As allied health providers, and if we work with pediatrics, we often hear that we’re mandated reporters, but that is the extent of our training. We never really hear when reporting is appropriate, what a family experiences once a report is made, or why culturally and linguistically diverse families are overrepresented in the system.

Reporting Is a Judgment Call, Not Just a Legal One

The legal standard for reporting in most jurisdictions is reasonable suspicion, not certainty. In practice, that standard gets applied inconsistently. Clinicians do not share a common threshold for what counts as suspicious enough to report. In one vignette study, no single case was reported by every participating clinician, and even a case highly suggestive of abuse was reported by only 58% of participants (Kuruppu et al., 2020).

The clinician’s relationship shapes that variability, their trust in the child welfare system, and how much training they've had around reporting (Kuruppu et al., 2020). Two clinicians can look at the same situation and come to very different conclusions, and both may believe they're following the law correctly.

What Happens After a Report Is Filed

A report doesn't end when you make the call. It starts a process, and most of us were never taught what that process looks like.

Only about 60% of reports nationally are accepted for investigation, and of those, roughly 29% are substantiated (Hussey et al., 2005). That leaves most reports ending in "unsubstantiated". Unsubstantiated does not mean nothing happened or it was a false alarm; it just means that there wasn’t sufficient evidence to move forward.

Additionally, children with unsubstantiated reports show similar rates of behavioral, emotional, and developmental difficulty as children with substantiated ones (Hussey et al., 2005; Holbrook, 2019). This means that even though their case may not have been substantiated, they still need supports that they are not receiving.

Lastly, reporters don’t receive feedback on what happened after their report.

Where Poverty and Neglect Get Confused

One of the more consequential blind spots in reporting decisions is distinguishing a family without enough resources from a family causing harm. Poverty does not equal neglect.

Structural conditions like poverty, housing instability, and lack of access to services, shape which families come into contact with the child welfare system in the first place (Kim et al., 2026). The research on why CLD families are overrepresented in the child welfare system point to differential exposure to socioeconomic risk factors (Kim et al., 2026), while others find that county-level and decision-point factors contribute independently to disparities in substantiation and placement (Maguire-Jack et al., 2020; LaBrenz et al., 2022). Both explanations can be true in different places, for different families, at different points in the system, which is exactly why a single clinician's reporting decision doesn't happen in a vacuum. It happens inside a much larger set of case, agency, and community factors, all interacting at once (Allan et al., 2025).

Before finalizing a report, here are a few things to consider:

• Would this concern exist if the family had more money, time, or access to support?

• Have I ruled out a language barrier or a cultural difference in caregiving before calling this neglect?

• Am I hesitating to report because the threshold isn't met, or because I know this family and don't want to disrupt the relationship?

A Framework for the Decision Itself

A reporting decision doesn't have to be either purely instinctive or purely mechanical. A middle ground could look something like this:

1. Observe: What did I actually see or hear? Stick to facts, not interpretation.

2. Contextualize: Does this reflect a resource gap or cultural difference, or does it reflect genuine risk to the child?

3. Consult: Where possible, talk it through with a supervisor or team member rather than deciding alone.

4. Report or document: If the threshold is met, report. If it isn't, document your reasoning and keep monitoring.

None of this removes the weight of the decision. It just gives you considerations before you make the call.

Next Steps

• View the Mandatory Reporting and the Families We Serve presentation. If you don’t already have one, you’ll need to create a free account in your CLD Open Access group. 

• If you're not ready to register yet, bookmark this post and use it as your starting point.

References

Allan, H., Hollinshead, D., Rockwell, K., Ender, K., Antwi-Boasiako, K., O'Leary, D., Middel, F., & Fluke, J. (2025). Illuminating the complexity of decision making in child welfare using the decision-making ecology: A scoping review. Children and Youth Services Review, 169, Article 108121. https://doi.org/10.1016/j.childyouth.2024.108121

Holbrook, H. M. (2019). Referral patterns and service provision in Child Protective Services: Child, caregiver, and case predictors [Doctoral dissertation, University of Vermont]. UVM ScholarWorks. https://hdl.handle.net/20.500.14849/4899

Hussey, J. M., Marshall, J. M., English, D. J., Knight, E. D., Lau, A. S., Dubowitz, H., & Kotch, J. B. (2005). Defining maltreatment according to substantiation: Distinction without a difference? Child Abuse & Neglect, 29(5), 479–492. https://doi.org/10.1016/j.chiabu.2003.12.005

Kim, H., Kim, Y. Y., & Schneider, W. (2026). Understanding Black-White disparities in Illinois child welfare: A socioeconomic explanation. Child Maltreatment. Advance online publication. https://doi.org/10.1177/10775595261428148

Kuruppu, J., McKibbin, G., Humphreys, C., & Hegarty, K. (2020). Tipping the scales: Factors influencing the decision to report child maltreatment in primary care. Trauma, Violence, & Abuse, 21(3), 427–438. https://doi.org/10.1177/1524838018781102

LaBrenz, C., Kim, Y., Baiden, P., Shipe, S. L., Littleton, T., Choi, M., Bai, R., & Stargel, L. (2022). State child maltreatment policies and disparities in substantiation: A study of state-administered child welfare systems in the U.S. Child Maltreatment, 28(4), 700–712. https://doi.org/10.1177/10775595221143136

Maguire-Jack, K., Font, S. A., & Dillard, R. (2020). Child protective services decision-making: The role of children's race and county factors. American Journal of Orthopsychiatry, 90(1), 48–62. https://doi.org/10.1037/ort0000388