No follow-up after positive newborn screening: medical neglect?

The current study examined medical professionals' behaviors related to reporting medical neglect when a family is noncompliant with follow-up services after a positive newborn screening result. Pediatric medical professionals within an urban medical campus were provided with five case vignettes in relation to different diseases. Medical professionals rated the severity of family noncompliance with follow-up services and indicated whether they would report suspected medical neglect to Child Protective Services (CPS). Physicians were more likely to report medical neglect than the other mandated reporters in the study. Logistic regression analyses found that medical professionals' perceptions of the severity of family noncompliance with services were significantly predictive of decisions to report medical neglect. Respondent gender and the method by which families were notified of screening results also significantly affected reporting behaviors in certain instances. Although all vignettes included information that met legal statutes for reporting neglect, medical professionals indicated that they would only report neglect 40-61% of the time across vignettes. Continued investigation of the rationale behind medical professionals' decision-making process and training protocols designed to improve mandated reporter knowledge and reporting behaviors are needed to further reduce bias and improve objectivity when considering ethical and professional obligations to report medical neglect.

Multidisciplinary assessment of child maltreatment: A multi-site pilot descriptive analysis of the Florida Child Protection Team model.

The Florida Child Protection Team (CPT) program is a statewide assessment model that was developed to provide objective multidisciplinary evaluations of complex cases of alleged child maltreatment. However, only limited research has examined the content and quality of CPT assessment practices. In fact, the limited research on the quality and content of child protection assessments in relation to child protection assessment "best practices" is a system wide problem. In the current study, we sought to systematically evaluate the assessment practices of a pilot sample of CPTs. Specifically, we were interested in gaining a better understanding of the population served by CPTs, the types of evaluations offered, the content of the assessments, clinical interpretations and findings, and recommendations. The results show areas in which CPT functions as an effective multidisciplinary assessment team and relative weaknesses in assessment practices that may require changes in CPT policy and/or additional training.