Opinion

Mandatory Child Abuse Reporting Belongs in Dustbin, New Research Shows

mandatory reporting: Angry Woman Screaming while Talking on mobile Phone

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Last week, a committee of the Idaho Legislature did something that, in the politics of child welfare, is revolutionary. The committee took a look at the state’s “mandatory reporting” law for child abuse and neglect — and actually voted to narrow it. Right now, in Idaho everyone is a mandated reporter. The bill would change that to only certain professionals who come into contact with children.

What’s so revolutionary about that? Only the fact that in 50 years, states have moved to broaden who has to report their slightest suspicion of child abuse hundreds, probably thousands of times. As far as I know, this one legislative committee in Idaho is the first to say: Maybe we should follow the evidence.

mandatory reporting: Richard Wexler (headshot), executive director of National Coalition for Child Protection Reform, smiling balding man with white-gray hair in black top.

Richard Wexler

More than half a century after they were enacted — passed in an early flurry of hysteria over child abuse, with no evidence that they would work — the research finally is catching up. The research shows the laws do nothing to actually reduce child abuse, while causing enormous collateral damage. The research shows that mandatory reporting laws contribute to undermining the fabric of entire poor communities. 

Some cases in point:

Dr. John Cox is (or rather was) a pediatric emergency room physician at Children’s Hospital of Wisconsin. One day he fell asleep while cuddling his adopted infant daughter and accidentally broke her collarbone. Though this is an injury that usually heals on its own, he took the infant to his own pediatrician at Children’s Wisconsin.

As NBC News reports:

What followed, according to more than 15 medical experts who later reviewed Cox’s case, was a series of medical mistakes and misstatements by hospital staff members that has devastated Cox’s family and derailed his career. A nurse practitioner on the hospital’s child abuse team confused the baby’s birthmarks for bruises, according to seven dermatologists who have reviewed the case. A child abuse pediatrician misinterpreted a crucial blood test, four hematologists later said. Then, two weeks after the incident, armed with those disputed medical reports, Child Protective Services took the child.

Nine months later the child is still in foster care, and Cox is facing criminal charges.

Things are so bad that several doctors at Children’s Wisconsin say they are afraid to bring their own children there in a case of accidental injury because the hospital’s “child abuse pediatricians” are so fanatical about finding abuse — whether it’s there or not.

But this isn’t about the glaring flaws in the field of child abuse pediatrics (though that is always a worthy topic), it’s about how the nightmare started.

Cox’s pediatrician had no actual concerns about abuse. But he “teared up” as he explained that he had to report Cox to the child abuse pediatricians. Doctors, after all, are mandated reporters of child abuse.

When Christy Cartwright’s son was a victim of homophobic bullying at his high school in tiny Carrizozo, N.M., she did what any good mother would do. She demanded that the school take action. She did the same when her daughter did not have the right special education plan.

What followed was a succession of reports alleging child abuse — all coming from the school system. According to Searchlight New Mexico:

“The first report accused Cartwright of abusing her grandson — who earlier that year had moved to Texas. The second said that Cartwright’s kids had missed more than two consecutive weeks of school: a clear case of educational neglect. It also accused her and her partner, Harold Burch, of giving the children marijuana, suggested the parents were high on meth, and charged them with ‘brain washing the children to say they are bullied at school.’

“Two months later, [the state Children Youth and Families Division] sent Cartwright an official letter concluding that all allegations made by the school were baseless. The state tossed out the case.”

The high school principal, W. Todd Lindsay, derided Cartwright’s concerns. “Everything’s ‘bully, bully, bully,’ that’s all you ever hear about,” he said. Later, in a statement that if true would make his school unique in all of America, Lindsay declared: “I’m telling you for a fact, there is no bullying at this school.”

Lindsay claims there’s no retaliation either; it’s just that “… teachers are mandated by law. If they see something, they have to report it.” The president of the Albuquerque Teachers Federation also cited the mandatory reporting law. Ellen Bernstein told Searchlight New Mexico: “The pressure on teachers to report is enormous. It’s my duty to report. If I’m wrong, that’s for the investigator to decide.”

The evidence that mandatory reporting laws are doing enormous harm isn’t just anecdotal.

THE ORIGINS OF MANDATORY REPORTING

Mandatory reporting laws were not the result of careful thought, planning and scientific testing to see what effects they might have. They were a knee-jerk response to Dr. C. Henry Kempe’s 1962 article “The Battered Child Syndrome.” Within a year the federal government had proposed a model law for the states. By 1965, 47 states had adopted such laws.

Originally the laws were relatively narrow in terms of both what should be reported — serious physical abuse — and who should be required to report it — mostly doctors. But, again with no evidence that the laws worked, both mandates were expanded. One profession after another was added. Now, in 18 states, everyone is a mandated reporter. What must be reported also expanded to include anything in a state’s definition of child abuse or neglect. Since neglect laws make it easy to confuse poverty with neglect, poor families inevitably became the primary target.

All this was egged on by that repository for so many bad ideas in child welfare, the Child Abuse Prevention and Treatment Act. CAPTA requires states to have mandatory reporting laws, and specifically requires that they include “neglect.”

But it wasn’t long before some proponents of mandatory reporting had second thoughts.

  • As far back as 1983, Dr. Eli Newberger of Children’s Hospital in Boston wrote that “had professionals, like me, known then what we know now, we would never have urged on Congress, federal and state officials broadened concepts of child abuse as the basis for reporting legislation.”
  • In 1998, the National Research Council concluded that “Mandatory reporting requirements were adopted without evidence of their effectiveness; no reliable study has yet demonstrated their positive or negative effects on the health and well-being of children at risk of maltreatment, their parents and caregivers and service providers.”
  • In 2011, in the wake of the scandal involving former Penn State football coach (and former foster parent and group home operator) Jerry Sandusky, there were calls to vastly expand mandated reporting even further. But another leading proponent of these laws, professor David Finkelhor said: “Maybe it’s better that people use discretion … If everybody obeyed the letter of the law and reported a suspicion of abuse, the agencies would be completely overwhelmed with reports.”
  • Even Richard Gelles, among the most fervent proponents of what amounts to a “take the child and run” approach to child welfare, someone who has advocated for orphanages and brags about helping to write the Adoption and Safe Families Act, opposed such expansion, writing: “Forty years after the first federal mandatory reporting law was enacted, there isn’t a single study showing that investigations alone increase the safety of children.”

THE NEW RESEARCH

But now, at last, these laws are being studied. The results are ugly.

For starters, mandatory reporting doesn’t make children safer. While it is impossible to compare states with mandatory reporting to states without — because every state has it — one can compare states in which some people are mandatory reporters to states in which everyone is a mandatory reporter.

An international team of researchers did just that. They studied reports of physical abuse. They found that the proportion of reports that were “substantiated” — which may mean only that a caseworker decides it’s slightly more likely than not that abuse occurred — plummeted in states with universal mandatory reporting (UMR). In other words, it dramatically increased the proportion of false reports. They write:

“… our results suggest that, at best, UMR does not appear to be achieving its intended goal of improving identification of children victimized by physical abuse. In fact, UMR can potentially lead to poorer outcomes. For example, more reports made but without sufficient evidence can divert valuable but limited resources from endangered children who are actually in need of protection.”

But that’s only the beginning. 

Another study looked at the plight of a group most likely to be needlessly removed to foster care: children of mothers who are themselves victims of domestic violence.

Under so called “failure to protect” laws and regulations, one can be labeled a bad mother — and children can be removed — if the mother “allowed” children to witness a husband or boyfriend attacking her.

Taking away a child under these circumstances actually compounds the trauma of removal for that child. That’s why, thanks to a class-action lawsuit, the practice is illegal in New York. (The National Coalition for Child Protection Reform’s vice president, Carolyn A. Kubitschek, was co-counsel for plaintiffs in that lawsuit.)

Battered women know the danger their children face if they seek help. Building on previous research, a study published in December found that mandatory reporting laws drove many women away from seeking help for fear that their children would be taken away. Worse, the fears were justified. According to the study:

Most survivors described severe consequences of Child Protective Services involvement, primarily the removal of their children from their care and home. One survivor explained how “CPS was brought in, and my kids were taken away and that was almost life ending.” Another survivor illustrates the challenge of CPS involvement in cases of domestic violence, explaining that “[t]hey removed my children from my home and charged me with allowing domestic violence to happen to me.”

MANDATORY REPORTING hurtS POOR COMMUNITIES

Perhaps most damning is a study by Kelley Fong, a Ph.D. candidate in sociology and social policy at Harvard. As first reported by Rise, Fong interviewed scores of impoverished mothers in Providence, R.I. They described how mandated reporters are “omnipresent,” and how that spreads fear throughout their neighborhoods — again, for good reason. Though the mothers had not been selected because of involvement with CPS, nearly two-thirds had been subjected to a child abuse investigation.

Here’s one example from the study:

Leslie, a Hispanic mother, asked hospital staff when her newborn twins would be discharged so she could arrange housing for them, sharing that she had been sleeping at her workplace and her mother’s garage apartment. “I was trying to be honest just so I can prepare myself … [but] that backfired on me,” as the hospital notified CPS. “After that moment I learned how to play the game.”

Playing the game means watching every word spoken in front of a mandated reporter — even if that means losing out on help. Another mother decided not to seek public assistance when she found out she’d have to reveal the fact that the family was living in their car.

Some mothers refused voluntary home visiting services for new mothers — an intervention which, when following the Nurse-Family Partnership model, has a solid evidence base. But the visitors are mandated reporters and the mothers were too afraid the visits could lead to loss of the children.

And you don’t dare reveal to a mandated reporter that you sometimes lose your temper or get depressed. As one mother explained: “I feel like I can’t tell anybody anything because oops, I might’ve said too much. I might have a knock on my door, and somebody might be here to take my kids. That’s one of my biggest fears.”

GO BACK TO THE DRAWING BOARD

Mandatory reporting laws perfectly illustrate a double standard that pervades child welfare. If you want to do anything that helps keep families together you’d better be able to dot every i and cross every t on lots and lots of rigorous studies. In contrast, interventions that tear families apart, whether it’s mandatory reporting, foster care or residential treatment, dominate the field — with no evidence of effectiveness and considerable evidence of harm.

Even if it passes, the proposed change in Idaho would be only a small step forward. Mandatory reporting laws should be judged by the same standard as family preservation programs: If there’s no evidence base, then don’t do it. The laws should be scrapped. The terror of mandated reporting belongs in the dustbin of child welfare history.

Richard Wexler is executive director of the National Coalition for Child Protection Reform.

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