To view or obtain copies of other manuals in this series, contact the 

National Clearinghouse on Child Abuse and Neglect Information at:

800-FYI-3366

nccanch@calib.com

http://www.calib.com/nccanch/pubs/index.cfm#Umanuals
 

 

 

 

 

A Coordinated Response
	

to Child Abuse and Neglect:
	

The Foundation for Practice
	

Jill Goldman
	

Marsha K. Salus
	

with
	

Deborah Wolcott
	

Kristie Y. Kennedy
	

2003
	

U.S. Department of Health and Human Services
	

Administration for Children and Families
	

Administration on Children, Youth and Families
	

Children’s Bureau
	

Office on Child Abuse and Neglect
	

Table of Contents

PREFACE ........................................................................................................................................................................... 1
	

ACKNOWLEDGMENTS........................................................................................................................ 3
	

1. PURPOSE AND OVERVIEW .......................................................................................................................... 7
	

2.		 WHAT ARE THE PHILOSOPHICAL TENETS OF CHILD PROTECTION? .............................. 9
	

Key Principles of Child Protection ...............................................................................................................9
	

Philosophical Tenets...................................................................................................................................... 10
	

3.		 WHAT IS CHILD MALTREATMENT? .....................................................................................................13
	

Definitions in Federal Law .......................................................................................................................... 13
	

Sources of Definitions in State Law ........................................................................................................... 15
	

General Definitions by Type of Maltreatment......................................................................................... 16
	

4.		 WHAT IS THE SCOPE OF THE PROBLEM?.........................................................................................23
	

Reported Child Maltreatment Victims...................................................................................................... 23
	

Child Maltreatment Perpetrators................................................................................................................ 24
	

Nonreported Child Abuse and Neglect..................................................................................................... 25
	

5.		 WHAT FACTORS CONTRIBUTE TO CHILD ABUSE AND NEGLECT?..................................27
	

Parent or Caregiver Factors.......................................................................................................................... 28
	

Family Factors ................................................................................................................................................ 29
	

Child Factors .................................................................................................................................................. 32
	

Environmental Factors ................................................................................................................................. 33
	

Protective Factors........................................................................................................................................... 34
	

6.		 WHAT ARE THE CONSEQUENCES OF CHILD ABUSE AND NEGLECT? ...........................35
	

Health and Physical Effects ......................................................................................................................... 36
	

Cognitive Development and Academic Achievement ............................................................................ 37
	

Emotional, Psychosocial, and Behavioral Development........................................................................ 37
	

Resilience......................................................................................................................................................... 38
	

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 i 
7. WHAT CAN BE DONE TO PREVENT CHILD ABUSE AND NEGLECT?................................41
	

Prevention as a Strategy ................................................................................................................................ 41
	

Types of Prevention Activities ..................................................................................................................... 42
	

Major Prevention Program Models............................................................................................................ 43
	

Role of Various Entities in Prevention Efforts......................................................................................... 47
	

8.		 WHICH LAWS AND POLICIES GUIDE PUBLIC INTERVENTION 

IN CHILD MALTREATMENT? ...................................................................................................................51
	

The Federal Role in Addressing Child Abuse and Neglect ................................................................... 51
	

Basis for State Intervention.......................................................................................................................... 55
	

9.		 WHAT DOES THE CHILD PROTECTION PROCESS LOOK LIKE?..........................................59
	

Identification.................................................................................................................................................. 59
	

Reporting......................................................................................................................................................... 61
	

Intake ............................................................................................................................................................... 65
	

Initial Assessment or Investigation ............................................................................................................ 66
	

Family Assessment......................................................................................................................................... 68
	

Planning........................................................................................................................................................... 70
	

Service Provision ............................................................................................................................................ 70
	

Evaluation of Family Progress..................................................................................................................... 71
	

Case Closure ................................................................................................................................................... 72
	

10.		 WHO SHOULD BE INVOLVED IN CHILD PROTECTION 

AT THE COMMUNITY LEVEL? .................................................................................................................73
	

Child Protective Services .............................................................................................................................. 73
	

Law Enforcement........................................................................................................................................... 73
	

Educators and Early Child Care Providers............................................................................................... 74
	

Health Care Providers................................................................................................................................... 75
	

Mental Health Professionals........................................................................................................................ 75
	

Legal and Judicial System Professionals .................................................................................................... 75
	

Substitute Care Providers ............................................................................................................................. 77
	

Faith Community.......................................................................................................................................... 77
	

Community Organizations and Support Services Providers................................................................. 77
	

Concerned Citizens....................................................................................................................................... 78
	

11.		 HOW CAN ORGANIZATIONS WORK TOGETHER TO PROTECT CHILDREN?.............. 79
	

Principles to Guide Collaboraton .............................................................................................................. 79
	

Effective Leadership—An Essential Component of Successful Collaboration................................... 80
	

Collaborative Models.................................................................................................................................... 81
	

Conclusion...................................................................................................................................................... 81
	

ENDNOTES ....................................................................................................................................................................83
	

ii Table of Contents
	
APPENDICES:
	

APPENDIX A—GLOSSARY OF TERMS ....................................................................................................91
	

APPENDIX B—RESOURCE LISTINGS OF SELECTED NATIONAL
	

ORGANIZATIONS CONCERNED WITH CHILD MALTREATMENT......................................97
	

APPENDIX C—STATE TOLL-FREE TELEPHONE
	

NUMBERS FOR REPORTING CHILD ABUSE ..................................................................................103
	

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 iii 

User Manual has provided guidance on 

User Manual in 

 has provided guidance on 

 in 

 to reflect the increased knowledge base and 

Preface

Each day, the safety and well-being of some children across the Nation are threatened by 

child abuse and neglect. Intervening effectively 

in the lives of these children and their families 

is not the sole responsibility of any single agency 

or professional group, but rather is a shared 

community concern. 

Since the late 1970s, the Child Abuse and Neglect 

User Manual Series has provided guidance on has provided guidance on 

child protection to hundreds of thousands of 

multidisciplinary professionals and concerned 

community members. The User Manual Series 

provides a foundation for understanding child 

maltreatment and the roles and responsibilities of 

various practitioners in its prevention, identification, 

investigation, assessment, and treatment. Through 

the years, the manuals have served as valuable 

resources for building knowledge, promoting 

effective practices, and enhancing community 

collaboration. 

Since the last update of the User Manual Series in in 

the early 1990s, a number of changes have occurred 

that dramatically affect each community’s response 

to child maltreatment. The changing landscape 

reflects increased recognition of the complexity 

of issues facing parents and their children, new 

legislation, practice innovations, and system reform 

efforts. Significant advances in research have 

helped shape new directions for interventions, while 

ongoing evaluations help us to know “what works.” 

The Office on Child Abuse and Neglect (OCAN) 

within the Children’s Bureau of the Administration 

for Children and Families (ACF), U.S. Department 

of Health and Human Services (DHHS), has 

developed this third edition of the User Manual 

Series to reflect the increased knowledge base and to reflect the increased knowledge base and 

the evolving state of practice. The updated and 

new manuals are comprehensive in scope while also 

succinct in presentation and easy to follow, and 

they address trends and concerns relevant to today’s 

professional. 

This manual, A Coordinated Response to Child 

Abuse and Neglect: The Foundation for Practice, 

provides the keystone for the series. The manual 

addresses the definition, scope, causes, and 

consequences of child abuse and neglect. The manual 

also presents an overview of prevention efforts and 

the child protection process from identification and 

reporting through investigation and assessment to 

service provision and case closure. Because child 

protection is a multidisciplinary effort, the manual 

describes the roles and responsibilities of different 

professional groups and offers guidance on how 

the groups can work together effectively to protect 

the safety, permanency, and well-being of children. 

The primary audience for this manual includes 

new child protective services (CPS) caseworkers 

and other professionals working with children and 

families. Schools of social work may add it to class 

reading lists to orient students to the field of child 

protection. In addition, other professionals and 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 1 
Child Abuse and Neglect User Manual —is available from the 

Services: A Guide for and 

concerned community members may consult the 

manual for a greater understanding of child abuse 

and neglect. 

This manual is intended to accompany each 

profession-specific manual in the User Manual 

Series. These include, for example, Child Protective 

Services: Services: A Guide for Caseworkers Caseworkers and and The Role of 

Educators in the Prevention and Treatment of Child 

Abuse and Neglect. More detailed information on 

specific topics can be found in the professionspecific and special issue manuals. 

User Manual Series 

This manual—along with the entire Child Abuse and Neglect User Manual Series —is available from the —is available from the 

National Clearinghouse on Child Abuse and Neglect Information. Contact the Clearinghouse for a full 

list of available manuals and ordering information: 

National Clearinghouse on Child Abuse and Neglect Information 

330 C Street, SW 

Washington, DC 20447 

Phone: (800) FYI-3366 or (703) 385-7565 

Fax: (703) 385-3206 

E-mail: nccanch@calib.com 

The manuals also are available online at www.calib.com/nccanch/pubs/usermanual.cfm. 

2 Preface
	
Coordinating by James L. Jenkins, 

 

 by James L. Jenkins, 

Acknowledgments

PRIMARY AUTHORS 

Jill Goldman, M.B.A., a consultant with Caliber 

Associates, has spent the last 10 years conducting 

research and writing publications on child 

maltreatment and other issues related to children, 

youth, and families. She previously served as 

manager of product development and program 

services for the National Clearinghouse on Child 

Abuse and Neglect Information. 

Marsha K. Salus, M.S.W., is a social work 

consultant. She has worked in the child welfare field 

for 27 years. She began her career as a CPS worker 

and supervisor. She has developed several national 

curricula for child welfare workers and supervisors. 

She developed a number of preservice and inservice 

training programs for child welfare workers and 

supervisors in a variety of States. She has worked 

with several States to establish standards of practice 

for child welfare supervision. 

CONTRIBUTORS 

Deborah Wolcott, Ph.D., Fairfax County Public 

Schools, developed the chapter on prevention. 

Kristie Y. Kennedy, J.D., M.A., American Bar 

Association, provided input on the Federal basis for 

intervention and statutory issues. 

ACKNOWLEDGMENT OF PRIOR EDITIONS 

This manual, originally published in 1992 as 

A Coordinated Response to Child Abuse and 

Neglect: A Basic Manual by Diane DePanfilis and 

Marsha K. Salus, was revised and expanded by Jill 

Goldman and Marsha K. Salus in 2002. The first 

edition of the manual was published in 1979 as 

A Community Approach: The Child Protection 

Coordinating Coordinating Committee Committee by James L. Jenkins, by James L. Jenkins, 

Robert A. MacDicken, and Nancy J. Ormsby. The 

prior work informed and contributed significantly 

to the content of this publication. 

REVIEWERS 

Diane DePanfilis, Ph.D. 

University of Maryland at Baltimore 

School of Social Work 

Sgt. Richard Cage 

Montgomery County Police Department 

Family Services Division 

Wayne Holder 

National Resource Center on Child Maltreatment 

Sandi McLeod 

National Clearinghouse on 

Child Abuse and Neglect Information 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 3 
 

TECHNICAL ADVISORY PANEL 

The following were members of the January 2001 

Technical Advisory Panel for the User Manual Series 

contract. The organizations identified reflect each 

member’s affiliation at that time. 

Carolyn Abdullah 

FRIENDS National Resource Center 

Washington, DC 

Lien Bragg 

American Public Human Services Association 

Washington, DC 

Sgt. Richard Cage 

Montgomery County Police Department 

Wheaton, MD 

Diane DePanfilis, Ph.D. 

University of Maryland at Baltimore 

School of Social Work 

Baltimore, MD 

Pauline Grant 

Florida Department of Children and Families 

Jacksonville, FL 

Jodi Hill 

Connecticut Department of Children and Families 

Hartford, CT 

Robert Ortega, Ph.D. 

University of Michigan School of Social Work 

Ann Arbor, MI 

Nancy Rawlings 

Kentucky Cabinet for Families and Children 

Frankfort, KY 

Barry Salovitz 

Child Welfare Institute/National Resource Center 

on Child Maltreatment 

Glenmont, NY 

Sarah Webster 

Texas Department of Protective and Regulatory 

Services 

Austin, TX 

Ron Zuskin 

University of Maryland at Baltimore 

School of Social Work 

Baltimore, MD 

The following members were subsequently added to 

the Technical Advisory Panel: 

William R. (Reyn) Archer III, M.D. 

Hill and Knowlton, Inc. 

Washington, DC 

Douglas Besharov 

American Enterprise Institute 

Washington, DC 

David Popenoe, Ph.D. 

National Marriage Project 

Princeton, NJ 

Bob Scholle 

Independent Consultant 

Pittsburgh, PA 

Brad Wilcox, Ph.D. 

University of Virginia 

Department of Sociology 

Charlottesville, VA 

4 Acknowledgments
	
User Manual was 

Catherine Nolan, Director, Office on Child Abuse ADDITIONAL ACKNOWLEDGMENTS and Neglect. 

Also providing input and review were Sally Flanzer, The third edition of the User Manual Series was was Director, Division of Data, Research, and Innovation, developed under the guidance and direction of and Susan Orr, Associate Commissioner, Children’s Irene Bocella, Federal Task Order Officer, and Bureau. 

This manual was developed and produced by Caliber Associates, Fairfax, VA, under 

Contract Number HHS-282-98-0025. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 5 
6 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CHAPTER 1

Purpose and Overview

Child abuse and neglect is a community concern. Eachcommunityhasalegalandmoralobligation 

to promote the safety, permanency, and well-being of 

children, which includes responding effectively to 

child maltreatment. At the State and local levels, 

professionals assume various roles and responsibilities 

ranging from prevention, identification, and 

reporting of child maltreatment to intervention, 

assessment, and treatment. Child protective services 

(CPS) agencies, along with law enforcement, play a 

central role in receiving and investigating reports of 

child maltreatment. To protect children from harm, 

CPS also relies on community members to identify 

and report suspected cases of child maltreatment, 

including physical abuse, sexual abuse, neglect, and 

psychological maltreatment. Many community 

professionals (including health care providers, mental 

health professionals, educators, and legal and court 

system personnel) are involved in responding to child 

abuse and neglect and providing needed services. In 

addition, community-based agency staff, substance 

abuse treatment providers, domestic violence victim 

advocates, clergy, extended family members, and 

concerned citizens also play important roles in 

supporting families and keeping children safe. 

This manual—the first in the series—provides an 

overview of the problem of child abuse and neglect 

and the prevention and intervention processes. It 

describes not only the activities involved in child 

protection, but also the roles and responsibilities of 

various community members in conducting these 

activities and working collaboratively. It is intended to 

provide the basic information that professionals and 

the public need to become involved in, and enhance, 

their community’s response to child maltreatment. 

While the manual is comprehensive in scope and 

touches on major issues, it cannot reflect all the 

detailed information related to this complex problem. 

It is intended, therefore, as a starting point. 

This manual answers the following 10 questions: 

•	 What are the philosophical tenets of child 

protection? 

•	 What is child maltreatment? 

•	 What is the scope of the problem? 

•	 What factors contribute to abuse and neglect? 

•	 What are the consequences of abuse and neglect? 

•	 What can be done to prevent abuse and neglect? 

•	 Which laws and policies guide public intervention 

in child maltreatment? 

•	 What does the child protection process look 

like? 

•	 Who should be involved in child protection at 

the community level? 

•	 How can organizations work together to protect 

children? 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 7 
8 
 

 

 

 

 

 

 

 

 

CHAPTER 2

What Are the Philosophical 

Tenets of Child Protection?

The importance of the family in U.S. society is 

central to the Nation’s history and tradition. 

Parents have a fundamental right to raise their 

children as they see fit, and society presumes that 

parents will act in their children’s best interest. 

When parents do not protect their children from 

harm and meet their basic needs—as with cases of 

child abuse and neglect—society has a responsibility 

to intervene to protect the health and welfare of 

these children. Any intervention into family life 

on behalf of children must be guided by State 

and Federal laws, sound professional standards for 

practice, and strong philosophical underpinnings. 

This chapter presents key principles underscored 

in Federal legislation and the philosophical tenets 

on which the community’s responsibility for child 

protection is based. 

KEY PRINCIPLES OF CHILD PROTECTION 

The key principles guiding child protection 

are largely based on Federal statutes, primarily 

delineated in the Child Abuse Prevention and 

Treatment Act (CAPTA) and the Adoption and 

Safe Families Act (ASFA). CAPTA, in its original 

inception, was signed into law in 1974 (P.L. 93-247) 

and is reauthorized by Congress every 5 years. As 

of the publication of this manual, CAPTA is in the 

process of its latest reauthorization. ASFA was signed 

into law in 1997 (P.L. 105-89) and built upon earlier 

laws and reforms to promote the safety and well-being 

of maltreated children. These laws and other guiding 

legislation are referenced throughout this publication 

and are specifically discussed in “Federal Legislation 

and Programs” in Chapter 8. ASFA promotes three 

national goals for child protection: 

•	 Safety. All children have the right to live in an 

environment free from abuse and neglect. The 

safety of children is the paramount concern that 

must guide child protection efforts. 

•	 Permanency. Children need a family and 

a permanent place to call home. A sense of 

continuity and connectedness is central to a 

child’s healthy development. 

•	 Child and family well-being. Children 

deserve nurturing environments in which their 

physical, emotional, educational, and social 

needs are met. Child protection practices must 

take into account each child’s needs and should 

promote healthy development. 

In addition, ASFA underscored the importance 

of accountability of service delivery systems in 

achieving positive outcomes for children related to 

each of these goals. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 9 
 

 

PHILOSOPHICAL TENETS 

The following philosophical tenets expand upon 

the principles set forth in ASFA and the values that 

underlie sound practices in community responses to 

child abuse and neglect: 

•	 Prevention programs are necessary to 

strengthen families and reduce the 

likelihood of child abuse and neglect. 

Child maltreatment results from a combination 

of factors: psychological, social, situational, 

and societal. Factors that may contribute to 

an increased risk for child abuse and neglect 

include, for example, family structure, poverty, 

substance abuse, poor housing conditions, 

teenage pregnancy, domestic and community 

violence, mental illness, and lack of support 

from extended families and community 

members. To reduce the occurrence of 

maltreatment, communities should develop and 

implement prevention programs that support 

children and families. 

•	 The responsibility for addressing child 

maltreatment is shared among community 

professionals and citizens. No single agency, 

individual, or discipline has all the necessary 

knowledge, skills, or resources to provide the 

assistance needed by abused and neglected 

children and their families. While public 

child protective services (CPS) agencies, law 

enforcement, and courts have legal mandates 

and primary responsibility for responding to 

child maltreatment, other service providers 

working with children and families—along with 

community members—play important roles in 

supporting families and protecting children. 

To be effective in addressing this complex 

problem, the combined expertise and resources 

of interdisciplinary agencies and professionals 

are needed. 

•	 A safe and permanent home is the best place 

for a child to grow up. Most children are 

best cared for in their own families. Children 

naturally develop a strong attachment to their 

families and when removed from them, they 

typically experience loss, confusion, and other 

negative emotions. Maintaining the family as 

a unit preserves important relationships with 

parents, siblings, and extended family members 

and allows children to grow and develop within 

their own culture and environment. 

•	 When parents (or caregivers) are unable or 

unwilling to fulfill their responsibilities 

to provide adequate care and to keep 

their children safe, CPS has the mandate 

to intervene. Both laws and good practice 

maintain that interventions should be designed 

to help parents protect their children in the 

least intrusive manner possible. Interventions 

should build on the family’s strengths and 

address the factors that contribute to the risk 

of maltreatment. Reasonable efforts must be 

made to maintain child safety and keep the 

children with their families except when there is 

significant risk to child safety. Referral to court 

and removal of children from their families 

should only be done when it is determined 

that children cannot be kept safely in their own 

homes. 

•	 Most parents want to be good parents 

and have the strength and capacity, when 

adequately supported, to care for their 

children and keep them safe. Underlying 

CPS intervention is the belief that people have 

the strength and potential to change their lives. 

Professionals must search for and identify the 

strengths and the inner resiliencies in families 

that provide the foundation for change. 

•	 To help families protect their children and 

meet their basic needs, the community’s 

response must demonstrate respect for 

every person involved. All people deserve 

to be treated with respect and dignity. This 

means showing respect for a person, while not 

necessarily approving or condoning his or her 

10 What Are the Philosophical Tenets of Child Protection?
	
 

actions. In addition to caregivers and children, 

service providers should demonstrate respect 

for mothers, fathers, grandparents, other family 

members, and the family’s support network. 

•	 Services must be individualized and tailored. 

While people may have similar problems, there 

are elements that will vary from family to 

family. In addition, each family’s strengths 

and resources are different. The community’s 

response, therefore, must be customized to 

reflect the particular circumstances, strengths, 

and needs of each family. 

•	 Child protection and service delivery 

approaches should be family centered. 

Parents, children, their extended families, and 

support networks (e.g., the faith community, 

teachers, health care providers, substitute 

caregivers) should be actively involved as 

partners in developing and implementing 

appropriate plans and services to reduce or 

eliminate the risk of maltreatment. Tapping 

into the strengths and resources of a family’s 

natural support network is fundamental to 

enhancing family functioning. 

•	 Interventions need to be sensitive to the 

cultures, beliefs, and customs of all families. 

Professionals must acknowledge and show 

respect for the values and traditions of families 

from diverse cultural, ethnic, and religious 

backgrounds. To become culturally competent, 

professionals must first understand themselves 

and the effects of their own background on 

their values, behaviors, and judgments about 

others.1 In working with children and families 

different from themselves, professionals need to 

be aware of the context of the family’s culture 

and background in order to help provide access 

to culturally relevant services and solutions. 

•	 To best protect a child’s overall well-being, 

agencies must assure that children move to 

permanency as quickly as possible. Along 

with developing plans to facilitate reunification 

of children, agencies must develop alternative 

plans for permanence from the time the child 

enters care. For those children who cannot be 

safely reunified with their families, timely efforts 

must be made to ensure a stable, secure, and 

permanent home for the child through adoption 

or other permanent living arrangements. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 11 
12 
 

 

 

 

 

 

 

 

CHAPTER 3

What Is Child

Maltreatment?

To prevent and respond to child abuse and neglect effectively, there needs to be a common 

understanding of the definitions of those actions 

and omissions that constitute child maltreatment. 

Unfortunately, there is no single, universally applied 

definition of child abuse and neglect. Over the past 

several decades, different stakeholders—including 

State and Federal legislative bodies, agency officials, 

and researchers—have developed definitions of 

maltreatment for different purposes. Definitions 

vary across these groups and within them. For 

example, legal definitions describing the different 

forms of child maltreatment for reporting and 

criminal prosecution purposes are found mainly 

in State statutes, and definitions vary from State 

to State. Similarly, agency guidelines for accepting 

reports, conducting investigations, and providing 

interventions vary from State to State and sometimes 

from county to county. In addition, researchers use 

varying methods to measure and define abuse and 

neglect, making it difficult to compare findings 

across studies. Despite the differences, there are 

commonalities across definitions. This chapter 

describes sources of definitions in Federal and State 

laws and summarizes those elements commonly 

recognized as child maltreatment. 

DEFINITIONS IN FEDERAL LAW 

The Child Abuse Prevention and Treatment Act 

(CAPTA) provides minimum standards for defining 

physical child abuse, child neglect, and sexual abuse 

that States must incorporate in their statutory 

definitions to receive Federal funds. Under CAPTA, 

child abuse and neglect means: 

•	 Any recent act or failure to act on the part of a 

parent or caretaker that results in death, serious 

physical or emotional harm, sexual abuse, or 

exploitation; 

•	 An act or failure to act that presents an 

imminent risk of serious harm. 

The definition of child abuse and neglect refers 

specifically to parents and other caregivers. A “child” 

under this definition generally means a person who 

is under the age of 18 or who is not an emancipated 

minor. In cases of child sexual abuse, a “child” is one 

who has not attained the age of 18 or the age specified 

by the child protection law of the State in which the 

child resides, whichever is younger. 

While CAPTA provides definitions for sexual abuse 

and the special cases related to withholding or 

failing to provide medically indicated treatment, 

it does not provide specific definitions for other 

types of maltreatment—physical abuse, neglect, or 

psychological maltreatment. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 13 
CAPTA Definition of 

Withholding of Medically Indicated Treatment 

CAPTA defines the “withholding of medically indicated treatment” as: 

“[T]he failure to respond to the infant’s life-threatening conditions by providing treatment...which, in 

the treating physician’s reasonable medical judgment, will be most likely to be effective in ameliorating 

or correcting all such conditions.” 

The term “withholding of medically indicated treatment” does not include the failure to provide 

treatment (other than appropriate nutrition, hydration, and medication) to an infant when, in the 

treating physician’s reasonable medical judgment: 

• The infant is chronically and irreversibly comatose; 

• The provision of such treatment would merely prolong dying; 

• The provision of such treatment would not be effective in ameliorating or correcting all of the 

infant’s life-threatening conditions; 

• The provision of such treatment would otherwise be futile in terms of the survival of the infant; 

• The provision of such treatment would be virtually futile in terms of the survival of the infant, and 

the treatment itself under such circumstances would be inhumane.2 

CAPTA Definition of Sexual Abuse 

CAPTA defines “sexual abuse” as: 

“[T]he employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or 

assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for 

the purpose of producing a visual depiction of such conduct;” 

“[T]he rape, and in cases of caretaker or inter-familial relationships, statutory rape, molestation, 

prostitution, or other form of sexual exploitation of children, or incest with children.” 

14 What Is Child Maltreatment?
	
SOURCES OF DEFINITIONS IN STATE LAW 

While the Federal legislation sets minimum 

definitional standards, each State is responsible 

for providing its own definition of maltreatment 

within civil and criminal contexts. The problem 

of child maltreatment is generally subject to State 

laws (both statutes and case law) and administrative 

regulations. Definitions of child abuse and neglect 

are located primarily in three places within each 

State’s statutory code: 

•	 Mandatory child maltreatment reporting 

statutes (civil laws) provide definitions of 

child maltreatment to guide those individuals 

mandated to identify and report suspected 

child abuse. These reports activate the child 

protection process. (See Chapter 9, “What Does 

the Child Protection Process Look Like?,” for 

more information on mandated reporters and 

reporting procedures.) 

•	 Criminal statutes define those forms of child 

maltreatment that are criminally punishable. 

In most jurisdictions, child maltreatment is 

criminally punishable when one or more of the 

following statutory crimes have been committed: 

homicide, murder, manslaughter, false 

imprisonment, assault, battery, criminal neglect 

and abandonment, emotional and physical 

abuse, child pornography, child prostitution, 

computer crimes, rape, deviant sexual assault, 

indecent exposure, child endangerment, and 

reckless endangerment. 

•	 Juvenile court jurisdiction statutes provide 

definitions of the circumstances necessary for 

the court to have jurisdiction over a child 

alleged to have been abused or neglected. When 

the child’s safety cannot be ensured in the home, 

these statutes allow the court to take custody of 

a child and to order specific treatment services 

for the parents and child. 

Together, these legal definitions of child abuse and 

neglect determine the minimum standards of care 

and protection for children and serve as important 

guidelines for professionals regarding those acts and 

omissions that constitute child maltreatment. 

Child protective services (CPS) workers use statutory 

definitions of child maltreatment to determine 

whether maltreatment has occurred and when 

intervention into family life is necessary. For 

particular localities within a State, local CPS policies 

and procedures, based on statutes and regulations, 

further define different types of maltreatment 

and the conditions under which intervention and 

services are warranted. 

State Statutes 

To review a summary of reporting laws, visit the State Statutes section of the National Clearinghouse 

on Child Abuse and Neglect’s Web site at www.calib.com/nccanch/statutes. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 15 
cao a practice to treat illness 

 

 

 

a practice to treat illness 

GENERAL DEFINITIONS BY 

TYPE OF MALTREATMENT 

There are four commonly recognized forms of child 

abuse or maltreatment: 

•	 Physical 

•	 Sexual 

•	 Neglect 

•	 Psychological 

There is great variation from State to State regarding 

the details and specificity of child abuse definitions, 

but it is still possible to identify commonalities 

among each different type of child maltreatment. 

These commonalities, in part, reflect societal views 

of parental actions that are seen as improper or 

unacceptable because they place children at a risk of 

physical and emotional harm. 

Physical Abuse 

Generally, physical abuse is characterized by physical 

injury, such as bruises and fractures that result from: 

•	 Punching 

•	 Beating 

•	 Kicking 

•	 Biting 

•	 Shaking 

•	 Throwing 

•	 Stabbing 

•	 Choking 

•	 Hitting with a hand, stick, strap, or other 

object 

•	 Burning 

Although an injury resulting from physical abuse 

is not accidental, the parent or caregiver may not 

have intended to hurt the child. The injury may 

have resulted from severe discipline, including 

injurious spanking, or physical punishment that is 

inappropriate to the child’s age or condition. The 

injury may be the result of a single episode or of 

repeated episodes and can range in severity from 

minor marks and bruising to death. 

Some cultural practices are generally not defined as 

physical abuse, but may result in physically hurting 

children. For example: 

•	 “Coining” or cao gio—a practice to treat illness 

by rubbing the body forcefully with a coin or 

other hard object. 

•	 Moxabustion—an Asian folkloric remedy that 

burns the skin. 

As Howard Dubowitz, a leading researcher in 

the field, explains: “While cultural practices 

are generally respected, if the injury or harm is 

significant, professionals typically work with 

parents to discourage harmful behavior and suggest 

preferable alternatives.”3 

Sexual Abuse 

Child sexual abuse generally refers to sexual acts, 

sexually motivated behaviors involving children, or 

sexual exploitation of children.4 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; 

16 What Is Child Maltreatment?
	
 

 

 

 

 

 

 

 

 

 

 

 

 

 (NIS-3)

• Use of a child in prostitution, pornography, Physical Neglect
	

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—sexual abuse occurring among 

family members, including those in biological 

families, adoptive families, and step-families.5 

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, such as aunts, uncles, grandparents, 

cousins, or the boyfriend or girlfriend of a parent. 

Child Neglect 

Child neglect, the most common form of child 

maltreatment, is generally characterized by omissions 

in care resulting in significant harm or risk of 

significant harm. Neglect is frequently defined in 

terms of a failure to provide for the child’s basic 

needs—deprivation of adequate food, clothing, 

shelter, supervision, or medical care. Neglect laws 

often exclude circumstances in which a child’s needs 

are not met because of poverty or an inability to 

provide. In addition, many States establish religious 

exemptions for parents who choose not to seek 

medical care for their children due to religious beliefs 

that may prohibit medical intervention. 

The Department of Health and Human Services’ 

Third National Incidence Study of Child Abuse and 

Neglect Neglect (NIS-3) (NIS-3)6 is the single most comprehensive 

source of information about the current incidence 

of child maltreatment in the United States. NIS-3 

worked with researchers and practitioners to define 

physical, educational, and emotional neglect in a 

succinct and clear manner, as described below. 

•	 Refusal of health care—the 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—the failure to seek timely 

and appropriate medical care for a serious 

health problem that any reasonable layman 

would have recognized as needing professional 

medical attention. 

•	 Abandonment—the 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 child 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 

the parent or caretaker knowing or attempting 

to determine the child’s whereabouts. 

•	 Other physical neglect—includes inadequate 

nutrition, clothing, or hygiene; conspicuous 

inattention to avoidable hazards in the home; 

and other forms of reckless disregard of the 

child’s safety and welfare (e.g., driving with the 

child while intoxicated, leaving a young child in 

a car unattended). 

Educational Neglect 

•	 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. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 17 
•	 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 

•	 Inadequate nurturing or affection—marked 

inattention to the child’s needs for affection, 

emotional support, or attention. 

•	 Chronic or extreme spouse abuse—exposure 

to chronic or extreme spouse abuse or other 

domestic violence in the child’s presence. 

•	 Permitted drug or alcohol abuse— 

encouragement or permitting of drug or alcohol 

use by the child. 

•	 Permitted other maladaptive behavior— 

encouragement or permitting 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 layman would have recognized as 

needing professional, psychological attention 

(e.g., suicide attempt). 

18 What Is Child Maltreatment?
	
 

 

 

Spotlight on Chronic Neglect 

One issue in defining child neglect involves consideration of “incidents” of neglect versus a pattern 

of behavior that indicates neglect. Susan J. Zuravin, from the University of Maryland at Baltimore 

School of Social Work, recommends that if some behaviors occur in a “chronic pattern,” they should 

be considered neglectful.7 Examples include lack of supervision, inadequate hygiene, and failure to 

meet a child’s educational needs. This suggests that rather than focusing on individual incidents that 

may or may not be classified as “neglectful,” one should look at an accumulation of incidents that may 

together constitute neglect. “If CPS focuses only on the immediate allegation before them and not the 

pattern reflected in multiple referrals, then many neglected children will continue to be inappropriately 

excluded from the CPS system.”8 For example, a family exhibiting a pattern of behavior that may 

constitute neglect might include frequent reports of not having enough food in the home or keeping 

older children home from school to watch younger children. In most CPS systems, however, the 

criteria for identifying neglect focuses on recent, discrete, verifiable incidents. 

One study found that many children who had been referred to CPS for neglect did not receive services 

because their cases did not meet the criteria for “incidents” of neglect. It also found, however, that all 

of these children had, in fact, suffered severe developmental consequences. In recognition of this issue, 

the Missouri Division of Family Services (n.d.) has assigned one of its CPS staff as a “Chronic Neglect 

Specialist.” This office defines chronic neglect as “. . . a persistent pattern of family functioning in 

which the caregiver has not sustained and/or met the basic needs of the children which results in harm 

to the child.” The focus here is on the “accumulation of harm.” CPS and community agencies across 

the country are recognizing the importance of early intervention and service provision to support 

families so that neglect does not become chronic or lead to other negative consequences.9 

Psychological Maltreatment
	

Psychological maltreatment—also known as 

emotional abuse and neglect—refers to “a repeated 

pattern of caregiver behavior or extreme incident(s) 

that convey to children that they are worthless, 

flawed, unloved, unwanted, endangered, or only of 

value in meeting another’s needs.”10 Summarizing 

research and expert opinion, Stuart N. Hart, Ph.D., 

and Marla R. Brassard, Ph.D., present six categories 

of psychological maltreatment: 

•	 Spurning (e.g., belittling, hostile rejecting, 

ridiculing); 

•	 Terrorizing (e.g., threatening violence against 

a child, placing a child in a recognizably 

dangerous situation); 

•	 Isolating (e.g., confining the child, placing 

unreasonable limitations on the child’s freedom 

of movement, restricting the child from social 

interactions); 

•	 Exploiting or corrupting (e.g., modeling 

antisocial behavior such as criminal activities, 

encouraging prostitution, permitting substance 

abuse); 

•	 Denying emotional responsiveness (e.g., 

ignoring the child’s attempts to interact, failing 

to express affection); 

•	 Mental health, medical, and educational neglect 

(e.g., refusing to allow or failing to provide 

treatment for serious mental health or medical 

problems, ignoring the need for services for 

serious educational needs).11 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 19 
no experienced maltreatment. Additionally, 

 

 

 

 

 

 

 experienced maltreatment. Additionally, 

 

 

To warrant intervention, psychological maltreatment 

must be sustained and repetitive. For less severe 

acts, such as habitual scapegoating or belittling, 

demonstrable harm to the child is often required for 

CPS to intervene. 

Psychological maltreatment is the most difficult form 

ofchildmaltreatmenttoidentify. Inpart,thedifficulty 

in detection occurs because the effects of psychological 

maltreatment, such as lags in development, learning 

problems, and speech disorders, are often evident in 

both children who have experienced and those who 

have not experienced maltreatment. Additionally, experienced maltreatment. Additionally, 

the effects of psychological maltreatment may only 

become evident in later developmental stages of the 

child’s life. 

Although any of the forms of child maltreatment may 

be found alone, they often occur in combination. 

Psychological maltreatment is almost always present 

when other forms are identified. 

20 What Is Child Maltreatment?
	
Case Examples of Maltreatment 

Physical Abuse 

During a violent fight between her mother and her mother’s boyfriend, 8-year-old Kerry called 911. 

She told the operator that her mother’s boyfriend always hit her mommy when he came home drunk. 

In addition, Kerry said she was worried about her 5-year-old brother, Aaron, because he tried to help 

their mom and the boyfriend punched him in the face. As a result, Aaron fell, hit his head on the 

coffee table, and had not moved since. The operator heard yelling in the background and the mother 

screaming, “Get off the phone!” When the police and paramedics arrived, Aaron was unconscious and 

the mother had numerous bruises on her face. 

Child Neglect 

Robert and Carlotta are the parents of a 9-month-old son named Ruiz. Robert and Carlotta used 

various drugs together until Robert was arrested and sent to prison for distributing cocaine. Since 

Robert’s arrest, Carlotta has been living with different relatives and friends. Recently, she left her son 

with her sister who also has a history of drug use. Her sister then went to a local bar and left Ruiz 

unattended. After hearing the baby boy cry for over an hour, the neighbors called the police. When 

Carlotta arrived to pick up Ruiz, the police and the CPS worker were also there. It appeared that she 

had been using drugs. 

Sexual Abuse 

Jody, age 11, said that she was asleep in her bedroom and that her father came in and took off his robe 

and underwear. She stated that he got into bed with her and pulled up her nightgown and put his 

private part on her private part. She stated that he pushed hard and it hurt. Jody said that the same 

thing had happened before while her mother was at work. Jody stated that she told her mother, but 

her father insisted that she was telling a lie. 

Psychological Abuse 

Jackie is a 7-year-old girl who lives with her mother. Jackie’s mother often screams at her, calls her 

degrading names, and threatens to kill her when Jackie misbehaves. Jackie doesn’t talk in class anymore, 

doesn’t have any friends in her neighborhood, and has lost a lot of weight. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 21 
22 
 

CHAPTER 4

What Is the Scope

of the Problem?

Each year, hundreds of thousands of children in the United States are victims of maltreatment. 

Knowledge of the scope of the problem is drawn 

primarily from data reported by State child protective 

service (CPS) agencies to the National Child Abuse 

and Neglect Data System (NCANDS). Not all 

maltreatment, however, is known by the authorities. 

This chapter summarizes the 2000 NCANDS 

findings related to the number and characteristics 

of child maltreatment victims and perpetrators 

reported to CPS and also discusses estimates of the 

actual incidence of abuse and neglect, including 

incidents that are not reported to CPS. 

REPORTED CHILD MALTREATMENT VICTIMS 

The number of children actually maltreated is 

unknown. In 2000, there were an estimated 879,000 

victims of maltreatment nationwide.12 The term 

“victims” refers to those children who were found 

by CPS to have experienced abuse or neglect (i.e., 

substantiated cases). 

During that same year, an estimated 3 million 

referrals were made to CPS regarding one or more 

children in a family, and nearly two-thirds of those 

referrals were “screened in” for investigation of 

potential maltreatment. “Screened in” indicates 

that the referral was deemed appropriate for 

investigation or assessment based on State statutes 

and agency guidelines. The CPS processes for 

screening referrals, conducting investigations, and 

substantiating maltreatment are described further in 

Chapter 9, “What Does the Child Protection Process 

Look Like?” 

For every 1,000 children in the population in 2000, 

approximately 12 were victims of maltreatment.13 

Exhibit 4-1 presents NCANDS data on the reported 

annual victimization rates over the past 11 years. 

Exhibit 4-1 

Trend of Reported Victimization 

1990–2000 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 23 
 

 

 

 

 

 

 

Types of Maltreatment
	

The following findings describe reported child 

victimization rates by major types of maltreatment 

as stated in NCANDS for 2000: 

•	 Neglect. More than half of all reported victims 

(62.8 percent) suffered neglect (including 

medical neglect), an estimated rate of 7 per 1,000 

children. 

•	 Physical abuse. Approximately one-fifth of 

all known victims (19.3 percent) were physically 

abused, an estimated rate of 2 per 1,000 

children. 

•	 Sexual abuse. Of all reported maltreated 

children, just over one-tenth (10.1 percent) had 

been sexually abused, an estimated rate of 1 per 

1,000 children. 

•	 Psychological maltreatment. Less than onetenth (7.7 percent) were identified as victims of 

psychological maltreatment, or less than 1 per 

1,000 children.14 

Keep in mind that some children are reported as 

victims of more than one type of maltreatment. 

Characteristics of Victims 

Overall, in 2000, 52 percent of victims of child 

maltreatment were girls and 48 percent were boys. 

While rates of most types of maltreatment were 

similar for both sexes, more girls than boys were 

sexually abused. 

The youngest and most vulnerable children—children 

under the age of 3—had the highest victimization 

rate, approximately 16 per 1,000.15 Overall, rates of 

victimization declined as children’s age increased. 

(Victimization patterns by age, however, differ by 

type of maltreatment.) 

While children of every race and ethnicity were 

maltreated, victimization rates varied. Out of all 

children reported as maltreated in 2000: 

•	 50.6 percent of victims were White; 

•	 24.7 percent of victims were African American; 

•	 14.2 percent of victims were Hispanic; 

•	 1.6 percent of victims were American IndianAlaska Native; 

•	 1.4 percent of victims were Asian-Pacific 

Islander.16 

It is important to remember that these figures 

represent those children who have been referred 

to CPS, investigated, and found to have credible 

evidence of maltreatment. Other studies suggest 

that there are not significant differences in the 

actual incidence of maltreatment by race, but rather 

that certain races may receive different attention 

during the processes of referral, investigation, and 

service allocation.17 

Fatalities 

According to NCANDS, an estimated 1,200 children 

known to CPS died of abuse and neglect in 2000. 

Over two-fifths of these children (43.7 percent) were 

less than 1 year old. Child maltreatment fatalities 

were more frequently associated with neglect (34.9 

percent) than with other types of maltreatment, 

including physical abuse. 

CHILD MALTREATMENT PERPETRATORS 

The majority of victims reported to NCANDS in 

2000 (78.8 percent) were maltreated by a parent. This 

is not surprising given that child maltreatment is 

defined as the abuse or neglect of children by parents 

or caregivers. The definition of who is considered a 

caregiver (e.g., babysitter, daycare worker, residential 

facility staff, relatives, or household members) varies 

24 What Is the Scope of the Problem?
	
 

 

from State to State. Approximately three-fifths of 

perpetrators of maltreatment (59.9 percent) were 

women. Nearly 42 percent of that group of women 

perpetrators were younger than 30. While mothers 

were more frequently identified as perpetrators of 

neglect and physical abuse (the most common forms 

of maltreatment), fathers were more frequently 

identified as the perpetrators of sexual abuse.18 

NONREPORTED CHILD
	

ABUSE AND NEGLECT
	

Not all victims of abuse and neglect are reported 

to CPS and not all reports are verifiable. As 

such, the statistics presented above likely underrepresent the true scope of child maltreatment. The 

Third National Incidence Study of Child Abuse 

and Neglect (NIS-3) surveyed community-level 

professionals (e.g., educators, medical professionals, 

and mental health care providers) who came into 

contact with children in 1993. The study estimated 

that less than one-third of the children who were 

identified as having experienced harm from abuse 

or neglect had been investigated by CPS.19 General 

population surveys also suggest that maltreatment is 

higher than the official reports. For example, based 

on what parents say they did in disciplining their 

children, a 1995 Gallup Poll estimated the number 

of physical abuse victims to be 16 times the official 

reported number of victims for that time period. 

Key Sources of Child Abuse and Neglect Statistics 

The primary sources of national statistics on child abuse and neglect are two reports sponsored by the 

Children’s Bureau of the U.S. Department of Health and Human Services: 

• Child Maltreatment: Reports from the States to the National Child Abuse and Neglect 

Data System (NCANDS). NCANDS collects national information on maltreated children 

known to State CPS. The annual NCANDS report presents national and State level findings on 

the number and sources of child abuse and neglect reports, investigation dispositions, types of 

maltreatment, characteristics of children victimized, relationship of perpetrators to victims, and 

services provided for child maltreatment victims. 

• National Incidence Study of Child Abuse and Neglect (NIS). NIS is designed to estimate 

the actual number of abused and neglected children nationwide including both cases reported 

and cases not reported to CPS. NIS bases estimates on information provided by a nationally 

representative sample of community professionals (e.g., educators, law enforcement personnel, 

medical professionals, and other service providers) who come into contact with maltreated 

children. 

The most recent reports from these studies are available from the National Clearinghouse 

on Child Abuse and Neglect Information, 800-FYI-3366, nccanch@calib.com, or online at 

www.calib.com/nccanch. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 25 

 result in child abuse and neglect. The factors 

 

CHAPTER 5

What Factors

Contribute to Child 

Abuse and Neglect?

There is no single known cause of child maltreatment. Nor is there any single 

description that captures all families in which 

children are victims of abuse and neglect. Child 

maltreatment occurs across socio-economic, religious, 

cultural, racial, and ethnic groups. While no specific 

causes definitively have been identified that lead a 

parent or other caregiver to abuse or neglect a child, 

research has recognized a number of risk factors or 

attributes commonly associated with maltreatment. 

Children within families and environments in 

which these factors exist have a higher probability of 

experiencing maltreatment. It must be emphasized, 

however, that while certain factors often are present 

among families where maltreatment occurs, this 

does not mean that the presence of these factors will 

always result in child abuse and neglect. The factors result in child abuse and neglect. The factors 

that may contribute to maltreatment in one family 

may not result in child abuse and neglect in another 

family. For example, several researchers note the 

relation between poverty and maltreatment, yet it 

must be noted that most people living in poverty do 

not harm their children. Professionals who intervene 

in cases of child maltreatment must recognize the 

multiple, complex causes of the problem and must 

tailor their assessment and treatment of children and 

families to meet the specific needs and circumstances 

of the family. 

Risk factors associated with child maltreatment can 

be grouped in four domains: 

• Parent or caregiver factors 

• Family factors 

• Child factors 

• Environmental factors 

It is increasingly recognized that child maltreatment 

arises from the interaction of multiple factors across 

these four domains.20 The sections that follow 

examine risk factors in each category. Available 

research suggests that different factors may play 

varying roles in accounting for different forms of 

child maltreatment (physical abuse, sexual abuse, 

neglect, and psychological or emotional abuse). 

Some of these differences are highlighted throughout 

the chapter. 

A greater understanding of risk factors can 

help professionals working with children and 

families both to identify maltreatment and highrisk situations and to intervene appropriately. 

Assessment of the specific risk factors that affect 

a family may influence the prioritization of 

intervention services for that family (e.g., substance 

abuse treatment). Moreover, addressing risk and 

protective factors can help to prevent child abuse 

and neglect. For example, prevention programs 

may focus on increasing social supports for families 

(thereby reducing the risk of social isolation) or 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 27 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

providing parent education to improve parent’s 

age-appropriate expectations for their children. 

Prevention activities and their link to risk factors are 

discussed further in Chapter 7, “What Can Be Done 

to Prevent Child Abuse and Neglect?” 

PARENT OR CAREGIVER FACTORS 

Parent or caregiver factors potentially contributing 

to maltreatment relate to: 

•	 Personality characteristics and psychological 

well-being 

•	 History of maltreatment 

•	 Substance abuse 

•	 Attitudes and knowledge 

•	 Age 

Personality Characteristics and
	

Psychological Well-being
	

No consistent set of characteristics or personality 

traits has been associated with maltreating parents 

or caregivers. Some characteristics frequently 

identified in those who are physically abusive or 

neglectful include low self-esteem, an external locus 

of control (i.e., belief that events are determined 

by chance or outside forces beyond one’s personal 

control), poor impulse control, depression, anxiety, 

and antisocial behavior.21 While some maltreating 

parents or caregivers experience behavioral and 

emotional difficulties, severe mental disorders are 

not common.22 

Parental Histories and the Cycle of Abuse 

A parent’s childhood history plays a large part in 

how he or she may behave as a parent. Individuals 

with poor parental role models or those who did not 

have their own needs met may find it very difficult 

to meet the needs of their children. 

While the estimated number varies, child 

maltreatment literature commonly supports the 

finding that some maltreating parents or caregivers 

were victims of abuse and neglect themselves as 

children.23 One review of the relevant research 

suggested that about one-third of all individuals 

who were maltreated will subject their children to 

maltreatment.24 Children who either experienced 

maltreatment or witnessed violence between their 

parents or caregivers may learn violent behavior 

and may also learn to justify violent behavior as 

appropriate.25 

An incorrect conclusion from this finding, however, 

is that a maltreated child will always grow up to 

become a maltreating parent. There are individuals 

who have not been abused as children who become 

abusive, as well as individuals who have been abused 

as children and do not subsequently abuse their 

own children. In the research review noted above, 

approximately two-thirds of all individuals who 

were maltreated did not subject their children to 

abuse or neglect.26 

It is not known why some parents or caregivers who 

were maltreated as children abuse or neglect their own 

children and others with a similar history do not.27 

While every individual is responsible for his or her 

actions, research suggests the presence of emotionally 

supportive relationships may help lessen the risk of 

the intergenerational cycle of abuse.28 

Substance Abuse 

Parental substance abuse is reported to be a 

contributing factor for between one- and two-thirds 

of maltreated children in the child welfare system.29 

Research supports the association between substance 

abuse and child maltreatment.30 For example: 

•	 A retrospective study of maltreatment experience 

in Chicago found children whose parents abused 

alcohol and other drugs were almost three times 

likelier to be abused and more than four times 

likelier to be neglected than children of parents 

who were not substance abusers.31 

28 What Factors Contribute to Child Abuse and Neglect?
	
 

 

 

 

 

 

 

 

 

 

•	 A Department of Health and Human Services 

study found all types of maltreatment, and 

particularly neglect, to be more likely in alcoholabusing families than in nonalcohol-abusing 

families.32 

Substance abuse can interfere with a parent’s mental 

functioning, judgment, inhibitions, and protective 

capacity. Parents significantly affected by the use 

of drugs and alcohol may neglect the needs of 

their children, spend money on drugs instead of 

household expenses, or get involved in criminal 

activities that jeopardize their children’s health or 

safety.33 Also, studies suggest that substance abuse 

can influence parental discipline choices and childrearing styles.34 

Over the past decade, prenatal exposure of 

children to drugs and alcohol during their 

mother’s pregnancy and its potentially negative, 

developmental consequences has been an issue of 

particular concern. The number of children born 

each year exposed to drugs or alcohol is estimated 

to be between 550,000 and 750,000.35 While this 

issue has received much attention, children who are 

exposed prenatally represent only a small proportion 

of children negatively affected by parental substance 

abuse.36 

The number and complexity of co-occurring 

family problems often makes it difficult to 

understand the full impact of substance abuse on 

child maltreatment.37 Substance abuse and child 

maltreatment often co-occur with other problems, 

including mental illness, HIV/AIDS or other health 

problems, domestic violence, poverty, and prior 

child maltreatment. These co-occurring problems 

produce extremely complex situations that can be 

difficult to resolve.38 Because many of the problems 

may be important and urgent, it can be difficult to 

prioritize what services to provide. Additionally, 

identifying and obtaining appropriate resources 

to address these needs is a challenge in many 

communities. 

Attitudes and Knowledge
	

Negative attitudes and attributions about a child’s 

behavior and inaccurate knowledge about child 

development may play a contributing role in child 

maltreatment.39 For example, some studies have 

found that mothers who physically abuse their 

children have both more negative and higher than 

normal expectations of their children, as well as 

less understanding of appropriate developmental 

norms.40 Not all research, however, has found 

differences in parental expectations.41 

A parent’s lack of knowledge about normal child 

development may result in unrealistic expectations. 

Unmet expectations can culminate in inappropriate 

punishment (e.g., a parent hitting a one-year-old 

for soiling his pants). Other parents may become 

frustrated with not knowing how to manage a 

child’s behavior and may lash out at the child. Still 

others may have attitudes that devalue children or 

view them as property. 

Age 

Caretaker age may be a risk factor for some forms 

of maltreatment, although research findings are 

inconsistent.42 Some studies of physical abuse, 

in particular, have found that mothers who were 

younger at the birth of their child exhibited higher 

rates of child abuse than did older mothers.43 Other 

contributing factors, such as lower economic status, 

lack of social support, and high stress levels may 

influence the link between younger childbirth— 

particularly teenage parenthood—and child abuse.44 

FAMILY FACTORS 

Specific life situations of some families—such 

as marital conflict, domestic violence, single 

parenthood, unemployment, financial stress, and 

social isolation—may increase the likelihood of 

maltreatment. While these factors by themselves may 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 29 
 

 

 

 

not cause maltreatment, they frequently contribute 

to negative patterns of family functioning. 

Family Structure 

Children living with single parents may be at higher 

risk of experiencing physical and sexual abuse and 

neglect than children living with two biological 

parents.45 Single parent households are substantially 

more likely to have incomes below the poverty line. 

Lower income, the increased stress associated with 

the sole burden of family responsibilities, and fewer 

supports are thought to contribute to the risk of 

single parents maltreating their children. In 1998, 

23 percent of children lived in households with a 

single mother, and 4 percent lived in households 

with a single father.46 A strong, positive relationship 

between the child and the father, whether he resides 

in the home or not, contributes to the child’s 

development and may lessen the risk of abuse. 

In addition, studies have found that compared to 

similar non-neglecting families, neglectful families 

tend to have more children or greater numbers 

of people living in the household.47 Chronically 

neglecting families often are characterized by a 

chaotic household with changing constellations 

of adult and child figures (e.g., a mother and her 

children who live on and off with various others, 

such as the mother’s mother, the mother’s sister, or 

a boyfriend).48 

30 What Factors Contribute to Child Abuse and Neglect?
	
 

 

 

 

 

 

 

 

 

 

The Child Abuse and Father Absence Connection 

• The rate of child abuse in single parent households is 27.3 children per 1,000, which is nearly twice 

the rate of child abuse in two parent households (15.5 children per 1,000). 

• An analysis of child abuse cases in a nationally representative sample of 42 counties found that 

children from single parent families are more likely to be victims of physical and sexual abuse than 

children who live with both biological parents. Compared to their peers living with both parents, 

children in single parent homes had: 

- 77 percent greater risk of being physically abused; 

- 87 percent greater risk of being harmed by physical neglect; 

- 165 percent greater risk of experiencing notable physical neglect; 

- 74 percent greater risk of suffering from emotional neglect; 

- 80 percent greater risk of suffering serious injury as a result of abuse; 

- 120 percent greater risk of experiencing some type of maltreatment overall. 

• A national survey of nearly 1,000 parents found that 7.4 percent of children who lived with one 

parent had been sexually abused, compared to only 4.2 percent of children who lived with both 

biological parents. 

• Using data from 1,000 students tracked from seventh or eighth grade in 1988 through high school 

in 1992, researchers determined that only 3.2 percent of the boys and girls who were raised with 

both biological parents had a history of maltreatment. However, a full 18.6 percent of those in 

other family situations had been maltreated. 

• A study of 156 victims of child sexual abuse found that the majority of the children came from 

disrupted or single-parent homes; only 31 percent of the children lived with both biological 

parents. Although stepfamilies make up only about 10 percent of all families, 27 percent of the 

abused children in this study lived with either a stepfather or the mother’s boyfriend.49 

Marital Conflict and Domestic Violence
	

According to published studies, in 30 to 60 percent 

of families where spouse abuse takes place, child 

maltreatment also occurs.50 Children in violent 

homes may witness parental violence, may be victims 

of physical abuse themselves, and may be neglected 

by parents who are focused on their partners or 

unresponsive to their children due to their own 

fears.51 A child who witnesses parental violence is 

at risk for also being maltreated, but, even if the 

child is not maltreated, he or she may experience 

harmful emotional consequences from witnessing 

the parental violence.52 

Stress 

Stress is also thought to play a significant role in 

family functioning, although its exact relationship 

with maltreatment is not fully understood.53 Physical 

abuse has been associated with stressful life events, 

parenting stress, and emotional distress in various 

studies.54 Similarly, some studies have found that 

neglectful families report more day-to-day stress than 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 31 
 

 more 

 more events and life 

 

 

 

 

 

 

 

 

 

 

 

non-neglectful families.55 It is not clear, however, 

whether maltreating parents actually experience experience more more 

life stress or, rather, perceive perceive more events and life more events and life 

experiences as being stressful.56 In addition, specific 

stressful situations (e.g., losing a job, physical illness, 

marital problems, or the death of a family member) 

may exacerbate certain characteristics of the family 

members affected, such as hostility, anxiety, or 

depression, and that may also aggravate the level of 

family conflict and maltreatment.57 

Parent-Child Interaction 

Families involved in child maltreatment seldom 

recognize or reward their child’s positive behaviors, 

while having strong responses to their child’s 

negative behaviors.58 Maltreating parents have been 

found to be less supportive, affectionate, playful, and 

responsive with their children than parents who do 

not abuse their children.59 Research on maltreating 

parents, particularly physically abusive mothers, 

found that these parents were more likely to use 

harsh discipline strategies (e.g., hitting, prolonged 

isolation) and verbal aggression and less likely to use 

positive parenting strategies (e.g., using time outs, 

reasoning, and recognizing and encouraging the 

child’s successes).60 

CHILD FACTORS 

Children are not responsible for being victims of 

maltreatment. Certain factors, however, can make 

some children more vulnerable to maltreating 

behavior. The child’s age and development—physical, 

mental, emotional, and social—may increase the 

child’s vulnerability to maltreatment, depending 

on the interactions of these characteristics with the 

parental factors previously discussed. 

Age 

The relationship between a child’s age and 

maltreatment is not clear cut and may differ by type 

of maltreatment. In 2000, for example, the rate of 

documented maltreatment was highest for children 

between birth and 3 years of age (15.7 victims per 

1,000 children of this age in the population) and 

declined as age increased.61 The inverse relationship 

between age and maltreatment is particularly strong 

for neglect, but not as evident for other types of 

maltreatment (physical, emotional, or sexual abuse). 

Infants and young children, due to their small 

physical size, early developmental status, and need 

for constant care, can be particularly vulnerable to 

child maltreatment. Very young children are more 

likely to experience certain forms of maltreatment, 

such as shaken baby syndrome and nonorganic 

failure to thrive. Teenagers, on the other hand, are 

at greater risk for sexual abuse.62 

Disabilities 

Children with physical, cognitive, and emotional 

disabilities appear to experience higher rates of 

maltreatment than do other children.63 A national 

study, completed in 1993, found that children 

with disabilities were 1.7 times more likely to be 

maltreated than children without disabilities.64 To 

date, the full degree to which disabilities precede or 

are a result of maltreatment is unclear. 

In general, children who are perceived by their 

parents as “different” or who have special needs— 

including children with disabilities, as well as 

children with chronic illnesses or children with 

difficult temperaments—may be at greater risk of 

maltreatment.65 The demands of caring for these 

children may overwhelm their parents. Disruptions 

may occur in the bonding or attachment processes, 

particularly if children are unresponsive to 

affection or if children are separated by frequent 

hospitalizations.66 Children with disabilities also 

may be vulnerable to repeated maltreatment because 

they may not understand that the abusive behaviors 

are inappropriate, and they may be unable to escape 

or defend themselves in abusive situations.67 Some 

researchers and advocates have suggested that some 

32 What Factors Contribute to Child Abuse and Neglect?
	
 

 

 

 

 

 

 

societal attitudes, practices, and beliefs that devalue 

and depersonalize children with disabilities sanction 

abusive behavior and contribute to their higher 

risk of maltreatment.68 For instance, there may be 

greater tolerance of a caregiver verbally berating or 

physically responding to a disabled child’s inability 

to accomplish a task or act in an expected way than 

there would be if similar behavior was directed at a 

normally abled child. 

Other Child Characteristics 

While some studies suggest that infants born 

prematurely or with low birth-weight may be at 

increased risk for maltreatment, other studies do 

not.69 The relationship between low birth-weight and 

maltreatment may be attributable to higher maternal 

stress heightened by high caregiver demands, but it 

also may be related to poor parental education about 

low birth-weight, lack of accessible prenatal care, and 

other factors, such as substance abuse or domestic 

violence.70 

Child factors such as aggression, attention deficits, 

difficult temperaments, and behavior problems—or 

the parental perceptions of such problems—have 

been associated with increased risk for all types of 

child maltreatment.71 These factors may contribute 

indirectly to child maltreatment when interacting 

with certain parental characteristics, such as poor 

coping skills, poor ability to empathize with the 

child, or difficulty controlling emotions. In addition, 

these same child characteristics may be reinforced by 

the maltreatment (e.g., a physically abused child 

may develop aggressive behaviors that elicit harsh 

reactions from others) and create conditions that 

can lead to recurring maltreatment.72 

ENVIRONMENTAL FACTORS 

Environmental factors are often found in 

combination with parent, family, and child 

factors, as highlighted in previous sections of this 

chapter. Environmental factors include poverty and 

unemployment, social isolation, and community 

characteristics. It is important to reiterate that 

most parents or caregivers who live in these types of 

environments are not abusive. 

Poverty and Unemployment 

Poverty and unemployment show strong associations 

with child maltreatment, particularly neglect.73 The 

NIS-3 study, for example, found that children from 

families with annual incomes below $15,000 in 1993 

were more than 22 times more likely to be harmed 

by child abuse and neglect as compared to children 

from families with annual incomes above $30,000.74 

It is important to underscore that most poor 

people do not maltreat their children. However, 

poverty—particularly when interacting with other 

risk factors such as depression, substance abuse, 

and social isolation—can increase the likelihood 

of maltreatment. In 1999, 85 percent of States 

identified poverty and substance abuse as the top 

two problems challenging families reported to child 

protective service (CPS) agencies.75 

Rod Plotnik, emeritus professor, Department of 

Psychology, San Diego State University, describes 

several theories related to the association between 

poverty and maltreatment, all of which may hold 

some truth. One theory is that low income creates 

greater family stress, which, in turn, leads to higher 

chances of maltreatment. A second theory is that 

parents with low incomes, despite good intentions, 

may be unable to provide adequate care while raising 

children in high-risk neighborhoods with unsafe or 

crowded housing and inadequate daycare. A third 

theory is that some other characteristics may make 

parents more likely to be both poor and abusive. 

For example, a parent may have a substance abuse 

problem that impedes the parent’s ability to obtain 

and maintain a job, which also may contribute to 

abusive behavior. A final theory is that poor families 

may experience maltreatment at rates similar to other 

families, but that maltreatment in poor families is 

reported to CPS more frequently, in part because 

they have more contact with and are under greater 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 33 
 

 

 

 

 

 

 

 

scrutiny from individuals who are legally mandated 

to report suspected child maltreatment.76 

Social Isolation and Social Support 

Some studies indicate that compared to other 

parents, parents who maltreat their children report 

experiencing greater isolation, more loneliness, 

and less social support.77 Social isolation may 

contribute to maltreatment because parents have 

less material and emotional support, do not have 

positive parenting role models, and feel less pressure 

to conform to conventional standards of parenting 

behaviors.78 It is not clear, however, whether social 

isolation in some cases precedes and serves as a 

contributing factor to maltreatment or whether 

it is a consequence of the behavioral dynamics of 

maltreatment.79 

Violent Communities 

Children living in dangerous neighborhoods have 

been found to be at higher risk than children from 

safer neighborhoods for severe neglect and physical 

abuse, as well as child sexual victimization.80 Some 

risk may be associated with the poverty found 

in dangerous neighborhoods, however, concerns 

remain that violence may seem an acceptable 

response or behavior to individuals who witness it 

more frequently. 

Societal attitudes and the promotion of violence in 

cultural norms and the media have been suggested as 

risk factors for physical abuse.81 In addition, while 

the research is controversial, some studies show a 

positive relationship between televised violence and 

aggressive behaviors, particularly for individuals 

who watch substantial amounts of television.82 

PROTECTIVE FACTORS 

Just as there are factors that place families at risk 

for maltreating their children, there are other factors 

that may protect them from vulnerabilities—factors 

that promote resilience. In general, research has 

found that supportive, emotionally satisfying 

relationships with a network of relatives or friends 

can help minimize the risk of parents maltreating 

children, especially during stressful life events.83 For 

example, parents who were abused as children are 

less likely to abuse their own children if they have 

resolved internal conflicts and pain related to their 

history of abuse and if they have an intact, stable, 

supportive, and nonabusive relationship with their 

partner.84 Additionally, programs on marriage 

education and enhancement may provide a roadmap 

of expected challenges such as the birth of the first 

child, parenting adolescents, and common gender 

differences which may act as a protective factor by 

strengthening families.85 

34 What Factors Contribute to Child Abuse and Neglect?
	
 

CHAPTER 6

What Are the 

Consequences of Child

Abuse and Neglect?

The consequences of child maltreatment can be profound and may endure long after the 

abuse or neglect occurs. The effects can appear in 

childhood, adolescence, or adulthood, and may affect 

various aspects of an individual’s development (e.g., 

physical, cognitive, psychological, and behavioral). 

These effects range in consequence from minor 

physical injuries, low self-esteem, attention disorders, 

and poor peer relations to severe brain damage, 

extremely violent behavior, and death.86 

While substantial evidence exists for the negative 

consequences of maltreatment, practitioners should 

be aware of the limitations of current research. First, 

many research efforts have studied the effects of child 

maltreatment among individuals from lower socioeconomic backgrounds, prison populations, mental 

health patients, or other clinical populations who 

may exhibit the most serious behavior problems and 

whose families often have had many other problems 

(e.g., poverty, parental substance abuse, domestic 

violence). Further, many early studies examining 

consequences did not compare outcomes among 

maltreated individuals with outcomes among 

individuals who had not experienced maltreatment. 

In addition, studies often rely on official records or 

self-reporting of current or past child maltreatment, 

both of which may undercount the true prevalence 

of maltreatment. Finally, the nature and extent 

of maltreatment are different for each child and 

family, and these differences may influence the 

consequences. 

Despite the above challenges, it is still possible to 

identify effects that have been more commonly 

associated with individuals who have experienced 

abuse and neglect. These effects are discussed 

in the sections that follow as they relate to three 

overlapping areas: 

•	 Health and physical effects 

•	 Intellectual and cognitive development 

•	 Emotional, psychological, and behavioral 

consequences 

While maltreated children have a higher risk of 

certain problems, it cannot be concluded that 

any given consequence will always occur. Not all 

children who have been maltreated will suffer severe 

consequences. A number of factors may influence 

the effects of maltreatment, including the child’s 

age and developmental status at the time of the 

maltreatment, as well as the type, the frequency, the 

duration, and the severity of the maltreatment and 

co-occurring problems.87 In addition, research has 

identified certain protective factors that mediate the 

effects of maltreatment. These protective factors 

and a child’s resilience to negative consequences are 

addressed in the final section of this chapter. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 35 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

HEALTH AND PHYSICAL EFFECTS 

Health and physical effects can include the 

immediate effects of bruises, burns, lacerations, and 

broken bones and also longer-term effects of brain 

damage, hemorrhages, and permanent disabilities. 

Negative effects on physical development can result 

from physical trauma (e.g., blows to the head or 

body, violent shaking, scalding with hot water, or 

asphyxiation) and from neglect (e.g., inadequate 

nutrition, lack of adequate motor stimulation, or 

withholding medical treatments). Specific physical 

effects as they relate to the early brain development 

of infants are highlighted in the following sections, 

along with some general health problems associated 

with maltreatment. The issue of child fatalities, the 

most tragic consequence of child maltreatment, is 

discussed in Chapter 4, “What Is the Scope of the 

Problem?” 

Physical Effects on Infants 

Infants and young children are particularly 

vulnerable to the physical effects of maltreatment. 

Shaking an infant may result in bruising, bleeding, 

and swelling in the brain. The health consequences 

of “shaken baby syndrome” can range from 

vomiting or irritability to more severe effects, such 

as concussions, respiratory distress, seizures, and 

death.88 Other possible consequences include partial 

loss of vision or blindness, learning disabilities, 

mental retardation, cerebral palsy, or paralysis.89 

Infants who have been neglected and malnourished 

may experience a condition known as “nonorganic 

failure to thrive.” With this condition, the child’s 

weight, height, and motor development fall 

significantly below age-appropriate ranges with no 

medical or organic cause. The death of the child is 

the end result in extreme cases. Nonorganic failure 

to thrive can result in continued growth retardation 

as well as cognitive and psychological problems.90 

Even with treatment, the long-term consequences 

can include continued growth problems, diminished 

cognitive abilities, retardation, and socio-emotional 

deficits such as poor impulse control. 

Effects on Brain Development 

Over the last decade, researchers have enhanced 

the field’s understanding of the adverse effects of 

maltreatment on early brain development. Recent 

brain research has established a foundation for 

the neurobiological explanations for many of the 

physical, cognitive, social, and emotional difficulties 

exhibited by children who experienced maltreatment 

in their early years. 

One explanation begins with the link between chronic 

physical abuse, sexual abuse, or neglect and the chronic 

stress it typically causes in a young child. In reaction 

to this persistent stress associated with ongoing 

maltreatment, the child’s brain may strengthen the 

pathways among neurons that are involved in the fear 

response. As a result, the brain may become “wired” 

to experience the world as hostile and uncaring. This 

negative perspective may influence the child’s later 

interactions, prompting the child to become anxious 

and overly aggressive or withdrawn.91 

Research shows that maltreatment also may inhibit 

the appropriate development of certain regions 

of the brain. A neglected infant or young child, 

for example, may not be exposed to stimuli that 

would activate important regions of the brain and 

strengthen cognitive pathways. Consequently, the 

connections among neurons in these inactivated 

regions can literally whither away, hampering 

the individual’s later functioning. If the regions 

responsible for emotional regulation are not 

activated, the child may have trouble controlling 

his or her emotions and behaving or interacting 

appropriately (e.g., impulsive behavior, difficulties 

in social interactions, or a lack of empathy).92 

36 What Are the Consequences of Child Abuse and Neglect?
	
 

 

 

 

 

 

 

 

Other Health-related Problems
	

Maltreatment may affect an individual’s health in 

a number of direct and indirect ways. Victims of 

sexual abuse, for example, may become infected 

with sexually transmitted diseases including syphilis 

and human immunodeficiency virus (HIV). Studies 

have found that women who had experienced sexual 

abuse were more likely to experience ongoing health 

problems such as chronic pelvic pain and other 

gynecologic problems, gastrointestinal problems, 

headaches, and obesity.93 Recent research suggests 

that adults who were maltreated as children show 

higher levels of many health problems not typically 

associated with abuse and neglect—heart disease, 

cancer, chronic lung disease, and liver disease.94 The 

link between maltreatment and these diseases may 

be depression, which can influence the immune 

system and may lead to higher risk behaviors such 

as smoking, alcohol and drug use, and overeating.95 

COGNITIVE DEVELOPMENT AND
	

ACADEMIC ACHIEVEMENT
	

Current research differs on findings related to 

the consequences of maltreatment on cognitive 

development, verbal abilities, and problem-solving 

skills. Some studies find evidence of lowered 

intellectual and cognitive functioning in abused 

children as compared to children who had not been 

abused,96 and other studies find no differences.97 

Research has consistently found that maltreatment 

increases the risk of lower academic achievement 

and problematic school performance.98 Abused 

and neglected children in these studies received 

lower grades and test scores than did nonmaltreated 

children. 

EMOTIONAL, PSYCHOSOCIAL, AND
	

BEHAVIORAL DEVELOPMENT
	

All types of maltreatment—physical abuse, sexual 

abuse, neglect, and psychological or emotional 

maltreatment—can affect a child’s emotional and 

psychological well-being and lead to behavioral 

problems. These consequences may appear 

immediately after the maltreatment or years later. 

Emotional and Psychological Consequences 

While there is no single set of behaviors that is 

characteristic of all children who have been abused 

and neglected, the presence of emotional and 

psychological problems among many maltreated 

children is well documented. Clinicians and 

researchers report behaviors that range from passive 

and withdrawn to active and aggressive.99 Physically 

and sexually abused children often exhibit both 

internalizing and externalizing problems.100 

Emotional and psychosocial problems identified 

among individuals who were maltreated as children 

include: 

• Low self-esteem 

• Depression and anxiety 

• Post-traumatic stress disorder (PTSD) 

• Attachment difficulties 

• Eating disorders 

• Poor peer relations 

• Self-injurious behavior (e.g., suicide attempts)101 

Maltreated children who developed insecure 

attachments to caregivers may become more 

mistrustful of others and less ready to learn from 

adults. They also may experience difficulties in 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 37 
 

 

 

 

 

 

 

understanding the emotions of others, regulating 

their own emotions, and in forming and maintaining 

relationships with peers.102 

Violence, Substance Abuse, 

and Other Problem Behaviors 

Individuals victimized by child maltreatment are 

more likely than people who were not maltreated 

to engage in juvenile delinquency, adult criminality, 

and violent behavior.103 A study sponsored by the 

National Institute of Justice followed cases from 

childhood through adulthood and compared 

arrest records of a group of substantiated cases of 

maltreatment with a comparison group composed 

of individuals who were not officially recorded 

as maltreated. While most members of both 

groups had no juvenile or adult criminal records, 

being abused or neglected as a child increased the 

likelihood of arrest as a juvenile by 53 percent and 

as a young adult by 38 percent.104 Physically abused 

children were the most likely of maltreated children 

to be arrested later for violent crime, followed closely 

by neglected children. 

Other studies also have found maltreated children 

to be at increased risk (at least 25 percent more 

likely) for a variety of adolescent problem behaviors, 

including delinquency, teen pregnancy, drug use, 

low academic achievement, and mental health 

problems.105 It must be underscored, however, that 

while the risk is higher, most abused and neglected 

children will not become delinquent, experience 

adolescent problem behaviors, or become involved 

in violent crime. 

Research also suggests a relationship between child 

maltreatment and later substance abuse.106 In 

addition to being a risk factor, child maltreatment, 

particularly sexual abuse, may be a precursor of 

substance abuse.107 

RESILIENCE 

Not every child who is maltreated will experience the 

negative consequences discussed above. “Protective 

factors” that appear to mediate or serve as a “buffer” 

against the effects of the negative experiences may 

include: 

•	 Personal characteristics, such as optimism, 

high self-esteem, high intelligence, or a sense of 

hopefulness.108 

•	 Social support and relationships with a 

supportive adult(s).109 

The finding that the seriousness of negative effects 

experienced by victims can be influenced by the 

availability of support from parents, relatives, 

professionals, and others has important implications 

for prevention and early intervention, discussed later 

in this manual. 

Studies have documented the link between abuse 

and neglect of children and a range of physical, 

emotional, psychological, and behavioral problems. 

In addition to the tragic consequences endured by 

the children who have been maltreated, society pays 

a high monetary cost for child maltreatment. The 

costs for child maltreatment include both direct 

costs (i.e., those associated with the immediate 

needs of abused and neglected children) and indirect 

costs (i.e., those associated with the longer term and 

secondary effects of child maltreatment). Since 

some maltreatment goes unrecognized and it is 

difficult to link costs to specific incidents, it is not 

possible to determine the actual cost of child abuse 

and neglect. As estimated by Prevent Child Abuse 

America, the total annual cost of child abuse and 

neglect in the United States may be as high as $94 

billion, as shown in Exhibit 6-1. 

38 What Are the Consequences of Child Abuse and Neglect?
	
Exhibit 6-1 

The Estimated Costs of Child Maltreatment110 

Source of Costs Estimated Annual Cost 

Direct Costs 

Hospitalization $6,205,395,000 

Chronic health problems $2,987,957,400 

Mental health care system $425,110,400 

Child welfare system $14,400,000,000 

Law enforcement $24,709,800 

Judicial system $341,174,702 

Total direct costs $24,384,347,302 

Indirect Costs 

Special education $223,607,803 

Mental health and health care $4,627,636,025 

Juvenile delinquency $8,805,291,372 

Lost productivity to society (due to unemployment) $656,000,000 

Adult criminality $55,380,000,000 

Total indirect costs $69,692,535,227 

Total Cost $94,076,882,529 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 39 
40 
 

 

CHAPTER 7

What Can Be Done

to Prevent Child

Abuse and Neglect?

The seriousness of the effects of maltreatment, presented in the previous chapter, underscore the 

importance for professionals, along with concerned 

community members, to help prevent child 

maltreatment. To break the cycle of maltreatment, 

communities across the country must continue to 

develop and implement strategies that prevent abuse 

or neglect from happening. While experts agree that 

the causes of child abuse and neglect are complex, 

it is possible to develop prevention initiatives that 

address known risk factors. This chapter provides 

an overview of prevention as a strategy, differentiates 

the various types of prevention activities, describes 

major prevention program models, and presents the 

roles of various sectors in prevention efforts. 

PREVENTION AS A STRATEGY 

Prevention efforts most commonly occur before 

a problem develops so that the problem itself, or 

some manifestation of the problem, can be stopped 

or lessened.111 Child abuse and neglect prevention 

covers a broad spectrum of services—such as public 

awareness, parent education, and home visitation— 

for audiences ranging from the general public to 

individuals who have abused or neglected a child. 

Community groups, social services agencies, schools, 

and other concerned citizens may provide these 

services. Typically, prevention activities attempt to 

deter predictable problems, protect existing states 

of health, and promote desired life objectives.112 

More specifically, family support services, a major 

component of child abuse prevention, are designed 

to strengthen and stabilize families, increase 

parental abilities, provide a safe and stable family 

environment, and enhance child development.113 

To prevent child abuse and neglect, programs may 

focus on one or several risk factors discussed in 

Chapter 5, “What Factors Contribute to Child 

Abuse and Neglect?” For example, prevention 

programs may include: 

•	 Substance abuse treatment programs for women 

with children; 

•	 Respite care programs for families with children 

who have disabilities; 

•	 Parent education programs and support groups 

for families affected by domestic violence. 

Many prevention programs also focus efforts on 

strengthening child and family protective factors 

such as the knowledge and skills children need 

to help protect themselves from sexual abuse, the 

promotion of positive interactions between children 

and parents, and the knowledge and skills parents 

need to raise healthy, happy children. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 41 
 

 

 

TYPES OF PREVENTION ACTIVITIES 

Child abuse and neglect prevention activities 

generally occur at three basic levels: 

•	 Primary, or universal, prevention activities are 

directed at the general population with the goal 

of stopping the occurrence of maltreatment 

before it starts. 

•	 Secondary, or selective, prevention activities 

focus on families at high risk of maltreatment 

to alleviate conditions associated with the 

problem. 

•	 Tertiary, or indicated, prevention activities direct 

services to families where maltreatment has 

occurred to reduce the negative consequences of 

the maltreatment and to prevent its recurrence. 

Primary or Universal Prevention 

Primary prevention includes activities or services 

available to the general public. Frequently such 

activities aim to raise awareness among community 

members, the public, service providers, and decisionmakers about the scope and problems associated 

with child maltreatment. For example: 

•	 Public awareness campaigns informing citizens 

how and where to report suspected child abuse 

and neglect; 

•	 Public service announcements on the radio or 

television encouraging parents to use nonviolent 

forms of discipline. 

These types of programs are particularly popular 

during April, which is designated by presidential 

proclamation as Child Abuse Prevention Month. 

Other primary prevention efforts focus on support 

services available to the general population, such as 

pediatric care for all children, childcare, or parent 

education classes. 

Secondary or Selective Prevention
	

Secondary prevention activities focus efforts and 

resources on children and families known to 

be at higher risk for maltreatment. Several risk 

factors such as substance abuse, young maternal 

age, developmental disabilities, and poverty are 

associated with child maltreatment. Programs may 

direct services to communities or neighborhoods 

that have a high incidence of one or several risk 

factors. Examples of secondary prevention programs 

include the following: 

•	 Parent education programs located in high 

schools for teen mothers; 

•	 Substance abuse treatment programs for parents 

with young children; 

•	 Respite care for families who have children with 

special needs; 

•	 Family resource centers offering information 

and referral services to families living in lowincome neighborhoods. 

Family support activities that are available to 

individuals identified as at risk or community 

members in a high-risk neighborhood also are 

considered secondary prevention. For example, 

local hospitals or community organizations may 

offer prenatal care and parenting classes to new 

or expectant parents. Local agencies may provide 

home visitation services for at risk families with 

infants and young children. Family support services 

are intended to assist parents in creating safe home 

environments and fostering healthy children. 

Tertiary or Indicated Prevention 

Tertiary prevention activities focus efforts on families 

in which maltreatment has already occurred. The goal 

of these programs is to prevent maltreatment from 

recurring and to reduce the negative consequences 

associated with maltreatment (e.g., social-emotional 

problems in children, lower academic achievement, 

42 What Can Be Done to Prevent Child Abuse and Neglect?
	
decreased family functioning). These prevention 

programs may include services such as: 

•	 Intensive family preservation services with 

trained mental health counselors available to 

families 24 hours per day for several weeks; 

•	 Parent mentor programs with stable, nonabusive 

families acting as “role models” and providing 

support to families in crisis; 

•	 Mental health services for children and families 

affected by maltreatment to improve family 

communication and functioning. 

A combination of primary, secondary, and tertiary 

prevention services are necessary for any community 

to provide a full continuum of services to deter the 

devastating effects of child maltreatment. 

MAJOR PREVENTION PROGRAM MODELS 

Many popular prevention programs are patterned 

after one of four models: 

•	 Public awareness activities 

•	 Parent education programs 

•	 Skills-based curricula for children 

•	 Home visitation programs 

Public Awareness Activities
	

Public awareness activities are an important part of 

an overall approach to addressing child abuse and 

neglect. The purpose of public awareness activities 

is to raise community awareness of child abuse 

and neglect as a public issue and to provide the 

public with information about available resources 

and solutions. Such activities have the potential 

to reach diverse community audiences: parents 

and prospective parents, children, and community 

members, including professionals, who are critical to 

the identification and reporting of abuse. 

In designing prevention education and public 

information activities, national, State, and local 

organizations use a variety of media to promote 

these activities, including: 

•	 Public service announcements 

•	 Press releases 

•	 Posters 

•	 Information kits and brochures 

•	 Television or video documentaries and dramas 

Through these media, communities are able to 

promote support for healthy parenting practices, 

child safety skills, and protocols for reporting 

suspected maltreatment. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 43 
Don’t Shake the Bab State contacts was established to ensure that all professionals involved in the 

 

 

 

 

 

 

 

 

 State contacts was established to ensure that all professionals involved in the 

 

 

 

 

Organizations Supporting Public Awareness Activities 

State Children’s Trust Funds 

State Children’s Trust Funds (CTFs) exist in all 50 States and the District of Columbia with the specific goal 

of preventing child maltreatment. CTFs coordinate prevention activities throughout their State by promoting 

and funding a variety of community-based programs including public awareness campaigns, home visitation 

programs, skills-based curricula for children, and parent education and support activities. In addition, many 

CTFs develop and distribute posters for community groups, schools, and many other professionals working 

with children. The poster may encourage parents to use positive discipline techniques or encourage children 

to say “no” to touching that makes them uncomfortable. 

Don’t Shake the Baby Campaign 

One of the largest public awareness initiatives focuses on the prevention of Shaken Baby Syndrome. A national 

network of Don’t Shake the Baby Don’t Shake the Baby State contacts was established to ensure that all professionals involved in the State contacts was established to ensure that all professionals involved in the

care of children (e.g., teachers, physicians, nurses, home visitors, parent educators) become aware of the dangers 

associated with shaking infants. In addition to professionals, this campaign targets parents to alert them to the 

dangers of shaking their baby as well as playing with the baby in certain ways (e.g., throwing the baby in the air, 

bouncing the baby on a knee, twisting the baby in the air). 

Prevent Child Abuse America 

Prevent Child Abuse America, formerly the National Committee to Prevent Child Abuse (NCPCA), is 

a leading national organization actively engaged in public awareness activities. Prevent Child Abuse 

America, together with Marvel Comics, developed Spider-Man comic books that address child sexual 

abuse and child safety issues. This organization also distributes an information packet each year to 

assist community groups planning Child Abuse Prevention Month activities. Both the national office 

and Prevent Child Abuse America State Chapters throughout the country provide public awareness and 

other activities to prevent child abuse and neglect. 

Blue Ribbon Campaign 

The Blue Ribbon Campaign began as a tribute from a Virginia grandmother to a grandchild whose 

battered body was found at the bottom of a canal. By tying a blue ribbon—signifying the pain and 

bruises suffered by abused children—around the antennae of her van, Bonnie Finney sought to raise 

awareness of the devastating effects of child abuse and neglect. Since those early days in the 1980s, the 

Blue Ribbon Campaign has grown into a national effort to raise awareness of the scope and problem 

of child maltreatment. The blue ribbon, often worn during April for Child Abuse Prevention Month, 

serves as the most recognized symbol for child abuse prevention. 

44 What Can Be Done to Prevent Child Abuse and Neglect?
	
Parents affiliates work within their 

Talk About Touching, Safe ,

Recovery, ,

 

 affiliates work within their 

 

,

,

, and .

 

Parent Education Programs
	

Parent education programs focus on enhancing 

parental competencies and promoting healthy 

parenting practices and typically target teen and 

highly stressed parents. Some of these programs 

are led by professionals or paraprofessionals, while 

others are facilitated by parents who provide mutual 

support and discuss personal experiences. These 

programs address issues such as: 

•	 Developing and practicing positive discipline 

techniques; 

•	 Learning age-appropriate child development 

skills and milestones; 

•	 Promoting positive play between parents and 

children; 

•	 Locating and accessing community services and 

supports. 

Parent education programs are designed and 

structured differently, usually depending on the 

curriculum being used and the target audience. 

Programs may be short-term (i.e., those offering 

classes once a week for 6 to 12 weeks) or they may 

be more intensive (i.e., those offering services more 

than once a week and for up to 1 year). Popular 

parent education programs include: 

•	 Parents as Teachers—visit www.patnc.org for 

more information; 

•	 Every Person Influences Children (EPIC)— 

visit www.epicforchildren.org for more 

information; 

•	 The Nurturing Parenting Program—visit 

www.nurturingparenting.com for more 

information. 

In addition to parent education programs, mutual 

support groups also may strengthen families and 

help prevent child maltreatment. For example, 

Parents Parents Anonymous Anonymous affiliates work within their affiliates work within their 

communities and States to provide support and 

resources to overwhelmed families struggling to 

cope with everyday stresses and strains. 

Skills-based Curricula for Children 

Many schools and local community social service 

organizations offer skills-based curricula to teach 

children safety and protection skills. Most of 

these programs focus efforts on preventing child 

sexual abuse and teaching children to distinguish 

appropriate touching from inappropriate touching. 

Many curricula have a parent education component 

to give parents and other caregivers the knowledge 

and skills necessary to recognize and discuss sexual 

abuse with their children. Curricula may use various 

methods to teach children skills including: 

•	 Workshops and school lessons 

•	 Puppet shows and role-playing activities 

•	 Films and videos 

•	 Workbooks, storybooks, and comics 

Examples of skills-based curricula include programs 

such as Talk About Touching, ouching, Safe Child, Reach, 

Recovery, Recovery, Challenge, Good Touch/Bad Touch, Kids 

on the Block, and Illusion Theater Illusion Theater.

Home Visitation Programs 

Home visitation programs that emphasize the health 

and well-being of children and families have existed 

in the United States since the late 19th century. 

Organizations and agencies in fields as varied as 

education, maternal and child health, and health 

and human services, use home visitation programs 

to help strengthen families. Home visitation 

programs offer a variety of family-focused services 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 45 
 

 

to pregnant mothers and families with newborns. 

Activities encompass structured visits in the family’s 

home, informal visits, and telephone calls. Topics 

addressed through these programs often include: 

•	 Positive parenting practices and nonviolent 

discipline techniques; 

•	 Child development; 

•	 Maternal and child health issues; 

•	 Accessing available social services; 

•	 Establishing social supports and networks; 

•	 Learning to advocate for oneself, one’s child, 

and one’s family; 

•	 Preventing accidental childhood injuries through 

the development of a safe home environment. 

Recent evaluations suggest that both short- and 

long-term positive outcomes may occur for mothers 

and children receiving home visitation services. 

During a two-year period, nurses provided home 

visitation services to a group of poor, unmarried, 

teen mothers in Elmira, New York. Only 4 percent 

of the nurse-visited families had verified reports of 

child abuse and neglect compared to 19 percent of 

the families who did not receive home visits by 

nurses.114 A follow-up study further supported these 

positive results: the number of verified reports of 

child maltreatment for the nurse-visited group of 

mothers was nearly half that of mothers who did not 

receive home visitation services during the next 15 

years.115 Additional positive outcomes among nursevisited mothers included lower levels of smoking, 

fewer and better-spaced subsequent pregnancies, and 

more months working, as well as fewer emergency 

room visits by children for injuries. Several studies 

of home visitation programs using nonmedical 

professionals also showed a significantly lower 

number of verified maltreatment reports for homevisited mothers.116

Home Visitation Programs 

• Home Visitation 2000 provides services to first-time mothers in Denver, Colorado. This program 

focuses efforts on improving maternal health, environmental health (home safety), quality of caregiving 

for infants and toddlers, maternal life course development (education and employment), and social 

support. For more information, visit www.unitedwaydenver.org/IRIS/aa0g6f81.htm. 

• Hawaii’s Healthy Start is a statewide, multisite program that screens, identifies, and provides 

services to families at high risk for child abuse and neglect. Most families are enrolled after 

the birth of a child, but some enroll during the prenatal period. For more information, visit 

www.state.hi.us/doh/legrpts2002/mchs_healthystart.pdf. 

• Healthy Families America (HFA) is a national initiative launched by Prevent Child Abuse America 

and Ronald McDonald House Charities in 1992. Modeled after Hawaii’s Healthy Start, HFA currently 

has home visitation programs in more than 3,000 sites across the country. For more information, visit 

www.healthyfamiliesamerica.org. 

46 What Can Be Done to Prevent Child Abuse and Neglect?
	
 

ROLE OF VARIOUS ENTITIES 

IN PREVENTION EFFORTS 

Prevention programs typically are administered 

through specific entities, based on an area of interest 

or professional expertise. Increasingly, health 

care providers, community organizations, social 

services agencies, schools, the faith community, 

and employers are becoming involved in the wellbeing of children and families. All members of the 

community are working together to prevent child 

maltreatment and ensure the health and safety 

of children and families. The following sections 

describe how these organizations are providing 

prevention services to strengthen and support 

families. 

Health Care Providers 

Health care providers are in a unique position to 

assist in the prevention of child maltreatment. 

These professionals have routine access to children 

and families by providing regular appointments, 

immunizations, and interventions to common 

illnesses. Activities that promote the health of 

children and their parents and contribute to the 

prevention of child maltreatment include: 

•	 Prenatal health care that improves pregnancy 

outcomes and health among new mothers and 

infants; 

•	 Early childhood health care that supports 

normal development and the health of young 

children; 

•	 Family-centered birthing and perinatal coaching 

that strengthens early attachment between 

parents and their children; 

•	 Home health visitation that provides support, 

education, and community linkages for new 

parents; 

•	 Support programs that assist parents of 

children with special health and developmental 

problems. 

Primary care providers emphasize the prevention of 

disease and the promotion of health and well-being. 

With this foundation, they have a natural role in the 

prevention of child abuse and neglect. 

Community-based Organizations 

Many community organizations offer a wide range 

of services for children and families. Boys and Girls 

Clubs, scouting troops, and local YMCA/YWCAs 

provide social and recreational opportunities for 

children and families. Community centers, food 

banks, emergency assistance programs, and shelters 

offer various family support services to increase 

family resources and decrease stress. Exchange 

Clubs, fraternal organizations, advocacy groups, 

and ethnic, cultural, and religious organizations also 

support child maltreatment prevention activities. 

Specific examples of prevention activities found 

within community-based organizations include: 

•	 Self-help and mutual aid groups that provide 

nonjudgmental support and assistance to 

troubled families; 

•	 Natural support networks that provide 

families with informal helpers and community 

resources; 

•	 Child and respite care programs that reduce the 

stress parents experience and provide positive 

modeling for parents and children. 

Many grassroots efforts develop dynamic 

partnerships of professionals, businesses, faith-based 

organizations, concerned citizens, and other groups 

interested in creating prevention efforts that address 

the needs of their community. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 47 
 

 

Social Services Agencies
	

Increasingly, social service agencies and professionals 

are expanding their focus to include programs 

that prevent family problems from escalating to 

abuse or neglect. Effective social service initiatives 

for strengthening families and preventing child 

maltreatment include: 

•	 Parent education services, which help parents to 

develop adequate child-rearing knowledge and 

skills; 

•	 Parent aide programs, which provide supportive, 

one-on-one relationships for parents; 

•	 Crisis and emergency services, which support 

parents and children at times of exceptional 

stress or crisis; 

•	 Treatment for abused children, which prevents 

an intergenerational repetition of family 

violence. 

As State and local social service agencies examine 

new ways of “doing business,” many are pooling 

resources to provide more prevention services. 

Schools 

With increased public and professional attention 

on the serious social problems affecting children 

and adolescents, schools have become the focus for 

many new prevention efforts including: 

•	 Comprehensive, integrated prevention 

curricula to provide children with the skills, 

knowledge, and information necessary to cope 

successfully with the challenges of childhood 

and adolescence; 

•	 Personal safety programs; 

•	 Support programs for children with special 

needs to help reduce the stress on families with 

a child with disabilities. 

Since most children attend public or private schools, 

school-based prevention activities have the potential 

to reach the majority of U.S. children. 

Faith Community 

Religious institutions are among the most influential 

organizations in many communities. Churches, 

temples, synagogues, mosques, and other faith-based 

groups play an important role in reaching out to 

and helping families at risk. Spiritual leaders can 

use their religious messages as a positive force in 

preventing child abuse and neglect and advocating 

nonabusive parenting practices. Faith communities 

frequently foster and offer important social supports 

to families.117 Empirical studies suggest a significant 

relationship between an individual’s participation in 

faith practices and physical and mental well-being.118 

Improved social supports and enhanced well-being 

can help strengthen families and act as protective 

factors. Faith communities can participate in 

prevention efforts through activities such as: 

•	 Training religious and lay leaders to recognize 

the signs and symptoms of child maltreatment; 

•	 Sponsoring or allowing self-help, parent 

education, and support groups to meet at their 

facilities; 

•	 Offering respite care for congregation members 

in need of short-term relief from caregiving 

responsibilities; 

•	 Collecting clothes and baby care products (e.g., 

diapers, car seats) for new parents; 

•	 Sponsoring after school programs and safety 

training for latchkey children; 

•	 Organizing mentoring programs that pair 

responsible adults with children; 

•	 Disseminating information on child 

development, parental stress, and community 

resources for parents; 

48 What Can Be Done to Prevent Child Abuse and Neglect?
	
•	 Offering special outreach and education 

programs for parents and students associated 

with parochial schools. 

Employers 

As the number of parents working outside the 

home continues to grow, the need increases for 

workplace policies that support family functioning 

and promote the prevention of child maltreatment. 

Family-focused initiatives for the workplace 

include: 

•	 Flexible work schedules and other “family 

friendly” policies that help employees to 

balance the demands of their work and parental 

commitments; 

•	 Parental leave policies that reduce stress on new 

parents and help facilitate positive attachments 

between parents and their infants; 

•	 Employer-supported child care; 

•	 Family-oriented policies that support healthy 

and humane working conditions and ensure 

adequate family income; 

•	 Employee assistance programs that can provide 

information on reducing stress. 

For all working parents, a supportive work 

environment can help ease the stress of the dual 

responsibilities of work and family. For some 

already vulnerable parents, a supportive work 

climate may prevent family dysfunction, breakdown, 

abuse, and neglect.119 

Working together, the various sectors of the community—health care providers, community-based 

organizations, social services agencies, schools, the faith community, employers, other community 

practitioners and concerned citizens—can help strengthen families, foster healthy child development, 

and reduce child maltreatment. 

For more information on child abuse and neglect prevention, contact one of the organizations listed 

in Appendix B. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 49 
50 
parens —a legal —a legal 

CHAPTER 8

Which Laws and Policies 

Guide Public Intervention

in Child Maltreatment?

Most Americans believe, and professionals agree, that parents are in the best position 

to nurture, protect, and care for the needs of their 

children. Although most parents are usually capable 

of meeting these needs, the State has the authority to 

intervene in the parent-child relationship if a parent 

is unable or fails to protect his or her child from 

preventable and significant harm. The purpose 

of this chapter is to present basic information 

about the Federal and State governments’ power 

and authority to intervene into the private lives of 

families when child maltreatment is alleged. The 

first section reviews the Federal role in addressing 

child maltreatment, while the second section 

discusses the basis for State intervention in family 

life, highlights State child maltreatment reporting 

statutes, and describes the functions of civil and 

criminal courts. 

THE FEDERAL ROLE IN ADDRESSING
	

CHILD ABUSE AND NEGLECT
	

States initiated mechanisms to assist and protect 

children prior to any Federal-level activity. In 1912, 

the Federal government established the Children’s 

Bureau to address these issues. Federal programs 

designed to support child welfare services and to 

direct Federal aid to families date from 1935, with 

the passage of the Social Security Act (SSA). Since 

State-supervised and State-administered programs 

were already in place, the child welfare policy of the 

SSA layered Federal funds over existing State-level 

foundations. These child welfare programs, thus, 

were new only to the extent that they established 

a uniform framework for administration.120 

Congress has amended the Act several times and 

changed the Act significantly with the passage of 

the Personal Responsibility and Work Opportunity 

Reconciliation Act of 1996. Within the Federal 

government, the Children’s Bureau and its Office 

on Child Abuse and Neglect (OCAN) serve as a 

focal point for efforts to respond to the problem of 

child maltreatment. 

Parens Patriae 

The basis for intervention in child maltreatment is 

grounded in the concept of parens patriae—a legal 

term that asserts the government’s role in protecting 

the interests of children and intervening when parents 

fail to provide proper care. The legal framework 

regarding the parent-child relationship balances 

the rights and responsibilities among parent, child, 

and State, as guided by Federal statutes. It has long 

been recognized that parents have a fundamental 

liberty interest, protected by the Constitution, to 

raise their children as they choose. This parentchild relationship grants certain rights, duties, and 

obligations to both parent and child, including the 

responsibility of the parent to protect the child’s 

safety and well-being. If a parent, however, is unable 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 51 
parens , may restrict the parent’s control by 

 

 

 

or unwilling to meet this responsibility, the State has 

the power and authority to take action to protect a 

child from significant harm. 

A series of U.S. Supreme Court cases have defined 

when it is constitutional for the State to intervene 

in family life.121 Although the Court has given 

parents great latitude in the upbringing and 

education of their children, it has held that the 

rights of parenthood and the family have limits 

and can be regulated in the interest of the public. 

The Court has further concluded that the State, as 

parens patriae, may restrict the parent’s control by 

regulating or prohibiting the child’s labor, requiring 

school attendance, and intervening in other ways 

to promote the child’s well-being.122 This doctrine 

has evolved into the principle that the community, 

in addition to the parent, has a strong interest in 

the care and nurturing of children, who represent 

the future of the community. When basic needs 

of children are not met or when their rights have 

been violated, as with cases of child maltreatment, 

the State has an obligation to intervene to assist the 

affected individuals. 

Federal Legislation and Programs 

Over the past several decades, Congress also has 

passed significant pieces of child welfare legislation 

that support the States’ duty and power to act 

on behalf of a child when parents are unable or 

unwilling. Key Federal legislation that addresses the 

protection of maltreated children are highlighted 

below: 

•	 The Child Abuse Prevention and Treatment 

Act (CAPTA) of 1974 (P.L. 93-247) was 

established to ensure that victimized children 

are identified and reported to appropriate 

authorities. The Act was most recently amended 

in 1996 (P.L. 104-235) and continues to provide 

minimum standards for definitions and reports 

of child maltreatment. 

•	 The Adoption Assistance and Child Welfare 

Act of 1980 (P.L. 96-272) requires States to 

establish programs and implement procedures 

to support maltreated children and their 

families, in their own homes, and facilitate 

family reunification following out-of-home 

placements. 

•	 Family Preservation and Support Services 

Program enacted as part of the Omnibus 

Budget Reconciliation Act of 1993 (P.L. 103-

66) provides funding for prevention and support 

services for families at risk of maltreatment 

and family preservation services for families 

experiencing crises that might lead to out-ofhome placement. 

•	 The Adoption and Safe Families Act (ASFA) 

of 1997 (P.L. 105-89) was built on earlier laws 

and reforms in the field to promote the safety, 

permanency, and well-being of maltreated 

children. A component of ASFA is the 

Promoting Safe and Stable Families (PSSF) 

Program, which was developed from and 

expanded upon the Family Preservation and 

Support Services Program mentioned above. 

While the legislation reaffirms the importance 

of making reasonable efforts to preserve and 

reunify families, it also specifies instances 

where reunification efforts do not have to be 

made (e.g., when a child is not safe with his or 

her family), establishes tighter time frames for 

termination of parental rights, and promotes 

adoption initiatives. 

•	 Child Abuse Prevention and Enforcement 

Act of 2000 (P.L. 106-177) focuses on improving 

the criminal justice system’s ability to provide 

timely, accurate criminal-record information 

to agencies engaged in child protection, and 

enhancing prevention and law enforcement 

activities. 

52 Which Laws and Policies Guide Public Intervention in Child Maltreatment?
	
•	 Strengthening Abuse and Neglect Courts 

Act of 2000 (P.L.106-314) was designed to 

improve the administrative efficiency and 

effectiveness of the courts’ handling of abuse 

and neglect cases. 

•	 Promoting Safe and Stable Families 

Program Reauthorization of 2002 (P.L.107-

133) continued to build upon ASFA by 

extending the PSSF for an additional 5 years 

and increasing discretionary funding. It also 

created several new programs including a new 

state grant program that provides education and 

training vouchers for youth aging out of foster 

care and a mentoring program for children with 

incarcerated parents. 

These and other pieces of legislation also provide for 

a variety of funding streams—particularly State grant 

and discretionary grant programs—which support 

prevention and treatment services for children and 

families. 

Federal Agencies 

The Children’s Bureau, an agency within the 

Administration for Children and Families (ACF), 

Administration on Children, Youth and Families, 

U.S. Department of Health and Human Services, 

is the focal point for Federal efforts to address the 

problem of child abuse and neglect. The Children’s 

Bureau’s mission is to provide for the safety, 

permanency, and well-being of children and families 

through leadership, support for necessary services, 

and productive partnerships with States, Tribes, and 

communities. The Children’s Bureau fulfills this 

mission through its Office on Child Abuse and 

Neglect (OCAN) and its five divisions: 

•	 OCAN provides leadership and direction on the 

issues of child maltreatment and the prevention 

of abuse and neglect as directed by CAPTA and 

the Children’s Justice Act. Also, OCAN is the 

focal point for interagency collaborative efforts, 

national conferences, and special initiatives 

related to child abuse and neglect. 

•	 The Division of Child Welfare Capacity Building 

provides leadership and direction in the areas of 

training, technical assistance, and information 

dissemination as directed by Titles IV-B and IVE of the Social Security Act (SSA) and CAPTA. 

•	 The Division of Policy provides leadership 

and direction in policy development and 

interpretation as directed by Titles IV-B and 

IV-E of SSA, the Basic State Grant (BSG), and 

CAPTA. 

•	 The Division of Program Implementation 

provides leadership and direction in the 

operation and review of programs as directed by 

Titles IV-B and IV-E of SSA, CAPTA, and BSG. 

•	 The Division of Data, Research, and Innovation 

provides leadership and direction in program 

development, innovation, research, and 

management of the Bureau’s information 

systems as directed by Titles IV-B and IV-E of 

SSA and CAPTA. 

•	 The Division of State Systems provides leadership 

and direction to States in the development and 

operation of automated systems, including all 

Statewide Automated Child Welfare Information 

System (SACWIS), to support welfare programs 

under Titles IV-B and IV-E of SSA. 

While this discussion focuses primarily on activities 

related to child protection and the “front end” of the 

child welfare system (e.g., prevention, investigation, 

assessment, and service planning), the Children’s 

Bureau also oversees activities and programs related 

to foster care, permanency planning, adoption, and 

other “back end” child welfare issues. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 53 
Selected Child Maltreatment State Grant Programs 

The following are selected, legislatively mandated child maltreatment or child welfare grant programs 

available to State entities that meet certain eligibility requirements: 

• Basic State Grants provide funds for States to enhance their child protective services (CPS) 

systems and to develop and strengthen child maltreatment prevention, treatment, and research 

programs. 

• The Community-based Family Resource and Support (CBFRS) Program supports the 

development of comprehensive networks of community-based, prevention-focused family resource 

and support programs. 

• Children’s Justice Act (CJA) Grants help States to develop, establish, and operate programs 

designed to improve the investigation and prosecution of child abuse and neglect cases, particularly 

cases of child sexual abuse and exploitation, and fatality cases. 

• Child Welfare Services assist State public welfare agencies in delivering child welfare services 

(including preventive interventions, alternative placements, and reunification services) with the 

goal of keeping families together. 

• Promoting Safe and Stable Families Program (formerly called the Family Preservation and 

Support Services Program) supplies funds to States to provide family support, family preservation, 

time-limited family reunification services, and services to promote and support adoptions. These 

services are aimed at preventing the risk of abuse as well as promoting nurturing families, assisting 

families at risk of having a child removed from the home, promoting the timely return of a child 

to his or her home, and, if returning home is not an option, placing a child in a permanent setting 

with services that support the family. 

The Office on Child Abuse and Neglect convenes 

a Federal Interagency Work Group (FEDIAWG) 

on Child Abuse and Neglect that provides a forum 

for collaboration among Federal agencies with an 

interest in child maltreatment. The FEDIAWG 

shares information, makes policy and programmatic 

recommendations, implements joint activities, and 

works toward establishing complementary agendas 

in the areas of training, research, legislation, 

information dissemination, and delivery of services 

as they relate to the prevention, intervention, and 

treatment of child abuse and neglect. 

In addition to the Children’s Bureau, several 

other Federal agencies support programs and 

research and demonstration initiatives related to 

child maltreatment and child protection. For 

example, the Child Protection Division within 

the Office on Juvenile Justice and Delinquency 

Prevention (OJJDP), U.S. Department of Justice, 

conducts research, provides training and technical 

assistance, and supports demonstration programs 

that address child victimization and missing and 

exploited children. Several agencies within the 

U.S. Department of Health and Human Services— 

including the National Institutes for Health (NIH), 

Centers for Disease Control and Prevention, 

Maternal and Child Health Bureau (MCHB), 

Health Resources and Services Administration 

(HRSA), and the Substance Abuse and Mental 

Health Service Administration (SAMHSA), to name 

a few—conduct research and support service delivery 

54 Which Laws and Policies Guide Public Intervention in Child Maltreatment?
	
 

 

 

 

on the identification, prevention, and treatment 

of child maltreatment as well as risk factors and 

consequences. 

BASIS FOR STATE INTERVENTION 

States must comply with the child abuse and 

neglect guidelines mandated under CAPTA in order 

to receive Federal funds. Beyond that, however, 

States generally have autonomy in how services are 

provided to maltreated children and their families. 

All States have enacted child maltreatment laws that 

play a significant role in reporting and intervening 

in cases of child abuse and neglect. In order to 

enforce these laws, civil and criminal courts often 

must intervene in the lives of families when parents 

are unable or unwilling to provide for the safety and 

well-being of their children. 

State Reporting Statutes 

Many States define the parent-child legal relationship 

in their State statutes. These statutes define who is 

considered a “parent” (birth or adoptive parent) or 

other caregiver and indicate that the law imposes 

rights, privileges, duties, and obligations on this 

relationship. As noted above, the State has the 

authority to intervene in this relationship if the 

parent fails to provide for or protect the child. The 

State’s intervention into family life is often triggered 

by a report of child maltreatment by a voluntary or 

mandated reporter as defined by State law under the 

CAPTA requirements. 

Through mandated reporting statutes, the State 

requires certain individuals, typically defined 

by profession (e.g., health care professionals), to 

identify and help protect children from harm. 

These statutes also include definitions of the acts 

and omissions considered abuse and neglect in a 

particular State. Reports of suspected maltreatment, 

which are required under such laws, activate the child 

protection process. Currently, all States, the District 

of Columbia, and U.S. territories have enacted 

statutes requiring that the maltreatment of children 

be reported to a designated agency or official. 

Reporting laws generally specify the conditions 

under which the State may intervene in family life. 

(See Chapter 9, “What Does the Child Protection 

Process Look Like?”, for more information about 

reporting of maltreatment and child protection 

procedures after a report has been made.) 

Child Protective Service Agency 

State legislation mandates that CPS agencies 

respond to reports of alleged child maltreatment 

and children at risk of maltreatment, determine 

the safety of the children who are the subject of the 

report, and decide what initial response is needed. 

Intervention into family life on behalf of children 

must be guided by the legal basis for action and 

sound family-centered practice.123 While CPS 

agencies are at the center of the child protection 

system, an array of service providers and community 

professionals collaborate to protect children and 

support families. (See Chapter 10, “Who Should 

Be Involved in Child Protection at the Community 

Level?”, for further information about the roles and 

responsibilities of various community practitioners 

in child protection.) 

Civil Court Intervention 

Family and juvenile courts have the authority to 

make decisions about what happens to a child after 

he or she has been identified as needing the court’s 

protection. The courts’ involvement is initiated by 

the filing of a petition, usually by CPS, containing 

the allegations of abuse or neglect. The primary 

purpose of these courts is to resolve conflict and 

otherwise intervene in the lives of families in a 

manner that promotes the best interest of the 

child. The court is responsible for making the final 

determination about whether a child ought to be 

removed from his or her home, where a child is to 

be placed, or whether to terminate parental rights. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 55 
 

In cases of child maltreatment, family and juvenile thus making the child eligible for temporary or 

court intervention may be required when: permanent placement or adoption, when a parent:
	

•	 Families refuse to cooperate after an initial 

assessment has determined that an incident of 

abuse or neglect has occurred; 

•	 The child is determined to be in imminent 

danger of harm and the child’s safety cannot be 

assured in the home through services provided 

to the family; 

•	 Families are unwilling to accept needed services, 

yet maltreatment exists and the safety of the 

child is a concern. 

There are four types of court hearings held in 

family or juvenile courts when abused and neglected 

children are involved: 

•	 Emergency hearings are convened to determine 

the need for intervention on behalf of, or 

emergency protection of, a child who may have 

been a victim of maltreatment. 

•	 Adjudicatory hearings are held to determine 

whether a child has been maltreated or whether 

some other legal basis exists for the State to 

intervene to protect the child. 

•	 Dispositional hearings are convened to 

determine the action to be taken on the case 

after adjudication, for example, whether State 

custody and out-of-home placement is necessary 

and what services the children and family will 

need to reduce the risk of maltreatment and to 

address the effects of maltreatment. 

•	 Review hearings are held to review the 

dispositions and to determine the need to 

continue out-of-home placement, services, or 

court jurisdiction of a child. 

One of the most drastic options available to a 

juvenile or family court judge is the termination of 

parental rights. Parental behaviors that may lead to 

such action are usually defined in State statutes. The 

parent-child relationship may be limited or ended, 

•	 Abandons the child; 

•	 Has a long-term mental illness or deficiency; 

•	 Severely or chronically abuses or neglects the 

child or other children in the household; 

•	 Has a long-term alcohol or drug abuse 

problem; 

•	 Fails to support or maintain contact with the 

child. 

Parental rights are not terminated simply because a 

person is not a model parent. In all States, parental 

rights can be terminated only if the State can prove 

by clear and convincing evidence that a parent has 

failed to provide for or protect the child in one of the 

ways defined in a State’s statutes. Most State statutes 

also contain provisions for parents to voluntarily 

relinquish their rights. In addition to temporarily 

placing children in out-of-home care, the State has 

the authority to return a child to his or her parents. 

Children may return home once a determination is 

made that they will be safe and that their parents will 

be able to provide the appropriate care. 

Criminal Court Intervention 

Depending on State law, behavior that constitutes 

child abuse and neglect in the civil court process may 

also be considered a crime. Each State has enacted 

criminal statutes that define those forms of child 

abuse and neglect that are criminally punishable. In 

most jurisdictions, child maltreatment is criminally 

punishable when one or more of the following 

statutory crimes have been committed: 

•	 Homicide, murder, or manslaughter 

•	 False imprisonment 

•	 Assault or battery 

•	 Criminal neglect and abandonment 

56 Which Laws and Policies Guide Public Intervention in Child Maltreatment?
	
• Emotional, physical, or sexual abuse 

• Pornography or child prostitution 

• Rape or deviant sexual assault 

• Indecent exposure 

• Child endangerment or reckless endangerment 

The same family may be simultaneously involved in 

both a criminal and civil case. Criminal prosecution, 

however, is directed at deterring future incidents and 

rehabilitating the defendant rather than ensuring the 

safety of the child. In a criminal case, the burden 

of proof—beyond a reasonable doubt—is higher than 

in a civil case and the rules of evidence are more 

stringent. 

Responsibility for investigation of crimes related to 

child abuse and neglect rests with law enforcement 

agencies and the district attorney or local 

prosecutor. They are vested with the responsibility 

for deciding under what circumstances prosecution 

of perpetrators of child abuse and neglect will occur. 

Criminal courts serve to protect victims and the 

public from offenders and to rehabilitate those who 

break the law. 

The defendant in a criminal case is entitled to 

full protection guaranteed by the Fourth, Fifth, 

and Sixth amendments to the U.S. Constitution. 

These protections include the right to a jury, the 

right to cross-examination, the right to appointed 

counsel, and the right to a public and speedy trial. 

Criminal prosecution may result in such penalties as 

probation or incarceration. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 57 
58 
CHAPTER 9

What Does the 

Child Protection 

Process Look Like?

This chapter traces the child protection process beginning with the identification and reporting 

of suspected child maltreatment. As previously 

discussed, every State has enacted reporting laws. 

These laws provide guidance to individuals required 

to identify and report suspected maltreatment, 

require investigations by specified agencies to 

determine if a child was abused, and provide for 

the delivery of protective services and treatment to 

maltreated children and their families. Reports of 

maltreatment required under such laws activate the 

child protection process, which includes: 

• Intake 

• Initial assessment and investigation 

• Family assessment 

• Case planning 

• Service provision 

• Evaluation of family progress 

• Case closure 

Exhibit 9-1 presents an overview of the typical child 

protection process for most locales and is described 

further below. 

IDENTIFICATION 

The first step in any child protection response 

system is the identification of possible incidents of 

child maltreatment. Medical personnel, educators, 

child care providers, mental health professionals, 

law enforcement personnel, the clergy, and other 

professionals are often in a position to observe 

families and children on an ongoing basis and 

identify abuse or neglect when they occur. Private 

citizens, such as family members, friends, and 

neighbors, also may identify suspected incidents of 

child maltreatment. 

To ensure that community professionals working 

with children and families recognize possible 

indicators of child maltreatment, preservice and 

inservice training must be provided on an ongoing 

basis. In addition, public awareness campaigns 

should be planned and implemented to promote 

understanding of the problem in the community. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 59 
Exhibit 9-1
	

Overview of Child Protection Process
	
 

REPORTING 

The next step in responding to child maltreatment is 

to report the suspected incident. Although there is 

tremendous variation in the requirements described 

in State reporting laws, they typically: 

•	 Specify selected individuals mandated to report 

suspected child maltreatment; 

•	 Define reportable conditions; 

•	 Explain how, when, and to whom reports are to 

be filed and the information to be contained in 

the report; 

•	 Describe the agencies designated to receive and 

investigate reports; 

•	 Describe the abrogation of certain privileged 

communication rights (e.g., doctor–patient); 

•	 Provide immunity from legal liability for 

reporters; 

•	 Provide penalties for failure to report and false 

reporting. 

Key aspects of reporting laws are described in the 

sections that follow. 

Mandatory Reporters
	

Every State has statutes identifying mandatory 

reporters of child maltreatment and the circumstances 

under which they are required to report. This 

designation creates a legal responsibility to report, 

which can result in criminal and civil liability for 

failure to report as required. In approximately 

18 States, any person who suspects child abuse or 

neglect is required to report.124 Most States, however, 

limit mandatory reporting to professionals working 

with children. Individuals typically designated as 

mandatory reporters include: 

•	 Physicians, nurses, hospital personnel, and 

dentists 

•	 Medical examiners 

•	 Coroners 

•	 Mental health professionals 

•	 Social workers 

•	 School personnel 

•	 Child care providers 

•	 Law enforcement officers 

In addition, any person in any State may report 

incidents of suspected abuse or neglect. 

The legal standards used to determine when a 

mandatory reporter is required to notify authorities 

of abuse or neglect also vary slightly from State to 

State. Typically, a report must be made when a 

reporter has reasonable cause to know, suspect, or 

believe that a child has been abused or neglected. 

State Statutes 

To review a summary of reporting laws, visit the State Statutes section of the National Clearinghouse on 

Child Abuse and Neglect Web site at www.calib.com/nccanch/statutes. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 61 
Reporter Percent 

Education personnel 16.1 

Legal, law enforcement, criminal justice personnel 15.2 

Social services and mental health personnel 14.4 

Medical personnel 8.3 

Child daycare and substitute care providers 2.0 

Anonymous or unknown reporters 13.6 

Other relatives 8.3 

Friends and neighbors 5.9 

Parents 5.9 

Alleged victims 0.9 

Alleged perpetrators 0.1 

Other 9.2 

Based only on sources of “screened-in” referrals in 2000 

Exhibit 9-2 

Sources of Child Abuse and Neglect Reports in 2000125 

Reporting Procedures
	

Every State has reporting laws specifying procedures 

that a mandatory reporter must follow when making 

a report of suspected child abuse and neglect. 

Generally, these procedures specify how, where, 

when, and what to report. 

How and When to Report 

The majority of States require that reports of child 

maltreatment be made orally—either by telephone or 

in person—to the specified authorities. Some States 

require that a written report follow the oral report, 

while in other States written reports are filed only 

upon request, and still other States require written 

reports only from mandated reporters. 

Reports of suspected maltreatment are required by 

statute to be made immediately to protect children 

from potentially serious consequences that may be 

caused by a delay in reporting. While an individual 

may want to collect additional information before 

reporting, waiting for proof may place the child in 

danger. 

Who Receives the Reports 

Each State designates specific agencies to receive 

reports of child abuse and neglect. In most States, 

child protective services (CPS) has the primary 

responsibility for receiving reports. Other States 

allow reports to be made to either CPS or law 

enforcement. Some State laws require that certain 

forms of maltreatment—such as sexual abuse, child 

pornography, or severe physical abuse—be reported 

to law enforcement in addition to CPS. The nature 

of the relationship of the alleged perpetrator may 

also affect where reports are made. Most alleged 

cases of child maltreatment within the family are 

reportable to CPS. Depending on the State, reports 

of allegations of abuse or neglect by other caregivers, 

such as foster parents, daycare providers, teachers or 

residential care providers, may need to be filed with 

a law enforcement office. Additionally, in some 

States, allegations of abuse in out-of-home care are 

reported to a centralized investigative body within 

CPS at the State or regional level. 

In most States, statutes also include requirements for 

cross-system reporting procedures or information 

62 What Does the Child Protection Process Look Like?
	
 

 

Reporting Child Abuse and Neglect 

See Appendix C for a list of State toll-free telephone numbers for reporting suspected child abuse or 

call the Childhelp USA National Child Abuse Hotline at 1-800-4-A-CHILD. This hotline is available 

24 hours a day, 7 days a week. 

sharing among professional entities. Typically, 

reports are shared among social services agencies, 

law enforcement, and prosecutors’ offices. 

Contents of the Report 

Reporting laws also describe the information that 

must be contained in the report. Typically, reports 

contain the following information: 

•	 The name, age, sex, and address of the child; 

•	 The nature and extent of the child’s injuries or 

condition; 

•	 The name and address of the parent or other 

person(s) responsible for the child’s care; 

•	 Any other information relevant to the 

investigation. 

It is essential that reporters provide as much detailed 

information as possible about: 

•	 The child, the child’s condition, and the child’s 

whereabouts; 

•	 The parents and their whereabouts; 

•	 The person alleged to have caused the child’s 

condition and his or her current location; 

•	 The family, including other children in the 

home; 

•	 The type and nature of the maltreatment, such 

as the length of time it has been occurring, 

whether the maltreatment has increased in 

severity or frequency, and whether objects or 

weapons were used. 

If the alleged maltreatment occurred in an outof-home care setting, reporters should provide 

information about the setting, such as hours of 

operation; number of other children in the facility, 

if known; and identification of any others in the 

facility who may have information about the 

alleged maltreatment. The more comprehensive 

the information provided by the reporter, the better 

able CPS staff will be to evaluate the appropriateness 

of the report for CPS intervention, determine the 

urgency of the response needed, and prepare for an 

initial assessment and investigation, if warranted. 

While most States allow anonymous reporting, it 

is preferred that reporters provide their name and 

contact information. This information will enable 

a caseworker to ask follow-up questions or obtain 

clarification. At intake, caseworkers should discuss 

immunity for reporters, issues of confidentiality, 

and the extent and nature of follow up with the 

reporter upon completion of the initial assessment 

or investigation. 

Special Issues, Exceptions, and
	

Penalties Related to Reporting
	

To encourage reporting of child maltreatment and 

provide protection for reporters, State statutes include 

provisions related to privileged communications, 

immunity for reporters, and penalties for failure to 

report. The laws also discourage intentionally false 

reporting through specified penalties. 

Privileged Communications 

The law provides special protection to 

communications in certain relationships. For 

example, the content of communications between 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 63 
 

 

an attorney and client, physician and patient, 

and clergy and congregant often is protected by 

a privilege. This means that professionals in 

such relationships are prohibited from disclosing 

confidential information communicated to them by 

their client, patient, or penitent to any unauthorized 

person. Mandatory child abuse reporting statutes 

specify when communications are confidential. 

The attorney-client privilege is most frequently 

maintained by States. The privilege pertaining to 

clergy-congregant also is frequently recognized by 

States. Most States, however, void the physicianpatient, mental health professional-patient, and 

husband-wife privileges in instances of child 

maltreatment. When a privileged communication 

is voided, a mandated reporter must report instances 

of child maltreatment and cooperate in the ensuing 

investigation. 

Immunity to Reporters 

Every State provides immunity from civil or 

criminal liability for individuals making reports 

of suspected or known instances of child abuse 

or neglect. Immunity provisions typically apply 

both to mandatory reporters and permissive 

reporters (i.e., individuals not required under law 

to report). These provisions may not prevent the 

filing of civil lawsuits, but they help prevent, within 

limitations, an outcome unfavorable to the reporter. 

Immunity provisions, like other aspects of reporting 

statutes, vary from State to State. The majority of 

jurisdictions require that reports be made in good 

faith. A number of States include a presumption 

in their statutes that the reporter is acting in good 

faith. Immunity, therefore, does not extend to 

reports made maliciously or in bad faith. 

Penalties for Failure to Report 

To encourage reporting, the majority of States 

now provide in their reporting statutes a specific 

penalty for failure to report suspected cases of 

abuse. Most of these jurisdictions impose penalties 

on mandatory reporters who knowingly or willfully 

fail to report suspected abuse. Failure to report is 

typically classified as a misdemeanor. Sanctions 

specified in the statutes are generally in the form of 

a fine or imprisonment. 

Penalties for False Reporting 

In order to prevent malicious or intentional false 

reporting, the majority of States impose penalties for 

false reporting of abuse. Most of these jurisdictions 

impose penalties on mandatory reporters who 

knowingly or willfully file a false report of abuse or 

neglect. False reporting is typically classified as a 

misdemeanor. Sanctions specified in the statutes are 

generally in the form of a fine or imprisonment. 

Problems in Reporting 

Paradoxically, both underreporting and 

overreporting have been cited as problems in the 

identification of child abuse and neglect. 

Underreporting 

Numerous professionals admit that during their 

careers, they have failed to report suspected 

maltreatment to the appropriate agencies.126 One 

possible reason is that professionals still lack 

training and knowledge about legal obligations and 

procedures for reporting. The issue of subjectivity 

also may account for some of the underreporting 

of abuse. Many laws defining child maltreatment 

are broadly written with ambiguous requirements, 

which may result in professionals lacking guidance 

and clarity regarding when intervention is required. 

One of the biggest obstacles to reporting is personal 

feelings. Some people do not want to get involved. 

Others have difficulty reporting a person they 

suspect is an abuser, especially if they know that 

person well. Still others may think they can help 

the family more by working with the child or family 

themselves. Mandated reporters may believe that 

their professional relationship with the child will 

be strained if they report their suspicions of abuse. 

When a professional has established a relationship 

64 What Does the Child Protection Process Look Like?
	
 

 

with a parent or family prior to recognizing 

maltreatment, reporting becomes a delicate issue. 

Some reporters also may be reluctant to report 

because they have had negative experiences with CPS 

or they view social services agencies as overburdened, 

understaffed, or incompetent. At times, professionals 

become concerned that nothing will be done if they 

report or that the investigation and service provision 

will do more harm than good. Consequently, they 

choose not to report. This reluctance to report, 

which can have serious consequences for a child in 

an unsafe situation, underscores the critical need for 

ongoing communication and feedback between CPS 

and mandated reporters. It also underscores the need 

for CPS to function sensitively and competently in 

the best interests of the child while creating as little 

disruption as possible. 

Professionals must report regardless of their concerns 

or previous experiences. The law requires it, and no 

exemptions are granted to those who have had a 

bad experience. In addition, while reporting does 

not guarantee that the situation will improve, not 

reporting guarantees that, if abuse and neglect exists, 

the child will continue to be at risk of further and 

perhaps more serious harm. 

Overreporting 

Only a portion of reports received and investigated 

by CPS reflect children who are found to be victims 

of, or at risk for, maltreatment. While the children 

and families in these reports may be in need of 

help or services, they frequently do not meet the 

legal definition of maltreatment in that family’s 

jurisdiction. This apparent pattern of over-reporting 

raises several concerns. First, children and families 

who will not receive child welfare services may be 

subjected to an intrusive public agency investigation. 

Second, these reports may divert CPS resources from 

higher risk cases. 

Overreporting may occur in a community following 

a serious case of child maltreatment that receives a 

lot of media attention. There is often a significant 

increase in the number of reports of suspected 

child maltreatment made during such times, in 

part because the community’s awareness has been 

heightened. 

INTAKE 

Intake is the point at which reports of suspected 

child maltreatment are received by the agency 

designated by the State (typically the CPS agency 

and sometimes the police department). The 

agency receiving the report must make two primary 

decisions at intake: 

•	 Does the reported information meet the statutory 

and agency guidelines for child maltreatment? 

•	 How urgent is the required response? 

The first decision consists of three essential steps: 

1.		 Gathering sufficient information from the 

reporter to allow accurate decision-making; 

2.		 Evaluating the information to determine if it 

meets the statutory and agency guidelines for 

child maltreatment; 

3.		 Assessing the credibility of the reporter based on 

the relationship of the alleged victim and family, 

knowledge of the family and circumstances, and 

apparent motives for reporting. 

There will be a check of agency records and State 

central registries to determine if the family is 

currently involved in an open case or has a history 

of involvement in a maltreatment case. (A central 

registry is a database containing information 

on all previously substantiated reports of child 

maltreatment.) 

When the agency determines that an initial 

assessment or investigation is warranted, the report 

is “screened in”; cases closed without further 

investigation are referred to as “screened out.” While 

screening rates vary substantially across States, CPS 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 65 
 

 

 

agencies screened in and investigated approximately 

62 percent of the nearly 3 million report referrals 

received nationwide in 2000.127 In some instances, 

screened out cases will receive referrals to other 

community services (e.g., substance abuse treatment, 

mental health services, child care, domestic violence 

shelters, or income support agencies). 

Once the CPS agency determines that an initial 

assessment is warranted, the immediacy of the 

response is evaluated. The decision regarding the 

urgency of the response is based on an analysis of 

the information gathered to determine if the child is 

at imminent risk of serious harm. This decision will 

be based upon a number of factors including: 

•	 The nature of the act or omission; 

•	 The severity of harm to the child; 

•	 The relationship of the child to the person 

responsible for the maltreatment; 

•	 The access of the perpetrator to the child; 

•	 The child’s vulnerability (e.g., due to age, illness, 

or disability); 

•	 The other known cases of maltreatment by the 

parent or caregiver; 

•	 The availability of persons who can protect the 

child. 

Some CPS agencies provide guidelines for initial 

assessment response times, although it is difficult 

to generalize. Caseworkers are required to respond 

to reports within a specified time, typically ranging 

from 24 to 72 hours on more serious cases. If it is 

determined that the child in a report may not be 

safe, caseworkers must respond immediately. 

INITIAL ASSESSMENT OR INVESTIGATION 

The initial assessment or investigation follows the 

intake process for those reports that are screened in.
	

Primary Initial Assessment
	

or Investigation Decisions
	

The purpose of the initial assessment or investigation 

of cases of child abuse and neglect is to determine 

the following: 

•	 Is child maltreatment substantiated as defined 

by State statute? 

•	 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 to reduce the risk or address the 

treatment needs of the child? 

CPS agencies and law enforcement are each 

responsible for conducting initial assessments or 

investigations in cases of child abuse and neglect. 

Exhibit 9-3 presents the primary decisions or issues 

considered at this stage according to the agency that 

typically considers the decision. 

Involvement of Other Professionals 

In addition to CPS and law enforcement, other 

disciplines have a role to play in the initial 

assessment process: 

•	 Medical personnel may be involved in 

assessing and responding to the medical needs 

of a child or parent and perhaps in documenting 

the nature and extent of maltreatment. It is 

helpful to have medical practitioners in each 

community who have had specific training in 

66 What Does the Child Protection Process Look Like?
	
Exhibit 9-3 

Primary Decisions Considered During Initial Assessment or Investigation 

CPS Law Enforcement CPS and Law Enforcement 

Is the child safe? If not, what 

measures are necessary to ensure 

the child’s safety? 

Did the child suffer maltreatment 

or is he or she threatened by harm 

as defined by the State reporting 

law? 

Is maltreatment likely to occur in 

the future? If so, what is the level 

of risk of maltreatment? 

Are there emergency needs in the 

family that must be met? 

Are continuing agency services 

necessary to protect the child and 

reduce the risk of maltreatment 

occurring in the future? 

Did a crime occur? 

Who is the alleged 

offender? 

Is there evidence to arrest 

the alleged offender? 

Has all physical evidence 

been obtained, preserved, 

and/or photographed? 

Have all witnesses been 

interviewed? 

Do sources of corroboration 

or witnesses exist? 

Has all physical evidence 

been obtained or preserved? 

Are there any other victims 

(e.g., siblings)? 

Should the child be taken 

into protective custody? 

child maltreatment because they will provide 

a more complete and accurate evaluation than 

will an examiner without specific training. 

•	 Mental health personnel may be involved in 

assessing the effects of any alleged maltreatment 

and in determining the validity of specific 

allegations. At this stage of the CPS process, 

referrals to mental health providers are primarily 

for help in determining whether abuse occurred, 

whether there is sufficient information to file 

charges related to child maltreatment, and 

whether the child is capable of providing valid 

and reliable information. In addition, referrals 

to mental health practitioners may be made for 

assistance in assessing the safety of the child. 

For example, parents or caregivers may be 

referred for an evaluation of their mental status, 

the presence of psychiatric problems, personality 

disorders, or substance abuse. 

•	 Teachers and child care providers may be 

involved in providing direct information about 

the effects of maltreatment and in describing 

information pertinent to risk assessment. 

In addition, during the investigative stage, 

educators provide support for the efforts 

of CPS and law enforcement. For example, 

if the CPS caseworker or law enforcement 

needs to interview the child in the school, the 

school should provide a private place for the 

interview. 

•	 Foster care, residential, or child care 

licensing personnel may participate in 

the initial assessment if abuse is allegedly 

committed by an out-of-home caregiver. Each 

State differs with respect to who is responsible 

for initially assessing or investigating allegations 

of child abuse and neglect in out-of-home 

care. In some States, local CPS staffs have 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 67 
 

Major Types of Investigation Dispositions 

• Substantiated is an investigation disposition that concludes that the allegation of maltreatment 

or risk of maltreatment was supported or founded by State law or State policy. This is the highest 

level of finding by a State Agency. 

• Indicated or Reason to Suspect is an investigation disposition that concludes that maltreatment 

cannot be substantiated under State law or policy, but there is reason to suspect that the child 

may have been maltreated or was at risk of maltreatment. This is applicable only to States that 

distinguish between substantiated and indicated dispositions. 

• Not Substantiated is an investigation disposition that determines that there is not sufficient 

evidence under State law or policy to conclude that the child has been maltreated or is at risk of 

being maltreated.128 

responsibility for investigating certain types of 

allegations, for example, those in foster care 

and daycare. Frequently, the investigation of 

alleged maltreatment in institutional settings is 

handled by central or regional CPS or licensing 

staff, rather than by local CPS agencies. 

Depending on the nature of the allegations, law 

enforcement agencies also will assume a primary 

role in investigating these types of cases. 

Other community service providers also may have 

past experience with the child or family and may 

be used as a resource in addressing any emergency 

needs that the child or family may have. 

Investigation in Out-of-Home Care Settings 

In cases of child maltreatment in out-of-home 

care (e.g., residential facilities, foster homes), an 

investigation must be completed by an independent 

authority designated by the State. For cases 

involving out-of-home care abuse, there are other 

decisions and issues to consider: 

•	 Did the reported event occur? 

•	 Are personnel actions indicated and, if so, are 

they being initiated appropriately by the child 

care facility? 

•	 What responsibility do others in the facility 

have for any incident of maltreatment, and is 

a corrective action plan needed to prevent the 

likelihood of future incidents? 

•	 Can the problem, if validated, be addressed 

administratively? 

•	 Is the administrative authority responsible and, 

if so, in what manner? 

•	 Should the facility’s or foster care or other child 

care provider’s license be revoked? 

These decisions are made by thoroughly gathering 

and analyzing information from and about the child, 

family, or in some cases, the out-of-home provider. 

Typically, a protocol is employed for interviewing 

the child victim, family members, the person alleged 

to have maltreated the child, and others possessing 

information about the child and the family. 

FAMILY ASSESSMENT 

The family assessment is a comprehensive process for 

identifying, considering, and weighing factors that 

affect the child’s safety, permanency, and well-being. 

The family assessment is a process designed to gain 

a greater understanding about the strengths, needs, 

68 What Does the Child Protection Process Look Like?
	
Differential Response Systems 

Over the past decade, States have begun to enhance CPS practice and build community partnerships 

in responding to cases of child maltreatment. One area of CPS reform emphasizes greater flexibility 

in responding to allegations of abuse and neglect. A “dual track” or “multiple track” response permits 

CPS agencies to respond differentially according to the children’s safety, the degree of risk present, and 

the family’s needs for support services. Implementation models vary across States piloting differential 

response systems. Typically, in cases where abuse and neglect are severe or serious criminal offenses 

against children have occurred, an investigation will commence. The investigation focuses on evidence 

gathering and may include a referral to law enforcement. In less serious cases of child maltreatment, 

where the family may benefit from community services, an assessment will be conducted. In these 

cases the facts regarding what happened will be obtained, but the intervention will emphasize the 

comprehensive assessment of family strengths and needs and an appropriate match with community 

services. 

The assessment is designed to be a process where parents or caregivers are partners with CPS, and that 

partnership begins with the very first contact. In addition, the family’s support network is frequently 

brought into the process. States that have implemented the differential response strategy have shown 

that a majority of cases now coming to CPS can be handled safely through an approach that emphasizes 

service delivery and voluntary family participation as well as the fact finding of “traditional” CPS 

investigations.129 

and resources of the family so that children can be 

safe and the risk of maltreatment can be reduced. 

The family assessment is initiated immediately 

after the decision is made that ongoing services are 

needed. The following are the key decisions made as 

a result of the family assessment: 

•	 What are the risks and needs of this family that 

affect safety, permanency, or well-being? 

•	 What are the effects of maltreatment that affect 

safety, permanency, and well-being? 

•	 What are the individual and family strengths? 

•	 How do the family members perceive their 

conditions, problems, and strengths? 

•	 What must change in order for the effects of 

maltreatment to be addressed and for the risk of 

maltreatment to be reduced or eliminated? 

•	 What is the parent’s or caregiver’s level of 

readiness for change? What is their motivation 

and capacity to assure safety, permanency, and 

well-being? 

Family assessment should be strengths-based, 

culturally sensitive, and developed with the family. 

In addition to gathering information regarding 

problems, risks, and needs, strengths should be 

identified that may mitigate the identified concern(s) 

and the family’s stated goals as they relate to each 

problem. The strengths identified will provide the 

foundation upon which the family can change. 

Assessments should be conducted in a partnership 

with the family to help parents or caregivers 

recognize and remedy conditions so children can 

safely remain in their own home. Family assessments 

must be individualized and tailored to the unique 

strengths and needs of each family. When possible, 

this assessment also should be undertaken in 

conjunction with the extended family and support 

network through family decision-making meetings 

and other processes designed to involve this network 

in the process.130 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 69 
Concurrent Planning 

The passage of the Adoption and Safe Families Act (ASFA) in 1997 has resulted in time limits for 

permanency for children and termination of parental rights so that children are provided safe, stable, 

and permanent placements more quickly. Concurrent planning works toward reunification of children 

in care with their birth families while at the same time establishing a “back-up” permanency plan that 

will be implemented if the children cannot be reunified with their birth family. The concurrent plan 

provides a safeguard to assure secure childhood attachments by developing a stronger bond to the birth 

families and simultaneously supporting ties between the child and other possible permanent families, 

for example, kin or foster parents. Concurrent permanency plans provide a structured approach to 

move children quickly from temporary foster care to the stability of a safe and continuous family 

home.131 

PLANNING 

The comprehensive assessment of the family’s 

circumstances and conditions is the foundation 

on which the case plan is built. Armed with this 

knowledge, CPS caseworkers, other service providers 

or community professionals, and the family 

and its support network will determine the best 

possible strategies for reducing or eliminating the 

behaviors and conditions contributing to the risk 

of maltreatment of the child. The purposes of case 

planning are to identify the strategies with clients 

that will help address the effects of maltreatment 

and lessen the risk of further abuse and neglect; to 

provide a clear and specific guide for the professional 

and the family for changing the behaviors and 

conditions that impact risk; to provide a benchmark 

for measuring client progress toward achieving 

outcomes; and to provide a framework for case 

decision-making. 

The key decisions made at the case planning stage 

are: 

•	 What are the client outcomes that, when 

achieved, will indicate that risk has been 

reduced and the effects of maltreatment have 

been successfully addressed? 

•	 What goals must be accomplished to achieve the 

outcomes? 

•	 What intervention approaches or services will 

facilitate the successful goal achievement and 

the accomplishment of outcomes? 

•	 How and when will progress toward achievement 

of these outcomes and goals be evaluated? 

In order to achieve the client outcomes, the case 

plan must be developed with, not for, the family. 

Involving the family in planning serves several 

purposes. It facilitates the family’s investment in 

and commitment to the plan, it empowers parents 

or caregivers to take the necessary action to change 

behavior, and ensures that the agency and the family 

are working toward the same end. Some CPS 

agencies use models that optimize family strengths 

in the planning process. These models bring 

together the family, the extended family, and others 

important in the family’s life—for example, friends, 

clergy, neighbors—to make decisions regarding how 

best to ensure the safety of the family members. 

SERVICE PROVISION 

Once the case plan has been developed, the CPS 

caseworker must provide or arrange for services 

identified in the plan to help family members achieve 

the outcomes, goals, and tasks outlined in the case 

plan. Selecting and matching interventions that will 

support the family in achieving outcomes and goals 

is a major responsibility in child protection. 

70 What Does the Child Protection Process Look Like?
	
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The needs of families are often complex. As discussed 

in Chapter 5, child abuse and neglect is caused by 

multiple and interacting intrapersonal, interpersonal, 

and environmental factors. Interventions need 

to address as many of these contributing issues as 

possible.132 Research on the effectiveness of child 

abuse and neglect treatment suggests that successful 

intervention with maltreating families requires 

addressing both the interpersonal and concrete needs 

(e.g., housing, child care) of all family members. 

Evaluation projects found that programs that rely 

solely upon professional therapy, without augmenting 

the service strategies with other supportive or 

remedial services to children and families, will offer 

less opportunity for maximizing client gains.133 

Therefore, each community must provide a broad 

range of services to meet the multidimensional 

needs of abused and neglected children and their 

families. These may include: 

•	 Services provided to the entire family (e.g., family 

preservation services, multisystemic therapy for 

children and families, or family strengthening 

programs); 

•	 Services provided specifically to parents or 

caregivers (e.g., sex offender treatment, parent 

education, substance abuse treatment, or mutual 

support programs); 

•	 Services provided to children (e.g., counseling, 

therapeutic preschool, peer-based training, or 

mentoring programs). 

Depending on the assessed needs, strengths, and 

safety issues, services may be provided either in or 

out of the family’s home. When a child is unsafe 

because the risk of imminent harm is great or when 

the child’s behavioral and emotional needs cannot 

be addressed at home, out-of-home placement 

services, such as foster care, should be considered. 

Selection of services in a particular case is based on: 

•	 Assessing factors that contribute to the risk of 

maltreatment; 

•	 Identifying family strengths; 

•	 Targeting outcomes for change; 

•	 Identifying treatment approaches best suited 

to the desired outcome, based on any available 

research evidence; 

•	 Listing resources available and accessible in the 

community. 

The CPS caseworker serves as the case manager, 

articulating the needs of the family, coordinating 

services provided to them, and advocating on their 

behalf.134 The case management functions include: 

collecting and analyzing information, reaching 

decisions at all stages of the case process, coordinating 

services provided by others, and directly providing 

supportive services. This critical case-management 

functionrequiresopenandcontinuouscommunication 

among CPS, the family, and other service providers; 

developing a teamwork relationship; clarifying roles 

and responsibilities in delivering and monitoring 

services; and reaching consensus on goals and methods 

for monitoring progress toward goal achievement. 

EVALUATION OF FAMILY PROGRESS 

Evaluating whether risk behaviors and conditions 

have changed is central to case decisions. Monitoring 

change should begin as soon as an intervention is 

implemented and should continue throughout the 

life of a case until appropriate outcomes have been 

achieved.135 

The importance of evaluating family progress is to 

help answer the following questions: 

•	 Is the child safe? Have the protective factors, 

strengths, or the safety factors changed, 

warranting a change or elimination of the safety 

plan or the development of a safety plan? 

•	 What changes, if any, have occurred with respect 

to the conditions and behaviors contributing to 

the risk of maltreatment? 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 71 
 

 

 

 

•	 What outcomes have been accomplished and 

how does the caseworker know that they have 

been accomplished? 

•	 What progress has been made toward achieving 

case goals? 

•	 Have the services been effective in helping 

clients achieve outcomes and goals and, if not, 

what adjustments need to be made to improve 

outcomes? 

•	 What is the current level of risk in the family? 

•	 Have the risk factors been reduced sufficiently 

so that parents or caregivers can protect their 

children and meet their developmental needs so 

the case can be closed? 

•	 Has it been determined that reunification is not 

likely in the ASFA-required time frames and there 

is no significant progress toward outcomes? If so, 

is an alternative permanent plan goal needed? 

Since intervention and service provision to families at 

risk of maltreatment is a collaborative effort between 

CPS and other agencies or individual providers, the 

evaluation of family progress must be a collaborative 

venture. It is the CPS caseworker’s responsibility to 

manage the comparison of client progress based on 

information reported from all service providers. In 

some cases, it may be appropriate to convene a team 

meeting to review the progress in relation to the 

family assessment and the case plan. 

The process of evaluating family progress is a 

continual case management function. Once the 

case plan is established, each client contact will be 

focused on assessing the progress being made to 

achieve established outcomes, goals, and tasks, and 

to reassess safety. Formal case evaluations should 

occur at regular intervals. Good practice suggests 

evaluation of progress at least every 3 months. 

CASE CLOSURE 

Closure is the point at which the agency no longer 

maintains an active relationship with the family. 

The decision to end the agency’s involvement must 

be based on the monitoring and evaluation of the 

case. ASFA requires decisions regarding case closure 

to be made in conjunction with the family and 

individuals important to the family. The preeminent 

concerns that inform case closure decisions are 

based on safety and permanency outcomes. The 

agency should support the family’s right to selfdetermination by ending services when the risks to 

child safety have been reduced significantly and the 

family believes they no longer need services.136 

For more detailed information on the child protection process, check other manuals in the series at 

www.calib.com/nccanch/pubs/usermanual.cfm. 

72 What Does the Child Protection Process Look Like?
	
CHAPTER 10

Who Should Be Involved 

in Child Protection at the 

Community Level?

Child protective services (CPS) is typically the central agency in each community’s child 

protection system. It usually plays the lead role in 

coordinating communication and services among 

the various disciplines responsible for addressing 

child maltreatment. In addition to CPS, law 

enforcement, educators, child care providers, health 

care providers, mental health care providers, legal 

and judicial system professionals, substitute care 

providers, support service providers, domestic 

violence victim advocates, substance abuse treatment 

providers, and concerned community members all 

play important roles in keeping children safe. All 

relevant professionals must be aware of their role 

in child protection and the unique knowledge and 

skills they bring to their community’s prevention 

and intervention efforts. They must also understand 

the roles, responsibilities, and expertise of other 

professionals. 

CHILD PROTECTIVE SERVICES 

CPS is the agency mandated in most States to 

respond to reports of child abuse and neglect. 

CPS is responsible for: 

•	 Receiving reports of child abuse and neglect; 

•	 Conducting initial assessments and investigations 

regarding suspected maltreatment; 

•	 Conducting assessments of family strengths, 

resources, and needs; 

•	 Developing individualized case plans; 

•	 Providing direct services to support families 

in addressing the problems that led to 

maltreatment and reducing the risk of 

subsequent maltreatment; 

•	 Coordinating services provided by other 

professionals; 

•	 Completing case management functions such 

as maintaining case records, systematically 

reviewing case plans, and developing court 

reports. 

CPS also helps educate the community about child 

abuse and neglect and seeks to enhance community 

prevention and treatment resources. 

LAW ENFORCEMENT 

In the initial stages of the child protection response, 

law enforcement and CPS often have similar 

responsibilities. Law enforcement’s involvement 

in the initial assessment and investigation of 

child abuse and neglect varies across States and 

communities. For example, in many States, sexual 

abuse or severe physical abuse must be investigated 

by law enforcement. In a few States, abuse 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 73 
 

 

 allegations are reported initially to law enforcement 

rather than to CPS.137 Whether the community has 

a protocol for joint or separate initial assessments 

and investigations, a high degree of coordination 

between CPS and law enforcement is necessary to 

minimize the confusion and trauma to the child as 

a result of system intervention. 

The primary responsibilities of law enforcement 

include: 

•	 Identifying and reporting suspected child 

maltreatment; 

•	 Receiving reports of child abuse and neglect; 

•	 Conducting investigations of reports of child 

maltreatment when there is a suspicion that a 

crime has been committed; 

•	 Gathering physical evidence; 

•	 Determining whether sufficient evidence exists 

to prosecute alleged offenders; 

•	 Assisting with any need to secure the protection 

of the child; 

•	 Providing protection to CPS staff when a 

caseworker’s personal safety may be in jeopardy 

if confrontation occurs with alleged offenders; 

•	 Supporting the victim through the criminal 

court process. 

In several States, law enforcement plays a key role in 

multidisciplinary teams or Child Advocacy Centers 

(CACs). These teams and centers aim to reduce the 

trauma to the child caused by multiple interviewing. 

They also work to improve the prosecution of cases, 

particularly in sexual abuse cases.138 (For more 

information on multidisciplinary teams and CACs, 

see Chapter 11, “How Can Organizations Work 

Together to Protect Children?”) 

EDUCATORS AND
	

EARLY CHILD CARE PROVIDERS
	

Principals, teachers, school social workers, and 

counselors, as well as early childhood education 

and child care providers, play a critical role in the 

community child protection system. Key functions 

of educators include: 

•	 Developing and implementing prevention 

programs for children and parents; 

•	 Identifying and reporting suspected child abuse 

and neglect; 

•	 Recognizing and reporting child abuse and 

neglect occurring in the school system or child 

care program; 

•	 Developing a school or program policy for 

reporting instances of child abuse and neglect 

and cooperating with CPS investigations; 

•	 Keeping CPS informed of the changes or 

improvements in the child’s behavior and 

condition following the investigation; 

•	 Providing input in diagnostic and treatment 

services for the child; 

•	 Supporting the child through potentially 

traumatic events, for example, court hearings 

and out-of-home placement; 

•	 Providing support services for parents such as 

school-sponsored self-help groups; 

•	 Serving on child maltreatment multidisciplinary 

teams. 

74 Who Should Be Involved in Child Protection at the Community Level?
	
Attorneys representing the CPS who are who are 

HEALTH CARE PROVIDERS 

Physicians, nurses, emergency medical technicians, 

and other medical personnel play a major role in the 

child protection system in every community. Key 

functions of health care providers include: 

MENTAL HEALTH PROFESSIONALS 

Mental health services are a prerequisite for any 

community system designed to prevent and 

treat child abuse and neglect. Key functions of 

psychiatrists, psychologists, social workers, and 

•	 Identifying and reporting suspected cases of 

child abuse and neglect; 

•	 Providing diagnostic and treatment services 

(medical and psychiatric) for maltreated 

children and their families; 

•	 Providing consultation to CPS regarding 

medical aspects of child abuse and neglect; 

•	 Participating on the multidisciplinary caseconsultation team; 

•	 Providing expert testimony in child protection 

judicial proceedings; 

•	 Providing information to parents regarding the 

needs, care, and treatment of children; 

•	 Identifying and providing support for families 

at risk of child maltreatment; 

•	 Developing and conducting primary prevention 

programs; 

•	 Providing training for medical and nonmedical 

professionals regarding the medical aspects of 

child abuse and neglect; 

•	 Participating on community multidisciplinary 

teams. 

other mental health professionals include: 

•	 Identifying and reporting suspected cases of 

child abuse and neglect; 

•	 Conducting necessary evaluations of abused and 

neglected children and their families; 

•	 Providing treatment for abused and neglected 

children and their families; 

•	 Providing clinical consultation to CPS; 

•	 Providing expert testimony in child protection 

judicial proceedings; 

•	 Providing self-help groups for parents who have 

maltreated or are at risk of maltreating their 

children; 

•	 Developing and implementing prevention 

programs; 

•	 Participating on community multidisciplinary 

teams. 

LEGAL AND JUDICIAL SYSTEM PROFESSIONALS 

Responsibilities of legal professionals vary depending 

upon who the attorney’s client is and the stage of a 

judicial proceeding. 

Attorneys Attorneys representing representing the CPS agency who are who are 

responsible for presenting child maltreatment cases 

in court: 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 75 
•	 Assure that CPS personnel are given appropriate 

legal advice and consultation, for example, 

on decisions regarding emergency removal of 

children; 

•	 Prepare necessary legal pleadings when court 

intervention becomes necessary; 

•	 Participate in multidisciplinary team meetings 

when potential legal actions on behalf of the 

child may be explored; 

•	 Prepare CPS caseworkers, expert witnesses, and 

other witnesses, especially children, for testifying 

in court. 

Criminal prosecutors: 

•	 Assure that any criminal action is coordinated 

with a civil child protection proceeding 

involving the same child; 

•	 Assure that the child is adequately prepared for 

testifying; 

•	 Provide the child with victim advocacy services 

when necessary; 

•	 Assist the court in arriving at a sentence that 

serves the interest of justice and assures that 

proper treatment is provided; 

•	 Participate in multidisciplinary team meetings 

when potential legal actions on behalf of the 

child may be explored. 

Guardians ad Litem, legal counsel for children, 

and court-appointed special advocates 

(CASAs): 

•	 Assure that the needs and interests of a child in 

child protection judicial proceedings are fully 

protected; 

•	 Conduct an independent investigation into 

background and facts of the case; 

•	 Determine the child’s educational, psychological, 

and other treatment needs and help assure that 

the judicial intervention leads to appropriate 

treatment; 

•	 Facilitate a speedy, nonadversarial resolution of 

the case whenever possible and appropriate. 

Defense attorneys for the parents or other 

maltreating caregiver: 

•	 Assure that the parents’ or caregivers’ statutory 

and constitutional rights are fully protected in 

any judicial proceeding; 

•	 Assure that the parents or caregivers understand 

the judicial process and the potential impact of 

the process. 

Juvenile or family court judges: 

•	 Provide emergency protective orders when 

necessary, 24 hours a day, 7 days a week; 

•	 Resolve speedily all court cases of alleged child 

maltreatment; 

•	 Apply relevant case law and adjust the court 

process, as appropriate, to deal sensitively with 

child victims; 

•	 Encourage the development of greater 

community resources for maltreated children 

and their families. 

Court personnel help assure that children and 

families are dealt with sensitively throughout the 

judicial process. It is important for all family 

members to feel respected by the legal system as they 

go through a process that may feel intimidating and 

overwhelming. They also identify possible child 

maltreatment in cases before the court for other 

reasons, for example, delinquency. 

76 Who Should Be Involved in Child Protection at the Community Level?
	
 

Kinship Care 

In recent decades, increasing numbers of substitute care providers are relatives of the maltreated children. 

“Kinship care” often involves formal child placement by the child welfare agency and juvenile court in 

the home of a child’s relative—most frequently the child’s grandmother.139 Kinship care offers several 

benefits including greater familiarity between the caregiver and the child, potentially less traumatic 

placements, more visitation and contact with birth parents, and fewer placement changes.140 

SUBSTITUTE CARE PROVIDERS 

When children are removed from their parents’ 

care and placed in foster care or residential care to 

ensure their safety, foster parents and residential care 

providers become part of the treatment team, which 

is focused on the objective of family reunification. 

Substitute care providers help ensure that the basic 

needs of maltreated children are met in safe, stable, 

and nurturing environments. Foster families 

typically become a part of their child’s extended 

family and help negotiate relationships that support 

the birth parents and case plan goals. 

FAITH COMMUNITY 

Clergy and spiritual leaders can play important roles 

in supporting families and protecting children by: 

•	 Providing counseling, support, and spiritual 

leadership to their congregation; 

•	 Developing and implementing prevention 

programs to help stop child maltreatment; 

•	 Identifying and reporting suspected child abuse 

and neglect; 

•	 Supporting the child and family through 

potentially traumatic events, for example, court 

hearings and out-of-home placement; 

•	 Attending family team meetings to help make 

decisions about case plans; 

•	 Organizing self-help or mutual support groups 

at their facilities for parents who have maltreated 

a child or are at risk for doing so; 

•	 Participating in community multidisciplinary 

teams. 

COMMUNITY ORGANIZATIONS
	

AND SUPPORT SERVICES PROVIDERS
	

There are many other individuals who support the 

community intervention efforts, including youth 

service workers, community-based organizations, 

housing and job assistance agencies, civic groups, 

volunteers, and parent aides. These individuals 

offer prevention, support, and treatment services 

to abused and neglected children and their families. 

Support services frequently address the reduction of 

risk factors and enhancement of protective factors 

discussed in Chapter 5, “What Factors Contribute 

to Child Abuse and Neglect?” Involvement may 

occur prior to CPS involvement (e.g., supporting 

families at risk), concurrent with CPS involvement 

(e.g., attending family team meetings to help make 

decisions about case plans), or following CPS 

involvement (e.g., providing ongoing support and 

services). 

Some examples of the diverse community support 

provided to maltreated children and their families 

include: 

•	 Home visitors supporting new parents and 

modeling appropriate parenting practices; 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 77 
•	 Substance abuse treatment providers offering 

services to parents who are addicted to drugs; 

•	 Big Brother/Big Sister Organizations providing 

mentoring and social opportunities for 

maltreated children; 

•	 Domestic violence shelters offering safe housing 

arrangements for abused spouses and their 

children; 

•	 Neighborhood centers helping to build family 

skills and providing networking opportunities; 

•	 Homeless shelter staff providing homemaking 

and advocacy services for families in a shelter; 

•	 Child care programs offering respite care to 

stressed parents; 

•	 Family service agencies lending support to teen 

parents. 

As part of ongoing CPS reform movements across 

the country, community organizations and support 

service providers increasingly are playing more active 

roles in collaborative child protection efforts. 

CONCERNED CITIZENS 

In addition to the various practitioners described 

above, concerned citizens, particularly friends and 

neighbors, play an important role in responding 

to child maltreatment. All individuals in the 

community can contribute to the protection of 

children by providing social and emotional support 

to fellow community members, reporting suspected 

maltreatment, modeling good parenting behaviors, 

advocating for needed resources, and helping educate 

others about the problems of maltreatment. 

78 Who Should Be Involved in Child Protection at the Community Level?
	
 

 

 

 

CHAPTER 11

How Can Organizations

Work Together to

Protect Children?

National, State, and local movements to integrate services and improve collaboration 

have been among the most significant trends in 

human services over the last decade.141 Catalysts 

supporting this trend toward increased collaboration 

include changes in Federal funding programs 

that now encourage collaborative efforts and 

the desire to enhance service delivery to clients 

who exhibit multifaceted problems.142 Likewise, 

many communities are experimenting with a new 

approach to child protection and family well-being 

by broadening the commitment and responsibility 

from a single public agency to the community.143 

This chapter examines the essential elements of a 

well-coordinated child protection system. Other 

manuals in the series include more detailed 

information regarding community collaboration 

and integrated service systems. 

PRINCIPLES TO GUIDE COLLABORATION 

Collaboration is grounded in interdependent 

relationships. There are several basic guidelines to 

foster collaborative efforts: 

•	 Build and maintain trust. Trust enables 

people to share information, perceptions, and 

feedback. Professionals and nonprofessionals 

working together must trust each other, respect 

each other, view each other as an important 

contributor, and value the uniqueness of their 

colleagues. Collaborators can build trust by: 

- Reaching agreement regarding norms for 

behavior for working together; 

- Developing mutual respect, which enables 

them to be creative, take risks, and openly 

explore difficult issues; 

- Correcting common misconceptions and 

learning up-to-date information regarding 

other agencies; 

- Developing an informal, relaxed atmosphere, 

for example, by getting to know team 

members outside of the work setting; 

- Viewing all participants as equal members 

in designing and implementing the 

collaborative efforts.144 

•	 Reach agreement on core values. All the 

parties must reach consensus on a core set of 

values for the collaborative effort. Each of the 

parties must honor the importance of the values 

and their implementation in practice. 

•	 Reach agreement and stay focused on 

common goals. A well-coordinated system is 

based on agreement between all of the parties 

on common goals, such as the prevention of 

child abuse, the safety of children, and the 

permanency for children. In spite of the fact 

that the professionals or agencies involved in 

child welfare have differences in philosophy, 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 79 
 

 

 

 

 

 

 

 

 

 

 

focus, mission, and perceptions, which may 

sometimes come into conflict with one another, 

it is possible to agree on common goals. This 

requires that all parties: 

- Set aside or merge their vested interests; 

- Believe that by developing and maintaining 

common goals children and families will 

attain more positive outcomes. 

•	 Develop a common language. Each 

profession and agency has its own terminology, 

jargon, and acronyms. It is important to help 

the parties overcome language barriers. Each of 

the parties should: 

- Explain the technical language, words, and 

phrases they use; 

- Refrain from using acronyms and 

professional jargon; 

- Achieve a common understanding of what 

terms mean, for example, “strengths-based” 

or “family involvement.” 

•	 Demonstrate respect for the knowledge 

and experience of each person. Respect is 

a fundamental starting point for understanding 

and action. Effective collaboration requires 

the expertise and knowledge of all parties, 

who should listen to and be respectful of 

each person’s opinions and ideas. Any 

misunderstandings, unreasonable expectations, 

myths, previous problems, or other issues must 

be worked through. 

•	 Assume positive intentions of the parties. 

When a variety of professionals, as well as 

nonprofessionals, comes together to develop 

and implement a collaborative effort, they bring 

with them different ideas, perspectives, and 

approaches. It is important to believe that each 

of the parties is genuinely interested in working 

toward the agreed upon goals and positive 

outcomes for children and families. 

•	 Recognize the strengths, needs, and 

limitations of all of the parties. Each person 

and agency comes to the collaborative process 

with strengths, needs, and limitations. For 

example, community agencies bring with them 

specific resources needed to build an effective 

community response to child maltreatment. 

They also bring with them limitations, such 

as differing missions, goals, policies, and 

procedures. Capitalizing on the strengths and 

being aware of and addressing any barriers 

to participation are essential. It may require 

being open to and exploring alternative ways 

individuals can contribute to the collaborative 

effort. 

•	 Work through conflict. Conflict is healthy 

and inevitable when people work together 

collaboratively. The extent to which people feel 

comfortable with conflict and airing differences 

affects reaching consensus or an acceptable 

conclusion. Since communication is a 

significant part of one’s culture, great care must 

be taken to encourage the equal participation of 

all members. 

•	 Share decision-making, risk taking, and 

accountability. A true collaborative effort means 

thatdecisionsare madeandrisksaretakenasateam. 

Members participate in planning and decisionmaking and openly collaborate with others. All 

members feel a professional responsibility for 

the performance of the partnership. This means 

the entire team is accountable for achieving the 

outcomes and goals.145 

EFFECTIVE LEADERSHIP—
	

AN ESSENTIAL COMPONENT OF
	

SUCCESSFUL COLLABORATION
	

Leadership is key to successful collaboration. The 

leader: 

•	 Assures that all of the stakeholders are 

represented on the team; 

80 How Can Organizations Work Together to Protect Children?
	
 

 

 

•	 Is able to search for and discover opportunities, 

benefits, and resources; 

•	 Can build trust across agencies, professionals, 

and nonprofessionals; 

•	 Is responsive to the needs of the group; 

•	 Is flexible and can flow with the dynamics of the 

group; 

•	 Understands the dynamics of power, authority, 

and influence and uses this knowledge to 

facilitate collaboration; 

•	 Is able to manage conflict effectively; 

•	 Does not promote his or her own agenda to the 

exclusion of others; 

•	 Understands and responds appropriately to 

people from diverse cultures; 

•	 Treats all members with respect; 

•	 Facilitates group discussions effectively; 

•	 Frames needs, problems, and opportunities for 

the group.146 

COLLABORATIVE MODELS 

The following models demonstrate the effectiveness 

of collaboration. 

Fatality Review Team 

In the event of a child’s death due to abuse or 

neglect, a child fatality review team provides a 

systemic and multidisciplinary means to identify 

discrepancies between policy and practice and 

gaps in communication systems. Child fatality 

review teams typically consist of representatives 

from pertinent agencies or offices, such as CPS, law 

enforcement, and the coroner or medical examiner. 

The outcomes achieved through child fatality review 

teams include: the improvement of child protection 

through better coordination and collection of 

information; the protection of siblings in at-risk 

families; a decrease in the number of child deaths; 

and an enhanced collection of evidence, which 

improves the prosecution of abusers.147 

Child Advocacy Centers 

Child advocacy centers (CAC) are community-based 

facilities designed to coordinate services to victims 

of nonfatal abuse and neglect, especially in cases of 

child sexual abuse and severe physical abuse. The 

key goal of these centers is to reduce the trauma to 

victims that may result from agency intervention. 

CACs seek to improve the handling of cases at key 

points in the child protection process—investigation, 

prosecution, and treatment—by assuring the 

collaboration of the key professionals and agencies 

involved.148 

The Child Advocacy Center is a child-friendly 

facility where all of the key professionals—child 

protective services (CPS), law enforcement, 

prosecutors, mental health professionals, and child 

advocates—are co-located. Also, CACs typically 

work closely with medical personnel who specialize 

in child sexual abuse. CACs enhance coordination 

and achievement of positive outcomes by the close 

proximity of professionals, the assignment of a child 

advocate who monitors the case through the various 

systems, and the case review, which promotes formal 

and informal discussion of cases. 

CONCLUSION 

Every child deserves to grow up in a safe and 

nurturing environment. Unfortunately, hundreds 

of thousands of children are reported to be victims 

of child abuse and neglect each year.150 An untold 

number of other children are maltreated but not 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 81 
reported to responding agencies. As outlined in this 

manual, a number of practitioners and professionals 

assume different roles and responsibilities in 

identifying and responding to reported cases of child 

abuse and neglect. Child maltreatment, however, is 

so widespread and, thus, such a significant issue 

that every citizen and organization shares in the 

responsibility for responding to this problem. 

Interventions are designed to strengthen families as 

an integral part of ensuring child safety, permanency, 

and well-being. This includes promoting responsible 

parenting, fostering families’ support networks, and 

providing comprehensive services customized to 

meet the circumstances, strengths, and needs of each 

family. 

This manual is intended as a foundation for 

understanding child maltreatment issues and 

responses. Interested parties are encouraged to read 

the accompanying profession-specific and specialissue publications contained in the User Manual 

Series. 

Integrated Service Delivery Systems 

Many communities throughout the United States are attempting to create integrated service delivery 

systems that honor the unique strengths, needs, and culture of each child and family. One example is 

the six sites implementing “Partnerships in Action,” which brings together families and child welfare, 

mental health, and other related systems. 

• The program in Branch County, Michigan, assessed and redesigned community-based services to 

develop a seamless, integrated system of care for pregnant women and their families with newborn 

children (up to 6 years of age). 

• The program in the Pueblo of Zuni, New Mexico, created a single point of entry among tribal 

agencies for families experiencing domestic violence and child abuse. Also, the program 

strengthened domestic violence codes and created a state-of-the-art shelter for female victims of 

domestic violence and their children. 

• The program in Lorain County, Ohio, developed an infrastructure to provide the strongest possible 

community safety net for adolescents who “fell through the cracks” because their needs were not 

severe enough to require immediate, crisis, or intensive services from child welfare or mental 

health agencies. An essential part of the program was the development of a written operational 

interagency agreement. 

• The Rhode Island program provided seed money to communities to develop a specialized team 

approach for transition planning for youth with multiple agency needs who are incarcerated in a 

training school. 

• The program in Sedgwick County, Kansas, collaborated with a private contractor providing 

foster care to develop individualized plans of care for children diagnosed with serious emotional 

disturbances in need of mental health services. They also provided training to staff regarding 

family involvement. 

• The program in Maryland identified the individual and collective effects of multiple reform efforts 

in the State and identified ways the efforts could reinforce each other.149 

82 How Can Organizations Work Together to Protect Children?
	
assuring children’s rights to protection and per . 

child protection practic (pp. 16-17). Thousand Oaks, CA: 

Aggression and Violent Behavio , 

5 (2),

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 (pp. 16-17). Thousand Oaks, CA: 

 

 

 

 

 

 

 (p. 2). Chicago, IL: 

, 61-70; 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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86 Endnotes
	
Trauma, V (3),

Social W (6),

Current contr . 

Developmental Revie , 

Pediatric , 10 (1), 43-49.

Maltr (1), 3-12

Child Abuse and Neglect, 1 (4),

Abnor (1),

American Journal of Psychiatry, 15 (8), 

Interpersonal Violenc , 

Child Development, 6 (5),

Str (3), 445-459; Riggs, S., Alario, A. J., & McHorney, 

Pediatrics & Adolescent Medicin , 15 (4), 390-395; Kelley, B. T., 

maltr . Washington, DC: U.S. Department of Justice, 

(3), 320-324; Hoffman-Plotkin, D., & 

 

(3),

(3),

. New York, NY: Academic 

(1), 183-194; Eckenrode, J., Laird, 

(6),

. 

 

 

, 

 

 

 

, (1), 43-49.

(2),

(3),

(6),

(2),

(12), 1490-1496; Zuravin, S. J.,

(1), 3-12

(4),

 

(1), 97-112

(1),

 

 (8), 

 

(8),

(3),

 (pp. 432-463). 

 

 

, (1), 44-52; 

(4),

 (3), 73-85; Wonderlich, S., Donaldson, M. A., Carson, D. K., 

 

, 

 

 

(1),

 (5),

(3), 445-459; Riggs, S., Alario, A. J., & McHorney, 

(5),

 

 , (4), 390-395; Kelley, B. T., 

. Washington, DC: U.S. Department of Justice, 

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A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 89 

Caseworker – demonstrated 

 

 

 

 – demonstrated 

 

 

 

APPENDIX A

Glossary of Terms

Adjudicatory Hearings – held by the juvenile and 

family court to determine whether a child has been 

maltreated or whether another legal basis exists for 

the State to intervene to protect the child. 

Adoption and Safe Families Act (ASFA) – signed 

into law November 1997 and designed to improve 

the safety of children, to promote adoption and 

other permanent homes for children who need 

them, and to support families. The law requires 

CPS agencies to provide more timely and focused 

assessment and intervention services to the children 

and families that are served within the CPS system. 

CASA – court-appointed special advocates (usually 

volunteers) who serve to ensure that the needs and 

interests of a child in child protection judicial 

proceedings are fully protected. 

Case Closure – the process of ending the 

relationship between the CPS worker and the family 

that often involves a mutual assessment of progress. 

Optimally, cases are closed when families have 

achieved their goals and the risk of maltreatment 

has been reduced or eliminated. 

Case Plan – the casework document that outlines the 

outcomes, goals, and tasks necessary to be achieved 

in order to reduce the risk of maltreatment. 

Case Planning – the stage of the CPS case process 

where the CPS caseworker develops a case plan with 

the family members. 

Caseworker Caseworker Competency Competency – demonstrated – demonstrated 

professional behaviors based on the knowledge, 

skills, personal qualities, and values a person holds. 

Central Registry – a centralized database containing 

information on all substantiated/founded reports of 

child maltreatment in a selected area (typically a 

State). 

Child Abuse Prevention and Treatment Act 

(CAPTA) – the law (P.L. 93-247) that provides a 

foundation for a national definition of child abuse 

and neglect. Reauthorized in October 1996 (P.L. 

104-235), it was up for reauthorization at the time of 

publication. CAPTA defines child abuse and neglect 

as “at a minimum, any recent act or failure to act 

on the part of a parent or caretaker, which results 

in death, serious physical or emotional harm, sexual 

abuse or exploitation, or an act or failure to act 

which presents an imminent risk of serious harm.” 

Child Protective Services (CPS) – the designated 

social services agency (in most States) to receive 

reports, investigate, and provide intervention and 

treatment services to children and families in which 

child maltreatment has occurred. Frequently, this 

agency is located within larger public social service 

agencies, such as Departments of Social Services. 

Concurrent Planning – identifies alternative forms 

of permanency by addressing both reunification or 

legal permanency with a new parent or caregiver if 

reunification efforts fail. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 91 
 

 

 

 

 

 

Cultural Competence – a set of attitudes, 

behaviors, and policies that integrates knowledge 

about groups of people into practices and standards 

to enhance the quality of services to all cultural 

groups being served. 

Differential Response – an area of CPS reform that 

offers greater flexibility in responding to allegations 

of abuse and neglect. Also referred to as “dual track” 

or “multi-track” response, it permits CPS agencies to 

respond differentially to children’s needs for safety, 

the degree of risk present, and the family’s needs for 

services and support. See “dual track.” 

Dispositional Hearings – held by the juvenile 

and family court to determine the disposition of 

children after cases have been adjudicated, such 

as whether placement of the child in out-of-home 

care is necessary and what services the children and 

family will need to reduce the risk of maltreatment 

and to address the effects of maltreatment. 

Dual Track – term reflecting new CPS response 

systems that typically combine a nonadversarial 

service-based assessment track for cases where 

children are not at immediate risk with a traditional 

CPS investigative track for cases where children 

are unsafe or at greater risk for maltreatment. See 

“differential response.” 

Evaluation of Family Progress – the stage of the 

CPS case process where the CPS caseworker measures 

changes in family behaviors and conditions (risk 

factors), monitors risk elimination or reduction, 

assesses strengths, and determines case closure. 

Family Assessment – the stage of the child 

protection process when the CPS caseworker, 

community treatment provider, and the family reach 

a mutual understanding regarding the behaviors and 

conditions that must change to reduce or eliminate 

the risk of maltreatment, the most critical treatment 

needs that must be addressed, and the strengths on 

which to build. 

Family Group Conferencing – a family meeting 

model used by CPS agencies to optimize family 

strengths in the planning process. This model brings 

the family, extended family, and others important 

in the family’s life (e.g., friends, clergy, neighbors) 

together to make decisions regarding how best to 

ensure safety of the family members. 

Family Unity Model – a family meeting model 

used by CPS agencies to optimize family strengths in 

the planning process. This model is similar to the 

Family Group Conferencing model. 

Full Disclosure – CPS information to the family 

regarding the steps in the intervention process, the 

requirements of CPS, the expectations of the family, 

the consequences if the family does not fulfill the 

expectations, and the rights of the parents to ensure 

that the family completely understands the process. 

Guardian ad Litem – a lawyer or lay person who 

represents a child in juvenile or family court. Usually 

this person considers the “best interest” of the child 

and may perform a variety of roles, including those 

of independent investigator, advocate, advisor, and 

guardian for the child. A lay person who serves in 

this role is sometimes known as a court-appointed 

special advocate or CASA. 

Home Visitation Programs – prevention 

programs that offer a variety of family-focused 

services to pregnant mothers and families with new 

babies. Activities frequently encompass structured 

visits to the family’s home and may address 

positive parenting practices, nonviolent discipline 

techniques, child development, maternal and child 

health, available services, and advocacy. 

Immunity – established in all child abuse laws to 

protect reporters from civil law suits and criminal 

prosecution resulting from filing a report of child 

abuse and neglect. 

Initial Assessment or Investigation – the stage of the 

CPS case process where the CPS caseworker determines 

the validity of the child maltreatment report, assesses 

the risk of maltreatment, determines if the child is safe, 

develops a safety plan if needed to assure the child’s 

protection, and determines services needed. 

92 Appendix A—Glossary of Terms
	
Physical can include not 

Psychological includes the lack of 

Parens Doctrine

 can include not 

 includes the lack of 

 Doctrine

Intake – the stage of the CPS case process where the 

CPS caseworker screens and accepts reports of child 

maltreatment. 

Interview Protocol – a structured format to ensure 

that all family members are seen in a planned 

strategy, that community providers collaborate, and 

that information gathering is thorough. 

Juvenile and Family Courts – established in most 

States to resolve conflict and to otherwise intervene 

in the lives of families in a manner that promotes the 

best interest of children. These courts specialize in 

areas such as child maltreatment, domestic violence, 

juvenile delinquency, divorce, child custody, and 

child support. 

Kinship Care – formal child placement by the 

juvenile court and child welfare agency in the home 

of a child’s relative. 

Liaison – the designation of a person within an 

organization who has responsibility for facilitating 

communication, collaboration, and coordination 

between agencies involved in the child protection 

system. 

Mandated Reporter – groups of professionals 

required by State statutes to report suspected child 

abuse and neglect to the proper authorities (usually 

CPS or law enforcement agencies). Mandated 

reporters typically include: educators and other 

school personnel, health care and mental health 

professionals, social workers, childcare providers, 

and law enforcement officers. 

Multidisciplinary Team – established between 

agencies and professionals within the child 

protection system to discuss cases of child abuse 

and neglect and to aid in decisions at various stages 

of the CPS case process. These terms may also be 

designated by different names, including child 

protection teams, interdisciplinary teams, or case 

consultation teams. 

Neglect – the failure to provide for the child’s 

basic needs. Neglect can be physical, educational, 

or emotional. Physical Physical neglect neglect can include not can include not 

providing adequate food or clothing, appropriate 

medical care, supervision, or proper weather 

protection (heat or coats). Educational neglect 

includes failure to provide appropriate schooling, 

special educational needs, or allowing excessive 

truancies. Psychological Psychological neglect neglect includes the lack of includes the lack of 

any emotional support and love, chronic inattention 

to the child, exposure to spouse abuse, or drug and 

alcohol abuse. 

Out-of-Home Care – child care, foster care, or 

residential care provided by persons, organizations, 

and institutions to children who are placed outside 

their families, usually under the jurisdiction of 

juvenile or family court. 

Parent or caretaker – person responsible for the 

care of the child. 

Parens Patriae Patriae Doctrine Doctrine - originating in feudal 

England, a doctrine that vests in the State a right of 

guardianship of minors. This concept has gradually 

evolved into the principle that the community, in 

addition to the parent, has a strong interest in the 

care and nurturing of children. Schools, juvenile 

courts, and social service agencies all derive their 

authority from the State’s power to ensure the 

protection and rights of children as a unique class. 

Physical Abuse – the inflicting of a nonaccidental 

physical injury upon a child. This may include, 

burning, hitting, punching, shaking, kicking, 

beating, or otherwise harming a child. It may, 

however, have been the result of over-discipline or 

physical punishment that is inappropriate to the 

child’s age. 

Primary Prevention – activities geared to a sample 

of the general population to prevent child abuse 

and neglect from occurring. Also referred to as 

“universal prevention.” 

Protocol – an interagency agreement that delineates 

joint roles and responsibilities by establishing 

criteria and procedures for working together on 

cases of child abuse and neglect. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 93 
 

 

 

 

 

 

 

Protective Factors – strengths and resources that 

appear to mediate or serve as a “buffer” against 

risk factors that contribute to vulnerability to 

maltreatment or against the negative effects of 

maltreatment experiences. 

Psychological Maltreatment – a pattern of 

caregiver behavior or extreme incidents that 

convey to children that they are worthless, flawed, 

unloved, unwanted, endangered, or only of value to 

meeting another’s needs. This can include parents 

or caretakers using extreme or bizarre forms of 

punishment or threatening or terrorizing a child. 

The term “psychological maltreatment” is also 

known as emotional abuse or neglect, verbal abuse, 

or mental abuse. 

Response Time – a determination made by CPS 

and law enforcement regarding the immediacy of 

the response needed to a report of child abuse or 

neglect. 

Review Hearings – held by the juvenile and family 

court to review dispositions (usually every 6 months) 

and to determine the need to maintain placement in 

out-of-home care or court jurisdiction of a child. 

Risk – the likelihood that a child will be maltreated 

in the future. 

Risk Assessment – to assess and measure the 

likelihood that a child will be maltreated in the future, 

frequently through the use of checklists, matrices, 

scales, and other methods of measurement. 

Risk Factors – behaviors and conditions present in 

the child, parent, or family that will likely contribute 

to child maltreatment occurring in the future. 

Safety – absence of an imminent or immediate 

threat of moderate-to-serious harm to the child. 

Safety Assessment – a part of the CPS case process 

in which available information is analyzed to 

identify whether a child is in immediate danger of 

moderate or serious harm. 

Safety Plan – a casework document developed when 

it is determined that the child is in imminent risk 

of serious harm. In the safety plan, the caseworker 

targets the factors that are causing or contributing to 

the risk of imminent serious harm to the child, and 

identifies, along with the family, the interventions 

that will control the safety factors and assure the 

child’s protection. 

Secondary Prevention – activities targeted to 

prevent breakdowns and dysfunctions among 

families who have been identified as at risk for abuse 

and neglect. 

Service Agreement – the casework document 

developed between the CPS caseworker and the 

family that outlines the tasks necessary to achieve 

goals and outcomes necessary for risk reduction. 

Service Provision – the stage of the CPS casework 

process when CPS and other service providers 

provide specific services geared toward the reduction 

of risk of maltreatment. 

Sexual Abuse – inappropriate adolescent or adult 

sexual behavior with a child. It includes fondling 

a child’s genitals, making the child fondle the 

adult’s genitals, intercourse, incest, rape, sodomy, 

exhibitionism, sexual exploitation, or exposure to 

pornography. To be considered child abuse, these 

acts have to be committed by a person responsible 

for the care of a child (for example a baby-sitter, 

a parent, or a daycare provider) or related to the 

child. If a stranger commits these acts, it would be 

considered sexual assault and handled solely be the 

police and criminal courts. 

Substantiated – an investigation disposition 

concluding that the allegation of maltreatment or 

risk of maltreatment was supported or founded 

by State law or State policy. A CPS determination 

means that credible evidence exists that child abuse 

or neglect has occurred. 

Tertiary Prevention – treatment efforts geared to 

address situations where child maltreatment has 

already occurred with the goals of preventing child 

94 Appendix A—Glossary of Terms
	
maltreatment from occurring in the future and of 

avoiding the harmful effects of child maltreatment. 

Treatment – the stage of the child protection 

case process when specific services are provided 

by CPS and other providers to reduce the risk of 

maltreatment, support families in meeting case 

goals, and address the effects of maltreatment. 

Universal Prevention – activities and services 

directed at the general public with the goal of 

stopping the occurrence of maltreatment before it 

starts. Also referred to as “primary prevention.” 

Unsubstantiated (not substantiated) – an 

investigation disposition that determines that there 

is not sufficient evidence under State law or policy 

to conclude that the child has been maltreated or at 

risk of maltreatment. A CPS determination means 

that credible evidence does not exist that child abuse 

or neglect has occurred. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 95 
96 
APPENDIX B

Resource Listings of

Selected National

Organizations Concerned

with Child Maltreatment

Listed below are several representatives of the many national organizations and groups that deal with various 

aspects of child maltreatment. Please visit www.calib.com/nccanch to view a more comprehensive 

list of resources and visit www.calib.com/nccanch/database/index.cfm to view an organization database. 

Inclusion on this list is for information purposes and does not constitute an endorsement by the Office on 

Child Abuse and Neglect or the Children’s Bureau. 

Childhelp USA FOR THE GENERAL PUBLIC 

address:		 15757 North 78th St. 

Scottsdale, AZ 85260 American Bar Association Center on Children 

and the Law phone:		 (800) 4-A-CHILD

(800) 2-A-CHILD (TDD line) 

address:		 740 15th St., NW (480) 922-8212 

Washington, DC 20005 fax: (480) 922-7061 

phone: (202) 662-1720 e-mail: help@childhelpusa.org 

fax: (202) 662-1755 Web site: www.childhelpusa.org 

e-mail: ctrchildlaw@abanet.org Provides crisis counseling to adult survivors and 

Web site: www.abanet.org/child child victims of child abuse, offenders, and parents 

and operates a national hotline. Promotes improvement of laws and policies affecting 

children and provides education in child-related law 

topics. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 97 
 

 

 

National Center for Missing and Exploited 

Children (NCMEC) 

address: Charles B. Wang International 

Children’s Building 

699 Prince St. 

Alexandria, VA 22314-3175 

phone: (800) 843-5678 

(703) 274-3900 

fax: (703) 274-2220 

Web site: www.missingkids.com 

Provides assistance to parents, children, law 

enforcement, schools, and the community in 

recovering missing children and raising public 

awareness about ways to help prevent child 

abduction, molestation, and sexual exploitation. 

Parents Anonymous 

address: 675 West Foothill Blvd., Suite 220 

Claremont, CA 91711 

phone: (909) 621-6184 

fax: (909) 625-6304 

e-mail: parentsanon@msn.com 

Web site: www.parentsanonymous.org 

Leads mutual support groups to help parents provide 

nurturing environments for their families. 

COMMUNITY PARTNERS 

The Center for Faith-based and Community 

Initiatives 

e-mail:		 CFBCI@hhs.gov 

Web site:		 www.hhs.gov/faith 

Welcomes the participation of faith-based and 

community-based organizations as valued and 

essential partners with the U.S. Department of 

Health and Human Services. Funding goes to 

faith-based organizations through Head Start and 

to programs for refugee resettlement, runaway and 

homeless youth, independent living, child care, 

child support enforcement, and child welfare. 

Family Support America 

(formerly Family Resource Coalition of America) 

address: 20 N. Wacker Dr., Suite 1100 

Chicago, IL 60606 

phone: (312) 338-0900 

fax: (312) 338-1522 

e-mail: info@familysupportamerica.org 

Web site: www.familysupportamerica.org 

Works to strengthen and empower families and 

communities so that they can foster the optimal 

development of children, youth, and adult family 

members. 

National Children’s Alliance 

address: 1612 K St., NW, Suite 500 

Washington, DC 20006 

phone: (800) 239-9950 

(202) 452-6001 

fax: (202) 452-6002 

e-mail: info@nca-online.org 

Web site: www.nca-online.org 

Provides training, technical assistance, and 

networking opportunities to communities seeking 

to plan, establish, and improve Children’s Advocacy 

Centers. 

National Exchange Club Foundation for the 

Prevention of Child Abuse 

address:		 3050 Central Ave. 

Toledo, OH 43606-1700 

phone:		 (800) 924-2643 

(419) 535-3232 

fax: (419) 535-1989 

e-mail: info@preventchildabuse.com 

Web site: www.nationalexchangeclub.com 

98 Appendix B—Resource Listings
	
 

 

Conducts local campaigns in the fight against child 

abuse by providing education, intervention, and 

support to families affected by child maltreatment. 

National Fatherhood Initiative 

address: 101 Lake Forest Blvd., Suite 360 

Gaithersburg, MD 20877 

phone: (301) 948-0599 

fax: (301) 948-4325 

Web site: www.fatherhood.org 

Works to improve the well-being of children by 

increasing the proportion of children growing up 

with involved, responsible, and committed fathers.
	

PREVENTION ORGANIZATIONS 

National Alliance of Children’s Trust and 

Prevention Funds (ACT) 

address:		 Michigan State University 

Department of Psychology 

East Lansing, MI 48824-1117 

phone:		 (517) 432-5096 

fax:		 (517) 432-2476 

e-mail:		 millsda@msu.edu 

Web site:		 www.ctfalliance.org 

Assists State children’s trust and prevention funds to 

strengthen families and protect children from harm. 

Prevent Child Abuse America 

address:		 200 South Michigan Ave., 17th Floor 

Chicago, IL 60604-2404 

phone:		 (800) 835-2671 (orders) 

(312) 663-3520 

fax: (312) 939-8962 

e-mail: mailbox@preventchildabuse.org 

Web site: www.preventchildabuse.org 

Conducts prevention activities such as public 

awareness campaigns, advocacy, networking, research, 

and publishing. Also, provides information and 

statistics on child abuse. 

Shaken Baby Syndrome Prevention Plus 

address: 649 Main St., Suite B Groveport, OH 

43125 

phone: (800) 858-5222 

(614) 836-8360 

fax: (614) 836-8359 

e-mail: sbspp@aol.com 

Web site: www.sbsplus.com 

Develops, studies, and disseminates information and 

materials designed to prevent shaken baby syndrome 

and other forms of physical child abuse and to 

increase positive parenting and child care. 

CHILD WELFARE ORGANIZATIONS 

American Humane Association Children’s 

Division 

address:		 63 Inverness Dr., East 

Englewood, CO 80112-5117 

phone:		 (800) 227-4645 

(303) 792-9900 

fax: (303) 792-5333 

e-mail: children@americanhumane.org 

Web site: www.americanhumane.org 

Conducts research, analysis, and training to help 

public and private agencies respond to child 

maltreatment. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 99 
 

American Public Human Services Association 

address:		 810 First St., NE, Suite 500 

Washington, DC 20002-4267 

phone:		 (202) 682-0100 

fax:		 (202) 289-6555 

Web site:		 www.aphsa.org 

Addresses program and policy issues related 

to the administration and delivery of publicly 

funded human services. Professional membership 

organization. 

American Professional Society on the Abuse of 

Children 

address:		 940 N.E. 13th St. 

CHO 3B-3406 

Oklahoma City, OK 73104 

phone: (405) 271-8202 

fax: (405) 271-2931 

e-mail: tricia-williams@ouhsc.edu 

Web site: www.apsac.org 

Provides professional education, promotes research to 

inform effective practice, and addresses public policy 

issues. Professional membership organization. 

AVANCE Family Support and Education 

Program 

address:		 301 South Frio, Suite 380 

San Antonio, TX 78207 

phone:		 (210) 270-4630 

fax:		 (210) 270-4612 

Web site:		 www.avance.org 

Operates a national training center to share and 

disseminate information, material, and curricula 

to service providers and policy makers interested in 

supporting high-risk Hispanic families. 

Child Welfare League of America
	

address: 440 First St., NW, Third Floor 

Washington, DC 20001-2085 

phone: (202) 638-2952 

fax: (202) 638-4004 

Web site: www.cwla.org 

Provides training, consultation, and technical 

assistance to child welfare professionals and agencies 

while also educating the public about emerging 

issues affecting children. 

Children’s Defense Fund 

address: 25 E St., NW 

Washington, DC 20001 

phone: (202) 628-8787 

fax: (202) 662-3540 

e-mail: cdfinfo@childrensdefense.org 

Web site: www.childrensdefense.org 

Provides technical assistance to State and local 

child advocates, gathers and disseminates data on 

children, and advocates for children’s issues. 

National Black Child Development Institute 

address: 1023 15th St., NW, Suite 600 

Washington, DC 20005 

phone: (202) 387-1281 

fax: (202) 234-1738 

e-mail: moreinfo@nbcdi.org 

Web site: www.nbcdi.org 

Operates programs and sponsors a national training 

conference through Howard University to improve 

and protect the well-being of African-American 

children. 

100 Appendix B—Resource Listings
	
 

 

National Children’s Advocacy Center 

address: 200 Westside Sq., Suite 700 

Huntsville AL 35801 

phone: (256) 533-0531 

fax: (256) 534-6883 

e-mail: webmaster@ncac-hsv.org 

Web site: www.ncac-hsv.org 

Provides prevention, intervention, and treatment 

services to physically and sexually abused children 

and their families within a child-focused team 

approach. 

National Indian Child Welfare Association 

address:		 5100 SW Macadam Ave., Suite 300 

Portland, OR 97201 

phone:		 (503) 222-4044 

fax:		 (503) 222-4007 

e-mail:		 info@nicwa.org 

Web site:		 www.nicwa.org 

Disseminates information and provides technical 

assistance on Indian child welfare issues. Supports 

community development and advocacy efforts to 

facilitate tribal responses to the needs of families 

and children. 

National Resource Center on Child 

Maltreatment 

address:		 Child Welfare Institute 

3950 Shackleford Rd., Suite 175 

Duluth, GA 30096 

phone:		 (770) 935-8484 

fax:		 (770) 935-0344 

e-mail:		 tsmith@gocwi.org 

Web site:		 www.gocwi.org 

Helps States, local agencies, and Tribes develop 

effective and efficient child protective services systems. 

Jointly operated by the Child Welfare Institute and 

ACTION for Child Protection, it responds to needs 

related to prevention, identification, intervention, 

and treatment of child abuse and neglect. 

FOR MORE INFORMATION 

National Clearinghouse on Child Abuse and 

Neglect Information 

address: 330 C St., SW 

Washington, DC 20447 

phone: (800) 394-3366 

(703) 385-7565 

fax: (703) 385-3206 

e-mail: nccanch@calib.com 

Web site: www.calib.com/nccanch 

Collects, stores, catalogs, and disseminates 

information on all aspects of child maltreatment 

and child welfare to help build the capacity of 

professionals in the field. A service of the Children’s 

Bureau. 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 101 
102 
APPENDIX C

State Toll-free

Telephone Numbers for

Reporting Child Abuse

Each State designates specific agencies to receive and investigate reports of suspected child abuse and neglect. Typically, this responsibility is carried out by child protective services (CPS) within a Department 

of Social Services, Department of Human Resources, or Division of Family and Children Services. In some 

States, police departments also may receive reports of child abuse or neglect. 

Many States have an in-State toll-free telephone number, listed below, for reporting suspected abuse. The 

reporting party must be calling from the same State where the child is allegedly being abused for 

most of the following numbers to be valid. 

For States not listed or when the reporting party resides in a different State than the child, please call 

Childhelp, 800-4-A-Child (800-422-4453), or your local CPS agency. 

Alaska (AK) Illinois (IL) Massachusetts (MA) 

800-478-4444 800-252-2873 800-792-5200 

Arizona (AZ) Indiana (IN) Michigan (MI) 

888-SOS-CHILD 800-800-5556 800-942-4357 

(888-767-2445) Iowa (IA) Mississippi (MS) 

Arkansas (AR) 800-362-2178 800-222-8000 

800-482-5964 

Kansas (KS) Missouri (MO) 

Connecticut (CT) 800-922-5330 800-392-3738 

800-842-2288 

800-624-5518 (TDD) Kentucky (KY) 

800-752-6200 

Montana (MT) 

800-332-6100 

Delaware (DE) 

800-292-9582 Maine (ME) Nebraska (NE) 

800-452-1999 800-652-1999 

Florida (FL) 

800-96-ABUSE Maryland (MD) Nevada (NV) 

(800-962-2873) 800-332-6347 800-992-5757 

A Coordinated Response to Child Abuse and Neglect: The Foundation for Practice
	 103 
New Hampshire (NH) 

800-894-5533 

800-852-3388 (after hours) 

New Jersey (NJ) 

800-792-8610 

800-835-5510 (TDD) 

New Mexico (NM) 

800-797-3260 

New York (NY) 

800-342-3720 

North Dakota (ND) 

800-245-3736 

Oklahoma (OK) 

800-522-3511 

Oregon (OR) 

800-854-3508, ext. 2402 

Pennsylvania (PA) 

800-932-0313 

Rhode Island (RI) 

800-RI-CHILD 

(800-742-4453) 

Texas (TX) 

800-252-5400 

Utah (UT) 

800-678-9399 

Vermont (VT) 

800-649-5285 

Virginia (VA) 

800-552-7096 

Washington (WA) 

866-END-HARM 

(866-363-4276) 

West Virginia (WV) 

800-352-6513 

Wyoming (WY) 

800-457-3659 

104 Appendix C—State Toll-free Telephone Numbers for Reporting Child Abuse
	


To view or obtain copies of other manuals in this series, contact the 

National Clearinghouse on Child Abuse and Neglect Information at:
	

800-FYI-3366
	

nccanch@calib.com
	

www.calib.com/nccanch/pubs/usermanual.cfm