Decision making processes used by teachers in cases of suspected child abuse.
Paper presented at the Australian Association for Research in Education (AARE) Annual Conference: 29 November - 3 December 1998, Adelaide
Ms. Faye McCallum and Dr. Bruce Johnson
School of Education
University of South Australia
Holbrooks Road Underdale. S.A. 5032
Introduction
Child abuse and neglect is a major social problem. Mandating professionals to report suspected cases of abuse has long been a central tertiary prevention strategy, yet under-reporting still exists (Johnson, 1995; Elliot, 1996). Little is known about the private and group decision making of professionals - in particular, teachers - as they consider cases of suspected child abuse or neglect. In South Australia, a range of professionals are obliged by law to report suspected child abuse and neglect. Winefield and Bradley (1992) found that teachers had a higher than average rate of substantiated reports (62% substantiation rate). Yet little is known of the decision making processes teachers use when they suspect abuse or neglect.
An assumption inherent in the mandatory notification law is that teachers and other professionals will have few difficulties knowing their obligations and fulfilling their legal responsibilities. However, there are many impediments which do not facilitate the reporting process and affects reporting behaviours. This paper will show how one group of mandated reporters, teachers, struggle when faced with making decisions about suspected child abuse and neglect. It will go on to highlight a mismatch between the training approaches used in mandatory notification for teachers and the demands of the decision making processes employed by teachers. Implications for teachers' practice will be outlined.
Under-reporting: Review of literature
The law in South Australia makes each individual mandated reporter responsible for reporting cases of suspected child abuse or neglect to Family and Youth Services (FAYS). However, many teachers feel the need to consult with colleagues or to report their suspicions to a higher authority rather than to follow the procedures they have been trained in, which are to report directly. This may reflect a lack of confidence in their judgement or this may be a result of poor training, or, a result of hierarchical expectations. Kalichman and Brosig (1992) also found that 96% of participants in their study, discussed their decision to report or not to report with a colleague.
This is one example of the dilemmas faced by teachers as they make decisions about suspected child abuse or neglect. There is numerous research, conducted with many professional groups, to support this further. Lumsden (1992) and Finkelhor and Zellman (1991) suggest that there is general agreement that the under-reporting of suspected child abuse and neglect is a problem among all mandated professionals, including teachers. Kalichman, Craig and Follingstad (1988) found that mental health professionals reported selectively and their decision depended on the level of certainty they had that abuse was occurring. In a later study, Kalichman and Craig (1991) provided an explanation for psychologists' lack of response to mandatory reporting laws due to ethical considerations related to client confidentiality. Thompson-Cooper, Fugere and Cormier (1993) also found that similar ethical dilemmas existed for other professionals.
The findings of Reiniger, Robison and McHugh (1995) questioned the training context and quality of child welfare professionals for their lack of reporting. They queried whether the failure to report was because of professionals' ignorance of the law and procedures, or their inability to recognise indicators of child abuse and neglect. A surprising finding was that teachers were no more knowledgeable about indicators of abuse than were other professionals despite the fact that they work with primary school age children. Hay (1988) also found that teachers rarely report child abuse, partly because they lack the knowledge about how to identify and report, but also because they are reluctant to get involved in legal proceedings if they arise. In the United States, Abrahams, Casey and Daro (1992) suggest that despite teachers' increasing awareness of child abuse, the education of teachers to confront the problem has not increased proportionately.
Professional experience seems to be a factor influencing reporting behaviour (Barksdale 1988; Nightingale and Walker 1986) although other studies using different methodologies appear to contradict these findings (Haas 1988; Pope and Baajt 1988). Race and social class may influence reporting behaviours (Newberger, 1983) as may the age of the victim (Kalichman and Craig 1991; Zellman 1992). Reporting tendency and reporting rate were not related to the gender of the victim (Dukes and Kean, 1989; Crenshaw, Crenshaw and Lichtenberg 1995). Type of abuse may also be influential with evidence that sexual abuse may be more likely to be reported than other forms of abuse (Nightingale and Walker, 1986). Levin (1983) and McIntyre (1990) found that physical abuse was most often detected, followed by physical neglect, emotional abuse, emotional neglect, followed by sexual abuse. Brosig and Kalichman (1992) refer to the studies of Green and Hansen (1989) who found that psychologists were less likely to report abuse if it was not severe, and Wilson and Gettinger's (1989) results indicate that past abuse was less likely to be reported than presently occurring abuse. Severe abuse is more likely to be reported by educators (Crenshaw, Crenshaw and Lichtenberg 1995), and trust in the child protection service, particularly in cases of emotional abuse and neglect was also a factor (Crenshaw, Crenshaw and Lichtenberg 1995).
Fear of making a mistake and causing problems for the family, particularly the child, may also discourage notification (Winefield and Castelle-McGregor 1986; Newberger 1983) as does the fear for notifiers personal safety. Pollack and Levy (1989) suggests that 'counter transference fear' may not only be composed of a realistic perception of the dangers of the situation, but that other psycho dynamic issues may also play their part. These may include such issues as concern about competence to report and fear of ridicule from colleagues should there be no substantiation. Other psycho dynamic factors may also be involved such as guilt, anger and sympathy, which may affect the decision making process.
Winefield (1987:1993) discusses many reasons why notification may not take place. It is particularly difficult for notifiers who work with small groups in rural areas, and who fear that their physical safety may be threatened. In addition, Bavolek (1983) showed that teachers suffered from a lack of knowledge and awareness. Crenshaw (1995) found that educators had very low rates of recognising and reporting child abuse. These rates varied with the type of abuse ranging from 78% of recognised physical abuse being reported to 22% of recognised emotional abuse (Crenshaw and Lichtenberg 1995).
Methodology
The literature provides clear and purposeful rationale for undertaking a study of teachers' decision making about suspected child abuse and consequently, a qualitative, interpretive study was conducted to provide insights into teachers' deliberations, thoughts, feelings, and past experiences related to suspected child abuse. The aim of the study was not to simply support or refute pre-stated hypotheses, but to contribute to an understanding of professionals' thinking and decision making about reporting abuse (Glaser & Strauss, 1967).
Purposive sampling (Lincoln and Guba 1985) was used to select 15 teachers to participate in the study. This involved making judgements about the selection of participants based on theoretical and practical considerations rather than on the criterion of randomness. This method facilitates the selection of a certain type of informant with knowledge relevant to the aims of the study. (Morse 1989). As the research is concerned with the decision making of teachers about suspected child abuse, participants needed to have had relevant experiences with children they suspected were being abused. Contact was made with schools in the north western suburbs of Adelaide because reports from teachers in these areas were relatively high in the period 1994-1996. Data was collected by audio taped structured interviews. Data analysis was assisted by the use of NUD*IST which allows the division of raw material into manageable chunks and the ultimate categorising and subcategorising of the data into themes that can be retrieved.
Findings
Overview
The research undertaken with teachers in South Australia found similar problems to those reported in the literature. In regards to training, there were problems identified that suggested a lack of sufficient training affected the confidence of teachers to report their suspicions. These were identified as procedural inadequacies. For example, some teachers didn't know how to report and also couldn't identify the indicators of abuse. These teachers felt that they didn't have the physiological knowledge to accurately identify abuse, so they tended to base their suspicions on behavioural indicators and what they knew of the family situation and/or child.
Teachers' work, like in many other professions seems to be intensifying. They are grappling with learning new skills and have new demands placed on them which adversely affects their ability to make a confident decision and to follow it through with a notification. One teacher summed this when she said
Generally, it's a time factor thing. To actually get to the phone confidentially and make the report....
Experienced notifiers are also discouraged because they feel that social services will not act on their report (Crenshaw et al 1995; Morris, Johnson and Clasen 1985; Saulsbury and Campbell 1985). This frustration with the system may impact significantly on reporting behaviour (Zellman 1990). Evidence in this study supports the views proposed by the above authors. For example, on occasions some teachers knew they didn't have sufficient evidence for the authorities to act so it was seen as a wasted phone call, they had reported before and to no avail, knew the department was over-worked and therefore would not prioritise their situation and there were doubts expressed about the workers to whom they reported. One participant stated:
It's the level of expertise at the other end (of the phone). There's been a couple of times when I've been appalled at the professionalism. I thought if I'd been a parent or community person all nervous ringing in, questioning and commenting at the other end. I'm not fearful of doing it. There's certainly a lot of teachers that get nervous and uptight....it's just that the system is so poor at times. That's when I feel angry I suppose nearly as much as I feel uncomfortable.
This evidence suggests that the decision making processes employed by teachers are complex and that further research about teachers' deliberations of whether to report or not is required. This is significant because teachers are in a position to play a vital role in collaborating with others to respond to the problem of child abuse and neglect because, as Watts (1997) writes, teachers are well situated to identify and report abuse and are well situated to observe behaviour changes and schools also may offer helpful curriculum programs.
Emergent theme one: "Subjectivity" and the problem of "Evidence"
From an analysis of teachers' interviews, it is evident that developing a "suspicion" of abuse is a highly subjective process. Thorson (1996) suggests that it is extremely difficult to generalise about the "reasonable grounds" that may lead teachers to suspect that a child is being abused. A vivid example of this was shown in the recent (1997) landmark case in Victoria which highlighted this difficulty when a charge against a school Principal was dismissed on the grounds that she had not formed the 'belief' that the child was being abused. Although a belief infers a higher degree of conviction than a suspicion, nevertheless the same difficulties exist. How much "evidence" is needed to form a suspicion? Bell and Tooman (1994) suggest that;
"Mandatory reporters must take their report on the basis of a 'reasonable suspicion' that a child is being abused - a vague, amorphous or inarticulate concern over a child's welfare is not a sufficient reason to report."
The subjective nature of the decision whether or not to report cannot be overlooked. A teacher brought up with affluence might have a different view of neglect than one brought up in a poorer home (Brocker in Alter, 1985). A teacher brought up with corporal punishment, believing that it did him/her, no harm, will have a different attitude to some parental methods of discipline than another raised without that type of punishment (Rosenfield and Newerger in Alter, 1985).
Insufficient evidence to make a decision is a problem which was raised in the literature and was commonly stated by teachers in this study. For many, this question is frequently asked: What is a reasonable suspicion and how much evidence is needed before a suspicion becomes reportable? If, for example, a child comes to school with a black eye and says that s/he walked into a door, a teacher might have a suspicion that s/he had been hit at home but in the absence of verbal confirmation or other behavioural indicators the decision to report is not clear. If it turns out that the child did walk into a door, the relationship of trust between the teacher and the family is severely damaged. Should one report what is almost certainly a 'one-off?'
Bavolek (1983) found that comments by over half of the school personnel he surveyed, indicated that they needed concrete evidence before they were willing to report even though the law stated clearly that they were to report on 'suspicion.' Reiniger, Robinson and McHugh (1995) found that teachers were no more knowledgeable about the indicators of abuse than other professionals. Additionally, teachers often felt they didn't have enough evidence for the child protective services to act and because they were busy they didn't see the point of phoning. The decision to identify abuse is made easier by a thorough knowledge of the definitions of abuse, the indicators of abuse, as well as an individual's alertness to the signs of possible abuse. (Watts 1997)
Emergent theme two: "Within-house" decision making
Another theme that emerged from teachers' accounts of their decision making related to power imbalances in school structures. Teachers in this study reported instances where quite specific workplace directives about reporting procedures were given by senior staff. In schools where set procedures for making notifications were implemented, the Principal was usually consulted before a final decision was made to report. In other situations, Principals told their staff that they would deal directly with the situation and that teachers then had no further dealings with the matter. In one case, the decision was taken out of the hands of the teacher:
The procedure to follow through with notifications in our school is 'not to follow through'.
In other situations a more consultative approach was adopted where school personnel believed that they could deal effectively with the situation at the school level. For example,
A discussion occurred with the principal and it was decided in the best needs of the child and family to approach the parents first and after that the principal said if we felt they weren't going to do anything about it then we were to report. That was his directive to me.
I consulted the principal, the reaction was to talk to the child first, not to report it. After I had talked to the child I went back to the principal, it was decided not to report it but to let the parents know and then to see if they were prepared to get support for both children.
Keeping discussions "in-house" was an option that was used in preference to reporting by quite a few teachers despite the quite clear mandatory reporting guidelines to the contrary.
Emergent theme three: Personal beliefs and fears
The teachers' personal beliefs about child abuse played a part in the decisions they made. For example, if teachers felt the situation was a 'one-off', like in the example below, then they wouldn't report.
There was a case with a 5 year old boy who came to school with a carpet burn across his face and I asked "what happened to you?" and he said "we were playing and Dad pushed me down" so I left it at that.
The basis for such decisions was that it was pointless involving others when the situation was a single mistake. Teachers also expressed feelings of fear which influenced their decision making. The fear of being identified which may affect their personal safety affected their decisions. One example is,
I'm not scared of reporting but I know some teachers are because they think it will come back at them somehow......
Teachers' reasons for these feelings ranged from situations which were based on previous experience where there had been repercussions following a report, but it was also an issue in particular settings where the likelihood of identification was high. Some teachers also feared that they would worsen the situation, be accused of interfering or that their decision may be wrong.
Teachers in this study also reported that they made decisions to report suspected child abuse based on moral not legal grounds. For example,
It is my role legally, but, morally I am a person so morally I should go and try and do something about it to prevent this from happening again.
Other thoughts went through my mind on this one. We (the school) knew that this family was at risk because ............. but we had nothing previously that we had been able to report on. So, the thoughts that went through my mind were I am doing the right thing for the child, it just wasn't OK, it wasn't acceptable.
In a survey conducted by McIntyre (1990), 96% of teachers said that they felt morally (as opposed to legally) obligated to report child abuse. The above examples provide evidence that has implications for teacher training and the ongoing professional development of teachers.
Implications
Training issues
The issues raised about under-reporting and the dilemmas associated with making decisions have implications for the approaches currently used to train mandated reporters to fulfil their role. There appears to be a mismatch between these approaches which are largely rational and information based sessions, and the realities of life in schools faced by teachers. Teachers often face serious dilemmas over reporting issues, that their training largely ignores. When teachers were asked about incidents where they had not reported there were often comments made like
.....it was the lack of training. I didn't have enough to create a suspicion.
Decisions over reporting are very subjective, are made intuitively based on little physiological knowledge and at a time when teachers are emotion charged and often stressed from heavy workloads.
Conroy (Age, 1997) described the mandatory notification training currently received by teachers as hopelessly inadequate, with teachers receiving only two hours preparation (in Victoria). Yet teachers face fines of up to $1000 for failing to report abuse. She went on to say that there was a need to review the provisions of mandatory reporting. In South Australia, the training strategy used to train professionals has been the 'train the trainer' model conducted by FAYS (formerly FACS). In 1991 this became mandatory for teachers. The course takes the form of a one day workshop during which the attitudes of participants to child abuse are explored. This includes dealing with attitudes such as discounting and helping participants to recognise signs of child abuse. The legal requirements and methods of reporting are explained but the evidence presented in this paper suggests that teachers under-report their suspicions of abuse, bringing into question the efficacy of the training they receive.
It has been stated before that there is difficulty for teachers with the definitions of child abuse which appears to create confusion for teachers where they don't act on the information that they have. Clearly, the training for teachers needs to address this more fully and to also consider the problems of implementing the information in practice. For example, What does 'sufficient evidence' equate to and what really is 'reasonable grounds'? Psychological factors may also be involved such as guilt, anger and sympathy, which may affect the decision making process. Clearly, if this is so, education and training must address these factors and ensure that teachers are given insight and understanding into these processes.
Inferences concerning reporting practices of teachers may also be drawn from studies into other mandated reporter behaviour, as the reasons for deciding not to report can in some cases be generalised. In general, clinicians trained in the detection of child abuse and neglect will be more likely to report (Nightingale and Walker 1986). The literature presents a rather ambiguous picture concerning the effects of training. Brosig and Kalichman (1992) suggest that the clinical psychologists in their study would have benefited from training. However, the Finlayson and Koocher (1991) study into the reporting practices of paediatric psychologists found that specialised training and experience in sexual abuse did not influence the participants' beliefs about whether or not they would report child abuse. And Benner (1995) stresses that it is important to ensure that the practitioner is not expected to make decisions for that which they have not been prepared or which are beyond the stage at which they are currently able to perform.
Demanding nature of decision-making process
It is has been shown that decision-making about suspected child abuse is highly complex. Teachers are well placed to perform the role required of a mandated reporter and many are adequately fulfilling this role because teachers are within the top three professional groups who report most cases of child abuse and neglect. However, it appears that the process could be improved if the demands placed on teachers are better understood.
Such demands involve personal and professional conflicts and dilemmas. The intensity of the personal feelings associated with child abuse are not to be under-estimated. Some psychologists may say that the decision to report is influenced by the concept of 'counter transference' or the
"totality of the emotional reactions, both unconscious and conscious, of the reporter to the child, family, and abuse situations. This includes the unconscious and preconscious impact of the mandated reporters needs, conflicts and life experiences on his/her perceptions, understanding and reactions." (Pollack, 1989)
Watts (1998) suggests that teachers may discount abuse because confronting abuse can provoke negative and upsetting feelings. In such instances, mandated notifiers often ask for help and advice from family and friends but when complicated professional decisions are expected there are times when they may feel isolated and overwhelmed by the responsibility that rests on them. Child protection decision making is difficult for teachers and other professionals, since the decisions which have to be made usually emanate from dilemmas. Child protection situations are rarely clear-cut, and decisions deriving from those situations are rarely clear-cut. (Watts 1997)
The very nature of teachers' work means that teachers and children (and often the families as well) spend a considerable amount of time together and strong relationships can develop. Teachers can also be privy to domestic situations of the children when they engage in home visits or maintain regular daily contact with caregivers. As a result, some teachers will create a strong sense of advocacy towards children and their families. The following example was given by a teacher in this study who said,
....it was the ongoing relationship between the mother and myself. I didn't report as she needed support. I thought about the ongoing thing, you know we've got a really good thing going already with supporting her and working with me.
Kalichman, Craig and Follingstad (1989) claim that there is sometimes fear shown by the mandated reporter because of potential interference with the relationship hence reporting is discouraged. The role of the teacher in preventative and educative strategies should be more highly valued.
Summary and conclusion
The teachers who were interviewed as part of this research were mainly mature, experienced teachers. Yet many of these teachers
• felt personally vulnerable;
• lacked confidence, both procedurally and in their skill level;
• tended to consult others before making a final decision when their training contradicts this;
• felt the repercussions of reporting in their work situation;
• lacked faith in the welfare system;
• felt over-worked;
• often conducted enquires in the search for more information when their training contradicts this;
• dealt with some crisis situations instead of reporting;
• felt a need for more training on detection of child abuse;
• expressed a desire to work more with inter-agencies in an endeavour to support families in crisis;
• expressed issues about safety and access to professional support services;
• wanted to establish closer links with other mandated professionals;
• wanted the child protective services to provide feedback to notifiers.
The nature and scope of teachers' concerns about fulfilling their role as mandated notifiers brings into question the adequacy of current procedures. Mandatory reporting of child abuse may need to be reviewed, to ensure it is effective and working as envisaged. It might also be time to review what the community expects of its schools. (Lord, The Age, 1997:17)
References
ABRAHAMS, N; CASEY, K & DARO, D. (1992) Teachers' knowledge, attitudes, and beliefs about child abuse and its prevention. CHILD ABUSE & NEGLECT. V.16. pgs. 229-238.
ALTER, C.F. (1985) Decision-making factors in cases of child neglect. CHILD WELFARE. V. 65. N.2 pgs. 99-111.
BARKSDALE, C (1988) Child abuse reporting: A clinical dilemma? CHILD ABUSE REPORTING. pgs. 170-182
BAVOLEK, S.J. (1983) Why aren't school personnel reporting child abuse in Wisconsin? TEASE. V. 6. N. 1.
BENNER (1995) RCN Nursing Update. NURSING STANDARD. November 15. Vol. 10. No.8.
BROSIG, C.L. & KALICHMAN S.C. (1992) Clinicians' reporting of child abuse. A review of the empirical literature. CLINICAL PSYCHOLOGY REVIEW. V.12. pgs. 155-168.
CONROY, P. (1997) Warning to teachers on child abuse. THE AGE. 13.12.97
CRENSHAW, W.B; CRENSHAW, L.M. & LICHTENBERG, J. W. (1995) When educators confront child abuse: an analysis of the decision to report. CHILD ABUSE AND NEGLECT. V. 19. N. 9. pgs. 1095 - 1113.
DUKES, R.L. & KEAN, R.B. (1989) An experimental study of gender and situation in the perception and reportage of child abuse. CHILD ABUSE AND NEGLECT. V. 13.pgs. 351 - 360.
ELLIOT, I (1996) CHILD PROTECTION AND SCHOOLS: AN EXAMINATION OF THE REPORTING BEHAVIOUR OF TEACHERS. Paper presented at the 11th. International Congress on Child Abuse and Neglect, Dublin, Ireland.
FINKELHOR, D. & ZELLMAN, G.L. (1991) Flexible reporting options for skilled child abuse professionals. CHILD ABUSE & NEGLECT. V. 15 pgs. 335-341
FINLAYSON, L.M. & KOOCHER, G.P. (1991) Professional judgement and child abuse reporting in sexual abuse cases. PROFESSIONAL PSYCHOLOGY: RESEARCH AND PRACTICE. V. 22. N. 6. pgs. 464 - 472.
GLASER, B., & STRAUSS, A.(1967) THE DISCOVERY OF GROUNDED THEORY. New York: Aldine.
HAAS, L.J. (1988) Personal and Professional Characteristics as factors in psychologicts' ethical decision making. PROFESSIONAL PSYCHOLOGY: RESEARCH AND PRACTICE. V. 19. pgs. 35-42
HAY, J (1988) Teachers & Child Abuse prevention. SET RESEARCH INFORMATION FOR TEACHERS No. 1, item 13. pgs. 1-4
JOHNSON, B (1995) Teaching and learning about personal safety. PAINTERS PRINTS: Adelaide Australia.
KALICHMAN, S. C; CRAIG, M.E. & FOLLINGSTAD (1988) Mental Health professionals & suspected cases of Child Abuse: An investigation of factors influencing reporting. COMMUNITY MENTAL HEALTH JOURNAL. V.24. N.1 SPRING
KALICHMAN, S. C. & CRAIG, M.E. (1991) Professional psychologists' decisions to report suspected child abuse: Clinican and situation influences. PROFESSIONAL PSYCHOLOGY. V.22. N. 1. pgs. 84-89
LEVIN, P.G. (1983) Teachers' perceptions, attitudes and reporting of child abuse and neglect. CHILD WELFARE. V. 62. N.1. pgs. 14-20
LINCOLN, Y. & GUBA, E. (1985) NATURALISTIC INQUIRY. Beverly Hills: Sage
LORD, P (1997) Too much to do for teachers on the front line. THE AGE. 10.12.97. pg. A17
LUMSDEN, L.S. (1992) STEMMING THE TIDE OF CHILD SEXUAL ABUSE. THE ROLE SCHOOLS CAN PLAY. Oregon School Study Council Bulletin. V. 35, N. 5.
McINTYRE, T. (1990) The teacher's role in cases of suspected Child Abuse EDUCATION & URBAN SOCIETY. V. 22. N. 3 MAY pgs. 300-306
MORRIS, J.L; JOHNSON, C.F & CLASEN, M. (1985) To report or not to report. AJDC. V. 139.
MORSE, J. (1989) Strategies for sampling. In J. Morse (Ed.) QUALITATIVE NURSING RESEARCH: A CONTEMPORARY DIALOGUE. Maryland: Aspen Publishers.
NEWBERGER, E.H.(1983) The helping hand strikes again: unintended consequences of child abuse reporting. JOURNAL OF CLINICAL CHILD PSYCHOLOGY. V. 12 pgs. 307-311
NIGHTINDALE, N.N. & WALKER, E.F. (1986) Identification and reporting of child maltreatment by head start personnel: attitudes and experiences. CHILD ABUSE AND NEGLECT. V. 10 pgs. 191 - 199
POLLAK, J & LEVY, S. (1989) Countertransference and failure to report child abuse and neglect. CHILD ABUSE & NEGLECT, V. 13. pgs. 515-522.
POPE, K.S. & BAAJT, T. (1988) When laws and values conflict: A dilemma for psychologists. AMERICAN PSYCHOLOGIST. V. 43. pgs. 828-829
REINIGER, A; ROBISON & McHUGH (1995) Mandated training of professionals: a means for improving reporting of suspected Child Abuse. CHILD ABUSE & NEGLECT, V. 19. N. 1 pgs. 63-69
SAULSBURY, F.T. & CAMPBELL, R.E. (1985) Evaluation of child abuse reporting by physicians. AJDC. V. 139. pgs. 393 - 395
THOMPSON-COOPER, I; FUGERE & CORMIER (1993) The child abuse reporting laws: an ethical dilemma for professionals. CANADA JOURNAL OF PSYCHIATRY. V. 38. pgs. 557-562
WATTS, V. (1997) Responding to child abuse. A handbook for teachers. CENTRAL QUEENSLAND UNIVERSITY PRESS, Queensland.
WINEFIELD, H. & BRADLEY, P.W. (1992) Substantiation of reported Child Abuse or neglect: predictors and implications. CHILD ABUSE & NEGLECT.V. 16.pgs. 661-671.
WINEFIELD, H. & CASTELL-McGREGOR, S. N. (1986) Experiences & views of general practitioners concerning sexually-abused chn. MEDICAL JOURNAL. OF AUSTRALIA. V. 145.
WINEFIELD, H. & CASTELL-McGREGOR, S. N. (1987) Child sexual abuse cases: facilitating their detection and reporting by general practitioners. AUSTRALIAN JOURNAL OF SOCIAL ISSUES. V.22. N. 3.
WINEFIELD, H. , HARVEY, E.J. & BRADLEY, P.W. (1993) The impact on families of reported child abuse or neglect. AUSTRALIAN JOURNAL OF SOCIAL ISSUES. V. 28. N. 3.
ZELLMAN, G.L. (1990) Report decision-making patterns among mandated child abuse reporters. CHILD ABUSE & NEGLECT. V. 14. pgs. 325-336.
ZELLMAN, G.L. (1992) The impact of case characteristics on child abuse reporting decisions. CHILD ABUSE & NEGLECT. V.16. pgs. 57-74