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Child Maltreatment: Prevention Strategies

Child maltreatment is a serious problem that can have lasting harmful effects on victims. The goal for child maltreatment prevention is clear—to stop child abuse and neglect from happening in the first place. Child abuse is a complex problem rooted in unhealthy relationships and environments. Safe, stable and nurturing relationships and environments for all children and families can prevent child abuse. However, the solutions are as complex as the problem.

We can stop child abuse and neglect by reducing risk of it happening at all and increasing the factors that protect children. Preventing child maltreatment means influencing individual behaviors, relationships among families and neighbors, community involvement, and the culture of a society. Prevention strategies include effective programs that focus on individual behavior and attitude change, and also efforts that change policies and societal norms to create environments that support safe, stable, nurturing relationships for children and families. We need to implement effective prevention strategies to stop child abuse and neglect before it happens and to foster commitment to social change.

Effective Programs to Stop Child Maltreatment

  • Child-Parent Centers
    Child-Parent Centers (CPCs) provide comprehensive educational and family support to economically disadvantaged children (beginning at age 3 and thru the third grade) and their parents. The program requires parental participation and emphasizes a child-centered, individualized approach to social and cognitive development. In a matched control trial, children participating in these centers had a 52 percent reduction in child maltreatment (Reynolds & Robertson, 2003).
  • Durham Family Initiative
    Durham Family Initiative works to improve family well-being and reduce child maltreatment by coordinating services for high-risk families. Children who are at risk for maltreatment are identified through home visits after birth or through referrals from pre-kindergarten, schools, and clinics. The program also worked with community leaders and agencies to implement a shared information system, standardized data collection system, cross-training, and institutionalizing the integration of services across organizations. In a randomized controlled trial, this model resulted in a 57% reduction in child maltreatment in Durham county compared to control counties (Daro & Dodge, 2009).
  • Nurse-family Partnership
    Nurse-Family Partnership is a nurse home visitation program for low-income, first-time parents and their children beginning prenatally and continuing up to the child’s second birthday. The program encourages healthy behaviors during and after pregnancy, teaches appropriate parenting skills, and links parents to community services. A randomized controlled trial documented a 48 percent reduction in child maltreatment at the 15-year follow-up (Olds et al., 1997).
  • Triple P
    Triple P is a multi-level system of parenting interventions based on need usually delivered through health care. In the U.S. Triple P System Trial, funded by the CDC, researchers found an 28% reduction in substantiated abuse cases, an 44% reduction in child out-of-home placements, and an 35% reduction in hospitalizations and emergency room visits for child injuries in nine study counties in South Carolina where parenting interventions were implemented (Prinz et al., 2009).
  • The Safe Environment for Every Kid (SEEK)
    SEEK program screens parents of children ages 0-5 in pediatric primary care settings to identify parental exposure to partner violence, mental illness, or substance abuse and provide appropriate referrals. A randomized controlled trial showed significantly lower rates of child maltreatment in all the outcome measures: fewer child protective services reports, fewer instances of possible medical neglect documented as treatment non-adherence, fewer children with delayed immunizations, and less harsh punishment reported by parents.

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Guidelines and Planning Tools

  • Understanding Evidence is a new, interactive web resource developed by CDC's Division of Violence Prevention that supports public health practitioners in making evidence-informed decisions around violence prevention.
  • Essentials for Childhood proposes strategies communities can consider to promote the types of relationships and environments that help children grow up to be healthy and productive citizens so that they, in turn, can build stronger and safer families and communities for their children.
  • Public Health Leadership for Child Maltreatment Prevention Toolkit
    This toolkit was developed to help state health departments promote and enhance child maltreatment prevention efforts.
  • Developing and Sustaining Prevention Programs
    The Child Welfare Information Gateway provides resources on developing a prevention program, conducting a community needs assessment, funding, collaborating, evaluating program effectiveness, and building community support.

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Community and Societal Level Examples

Various examples can be found in Essentials for Childhood, below is an example of organizational or internal policy:

Primary health care organizations can make it their policy to deliver components of evidence-based programs such as Triple P as their standard of care. More specifically, community health centers or private pediatric practices can make anticipatory guidance and brief consultation on common developmental issues part of their standard protocol during well-baby visits. They can also coordinate with other more specialized services to provide more intensive approaches to address problems with parenting and child behavior.

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Reviews of Effective and Promising Programs

  • California Evidence-based Clearinghouse for Child Welfare
    This organization provides on-line access to information about evidence-based child welfare practices in a simple, straightforward format. Evidence-based practices are those that have empirical research supporting their efficacy.
  • Community Guide
    Provides systematic reviews of interventions, including early childhood home visitation.
  • Child Welfare Information Gateway
    This site connects child welfare and related professionals to comprehensive information and resources to help protect children and strengthen families.
  • Promising Practices Network
    Promising Practice Network provides summaries of effective programs and issue briefs summarizing current research related to child well-being, including their physical and mental health, academic success, and economic security.
  • Violence Prevention Evidence Base
    This database, developed by The Centre for Public Health at Liverpool John Moores University, provides access to abstracts from published studies that have measured the effectiveness of interventions to prevent violence. To be included in the database, studies must have measured the impact of interventions directly on violence. Studies have been selected through a systematic review of published academic literature. The abstracts can be searched by violence type, keywords, and geographical area of implementation.
  • World Report on Violence and Health [PDF 176 KB]
    This report is the first comprehensive review of violence on a global scale. Chapter 3 provides detailed information on child maltreatment, including prevention strategies.

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References

Daro, D., & Dodge, K.A. (2009). Creating Community responsibility for child protection: Possibilities and challenges. Future of Children, 19, 67-93.

Olds DL, Eckenrode J, Henderson CR, Kitzman H, Powers J, Cole R, et al. Long-term effects of home visitation on maternal life course and child abuse and neglect: Fifteen-year follow-up of a randomized trial. JAMA1997;278(8): 637–643.

Prinz RJ, Sanders MR, Shapiro CJ, Whitaker DJ, Lutzker JR. Population-based prevention of child maltreatment: The U.S. Triple P System Population Trial. Prevention Science 2009;10(1):1–12.

Reynolds AJ, Robertson DL. School-based early intervention and later child maltreatment in the Chicago Longitudinal Study. Child Development 2003;74(1):3–26.

 

Adverse Childhood Experiences (ACES)

Understanding Evidence

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