Mandated Child Abuse Reporting in a Multicultural Environment

The abuse and neglect of children has been linked to their cognitive, academic, psychological, and behavioral demise. As a result of the deleterious effects that abuse can have on children’s development and well-being, all 50 states, including the District of Columbia, have enacted child abuse reporting laws for mental health professionals. These laws typically require a mandated child abuse report when child maltreatment has been reasonably suspected. Although mandated child abuse reporting laws appear straight-forward, mandated reporting often entails complex and nuanced decision-making, particularly when a child is from a diverse cultural background. Thus, this article offers a discussion for mental health professionals (e.g., psychologists, psychiatrists, counselors, social workers) regarding mandated child abuse reporting within a multicultural environment.

In Situ Team-Based Simulation Training to Close the Loop on Event Reporting

Reporting adverse events is often stigmatized in medicine. Adverse events are underreported. Underreporting has been linked to fear, the time required to complete a report, and a belief that reporting may not result in improvement.1 The reluctance to report is multidimensional and may relate to guilt, fear of punishment of self or others, fear of embarrassment, fear of litigation, and lack of confidence to effect change. Central to this fear is the widely held belief that errors and adverse events are due to carelessness and that blame must be assigned—often to the provider “at fault” or at the sharp end of the process. However, reporting of events offers an invaluable opportunity to identify latent systems issues and review and redesign error-trapping procedures and workflows. Without measurement, it is challenging to leverage adverse events as catalysts for targeted process improvement. Mandated reporting at the state and national levels is an influential catalyst to enhance data collection of adverse events. Aggregated data across varied practice settings are powerful. Mandated reporting alleviates some of the fear associated with reporting and increases reporting volume and relevance.

Integrating Validity Evidence to Revise a Child Abuse Knowledge Test for Early Childhood Education Providers: A Mixed Methods Approach

Knowledge tests used to evaluate child protection training program effectiveness for early childhood education providers may suffer from threats to construct validity given the contextual variability inherent within state-specific regulations around mandated reporting requirements. Unfortunately, guidance on instrument revision that accounts for such state-specific mandated reporting requirements is lacking across research on evaluation practices. This study, therefore, explored how collection and integration of validity evidence using a mixed methods framework can guide the instrument revision process to arrive at a more valid program outcome measure.

International Influences on Women’s Representation on High Courts

Chapter 6 examines the influence of international factors on the appointment of women to high courts in the case studies, focusing on the impact of international and regional norms, the ratification of the Convention on Elimination of All Forms of Discrimination Against Women (CEDAW), and the advocacy of international and domestic nongovernmental women’s rights organizations. The emergence of regional norms of gender equity in governance, including in the judiciary, is traced for Africa, Europe, and Latin America. Drawing on United Nations and country-specific primary sources, the rise of CEDAW mandated reporting on gender diversity in the judiciary and on high courts is documented in four of the case study countries (Canada, Colombia, Ireland, South Africa). Including the United States, the five case studies highlight the role of domestic advocacy organizations that exert pressure on appointers to consider women candidates for judgeship on high courts.

Professional training in veterinary forensic sciences accessible within the curricula of 30 veterinary medical colleges in the United States

A study of the curriculum offered by veterinary colleges in the United States was performed on the topic of veterinary forensic science, the field of science utilizing the expertise of a veterinarian to gather and interpret evidence associated with animal crime (i.e. animal abuse and/or neglect). In this study, data was collected from 30 United States veterinary colleges in regard to curriculum accessible to veterinary students, specific to the field of veterinary forensic science. Each school provided any mention and characterization of the topic available to students throughout the four years of veterinary education, including lectures in core courses, lectures worked into elective courses, and/or separate elective courses. Completion of this study revealed the inconsistencies of training in veterinary forensic science found at the colleges surveyed. There are no current standards on this topic required for the education of veterinary professionals. Based on this study, 13 colleges (43.3%) provide some mention of the topic in their course work and seven colleges (23.3%) provide a specific elective course, while 10 colleges (33.3%) offer no training at all in veterinary forensic science. With mandated reporting in 18 of the 50 states, new graduates are expected to be competent at recognizing and reporting suspected cases of animal abuse/neglect; however, many veterinarians have never even been exposed to the topic of veterinary forensics during their education.

Reimagining Schools' Role Outside the Family Regulation System

The United States’ family regulation system often begins with well-intentioned professionals making child protection hotline calls, jeopardizing their own ability to work with families and subjecting the families to surveillance. By the system’s own standards, most of this surveillance leads to no meaningful action. Nowhere is this reality more present than in schools. Educational personnel serve as the leading driver of child maltreatment allegations, yet decades worth of data reveal educator reports of maltreatment are the least likely to be screenedin and the least likely to be substantiated or confirmed. In other words, education personnel— whether motivated by genuine concern, which may nevertheless be informed by implicit biases towards low-income families and families of color; fear of liability; or the desire to access services they believe families cannot acquire elsewhere— overwhelm our child welfare system with unnecessary allegations of maltreatment. This reality has fundamentally transformed the relationship between families and schools. Carrying the heavy burden of mandated reporting laws, public schools disproportionately refer Black and low-income families to the family regulation system, abdicating schools’ opportunity to serve these same families in the communities in which they reside. Rather than serving as the great equalizer, public schools increasingly contribute to the carceral state’s regulation of families. This Article argues that schools must shift their role away from the reporting and surveillance of these families, and instead directly provide and arrange for services for families. This change begins with sharply limiting or repealing mandatory reporting obligations (permitting voluntary reports in severe cases)—but that is only the start. Schools are well-positioned to create new pathways to the supports and services from which most families reported to the family regulation system might actually benefit. Schools are already a primary source of food for impoverished children, and can help ensure low-income families access all the public benefits to which they are entitled. Schools can largely refer children and families to the same services that the family regulation system can—such as mental health services and substance abuse treatment—but without that system’s coercive authority and its associated problems. Where some services are tied to the family regulation system’s involvement, then law should permit schools to refer families directly. Schools know which families need legal services to defend their housing, access benefits, obtain orders of protection—or any of the myriad of other supports that poverty lawyers can provide. This shift would tie schools to the families and communities that they serve and benefit those families and communities far more than the surveillance and policing they experience under the current family regulation system.

Mutual Deference Between Hospitals and Courts

This Article explores the phenomenon of “mutual deference” between the medical and legal systems to show that placing mandated reporting responsibilities on clinicians results in lasting harm for families. On the medical side, clinicians are obligated to defer any “reasonable suspicion” that a child may be at risk to the legal system; their concern may be mild or severe, medical or nonmedical in nature. But the legal system, comprised of lay-people in the field of medicine, is illequipped to evaluate a medical concern, and so defers back to the clinician’s report when making critical decisions around family integrity. Thisdeference often functions to elevate a clinician’s “reasonable suspicion” to a finding of “imminent risk,” justifying needless and prolonged separation of families. More systemically, mutual deference creates and reinforces medical and legal associations between low-income communities of color and notions of child maltreatment. Mutual deference insulates the medical reporter and the legal system from liability while imposing tremendous harm on the families caught in the middle. That mandated reporting laws discourage clinicians from considering this harm when deciding whether to report a family reflects the extent to which the family regulation system has prioritized prosecution over supporting families. Efforts to re-envision how society’s support for and protection of families can move away from state-sanctioned violence and towards strengthening families within their communities must begin with removing mandated reporter responsibilities from medical providers.

Epidemiology of mucopolysaccharidoses (MPS) in United States: challenges and opportunities

Background Mucopolysaccharidoses (MPS) are rare, inherited lysosomal storage disorders characterized by progressive multiorgan involvement. Previous studies on incidence and prevalence of MPS mainly focused on countries other than the United States (US), showing considerable variation by country. This study aimed to identify MPS incidence and prevalence in the US at a national and state level to guide clinicians and policy makers. Methods This retrospective study examined all diagnosed cases of MPS from 1995 to 2015 in the US using the National MPS Society database records. Data included year of birth, patient geographic location, and MPS variant type. US population information was obtained from the National Center for Health Statistics. The incidence and prevalence rates were calculated for each disease. Incidence rates were calculated for each state. Results We obtained information from 789 MPS patients during a 20-year period. Incidence of MPS in the US was found to be 0.98 per 100,000 live births. Prevalence was found to be 2.67 per 1 million. MPS I, II, and III had the highest incidence rate at birth (0.26/100,000) and prevalence rates of 0.70–0.71 per million. Birth incidences of MPS IV, VI, and VII were 0.14, 0.04 and 0.027 per 100,000 live births. Conclusions This is the most comprehensive review of MPS incidence and prevalence rates in the US. Due to the large US population and state fragmentation, US incidence and prevalence were found to be lower than other countries. Nonetheless, state-level studies in the US supported these figures. Efforts should be focused in the establishment of a national rare disease registry with mandated reporting from every state as well as newborn screening of MPS.

Counseling Preparation

All counselors have to start somewhere, so Chapter 3 opens by describing the broader ethical and legal considerations an effective school-based practitioner must understand before initiating cognitive behavioral therapy (CBT). Special attention is paid to the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA), in addition to the careful attention practitioners must pay to these laws when serving students with medical needs. Chapter 3 highlights important ethical principles that school psychologists often abide by, including confidentiality and mandated reporting. Next, Chapter 3 introduces basic counseling skills that all practitioners can benefit from. These micro skills, like how to build a strong therapeutic alliance and how to listen, observe, and ask questions, are essential to maximizing CBT’s effectiveness.