Pediatricians Vary on Reporting Child Abuse

Threshold for alerting authorities is higher for some than others, study finds

WEDNESDAY, July 6, 2005 (HealthDay News) -- Is a child's broken arm a simple case of playground injury or something more sinister?

According to a new report, American pediatricians have widely varying opinions about just when they should report suspected cases of child abuse.

"We found that physicians have different interpretations and different thresholds for when 'reasonable suspicion' exists," study co-author Dr. Benjamin H. Levi, a professor of pediatrics and humanities at Pennsylvania State College of Medicine, Hershey, said in a prepared statement.

Levi and co-researcher Georgia Brown interviewed 1,249 Pennsylvania pediatricians and asked them how high suspected child abuse would have to rank on a scale of one to 10 (one being the highest likelihood of abuse and 10 the lowest) before they felt it amounted to reasonable suspicion.

Twelve percent of the respondents said a case would have to rank as a one or two to qualify as reasonable suspicion for reporting child abuse, 41 percent set their threshold at three or four, and 47 percent set their mark at five to 10 on the scale.

Another measurement scale used in the study also found widespread inconsistency among pediatricians.

"There will always be subjectivity involved. But if pediatricians are applying the reporting guidelines in different ways, this has profound implications for children who may or may not be victims of abuse, as well as families and caregivers who are subject to inconsistent standards," Levi said.

Currently, people who deal with children in a professional capacity are required to alert child protection services whenever there's "reasonable suspicion" of child abuse.

"Child abuse is obviously a critical social issue, and more studies are needed to determine whether these findings are applicable to the greater population of mandated reporters," Levi said.

"If we do find that there is widespread confusion about what constitutes reasonable suspicion across classes of mandated reporters, it will require rethinking what society should expect from mandated reporters, what sort of training and guidelines may be needed to meet the expectations, and what will determine our societal threshold for reporting possible child abuse," he said.

More information

The Nemours Foundation outlines how to recognize the signs of child abuse.

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