse, some forms of sexual abuse, killing of another person or the child's sibling, or termination of parental rights for another child), they constitute enough threat to a child's safety that reasonable efforts are not required to prevent placement or to reunify the family. The sequence of least intrusive to most intrusive safety interventions include:

  • In-home services, perhaps combined with partial out-of-home services (e.g., daycare services);
  • Removal of abusive caregiver;
  • Relative or kinship care;
  • Out-of-home-placement.

When possible, the safety assessment should be conducted jointly with the family; it may not, however, be safe to include the perpetrator. The safety plan also should be negotiated with the family. This accomplishes the following:

  • Caseworker and caregiver can assess the feasibility of the caregiver following the safety plan.
  • Caseworker can be assured that the caregiver understands the consequences of his or her choices.
  • Caregiver is provided with a sense of control over what happens.
  • Caregiver is able to salvage a sense of dignity.

Decision Point Four: Determining Emergency Needs

Child maltreatment is often not an isolated problem; many families referred to CPS experience multiple and complex problems, often at crisis levels. Due to any number of these problems that may be identified during the initial assessment or investigation, the CPS caseworker is often in the position of determining whether a family has emergency needs and of arranging for emergency services for the child and family. Examples of emergency services can include:

  • Medical attention
  • Food, clothing, and shelter
  • Mental health care
  • Crisis counseling

Decision Point Five: Offering Services

The decision that a caseworker makes at the end of the initial assessment or investigation is whether a family should be offered ongoing child protective services or other agency services. Who is offered services and on what basis that decision is made depend on the guidelines and availability of services that vary from State to State and sometimes county to county. In some cases, the decision is made based on whether a report is substantiated. In other instances, the decision to offer services is based on the level of perceived risk of maltreatment in the future since substantiation alone is not the best predictor of future maltreatment.

Noninvestigative or Alternative Responses

Traditionally CPS agencies are required to respond to all reports of child maltreatment with a standard investigation that is narrowly focused on determining whether a specific incident of abuse actually occurred. States are attempting to enhance CPS practice and build community partnerships in responding to cases of child maltreatment. One changing area of CPS practice is greater flexibility in responding to allegations of abuse and neglect. A "dual track" or "multi-track" response permits CPS agencies to respond differentially to children's needs for safety, the degree of risk present, and the family's need for support or services. Typically, in cases where abuse and neglect are serious or serious criminal offenses against children have occurred, an investigation will commence. An investigation focuses on evidence gathering and will include a referral to law enforcement. In less serious cases of child maltreatment where the family may benefit from services, an assessment will be conducted. In these cases, the facts regarding what happened will be obtained, but the intervention will emphasize a comprehensive assessment of family strengths and needs. The assessment is designed to be a process where parents or caregivers are partners with the CPS agency, and that partnership begins with the very first contact. States that have implemented the "dual track" approach have shown that a majority of cases now coming to CPS can be safely handled through an approach that emphasizes service delivery and voluntary family participation in addition to the fact finding of usual CPS investigations. CPS can switch a family to the investigative track at any point if new evidence is uncovered to indicate that the case is appropriate for investigation rather than assessment.

Initial Assessment or Investigation Process

To make accurate decisions during the initial assessment or investigation, caseworkers must:

  • Employ a protocol for interviewing the identified child, the siblings, all of the adults in the home, and the alleged maltreating parent or caregiver;
  • Observe the child, the siblings, and the parent or caregiver's interaction among family members, as well as the home, the neighborhood, and the general climate of the environment;
  • Gather information from any other sources who may have information about the alleged maltreatment or the risk to and safety of the children;
  • Analyze the information gathered in order to make necessary decisions.

Using Interview Protocols

The initial assessment or investigation of alleged maltreatment of children requires that CPS respond in an orderly, structured manner to gather sufficient information to determine if maltreatment took place and to assess the risk to and safety of the child. Employing a structured interview protocol ensures that all family members are involved and that information-gathering is thorough; increases staff control over the process; improves the capacity of CPS staff to collaborate with other disciplines; and increases staff confidence in the initial assessment or investigation conclusions. If at all possible, family members should be interviewed separately in the following order:

  • Identified child
  • Any siblings or other children in the home
  • Alleged perpetrator
  • All other adults in the home separately
  • Family as a whole

Depending on the circumstances of the report, it must be determined whether it is in the child's best interest for the CPS worker to initiate an unannounced visit to interview the parent or to contact the parent to schedule an interview. If the child is out of the home at the time (e.g., the child is at school), the process should begin with an introduction to the parent(s) to explain the purposes of the initial assessment or investigation and, if required by law, request permission to interview all family members individually, beginning with the identified child. It is important to remember that the safety of the child is of paramount importance in every case. If there is concern that talking with the parents first or obtaining their permission to interview the child places the child at risk of imminent harm, then the CPS caseworker should proceed in a manner that assures the child's safety. All family members should be interviewed alone to establish rapport and a climate of trust and openness with the caseworker, which is designed to increase the accuracy of the information gathered. A benefit noted across professional boundaries regarding the use of individual interviewing protocols is that it enables the caseworker to utilize information gathered from one interview to assist in the next interview.

Planning the Interview Process

Based on the information gathered at intake, each initial assessment or investigation should be planned with consideration given to:

  • Where the interviews will take place;
  • When the interviews will be conducted;
  • How many interviews will likely be needed;
  • How long each interview will likely last;
  • Whether other agencies should be notified to participate in the interviews.

Interviewing the Sources

During the initial assessment or investigation process, caseworkers should conduct interviews with the following individuals:

  • Identified child victim. The purpose of the initial interview with the identified child is to gather information regarding the alleged maltreatment and any risk of future maltreatment, and to assess the child's immediate safety. Because CPS's purpose is beyond just finding out what happened with respect to any allegations of maltreatment, the interview with the child addresses the strengths, risks, and needs regarding the child, his or her parents, and his or her family.

  • Siblings. Following the interview with the identified child, the next step in the protocol is to interview siblings. The purpose of these interviews is to determine if siblings have experienced maltreatment, to assess the siblings' level of vulnerability, to gather corroborating information about the nature and extent of any maltreatment of the identified child, and to gather further information about the family that may assist in assessing risk to the identified child and any siblings.

  • All of the nonoffending adults in the home. The primary purpose of these interviews is to find out what adults know about the alleged maltreatment, to gather information related to the risk of maltreatment and the safety of the child, to gather information regarding family strengths or protective factors, and to determine the adults' capacity to protect the child, if indicated.

  • Alleged maltreating parent or caregiver. The purpose of this interview is to evaluate the alleged maltreating caregiver's reaction to allegations of maltreatment as well as to the child and his or her condition, and to gather further information about this person and the family in relation to the risk to and safety of the child.

Obtaining Information from Other Sources

Other sources may have information that will help in understanding the nature and extent of the alleged maltreatment and in assessing the risk to and safety of the child. According to CWLA's Standards for Service for Abused or Neglected Children and Their Families, other potential sources include, but are not limited to, professionals such as teachers, law enforcement officers, and physicians. Other community agencies, institutions, caretakers, or individuals known to the child and the family, such as relatives and neighbors, also may be consulted. It also may be advisable to run a criminal background check on all adults in the home to ascertain prior abuse or other illegal activity. To protect the family's confidentiality, however, interviews or contacts with others should not be initiated without cause. The family also may disclose other persons who may have information about the alleged maltreatment or about the family in general. These contacts should be pursued within the constraints of the State law that mandates the scope of the initial assessment or investigation or, if indicated, clients may give permission for others to be contacted.

Following Up with the Children and Family

Following the completion of the interviews, the caseworker should reconvene the child and family, as appropriate, to:

  • Share with them a summary of the findings and impressions;
  • Seek individual responses concerning perceptions and feelings;
  • Indicate interest in the children and family;
  • Provide information about next steps, including whether ongoing services will be offered and whether court intervention will occur;
  • Demonstrate appreciation for their participation in the process.

Interviewing Techniques

Part of the caseworker's responsibility is to increase the likelihood that the family will engage with the agency and follow a recommended course of action. This section describes techniques for interviewing and observing children and families.

Interviewing Young Children

The primary goals of interviewing young children are increasing the accuracy and reliability of information, decreasing potential suggestibility, and minimizing trauma. Very young children are often more compliant, suggestible, and easily confused than older children. In addition to various emotions such as fear and anxiety, the accuracy of the interview is influenced by the child's age, understanding of events, interviewer style and demand for details, as well as by the structure and nature of questions. Interviewing young children involves special considerations that include the use of age-appropriate interviewing techniques and tools to minimize the trauma of the initial assessment or investigation process. Use of these tools also increases the reliability of the information obtained. In addition, the child may have already had to go through numerous earlier interviews, which will affect the caseworker's interview. Since investigatory interviews determine the need for protection and can influence the legal viability and the outcome of court cases, only caseworkers trained in interviewing young children should conduct these interviews.

Basic Interviewing Principles

Regardless of what methods the caseworker uses to interview children, there are some basic principles to consider in all such interviews:

  • Establish credibility and attempt to develop rapport with the child.
  • Help the child relax by playing with available toys, sit with the child at his or her eye-level, and wait patiently until the child is relatively comfortable.
  • Assess the child's understanding of key concepts that will help to establish credibility as the interview proceeds into sensitive areas.
  • Reduce vocabulary problems by using the child's language and clarify any areas of confusion.
  • Be attuned to the capacities and limitations of a young child as the interview progresses.

It is important to be aware of the child's level of comfort, and, if he or she becomes distracted or fidgety, take a break and continue the interview at a later time. The caseworker should directly address any fears that the child may have.

Developmental Considerations

Children go through a series of normal developmental stages and changes. Therefore, it is important to consider the following stages when interviewing young children:

  • Preschool children's thinking is very concrete, and their ability to think abstractly is still developing. Since irony, metaphor, and analogy are beyond their grasp, it is very important not to assume that children understand concepts presented.

  • Preschool children do not organize their thinking or speech logically. Instead, they say whatever enters their mind at the moment, with little censoring or consideration . Therefore, their narratives tend to be disjointed and rambling, resulting in the need for the interviewer to sort out relevant from irrelevant data; it is beyond the children's cognitive capacities to do this alone. It is important not to ask them leading questions, however.

  • Preschool children's understanding of space, distance, and time is not logical or linear, generally. Their memory will not work chronologically, since they have not learned units of measurement. To help place the time of an incident, use reference points such as birthdays, holidays, summer, night or day, lunchtime, or bedtime.

  • Issues of truth versus lying are particularly complex in the preschool years. Children in this age group may tell lies under two circumstances: to avoid a problem or punishment, or to impress adults or get attention. Research varies, however, on whether children can manufacture stories based on information that they have not learned or experienced. Despite their occasional tendency to tell false stories, children in the preschool years usually do know the difference between fact and fantasy and between the truth and a lie. Gentle probing and nonleading questions from the interviewer will usually help children reveal what is true and what is false.

  • Preschool children are generally egocentric. They think the world revolves around them and they relate all that happens to personal issues. These children do not usually think of what effect their actions will have on others, nor do they usually worry about what others think. As a result, interviewers of young children must be aware that children may be emotionally spontaneous in ways that are occasionally disconcerting to adults.

  • The attention span of preschool children is limited. Long interviews are often not possible because the child simply cannot concentrate or sit in one place for long periods of time. The interviewer should be flexible, conducting several short sessions over a period of time.

  • Many 2- and 3-year-olds are afraid to talk with an unfamiliar person without a parent present. The interviewer should work slowly to help children separate from the parent, when possible. If this process is difficult, the interview may need to begin with a parent present, working toward separate interviews at a later time once the child feels more comfortable. Interviewers should be flexible and follow a child's lead, as long as it is within the protocol and policies established by their agency.

Techniques and Tools for Interviewing Young Children

The most important tool in any interview is individualizing the approach based on the circumstances and the child's developmental status and level of comfort with the interviewer. Planning for the interview should take the setting into consideration. The ideal interview setting is a comfortable room where stress is minimized for the child. The following should be employed in creating the setting:

  • A neutral setting where the child does not feel pressured or intimidated. The alleged maltreating person should not be in the vicinity.
  • A room with a one-way mirror. This enables one person to be with the child while other professionals who need information can observe.
  • A small table and chairs or pillows or rugs for sitting on the floor.
  • Availability of anatomical dolls, felt-tipped markers or crayons and paper, toy telephones, doll house with dolls, Playdough, puppets, etc.
Anatomically Correct Dolls

The use of anatomically correct dolls can be useful when interviewing children regarding alleged sexual abuse. Anatomical dolls have genitalia and breasts proportional to body size and appropriate to the gender and age of the child. The clothes the dolls wear can be easily removed and are appropriate to the child's age and gender. The uses of dolls include:

  • Icebreaker. The dolls can be used to begin the conversation, cueing the child that the interviewer wants to talk about body parts. It can enhance the child's comfort level.

  • Anatomical model. This is one of the most common uses of the dolls. The interviewer can use the dolls to determine the child's labels for different body parts. They can also be used to help the child show where any touching occurred.

  • Demonstration aid. This is the most common function of the dolls. It enables the child to show behaviors that he or she has described to confirm the interviewer's understanding and help reduce any miscommunication. The dolls may be used with children who have limited verbal skills to help them show, rather than tell, what happened.

  • Memory stimulus and screening tool. The dolls may trigger a child's recall of specific events of a sexual nature. The child may either demonstrate a specific sexual act while interacting with the dolls or have a strong negative reaction.

Observing Young Children

Part of the process of gathering adequate information includes the caseworker's responsibility to observe the identified child, other family members, and the environment. Specific areas for observation are:

  • Physical condition of the child, including any observable effects of maltreatment;
  • Emotional status of the child, including mannerisms, signs of fear, and developmental status;
  • Reactions of the parents or caregivers to the agency's concerns;
  • Emotional and behavioral status of the parents or caregivers during the interviewing process;
  • Interactions between family members, including verbal and body language;
  • Physical status of the home, including cleanliness, structure, hazards or dangerous living conditions, signs of excessive alcohol use, and use of illicit drugs;
  • Climate of the neighborhood, including level of violence or support, and accessibility of transportation, telephones, or other methods of communication.

Community Involvement

While CPS agencies have the primary responsibility for conducting initial assessment or investigation, other agencies or professionals may be integrally involved in the process.

Coordinating with Law Enforcement

Since CPS and law enforcement often work together in responding to child abuse and neglect (in some States, all abuse and neglect reports go initially to the police), it is vital for them to establish strong working relationships and collaborate effectively. A memorandum of understanding (MOU) and protocols should be established between CPS and law enforcement agencies to identify roles and responsibilities as well as the circumstances that dictate when:

  • Reports should be initiated and shared between agencies;
  • Joint initial assessment or investigation should be initiated;
  • Cases necessitate immediate notification to other agencies;
  • Oral and written reports should be initiated and shared.

After an MOU or protocol is established, training should provide caseworkers with familiarity of the defined roles and responsibilities.

In addition, parameters should be established for cases where law enforcement assistance may be needed to remove a child or an alleged offender from the home, or when there is a concern for the caseworker's safety.

Involving Other Professionals

In addition to law enforcement, other disciplines often have a role in the initial assessment or investigation process:

  • Medical personnel may be involved in assessing and responding to medical needs of a child or parent and perhaps in documenting the nature and extent of maltreatment.

  • Mental health personnel may be involved in assessing the effects of any alleged maltreatment and in helping to determine the validity of specific allegations. They may also be involved in evaluating the parent's or caregiver's mental health status and its effect on the safety to the child.

  • Alcohol and other drug specialists may be involved in evaluating parental or caregiver substance abuse and its impact on the safety of the child.

  • Partner abuse experts may be asked to assist in examining the safety of the child in cases where partner abuse and child maltreatment co-exist. These professionals may also be involved in the safety planning process.

  • Educators may be involved in providing direct information about the effects of maltreatment and other information pertinent to the risk assessment.

  • Other community service providers who have had past experience with the child or family may be a resource in helping to address any emergency needs that the child or family may have.

  • Multidisciplinary teams may be used to help the CPS agency analyze the information related to the substantiation of maltreatment and the assessment of risk and safety.

  • Other community partners such as intensive, home-based service workers; parent aides; daycare providers; afterschool care providers; foster parents; volunteers; or relatives may be used to help the agency implement a plan to keep the child safe within his or her own home.

  • Juvenile court may be involved in helping to assure the safety of the child and to provide continuing protective services to the child and family when the child's safety cannot be protected, and the parents or caregivers have refused agency intervention.

Effects of Removal

In order to assure protection, CPS may have to remove the child or reach agreement with family members that the alleged offender will leave the family and have no unsupervised contact with the alleged victim. Removal of the alleged offender is a less intrusive intervention but it should only be used if the caseworker is certain that there will be no contact with the victim. The removal of a family member has a dramatic affect on the feelings, behaviors, and functioning of individual family members and the family as a whole.

When CPS has to remove children from their families to protect them, they set in motion numerous issues and problems for the child. Placement outside the family often negatively affects the child's emotional well-being. Being uprooted from the only family one has known, from one's routines and familiar surroundings, is emotionally debilitating to children. Parents who abuse or neglect their children may also demonstrate love and attention to their children. This may be the only adult to whom the child has bonded. It is important to remember that the child suffers a devastating loss—the loss of being taken away from his or her birth family.

Placement away from the birth family therefore means more than the physical loss of living with the family; it also means having to deal with the loss of relationships and the loss of control over one's life. Children coming into substitute care suffer a significant loss to their self-esteem and are under a great deal of stress. Therefore, it is important to remember that when placing children, caseworkers should always maintain a focus on reducing the uncertainty and anxiety for children. Some strategies for helping children better manage the placement include:

  • Involving the family and children in the safety plan and the placement process, when appropriate;
  • Providing contact with the family after placement as soon as possible-ideally, within the first week;
  • Reassuring children that there is nothing wrong with them and that they are not to blame for the placement;
  • Providing children with information about the reasons for the placement, where they are going, and how long they may remain there;
  • Allowing children to take as many personal favorite items as possible, such as photos of the family or home, toys or stuffed animals, and clothing;
  • Finding out as much about the children as possible—their likes and dislikes, routines, medical issues—and informing the substitute care provider;
  • Encouraging children to express their feelings and normalize those feelings, possibly through starting a journal or notebook;
  • Giving children a phone number to contact the caseworker.

Family members are also traumatized by the placement. They, too, need immediate contact with their children; concern and empathy from the caseworker; and involvement in the placement process.

Signs of Child Abuse

Types of Neglect

What is considered neglect is defined by the laws of each State. Physical, educational, and emotional neglect are the three major types of neglect.

Physical Neglect

The Department of Health and Human Services' Third National Incidence Study of Child Abuse and Neglect (NIS-3) defines physical neglect as any of the following:

  • Refusal of health care—failure to provide or allow needed care in accordance with recommendations of a competent health-care professional for a physical injury, illness, medical condition, or impairment.
  • Delay in health care—failure to seek timely and appropriate medical care for a serious health problem that any reasonable layperson would have recognized as needing professional medical attention.
  • Abandonment—desertion of a child without arranging for reasonable care and supervision.
  • Expulsion—other blatant refusals of custody, such as permanent or indefinite expulsion of a hild from the home without adequate arrangement for care by others or refusal to accept custody of a returned runaway.
  • Inadequate supervision—leaving a child unsupervised or inadequately supervised for extended periods of time, or allowing the child to remain away from home overnight without knowing or attempting to determine the child's whereabouts.
  • Other physical neglect—may include inadequate nutrition, clothing, or hygiene; conspicuous inattention to avoidable hazards in the home; and other forms of reckless disregard for the child's safety and welfare (e.g., driving with the child while intoxicated, leaving a young child unattended in a car).

Educational Neglect

The Department of Health and Human Services' Third National Incidence Study of Child Abuse and Neglect (NIS-3) defines educational neglect as any of the following:

  • Permitted chronic truancy—habitual absenteeism from school averaging at least 5 days a month if the parent or guardian is informed of the problem and does not attempt to intervene.
  • Failure to enroll or other truancy—failure to register or enroll a child of mandatory school age, causing the child to miss at least 1 month of school, or a pattern of keeping a school-aged child home without valid reasons.
  • Inattention to special education need—refusal to allow or failure to obtain recommended remedial education services or neglect in obtaining or following through with treatment for a child's diagnosed learning disorder or other special education need without reasonable cause.

Emotional Neglect

The Department of Health and Human Services' Third National Incidence Study of Child Abuse and Neglect (NIS-3) defines emotional neglect as any of the following:

  • Inadequate nurturing or affection—marked inattention to the child's needs for affection, emotional support, or attention.
  • Chronic or extreme spouse abuse—exposure of the child to chronic or extreme spouse abuse or other domestic violence.
  • Permitted drug or alcohol abuse—encouragement or permission of drug or alcohol use by the child.
  • Permitted other maladaptive behavior—encouragement or permission of other maladaptive behavior (e.g., chronic delinquency, severe assault) under circumstances where the parent or caregiver has reason to be aware of the existence and seriousness of the problem but does not intervene.
  • Refusal of psychological care—refusal to allow needed and available treatment for a child's emotional or behavioral impairment or problem in accordance with a competent professional recommendation.
  • Delay in psychological care—failure to seek or provide needed treatment for a child's emotional or behavioral impairment or problem that any reasonable layperson would have recognized as needing professional psychological attention (e.g., suicide attempt).

Sexual Abuse

Child sexual abuse generally refers to sexual acts, sexually motivated behaviors, or sexual exploitation involving children. Child sexual abuse includes a wide range of behaviors, such as:

  • Oral, anal, or genital penile penetration
  • Anal or genital digital or other penetration
  • Genital contact with no intrusion
  • Fondling of a child's breasts or buttocks
  • Indecent exposure
  • Inadequate or inappropriate supervision of a child's voluntary sexual activities
  • Use of a child in prostitution, pornography, Internet crimes, or other sexually exploitative activities

Sexual abuse includes both touching offenses (fondling or sexual intercourse) and nontouching offenses (exposing a child to pornographic materials) and can involve varying degrees of violence and emotional trauma. The most commonly reported cases involve incest, or sexual abuse occurring among family members, including those in biological families, adoptive families, and stepfamilies. Incest most often occurs within a father-daughter relationship; however, mother-son, father-son, and sibling-sibling incest also occurs. Sexual abuse is also sometimes committed by other relatives or caretakers.

Signs of Sexual Abuse

The presence of a single sign does not prove child abuse is occurring in a family; however, when these signs appear repeatedly or in combination you should take a closer look at the situation and consider the possibility of child abuse.

Consider the possibility of sexual abuse when the child:

  • Has difficulty walking or sitting
  • Suddenly refuses to change for gym or to participate in physical activities
  • Reports nightmares or bedwetting
  • Experiences a sudden change in appetite
  • Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior
  • Becomes pregnant or contracts a venereal disease, particularly if under age 14
  • Runs away
  • Reports sexual abuse by a parent or another adult caregiver

Consider the possibility of sexual abuse when the parent or other adult caregiver:

  • Is unduly protective of the child or severely limits the child's contact with other children, especially of the opposite sex
  • Is secretive and isolated
  • Is jealous or controlling with family members

Physical Abuse

Generally, physical abuse is characterized by physical injury, such as bruises and fractures that result from:

  • Punching
  • Beating
  • Kicking
  • Biting
  • Shaking
  • Throwing
  • Stabbing
  • Choking
  • Hitting with a hand, stick, strap, or other object
  • Burning

Although an injury resulting from physical abuse is not accidental, the parent or caregiver may not have intended to hurt the child. The injury may have resulted from severe discipline, including injurious spanking, or physical punishment that is inappropriate to the child's age or condition. The injury may be the result of a single episode or repeated episodes and can range in severity from minor marks and bruising to death.

As Howard Dubowitz, a leading researcher in the field explains: "While cultural practices are generally respected, if the injury or harm is significant, professionals typically work with parents to discourage harmful behavior and suggest preferable alternatives."

Signs of Physical Abuse

The presence of a single sign does not prove child abuse is occurring in a family; however, when these signs appear repeatedly or in combination you should take a closer look at the situation and consider the possibility of child abuse.

Consider the possibility of physical abuse when the child:

  • Has unexplained burns, bites, bruises, broken bones, or black eyes
  • Has fading bruises or other marks noticeable after an absence from school
  • Seems frightened of the parents and protests or cries when it is time to go home
  • Shrinks at the approach of adults
  • Reports injury by a parent or another adult caregiver

Consider the possibility of physical abuse when the parent or other adult caregiver:

  • Offers conflicting, unconvincing, or no explanation for the child's injury
  • Describes the child as "evil," or in some other very negative way
  • Uses harsh physical discipline with the child
  • Has a history of abuse as a child

Emotional Abuse

Psychological maltreatment, also known as emotional abuse, refers to "a repeated pattern of caregiver behavior or extreme incident(s) that convey to children that they are worthless, flawed, unloved, unwanted, endangered, or only of value in meeting another's needs."

  • Spurning (e.g., belittling, hostile rejecting, ridiculing)
  • Terrorizing (e.g., threatening violence against a child, placing a child in a recognizably dangerous situation)
  • Isolating (e.g., confining the child, placing unreasonable limitations on the child's freedom of movement, restricting the child from social interactions)
  • Exploiting or corrupting (e.g., modeling antisocial behavior such as criminal activities, encouraging prostitution, permitting substance abuse)
  • Denying emotional responsiveness (e.g., ignoring the child's attempts to interact, failing to express affection)
  • Mental health, medical, and educational neglect (e.g., refusing to allow or failing to provide treatment for serious mental health or medical problems, ignoring the need for services for serious educational needs)

Signs of Emotional Abuse

The presence of a single sign does not prove child abuse is occurring in a family; however, when these signs appear repeatedly or in combination you should take a closer look at the situation and consider the possibility of child abuse.

Consider the possibility of emotional maltreatment when the child:

  • Shows extremes in behavior, such as overly compliant or demanding behavior, extreme passivity, or aggression
  • Is either inappropriately adult (parenting other children, for example) or inappropriately infantile (frequently rocking or head-banging, for example)
  • Is delayed in physical or emotional development
  • Has attempted suicide
  • Reports a lack of attachment to the parent

Consider the possibility of emotional maltreatment when the parent or other adult caregiver:

  • Constantly blames, belittles, or berates the child
  • Is unconcerned about the child and refuses to consider offers of help for the child's problems
  • Overtly rejects the child

    Recognizing Child Abuse

    The following signs may signal the presence of child abuse or neglect.

    The Child:

    • Shows sudden changes in behavior or school performance.
    • Has not received help for physical or medical problems brought to the parents' attention.
    • Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes.
    • Is always watchful, as though preparing for something bad to happen.
    • Lacks adult supervision.
    • Is overly compliant, passive, or withdrawn.
    • Comes to school or other activities early, stays late, and does not want to go home.

    The Parent:

    • Shows little concern for the child.
    • Denies the existence of—or blames the child for—the child's problems in school or at home.
    • Asks teachers or other caretakers to use harsh physical discipline if the child misbehaves.
    • Sees the child as entirely bad, worthless, or burdensome.
    • Demands a level of physical or academic performance the child cannot achieve.
    • Looks primarily to the child for care, attention, and satisfaction of emotional needs.

Family Assessment

Comprehensive Family Assessment

Several kinds of assessments are conducted in child welfare, such as assessments of safety, risk and development. All serve distinct purposes and may be used at one or more points in the casework process, but they are not all comprehensive. For the purposes of these guidelines, “comprehensive” means that the assessment incorporates information Comprehensive Family Assessment Guidelines collected through other assessments and addresses the broader needs of the child and family that are affecting a child's safety, permanency, and well-being—the “big picture”—not just a set of symptoms.

Different types of assessments are used in child welfare: assessments of safety, risk assessments, and special assessments of particular needs such as developmental assessments. A comprehensive family assessment incorporates information collected through other assessments— particularly safety and risk assessments.

Those conducting comprehensive family assessment need to consider the family's history and the passage of time—what led to the current problems as well as the likely impact of both the maltreatment and the response on the child and family. Comprehensive means moving beyond the “here and now.”

The purpose of a comprehensive family assessment is to develop a service plan or a strategy for intervention that addresses the major factors affecting a child's well-being, safety, and permanency over time. This plan should aim at helping the family get on the right track for improved functioning.

In short, a comprehensive family assessment involves recognizing patterns of parental behavior over time in the broad context of needs and strengths, rather than focusing only on the incident that brought the family to the attention of the child welfare agency.


  Comprehensive Family Assessment

  • Recognizes patterns of parental behavior over time;
  • Examines the family strengths and protective factors to identify resources that can support the family's ability to meet its needs and better protect the children;
  • Addresses the overall needs of the child and family that affect the safety, permanency, and well-being of the child;
  • Considers contributing factors such as domestic violence, substance abuse, mental health, chronic health problems, and poverty; and
  • Incorporates information gathered through other assessments and focuses on the development of a service plan or plan for intervention with the family. The service plan addresses the major factors that affect safety, permanency, and child well-being over time.

Comprehensive Family Assessment

Assessment is the process of gathering information that will support service planning and decision-making regarding the safety, permanency, and well-being of children, youth, and families. It begins with the first contact with a family and continues until the case is closed. Assessment is based on the assumption that for services to be relevant and effective, workers must systematically gather information and continuously evaluate the needs of children and parents/caregivers as well as the ability of family members to use their strengths to address their problems.

Many assessments are conducted for different purposes throughout a family's involvement with the child welfare system. For example, initial assessments conducted during intake are used to assist in determining the immediate safety of and the future risk of harm to a child. Assessments of safety and risk are also used to guide decisions when new concerns are identified and before major case decisions like reunification. But safety and risk assessments alone are not sufficient for understanding the range of issues related to the present concerns. There is a need to gather information on broader issues that will affect each family's ability to resolve concerns that led to its involvement with the child welfare system. It is also critical to gather information on the strengths, resources, supports, connections, and capacities that will help families nurture their children and keep them safe.

Comprehensive family assessment is the process of identifying, gathering, and weighing information to understand the significant factors affecting the child's safety, permanency, and well-being, the parental protective capacities, and the family's ability to assure the safety of their children.

When Is Comprehensive Family Assessment Done?

Comprehensive family assessment is not necessary for every referral. When reports of child maltreatment are screened in as meeting state statutory requirements, the initial assessment work focuses on safety and risk. These assessments lead to decisions about the need for child protection services. If child protective services are needed, a comprehensive family assessment is usually the best means to obtain information to guide decisions on service planning.

As part of the decision to open a case for services, regardless of whether the child is placed outside the home, a comprehensive family assessment is undertaken as part of the development of a useful service plan. If the child welfare agency is responsible for serving the family, a comprehensive assessment is crucial. Identification of risk and safety factors and implementation of a plan to manage these issues in the short-term promotes further engagement of the family and the opportunity for a comprehensive family assessment.

Over the course of a family's involvement with child welfare, circumstances often change. These changes result from the various factors in the life of the child, youth, and/or the family as well as the effectiveness of the services provided through the service plan. Furthermore, additional information may become known to the agency and affect the plan for service delivery. Therefore, assessments should be completed not only at the outset of the service planning process, but also revised and updated periodically throughout the child, youth's and family's involvement with the child welfare agency.

Information about the children and the family is often available only as the relationship is built among the social worker, other service providers, and the family. Thus, early engagement of families and children in the helping relationship is a necessary prerequisite to developing a full and accurate understanding of the circumstances that create the need for child welfare services.

Comprehensive assessment information has to be updated whenever major changes in family circumstances occur and at points of key decision-making on a case. These include:

  • Decisions about in-home services
  • Placement decisions
  • Reunification decisions
  • Decisions related to changing the service plan (or case goal)
  • Decisions related to permanent placement for adolescents and eligibility for Chafee program activities and services
  • Formal reviews of progress, including court reviews
  • Termination of Parental Rights (TPR) decisions
  • Case closure

Fundamentals of Comprehensive Family Assessment

Comprehensive family assessments form the basis of effective practice in child welfare. These assessments help workers meet the needs of families and use resources efficiently. If workers are to engage and motivate families to change, the process of assessment needs to be relevant to the family's life.

Family involvement

An effective comprehensive family assessment must be completed in partnership with families. Family involvement in assessment fosters engagement by enhancing communication between the agency and the family about how the family got to this point, what has to change, what services are needed, the expectations for who will do what by when, the time frames, and what alternative resources might exist within the extended family and social network to address the safety, permanency, and well-being of the child or youth.

The quality of family involvement is related to their “stage of change”— their readiness for accepting the reality of their situation and their willingness to change. Family involvement is therefore dynamic, evolving as their readiness and capacity to change evolve. Understanding stages of change helps caseworkers make important decisions; for example, there are service plan implications if a parent refuses to or is unable to recognize problems in his or her parenting. Moreover, assessing stages of change helps caseworkers in engaging the parent to move forward in specific ways in the change process. The bottom line, however, remains the importance of family engagement no matter what the stage of change.


  • Stages of Change
  • Precontemplation: Initial resistance to change. For example, “I have done nothing wrong and resent CPS' involvement.”
  • Contemplation: A family member becomes aware of the problem but has not yet made an effort to change. For example, "I know I should clean up this messy house and handle the kids better."
  • Preparation: A family member is intending to take some action to change. For example, “Where can I get information on substance abuse treatment?” It is important to distinguish intention from actually taking action.
  • Action: A family member changes his or her behavior and/or environment. For example, “I've started to work real hard to change,” with specific examples of actions taken.
  • Maintenance: Family members work to prevent relapse and maintain the gains they have made during the change process. For example, “I have not had a drink in the past six months.”

Families are an essential source of information on what is affecting the safety, permanency, and well-being of their children. Understanding the family's views about their needs as well as their attitudes toward addressing these needs is critical in comprehensive family assessment. Gathering information on the family's perception of the problem, even when the family does not recognize or denies the existence of a problem, is crucial. This perception is usually affected by the family's cultural background and life experiences.

Families and extended family members are also a valuable source of information for ongoing assessment. Their views on which services and supports are helpful and which are not as well as their perceptions of why interventions are working or not working are essential. Even if their perceptions are incomplete or biased, they have to be sought out to gain a perspective for realistic service planning.

Family meetings are a particularly effective strategy to promote family involvement in initial and ongoing assessments. Family team meetings emphasize inclusion and promote the active participation of family members as collaborative partners in the initial and ongoing process. Policies and practices regarding family team meetings vary from state to state. When family team meetings are to be utilized, caseworkers need training to develop the skills that support the incorporation of such meetings into daily practice.

Individualization

Although some of the same factors may be present among families who enter the child welfare system (for example, substance abuse, mental illness, poverty), each family is unique in the way these factors affect their ability to protect their individual members. Workers need to be careful not have preconceived ideas of the needs of individual families and look for information to confirm these ideas. All the available information should be considered to see how it fits together to describe each family.

Through the process of comprehensive family assessment, the worker gathers information on the impact of specific needs and protective factors in each family. Families vary in their motivation to change, the context and duration of the issues that affect the safety, permanency, and well-being of their children, and the cultural context within which they parent. These variations must be taken into consideration along with their values, communication patterns, and functioning. This individualization carries through to service delivery—each family as a unit (and their individual members) should receive services that address specific areas in need of change in the context of the protective factors and resources identified.

Individualizing our response requires an agency commitment to distinguish between what the family needs and what the agency generally offers. We cannot simply give families what we have rather than what they need. It requires the child welfare agency to work with its community stakeholders to ensure that needed services are developed and made available in all the state's jurisdictions.

Components of Comprehensive Family Assessment

The circumstances that bring child welfare agencies into the homes and lives of children, youth, and families are often complex and challenging. Because of the combination of their physical, emotional, and social circumstances, these families often present challenges to agency staff. The agency is asked to make decisions constantly, sometimes based on the best information available at that time. The decisions based on that information will have important, long-term consequences for the safety, permanency, and well-being of the children, youth, and their families.

The decision-making process is more effective when staff work in collaboration with families and other community partners to gather information.

Developing a Comprehensive Focus

Areas of assessment

A comprehensive family assessment for families dealing with child maltreatment incorporates the information gathered during any safety and risk assessments, but goes beyond these assessments to explore internal and external factors that may be affecting the family's ability to keep the child or youth safe.

In addition, a comprehensive family assessment identifies historical patterns and the family environment that led to the current situation as well as the potential impact of the maltreatment on the child's future well-being.


Categories of Family Assessment

The following are characteristics or problem areas most commonly associated with families in the child welfare system:

  • Problems in accepting responsibility, in the ability to recognize problems, or in motivation to change;
  • Patterns of social interaction, including aggressiveness or passivity, the nature of contact and involvement with others, the presence or absence of social support networks and relationships;
  • Parenting practices (methods of discipline, patterns of supervision, understanding of child development and/or of emotional needs of children);
  • Background and history of the parents or caregivers, including the history of abuse and neglect;
  • Problems in access to basic necessities such as income, employment, adequate housing, child care, transportation, and needed services and supports; and
  • Behavior/conditions associated with
    • Domestic violence
    • Mental illness
    • Physical health
    • Physical, intellectual, and cognitive disabilities
    • Alcohol and drug use

Categories of Child and Youth Assessment

Children and youth who are maltreated experience a variety of stressors that impact their ability to develop appropriately. The focus of the comprehensive family assessment of children and youth is on gathering information that will assist in deciding what are the actions required to keep the children safe, in a permanent living situation, and in a state of well-being. Depending on the age and developmental level, environment, and family culture, it is necessary to get information on the strengths and needs of the child or youth related to:

  • Physical health and motor skills
  • Intellectual ability and cognitive functioning
  • Academic achievement
  • Emotional and social functioning
  • Vulnerability/ability to communicate or protect themselves
  • Developmental needs
  • Readiness of youth to move toward independence

Categories of Youth Assessment

For youth, assessment takes yet another focus. Not only must assessment provide information on the youth's safety, permanence, and well-being while in care, it must also focus on the young person's safety, permanence, and well-being as he/she develops skills needed as an adult. Necessary information on the strengths and needs of youth includes:

  • Readiness to live interdependently
  • Ability to care for one's own physical and mental health needs
  • Self-advocacy skills
  • Future plans for academic achievement
  • Life skills achievement
  • Employment /career development
  • Quality of personal and community connections

 


Who Is Assessed?

  • All children and youth in the family
  • Parents-both mothers and fathers-custodial or non-custodial
  • Other in-home caregivers or those frequently in the home caring for children
  • Potential kinship resources for child placement if the decision is made to place the child or youth outside the home, including resources of the tribe or clan to which the family belongs.

Identifying Strengths and Protective Factors

Comprehensive family assessments identify individual and family strengths and protective factors. The continuous exploration of the family's ability to address their problems is important because recognizing strengths can help families realize their capacity to change. In addition, the identified protective factors can assist in mitigating the needs identified and mobilizing and/or expanding the resources that the family can use to help meet their needs.

Strengths are those positive qualities or resources present in every family. Protective factors are the resources and characteristics of the family members that can directly contribute to the protection and development of the children. It is important to note that the assessment of protective factors is not simply a listing of positive qualities and resources; the protective factors must be relevant and dynamically involved in offsetting the risks related to abuse/neglect. For example, a mother may be a fine artist, which would be generally positive attribute, but this “strength” would not compensate for the lack of a protective factor such as the capacity to recognize her own need to change. The protective factors often have to be deliberately mobilized to play a relevant role within the service plan.

The following are some individual factors contributing to protection: good cognitive and social skills, a positive self-perception, motivation to change, a willingness to seek support, an awareness of the threats to safety, ability to take action to protect children, self-discipline, and focus on acquiring knowledge and skills.

The following are some environmental factors contributing to protection: support from family and friends, stability of the living environment, positive interactions with others, and a connection to the community.


Protective Factors

  • Presence of a supportive extended family willing and able to help
  • Demonstrated ability of parents to accept responsibility for their behavior and willingness to change
  • Value placed on the role of parent and desire to do a good job
  • Clear understanding of youth's and child's developmental needs
  • Willingness to meet the needs of the child or youth; ability to get the child to school, medical appointments, and so forth
  • Adjusting discipline to stage of development
  • Ability to control expression of anger
  • Physical and emotional health of parent or caregiver
  • Capacity to form and maintain healthy relationships
  • Positive patterns of problem solving in other life areas
  • Parental past experience protecting the child
  • Non-maltreating parent or other adult in the home willing and able to protect the child
  • Appropriate communication and problem solving skills of the adults that share child care

Review Existing Information

Review all relevant documentation that has emerged through:

  • The initial review of records and summary of any past experience in the child welfare system or other related service systems;
  • What was learned from the reporter and collateral contacts;
  • Initial contacts with the family;
  • Safety assessments, including safety plans, and risk assessments;
  • Observations of the home, interactions between adults in the home, parent/child interactions, affect of child or youth (for example, confident, fearful); and
  • Any specialized evaluations done as part of the initial assessment or in the recent past related to factors impacting children, youth, or adults in the home.

VIGNETTE 1: The Archuleta Family

The vignette illustrates guidelines for a comprehensive family assessment (CFA) at two points in child welfare services:

  • From the initial contact through the first comprehensive family assessment (approximately 60 days), and
  • During the following months up to and including the next formal review.

First Comprehensive Family Assessment — Preparation for Conducting the CFA

A. Review of existing information:

  • The referral, from an anonymous source, indicated that two children were alone in an apartment at 8:30 p.m. The children, Angela and Pablo, ages 4 and 8, were taken into custody when no caregivers could be found. A neighbor helped locate the children's mother's great aunt Tiana, who lives several miles away and the children were placed with her that evening.
  • As of now they remain in her care and have contact with their parents nightly by phone and semi-weekly face-to-face in supervised visits at the child welfare agency.
  • On the night of the referral, the parents, Carmen, 22, and Arturo, 30, were at a friend's house and arrived home at midnight, finding a note that their children had been removed. They explained that they had left food for the children and a phone number where they could be reached. They had instructed Pablo to knock on a neighbor's door if he needed help.
  • Further assessment found that Arturo has a police record involving one conviction for petty larceny and two for dealing small amounts of cocaine. Having served two sentences, he is now on parole.
  • Both parents were tested for drugs, and their urine screen or urine analysis (UAs) tested positive for cocaine and marijuana. Carmen has never been in drug treatment. Two years ago Arturo spent two weeks in an outpatient drug treatment program before dropping out. He says that the program interfered with his job stocking shelves at a department store. Arturo likely will be re-incarcerated for a parole violation.
  • The children have been left alone at least several times before. Parents say that they always leave a phone number and food for the children.
  • Both parents indicated a strong desire to have their children returned and said that they will cooperate with the child welfare agency.
  • Carmen expressed interest in attending church as she did when she was younger. She would like to go to her godparents' church.
  • Interviews with the children, the parents, the godparents, the school and relatives indicated that Carmen and Arturo often provide adequate care for the children and that they and the children are attached; however sometimes the children are afraid and insecure. There is no evidence of physical or sexual abuse. The children sometimes fend for themselves when the parents are partying.
  • There is an extended kin network, some of who are involved in drugs and have child welfare involvement and some of who are positive resources for the family (for example, Carmen's great aunt Tiana, and Carmen's godparents).

B. Identify and document risks, strengths/protective factors, and possible needs to guide the comprehensive family assessment:

  • Strengths/protective factors: Parents often provide adequate care for children, parents and children are bonded, parents want children back, some extended family members are good resources to help the parents, parents are having consistent contact with children while in out-of-home care, mother wants to be involved in church, family is financially self-sufficient while father is present.
  • Risks: Parents both use cocaine and marijuana, children have been left alone before, parents believe children can take care of themselves for an evening, children are young, children are sometimes afraid and insecure, father has police record, father has dropped out of drug treatment once, and some of extended family also has drug and child welfare involvement.
  • Possible service decisions: drug treatment for both parents, financial support for Carmen if Arturo is re-incarcerated, understanding of age-appropriate needs for children.

C. Map out a plan for gathering assessment information:

  • Talk with both parents about strengths/protective factors, resources and needs and assess readiness to use help and make change. The family should be encouraged to engage in self-assessment about what they believe is happening and why they are now involved with the agency. Ask about cultural context of family issues. Use ecomap and genogram with parents to record the information. Add to the ecomap and genogram after meeting with children, review of records, discussion with providers, and extended support system (the family meeting).
  • Talk with both children about their concerns and needs.
  • Obtain release of information as needed, review school, Head Start, and medical information on children and records from parole and drug treatment for Arturo.
  • Talk with providers from these organizations as needed.
  • Conduct a family meeting. With the parents and great aunt who is the current caregiver, identify providers and family/friends who should be invited. Make a plan for inviting and preparing all invitees for the meeting.

Meet with the Family

Family meetings with the parents and/or caretakers if the children are not living with their parents should occur as soon as possible after the child welfare agency has decided to open the case. Parents or caretakers should be invited to bring other supportive people to the meeting if they like. Siblings who are old enough to participate in such a meeting and have something useful to contribute should also be included. These other people, including former or current service providers, might help identify needs, protective factors, or be resources for commitment to the ensuing service plan. These meetings not only provide a fuller picture of the family situation and networks, but also help staff to understand who can be involved in the change process as they develop the service plan. Judgments should be made with the family as to who can safely be included, especially in situations involving domestic violence. Trained, objective facilitators can be very helpful in the family meetings.

A general understanding of who is in the family, where they reside, and how the connections work is useful information. Gathering this information from the family also provides a way to get the parent to engage in the discussion. Exploring their broader connections to faith communities, tribal, cultural, or ethnic bonds, or neighbors helps focus families on the resources that not only define them, but also could help address their current needs. Genograms, ecomaps, and ethnographic interviewing are useful tools to do this.

These family meetings should explore not only the current situation, but also the broader context of issues that affect the safety, permanency, and well-being of the children. Exploring how parenting issues have generally been addressed over time, as well as the family's level of understanding of the current safety and risk factors are important. Ask about and listen to the parents' perceptions of why they are now involved with child welfare, what they might fear, and what they can expect to gain from services. Exploring their commitment to change helps the caseworker recognize their readiness for change and the need to mobilize additional supports to the parents for their participation in the service plan.

Parents/caretakers should be asked to identify their needs relevant to the protection of their children. If they are or have been involved in services from other agencies, that involvement should be explored to identify services offered and provided and determine which services have been helpful to them in addressing parenting issues or related needs.

The caseworker should address any current pressing need that the family identifies relevant to the agency's intervention with the family, such as a rent payment to avoid eviction.

Interview Children

In most cases, it may be helpful to interview children separately from their parents. If children are living at home, seeking parental permission for these meetings and possible participants in the meetings whenever appropriate is wise. A trusted adult, possibly a teacher or minister, could be with the child. Not only would they provide support but also could use their ongoing relationship to help the child understand the process and purpose of the assessment. For older children, particularly, it is important to get each child's perspective on the issues. Whenever appropriate, children should be interviewed separately as well as together.

When children are interviewed, it is necessary to put them at ease by initially exploring “safe” areas of their lives—possibly school, religious, recreational activities.

The main purpose of meeting with the child is to gain an understanding of their perception of what is happening, how the current situation might or might not fit within their general experience of being parented, and what they need to feel safe. It would be very useful to know if there are adults in the child's life that they trust or go to for guidance and support.

These meetings might also identify some immediate needs that the caseworker could take care of for the child even as she/he is developing the service plan. An example might be arranging for the child to meet with a counselor.


VIGNETTE 2: The Archuleta Family — Assess the Needs of the Family

A. Meet with the parents:

  • Meet individually and jointly with parents. (Although not a known factor with this family, domestic violence would be an important area to explore in individual meetings.)
  • Gather information about family history and the current extended family and support system. Use the genogram and the ecomap in addition to the narrative as a means of recording this information.
  • Engage parents by focusing on their viewpoints.
  • Address their perspectives and ideas about issues such as:
    • What works well about their family and what contributes to effective functioning
    • What could work better about their family and what would be needed to achieve better functioning
    • What needs to change to make their home safe for their children and what services and other interventions would help them
    • In the past as well as now, what causes the parents the most stress, worry, sadness and also what brings them the most satisfaction, joy, and peace of mi
    • nd
    • What others think. For example, “What makes your godmother proudest about you? What does she worry about for you?”
    • What they think the impact of changing or not changing will be.
    • What will help them make and maintain changes
  • Plan the family meeting together.
  • Explain court involvement, if any, and what to expect in court hearings.

B. Meet with children:

  • Meetings with children are opportunities for observation of the child in terms of overall health, activity levels, development, communication skills, and so forth, as well as gathering information.
  • Talk with children separately and together at great aunt Tiana's house; inform parents, but do not include them because children have been afraid and insecure.
  • Build rapport with children; speak with them at their level of cognitive and emotional development (concrete, no leading questions), begin with their views of day-to-day life in the family, note the positives, then ask about what they would like to be better in their family and what could help things to be better.
  • Ensure that children understand next steps and child welfare's intent to help family. Understand their comprehension and clarify as needed.
  • Specify court involvement, if any, and what to expect in court hearings.

C. Review records and talk with providers as needed:

  • Review school and medical records for children and talk to providers to clarify needs.
  • • Review law enforcement and drug treatment records and talk to providers to clarify issues as needed.

D. Conduct a family meeting:

  • With parents, identify and invite key people including Tiana (who is caring for children in her home), Carmen's godparents, Pablo's school counselor, Head Start outreach worker for Angela, Arturo's parole officer, god-parents' minister, and the substance abuse counselor who conducted the recent assessments of both parents.
  • Obtain parental consent to contact all key people and invite them to meetings.
  • Prepare each invitee by explaining how family meetings work and the issues that will be discussed.
  • Clarify what the participants have contributed in terms of assisting with identified needs and the parents' views about this.
  • Support family meeting participants in planning how each might help the family.
  • Identify and review what participants have committed to do.


VIGNETTE 3: The Archuleta Family — Analysis of Information and Identification of Needs

A. Analyze the information:

  • Children need a permanency plan. It appears that the children may be able to return home. The childrens' great aunt Tiana, 46, may be an alternative.
  • Both parents need to gain control over their drug use. Both are aware that their drug use led directly to their involvement in the child welfare system. Carmen is aware that her parenting is impaired by her drug use and is determined to stop using drugs. Arturo believes that his drug use is recreational and that he already has control over it. He agrees to drug treatment but probably only to comply with the child welfare agency's requirements and to positively influence his upcoming parole violation hearing.
  • Carmen needs drug treatment.
  • Carmen needs training to get job skills—she likely will not have Arturo's income soon since he probably will be re-incarcerated after his parole violation hearing. Carmen is fearful of this, saying she cannot read English well. However, she says she would like to work as a way of socializing and making money, especially if Arturo is reincarcerated.
  • The children and the parents need to maintain contact with each other to support bonding and to keep parents aware of and involved in the children's development. Both parents want to do this and have demonstrated the ability to do so.
  • The children need assistance in coping with feelings of fear and insecurity, even though those fears are realistic. Parents need to understand the importance of their responsibilities to act consistently and protectively in order for the children's fears and insecurities to lessen.
  • Angela has delayed speech and needs to make progress in communication skills.
  • Tiana needs help with day care, respite care, and transportation of the children to school and appointments—she has requested these and is making good use now of the day care and cab vouchers offered by child welfare.
  • Carmen needs and wants to increase social connections to feel less isolated.
  • Both parents need a greater understanding of child development, for example, what can be expected of children ages 8 and 4 in terms of self-care and emotional reactions. Parents need to understand at what age it is appropriate to leave children alone.

B. Link results of assessment to the development of a service plan:

  • Work with parents and their support network to identify services, other interventions, and expectations for change that will link the needs to a practical plan of action. The plan should build on the strengths/protective factors, ideas, commitments, and resources identified in the needs assessment.
  • Examples of services and interventions planned with the Archuleta family include:
    • Carmen and Arturo will enter and complete drug treatment.
    • Carmen and Arturo will continue to have daily phone contact and semi-weekly supervised face-to-face contact with their children.
    • Carmen and Arturo will be drug free in all contact with their children.
    • Tiana will continue to provide care for the children.
    • Child welfare will continue to provide funding for day care and cab vouchers for transportation.
    • Godparents will provide respite care for Tiana.
    • Godparents will provide emotional support to parents, for example, by encouraging them to stick with drug treatment and helping Carmen become involved in the church again.
    • Children will remain in their schools and godparents will assist Tiana in providing transportation.
    • Both schools will have a counselor meet with the children weekly to help them adjust to removal from their parents.
    • Angela will get speech and language treatment.
    • Carmen will explore and select a job-training program once her drug treatment has been completed. This program will include English language skills.
    • Tiana will consider her own interest in and ability to provide a permanent home of the children, if needed. Other resources will be explored as well.
  • For purposes of concurrent planning, Tiana and other potential longterm caregivers should be assessed including background checks, assessing interest and readiness, as well as the needs they would have in this role.

Document Information

At the completion of the initial process of comprehensive family assessment, as well as when the information is updated, clear and full documentation has to be included in the case file. The service plan should be clear as to what services will be provided, how they will be accessed, and the specific responsibilities of the family members and the worker along with other service providers.

This is important for case management, for use in service planning and monitoring progress, to provide vital information if the court is involved or becomes involved, to share with other service providers as necessary, and to provide continuity of implementation in case the caseworker assigned to the case changes.

The requirements for documentation vary across jurisdictions. How much of the information on comprehensive family assessment is documented also varies. It is essential to document sufficient information regarding the assessment process and outcome to support case management, case coordination with other service providers, and court requirements. Some of this information may also be incorporated into some jurisdictions' automated information systems, supporting decisions on service planning and service provision.

Documentation of comprehensive family assessment information, like all child welfare documentation, should be written legibly in jargon-free language so that families can understand what is written. Additionally, they should be available in the family's language if English is not their primary language.

Documentation incorporates what is known from the assessment of the safety concerns, risks, strengths/protective factors, and needs; and it is framed in a way that suggests what expectations, services, and interventions would help meet the family's needs. Each child should be mentioned individually in documentation. Although the family's signature is needed on the service plan, the signature alone is not sufficient documentation of the family's involvement in the process.

Documentation should incorporate aspects of compliance with the Indian Child Welfare Act (ICWA) where appropriate. Documentation should also articulate what has to happen for the case to be closed.


VIGNETTE 5: The Archuleta Family — Disseminate Reassessment Findings and Update Plan

A. Share information with the family and other providers.

As before, work with the parents and their support network to identify services, other interventions, and expectations that link the reassessed needs to a practical plan. This modified plan should build on the strengths/protective factors, ideas, commitments, and resources identified in the assessment.

B. Update the plan, incorporating new information.

The revised plan for the Archuleta family includes the following goals:

  • Carmen will work with her drug treatment provider to revise her treatment plan and will follow through on it, having negative urine analysis.
  • Arturo will continue drug treatment while incarcerated.
  • Carmen will continue to have daily phone contact and semi-weekly supervised face-to-face contact with their children.
  • The child welfare agency and Arturo's parole officer will advocate for him to have more contact time with his children (phone calls, letters, audio tapes for his children).
  • Carmen will be drug-free in all contact with her children.
  • Tiana will continue to provide care for the children and will consider providing permanent care if the children cannot be returned.
  • Godparents will continue to provide respite care for Tiana.
  • Child welfare will continue to provide funding for day care when needed.
  • Godparents will provide emotional support to Carmen, such as to encourage her to remain drug free, get a job, and find a living arrangement where her efforts to avoid drugs will be supported.
  • Children will remain in their schools and godparents will assist Tiana in providing transportation.
  • Angela will continue seeing the Head Start mental health consultant and attending speech/language treatment.
  • Pablo will continue to see the child therapist. Tiana and Carmen will support recommendations made by the therapist.
  • Carmen will continue to participate in job training and will work with her job skills counselor to find and keep a job.
  • Carmen will explore other options for housing.
  • Carmen will be evaluated for depression and follow through on recommendations.
  • Tiana will consider her own interest and ability to provide a permanent home of the children if needed. Other resources, both paternal and maternal, will be explored as well.

Clinical Supervision and Mentoring

Clinical supervision is vital to reinforce what is covered in formal training as well as to provide guidance to caseworkers in gathering assessment information, using it to develop service plans, as well as interpreting ongoing assessment information at key decision points.

Clinical supervision assumes the supervisor focuses on guiding staff in making judgments and decisions on cases.

The patterns of supervision, the actual roles supervisors play, and the focus on guiding and supporting caseworker decisions vary within and across jurisdictions.

There are particular areas of practice that are known to be problematic for frontline staff. It would be useful to examine how each of these is or could be supported through supervision:

  • Incorporating information from intake, safety, and risk assessments into comprehensive family assessments;
  • Engaging families, children, and youth;
  • Working with other agencies;
  • Obtaining parental permission and authorizing releases of information;
  • Making decisions about specialized assessments;
  • Conducting re-assessments at particular points in the case process;
  • Making judgments based on comprehensive family assessment as to what has to change to achieve outcomes;
  • Using assessment information, including protective factors, in service planning; and
  • Evaluating family progress.

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

Alabama


Professionals Required to Report

Doctors, medical examiners, dentists, nurses, or pharmacists
School teachers or officials
Law enforcement officials
Daycare workers or social workers
Members of the clergy
Any other person called upon to render aid or medical assistance to a child

Reporting by Other Persons

Any other person who has reasonable cause to suspect that a child is being abused or neglected may report.

Standards for Making a Report

A report must be made when the child is known or suspected of being a victim of abuse or neglect.

Privileged Communications

Only the clergy-penitent and attorney-client privileges are permitted.

Inclusion of Reporter’s Name in Report
Not specifically required by statute
Disclosure of Reporter Identity

The department will not release the identity of the reporter except under court order when the court has determined that the reporter knowingly made a false report.

Alaska

Professionals Required to Report

Health practitioners, administrative officers of institutions
School teachers and administrators, childcare providers
Paid employees of domestic violence and sexual assault programs, and crisis intervention and prevention programs; paid employees of organizations that provide counseling or treatment to individuals seeking to control their use of drugs or alcohol
Peace officers; officers of the Department of Corrections
Persons who process or produce visual or printed matter, either privately or commercially
Members of a child fatality review team or the multidisciplinary child protection team

Mandated reporters may report cases that come to their attention in their nonoccupational capacities.
Any other person who has reasonable cause to suspect that a child has been harmed may report.

Standards for Making a Report

When, in the performance of their occupational duties, they have reasonable cause to suspect that a child has suffered harm as a result of abuse or neglect
When they have reasonable cause to suspect that visual or printed matter depicts a child engaged in the unlawful exploitation of a minor.


Privileged Communications

Neither the physician-patient nor the husband-wife privilege is recognized.
Inclusion of Reporter’s Name in Report
Not specifically required by statute
Disclosure of Reporter Identity
Not addressed in statutes reviewed


American Samoa

Professionals Required to Report

Physicians or surgeons, including physicians in training, osteopaths, optometrists, chiropodists, podiatrists, child health associates, medical examiners or coroners, dentists, nurses, or hospital personnel
Christian Science practitioners
School officials or employees
Social workers or workers in family care homes or childcare centers
Mental health professionals

Reporting by Other Persons

All other persons are urged and authorized to report.

Standards for Making a Report

When they have reasonable cause to know or suspect that a child has been subjected to abuse or neglect. When they have observed the child being subjected to circumstances or conditions that would result in abuse or neglect.

Privileged Communications

The physician-patient and the husband-wife privilege are not recognized as grounds for excluding evidence.

Inclusion of Reporter’s Name in Report

The name, address, and occupation of person making the report must be included in the report.

Disclosure of Reporter Identity

The identity of the reporter is not released to the subject of the report if such release would be detrimental to the
safety or interests of the reporter.

Arizona


Professionals Required to Report

Physicians, physician’s assistants, optometrists, dentists, behavioral health professionals, nurses, psychologists, counselors or social workers
Peace officers, members of the clergy, priests, or Christian Science practitioners
Parents, stepparents, or guardians
School personnel or domestic violence victim advocates
Any other person who has responsibility for the care or treatment of the minor.

Reporting by Other Persons

Any other person who reasonably believes that a minor is a victim of abuse or neglect may report.

Standards for Making a Report

When they reasonably believe that a minor is a victim of abuse or neglect
Privileged Communications

Only the attorney-client and the clergy-penitent privileges are recognized.

Inclusion of Reporter’s Name in Report
Not specifically required by statute
Disclosure of Reporter Identity
Not addressed in statutes reviewed

Arkansas

Professionals Required to Report

Physicians, surgeons, osteopaths, resident interns, coroners, dentists, nurses, or medical personnel
Teachers, school officials or counselors, daycare center workers
Childcare workers, foster care workers
Social workers, foster parents, or department employees
Mental health professionals
Domestic violence shelter employees or volunteers
Law enforcement personnel, peace officers, prosecuting attorneys, domestic abuse advocates, judges
Court Appointed Special Advocate (CASA) program staff or volunteers
Juvenile intake or probation officers
Any members of clergy, including ministers, priests, rabbis, accredited Christian Science practitioners, or other similar functionary of a religious organization

Reporting by Other Persons

Any other person with reasonable cause to suspect child maltreatment may report.

Standards for Making a Report

When they have reasonable cause to suspect child maltreatment. When they have observed the child being subjected to conditions or circumstances that would reasonably result in child maltreatment.

Privileged Communications

No privilege is granted except the attorney-client and clergy-penitent (including a Christian Science practitioner).

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity

The identity of the reporter shall not be disclosed unless a court determines that the reporter knowingly made a false report.

California

Professionals Required to Report
Penal Code 11166; 11165.7

Teachers, teacher’s assistants, administrative officers, certificated pupil personnel employees of any public or private school administrators and employees of public or private day camps, youth centers, youth recreation programs, or youth organizations.
Employees of childcare institutions, including, but not limited to, foster parents, group home personnel, and personnel of residential care facilities.
Social workers, probation officers, or parole officers.
Any person who is an administrator or a counselor in a child abuse prevention program in any public or private school.
District attorney investigators, peace officers, firefighters, except for volunteer firefighters.
Physicians, surgeons, psychiatrists, psychologists, dentists, licensed nurses, dental hygienists, optometrists, marriage counselors, family and child counselors and clinical social workers.
Emergency medical technicians I or II or paramedics
State or county public health employees
Coroners or medical examiners
Commercial film and photographic print processors
Child visitation monitors
Animal control officers or humane society officers
Clergy members, which includes priests, ministers, rabbis, religious practitioners, or similar functionary of a church, temple, or recognized denomination or organization.
Any custodian of records of a clergy member
Employees or volunteers of Court Appointed Special Advocate programs

Reporting by Other Persons
Penal Code 11166
Any other person who reasonably suspects that a child is a victim of abuse or neglect may report.

Standards for Making a Report


Penal Code 11166; 11165.7
When in his or her professional capacity, he or she has knowledge of or observes a child whom the reporter knows or reasonably suspects is the victim of abuse or neglect.


Commercial film and photographic print processors when they have knowledge of or observe any film, photograph, videotape, negative, or slide depicting a child under the age of 16 years engaged in an act of sexual conduct.

Privileged Communications
Penal Code 11166
Only the clergy-penitent privilege is permitted.

Inclusion of Reporter’s Name in Report
Penal Code 11167


Reports of mandated reporters shall include:
The name, business address, and telephone number of the mandated reporter
The capacity that makes the person a mandated reporter
Reports of other persons do not require the reporter’s name.

Disclosure of Reporter Identity
Penal Code 11167
The identity of the reporter shall be confidential, and shall be disclosed only:
To agencies investigating the report
When the person waives confidentiality
By court order

Colorado

Professionals Required to Report
19-3-304
Physicians, surgeons, physicians in training, child health associates, medical examiners, coroners, dentists, osteopaths, optometrists, chiropractors, podiatrists, nurses, hospital personnel, dental hygienists, physical therapists, pharmacists, registered dieticians
Public or private school officials or employees
Social workers, Christian Science practitioners, mental health professionals, psychologists, professional counselors, marriage and family therapists
Veterinarians, peace officers, firefighters, or victim’s advocates
Commercial film and photographic print processors
Counselors, marriage and family therapists, or psychotherapists
Clergy members, including priests; rabbis; duly ordained, commissioned, or licensed ministers of a church; members of religious orders; or recognized leaders of any religious bodies
Workers in the State department of human services

Reporting by Other Persons
19-3-304
Any other person may report known or suspected child abuse or neglect.

Standards for Making a Report
19-3-304
When they have reasonable cause to know or suspect child abuse or neglect
When they have observed a child being subjected to circumstances or conditions that would reasonably result in abuse or neglect.


Commercial film and photographic print processors when they have knowledge of or observe any film, photograph, videotape, negative, or slide depicting a child engaged in an act of sexual conduct.

Privileged Communications
19-3-304; 19-3-311
The clergy-penitent privilege is permitted.
The physician-patient, psychologist-client, and husband-wife privileges are not allowed as grounds for not reporting.

Inclusion of Reporter‘s Name in Report
19-3-307
The report shall include the name, address, and occupation of the person making the report.
Disclosure of Reporter Identity
19-1-307
The identity of the reporter shall be protected.

Connecticut

Professionals Required to Report
17a-101
Physicians or surgeons, nurses, medical examiners, dentists, dental hygienists, physician assistants, pharmacists, or physical therapists
Psychologists or other mental health professionals
School teachers, principals, guidance counselors, or coaches
Social workers
Police officers, juvenile or adult probation officers, or parole officers
Members of the clergy
Alcohol and drug counselors, marital and family therapists, professional counselors, sexual assault counselors, or battered women’s counselors
Emergency medical services providers
Any person paid to care for a child in any public or private facility, child daycare center, group daycare home, or family daycare home that is licensed by the State Employees of the Department of Children and Families and the Department of Public Health who are responsible for the licensing of child daycare center, group daycare homes, family daycare homes, or
youth camps.
The Child Advocate and any employee of the Office of Child Advocate

Reporting by Other Persons
17a-103
Any mandated reporter acting outside his or her professional capacity or any other person having reasonable cause to suspect that a child is being abused or neglected may report.

Standards for Making a Report
17a-101a
When, in the ordinary course of their employment or profession, they have reasonable cause to suspect or believe that a child has been abused or neglected.

Mandatory Reporters of Child Abuse and Neglect: Summary of State Laws
Privileged Communications
Not addressed in statutes reviewed

Inclusion of Reporter’s Name in Report
17a-101d; 17a-103
The reporter is not specifically required by statute to include his or her name in the report. The Commissioner shall use his or her best efforts to obtain the name and address of the reporter.

Disclosure of Reporter Identity
17a-28
The identity of the reporter shall not be released to the subject of the report unless there is reasonable cause to believe that the reporter knowingly made a false report.

Delaware

Professionals Required to Report
Tit. 16, 903
Physicians, dentists, interns, residents, osteopaths, nurses, or medical examiners
School employees
Social workers or psychologists

Reporting by Other Persons
Tit. 16, 903
Any person who knows or in good faith suspects child abuse or neglect shall make a report.

Standards for Making a Report
Tit. 16, 903
When they know or in good faith suspect child abuse or neglect
Privileged Communications
Tit. 16, 909
Only the attorney-client and clergy-penitent privileges are recognized.
Inclusion of Reporter’s Name in Report
Tit. 16, 905
Although reports may be made anonymously, the division shall request the name and address of any person making a report.
Disclosure of Reporter Identity
Not addressed in statutes reviewed

District of Columbia

Professionals Required to Report
4-1321.02
Physicians, medical examiners, dentists, chiropractors, or nurses
School officials, teachers, or daycare workers
Psychologists or other mental health professionals
Law enforcement officers (except an undercover officer whose identity or investigation might be jeopardized)
Social service workers

Reporting by Other Persons
4-1321.02
Any other person who knows or has reason to suspect that a child is being abused or neglected may report.

Standards for Making a Report
4-1321.02
When they know or have reasonable cause to suspect that a child known to him or her in his or her official capacity has been or is in danger of being abused or neglected. When they have reasonable cause to believe that a child is abused as a result of inadequate care, control, or subsistence in the home environment due to exposure to drug-related activity

Privileged Communications
4-1321.05
Neither the husband-wife nor the physician-patient privilege is permitted.
Inclusion of Reporter’s Name in Report
4-1321.03
Mandated reporters are required to provide their name, occupation, and contact information.
Disclosure of Reporter Identity
4-1321.03
The Central Register shall not release the identity of the reporter without first obtaining the permission of the
reporter.

Florida

Professionals Required to Report
39.201
Physicians, osteopaths, medical examiners, chiropractors, nurses, or hospital personnel
Other health or mental health professionals
Practitioners who rely solely on spiritual means for healing
School teachers or other school officials or personnel
Social workers, daycare center workers, or other professional childcare, foster care, residential, or institutional workers
Law enforcement officers or judges

Reporting by Other Persons
39.201
Any person who knows or has reasonable cause to suspect that a child is abused, abandoned, or neglected shall report.

Standards for Making a Report
39.201
When they know or have reasonable cause to suspect that a child is abused, abandoned, or neglected.

Privileged Communications
39.204
Only the attorney-client and clergy-penitent privileges are permitted.
Inclusion of Reporter’s Name in Report
39.201
The professionals who are mandated reporters are required to provide their names to hotline staff.

Disclosure of Reporter Identity
39.201; 39.202
The names of reporters are held confidential and may be released only: To the department, the central abuse hotline, law enforcement, or the appropriate State attorney. If the reporter consents to release in writing.

Georgia

Professionals Required to Report
19-7-5; 16-12-100
Physicians, hospital and medical personnel, podiatrists, dentists, or nurses
School teachers, administrators, guidance counselors, school social workers, or psychologists
Psychologists, counselors, social workers, or marriage and family therapists
Child welfare agency personnel (including any child-caring institution, child-placing agency, maternity home, family daycare home, group daycare home, and daycare center), child-counseling personnel, or child service organization personnel
Law enforcement personnel
Persons who process or produce visual or printed matter

Reporting by Other Persons
19-7-5
Any other person who has reasonable cause to believe that a child has been abused may report.

Standards for Making a Report
19-7-5; 16-12-100
When they have reasonable cause to believe that a child has been abused
When they have reasonable cause to believe that the visual or printed matter submitted for processing or producing depicts a minor engaged in sexually explicit conduct


Privileged Communications
19-7-5
No privileged communications are permitted for mandatory reporters.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
49-5-41
Any release of records shall protect the identity of any person reporting child abuse.

Guam

Professionals Required to Report
Tit. 19, 13201
Physicians, medical examiners, dentists, osteopaths, optometrists, chiropractors, nurses, hospital personnel, or Christian Science practitioners
School administrators, teachers, nurses, or counselors
Social services workers, daycare center workers or any other childcare or foster care workers
Mental health professionals, peace officers or law enforcement officials
Commercial film and photographic print processors

Reporting by Other Persons
Tit. 19, 13202
Any other person may report.

Standards for Making a Report
Tit. 19, 13201
Who, in the course of their employment, occupation or practice of their profession, come into contact with children, shall report when they have reason to suspect on the basis of their medical, professional, or other training and experience that a child is an abused or neglected child.

Any commercial film and photographic print processor who has knowledge of or observes any film, photograph, video tape, negative or slide depicting a child under the age of 18 years engaged in an act of sexual conduct.

Privileged Communications
Tit. 19, 13201
No person may claim privileged communications as a basis for his or her refusal or failure to report suspected child abuse or neglect or to provide Child Protective Services or the Guam Police Department with required information.
Inclusion of Reporter’s Name in Report
Tit. 19, 13203
Every report should include the name of the person making the report.
Persons who are required by law to report shall be required to reveal their names.

Disclosure of Reporter Identity
Tit. 19, 13203
The identity of the reporter is confidential and may only be disclosed: To the child protective agency and agency counsel, the Attorney General, or a licensing agency when abuse in licensed out-of-home care is reasonably suspected.
When the reporter waives confidentiality
By court order

Hawaii

Professionals Required to Report
350-1.1
Physicians, physicians in training, psychologists, dentists, nurses, osteopathic physicians and surgeons, optometrists, chiropractors, podiatrists, pharmacists, and other health-related professionals
Medical examiners or coroners
Employees or officers of any public or private school; childcare employees; employees or officers of any licensed or registered childcare facility, foster home, or similar institution.
Employees or officers of any public or private agency or institution, or other individuals, providing social, medical, hospital, or mental health services, including financial assistance.
Employees or officers of any law enforcement agency, including, but not limited to, the courts, police
departments, correctional institutions, and parole or probation offices
Employees of any public or private agency providing recreational or sports activities

Reporting by Other Persons
350-1.3
Any other person who becomes aware of facts or circumstances that cause the person to believe that child abuse or
neglect has occurred may report.

Standards for Making a Report
350-1.1
When, in their professional or official capacity, they have reason to believe that child abuse or neglect has occurred or that there exists a substantial risk that child abuse or neglect may occur in the reasonably foreseeable future
Privileged Communications
§ 350-5
The physician-patient, psychologist-client, husband-wife, and the victim-counselor privileges are not grounds for
failing to report.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
350-1.4
Every reasonable good faith effort shall be made by the department to maintain the confidentiality of the name of a reporter who requests that his or her name be confidential.

Idaho

Professionals Required to Report
16-1619
Physicians, residents on hospital staffs, interns, nurses, or coroners
School teachers or daycare personnel
Social workers or law enforcement personnel

Reporting by Other Persons
16-1619
Any person who has reason to believe that a child has been abused, abandoned, or neglected is required to report.

Standards for Making a Report
16-1619
When they have reason to believe that a child has been abused, abandoned, or neglected. When they observe a child being subjected to conditions or circumstances which would reasonably result in abuse, abandonment, or neglect

Privileged Communications
16-1619; 16-1620
Any privilege between a husband and wife and any professional and client, except for the clergy-penitent or
attorney-client privilege, shall not be grounds for failure to report.
Inclusion of Reporter’s Name in Report
Not addressed in statutes reviewed
Disclosure of Reporter Identity
Not addressed in statutes reviewed

Illinois

Professionals Required to Report
Ch. 325, 5/4; Ch. 720, 5/11-20.2
Physicians, hospital administrators and personnel, surgeons, physician assistants, osteopaths, chiropractors, genetic counselors, dentists, coroners, medical examiners, emergency medical technicians, nurses, acupuncturists, respiratory care practitioners, or home health aides.
School personnel, directors or staff of nursery schools or child daycare centers, recreational program or facility personnel, childcare workers, or homemakers.
Substance abuse treatment personnel, crisis line or hotline personnel, social workers, domestic violence
program personnel, psychologists, psychiatrists, or counselors
Social services administrators, foster parents, or field personnel of the Illinois Department of Public Aid, Public
Health, Human Services, Corrections, Human Rights, or Children and Family Services.
Truant officers, law enforcement officers, probation officers, funeral home directors or employees
Clergy members
Commercial film and photographic print processors

Reporting by Other Persons
Ch. 325, 5/4
Any other person who has reasonable cause to believe that a child is abused or neglected may report.

Standards for Making a Report
Ch. 325, 5/4; Ch. 720, 5/11-20.2
When they have reasonable cause to believe that a child known to them in their professional capacity may be abused or neglected.
Commercial film and photographic print processors when they have knowledge of or observe any film,
photograph, videotape, negative, or slide that depicts a child engaged in any sexual conduct.

Privileged Communications
Ch. 325, 5/4; Ch. 735, 5/8-803
The privileged quality of communication between any professional person required to report and his patient
or client shall not apply to situations involving abused or neglected children and shall not constitute grounds
for failure to report.
A member of the clergy shall not be compelled to disclose a confession or admission made to him or her as
part of the discipline of the religion.

Inclusion of Reporter’s Name in Report
Ch. 325, 5/7.9
The report shall include the name, occupation, and contact information of the person making the report.
Disclosure of Reporter Identity
Ch. 325, 5/11.1a
Any disclosure of information shall not identify the person making the report.


Indiana

Professionals Required to Report
31-33-5-2
Any staff member of a medical or other public or private institution, school, facility, or agency
Reporting by Other Persons
31-33-5-1
Any person who has reason to believe that a child is a victim of abuse or neglect must report.

Standards for Making a Report
31-33-5-1; 31-33-5-2
When they have reason to believe that a child is a victim of abuse or neglect

Privileged Communications
31-32-11-1
The following privileges are not permitted, and shall not be grounds for failing to report:
Husband-wife privilege
Health care provider-patient privilege
Therapist-client privilege between a certified social worker, certified clinical social worker, or certified marriage
and family therapist and a client of any of these professionals
Any privilege between a school counselor or psychologist and a student

Inclusion of Reporter’s Name in Report
31-33-7-4
The written report must include the name and contact information for the person making the report.
Disclosure of Reporter Identity
31-33-18-2
The identity of the reporter is protected whenever the report is made available to the subject of the report.


Iowa

Professionals Required to Report
232.69; 728.14
Health practitioners
Social workers
School employees, certified para-educators, coaches, or instructors employed by community colleges
Employees or operators of health care facilities, childcare centers, Head Start programs, family development
and self-sufficiency grant programs, substance abuse programs or facilities, juvenile detention or juvenile shelter care facilities, foster care facilities, or mental health centers
Employees of Department of Human services institutions
Peace officers, counselors, or mental health professionals
Commercial film and photographic print processors

Reporting by Other Persons
232.69
Any other person who believes that a child has been abused may report.

Standards for Making a Report
232.69; 728.14
When, in the scope of professional practice or their employment responsibilities, they reasonably believe that a child has been abused.

A commercial film and photographic print processor who has knowledge of or observes a film, photograph, videotape, negative, or slide that depicts a minor engaged in a prohibited sexual act or in the simulation of a prohibited sexual act

Privileged Communications
232.74
The husband-wife or health practitioner-patient privilege does not apply to evidence regarding abuse to a child.
Inclusion of Reporter’s Name in Report
232.70
The report shall contain the name and address of the person making the report.
Disclosure of Reporter Identity
232.71B
The department shall not reveal the identity of the reporter to the subject of the report.


Kansas

Professionals Required to Report
38-1522
Physicians, dentists, optometrists, nurses, chief administrative officers of medical care facilities, or emergency medical services personnel
Teachers, school administrators, or other school employees, licensed childcare providers
Psychologists, clinical psychotherapists, marriage and family therapists, social workers, clinical marriage and family therapists, professional counselors, or alcohol and drug abuse counselors
Firefighters, mediators, law enforcement officers, or juvenile intake and assessment workers

Reporting by Other Persons
38-1522
Any other person who has reason to suspect that a child has been injured as a result of maltreatment may report.

Standards for Making a Report
38-1522
When they have reason to suspect that a child has been injured as a result of maltreatment, When they know of the death of a child.

Privileged Communications
Not addressed in statutes reviewed
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
38-1507
Authorized disclosures of information shall not identify a reporter of a child in need of care.

Kentucky

Professionals Required to Report
620.030
Physicians, osteopathic physicians, nurses, coroners, medical examiners, residents, interns, chiropractors, dentists, optometrists, emergency medical technicians, paramedics, or health professionals
Teachers, school personnel, or child-caring personnel
Social workers or mental health professionals
Peace officers

Reporting by Other Persons
620.030
Any person who knows or has reasonable cause to believe that a child is dependent, neglected, or abused shall immediately report.

Standards for Making a Report
620.030
When they know or have reasonable cause to believe that a child is dependent, neglected, or abused.
Privileged Communications
620.050
Neither the husband-wife nor any professional-client/patient privilege, except the attorney-client and clergy-penitent privilege, shall be a ground for refusing to report.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
620.050
The identity of the reporter shall not be disclosed except:
To law enforcement officials, the agency investigating the report, or to a multidisciplinary team
Under court order, after a court has found reason to believe the reporter knowingly made a false report


Louisiana

Professionals Required to Report
Children’s Code art. 603
Physicians, surgeons, physical therapists, dentists, residents, interns, hospital staff members, podiatrists, chiropractors, licensed nurses, nursing aides, dental hygienists, emergency medical technicians, paramedics,
optometrists, coroners, or medical examiners
Psychiatrists, psychologists, marriage or family counselors, or social workers
Members of the clergy, including priest, rabbis, deacons or ministers, Christian Science practitioners, or other
similar functionary of a religious organization
Teachers, childcare providers, school principals, teacher’s aides, school staff members, foster home parents,
or group home or other childcare institutional staff members, personnel of residential home facilities, daycare providers, or any individuals who provide such services to children
Police officers, law enforcement officials, or probation officers
Commercial film or photographic print processors
Mediators

Reporting by Other Persons
Children’s Code art. 609
Any other person who has cause to believe that a child’s health is endangered as a result of abuse or neglect may
report.

Standards for Making a Report
Children’s Code art. 609; 610
When they have cause to believe that a child’s health is endangered as a result of abuse or neglect
Commercial film or photographic print processors when they have knowledge of or observe any film, photograph, videotape, negative, or slide depicting a child that constitutes child pornography

Privileged Communications
Children’s Code art. 603
Only the clergy-penitent privilege is permitted. No claim to privilege by other professionals is permitted.
Inclusion of Reporter’s Name in Report
Children’s Code art. 610
The report must include the name and address of the reporter.
Disclosure of Reporter Identity
Rev. Stat. 46:56
The identity of the reporter shall not be released unless a court finds that the reporter knowingly made a false report.

Maine

Professionals Required to Report
Tit. 22, 4011-A
Allopathic and osteopathic physicians, emergency medical services persons, medical examiners, podiatrists, physicians’ assistants, dentists, dental hygienists and assistants, chiropractors, nurses, home health aides,
medical or social service workers
Teachers, guidance counselors, school officials, children’s summer camp administrators or counselors, or childcare personnel
Social workers, psychologists, or mental health professionals
Court Appointed Special Advocates, guardians ad litem, homemakers, law enforcement officials, fire inspectors, municipal code enforcement officials, or chairs of licensing boards that have jurisdiction over
mandated reporters
Commercial film and photographic print processors
Clergy members acquiring the information as a result of clerical professional work except for information received during confidential communications
Humane agents employed by the Department of Agriculture, Food and Rural Resources

Reporting by Other Persons
Tit. 22, 4011-A
Any other person who knows or has reasonable cause to suspect that a child has been or is likely to be abused or
neglected may report.

Standards for Making a Report
Tit. 22, 4011-A
When the person knows or has reasonable cause to suspect that a child is or is likely to be abused or neglected.
Privileged Communications
Tit. 22, 4011-A
A member of the clergy may claim privilege when information is received during a confidential communication.
The husband-wife and physician and psychotherapist-patient privileges cannot be invoked as a reason not to
report.

Inclusion of Reporter‘s Name in Report
Tit. 22, 4012
The report shall include the name, occupation, and contact information for the person making the report.
Disclosure of Reporter Identity
Tit. 22, 4008
The identity of the reporter is protected in any release of information to the subject of the report.

Maryland

Professionals Required to Report
Fam. Law 5-704
Health practitioners
Educators or human service workers
Police officers

Reporting by Other Persons
Fam. Law 5-705
Any other person who has reason to believe that a child has been subjected to abuse or neglect must report.
Standards for Making a Report
Fam. Law 5-704; 5-705
When, acting in a professional capacity, the person has reason to believe that a child has been subjected to abuse or neglect.
Privileged Communications
Fam. Law 5-705
Only the attorney-client and clergy-penitent privileges are permitted.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Not addressed in statutes reviewed


Massachusetts

Professionals Required to Report
Ch. 119, 51A
Physicians, hospital personnel, medical examiners, emergency medical technicians, dentists, nurses, chiropractors, optometrists, or psychiatrists
Teachers, educational administrators, daycare workers or persons paid to care for or work with children in facilities that provide daycare or residential services, family daycare systems and childcare food programs, or school attendance officers
Psychologists, social workers, licensed allied mental health and human services professionals, drug and alcoholism counselors, clinical social workers, or guidance or family counselors
Probation officers, clerk or magistrates of district courts, parole officers, foster parents, firefighters or police officers
Priests, rabbis, clergy members, ministers, leaders of any church or religious body, accredited Christian Science practitioners, persons performing official duties on behalf of a church or religious body, leader of any church or religious body, or persons employed by a church or religious body to supervise, educate, coach, train, or counsel a child on a regular basis


Reporting by Other Persons
Ch. 119, 51A
Any other person who has reasonable cause to believe that a child is suffering from abuse or neglect may report.

Standards for Making a Report
Ch. 119, 51A
When, in his or her professional capacity, the person has reasonable cause to believe that a child is suffering injury from abuse or neglect that inflicts harm or a substantial risk of harm
Privileged Communications
Ch. 119, 51A
A clergy member shall report all cases of abuse, but need not report information gained in a confession or
other confidential communication.
Any other privilege relating to confidential communications shall not prohibit the filing of a report.

Inclusion of Reporter’s Name in Report
Ch. 119, 51A
Reports shall include the name of the reporter.
Disclosure of Reporter Identity
Not addressed in statutes reviewed


Michigan


Professionals Required to Report

Physicians, physician assistants, dentists, dental hygienists, medical examiners, nurses, persons licensed to provide emergency medical care, or audiologists
School administrators, counselors, or teachers
Regulated childcare providers
Psychologists, marriage and family therapists, licensed professional counselors, social workers, or social work
technicians
Law enforcement officers
Members of the clergy
Department employees, including eligibility specialists, family independence managers, family independence specialists, social services specialists, social work specialists, social work specialist managers, or welfare services specialists

Reporting by Other Persons
722.624
Any other person, including a child, who has reasonable cause to suspect child abuse or neglect, may report.

Standards for Making a Report
722.623
When they have reasonable cause to suspect child abuse or neglect

Privileged Communications
722.631
Only the attorney-client or clergy-penitent privilege can be grounds for not reporting.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
722.627
The identity of the reporter is protected in any release of information to the subject of the report.


Minnesota

Professionals Required to Report
626.556, Subd. 3
A professional or professional’s delegate who is engaged in the practice of the healing arts, hospital administration, psychiatric treatment, childcare, education, psychological treatment, social services, or law enforcement
A member of the clergy

Reporting by Other Persons
626.556, Subd. 3
Any other person may voluntarily report if the person knows, has reason to believe, or suspects that a child is being neglected or subjected to sexual or physical abuse.

Standards for Making a Report
626.556, Subd. 3
When they know or have reason to believe that a child is being neglected or sexually or physically abused
Privileged Communications
626.556, Subd. 3 & 8
A member of the clergy is not required by this subdivision to report information that is otherwise privileged under 595.02, subdivision 1, paragraph (c).
No evidence relating to the neglect or abuse of a child or to any prior incidents of neglect or abuse involving any of the same persons accused of neglect or abuse shall be excluded in any proceeding on the grounds of privilege set forth in section 595.02, subdivision 1, paragraph (a) [husband-wife], (d) [medical practitionerpatient],
or (g) [mental health professional-client].

Inclusion of Reporter’s Name in Report
626.556, Subd. 7
The report must include the name and address of the reporter.
Disclosure of Reporter Identity
626.556, Subd. 11
The name of the reporter shall be kept confidential while the report is under investigation.
After the investigation is complete, the subject of the report may compel disclosure of the name only upon the reporter’s consent or a finding by the court that the report was false and made in bad faith.


Mississippi


Professionals Required to Report
43-21-353
Physicians, dentists, interns, residents, or nurses
Public or private school employees or childcare givers
Psychologists, social workers, or child protection specialists
Attorneys, ministers, or law enforcement officers

Reporting by Other Persons
43-21-353
All other persons who have reasonable cause to suspect that a child is abused or neglected must report.
Standards for Making a Report
43-21-353
When they have reasonable cause to suspect that a child is abused or neglected
Privileged Communications
Not addressed in statutes reviewed
Inclusion of Reporter’s Name in Report
43-21-353
The department’s report shall include the name and address of the reporter, if known, and whether he or she is a material witness to the abuse.
Disclosure of Reporter Identity
43-21-353
The identity of the reporting party shall not be disclosed to anyone other than law enforcement officers or prosecutors without an order from the appropriate youth court.


Missouri

Professionals Required to Report
210.115; 568.110; 352.400
Physicians, medical examiners, coroners, dentists, chiropractors, optometrists, podiatrists, residents, interns, nurses, hospital and clinic personnel, or other health practitioners
Daycare center workers or other childcare workers, teachers, principals, or other school officials
Psychologists, mental health professionals, social workers
Ministers, which includes clergyperson, priest, rabbi, Christian Science practitioner, or other person serving in a similar capacity for any religious organization
Juvenile officers, probation, parole officers, or peace officers, law enforcement officials, or jail or detention center personnel
Other persons with responsibility for the care of children
Commercial film and photographic print processors, computer providers, installers, or repair persons, or Internet service providers


Reporting by Other Persons
210.115
Any other person who has reasonable cause to suspect that a child has been subjected to abuse may report.

Standards for Making a Report
210.115; 568.110
When they have reasonable cause to suspect that a child has been subjected to abuse or neglect
When they observe a child being subjected to conditions or circumstances that would reasonably result in abuse or neglect
Commercial film and photographic print processors when they have knowledge of or observe any film, photograph, videotape, negative, slide, or computer-generated image or picture depicting a child engaged in an act of sexual conduct

Privileged Communications
210.140
Only the attorney-client or clergy-penitent privilege may be grounds for failure to report.
Inclusion of Reporter’s Name in Report
210.130
The report must include the name, address, occupation, and contact information for the person making the report.
Disclosure of Reporter Identity
210.150
The names or other identifying information of reporters shall not be furnished to any child, parent, guardian, or
alleged perpetrator named in the report.

Montana

Professionals Required to Report
41-3-201
Physicians, residents, interns, members of hospital staffs, nurses, osteopaths, chiropractors, podiatrists, medical examiners, coroners, dentists, optometrists, or any other health professionals
School teachers, other school officials, employees who work during regular school hours, operators or employees of any registered or licensed day-care or substitute care facility, or any other operators or employees of child care facilities
Mental health professionals or social workers
Christian Science practitioners or religious healers
Foster care, residential, or institutional workers
Members of clergy
Guardians ad litem or court appointed advocates authorized to investigate a report
Peace officers or other law enforcement officials

Reporting by Other Persons
41-3-201
Any other person who knows or has reasonable cause to suspect that a child is abused or neglected may report.


Standards for Making a Report
41-3-201
When they know or have reasonable cause to suspect, as a result of information they receive in their professional or official capacity, that a child is abused or neglected.
Privileged Communications
41-3-201
A person listed as a mandated reporter may not refuse to make a report as required in this section on the grounds of a physician-patient or similar privilege.
A member of the clergy or priest is not required to make a report under this section if the communication is required to be confidential by canon law, church doctrine, or established church practice.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
41-3-201
The identity of the reporter shall not be disclosed in any release of information to the subject of the report.

Nebraska

Professionals Required to Report
28-711
Physicians, medical institutions, or nurses
School employees
Social workers

Reporting by Other Persons
28-711
All other persons who have reasonable cause to believe that a child has been subjected to abuse or neglect must report.
Standards for Making a Report
28-711
When they have reasonable cause to believe that a child has been subjected to abuse or neglect. When they observe a child being subjected to conditions or circumstances that reasonably would result in abuse or neglect.

Privileged Communications
28-714
The physician-patient, counselor-client, and husband-wife privileges shall not be grounds for failing to report.
Inclusion of Reporter’s Name in Report
28-711
The initial oral report shall include the reporter’s name and address.

Disclosure of Reporter Identity
28-719
The name and address of the reporter shall not be included in any release of information.


Nevada

Professionals Required to Report
432B.220
Physicians, dentists, dental hygienists, chiropractors, optometrists, podiatrists, medical examiners, residents, interns, nurses, or physician assistants.
Emergency medical technicians, other persons providing medical services, or hospital personnel
Coroners
School administrators, teachers, counselors, or librarians
Any persons who maintain or are employed by facilities or establishments that provide care for children, children’s camps, or other facilities, institutions, or agencies furnishing care to children
Psychiatrists, psychologists, marriage and family therapists, alcohol or drug abuse counselors, athletic trainers, or social workers
Clergymen, practitioners of Christian Science, or religious healers, unless they have acquired the knowledge of the abuse or neglect from the offenders during confessions
Persons licensed to conduct foster homes
Officers or employees of law enforcement agencies or adult or juvenile probation officers
Attorneys, unless they have acquired the knowledge of the abuse or neglect from clients who are, or may be, accused of the abuse or neglect
Any person who is employed by or serves as a volunteer for an approved youth shelter
Any adult person who is employed by an entity that provides organized activities for children
Any person who maintains, is employed by, or serves as a volunteer for an agency or service that advises persons regarding abuse or neglect of a child and refers them to services

Reporting by Other Persons
432B.220
Any other person may report.
Standards for Making a Report
432B.220
When, in their professional capacity, they know or have reason to believe that a child is abused or neglected
When they have reasonable cause to believe that a child has died as a result of abuse or neglect

Privileged Communications
432B.220; 432B.250
The clergy-penitent privilege applies when the knowledge is gained during religious confession.
The attorney-client privilege applies when the knowledge is acquired from a client who is or may be accused of abuse.
Any other person who is required to report may not invoke privilege for failure to make a report.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
432B.290
The identity of the reporter is kept confidential.


New Hampshire


Professionals Required to Report
169-C:29
Physicians, surgeons, county medical examiners, psychiatrists, residents, interns, dentists, osteopaths, optometrists, chiropractors, nurses, hospital personnel, or Christian Science practitioners
Teachers, school officials, nurses, or counselors
Daycare workers or any other child or foster care workers
Social workers
Psychologists or therapists
Priests, ministers, or rabbis
Law enforcement officials

Reporting by Other Persons
169-C:29
All other persons who have reason to suspect that a child has been abused or neglected must report.

Standards for Making a Report
169-C:29
When they have reason to suspect that a child has been abused or neglected
Privileged Communications.
169-C:32
Only the attorney-client privilege is permitted.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Not addressed in statutes reviewed


New Jersey

Professionals Required to Report
None specified in statute

Reporting by Other Persons
9:6-8.10
Any person having reasonable cause to believe that a child has been subjected to child abuse or acts of child abuse shall report.
Standards for Making a Report
9:6-8.10
When they have reasonable cause to believe that a child has been subjected to abuse.
Privileged Communications
Not addressed in statutes reviewed
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
9:6-8.10a
The identity of the reporter shall not be made public.
Any information that could endanger any person shall not be released.

New Mexico

Professionals Required to Report
32A-4-3
Physicians, residents, or interns
Law enforcement officers or judges
Nurses
Teachers or school officials
Social workers
Members of the clergy

Reporting by Other Persons
32A-4-3
Every person who knows or has a reasonable suspicion that a child is an abused or a neglected child shall report the matter immediately.
Standards for Making a Report
32A-4-3
When they know or have a reasonable suspicion that a child is abused or neglected

Privileged Communications
32A-4-3; 32A-4-5
A clergy member need not report any information that is privileged.
The report or its contents or any other facts related thereto or to the condition of the child who is the subject of the report shall not be excluded on the ground that the matter is or may be the subject of a physicianpatient
privilege or similar privilege or rule against disclosure.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
32A-4-33
Any release of information to a parent, guardian, or legal custodian shall not include identifying information about the reporter.


New York


Professionals Required to Report
Soc. Serv. Law 413
Physicians, physician assistants, surgeons, medical examiners, coroners, dentists, dental hygienists, osteopaths, optometrists, chiropractors, podiatrists, residents, interns, nurses, hospital personnel, emergency medical technicians, or Christian Science practitioners
School officials, social workers, social services workers, daycare center workers, providers of family or group family daycare, employees or volunteers in a residential care facility, or any other childcare or foster care
worker
Psychologists, therapists, mental health professionals, substance abuse counselors, or alcoholism counselors
Police officers, district attorneys or assistant district attorneys, investigators employed in the office of a district attorney, or other law enforcement officials

Reporting by Other Persons
Soc. Serv. Law 414
Any other person who has reasonable cause to suspect that a child is abused or maltreated may report.
Standards for Making a Report
Soc. Serv. Law 413
When they have reasonable cause to suspect that a child coming before them in their professional or official capacity is an abused or maltreated child. Where the parent, guardian, custodian, or other person legally responsible for the child comes before the reporter and states from personal knowledge facts, conditions, or circumstances that, if correct, would render the child an abused or maltreated child.

Privileged Communications
Not addressed in statutes reviewed

Inclusion of Reporter’s Name in Report
Soc. Serv. Law 415
The report shall include the name and contact information for the reporter.

Disclosure of Reporter Identity
Soc. Serv. Law 422-a
Any disclosure of information shall not identify the source of the report.
North Carolina
Professionals Required to Report
7B-301
Any institution
Reporting by Other Persons
7B-301
All persons who have cause to suspect that any juvenile is abused, neglected, or dependent, or has died as the result of maltreatment, shall report.

Standards for Making a Report
7B-301
When they have cause to suspect that any juvenile is abused, neglected, or dependent, or has died as the result of maltreatment.
Privileged Communications
7B-310
No privilege shall be grounds for failing to report.
Only the attorney-client privilege shall be grounds for excluding evidence of abuse in any judicial proceeding.

Inclusion of Reporter’s Name in Report
7B-301
The report must include the name, address, and telephone number of the reporter.
Disclosure of Reporter Identity
7B-302
The department shall hold the identity of the reporter in strictest confidence.

North Dakota

Professionals Required to Report
50-25.1-03
Physicians, nurses, dentists, optometrists, medical examiners or coroners, or any other medical or mental health professionals or religious practitioners of the healing arts
School teachers, administrators, or school counselors
Addiction counselors or social workers
Daycare center or any other childcare workers
Police or law enforcement officers
Members of the clergy

Reporting by Other Persons
50-25.1-03
Any other person who has reasonable cause to suspect that a child is abused or neglected may report.

Standards for Making a Report
50-25.1-03
When they have knowledge of or reasonable cause to suspect that a child is abused or neglected if the knowledge or suspicion is derived from information received by that person in that person’s official or professional capacity.
Privileged Communications
50-25.1-03; 50-25.1-10
A member of the clergy is not required to report such circumstances if the knowledge or suspicion is derived from information received in the capacity of spiritual adviser.
Any privilege of communication between husband and wife or between any professional person and the person’s patient or client, except between attorney and client, cannot be used as grounds for failing to report.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
50-25.1-11
The identity of the reporter is protected.

Northern Mariana Islands

Professionals Required to Report
Tit. 6, 5313
Any health care worker, including anesthesiologists, acupuncturists, chiropractors, dentists, health aides, hypnotists, massage therapists, mental health counselors, midwives, nurses, nurse practitioners, osteopaths, naturopaths, physical therapists, physicians, physician’s assistants, psychiatrists, psychologists, radiologists, religious healing practitioners, surgeons, or x-ray technicians
School teachers or other school officials
Daycare providers, nannies, au-pair workers, or any other person who is entrusted with the temporary care of a minor child in return for compensation, but does not include babysitters who are themselves minor children
Counselors or social workers
Peace officers or other law enforcement officials

Reporting by Other Persons
Tit. 6, 5313
Any other person may at any time report known or suspected instances of child abuse.

Standards for Making a Report
Tit. 6, 5313
When a mandated reporter comes into contact in a professional capacity with a child who the person knows or has
reasonable cause to suspect is abused or neglected
Privileged Communications
Tit. 6, 5316
Only the attorney-client privilege is permitted.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Tit. 6, 5325
The release of the identity of the reporter is prohibited.

Ohio

Professionals Required to Report
2151.421
Physicians, residents, interns, podiatrists, dentists, nurses, other health care professionals, speech pathologists, audiologists, coroners
Licensed school psychologists; administrators or employees of child daycare centers, residential camps, or child day camps; school teachers, employees, or authorities
Licensed psychologists, marriage and family therapists, social workers, professional counselors, or agents of county humane societies
Persons rendering spiritual treatment through prayer in accordance with the tenets of a wellrecognized religion
Superintendent, board member, or employee of a county board of mental retardation;
investigative agent contracted with by a county board of mental retardation; or employee of the department of mental retardation and developmental disabilities
Attorneys

Reporting by Other Persons
2151.421
Any other person who suspects that a child has suffered or faces a threat of suffering from abuse or
neglect may report.

Standards for Making a Report
2151.421
When a mandated person is acting in an official or professional capacity and knows or suspects that a child has suffered or faces a threat of suffering any physical or mental wound, injury, disability, or condition of a nature that reasonably indicates abuse or neglect of the child
Privileged Communications
2151.421
The attorney-client or physician-patient privilege is waived if the client or patient is a child who is suffering or faces the threat of suffering any physical or mental injury.
The physician-patient privilege shall not be a ground for excluding evidence regarding a child’s injuries, abuse, or neglect, or the cause of the injuries, abuse, or neglect in any judicial proceeding
resulting from a report.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
2151.421
The name of the person who made the report shall not be released.

Oklahoma

Professionals Required to Report
Tit. 10, 7103-7104; Tit. 21, § 1021.4
Physicians, surgeons, residents, interns, dentists, osteopaths, nurses, or other health care professionals
Teachers
Commercial film and photographic print processors

Reporting by Other Persons
Tit. 10, 7103
Any person who has reason to believe that a child is a victim of abuse or neglect must report.

Standards for Making a Report
Tit. 10, 7103-7104; Tit. 21, 1021.4
When they have reason to believe that a child is a victim of abuse or neglect
When a health care professional treats the victim of what appears to be criminally injurious conduct, including, but not limited to, child physical or sexual abuse. When a health care professional attends the birth of a child who tests positive for alcohol or a controlled dangerous substance.

When any commercial film and photographic print processor has knowledge of or observes any film, photograph, video tape, negative, or slide, depicting a child engaged in an act of sexual conduct.

Privileged Communications
Tit. 10, 7103
No privilege shall relieve any person from the requirement to report.
Inclusion of Reporter’s Name in Report
Tit. 10, 7108
Reports may be made anonymously.
Disclosure of Reporter Identity
Tit. 10, 7109
The department shall not release the identity of the person who made the initial report unless a court orders the release of information for good cause shown.

Oregon

Professionals Required to Report
419B.005
Physicians, interns, residents, optometrists, dentists, emergency medical technicians, naturopathic physicians, or nurses
Employees of the Department of Human Resources, State Commission on Children and Families, Childcare
Division of the Employment Department, the Oregon Youth Authority, a county health department, a community mental health and developmental disabilities program, a county juvenile department, a licensed child-caring agency, or an alcohol and drug treatment program
School employees, childcare providers, psychologists, members of clergy, social workers, foster care providers, counselors, or marriage and family therapists
Peace officers, attorneys, firefighters, or court appointed special advocates
Members of the legislative assembly

Reporting by Other Persons
419B.015
Any person may voluntarily make a report.
Standards for Making a Report
419B.010
When any public or private official has reasonable cause to believe that any child with whom the official comes in contact has suffered abuse
Privileged Communications
419B.010
A psychiatrist, psychologist, member of the clergy, or attorney shall not be required to report if such communication is privileged under law.
An attorney is not required to make a report of information communicated to the attorney in the course of representing a client, if disclosure of the information would be detrimental to the client.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
419B.035
The name, address, and other identifying information about the person who made the report may not be disclosed.

Pennsylvania

Professionals Required to Report
Ch. 23, 6311
Physicians, osteopaths, medical examiners, coroners, funeral directors, dentists, optometrists, chiropractors, nurses, hospital personnel, or Christian Science practitioners
Members of the clergy
School administrators, teachers, or school nurses
Social services workers, daycare center workers, or any other childcare or foster care workers, or mental health professionals
Peace officers or law enforcement officials

Reporting by Other Persons
Ch. 23, 6312
Any person who has reason to suspect that a child is abused may report.

Standards for Making a Report
Ch. 23, 6311
When, in the course of their employment, occupation, or practice of their profession, they have reasonable cause to suspect, on the basis of their medical, professional, or other training and experience, that a child coming before them is an abused child.
Privileged Communications
Ch. 23, 6311
Except for confidential communications made to an ordained member of the clergy that are protected under 42
Pa.C.S. 5943 (relating to confidential communications to clergymen), the privileged communication between any professional person required to report and the patient or client of that person shall not apply to situations involving child abuse and shall not constitute grounds for failure to report.
Inclusion of Reporter’s Name in Report
Ch. 23, 6313
Mandated reporters must make a written report that includes their name and contact information.
Disclosure of Reporter Identity
Ch. 23, 6340
The release of the identity of the mandated reporter is prohibited unless the secretary finds that the release will not be detrimental to the safety of the reporter.

Puerto Rico

Professionals Required to Report
Tit. 8, 441a
Professionals or public officials
Professionals in the fields of health, education, social work, or law and order
Persons engaged in managing or who work in caregiving institutions or centers that provide services 24 hours a day or any part thereof
Child rehabilitation institutions or centers; foster homes
Processors of film or photographs

Reporting by Other Persons
Tit. 8, 441b
Any person who has knowledge of or suspects that a minor is a victim of abuse must report.

Standards for Making a Report
Tit. 8, 441a
When in their professional capacity and in the performance of their functions, they should have knowledge of or suspect that a minor is or has been at risk of being a victim of abuse. When they have knowledge of or observe any motion picture, photograph, videotape, negatives, or slides that depict a minor involved in a sexual activity.

Privileged Communications
Not addressed in statutes reviewed
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Tit. 8, 441b
The identity of the person who made the report shall be kept in strict confidence.

Rhode Island

Professionals Required to Report
40-11-6
Any physician or duly certified registered nurse practitioner
Reporting by Other Persons
40-11-3(a)
Any person who has reasonable cause to know or suspect that a child has been abused or neglected must report.

Standards for Making a Report
40-11-3(a); 40-11-6
When they have reasonable cause to know or suspect that a child has been abused or neglected. When any physician or nurse practitioner has cause to suspect that a child brought to them for treatment is an abused or neglected child or when they determine that a child under the age of 12 years is suffering from any sexually transmitted disease.


Privileged Communications
40-11-11
The privileged quality of communication between husband and wife and any professional person and his or her patient or client, except that between attorney and client, shall not constitute grounds for failure to report.
Inclusion of Reporter‘s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Not addressed in statutes reviewed


South Carolina

Professionals Required to Report
20-7-510
Physicians, nurses, dentists, optometrists, medical examiners, or coroners
Any other medical, emergency medical services, or allied health professionals
School teachers or counselors, principals, or assistant principals
Childcare workers in any childcare centers or foster care facilities
Mental health professionals, social or public assistance workers, or substance abuse treatment staff
Members of the clergy including Christian Science practitioners or religious healers
Police or law enforcement officers, judges, funeral home directors or employees
Persons responsible for processing films or computer technicians

Reporting by Other Persons
20-7-510
Any other person who has reason to believe that a child’s physical or mental health or welfare has been or may be adversely affected by abuse and neglect may report.

Standards for Making a Report
20-7-510
When in their professional capacity they have received information which gives them reason to believe that a child has been or may be abused or neglected.


Privileged Communications
20-7-550
The privileged quality of communication between husband and wife and any professional person and his patient or client, except that between attorney and client or clergy member, including Christian Science Practitioner or religious healer, and penitent, does not constitute grounds for failure to report.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
20-7-510
The identity of the person making a report pursuant to this section must be kept confidential by the agency or department receiving the report and must not be disclosed.


South Dakota

Professionals Required to Report
26-8A-3
Physicians, dentists, osteopaths, chiropractors, optometrists, nurses, coroners
Teachers, school counselors or officials, child welfare providers
Mental health professionals or counselors, psychologists, social workers, chemical dependency counselors, employees or volunteers of domestic abuse shelters, or religious healing practitioners
Parole or court services officers or law enforcement officers
Any safety-sensitive position, as defined in 23-3-64

Reporting by Other Persons
26-8A-3
Any person who knows or has reasonable cause to suspect that a child has been abused or neglected may report.

Standards for Making a Report
26-8A-3
When they have reasonable cause to suspect that a child has been abused or neglected.
Privileged Communications
26-8A-15
The following privileges may not be claimed as a reason for not reporting:
Physician-patient
Husband-wife
School counselor-student
Social worker-client

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
26-8A-11.1
The name of the reporter is not disclosed unless:
The report is determined to be unsubstantiated
Within 30 days, the subject of the report requests disclosure of the reporter’s identity.
A hearing is held to determine whether the report was made with malice and without reasonable foundation and that release of the name will not endanger the life or safety of the reporte.r


Tennessee

Professionals Required to Report
37-1-403; 37-1-605
Physicians, osteopaths, medical examiners, chiropractors, nurses, hospital personnel, or other health or mental health professionals
School teachers, other school officials or personnel, daycare center workers, or other professional childcare, foster care, residential, or institutional workers
Social workers
Practitioners who rely solely on spiritual means for healing
Judges or law enforcement officers
Neighbors, relatives, or friends

Reporting by Other Persons
37-1-403; 37-1-605
Any person who has knowledge that a child has been harmed by abuse or neglect must report.

Standards for Making a Report
37-1-403; 37-1-605
When they have knowledge that a child has been harmed by abuse or neglect
When they are called upon to render aid to any child who is suffering from an injury that reasonably appears to have been caused by abuse. When they know or have reasonable cause to suspect that a child has been sexually abused

Privileged Communications
37-1-411
The following privileges may not be claimed:
Husband-wife
Psychiatrist-patient or psychologist-patient

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
37-1-409
The name of the reporter shall not be released, except as may be ordered by the court.

Texas

Professionals Required to Report
Fam. Code 261.101
A professional, for purposes of the reporting laws, is an individual who is licensed or certified by the state or who is an employee of a facility licensed, certified, or operated by the state and who, in the normal course of
official duties or duties for which a license or certification is required, has direct contact with children.


Professionals include:
Teachers or daycare employees
Nurses, doctors, or employees of a clinic or health care facility that provides reproductive services
Juvenile probation officers or juvenile detention or correctional officers

Reporting by Other Persons
Fam. Code 261.101
A person who has cause to believe that a child has been adversely affected by abuse or neglect shall immediately make a report.
Standards for Making a Report
Fam. Code 261.101
When they have cause to believe that a child has been adversely affected by abuse or neglect
Privileged Communications
Fam. Code 261.101
No privilege may be claimed to exempt a person from the duty to report.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Fam. Code 261.201
The identity of the reporter is confidential and may not be disclosed to the subject of the report.


Utah

Professionals Required to Report
62A-4a-403
Any person licensed under the Medical Practice Act or the Nurse Practice Act
Reporting by Other Persons
62A-4a-403
Any person who has reason to believe that a child has been subjected to abuse or neglect must report.
Standards for Making a Report
62A-4a-403
When they have reason to believe that a child has been subjected to abuse or neglect. When they observe a child being subjected to conditions or circumstances that would reasonably result in sexual abuse, physical abuse, or neglect.

Privileged Communications
62A-4a-403
The requirement to report does not apply to a clergyman or priest, without the consent of the person making the confession, with regard to any confession made to him in his professional character in the course of discipline enjoined by the church to which he belongs.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
62A-4a-412
The name and contact information of the reporter shall be deleted prior to any release of records to the subject of the report.


Vermont

Professionals Required to Report
Tit. 33, 4913
Physicians, surgeons, osteopaths, chiropractors, physician’s assistants, hospital administrators, nurses, medical examiners, dentists, psychologists, or other health care providers
School superintendents, school teachers, school librarians, daycare workers, school principals, school guidance counselors, mental health professionals, or social workers
Probation officers, police officers, camp owners, camp administrators or counselors
Members of the clergy

Reporting by Other Persons
Tit. 33, 4913
Any other person who has reasonable cause to believe that a child has been abused or neglected may report.

Standards for Making a Report
Tit. 33, 4913
When they have reasonable cause to believe that a child has been abused or neglected.
Privileged Communications
Tit. 33, 4913
A member of the clergy is not required to report if the knowledge comes from a communication that is required to be kept confidential by religious doctrine.
Inclusion of Reporter’s Name in Report
Tit. 33, 4914
Reports shall contain the name and address of the reporter.


Disclosure of Reporter Identity
Tit. 33, 4913
The name of the person making the report shall be confidential unless:
The person making the report requests disclosure.
A court determines that the report was not made in good faith.

Virgin Islands

Professionals Required to Report
Tit. 5, 2533
Physicians, hospital personnel, nurses, dentists, or any other medical or mental health professionals
School teachers or other school personnel, social service workers, daycare workers, or other childcare or foster care workers
Peace officers or law enforcement officials

Reporting by Other Persons
Tit. 5, 2533
Any other person who has reasonable cause to suspect that a child has been abused or neglected may report.

Standards for Making a Report
Tit. 5, 2533
When they have reasonable cause to suspect that a child has been subjected to abuse, sexual abuse, or neglect. When they observe the child being subjected to conditions or circumstances that would reasonably result in
abuse or neglect

Privileged Communications
Tit. 5, 2538
The privileged quality of communications between husband and wife and between any professional person and his patient or his client, except that between attorney and client, shall not constitute grounds for failure to report.

Inclusion of Reporter’s Name in Report
Tit. 5, 2534
The report shall include the name, address, and occupation of the reporter.
Disclosure of Reporter Identity
Not addressed by statutes reviewed
Mandatory Reporters of Child Abuse and Neglect: Summary of State Laws

Virginia

Professionals Required to Report
63.2-1509
Persons licensed to practice medicine or any of the healing arts, hospital residents or interns, nurses, or duly accredited Christian Science practitioners
Teachers or other persons employed in public or private schools, kindergartens, or nursery schools; persons providing childcare full-time or part-time for pay on a regularly planned basis
Social workers, mental health professionals, or any person responsible for the care, custody, and control of children
Probation officers, law enforcement officers, mediators, or court-appointed special advocates

Reporting by Other Persons
63.2-1510
Any person who suspects that a child is abused or neglected may report.

Standards for Making a Report
63.2-1509
When, in their professional or official capacity, they have reason to suspect that a child is abused or neglected.
Privileged Communications
63.2-1519
The physician-patient or husband-wife privilege is not permitted.
Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Not addressed in statutes reviewed


Washington

Professionals Required to Report
26.44.030
Practitioners, county coroners or medical examiners, pharmacists, or nurses
Professional school personnel or childcare providers
Social service counselors or psychologists
Employees of the State Department of Social and Health Services
Juvenile probation officers, law enforcement officers, personnel of the Department of Corrections, or placement and liaison specialists
Responsible living skills program staff, HOPE center staff, State family and children’s ombudsman, or any volunteer in the ombudsman’s office
Any adult with whom a child resides

Reporting by Other Persons
26.44.030
Any person who has reasonable cause to believe that a child has suffered abuse or neglect may report.

Standards for Making a Report
26.44.030
When they have reasonable cause to believe that a child has suffered abuse or neglect.
Privileged Communications
26.44.060
Making a report shall not be considered a violation of any of the following privileges:
Clergy-penitent
Physician or optometrist-patient
Psychologist-client

Inclusion of Reporter’s Name in Report
26.44.030
The department shall make reasonable efforts to learn the name, address, and telephone number of the reporter.
Disclosure of Reporter Identity
26.44.030
The department shall provide assurances of appropriate confidentiality of information in the report.


West Virginia

Professionals Required to Report
49-6A-2
Medical, dental, or mental health professionals; emergency medical services personnel
School teachers or other school personnel; childcare workers or foster care workers
Christian Science practitioners or religious healers
Social service workers
Peace officers or law enforcement officials, circuit court judges, family law masters, employees of the division of juvenile services, or magistrates
Members of the clergy

Reporting by Other Persons
49-6A-2
Any person who has reasonable cause to suspect that a child is abused or neglected may report.

Standards for Making a Report
49-6A-2
When they have reasonable cause to suspect that a child is abused or neglected. When they observe the child being subjected to conditions that are likely to result in abuse or neglect. When they believe that a child has suffered serious physical abuse or sexual abuse or sexual assault.

Privileged Communications
49-6A-7
The privileged quality of communications between husband and wife and between any professional person and his patient or his client, except that between attorney and client, cannot be invoked in situations involving suspected or known child abuse or neglect.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
Not addressed in statutes reviewed

Wisconsin

Professionals Required to Report
48.981
Physicians, coroners, medical examiners, nurses, dentists, chiropractors, optometrists, acupuncturists, other medical or mental health professionals, physical therapists, dietitians, occupational therapists, speechlanguage pathologists, audiologists, or emergency medical technicians
School teachers, administrators or counselors, childcare workers in daycare centers, group homes, or residential care centers, or daycare providers
Alcohol or other drug abuse counselors, marriage and family therapists, or professional counselors
Social workers, public assistance workers, first responders, police or law enforcement officers, mediators, or court appointed special advocates
Members of the clergy or a religious order, including brothers, ministers, monks, nuns, priests, rabbis, or sisters

Reporting by Other Persons
48.981
Any person, including an attorney, who has reason to suspect that a child has been abused or neglected or who has reason to believe that a child has been threatened with abuse or neglect and that abuse or neglect of the child will
occur may report.

Standards for Making a Report
48.981
When, in the course of their professional duties, they have reasonable cause to suspect that a child has been abused or neglected. When, in the course of their professional duties, they have reason to believe that a child has been threatened with abuse or neglect or that abuse or neglect will occu.r

Privileged Communications
48.981
A member of the clergy is not required to report child abuse information that he or she receives solely through confidential communications made to him or her privately or in a confessional setting.

Inclusion of Reporter’s Name in Report
Not specifically required in statute
Disclosure of Reporter Identity
48.981
The identity of the reporter shall not be disclosed to the subject of the report.

Wyoming

Professionals Required to Report
None specified in statute
Reporting by Other Persons
14-3-205
All persons must report.

Standards for Making a Report
14-3-205
When they know or have reasonable cause to believe or suspect that a child has been abused or neglected. When they observe any child being subjected to conditions or circumstances that would reasonably result in abuse or neglect.

Privileged Communications
14-3-210
Only the clergy-penitent and attorney-client privileges are permitted.
Inclusion of Reporter’s Name in Report
14-3-206
The reporter is not specifically required to provide his or her name in the written report.
If photographs or x-rays of the child are taken, the person taking them must be identified.

Disclosure of Reporter Identity
Not addressed in statutes reviewed

References:

Child Abuse: Implications for Child Development and Psychopathology by David A. Wolfe - 1999

Child Maltreatment: Theory and Research on the Causes and Consequences of ... by Dante Cicchetti, Vicki Carlson - 1989

Child Welfare Information Gateway

Child Abuse: An American Epidemic by Elaine Landau - Juvenile Nonfiction - 1990

Child Abuse and Its Consequences: Observational Approaches by Rachel Calam, Cristina Franchi - Medical - 1987

US Department of Health and Human Services; Child Sexual Abuse: Intervention and Treatment Issues, Faller, 1993

Child Abuse: Opposing Viewpoints by Jennifer A. Hurley - 1998

Child Abuse: Perspectives on Diagnosis, Treatment, and Prevention by Roberta Kalmar - Family & Relationships - 1977

Dangerous Families: Assessment and Treatment of Child Abuse by Peter Dale - Family & Relationships - 1986

Breaking the Cycle of Child Abuse by Christine Comstock Herbruck - Political Science - 1979

Child Abuse Trauma: Theory and Treatment of the Lasting Effects by John Briere - Psychology - 1992

Child Sexual Abuse: Intervention and Treatment Issues by Kathleen C. Faller - Family & Relationships - 1993

Child Abuse and Culture: Working with Diverse Families by Lisa Aronson Fontes - Psychology - 2005

Finding Courage to Speak: Women's Survival of Child Abuse by Paige Alisen - Psychology - 2003

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