Strategies for Saving and Improving Children's Lives

Abstract

At the Child Abuse Recognition, Research, and Education Translation (CARRET) Conference, national child abuse experts representing different disciplines discussed and developed new strategies that would address the barriers to reporting suspected child abuse and improve the protection of children. This article describes the experts' analysis of the barriers to and strategies for improving the outcome for abused children, in addition to the steps planned to facilitate continued action. Pediatrics 2008;122:S18-S20 A GENERATION AFTER the introduction of mandated reporting and the development of the child protection systems by the states, there are still major problems in effective communication and collaboration. These structural issues frustrated all of the conference participants: doctors, social workers, advocates, and families. As the articles and discussions presented in this journal supplement clearly illustrate, conference participants felt that improvements in these collaborations could save the lives of children and minimize the severe long-term consequences of maltreatment for many more children. METHODSTo translate these sentiments into action, conference participants, in facilitated small groups, discussed and debated the strategies presented by the speakers and panelists. Using a structured discussion format, they assessed feasibility and the potential impact of suggested systems changes and reforms. When the groups reconvened, key points were identified and prioritized.The final panel focused on ways to improve relationships between reporters and state child protective services (CPS). Using a consensus approach in which participants revisited each strategy and then ranked them, the participants then determined their final priorities stemming from the conference, which formed the core of an action plan. The participants then planned potential mechanisms for implementing these recommendations. Specifically, they considered the organizations responsible for implementation, their roles, the actions needed to implement the strategy, and the logistics and other needed information. Finally, the conference closed with discussion about immediate and medium-term action steps.In this manner, the various disparate groups were able to achieve agreement on high-impact priority areas for policy change and development, which are summarized below. RESULTSThe following 5 barriers to effective protection of children and the strategies for addressing them (Table 1) were prioritized for implementation:1. Barrier: Hospitals have varying interpretations of how the Health Insurance Portability and Accountability Act (HIPAA) applies in child abuse cases, which limits hospital-based personnel's ability to discuss cases with CPS. CPS regulations and practices vary according to locality, often preventing them from providing even the most basic feedback to mandated reporters concerning the outcome of their reports.Strategy: Clarify and expand confidentiality regulations to improve communication and collaboration between C...

Mandated reporters’ experiences with reporting child maltreatment: a meta-synthesis of qualitative studies

“…Interpersonal support can include increased opportunity for communication and teamwork between interdisciplinary and multidisciplinary colleagues through, for example, interdisciplinary training 42 or multidisciplinary conferences. 74 Relatedly, community support can include increased communication and collaboration between reporting professionals; the need for increased feedback from CPS about reported cases is also important. 54–56 75 76 Poor communication or collaboration between CPS and MRs has long been cited as an area for much needed improvement.…”

“… 54–56 75 76 Poor communication or collaboration between CPS and MRs has long been cited as an area for much needed improvement. 74 77–80 How exactly to improve collaboration, however, is complex and under-researched. As Winkworth and White 81 argued in relation to Australian initiatives to increase collaboration between child protection, family relationship and family support service systems, “So ubiquitous is reference to collaboration in policy documents that it is in danger of being ignored altogether by service deliverers who are not clear about its rationale, how it is built, or its real value”.…”

Comparative needs in child abuse education and resources: perceptions from three medical specialties

“…A semi-structured interview guide was used to conduct the focus groups. Topics included on the interview guide were derived from the published literature and designed to allow full exploration of the major elements of child abuse training, evaluation, assessment tools, and intervention that may involve physicians (5, 6). In order to ensure that the interview guide was not too narrowly focused to allow important concepts to come forward, the interview guide also contained a broad question aimed at capturing any information that participants felt was important to share.…”

Workforce Development and Multiagency Collaborations: A Presentation of Two Case Studies in Child Welfare

“…Multiple challenges to cross-sector collaboration were identified by an expert multidisciplinary panel convened in 2008 [49]. This panel was initiated by healthcare providers calling for increased transparency in outcomes of referrals to child welfare agencies [5,50]. Panelists described a tension between the mandates for child welfare agency involvement when child maltreatment is suspected and the goal of continuity in the relationship between a primary healthcare provider and a child's family [51].…”