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Monday, October 22, 2007
P2-45

WHAT DOES IT MEAN TO HAVE REASONABLE SUSPICION OF CHILD ABUSE?

Benjamin H. Levi, MD, PhD, Penn State College of Medicine, Hershey, PA

Purpose: Throughout the United States, laws require professionals who work with children to report cases of suspected child abuse to child protection services. If children are to be protected, parents treated justly, and mandated reporters to understand their responsibilities, however, there needs to exist a standard for when suspected abuse should be reported. The purpose of this study was to examine how mandated reporters understand reasonable suspicion, in the context of mandated reporting.

Methods: A survey was administered to individuals attending training seminars in Pennsylvania on mandated reporting of child abuse. Respondents were asked to imagine having encountered a child who has an injury (or condition) that might have been caused by abuse. Using a rank order scale (1=most likely explanation, 10=least likely explanation) and an estimated probability scale (mark an “x” along the line between 0-100% possibility), respondents were then asked to indicate how probable abuse would need to be before they felt there was reasonable suspicion of child abuse.

Results: 637 mandated reporters completed the survey (99% response rate; 66% white, 25% African American, 4% Hispanic). Most respondents were social workers (41%) and teachers (31%), along with daycare providers (12%) and school administrators (10%). There were no significant differences in responses based on geographic location, amount of prior child abuse education, type of employment, or number of years spent working with children. Respondents exhibited wide variation in the level of probability that they felt indicated reasonable suspicion. On the rank order scale, 18% indicated that “abuse” would have to rank 1st or 2nd to qualify as reasonable suspicion; 32% stated it could rank 3rd or 4th; 32% stated 5th or 6th; and 28% stated that abuse could rank as low as 7th-10th. On the estimated probability scale, 20% indicated “abuse” would need to be >70% likely before it qualified as reasonable suspicion; 21% stated that a 60-70% likelihood was needed; 28% that a 40-50% likelihood was needed; and 31% that only a 5-35% likelihood was needed. In comparing individual responses for the two scales, 83% were internally inconsistent.

Conclusion: There is wide variation among Pennsylvania mandated reporters in how they interpret reasonable suspicion in the context of suspected child abuse. Additionally, most mandated reporters' conceptions of reasonable suspicion are internally inconsistent.