Child abuse experts disagree about the threshold for mandated reporting

Context: Though reasonable suspicion serves as the standard threshold for when to report suspected child abuse, there is little guidance how to interpret the term. Objective: To examine how experts on child abuse interpret reasonable suspicion using 2 probability frameworks. Participants: Anonymous survey of clinical and research experts on child abuse. Main outcome measures: Responses on ordinal and visual analog scales quantifying the probability needed for "suspicion of child abuse" to rise to reasonable suspicion. Results: A total of 81 of 117 experts completed the survey (69% response rate, mean age 47 years, 69% female). On both the ordinal probability scale (rank order on a differential diagnosis) and the estimated probability scale (1% to 99% likelihood), experts demonstrated wide variability in defining reasonable suspicion, with no statistically significant differences found for age, race, gender, professional training, seniority, or prior education on reasonable suspicion. Conclusions: This study found no consensus in how experts on child abuse interpret reasonable suspicion.