What do university students who will work professionally with children know about maltreatment and mandated reporting?

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Abstract

This study examines the knowledge and understanding of child maltreatment held by students in majors and disciplines that lead to careers which fall into the mandated reporter category. Participants included 332 graduate and undergraduate students in majors ranging from Nursing to Administration of Justice. Subjects were asked to rate the importance of factors for determining maltreatment (e.g., seriousness of the act), to indicate whether an act depicted in a vignette was maltreatment, and whether they would report that incident. Results indicated less confidence and consistency in ratings relative to working professionals [Portwood, S. (1999). Coming to terms with a consensual definition of maltreatment. Child Maltreatment, 4(1), 56–68.] as well as differences in ratings by academic discipline. The results are discussed with respect to their implications for curriculum and training.

Introduction

Nationally, child maltreatment is an ongoing concern. The National Incidence Study of Child Abuse and Neglect conducted by the US Department of Health and Human Services (1998) indicated that approximately 44 per 1000 children are reported as maltreated every year. Moreover, the number of reported cases of maltreatment increases every year. For example, recent statistics indicate that in October 2002, in California 69,605 children were referred for emergency services related to child maltreatment (CWS/CMSM, 2003).

These referrals come from a variety of sources, not all of whom work professionally with children. However, the majority of the referrals come from professionals who are, by law, required to report any suspected cases of child maltreatment. Mandated reporters include, but are not limited to: (a) Teachers (instructional aids, teachers' aids, teachers' assistants, administrators, and certified pupil–personnel employees), (b) Administrators, presenters, and counselors in child-abuse prevention programs, (c) Head Start teachers, (d) School district police or security workers, (e) Administrators of public or private day camps, (f) Administrators of public or private youth centers, youth recreation programs, and youth organizations, (g) Administrators and employees of public or private organizations whose duties include direct contact with, or supervision of, children, (h) Licensees, administrators and employees of licensed community care and day care facilities, (i) Employees of child institutions, including foster parents, group home personnel, and personnel of residential care facilities, (j) Social workers, probation officers, and parole officers, (k) Peace officers, and (l) Health care professionals including licensed nurses, marriage, family, and child counselors, and clinical social workers.

Recent research has revealed that, across these various professions, many mandated reporters are not reporting suspected cases of child maltreatment (see, for example, Delaronde et al., 2000, Reinger et al., 1995. Sedlak (1991; as cited in Gilman, 2000) found that 65% of all maltreatment cases, as well as 60% of severe maltreatment cases, are not reported to Child Protective Services by the professionals who are aware of these cases. Underreporting may occur for a variety of reasons. Much of the underreporting may reflect the training, or lack thereof, these mandated reporters have received regarding state mandated reporting and child maltreatment. To address this issue, it is important to explore the knowledge and understanding of child maltreatment that pre-professionals have as they enter their careers and become mandated reporters. This study specifically examines the knowledge and understanding of child maltreatment held by undergraduate and graduate students in majors and disciplines that lead to careers which fall into the broad mandated reporter category.

The Federal Child Abuse Prevention and Treatment ACT of 1974 and revised in 1996 (PL 104-235) defines child maltreatment as “any action or lack of action that results in imminent risk of serious harm, death, serious physical or emotional harm, sexual abuse, or exploitation of a child…under 18…by a parent or caretaker who is responsible for the child's welfare” (Gilman, 2000; pp. 175). Although useful for providing a general framework for conceptualizing maltreatment, this definition is also quite broad and somewhat ambiguous. For example, does the harm have to be intentional? Moreover, as Barnett, Manly, and Cicchetti (1993) point out, not all child maltreatment leads to immediate harm. Given this ambiguity at the Federal level, it is hardly surprising that state laws and statutes regarding abuse also tend to vary greatly. It is these variations in legal definitions that may lead to problems with reporting cases of suspected child abuse and neglect. This may be especially salient in cases of emotional abuse/psychological abuse. Hamarman, Pope, and Czaja (2002) reported a greater degree of inconsistency in reporting rates across many states for emotional abuse relative to physical or sexual abuse and appeared to be a direct reflection of greater variation in the definition of this form of abuse compared to physical and sexual abuse. Even with its more consistent definition, sexual abuse is the most under-reported form of abuse (Gilman, 2000), whereas neglect, which makes up 65% of maltreatment reports, is very difficult to define (Gilman, 2000) and frequently is not easily recognized or well understood (Reyone and Gaeddert, 1998).

Overly broad definitions are likely to result in false positives, whereas definitions that are too narrow are likely to limit the number of children who are served or assisted (Gilman, 2000). Thus, it is not surprising that in a study of children under age five with non-accidental injuries who were reported to Child Protective Services, Miller, Fox, and Beckwith (1999) found that, in many cases, the filed petitions did not match the severity of the abuse. Consistent with this study are findings from Reyone and Gaeddert (1998) that teachers tend to view neglect as less serious with respect to harm than physical and sexual abuse, thus suggesting they may be less likely to report suspected cases of neglect.

Moving beyond difficulties within the context of legal definitions, some of the problems with low rates of mandated reporting may result from professionals' definitions of maltreatment not matching legal definitions for abuse and neglect. Some of this may reflect the fact that legal definitions must take into account parents' rights and due process, which often places the system at odds with the protection of children (Gilman, 2000). That is, legal definitions serve the purpose of criminal intent and may not always take into account the best interests of the child (Portwood, 1999). To illustrate, Portwood's (1999) study presented maltreatment scenarios to a diverse sample of legally mandated reporters. The results showed low to moderate ratings of whether the acts portrayed in the scenarios met the legal definition of maltreatment. That is, acts were rated as maltreatment that did not fit the legal definition, whereas other acts that may meet the legal definition were not rated as maltreatment. Delaronde et al. (2000) found that 58% of mandated reporters had not reported suspected maltreatment over the course of their career. Most of these non-reporters were strongly in favor of an alternate policy to the official mandated reporting policy of their state. Those who reported suspected cases, but were hesitant to do so, also favored an alternative policy. These findings suggest that there is not only dissatisfaction with legal definitions of maltreatment, but discomfort with current reporting mandates, among various groups of professionals who work with children and who encounter maltreatment cases in the course of their careers.

Moreover, outside the context of legal definitions of maltreatment, no consensus has been reached among professionals who deal with child maltreatment (e.g., psychologists, social workers, pediatricians) about an appropriate definition of maltreatment (Belsky, 1991, Emery and Laumann-Billings, 1998). This may reflect recognition by these professionals that there is no unique, consistent profile of parents who maltreat their children and there are many situational factors that appear to be strongly associated with child maltreatment (Emery and Laumann-Billings, 1998).

Under these situations, it is not surprising that mandated reporters tend to consciously or unconsciously use many different factors, in addition to legal definitions, to determine whether a report needs to be filed. One additional factor, experience at work with actual cases of maltreatment, appears to strongly influence the definitions that a reporter holds and, hence, the ultimate decision to report or to not report. Portwood (1998) found that subjects with more extensive work-related experience with abuse were less open to considering mitigating factors such as the perpetrator's own history of abuse, whereas subjects who lacked work-related experience with abuse were more likely to view ambiguous situations as cases of maltreatment. Another study found that clinicians in a hospital made reporting decisions based, in part, on their perception of risk factors such as single mothers with new boyfriends or families with low income (Thyen, Leventhal, Yazdgerdi, & Perrin, 1997). Stroud, Martens, and Barker (2000) found that referrals for prosecution from clinicians were less likely when the injury was more severe, whereas law enforcement agents referred a sexual abuse case for prosecution more often when the perpetrator was a stranger and not a family member. Issues regarding suspected versus verified abuse (Crenshaw, Crenshaw, & Lichtenberg, 1995) or the personal repercussions of making the report (Baxter and Beer, 1990) also may influence an individual's decision to report a case of maltreatment.

The most common theme in the extant literature to explain the level of underreporting appears to be a lack of knowledge and training with regard to mandated reporting requirements and recognition of child maltreatment itself. Portwood, Grady, and Dutton (2000) noted that although 87% of the law enforcement agents in their sample had some degree of contact with children, they received little formal training regarding child maltreatment issues and the training they did receive mainly focused on legal standards and not indicators of abuse.

Lack of mandated reporter training may be especially problematic in public schools where there exists a greater opportunity to observe and document cases of suspected maltreatment. Subjects from the studies of Baxter and Beer (1990) and Orelove, Hollahan, and Myles (2000) stated that they had little to no training in their school districts with respect to mandated reporting and child maltreatment issues. This may explain, in part, why teachers have reported that they are unaware of reporting laws and requirements and/or are under-prepared to recognize signs of child maltreatment (Crenshaw et al., 1995). Baxter and Beer's (1990) survey of administrators, regular teachers, counselors, and special education teachers revealed that while most teachers were aware of mandated reporting laws, less than 22% had read the state law and 45% were unsure if state law actually required all personnel to report suspected abuse. Moreover, 66% of the entire sample of teachers and school personnel felt apprehensive about reporting suspected abuse and most of the respondents wanted help with definitions, recognition, and legal procedures. These findings help explain Tite's (1993) data showing that there appears to be only moderate correspondence between teachers' definitions of abuse and decisions to report abuse.

Similar findings have been found in research on nurses (O'Toole, O'Toole, & Webster, 1994), clinicians (Kalichman, Craig, & Follingstad, 1990), and law enforcement personnel (Stroud et al., 2000). With respect to nurses, O'Toole et al. (1994) found that less serious types of abuse, such as neglect and psychological abuse, were neither recognized nor reported. Clinicians, on the other hand, appear to be more likely to report sexual abuse when they have more confidence that abuse is actually occurring (Kalichman et al., 1990). In situations where court action is considered, Stroud et al. (2000) found that initial child disclosure of sexual abuse was more common in cases where criminal action was taken than in cases dropped by the District Attorney. Across all these studies, a common theme appears to be that the decision to report or to not report a case of suspected maltreatment often depends on the mandated reporter's confidence that maltreatment has occurred. These findings again indicate that there is a need and desire among professionals for more training with respect to recognizing signs of abuse, as well as legal definitions of abuse and reporting requirements.

Unfortunately, recent attempts to increase reporting and to provide the kind of knowledge that is needed to understand maltreatment and mandated reporting by providing a mandatory training workshop for these kinds of professionals have had limited success (Aldridge, 1992, Reinger et al., 1995). Specifically, Reinger et al. (1995) found that post-training, 69% of recognized child maltreatment cases still were not reported to Child Protective Services. Aldridge (1992) also found at a 12-month follow-up to training, very poor performance on interview techniques assessments, suggesting that these professionals will have difficulty eliciting the kind of information they need to report suspected abuse. One idea to help combat this problem may be to provide greater education about child maltreatment and reporting issues to mandated reporters before they enter their professions. That is, university students in majors that are likely to lead to careers that would require they report suspected child maltreatment may be better served, and better able to meet the needs of children, if they had greater preparation during their undergraduate and graduate studies with respect to child maltreatment issues.

Therefore, building on the work by Portwood (1999), this study focused on graduate and undergraduate students in a variety of majors and disciplines at a large, metropolitan university and their understanding of issues pertaining to maltreatment and reporting suspected maltreatment. Specifically, the study examined factors that have been identified as important for future study, such as severity or frequency (National Research Council, 1993). Following Portwood's (1999) protocol, this study included factors that potentially influence a reporter's decisions about whether or not maltreatment has occurred (e.g., perpetrator characteristics such as age, gender, or family background). Subjects also were presented with scenarios depicting the major types of abuse (physical, sexual. psychological) and neglect. The goal was to discover how well various majors/disciplines leading to careers working with children are preparing their students to deal with maltreatment and their roles as mandated reporters.

Section snippets

Study participants

There were 332 participants in the study. Students were sampled from the following majors or disciplines: Child and Adolescent Development (N = 141), Human Performance (N = 49), Special Education (N = 52), Social Work (N = 23), Teaching Credential programs (N = 29), Administration of Justice (N = 16), Nursing (N = 10), and Liberal Studies, (N = 12). The average age of the participants was 29.3 years (SD = 9.3; range = 20–60). Graduate students were, on average, significantly older (N = 159, M = 33.0, SD = 10.4) than

Results

Zero-order correlational analyses of the data indicated that age was modestly, but consistently, associated with items on both the importance of factors for determining maltreatment scale and the maltreatment vignettes. In general, younger participants were less likely to rate factors involving frequency, perpetrator intention, child perception of the act or consent to the act, acceptability of the act, and perpetrator mental health, poverty, gender, education level or history of abuse as

Discussion

This study explored knowledge and beliefs regarding maltreatment of graduate and undergraduate students who will work in careers where they will be mandated reporters. A general caveat should be made with respect to interpreting the data presented in this study. First, the sample, although representative of the University as a whole, was recruited from a potentially self-selected population. That is, the professors who agreed to allow access to their students may have been interested in the

References (33)

  • U. Thyen et al.

    Concerns about child maltreatment in hospitalized children

    Child Abuse and Neglect

    (1997)
  • E. Tirosh et al.

    Attitudes toward corporal punishment and reporting abuse

    Child Abuse and Neglect

    (2003)
  • R. Tite

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

    Child Abuse and Neglect

    (1993)
  • J. Aldridge

    Further training of professionals dealing with child witnesses

  • J. Alpert et al.

    Graduate-level education and training in child sexual abuse

    Professional Psychology, Research and Practices

    (1990)
  • American Psychological Association

    Including information on child abuse and neglect in graduate and professional education and training

    (1996)
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