Child Abuse Assessment and Reporting

 

Courses Objectives:

Identifing Mandated Reporters

Standards for Making a Report of Child Abuse

Child Protective Services Privileged Communications

Disclosing the Reporter's Identity

Assessing Child Abuse: Signs and Symptoms of Child Abuse

 

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.63

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