Preventing Child Maltreatment
In 2006, 800,000 children were identified by state agencies as having been abused or neglected. More than 1,500 children died as a result of maltreatment. High rates of maltreatment are a cause for grave concern. Further, maltreatment often has profound adverse effects on children’s health and development. Maltreated children are more likely than others to suffer from depression, post-traumatic stress disorder, substance abuse, and engage in criminal activity.
They may very well enter the child welfare system, a complex web of social and legal services whose purpose is to ensure children’s safety. The child welfare system is expensive. Taking into account the costs of case management, administrative expenses, services to families and children, foster care, adoption services, administrative services, hospitalization, mental health care, and law enforcement that stem directly from maltreatment, the total for direct expenses is $33 billion. In light of the toll that maltreatment takes on child well-being, as well as its high financial costs, the expert contributors to this volume explore the vexing question of how to prevent child abuse and neglect.
Focus of the VolumeContributors to this volume present the best available research on policies and programs designed to prevent maltreatment. They examine a gradual shift in the field of child maltreatment toward prevention and explore how insights into the risk factors for maltreatment can help target prevention efforts. They assess whether programs such as community-wide interventions, parenting programs, home-visiting, drug and alcohol treatment, and school-based educational programs on sexual abuse, can prevent maltreatment. They also explore how CPS agencies might take a more active role in prevention.
What Approaches should be Implemented to Prevent Child Maltreatment?Prevention holds the key to reducing child maltreatment in the United States and to bringing down its well-documented long-term costs, both human and financial. The articles in this volume offer a host of policies and interventions, many supported by good evidence, for the field of child maltreatment prevention, including:
The Future of Children is a collaboration of the Woodrow Wilson School of Public and International Affairs at Princeton University and the Brookings Institution. The Future of Children, please visit www.futureofchildren.org
Why Should We Care About Preventing Child Maltreatment?
Contributors to the volume address issues facing the field of child abuse prevention including:
How the field of child maltreatment has come to realize the importance of prevention, driven by investments in families and children.
What characteristics of children and families are associated with an elevated risk of maltreatment and how those characteristics can be used to target prevention efforts.
An examination of specific prevention programs with evidence of effectiveness – community-wide prevention efforts, parenting programs, and home-visiting programs – involving health care professionals, social workers, child care staff, or schoolteachers.
A consideration of unique prevention issues: preventing abuse and neglect by parents with drug and alcohol addictions, and preventing sexual abuse.
The role the child protection system plays in prevention and how that role might change in the future.
Use Risk Factors to Create Accurate Risk Assessments. Although infants are far more likely to be maltreated than children of any other age, the overwhelming majority of infants are never maltreated, and many children are maltreated who are not infants. Risk assessment is never perfect, but researchers have identified five factors which are consistently correlated with maltreatment – child age, race, poverty, parental drug involvement, and single parenting. These factors interact in complex ways, but children who are characterized by all five are at higher risk than children who have only one. Information about these factors can be used to guide the targeting of interventions.
Invest in Proven Community-wide Interventions.Communities with large numbers of maltreatment reports or in which many families are characterized by the five risk factors are prime targets for community-wide prevention. Only one program shows solid evidence of preventing child abuse, the Triple P – Positive Parenting Program. This program consists of several levels of intervention: a media-based campaign targeting the entire community, intensive treatments for progressively smaller groups of families that are at progressively greater risk for maltreatment, and individual family treatment.
Integrate Home-visiting Programs into Prevention EffortsHome visiting programs are family-based interventions in which trained professionals visit parents in their homes and administer a standard program that can range in intensity from one visit to multiple visits over months or even years. Some home visiting programs have been shown to have positive effects in areas of family life related to child abuse risk.
Rethink the Approach to Families with Drug or Alcohol AbuseParental addictions alone are not a sufficient reason for removing children from their homes. Every unnecessary removal of a child from home is a threat to the child’s well-being, exactly the opposite of the goals of prevention programs. Before removing a child from a home with drug or alcohol abuse, CPS agencies should require drug-addicted parents with reports of maltreatment to enroll in drug treatment within a few months and allow them up to eighteen months to show progress in all problem areas, including addiction. If there is no measurable progress on every front, it then makes sense for the child to be removed and placed with relatives or an adoptive home.
Expand Programs to Prevent Sexual Abuse.Schools, religious groups, and youth organizations are now operating programs that teach children what to do in situations of potential abuse, how to stop potential offenders, and how to find help. Such programs also teach children not to blame themselves if they are victimized, a prevention strategy designed to head off emotional problems often triggered by abuse. Although there is little evidence that these programs prevent sexual abuse, there is reason to believe that they might, and there is evidence that they produce other benefits such as increased disclosure and less self-blame following abuse.
The evidence reviewed in this volume suggests several promising strategies to prevent child abuse and neglect. Two steps are now in order. The first is to redouble efforts to collect evidence on the effectiveness of prevention programs, in part by constructing programs in ways that makes it possible to evaluate rigorously their effects. The second step is to fund prevention programs. Policy makers have shown increased interest in strengthening early childhood programs by expanding home-visiting programs and improving the quality of child care. These initiatives, if properly designed and targeted, could well help prevent child abuse and neglect.
The Future of Children, vol. 19, no. 2, Fall 2009