child advocacy

Children and Youth Services Review 50 (2015) 96–100

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Children and Youth Services Review

journal homepage: www.elsevier.com/locate/childyouth

Comparing reports of suspected child maltreatment in states with and without Universal Mandated Reporting

Kathryn S. Krase a,⁎, Tobi A. DeLong-Hamilton b,1

a LIU Brooklyn, Department of Social Work, 1 University Plaza, Brooklyn, New York 11201, United States b University of Utah, 201 Presidents Circle, Room 201, Salt Lake City, UT 84112, United States

⁎ Corresponding author. Tel.: +1 718 780 6544. E-mail addresses: [email protected] (K.S. Krase),

(T.A. DeLong-Hamilton). 1 Tel.: +1 801 581 7151.

http://dx.doi.org/10.1016/j.childyouth.2015.01.015 0190-7409/© 2015 Elsevier Ltd. All rights reserved.

a b s t r a c t

a r t i c l e i n f o

Article history: Received 24 September 2014 Received in revised form 13 January 2015 Accepted 14 January 2015 Available online 22 January 2015

Keywords: Child abuse Child Protective Services Child abuse reporting State policy Federal policy

Every state has a statute through which certain individuals are required to report suspicions of child maltreat- ment to Child Protective Services. Some states require all adults to report suspicions of child maltreatment (Universal Mandated Reporting); other states only require certain professionals to make such reports. In response to high profile child sexual abuse cases, many states have considered moving to Universal Mandated Reporting. This study compares characteristics and outcomes of reports from states with and without Universal Mandated Reporting. Analysis found no differences in the rate of report or report disposition. Reports from edu- cational personnel in states with universal reporting made up a smaller proportion of reports than in states where only a delineated list of professionals are required to report. Additionally, states with Universal Mandated Reporting had more reports involving neglect as compared to other states. These findings are important to inform any movement to expand Universal Mandated Reporting.

© 2015 Elsevier Ltd. All rights reserved.

1. Introduction

In 2011, Penn State Assistant Football Coach, Jerry Sandusky, was indicted on 52 counts of child molestation (Ganim, 2011). Findings in his criminal trial indicated that college officials missed opportunities to report suspected abuse to Child Protective Services (Moulton, 2014). The Sandusky case pushed state and national lawmakers, child welfare workers and community members to reexamine mandated reporting laws.

1.1. Mandated reporting

Most suspicions of child maltreatment that are reported to Child Protective Services (CPS) are made by professionals (United States Department of Health and Human Services, Administration on Children, Youth & Families, 2013). Most professionals who make reports to CPS are mandated by the law in their state to do so. The policy of mandating professionals to make a report when they suspect child abuse and ne- glect (“mandated reporting”) developed in the mid-twentieth century in the United States and has since evolved to the complex system of fed- eral, state and local mandates that exists across the country today (Lau, Krase & Morse, 2008). Every state has a statute through which certain

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individuals are required to report suspicions of child maltreatment to Child Protective Services.

Some states require all adults to report suspicions of child maltreat- ment (Universal Mandated Reporting); other states only require certain professionals to make such reports (McElroy, 2012). In most states, cat- egories of professionals who regularly work with children and families are selected to be mandated. Professionals listed as mandated reporters by a given state often include: social workers, educational personnel, health care workers, mental health professionals, child care providers, medical examiners, and law enforcement. Eighteen (18) states are Universal Mandated Reporting Law (UMRL) states (see shaded states in Fig. 1). The other 32 states (not shaded) delegate mandated reporting to professionals generally involved with children (Lau, Krase & Morse, 2008). Hawaii and Alaska (not pictured) are not Universal Mandated Reporting states.

1.2. Factors that impact reporting behavior

High profile allegations of child sexual abuse at Penn State highlight- ed one of the perennial concerns of the child protection system: under- reporting of suspected child abuse in the United States. Research consis- tently shows that professionals fail to report more than half of their suspicions of child maltreatment to the proper authorities (Delaronde, King, Bendel, & Reece, 2000; Kenny, 2001b; Kesner & Robinson, 2002). Different characteristics and attitudes of the reporter and demographics of the alleged victim and perpetrator have been found to impact the likelihood of reporting suspicions to CPS.

Fig. 1. Mandated reporter requirements by state. Derived from data from U.S. Department of Health and Human Services, Children's Bureau (2013).

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The type of reporter was found to impact the likelihood of reporting suspicions to CPS (King, Reece, Bendel, & Patel, 1998). From a group of randomly selected pediatricians, master's level social workers (MSWs), and physicians' assistants (PAs), pediatricians were found to report the greatest proportion of their suspicions, followed by MSWs (King et al., 1998). Multivariate analysis revealed that the strongest pre- dictors of reporting were case-related attitudes, process concerns, insti- tutional setting, and the amount of training the professional received (King et al., 1998).

Variations in the likelihood to report child maltreatment by family therapists were found to be dependent on years of practice and primary professional identity (Brown & Strozier, 2004). Perhaps contrary to expectations, therapists with less practice experience were more likely to report suspicions to CPS than therapists with more than 10 years of experience. Additionally, therapists who were social workers reported more often, than marriage and family therapists, and counselors (Brown & Strozier, 2004).

Attitudes and beliefs of mandated reporters impact their likelihood to report. Professionals often do not feel adequately prepared to deal with child abuse and neglect (Levin, 1983). They report not knowing the signs of abuse and neglect (Hazzard, 1984; Kenny, 2004; Levin, 1983). They have difficulty differentiating “parental excesses from ‘normal’ parental disciplines” (Levin, 1983, p. 18). Often, professionals assume that someone else will report the child abuse or neglect (Crenshaw, Crenshaw, & Lichtenberg, 1995). Mandated reporters fear legal ramifications for logging reports that are unfounded (Abrahams, Casey, & Daro, 1992; Kenny, 2001a). They express concern for losing rapport with a family if they report them to CPS (Abrahams et al., 1992; Zellman, 1990a). Other professionals do not make reports be- cause they fear disrupting the functioning of families and sparking con- flict with families by reporting (Kenny, 2001a; Levin, 1983). Some reporters choose not to make reports to CPS because they feel that CPS does not actually help maltreated children and their families (Kenny, 2001b; Zellman, 1990b).

Race of the alleged child victim and/or perpetrator may also impact the likelihood of a professional to report suspicions to CPS. When con- trolling for other social and demographic factors, African-American families are more likely to be reported to CPS by certain professionals, including medical personnel (Hampton & Newberger, 1985; Jenny, Hymel, Ritzen, Reinert, & Hay, 1999; Lane, Rubin, Monteith, & Christian, 2002; Lu et al., 2004; Newberger, 1983).

1.3. Responsive policy efforts

In response to the Penn State case, efforts have been made at the fed- eral, state and local levels of government to encourage reports of child maltreatment. In 2011, a bill was offered, but not passed, in the United States Senate that would have encouraged states who have yet to do so to pass laws requiring all adults to report suspected child abuse and neglect. Such a requirement would be attached to certain federal funding streams (United States Senate Bill 1887, 2011). Numerous governors and state legislators have expanded the list of mandated reporters in their states in response to the Sandusky case (Louisiana Executive Order, 11/16/11; Wisconsin Executive Order #54, 2011; New York State Assembly Bill 8901, 2011; Virginia House Bill A3, 2011).

1.4. Prior examination of Universal Mandated Reporting

While policymakers respond to news items, prior research consis- tently calls for more empirical evidence examining mandated reporting as an effective intervention for child abuse (Lau, Krase & Morse, 2008; Krase, 2010; Krase, 2013a; Krase, 2013b; Brown & Strozier, 2004). Very little research has examined the effects of mandated reporting law on reporting behavior, or that suggest alternative ways of responding to child maltreatment from a systemic perspective.

Interviews with CPS administrators in 8 states with UMRL found dif- ferent opinions about the utility of such laws. Most administrators be- lieved that UMRL increased reports from well-meaning family members and friends, who would probably neglect to make a report, if not for the law requiring to do so. However, other administrators be- lieved that some reporters in UMRL states, specifically professionals, are probably less likely to report, because they figure that someone else will do it. One of the administrators conceded that their particular state was considered abolishing the UMRL (McElroy, 2012).

One previous study specifically examined the impact of UMRL on reporting behavior. Analysis of county-level report data from 2000 found higher rates of reports, and higher substantiation rates, in counties with Universal Mandated Reporting Laws (Palusci & Vandervort, 2014). This study was conducted with data from a time period when half as many states had UMRL. Additionally, data from only 18 total states were used for this study. Palusci and Vandervort urged further analysis with more recent and complete data before

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policymakers made any conclusions on the utility of expanding UMRL. The current study is responsive to that call.

1.5. Study rationale

The current study sought to find differences in report characteristics and outcomes, if any, between states with, and without, Universal Man- dated Reporting Laws. This research examined characteristics of reports that have yet to be explored; most notably, report source. The findings from this research will more completely inform responsive policy efforts than previous research.

2. Methods

2.1. Study design

Secondary analysis of data from the National Child Abuse and Neglect Data System (NCANDS) Child File FFY 2010, aggregated to the state level, was used for this research. NCANDS has become the primary source of information on reports of abused and neglected children in the United States (NDACAN, 2012). NCANDS provides detail on every report of suspected child abuse or neglect submitted by participating states. Report details include demographic characteristics of the alleged victim, as well as the type of maltreatment alleged, among other variables. The NCANDS is administered annually (NDACAN, 2012). Data for the NCANDS is collected through case reviews at the state level. States that agree to provide data for the given year of the study are given a list of variables to extract from their own data systems. This analysis in- cludes information on every report of alleged child abuse or maltreat- ment, including allegations that were later unsubstantiated.

NCANDS for 2010 provides data on reports of suspected child abuse and neglect that reached a disposition during the 2010 fiscal year (October 1, 2009 through September 30, 2010). The NCANDS Child File FFY 2010 includes 3.5 million reports from 49 states, the District of Columbia and Puerto Rico (NDACAN, 2012).

For the purposes of this study, NCANDS Child File Data were aggre- gated to the state level, and used to calculate the variables required of this study. As a result, 52 cases (all 50 states, Puerto Rico, and the District of Columbia) were examined in this study.

2.2. Measures

a) Rate of reports: This variable was calculated by dividing the total number of reports made to CPS by the total number of children in the state.

b) Report source: NCANDS identifies the report source of each report. There are thirteen categories of report source offered through one NCANDS variable: Social Services Personnel; Medical Personnel; Mental Health Personnel; Legal, Law Enforcement, or Criminal Justice; Education Personnel; Child Day Care Provider; Substitute Care Provider; Alleged Victim; Parent; Other Relative; Friends/ Neighbor; Alleged Perpetrator; and Anonymous Reporter. In this study, 13 discreet variables were calculated for each state that in- formed the proportion of total reports in the state that originated from each of the 13 report sources.

c) Professional/non-professional reporter: Two additional categories re- lated to report source were calculated for each state: for the propor- tion of total reports in a state coming from professional sources, and the proportion of total reports coming from non-professional sources.

d) Types of maltreatment: NCANDS identifies up to 4 types of child mal- treatment involved in a given report. For the purposes of this study, variables were calculated for each state to represent the rate and proportion of reports that included allegations of neglect, physical abuse, sexual abuse, emotional maltreatment and medical neglect, respectively. Additional variables were calculated to determine the

proportion of reports in a state that included neglect allegation ex- clusively, physical abuse allegation exclusively, sexual abuse allega- tion exclusively, emotional maltreatment allegation exclusively, medical neglect allegation exclusively, or allegations of multiple types of maltreatment.

e) Report disposition: This dichotomous variable reports whether the child was determined, upon investigation, to be a victim of child maltreatment, or not. The percentage of reports in which a child was found to be a victim after investigation was calculated for each state. In addition, disposition rates were calculated across the type(s) of maltreatment alleged in the report for each state.

2.3. Analysis plan

Descriptive analysis was conducted on all reports to better under- stand the population of reports of suspected child maltreatment across the country. Variables were then calculated at the state level. Bivariate analyses (Independent Samples t-tests) were conducted on each of 27 calculated state-level variables.

3. Findings

3.1. General report characteristics

Of the nearly 3.5 million reports included in NCANDS, 2010, almost 3/5 were made by professional reporters. More than 16% of reports were logged by law enforcement, and almost 16% from educational per- sonnel. An even amount of girls and boys were alleged victims in these reports. The average age of alleged victims reported was 8 years old.

Nearly 50% of reports exclusively involved neglect allegations. Almost 30% of reports included multiple forms of maltreatment. Just under 13% of reports exclusively included suspicions of physical abuse. Twenty-six percent (26%) of all reports were substantiated, indicated, or the child was determined to be a victim, after investigation.

3.2. Comparing states with and without Universal Mandated Reporting

3.2.1. Rate of report There were no significant differences in the rate of report for states

with Universal Mandated Reporting (M = 7.9, S.D. = 8.58), as com- pared to those without (M = 6.1., S.D. = 9.44; t(49) = −0.66, p = .51).

3.2.2. Report source Reports from educational personnel made up a smaller proportion of

total reports in states with Universal Mandated Reporting (M = .14, S.D. = 0.05), as compared to those in states without Universal Mandat- ed Reporting (M = .18, S.D. = 0.04; t(48) = 3.08, p = .003). There were no statistically significant differences found for any other report source. There were also no statistically significant differences in the proportion of reports that came from professional sources, or non-professional sources when comparing states with and without Universal Mandated Reporting.

3.2.3. Type of maltreatment When comparing states with and without Universal Mandated

Reporting, there were no significant differences in the rate at which a report included allegations of neglect, physical abuse, sexual abuse, emotional maltreatment, medical neglect, or multiple allegations. Reports including an allegation of neglect do, however, make up a larger proportion of total reports made in states with Universal Mandated Reporting (M = 0.68, S.D. = 0.15), as compared to states without Universal Mandated Reporting (M = 0.55, S.D. = 0.25; t(48) = −2.40, p = 0.02).

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When looking at reports that exclusively include neglect allegations (and no other type of maltreatment alleged), a similar pattern is found. Reports that only include an allegation of neglect make up a larger pro- portion of total reports made in states with Universal Mandated Reporting (M = 0.57, S.D. = 0.16), as compared to states without Universal Mandated Reporting (M = 0.43, S.D. = 0.20; t(48) = −2.56, p = 0.01).

Reports involving allegations of multiple types of maltreatment make up a smaller proportion of reports in states with Universal Mandated Reporting (M = 0.17, S.D. = 0.12), as compared to states without Universal Mandated Reporting (M = 0.29, S.D. = 0.20; t(48) = 2.28, p = 0.03).

3.2.4. Report disposition There were no significant differences in the proportion of reports

where a child was determined, upon investigation, to be a victim for states with Universal Mandated Reporting (M = 0.19, S.D. = 0.04), as compared to those without (M = 0.23, S.D. = 0.10; t(48) = 1.349, p = .184).

Reports exclusively involving allegations of medical neglect were less likely to result in a child determined to be a victim, upon investiga- tion, if the report was made in a state with Universal Mandated Reporting (M = 0.10, S.D. = 0.08), as compared to states without Universal Mandated Reporting (M = 0.22, S.D. = 0.20; t(37) = 2.11, p = 0.04). There were no significant differences between states with, and without, Universal Mandated Reporting, in report disposition involving allegations of neglect, physical abuse, sexual abuse, or emo- tional maltreatment.

4. Discussion

4.1. Differences between Universal Mandated Reporting states and others

Over the past few years, policy makers have touted the expansion of Universal Mandated Reporting Laws as the most important response to concerns for under-reporting of suspected child maltreatment. The findings from this study do not necessarily support this assertion.

Universal Mandated Reporting Laws would purport to increase re- ports of suspected child maltreatment. However, states with Universal Mandated Reporting Laws do not have higher rates of reporting than other states. This finding contradicts a finding in a previous study (Palusci & Vandervort, 2014). However, that prior research did not include an examination of all state report data, and involved analysis of data collected in 2000.

Universal Mandated Reporting Laws require all persons, regardless of professional role, to make reports of suspected child maltreatment. States with such laws would theoretically see greater proportions of re- ports coming from non-professional sources. However, this study did not find such differences. The only difference found between states with and without Universal Mandated Reporting was related to reports from educational personnel. In states with Universal Mandated Reporting, reports from educational personnel made up a smaller pro- portion of reports than in other states. This finding might suggest that educational personnel are less inclined to make reports in these states, because they now share the burden of reporting with many other peo- ple. Or, this finding might simply be related to statistically insignificant increases in the proportion of reports made by other sources that, together, significantly decrease the proportion of reports coming from educational personnel.

Most of the high profile coverage of child maltreatment that resulted in calls for the expansion of Universal Mandated Reporting involved al- legations of sexual abuse. However, there were no differences in the proportion of reports that involved sexual abuse in states with Universal Mandated Reporting compared to other states. States with Universal Mandated Reporting see a larger proportion of their reports including allegations of neglect, or exclusively include neglect. These states also

see a smaller proportion of reports that include multiple types of child maltreatment in the allegation.

Any change in a state's reporting laws would hopefully improve the validity of reports to CPS. Ideally, such changes would result in more ac- curate reporting. Conversely, one would hope that such changes would not increase unnecessary reports. Interestingly, the findings from this study show that when looking at all reports there is no difference in dis- position between states with, and without, Universal Mandated Reporting.

The only difference in report disposition found here relates to reports of medical neglect. Investigation of medical neglect allegations in states with Universal Mandated Reporting is less likely to find a child to be a victim, than such reports in other states. Interpretation of this finding should be done carefully. In general, medical neglect reports are most likely to come from medical professionals. However, it is possible that in Universal Mandated Reporting states, reports of medical neglect are more likely to come from non-professional report sources, and therefore may be less likely to be accurate. Alternatively, this find- ing may relate to the fact that the definition of neglect, and derivatively medical neglect, varies across states (Krase, 2013b). Or perhaps, this finding speaks to the complexities of neglect cases in general (Krase, 2013b). Additionally, reports of medical neglect make up a small pro- portion of a state's reports (almost always fewer than 5%). Therefore, small differences may be found to be statistically significant, but not meaningful. Further examination of this finding in future research is warranted.

4.2. Policy & practice implications

The findings from this research suggest, at best, that Universal Mandated Reporting Laws do not result in anticipated outcomes policymakers envision during consideration of adoption. Focus on Universal Mandated Reporting Laws as a panacea for child abuse may, in fact, detract from more constructive changes to the reporting system.

Alternatives to current policy should be considered. One such alter- native policy suggests that all mandated reporters immediately report to CPS only certain types of suspected maltreatment (i.e., sexual abuse, serious physical abuse, or maltreatment which places the child in imminent danger) to Child Protective Services (CPS) to be followed within 72 h by a written report. In less severe cases of suspected mal- treatment (i.e., minor physical abuse, neglect, emotional abuse, or at risk situations), the mandated reporter may report the suspected case to CPS or consult a Critical Intervention Specialist which would operate independently from CPS. The Critical Intervention Specialist and man- dated reporter would work together to determine a strategy to deal with the case and decide if it should be reported to CPS. Research finds support for such an alternative from various professional report sources (Delaronde et al., 2000).

Efforts to increase, or alternatively decrease, Universal Mandated Reporting will be difficult to see through fruition due to limited state budgets, and the current political climate. However, state and federal efforts to increase and improve training could result in anticipated out- comes. The vast majority of states have no requirements for training for most professional reports (Krase, 2013a). With the exception of educa- tional personnel, very few mandated reporters are required by law to receive training on their legal responsibilities. In states with Universal Mandated Reporting, public awareness campaigns often focus on in- creasing reports, but fail to target improvement of reporting. Training and awareness campaigns that harness social media and professional continuing education requirements should be explored at the local, state and federal levels.

4.3. Limitations

There are two significant limitations to the NCANDS data: its age and missing data. NCANDS data is not provided for independent analyses

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until the annual publication Child Maltreatment is published. As a result, there is a time lag of more than a year before the data is made available to outside researchers. Not all states contribute data to NCANDS, though the number of states that do has rapidly increased over the past ten years. In NCANDS, 2010, Oregon was the only state that did not supply data to NCANDS.

An additional limitation in this particular study is the comparison of administrative data across states. For instance, report disposition is a lo- cally determined event that the researchers in the present study did not have control over. It is possible, and even plausible, that a comparison of what seems to be similar reports across states will not be comparable if more carefully analyzed. A report categorized as including an allegation of neglect in one state might be categorized as emotional maltreatment in another state. Therefore it is possible, and even likely, that dissonance between actual and observe racial categorization occurs.

In terms of report disposition, there are different burdens of proof required for different levels of report disposition across states, ranging from the low level of reasonable suspicion to the high level of clear and convincing evidence. Even states with the same burden of proof may categorize similar cases differently.

Most importantly, the design of this study does not allow inference to causality. Therefore, it is impossible to say that Universal Mandated Reporting Laws impact reporting behavior based on the results of this study. However, the findings from the research can be used to inform further exploration.

4.4. Future research

Due to the research design of the current study, the impact of Uni- versal Mandated Reporting cannot be extrapolated from the findings re- ported here. However, future research can explore such impact if conducted in jurisdictions that consider and implement a change to or from Universal Mandated Reporting. Quasi-experimental research could be conducted in such an instance to capture any actual changes in reporting behavior or quality.

Other research in this area should focus on quantitative and qualita- tive exploration of the knowledge, thoughts and feelings of professional and non-professional reporters in, and out of, states with Universal Mandated Reporting Laws. At the individual level, it is important to un- derstand if professional and non-professional reporters understand their role as mandated reporters. Additionally, such research could explore the factors that impact the decision of both types of reporters to make reports of suspected child maltreatment to CPS.

5. Conclusion

When reports of suspected child maltreatment are not made, chil- dren and families are denied access to services to protect their health and safety. All potential reporters, whether mandated to report or not, need knowledge and support to make appropriate reports of suspected child abuse and neglect (Lau, Krase & Morse, 2008). Only when knowl- edge and support are adequately provided to reporters, both profession- al and non-professional, will we as a society be able to ensure that children and families suffering from child maltreatment are protected, and children and families at risk are provided services to minimize such risk.

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