Practice Guidelines

APSAC's National Interdisciplinary Guidelines Task Forces regularly publish concise, data-based guidelines on key areas of practice in the field of child maltreatment. APSAC Guidelines for Practice are submitted through a rigorous, multi-layered peer review process, which involves experts in subject areas not on the task force,  APSAC members, legal counsel, and APSAC's Board of Directors. All Guidelines for Practice have been approved by the APSAC Board.

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The Investigation and Determination of Suspected Psychological Maltreatment in Children and Adolescents 

These guidelines were written to provide front-line child protection workers with the information and tools to understand what psychological maltreatment (PM) is, to detect it in all its forms, to understand how it relates to other types of maltreatment, and to determine the nature and degree of its existence. They can also provide guidance to child welfare agencies and family or criminal courts for cases where PM may be an issue. Published 2017, revised 2019.

MUNCHAUSEN BY PROXY (MBP): Clinical & Case Management Guidance

Clinicians should consider the possibility of MBP in children with highly unusual clinical presentations, when clinical findings are unexpectedly inconsistent with the reports of the caregiver, and/or when a child’s response to standard treatments is surprising. One major misconception among clinicians is the idea that underlying disorders need to be ruled out in order for a conclusion of abuse or neglect to be made. In fact, children with genuine underlying medical, psychological or developmental problems are often the targets of this form of abuse and neglect. Victims may be directly harmed by the abuser’s induction behaviors, frequently undergo unnecessary and invasive evaluations and interventions, be kept out of appropriate school settings, miss social and developmental opportunities, and/or misperceive themselves to be excessively ill or disabled. Iatrogenic medical conditions may arise from unnecessary interventions and the child may become ill and/or permanently physically and/or mentally harmed as a result of well-intended diagnostic and treatment efforts. Any medical condition can be created, falsified or exaggerated. Additionally, falsified symptoms may be behavioral, psychiatric or educational. These guidelines provide education on terminology, warning signs and identification, assessment of abuse and psychopathology, reporting requirements, case management, treatment, and reunification. They are intended to provide guidance to medical providers, mandated reporters, child protective service workers, law enforcement, attorneys, therapists, and any professionals who may be involved with reporting, assessing and treating children impacted by MBP as well as their abusive caregiver(s). Published 2017.

Evidence-Based Service Planning Guidelines for Child Welfare

The American Professional Society on the Abuse of Children (APSAC) Task Force report on the evidence-based service planning (EBSP) approach to child welfare services (CWS) plans and recommendations for practice.  The focus of the policy report is on formal psychosocial services.  CWS plans prescribe services to promote core child welfare objectives and to benefit children and families.  The goal of EBSP is to construct service plans based on the general principles of evidence-based practice and prefer services with empirical support for clinical problems or needs associated with the causes or consequences of child abuse and neglect (CAN).  EBSP aims to facilitate to overarching service approach that is collaborative, respectful, and includes services that are most likely to lead to outcomes on both family identified and child welfare mission goals.  EBSP emphasizes a focused, assessment-driven, and science-informed approach that both favors plans that are sufficient and avoids overburdening families with compulsory services that address problems which are not directly related to the child welfare CAN referral.  Published 2014.

Forensic Interviewing in Cases of Suspected Child Abuse - English and Spanish Versions Available 
English Version

Forensic interviewing of suspected child abuse victims is a specialized skill. It is investigative in nature and used to obtain information to help determine whether abuse has occurred. Forensic interviews are most often conducted by specially trained child forensic interviewers, law enforcement investigators, and child protective service workers. These interviews can provide critical evidence for both criminal child abuse investigations, and civil child protection proceedings. Information from the interviews may also identify other victims, assist professionals responsible for assessing risk and safety needs of children and families, and facilitate case management decisions. Because children are often a key source of information about alleged abuse (especially child sexual abuse), it is critical that these interviews be done competently. These Guidelines are an update of the 2002 APSAC Practice Guidelines on “Investigative Interviewing in Cases of Alleged Child Abuse.”  They reflect current knowledge about best practices related to forensic interviews and should be considered in conjunction with the 2011 APSAC Handbook on Child Maltreatment – Third Edition (see especially Chapter 20, “Interviewing Children” by Saywitz, Lyon & Goodman). Published 2012.

Spanish Version
Integrating Prevention Into the Work of Child Maltreatment Professionals

Preventing maltreatment spares children pain and suffering, both physical and psychological, and improves their long-term health and developmental outcomes. The serious physical and mental harms manifested during adulthood further call us to action (Anda et al., 2002). Prevention mitigates the direct costs of child abuse and neglect, as well as improving all of our lives through increased productivity and decreased crime and need for medical, mental health and social services (Alexander et al., 2003). Prevent Child Abuse America (Wang & Holton, 2008) used "conservative" estimates to calculate these direct and indirect costs at $103.8 billion in 2007. Early prevention may be even more effective in preventing harm from abuse and neglect, saving money for society, and improving society's health and happiness overall, with the included objective of leveraging current practices and programs to change how society values children (Greeley, 2009). These guidelines are designed to assist the professional in going beyond reporting by integrating best practices for child maltreatment prevention activities into their daily work with children and families. Published in 2010.

The Commercial Sexual Exploitation of Children- The Medical Provider's Role in Identification, Assessment, and Treatment 

The commercial sexual exploitation of children (CSEC) is a major public health problem in the United States and worldwide. Although the true prevalence of CSEC is unknown, it has been estimated that approximately 244,000 U.S. children are at risk for commercial sexual exploitation each year (Estes & Weiner, 2002). In a recent study, Edwards and colleagues found that, among a nationally representative sample of more than 13,000 U.S. adolescents, 3.5% admitted to exchanging sex for money or drugs (Edwards, Iritani, & Hallfors, 2006). Many CSEC victims will present for medical care at some point during their period of exploitation, often for treatment of acute conditions. These guidelines provide medical professionals with an overview regarding the current understanding of the commercial sexual exploitation of children. They focus on the epidemiology of CSEC, the impact of exploitation on victim physical and mental health, and the role of the medical provider in identifying victims, assessing their needs and securing appropriate services. The guidelines primarily address the needs of victims of prostitution and other sexually oriented work (for example, exotic dancing) and sex tourism; the needs of victims of pornography are described in detail elsewhere (Cooper, 2005). Published 2013.

Psychosocial Evaluation of Suspected Sexual Abuse in Children, 2nd Ed. 

Produced by the APSAC Task Force on the Psychosocial Evaluation of Suspected Sexual Abuse in Children, chaired by Lucy Berliner, MSW. Second edition published in June, 1997. Topics covered include characteristics of the evaluator, components of the evaluation, interviewing procedure, the interview, and the report. Published in 1997.

Challenges in the Evaluation of Child Neglect

The purpose of these Guidelines, developed by an APSAC Task Force, is to give a broad overview of the current understanding of child neglect, using an evidence-based approach, to focus on the impact of neglect on children and the multidisciplinary approach to child neglect evaluations. Specific discussion of intervention strategies is beyond the scope of this work. Published in 2008. 

Use of Anatomical Dolls in Child Sexual Abuse Assessments

Produced by the APSAC Task Force on the Use of Anatomical Dolls in Child Sexual Abuse Assessments, chaired by Mark D. Everson, PhD and John E. B. Myers, JD. In addition to a summary of research findings, how to interpret behavior with dolls, the efficacy of anatomical dolls, and inappropriate uses are covered. Published in 1995.

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