An Evidence-Supported Approach to Reporting Child Maltreatment
Child maltreatment reporting training: workshop format and overview of content of training curriculum
Training Workshop Curriculum to Assist in Reporting Child Maltreatment: An Exemplary Model
The remaining part of this chapter depicts the training program for child maltreatment reporting that was validated by Alvarez et al. (2010) and briefly reviewed above. This section is written much like a treatment manual and includes factors to assist in determining appropriate participants, trainers, necessary materials or methods of obtaining necessary materials (i.e., PowerPoint presentation of training curriculum, evaluation materials, videotapes of curriculum implementation), protocol required to implement assessment and training, and background support. It is our intention that this information be utilized as a general guide in reporting child maltreatment to appropriate authorities, with the assumption that some of its protocols may need to be altered to accommodate the broad international audience for which this book is targeted.
Workshop participants are typically professionals who are mandated by law, or by industry policy, to report child maltreatment (e.g., mental health providers, teachers, physicians). Their educational degrees and experience in the identification and reporting of child maltreatment may vary considerably. The ideal number of workshop participants is about 13 people per trainer. This number of participants permits sufficient oversight of role-play interactions, which is a critical training component.
Training instructors should be professionals who are mandated by law to report child maltreatment (e.g., teachers, mental health providers, physicians), familiar with local/provisional and federal laws relevant to the reporting of child maltreatment, and formally trained in the curriculum. Whenever possible, it is helpful to include trainers who espouse a multidisciplinary perspective and to have co-trainers from diverse backgrounds.
PowerPoint presentation of training curriculum
Used by instructors to review training program.
Authors may be contacted to obtain this presentation.
Protocol checklist: Initiating Child Abuse Report with Caregiver(s)
Behavioral instructions in reporting child maltreatment with participating caregiver.
Used by instructors to teach reporting skills and to assess participants in these skills.
See Appendix A.
Protocol checklist: Resolving Upset of Caregiver(s) in Reporting Process
Behavioral instructions involved in resolving upset during reporting process.
Used by instructors to teach these skills and to assess participants in these skills.
See Appendix B.
Knowledge of Child Maltreatment Reporting Laws Test
Multiple choice test.
Used to assess participants’ knowledge in reporting child maltreatment.
See Appendix C.
Recognition of Child Maltreatment Test
Vignettes with Likert-type response sets.
Used to assess participants’ ability to identify scenarios that warrant a report.
See Appendix D.
Clinical Expertise in Reporting Child Maltreatment Test
Multiple choice test.
Used to assess participants’ clinical expertise in reporting child maltreatment.
See Appendix E.
Videotape Modeling of the Initiation of a Child Abuse Report with a Caregiver
Videotape demonstrating behavioral steps involved in reporting child maltreatment.
Used by trainers to demonstrate the relevant skill sets.
Authors may be contacted to obtain this videotape.
Videotape Modeling Specific to Resolving Upset of Caregiver in Reporting Process
Videotape demonstrating behavioral steps involved in resolving upset during reporting.
Used by trainers to demonstrate the relevant skill sets.
Authors may be contacted to obtain this videotape.
Workshop Format and Overview of Content of Training Curriculum
The workshop is implemented in a 2-h meeting, and its training components are summarized in Fig. 17.1. The workshop begins with a formal introduction of trainers, training agenda, and dissemination of study results and jurisdictional laws and/or policies that are conceptualized to enhance motivation of participants in the mandated reporting of child maltreatment. Instructors describe evidence-supported steps involved in reporting child maltreatment, including rationales for doing so. Two videotapes are subsequently shown to exemplify the implementation of the steps with a caregiver of a suspected victim of child maltreatment, including appropriate responses to an upset caregiver. Participants are instructed to practice the modeled skill sets, while instructors provide assistance. The workshop concludes with a discussion about child maltreatment reporting. When evaluation of participants is important, the participants may be tested before and after the workshop utilizing protocols in Appendices A and B (percentage of steps/instructions listed in the protocols that are satisfactorily demonstrated in role-play vignettes with a confederate caregiver) or multiple tests in Appendices C, D, and E.
Pre- and Postworkshop Assessment
When it is necessary to evaluate workshop performance (i.e., knowledge and skill sets specific to understanding and reporting child maltreatment), we have developed three assessment measures with good clinical utility, face validity, reliability, intervention sensitivity, and discriminative validity (Alvarez et al. 2010).
The first scale, i.e., Knowledge of Child Maltreatment Reporting Laws Test, is a 15-item multiple choice test with a four-item response set (see Appendix C). The first seven items of this scale are specific to federal law, whereas the last eight items are specific to Nevada and may need to be revised when assessing other jurisdictions.
The second measure (i.e., Recognition of Child Maltreatment Test; Appendix D) consists of four scenarios that depict child maltreatment and four scenarios that do not depict child maltreatment. Participants read each vignette and subsequently rate how likely they suspect child maltreatment and their likelihood of reporting the scenario. Responses are based on a seven-point scale from highly unlikely to highly likely, with higher scores indicating greater likelihood of suspecting and reporting child maltreatment. Better recognition of child maltreatment is indicated when scenarios that depict child maltreatment are scored high and scenarios that do not depict child maltreatment are scored low.
The third measure (i.e., Clinical Expertise in Reporting Child Maltreatment Test; Appendix E) is a 15-item multiple choice examination with a four-item response set. Items query participants about the various types of child maltreatment, child maltreatment reporting procedures, and the influence of the caregiver when reporting child maltreatment.
There is one correct answer for each item. All items and their respective response sets in each of the three measures were reliably assessed to be accurate as per professionals employed by a local child protective service agency. Answer keys are included at the end of each test. Each test requires about 5 min for completion, and these tests may be administered in group format. Therefore, they are feasible to administer.
The two protocol checklists (i.e., Initiating the Child Abuse Report with the Caregiver, Resolving Upset of Caregivers in the Reporting Process) may be utilized to assess skill sets of participants that are specific to reporting child maltreatment and managing upset in response to the reporting process. These scenarios involve a confederate (usually an instructor) portraying the role of a caregiver of a child who is suspected of child maltreatment. The participant is instructed to initiate a report of child maltreatment with the confederate (caregiver) either not utilizing the protocol checklists or utilizing the checklists to assist in guiding the report. At first the confederate is compliant (to assess skills that are specific to initiating the report) and later becomes upset (to assess skills that are specific to managing upset). Each instruction listed in each of the protocol checklists in Appendices A and B is assessed as being satisfactorily completed or not. A percentage score (# of completed items divided by total items possible multiplied by 100) may be quickly derived for each protocol (initiating the report in Appendix A, responding to upset in Appendix B) separately after the role-play interaction. Completion of 70 % of the protocol steps or more in each of the protocols is an indication of satisfactory completion for each skill set. Each role-play assessment requires approximately 5 min to administer and needs a confederate and examiner. Therefore, this measure offers the benefits of observational assessment, but may be limited to individual or research settings because this assessment strategy requires a trained confederate to portray the role of a caregiver and an independent rater to score the role-play interaction.
Implementing the Workshop
The workshop begins with the trainer providing a personal introduction and posing the following three questions in a slide show.
These questions provide an outlet for participants to indicate both good and bad experiences with the reporting process and provide an opportunity for the instructor to empathize with participant responses prior to the presentation of training material. Participants are typically quick to engage when these questions are presented, appearing more receptive to subsequent workshop information. This is important as some participants may be compelled to attend the workshop by their employers and may lack intrinsic motivation to receive training.
How many of you have previously reported child maltreatment?
What problems, if any, have you experienced in reporting child maltreatment?
What concerns do you have with the child abuse reporting process?
Agenda for Training Workshop
The training agenda includes a summary of the 2-h workshop format and topics to be discussed (see Fig. 17.1). It is reported that a PowerPoint presentation will be utilized to review definitions of the various types of child maltreatment and legal requirements specific to reporting suspected child maltreatment in their respective state or province (including a timetable of when reports must be made, report content, and what occurs within CPS after a report is made). The agenda indicates that participants will have opportunities to practice and discuss child maltreatment reporting skill sets with their peers after viewing videotapes of a professional initiating a child maltreatment report with a caregiver who later becomes upset about the report.
Relevant Background Information Specific to Reporting Child Maltreatment
After the agenda is reviewed, instructors engage workshop participants about the impact of inaccurate reporting of child maltreatment, the intent of which is to establish their motivation for training in accurate reporting of suspected child maltreatment. Two slides are presented to address professionals’ failure to report suspected child maltreatment accurately. It is indicated that approximately 40 % of mandated reporters fail to report suspected child maltreatment at some point in their careers and that 6 % consistently fail to report (Besharov 1994; Camblin and Prout 1983; Kenny and McEachern 2002; Zellman 1990a, b). Attendees are also informed that overreporting by professionals leads to a high proportion of unsubstantiated reports (Besharov 1994; Foreman and Bernet 2000; Kalichman 1999; Zellman and Coulborn-Faller 1996), some of which are clearly not warranted and can cost governments valuable resources. Instructors also provide information that is relevant to failure of professionals to report suspected child maltreatment as a result of perceived negative consequences. For instance, although it is reported by Baxter and Beer (1990) that about a quarter of professionals fear legal retaliation due to reporting suspected child maltreatment, this information is not true due to federal immunity for anyone reporting child maltreatment to officials in good faith. Relevant to concerns specific to physical retaliation by suspected perpetrators, it is pointed out that only approximately 4 % of clients respond with threats or attempts to harm professionals (Weinstein et al. 2000). Of course, trainers need to be careful to avoid negation of the potential for harm, however unlikely this may be to occur.
It is reported that Kalichman and Craig (1991) found 31 % of psychologists believed reports of child maltreatment would adversely affect relationships they had with their clients, and Kalichman et al. (1989) found 42 % of licensed psychologists believed reporting child maltreatment negatively impacted family therapy. It is therefore pointed out that some professionals may struggle between wanting to report in an attempt to improve circumstances for the child and fearing reporting efforts will result in further harm to the family unit. The instructor balances this tension in discussion, pointing out that the absence of mandated reporting may lead to continued child maltreatment, whereas reporting may lead to the provision of social and medical services to the family by CPS. It is also pointed out that Steinberg et al. (1997) determined that positive reporting of child maltreatment is significantly influenced by the presence of a positive therapeutic relationship prior to reporting, and involvement of clients in the reporting process may enhance relationships between professionals and clients throughout treatment (Levine and Doeuck 1995). For instance, Weinstein et al. (2001) determined that 40 % of reported cases of child maltreatment resulted in unchanged relationships with the professional making the report and that 32 % resulted in improved relationships. Thus, workshop participants are encouraged to utilize clinical judgment in the decision to include caregivers in the reporting process, including suspected perpetrators of child maltreatment.
Identifying Child Maltreatment
Accurate child maltreatment identification is frequently identified in the literature to be important in the reporting of child maltreatment (Foreman and Bernet 2000; Kalichman 1999). Therefore, the major types of child maltreatment are reviewed. Child maltreatment generally concerns psychological abuse, physical abuse/excessive corporal punishment, sexual abuse/exploitation, and child neglect, as governed by the state in which the workshop is conducted. However, states or local governing bodies vary as to what is specifically indicated to be child maltreatment. For instance, in Nevada “mental injury” is the concept used instead of “emotional” or “psychological” abuse. Therefore, instructors show specific definitions of child maltreatment that are governed in the state or local jurisdiction for which the workshop is conducted and subsequently attempt to solicit comments from workshop participants that demonstrate their understanding of these definitions.
To assist in further understanding how to accurately identify child maltreatment, the instructor provides a slide that specifies physical, behavioral, and emotional indications of the different types of maltreatment (see Fig. 17.2). The trainer stresses that many of the indicators of child maltreatment (e.g., difficulty sleeping) are often shared between the victim and perpetrator of child maltreatment and that victims and perpetrators of child maltreatment often experience multiple indicators of child maltreatment (e.g., low self-esteem, anxiety, depression, speech impairments). However, participants are also cautioned that specific indicators of child maltreatment may be present due to conditions or causes other than child maltreatment. For example, academic difficulties in adolescents may be indicative of physical abuse, but may simply result from a learning disability. In addition, participants are encouraged to consider developmental appropriateness of the presented indicators. For instance, self-stimulation of genital areas may indicate sexual abuse or simply be indicative of normal developmental exploration. Although the aforementioned information suggests that apparent signs of child maltreatment may be influenced by factors that are not specific to child maltreatment, it is emphasized that, in general, professionals should attempt to validate or disconfirm their initial suspicions with other professionals after examining relevant laws governing the protection of children from maltreatment.
Indicators of child maltreatment in perpetrators and victims of child maltreatment
Reporting Requirements and Procedures
Mandated reporters’ lack of knowledge regarding reporting requirements for suspected child maltreatment has been identified repeatedly in the literature and is problematic. Therefore, the federal mandate for professionals to report suspected maltreatment as required by the Child Abuse Prevention and Treatment Act (CAPTA) of 1974 for children less than 18 years of age is reviewed, including relevant laws of the state or province for which training occurs. Instructors need to adjust workshop content to accommodate local jurisdictional laws. Although child maltreatment protection laws may vary across states, instructors disclose that all states require that a report of child maltreatment has to be made when a professional believes (e.g., have reason or cause to believe, or have reasonable cause to believe) or suspects (e.g., have reason or cause to suspect, or have reasonable cause to suspect) child maltreatment has occurred or when “a reasonable person would suspect child maltreatment has occurred.” Thus, attendees are strongly urged to consult with at least a couple of professionals prior to initiating the reporting process of child maltreatment with CPS and to document any discussions that influence the reporting process. It is also highlighted that the timeline for reporting child maltreatment is usually determined to be as soon as possible, but no later than 24 h after suspicion of child maltreatment. It is mentioned that some states require a formal written report to be filed within a week of the initial report of suspected child maltreatment.
The distinction between objective evidence and feelings, both of which may be acceptable in the consideration of child maltreatment depending on the local jurisdiction, is discussed. Lack of evidence has been reported as a substantial factor in the decision by professionals not to report child maltreatment (Finalyson and Koocher 1991; Kalichman et al. 1989). Therefore, concepts of suspicion and belief are discussed in light of evidence.
The workshop is best suited for professionals (usually mental health professionals). Therefore, clarification is provided that confidentiality privileges and obtaining information in the context of research do not negate the reporting mandate. Many workshop participants are surprised to learn they should only provide information about the suspected perpetrator and victim of child maltreatment that is specific to the incident or incidents of suspected child maltreatment and future protection of the child. Additional information is provided to participants regarding immunity in the United States for reporting child maltreatment in “good faith,” and that failure to report may result in fines, jail time, civil liability, and/or sanctions by professional licensing boards. Workshop participants are encouraged to follow reporting practices of their employers, but are also informed that persons who suspect or believe child maltreatment has occurred are mandated to report to CPS, regardless of the beliefs or suspicions of their employers. Instructors encourage participants to consult with professional colleagues and professionals within CPS when they are unsure how to proceed and to document child maltreatment reports in clinical records as well as specific rationales leading to decisions not to report.
Workshop participants are informed that reports could be made to either local law enforcement or CPS and that these agency representatives will request specific information that is necessary to determine when official reports of child maltreatment are needed. Therefore, with few exceptions (i.e., important circumstances leading to suspected child maltreatment, information specific to the protection and whereabouts of referenced child) mandated reporters should generally not report information that is not relevant to suspected child maltreatment to assist in protecting confidentiality of clients. When children are suspected to be in immediate danger, or when suspected perpetrators are not family members or within the household of children who are suspected of child maltreatment, workshop participants are encouraged to contact the local police department rather than CPS.
Involving Caregivers in the Reporting Process
Workshop participants often do not realize that it may be advantageous to involve caregivers in the reporting of child maltreatment, including perpetrators suspected of child maltreatment when clinically determined. Similarly, they may be unfamiliar with various factors that suggest inclusion of caregivers in the reporting process is contraindicated. To assist workshop participants in gaining a better understanding of this tension, the workshop facilitators are trained to first solicit situations in which caregivers should be excluded from this process. Facilitators generally empathize or validate these scenarios and subsequently solicit situations in which the participation of caregivers in the child maltreatment reporting process may be indicated. Workshop participants are informed that clinical judgment should be emphasized in determining the appropriateness of involving caregivers in the reporting process to assist in assuring self- and other-preservation (Berliner 1993). Along these lines, it is emphasized that professionals exclude caregivers in the reporting process if they are uncomfortable doing so or suspect this process may be clinically contraindicated. Indeed, exceptions to including caregivers of child maltreatment in the reporting process are reviewed and may include their history of abrupt aggression, emotional instability or intoxication, and indications that caregivers may attempt to influence suspected victims to retract child maltreatment incidents that are valid (see Stadler 1989).
On the other hand, instructors explain that involving caregivers in the reporting process may assist in maintaining positive therapeutic relationships, particularly when limits of confidentiality are detailed during informed consent (see Weinstein et al. 2000). In doing so caregivers are less likely to become upset should a report of child maltreatment be indicated later in therapy (Steinberg 1994). Moreover, Nicolai and Scott (1994) empirically determined that professionals who routinely reviewed limits of confidentiality were more likely to report child maltreatment in case presentations, and reporting outcomes are generally more positive when caregivers are informed of the decision to report (Weinstein et al. 2001). Consistent with Taylor and Adelman (1998), instructors encourage workshop participants to explain to caregivers why reports need to be made, soliciting their input in the process of reporting and reviewing possible outcomes of reporting. Instructors also inform workshop attendees that it is generally a good idea to provide caregivers options in the reporting process. Following recommendations of Stadler (1989), instructors emphasize that caregivers should first be presented the option of initiating the report themselves. If this option is declined, professionals may offer to initiate the report in the caregiver’s presence. When both of these options are declined by caregivers, professionals are encouraged to indicate that the report can be made outside the caregiver’s presence. This strategy is likely to decrease anxiety while satisfying legal reporting requirements.
Workshop participants are informed about the process CPS undergoes after reports are initiated, which has been identified to be an important training strategy (Levine and Doeuck 1995; Weinstein et al. 2001). Compaan et al. (1997) found professionals are more likely to report child maltreatment when they have an understanding of the reporting process from the perspective of CPS, which helps them to guide caregivers through this process (Brosig and Kalichman 1992). The instructor indicates that there are several steps that occur after the report is made to CPS. First, the CPS agent may or may not accept the report. Reports are generally accepted when the extent of information provided is sufficient to permit an investigation to occur (e.g., identifying information provided), and the incident appears to be indicative of child maltreatment. If a report is accepted, it may or may not be recommended for investigation. If a report is accepted for investigation, most CPS organizations have a priority system to assist in determining their response time. For instance, if an incident is associated with imminent risk, the agency may need to respond immediately or at least within 24 h. In such events, the child may be removed prior to the conclusion of the investigation. In all jurisdictions, child abuse investigations must be initiated within 48–72 h of the report to determine whether maltreatment occurred and create a case plan to address potential concerns. It is explained to workshop participants that it is comforting for caregivers to learn mandated reports of suspected child maltreatment can include supportive feedback from them, such as outstanding efforts of caregivers to participate in treatment and demonstrations of affection and concern for their children. Similarly, caregivers are soothed to learn professionals can provide recommendations during their initial reports that children not be interviewed during school hours or that caregivers will be available by telephone to arrange investigative meetings that do not occur in their place of employment.
Workshop participants are informed that CPS and/or differential response agencies may provide services to families regardless of investigative outcomes and that services may be provided free of charge. Potential services may include mental health therapies, employment services, financial assistance, and parenting resources. Services are generally voluntary, although CPS agents may seek a court mandate to assure completion of services and well-being of children. Professionals and caregivers are often concerned that children will be removed or that criminal prosecution of the suspected perpetrator will occur. To reassure them, participants are informed that although this is a possible outcome of the reporting process, these consequences are unlikely unless maltreatment is severe. Indeed, separation of children from caregivers who are assessed to perpetrate child maltreatment generally occurs only when risk of harm is determined by CPS to be imminent, and in such cases separation is almost always temporary and in the homes of family members. For instance, participants are informed that prosecution rates have been reported to be 17 % for sexual abuse and approximately 2 % for other types of child maltreatment (Tjaden and Thoennes 1992). Lastly, instructors remind workshop participants that the goal of CPS is ultimately family welfare and reunification even in cases where a child needs to be removed for protective reasons.
Skills Training Specific to Involving Caregiver(s) in the Reporting Process
Two videotapes are presented to model the process of reporting child maltreatment with a caregiver, including skills that are specific to the management of an upset caregiver. The respective skill sets are consistent with the previously reviewed material. Participants are informed that the professional’s modeling corresponds to the behavioral instructions specified in Appendices A and B (which are distributed to participants immediately before the workshop). To assist workshop attendees in paying attention to important details, they are asked to put checks next to each behavioral instruction that is reviewed by the professional. The instructor presents the first videotaped scenario in which the professional informs a caregiver of his intent to report child maltreatment. The caregiver reacts with delayed compliance, suggesting disbelief and concern. After all behavioral instructions in Appendix A are modeled, the caregiver demonstrates her upset with the report. This permits the professional an opportunity to model each of the behavioral instructions listed in Appendix B. At the conclusion of the videos, participants are prompted to answer two questions that are biased to solicit positive responding (i.e., What did you like about the professional’s skills? If you were the professional, what would you do differently, if anything, to fit your style?). The videotapes may be obtained by the authors, or the behavioral instructions may be modeled by the instructors.
After the videotapes are briefly discussed, participants are divided into pairs and instructed to take turns role-playing the two skill sets listed in Appendices A and B, respectively. They should be told to utilize the instructions in Appendices A and B to guide their efforts. In doing so, many participants are initially hesitant to engage in role-plays and are assisted in their practice with encouragement and descriptive praise. It is also helpful to inform participants to glance at the respective checklist prior to initiating each behavioral step, rather than memorizing instructions. During role-play interactions, instructors should briefly visit with participants, pointing out their demonstration of skills and briefly answering their questions.
The workshop concludes with a 10–15-min discussion about workshop content. Questions are solicited and the following three questions are posed to facilitate positive exchange of ideas and facilitate generalization of workshop skill sets to everyday professional situations:
How did it feel to practice the skills presented?
How might you be able to apply the training you’ve learned today?
How might you avoid difficulties implementing this training?
Future Directions in Child Maltreatment Reporting
Research specific to the mandated reporting of child maltreatment is in its infancy. Indeed, there are literally millions of professionals mandated to report suspected child maltreatment, yet few are explicitly trained to report child maltreatment. Few training programs have been formally examined to assist professionals in the management of this mandate (see section “Established Training Programs to Assist in Reporting Child Maltreatment”), and even fewer were developed utilizing uncontrolled experimental methodology. Therefore, the controlled empirical development of training programs specific to optimizing the process of reporting child maltreatment is urgently needed, both in general, and to identify optimal components and mechanisms (such as the optimal training approach, dosage, delivery method, and teaching team composition). Along this vein, research should be focused on determining which situations warrant the inclusion of family members and suspected victims of child maltreatment in the reporting process, how best to involve these persons, and assessment of the benefits and risks of their inclusion. Indeed, there is a particular need to empirically determine the effects of training programs on family safety, cohesion, and stress during the reporting of child maltreatment. In doing so, professionals could be randomly assigned to experimental training programs in child abuse reporting or training as usual, and the effects of these training programs could be evaluated utilizing objective, real-world measures (e.g., cases founded for child maltreatment, days children separated from their caregivers, family cohesion). Establishing consistency in defining child maltreatment across states and provinces will assist in making it easier to develop standardized training curricula in child maltreatment reporting and facilitate dissemination of these programs. Lastly, it is important to psychometrically evaluate measures to evaluate child abuse reporting training programs, such as the ones reviewed in this chapter.
Appendix A: Protocol Checklist: Initiating Child Abuse Report with Caregiver(s)
The following protocol checklist may be used to guide mandated reporting of suspected child maltreatment or evaluation of others in doing so. Place a check next to each instruction that is completed.
Excuse everyone but caregiver(s).
Indicate importance of talking about (description of suspected maltreatment incident).
Remind caregiver(s) that laws mandate professionals to report child maltreatment.
State why child maltreatment is suspected.
Indicate report must be submitted within 24 h to CPS.
State report may not be accepted if not enough info or incident judged not to be abusive.
State CPS may accept report but not investigate.
State if report accepted CPS may conduct investigation of child maltreatment within 72 h.
State investigation usually involves caregiver(s), caregiver’s children, and relevant others.
State CPS may go wherever child is present to conduct investigation (e.g., school, home).
State you can include supportive feedback in report, including recommendations.
State prosecution estimated to occur in <3 % of abuse and neglect cases and 17 % in sex abuse.
State separation of child from caregivers almost always limited to most severe situations.
State that when separation occurs it is usually temporary and the child usually resides with family.
State report may lead to cost-free services and financial support.
Advise caregiver(s) to be cooperative and respectful with investigators.
State caregiver(s) may be present during call to CPS.
State caregiver(s) may speak privately with CPS after report is made.
State caregiver(s) may speak with CPS after report is made in your presence.