Child Maltreatment Reporting Beliefs and Practices of University of Wisconsin Cooperative Extension Family Living Educators

Introduction

Each year, child welfare agencies in the United States receive more than three million allegations of child maltreatment. While there is no uniformly agreed upon definition, the Child Abuse Prevention and Treatment Act (CAPTA) recognizes four major types of child maltreatment: physical abuse, neglect, sexual abuse, and emotional abuse. Neglect is the most common form of child maltreatment, involved in more than 60% of cases nationwide in 2005. Physical abuse occurred in about 17% of cases, and sexual abuse, which tends to receive more frequent media attention, comprised about 10%. Emotional abuse, including verbal abuse, accounts for about 7% of victims (Administration for Children & Families, 2006). Emotional abuse receives the least amount of attention, though studies have shown that children who experience verbal aggression exhibit higher rates of physical aggression, delinquency, and interpersonal problems (Vissing, 1991). In 2006, more than 1,500 child fatalities in the United States were attributed to child maltreatment; most were under the age of four (CDC, 2008).

Child maltreatment occurs in families of any race, socioeconomic class, and family structure or in any community. Families are at higher risk, however, when situational factors such as acute life stress and more enduring risk factors such as mental health issues or underlying risk factors like poverty are present (DePanfilis, 2006).

Consequences of child maltreatment and associated costs are high. Prevent Child Abuse America estimates that child abuse and neglect cost the nation $258 million each day or approximately $94 billion each year (Fromm, 2001). Direct costs of maltreatment, such as hospitalization, health care, mental health care, and immediate costs incurred by child welfare, law enforcement, and the judicial system, were estimated at $24 billion per year. Indirect costs include special education, juvenile delinquency, lost productivity, and adult criminality.

Child maltreatment can significantly compromise a child's cognitive and emotional capacities. Brain imaging surveys have shown that child maltreatment can cause permanent damage to the neural structure and function of the brain (Teicher, 2002). Early maltreatment appears to be associated with dysfunction of the limbic system, responsible for regulation of emotion and memory, resulting in later anti-social and aggressive behavior.

Maltreated children tend to have heightened levels of depression, hopelessness, and low self-esteem. Language deficits, reduced cognitive functioning, and attention deficit disorders also appear to be associated with maltreatment (Teicher, 2002). Abused and neglected children tend to do poorly in school, evidenced by low grades, poor test scores, and frequent retention in the same grade. Maltreatment negatively affects a child's emotional stability and self-regulation, problem-solving skills, and the ability to adapt to new or stressful situations, resulting in difficulty developing stable attachments to adult caregivers. Child sexual abuse has been identified as a risk factor for teen pregnancy, and studies have suggested a link between sexual victimization and later substance abuse (Virginia Child Protection Newsletter, 2006).

These grim outcomes suggest that more effort must be focused on identification, early intervention, and prevention of child maltreatment. Family Living educators have the potential to prevent child maltreatment through programs offered in their communities. They are in a critical position to identify suspected maltreatment and support early intervention efforts and access services for families if they can accurately identify indicators of child maltreatment and understand child abuse reporting expectations and procedures.

Purpose and Objectives

The purpose of the study reported here was to determine the beliefs and practices of Cooperative Extension educators in Wisconsin toward identifying and reporting child maltreatment. More specifically, the study was designed to:

• Confirm that educators work with populations at high risk for child maltreatment.
• Explore the ability of educators to identify indicators of child maltreatment.
• Determine educators' understanding of reporting responsibilities and current reporting practices.
• Identify additional child maltreatment resources educators might find helpful in their work.

Methodology

The study was limited to the attitudes and reporting behaviors of Family Living Program educators in Wisconsin, employed during fall 2006, who were responsible for Family Living programs at the county level. To select survey participants, the official University of Wisconsin Cooperative Extension Service 2006 directory was used. A total of 100 Extension professionals were surveyed.

The survey instrument was developed by the researcher based on a review of related literature. The survey consisted of four sections, 14 questions total. Section one contained an introduction to child abuse, including short definitions of the types of abuse and neglect recognized by Wisconsin Statutes. Section two, "My Knowledge of Child Abuse and Neglect," included self report of ability to recognize indicators of various types of abuse as well as identification of any prior work experience, academic preparation/education, or child maltreatment training. Section three pertained to knowledge of reporting and experiences with child maltreatment. The last section dealt with "Ways Child Abuse Touches My Work as an Extension Educator," including at-risk populations served, understanding of reporting responsibilities, and resources needed.

The instrument was assessed for credibility, transferability, dependability, and confirmability by a panel of eight experts consisting of two Extension program leaders, an evaluation specialist, a program manager, two program specialists, and two local county department child protective service professionals. The instrument was pilot tested using Extension faculty and academic staff. The study was approved by the University of Wisconsin Extension Institutional Review Board. Subsequent administration of the survey in 2007 to local county mandated and non-mandated reporters of child maltreatment yielded similar results.

County-based Family Living Program educators were invited by email to complete the survey online. The email briefly described the purpose of the survey and how results would be used and provided a hotlink to access the survey. Participation was voluntary and confidential. Of 100 possible respondents on the list serve used, seventy-seven completed the survey. The response rate, calculated as "surveys completed as a proportion of the eligible respondents," was 77%.

Responses were analyzed for frequency and cross-tabulated using Cramer's V and Phi coefficient analysis. Cross tabulation results were not statistically significant.

Results

Family Living Program educators work with a number of populations that exhibit one or more factors that increase the risk of child maltreatment (Figure 1). More than 90% of respondents indicated they work with single parent households and low-income families. More than 80 % work with step or blended families and families experiencing unemployment or financial difficulties. More than half of all respondents indicated they work with court-mandated families and families who have physical, emotional, and cognitive disabilities. Educators also work with other populations that may be at increased risk for child maltreatment, including divorced (91%), food insecure (61%), teen parents (57%), families with a history of domestic violence (57%), families with alcohol or other drug issues (60%), homeless (43%), and incarcerated (36%).

Figure 1.
High Risk Populations with Whom Extension Educators Work

Nearly three-fourths (74%) of respondents indicated they were confident they could recognize physical indicators of abuse. Only 42% were confident they could identify behavioral indicators associated with physical abuse. Respondents were less confident they could recognize behavioral indicators of sexual abuse (34%), neglect (40%), or emotional abuse (36%). Twenty percent indicated they could not recognize any indicators of abuse or neglect.

Almost half (48%) of respondents indicated that on at least one occasion they have had concerns about possible child maltreatment. About half (48%) also indicated they had been approached for advice or information by someone else who had concerns about abuse or neglect of a child. However, 13% believed they should report only when there is clear evidence maltreatment has occurred; 5% indicate they should report when a child discloses an incident; and 24% believe they should report when they have first hand/credible information about the maltreatment. Fourteen percent don't know or are unsure when they should report. Fewer than half (44%) correctly identified that a report should be made when there are suspicions a child may have been abused or neglected (Figure 2).

Figure 2.
Conditions for Reporting

When asked to identify their understanding of their child abuse and neglect reporting responsibilities, 37% incorrectly indicated they are mandated by Wisconsin Statutes to report; 30% selected the preferred response that Cooperative Extension encourages or expects them to report; 16% responded they are not required to report and 17% do not know or are unsure of their reporting responsibility (Figure 3).

Figure 3.
Understanding of Reporting Responsibilities

About half (56%) responded that they only somewhat understand the reporting process and what information they should provide to the agency receiving the report; 17% reported they did not understand the reporting process at all. One-fourth (25%) indicated they are reluctant to report child abuse or neglect because they do not feel qualified to make a judgment that maltreatment may have occurred and 25% have concerns that the alleged abuser will know or find out who reported.

Even though Family Living Program Educators work with a variety of families who may be experiencing multiple risk factors for child maltreatment, less than half (49%) indicate they have ever made a report of child maltreatment to Social Services. Slightly more than half (52%) indicate they have consulted a colleague about child maltreatment issues. Twelve percent report they have suspected child maltreatment but did not know what to do.

About one-fourth (26%) have discussed child maltreatment in their county Extension office. Ten percent have invited child protection professionals to provide in-service training. Only 4% have developed office policies pertaining to child maltreatment issues; 17% indicated no action has been taken to address child maltreatment issues in their county offices.

One-third (32%) of Family Living Program Educators indicated they had no prior work experience or academic preparation/education in the area of child maltreatment and had not attended any training pertaining to child abuse and neglect. Only a little more than half of respondents (55%) indicated they had attended some training on the topic.

Respondents were asked to identify educational materials or resources pertaining to child maltreatment they might find helpful in their work as Extension educators (Figure 4): 78% identified policies and procedures; 68% identified fact sheets describing indicators of child maltreatment; 52% a website with reference materials/links to other sources; 51% a conference workshop; 45% training materials for volunteers and 36% identified a web-based learning experience.

Figure 4
Resources Identified as Helpful to Educators

Cross tabulation of responses, although not statistically significant likely due to a small sample size, lead to an interesting result. When examined relative to the response "child abuse should be reported when there are suspicions a child may have been abused/neglected," there were no differences between educators with prior work experience or academic preparation/education. However, those who reported having attended child abuse/neglect training appear to be more likely than those who did not to indicate that suspicions of child maltreatment should be reported. Training may improve the educators' ability to recognize indicators of child maltreatment and increase their understanding of reporting suspicions of abuse.

Discussion

Survey results confirm that most University of Wisconsin Cooperative Extension Family Living Program educators work with one or more populations defined as high risk for child maltreatment, including low-income families, single parents, divorced parents, and other families experiencing a variety of challenges and life stressors. Child maltreatment is an important issue for educators. Nearly half of survey participants indicated they have had concerns about child maltreatment, and an equal number have been approached for advice or information by someone else who had concerns about child maltreatment.

Educators who interact regularly with children and families are on the front lines of the child protection system. If they are unable to recognize indicators of maltreatment, victims are left unprotected. Survey participants were not confident in their ability to identify many of the physical and behavioral indicators of child maltreatment; 20% were not confident they could identify any indicators at all.

Survey participants also demonstrated confusion about child maltreatment reporting responsibilities. About half of survey participants believe they are mandated to report child maltreatment, when, in fact, Wisconsin Statutes [48.981(2)] do not list them among persons required to report. About 16% believe they are not required to report, which technically is correct. However, University of Wisconsin Cooperative Extension encourages and expects all educators and staff to report suspicions of child maltreatment. Also of concern are 17% who are unsure of their reporting responsibilities.

The Centers for Disease Control and Prevention report that the actual number of children who experience maltreatment each year most likely exceeds estimates because many cases go unreported or undetected (CDC, 2008). Knowing where and how to report is essential to accessing appropriate services yet 10% of survey participants do not know where to call to report suspicions of child maltreatment. Only about one-fourth understand the reporting process and know what information they need to provide, about half have only some idea of what child protective service agencies are looking for, and 17% do not know at all.

Potential reporters may not report suspicions of child maltreatment because of a variety of other reasons, including lack of certainty that abuse has occurred, belief the report will cause additional harm, and the need to maintain a good relationship with the parent or child (Kenny, 2001). Lack of training may also explain the failure of some reporters. One study found that 65% of social workers, 53% of physicians, and 58% of physician assistants, all of whom were mandated reporters, were not reporting all cases of suspected abuse (Delaronde, King, Bendel, & Reece, 2000). The survey of 382 master's level social workers, pediatricians, physicians, and physician assistants found that 57% of respondents had received less than 10 hours of training on their obligations as mandated reporters (Delaronde et al., 2000). In another survey of 197 teachers, 74% indicated they received "minimal" or "inadequate" academic preparation to prepare them for being a mandated reporter, and 58% were not receiving adequate training on child maltreatment after entering their field (Kenny, 2001).

Reporting suspicions of child maltreatment can be stressful for reporters. When reporters are unclear about what is expected or required, maltreatment may go unreported. Nearly half of respondents believe they should report maltreatment only when there is clear evidence maltreatment has occurred, when a child discloses an incident, or when they have observed or have first hand/credible information about an incident. Each of these situations may provide sufficient reason for reporters to contact the child protection agency or law enforcement. However, they are not necessary for a report to be made. According to Wisconsin Statutes 48.981(2)3(c), any person who suspects that a child has been maltreated may report. Similar statutory language is present in all states.

One-third of survey participants indicated they had never attended any child maltreatment training. Respondents who had training were more likely to correctly indicate they should report when there are suspicions a child may have been abused or neglected. To create skilled reporters, research suggests that professionals who work with high-risk children and families should receive annual training on the detection of maltreatment and their reporting responsibilities (Vieth, 2005).

Family Living Program educators overwhelmingly (78%) indicated that policies and practices pertaining to reporting child maltreatment would be helpful to them in their work. More than two-thirds (68%) requested fact sheets describing indicators and other information about child maltreatment. About half also requested a Web site with reference materials and links to additional resources.

A review of Cooperative Extension Service state Web sites provided a variety of online resources. Extension Web sites in most states provided information about policies and procedures for identifying and reporting child maltreatment for 4-H staff and volunteers, including screening of volunteers for criminal offenses. Some state Web sites provided general information including fact sheets describing child maltreatment indicators or links to child protection or non-profit agencies with expertise in child maltreatment issues. A few Web sites, such as those from Colorado State Cooperative Extension and Washington State University Extension, provided specific child maltreatment reporting policies and procedures for all their Cooperative Extension personnel. In some states, such as Washington, Cooperative Extension faculty and staff are required to report by law (mandated reporters). In other states, such as Colorado, reporting of child maltreatment is not a legal requirement but an organizational expectation for Extension personnel.

Recommendations

To put an end to child maltreatment, suspected abuse and neglect must be reported into the system, and those reports must be of high quality. To accomplish that goal, educators working with high-risk populations must learn the necessary skills to competently perform reporting functions. Extension educators must be adequately trained on an annual basis.

Family Living Program educators work with a variety of high-risk populations. They interact regularly at food pantries, in parenting programs and other educational settings with families experiencing situational factors such as unemployment, underlying risk factors such as poverty or food insecurity, and enduring risk factors such as mental health and other special needs that place these families at higher risk of child abuse and neglect.

Family Living Program educators are experts at assessing local needs, organizing and engaging stakeholders. They can play an important role in identifying suspected victims, including child maltreatment prevention efforts in their programming, and serving as leaders creating awareness of child maltreatment issues in the community, if they have adequate training, knowledge, and resources.

The Cooperative Extension system in every state should:

• Require Extension personnel who work with at-risk children and families to participate in annual training on recognition and reporting of child maltreatment.
• Provide Extension personnel with easily accessible educational resources pertaining to identification and reporting of suspected maltreatment.
• Develop clearly defined, written policies and procedures for all Extension personnel reflecting the statutory child maltreatment reporting requirements in each state.

References

Centers for Disease Control and Prevention (2008). Child maltreatment. Retrieved August 10, 2009 from: http://www.cdc.gov/ncipc/dvp/CM_Data_Sheet.pdf

Delaronde, S., King, G., Bendel, R., & Reece, R. (2000). Opinions among mandated reporters toward child maltreatment reporting policies. Child Abuse & Neglect, 24, 901-905.

DePanfilis, D. (2006). Child neglect: Guide for prevention, assessment and intervention. Child Welfare Information Gateway. Retrieved August 10, 2009 from: http://www.childwelfare.gov/pubs/usermanuals/neglect/chapterfour.cfm

Fromm, S. (2001). Total estimated cost of child abuse and neglect in the United States. Prevent Child Abuse America. Retrieved August 10, 2009 from: http://www.preventchildabuse.org

Kenny, M. C. (2001). Child abuse reporting: Teachers' perceived deterrents, Child Abuse & Neglect, 25, 81-88.

Teicher, M. H. (2002, March). Scars that won't heal: The neurobiology of child abuse, Scientific American, 68-75.

U.S. Department of Health and Human Services, Administration for Children & Families, (2006). Child maltreatment 2005. Retrieved August 10. 2009 from: http://www.acf.hhs.gov/programs/cb/pubs/cm05/chapterfour.htm#child

Vieth, V.I., Bottoms, B. L., & Perona, A. R. (2005). Ending child abuse: New efforts in prevention, investigation, and training. New York: Routledge, 14-15.

Virginia Child Protection Newsletter (2006). Maltreatment and its effects on early brain development, 77. Retrieved August 10, 2009 from: http://psychweb.cisat.jmu.edu/graysojh/

Vissing, Y. M., Straus, M. A., Gelles, R. J., & Harrop, J. W. (1991). Verbal aggression by parents and psychosocial problems of children. Child Abuse & Neglect, 15, 223-238.