Child abuse and neglect: Physicians' knowledge, attitudes, and experiences

One important finding in this 1974 nationwide study of physicians' knowledge, attitudes, and practice on child abuse and neglect was a gap between stated attitudes and practice in regard to reporting cases. Almost all pediatricians, radiologists, and 'other' physicians believed that physicians 'should' report cases of child abuse and neglect. But fewer respondents in all three types of physicians believed that physicians 'usually' report such cases, and some could not comment on the practice of reporting. Although the majority of physicians felt that there was an increasing trend in the awareness of child abuse and neglect in their communities, only a minority believe that existing services were adequate and that existing programs were effective. This latter assessment agrees with findings of DeFrancis who in 1972 noted that no state and no community had developed an adequate child protective service program and cited the need for additional cooperation from schools, social agencies, and courts. A more recent study by Nagi also found defects in the present management of child abuse by welfare departments and offered suggestions for improvement of services by welfare departments and caseworkers. Other needs noted in this study were concise and practical references and brochures delineating reporting requirements, additional training programs for physicians, reliable systems of detection and reporting, and clarification of roles and responsibilities of community agencies involved in child abuse and neglect cases. Hopefully, the innovative programs and activities made possible by recent federal legislation in the field of child abuse and neglect will begin to meet these needs.