Characteristics of pediatric injury reports to CPS by healthcare professionals

Mandated reporting laws to child protective services (CPS) exist in all states and US territories. Concerns exist for the lack of confidence and education for general healthcare professionals when making reports to CPS.

We aimed to describe both the common injury characteristics and reasons for reports of suspected maltreatment to CPS by healthcare professionals.

We reviewed narrative intake reports of young children (≤3 y) with poorly explained/unexplained injuries from a single state database from July 1, 2023, through December 31, 2023. Child characteristics and reporter characteristics were identified. Reports were coded for understanding maltreatment concerns, reason for report and possible distractors in reports.

A total of 213 reports met criteria for inclusion. More than half of the reports were made for children younger than 12 months of age (62 %). The most common injury reported was a fracture (50 %) followed by bruise (33 %). Most reports were missing a specific maltreatment type of concern (70 %) and 4 % specifically stated no maltreatment concerns. When listed, the most common reason for healthcare professionals reporting was an unexplained/vague explanation for the injury (23 %). Distractors were noted and included 19 % of reports commenting on positive interactions of the family as well as 13 % stating the child was able to be discharged.

Narrative accounts of healthcare professional reports to CPS for young children with injuries lacked a clear understanding of the maltreatment concern. This can leave CPS with uncertainty in how to plan for safety of a child at initiation of an investigation. Improved collaboration between child welfare and healthcare professionals should include how to report and what to report at intake. This can ensure a clear understanding of the concerns for CPS and ultimately improve safety outcomes for children and families.