OUR KIDS AND WHAT YOU CAN DO TO HELP
Wingspread Journal, Winter 1996

NEW DIRECTIONS FOR CHILD ABUSE PREVENTION

by Anne Cohn Donnelly, DHP, and Deborah Daro, DSW

Anne Cohn Donnelly is the executive director and Deborah Daro is the research director for the National Committee to Prevent Child Abuse.

Although the child abuse issue was first recognized in the United States in the late 1800s, it was not until 1978 that experts gathered to craft a comprehensive approach to prevent child abuse. This meeting, held at Wingspread, represented the first attempt to draw together the small community of researchers and practitioners focusing on preventing. As a group, they crafted the first comprehensive plan to prevent child abuse, a plan which reflected the need for increased awareness and commitment. Much has changed since then.

By 1985, it was not unusual to find in almost every community some kind of child abuse prevention effort. Most efforts were supported by private agencies and were almost entirely volunteer based. Prevention programs across the country tended to be small, to have unstable funding, and to be local in their focus.

Preventing Child Abuse Today

Today, preventing child abuse has become a popular concern. Ten years ago it was difficult to get a newspaper to write a story about prevention as opposed to one about brutally battered babies. It was difficult to get politicians to focus on prevention as an important fiscal concern. And prevention as a concept did not appear to be part of the public consciousness. Today, however, the public is not only enormously concerned about child abuse, it wants to stop it before it occurs. Almost every state has some kind of a Children's Trust Fund to explicitly support prevention programs, and new moneys have flowed into prevention from our major social institutions, including welfare, education, and health. In sum, a greater commitment to prevention is more evident today than ever before.

What characterizes this new prevention system? As more governmental moneys come into this arena, public agencies are increasingly partnering with private agencies. Programs are now combinations of volunteers and professionals. More people are being paid to do the work of prevention. Prevention programs are growing in size-both in terms of budgets and in terms of the numbers of people they are touching, although they still tend to be "patchwork quilts" of short-term funds from a lot of different sources.

New Knowledge and its Impact on Prevention

Along with all the other changes in the field, tremendous growth has occurred in the past 30 years in our understanding of the causes and consequences of child maltreatment as well as in our ability to prevent its occurrence. Three areas appear particularly germane as we move toward creating a new child abuse prevention plan. These include the growing pool of evaluative data regarding program effectiveness, the changing attitudes of parents regarding appropriate discipline strategies, and the renewed interest in the importance of a child's first three to five years of life in shaping his or her life course.

With respect to program evaluation, a growing consensus is emerging regarding the types of prevention programs needed to effectively assist those parents facing the greatest challenges. While not fully consistent in their findings, repeated evaluations of child abuse prevention programs and other family-support services suggest that preventing maltreatment requires programs which are, among other things, intensive, comprehensive, and flexible. While short-term interventions and those which focus on a more limited array of issues do assist some parents and clearly have a role in a broad continuum of supportive measures, it is equally clear that parents with the fewest financial, emotional, and intellectual resources require enormous support to adequately provide for their children. It is both unrealistic and unfair to assume that a brief parenting course, access to written material, or an occasional visit by a family support worker will get the job done.

Further, it remains unclear whether short-term intensive services, such as those being promoted by the family preservation movement, are sufficient to prevent foster-care placement, or serious abuse, in severely dysfunctional families or families with adolescents. Parenting is a complex relationship which is shaped both by one's understanding of human relationships and child development as well as by one's intuitive sense of how to correctly apply this knowledge base to specific situations. Short-term interventions cannot provide the modeling and behavioral change often required to make parents consistently effective.

Research suggests that public attitudes can be influenced by direct and indirect public awareness and education efforts. Changes in smoking, diet, and exercise patterns are among the most notable examples of the public shifting behavior to adhere to more socially acceptable or healthier practices. Similar changes have been noted in the public's attitudes towards appropriate discipline practices, child welfare services, and the child abuse problem in general. Opinion polls by the National Committee to Prevent Child Abuse show that today, 16 percent fewer parents report the use of corporal punishment as a means of disciplining their children than was true in 1986. While the issue of corporal punishment is far from resolved, research supports the notion that public perceptions and behaviors can be influenced by media messages. This trend bodes well for the continued expansion of such interventions.

The final research area which has exploded in the past year has been the growing body of evidence on the crucial importance of a child's first few years of life. While not a perfect correlation, it does appear that children who suffer physical or emotional harm during the first years of life are at higher risk for a host of negative outcomes in adult life. The rapid development of the brain during this period and the formation of basic relationship patterns make a child's early years the time in which adult intellectual and social potentials are defined. When families and society fail to provide an infant and toddler with adequate nurturing, security, and stability, the results are profound and potentially irreversible. The implication for prevention efforts is the need to focus special attention on programs that will help insure that all children get off to a good start either by directly providing access to quality early childhood development programs or indirectly by offering parent support programs.

Future Trends and Challenges

In looking to the future, knowledge about prevention-both its importance and how to prevent it-will continue to grow even more dramatically in the next five to 10 years. There are many credible research projects in process today which address pressing questions about prevention. These questions include:

• What method works best for targeting prevention services?
• How can we effectively engage families at highest risk?
• What staffing patterns and staff characteristics are most critical to consider in designing prevention efforts?
• How can prevention efforts best address cultural and racial differences in parenting practices?

Second, because of recent research, it seems apparent that our definitions of child abuse and neglect for prevention purposes will broaden. Child abuse prevention programs are increasingly concerned with a child's ability to be ready to learn when she or he gets to school, a child having been immunized on schedule, and a child having proper nutrition. Research tells us that all those issues are intertwined with whether or not a child has been physically abused and all must be addressed simultaneously.

Related to this, child abuse prevention efforts are beginning to consolidate with other efforts targeted at children. Today, in a given community, there is probably one program for immunization, a different program getting children ready to learn, and yet a different program preventing the physical abuse of newborns. In the future, rather than the categorical funding and programming of the past, comprehensive service delivery from a single location seems more likely.

Third, the institutionalization of prevention seems inevitable. As prevention is increasingly government sponsored, as prevention programs grow in size and become more universal, efforts will be more structured, more stable, and more institutionalized. A key component of this institutionalized process is the increasing use of professionals to provide services with more training prevention programs and more opportunities to be credentialed to do prevention work.

How we allocate research dollars will become more critical. Research suggests that parents mistreat their children because they do not know how to provide a positive, nurturing environment for their children, why such an environment is beneficial for their children, or because the needs of their children cannot rise above their own needs in the face of the chaos surrounding them. The relative importance of these various factors differ across populations and across time. Rather than trying to seek a mathematical formula which will explain these complex interactions, it may be more fruitful to work on understanding how to compensate for these shortcomings in personal and environmental resources.

Rather than trying to identify which low-income, single parents do not need assistance, it may make sense to provide enhanced resources and support to all such families. Rather than trying to develop risk assessment strategies to determine which families facing foster care placement would benefit from intensive family preservation efforts, it may make more sense to provide greater support to families when they first come to the attention of Child Protective Services. Despite the hope on the part of many that research will perhaps find ways to solve problems with fewer dollars, it is far more likely that, in the near term, research efforts will complicate our quest for effective policies, and will raise more questions than they answer.

Readings on Child Abuse Prevention

Daro, D. Confronting Child Abuse. New York: The Free Press, 1988.

Daro, D. and Gelles, R. "Public Attitudes and Behaviors with Respect to Child Abuse Prevention." Journal of Interpersonal Violence, 7, pp. 517-531.

Kempe, R., Helfer, M.E. & Krugman, R. (eds.) The Battered Child, Fifth Edition. Chicago: University of Chicago Press, forthcoming.

National Research Council. Understanding Child Abuse and Neglect. Washington, DC: National Academy Press, 1993.

Schorr, L. with Schorr, D. Within Our Reach: Breaking the Cycle of Disadvantage. New York: Anchor Press/Doubleday, 1988.

U.S. Advisory Board on Child Abuse and Neglect. Child Abuse and Neglect: Critical First Steps in Response to a National Emergency. Washington, DC: U.S. Department of Health and Human Services, Office of Human Development, 1990.

Wiese, D. and Daro, D. Current Trends in Child Abuse Reporting and Fatalities: The Results of the 1994 Annual 50 State Survey. Chicago: National Committee to Prevent Child Abuse, 1995.