Child Abuse Identification and Reporting: The Pennsylvania Requirement _____________________________
By middle to late childhood, the consequences are more nota- ble. Studies have shown significant intellectual and linguistic deficits in physically abused children [3]. Other environmental conditions, such as poverty, may also compound this effect. In addition, a number of affective and behavioral problems have been reported among child abuse victims, including anxiety, depression, low self-esteem, excessive aggressive behaviors, conduct disorders, delinquency, hyperactivity, and social detachment [3]. Surprisingly, there has been little research on the effects of childhood bodily injury on adolescents [3]. However, differ- ences have been noted in parents who abuse their children during adolescence rather than preadolescence. It appears that lower socioeconomic status plays a lesser role in adoles- cent abuse as compared with abuse during preadolescence [21]. In addition, parents who abuse their children during adolescence are less likely to have been abused as children themselves compared with those parents who abused their children during preadolescence [21]. It is believed that the psychosocial effects of bodily injury manifest similarly in late childhood and adolescence. Research findings regarding the effects of childhood abuse on adult survivors indicate an increased risk for major psychiatric disorders, including depression, post-traumatic stress disorder, and substance abuse [36]. Some adult survivors function well socially and in terms of mental and physical health, even developing increased resilience as a result of their experiences, while others exhibit depression, anxiety, post-traumatic stress, substance abuse, criminal behavior, violent behavior, and poor interpersonal relationships [3; 17; 43]. A meta-analysis found that adult survivors of child abuse were more likely to experience depression than non-abused counterparts, with the rates varying according to the type of abuse sustained (1.5-fold increase for physical child abuse, 2.11-fold increase for neglect, and 3-fold increase for serious mental injury) [24]. Similar results were found in a longitudinal study that com- pared a child welfare cohort to a group with no child welfare involvement. The child welfare group was twice as likely to experience moderate-to-severe depression and generalized anxiety compared with the control group [25]. There is some evidence that vulnerability to long-term effects of maltreatment in childhood may be at least partially genetically mediated [18]. Although not all adult survivors of sexual abuse experience long-term psychological consequences, it is estimated that 20% to 50% of all adult survivors have identifiable adverse mental health outcomes [23]. Possible psychological outcomes include [10]: • Affective symptoms: Numbing, post-traumatic stress dis- order, anxiety, depression, obsessions and compulsions, somatization • Interpersonal problems: Difficulties trusting others, social isolation, feelings of inadequacy, sexual difficul- ties (e.g., difficulties experiencing arousal and orgasm), avoidance of sex
• Distorted self-perceptions: Poor self-esteem, self-loath- ing, self-criticism, guilt, shame • Behavioral problems: Risk of suicide, substance abuse, self-mutilation, violence • Increased risk-taking behaviors: Abuse of substances, cigarette smoking, sexual risk-taking Adult male survivors of child sexual abuse are three times as likely to perpetrate domestic violence as non-victims. In addi- tion, female survivors of child sexual abuse are more vulnerable to bulimia, being a victim of domestic violence, and alcohol use disorder [28]. In more recent years, research has focused on the impact of adverse childhood experiences (ACEs) in general. ACEs are defined as potentially traumatic experiences that affect an individual during childhood (before 18 years of age) and increase the risk for future health and mental health problems (including increased engagement in risky behaviors) as adults [42]. Abuse and neglect during childhood are clear ACEs, but other examples include witnessing family or community violence; experiencing a family member attempting or complet- ing suicide; parental divorce; parental or guardian substance abuse; and parental incarceration [42]. Adults who experienced ACEs are at increased risk for chronic illness, impaired health, violence, arrest, and substance use disorder [15; 28]. REPORTING SUSPECTED CHILD ABUSE Pennsylvania has a delineated process in place to facilitate the reporting of suspected child abuse. In addition, in 2014, Gov- ernor Corbett signed four new bills intended to streamline and clarify the child abuse reporting process in Pennsylvania. These bills were spurred by the Sandusky child sexual abuse case. In addition to the reporting guidelines and criteria outlined in the following section, it is also important to refer to your employer’s internal policies related to reporting suspected child abuse. ESTABLISHMENT OF STATEWIDE TOLL-FREE TELEPHONE NUMBER (23 PA.C.S. § 6332) The statewide toll-free telephone number is available for all persons, whether mandated by law or not, to use to report cases of suspected child abuse or children allegedly in need of GPS. PERSONS ENCOURAGED TO REPORT SUSPECTED CHILD ABUSE (23 PA.C.S. § 6312) There are two general categories of child abuse reporters: man- dated reporters and persons encouraged to report suspected child abuse. Persons encouraged to report suspected child abuse are individuals who report an incident of suspected child abuse. These persons are not required to act or intervene in cases of suspected abuse. Put plainly, persons encouraged to report suspected child abuse can report abuse while mandated reporters must report. However, it is important to note that
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