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Emerging Practices in the Prevention of Child Abuse and Neglect
Thomas, D., Leicht, C., Hughes, C., Madigan, A., Dowell, K.|
|Year Published: 2003|
Over the past decade, increasing resources have been devoted to the problem of child abuse and neglect. Numerous child abuse prevention programs, with State and Federal financial support, now operate in an array of settings including schools, prisons, hospitals, places of worship, and in dedicated facilities, and may target either general or specific populations. Child abuse prevention programs now increasingly reflect recognition that the problems besetting families, which can elevate the risks to children, are complex and interconnected, and that those problems require coordinated, holistic responses.
As research on child abuse and neglect has begun to demonstrate linkages between maltreatment and long-term adverse effects and other social problems, the last decade also has been marked by increasing knowledge-sharing and cooperation among public and private agencies with interests in the health of children, adolescents, and families. New initiatives now span professions and fields, altering the traditional dynamics of discovery and problem solving and expanding the possibilities in terms of collaborations and leveraging of available resources.
The impact of maltreatment on children and society is staggering and disheartening. Maltreatment can have devastating immediate and long-term physical, psychological, and behavioral effects on children; abuse and neglect ended in death for approximately 1,200 children in 2000. For children suffering physical injury at the hands of an abuser, a considerable range of medical resources may be immediately mobilized, including emergency rooms and trauma centers and orthopedic, neurological, and radiological treatment. Child maltreatment also has an impact on law enforcement and the judicial and correction systems, which incur costs for the investigation, prosecution, and confinement of perpetrators who are accused and convicted of child abuse and neglect.
Until recently, estimates of the costs associated with child abuse and neglect have been limited to the immediate and short-term consequences. Recent research, however, clearly shows that early victimization portends future difficulty for victims and a higher propensity for problem behavior as juveniles and, later as adults. Properly counted, the real, long-term costs of child maltreatment add exponentially to cost estimates of the immediate consequences.
The Promise of Prevention
Prevention is a major initiative of the U.S. Department of Health and Human Services. With strong leadership from the Administration and the Secretary, a primary focus of this effort is to share information on prevention programs that demonstrate positive outcomes for children and families. As part of this vision, the Children's Bureau, Office on Child Abuse and Neglect (OCAN), has launched a Child Abuse Prevention Initiative to promote greater visibility for child abuse prevention activities in 2003-2004. The Emerging Practices in the Prevention of Child Abuse and Neglect project is one important component of this Initiative.
Recognition of the need to reduce the risks faced by vulnerable children can be found in current public and private efforts aimed at strengthening families and building capacities and resilience. The Healthy Marriage and Responsible Fatherhood initiatives from the Administration for Children and Families are both designed to protect children through approaches that encourage the enrichment of relationships between parents, and between parents and their children. In one-parent households, new initiatives are focusing on increasing access and visitation, developing the nurturing capabilities of noncustodial parents, and improving the relationship between custodial and noncustodial parents. Other important initiatives are focusing on reducing teen pregnancy and out-of-wedlock births, addressing substance use and abuse among parents, improving opportunities for adoption, increasing child support compliance, ensuring safe and adequate child care, promoting safe and stable families, and providing work opportunities for ex-offenders who are parents.
Efforts to raise awareness about social problems, such as the hazards of smoking and tobacco use and driving under the influence of alcohol and illegal substances, are compelling. Such efforts have energized professionals across fields about the potential of public education campaigns, in concert with various direct programs and services targeted toward high-risk populations, to reduce socially undesirable outcomes and medically hazardous behaviors among both adults and teenagers. With increasing recognition of the human suffering and social costs of child maltreatment, the promise and prospects of initiatives that can prevent maltreatment in the first place have demonstrated a capacity to galvanize practitioners, researchers, and policy makers who can sometimes bring different perspectives to the problem.
Yet, despite the potential long-term benefits of preventing child abuse and neglect, only a small percentage of all resources specifically earmarked for child maltreatment in the United States is actually devoted to prevention. Furthermore, investment in prevention can be highly vulnerable during economic downturns, when legislatures search for line items to trim from overburdened State and Federal budgets.
About This Project
In FY 2001, the Children's Bureau initiated the Emerging Practices in the Prevention of Child Abuse and Neglect project to harvest new information on programs and initiatives operating around the country for the prevention of child maltreatment, and to disseminate that information to the professional community. The project involved scanning the environment for current information on prevention and seeking input directly from child abuse and neglect prevention programs. Under the guidance of an Advisory Group of experts in the field of child abuse prevention, including both practitioners and researchers, the Office on Child Abuse and Neglect developed and implemented a program nomination strategy to learn more about current effective and innovative prevention programs.
Nominations of programs and initiatives were accepted from across the field from June through August 2002. The pool of submitted nominations was peer reviewed by members of the Advisory Group in October-November 2002. This report presents the outcomes of both the literature review and the nomination process.
This project complements a closely related effort that is now underway to learn more about new developments in maltreatment prevention. The U.S. Centers for Disease Control and Prevention (CDC) is now in the early stages of developing a national audit of child maltreatment prevention programs. The CDC project will identify all existing child maltreatment programs and collect a wide range of descriptive data that will include program history, type(s) of abuse targeted, the level of prevention, the populations served, the services provided, and the medium and setting for services. In addition, the project will collect program evaluation data, where available, which will include both research design characteristics and information on specific outcomes. Though still in the early stages of development, the CDC project offers the potential of providing a substantial platform to support a host of activities in the maltreatment community, from connecting practitioners to interesting new programs to tracking growth in the field in the important area of evaluation research.
This report begins with an overview of maltreatment, which briefly describes existing national models of prevention, and is followed by the results of the nomination process for effective and innovative child maltreatment prevention programs. The report concludes with a discussion of the limits of existing knowledge about the effectiveness of prevention, the need to expand efforts to understand the performance and impact of prevention programs, and observations about this process and recommendations for next steps.