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Sequelae of reporting child abuse.

In the last 20 years each of the 50 states has developed and refined legislation that mandates professionals who have contact with or who are responsible for children to report suspected cases of child abuse or neglect. The language in these laws varies markedly, with different states defining their own criteria for intervention. All states have expanded their focus beyond physical abuse and neglect to include psychological and sexual abuse. In view of these differences, this article will examine the most common policies and practices. An important role for professionals has been to identify and report suspected cases of abuse. A requirement of medical screening is that early detection of the problem is beneficial to the patient; diagnosis alone does not justify a screening test. Therefore, it is important that we critically evaluate what happens to the more than I million children and their families who now are being reported to state child protection agencies each year. Before focusing on details of clinical management, it is helpful to identify important recent philosophical approaches. These are central to an appreciation of what underlies specific programs and policies.