Generally, the researchers agree that the decision to substantiate or unsubstantiate suspected child maltreatment is complex, involving factors beyond the facts of the case itself. Factors found to influence the decisionmaking can be grouped into four categories. One category, "case factors," are situations, events, or circumstances related to the child and family. A second category "decisionmaking factors," include caseworker characteristics, such as training, experience, beliefs, interactions with coworkers, and perceptions about the organization. A third category "organizational factors," are aspects of the child- protection-services (CPS) work environment, such as the structure of the agency; its resources, tools, and training; workloads; and supervision. The fourth category "external factors," include State laws and other policies that govern the CPS system. Regarding how decisionmaking impacts case outcomes, the three studies examined the connection between decisionmaking and re-referral in two ways: directly, i.e., by examining the correlation between particular case decisions and re-referral rates; and indirectly, i.e., by examining how CPS decisionmaking impacts service provision and how services impact re-referral. The high number of unsubstantiated cases that were re-referred suggests that including risk assessment in the decisionmaking process, rather than basing substantiation purely on the question of "what happened," is likely to reduce re-referral, assuming services are then provided to address identified issues. Recommendations for future research are presented. 70 notes