what has research shown to be useful in preventing child abuse?

Introduction

Child maltreatment is a pervasive public health issue affecting thousands of children beyond the The states.

In 2012, more than 1,600 children from newborns to historic period 17 died from abuse and neglect. The majority of these victims, 68 pct, were 4 years of age or younger. Child fatalities caused by corruption and neglect do not reveal the full extent of the trouble. State and local kid protective services agencies estimate that 686,000 were victims of maltreatment in 2012.

The consequences of child maltreatment are long term. Children who are victims of maltreatment are more likely to experience poor health status into adulthood including, substance abuse, depression, cardiovascular disease, diabetes, cancer and premature death.

Source: U.Due south. Department of Health and Homo Services, Administration for Children and Families, Assistants on Children, Youth and Families, Children'due south Bureau.(2012).Kid maltreatment 2012. Bachelor from http://www.acf.hhs.gov/programs/cb/resource/child-maltreatment-2012.

Defining Child Maltreatment

Child maltreatment includes all types of abuse and neglect of children nether age 18 by a parent, caregiver or another person in a custodial function (eastward.thousand., clergy, motorbus, or teacher). Four major types of child maltreatment are physical corruption, fail, emotional corruption and sexual abuse.  These types of child maltreatment are not mutually exclusive and oftentimes occur in combination.

• Physical corruption is the intentional use of physical strength against a child, such every bit hit, kicking, chocking, stabbing, shaking, burning, or other actions that result in, or have the potential to upshot in physical injury.
• Fail is the failure to come across a child's basic needs, including housing, food, habiliment, education and access to medical care. The definition of child neglect varies among states, agencies, professional groups and disciplines, and is considered the most frequently unreported type of child maltreatment.  Generally child neglect tin can be defined every bit "the failure to provide for a kid'southward basic physical, emotional or educational needs or to protect a child from harm or potential harm."
  • Concrete fail is the failure to provide nutrient, shelter or appropriate supervision.
  • Medical neglect has been divers by many states as failing to provide needed medical or mental wellness care to a child.
  • Educational neglect involves the failure of a parent or caregiver to educate a child or provide special educational needs.
  • Emotional fail is the inattention to a child'due south emotional needs or failure to provide psychological care.
• Emotional abuse refers to actions and behaviors that harm a child'south sense of self-worth or emotional well-being.
• Sexual abuse involves engaging a child in sexual acts including fondling, rape and exposing a child to other sexual activities. This type of corruption is the nigh under-reported type of child maltreatment. Bodily rates of sexual abuse against children are likely higher than officially reported rates.

Neglect is the nearly mutual type of maltreatment perpetrated against children, bookkeeping for 78 percent of all reports of child maltreatment.  In some states, kid fail accounts for more than than xc percent of all kid maltreatment cases.

Source: U.South. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Agency.(2012).Child maltreatment 2012. Bachelor from http://www.acf.hhs.gov/programs/cb/resource/child-maltreatment-2012.

Source: U.S. Department of Wellness and Human Services, Administration for Children and Families, Assistants on Children, Youth and Families, Children'south Bureau.(2012).Kid maltreatment 2012. Available from http://www.acf.hhs.gov/programs/cb/resource/kid-maltreatment-2012.

Child maltreatment is a circuitous social effect and research on prevention explores a wide range of social and economical interventions. Unhealthy relationships between caregiver and child and loftier levels of parental or caregiver stress, amongst many other things, may contribute to higher rates of child maltreatment. States have adopted strategies that aim to foreclose kid fail and abuse before it occurs, such as connecting new parents to community back up opportunities, achieving greater access to loftier quality child care, and coordinating funding. This policy primer reviews state legislative policy options to forbid child maltreatment.

Connecting New Families to Customs Support Opportunities

The starting time few years of life are vital for a child's brain development. Stress and lack of medical care during these important years tin can take negative long-term consequences on a child's physical and mental health that extend into adulthood. High rates of abuse, neglect and medical neglect in the early on years of a child'southward life bespeak that more than tin be washed to develop systems and strategies to support new and expecting families. During these showtime years, children are more than probable to be isolated from social and customs networks, and are more vulnerable to parental or caregiver abuse and neglect. Policymakers take adopted many different strategies to connect new families with health intendance services and other social support programs.

Source: U.S. Department of Wellness and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children'due south Bureau.(2012).Child maltreatment 2012. Bachelor from http://www.acf.hhs.gov/programs/cb/resource/child-maltreatment-2012.

Early Childhood Dwelling Visiting

Early childhood dwelling house visiting programs help new parents gain cognition of basic parenting skills past matching new families with trained providers, such as nurses, social workers or parent educators. These prevention-focused programs are voluntary, and are offered to new families every bit a connection to social and medical supports throughout pregnancy or the first few years of life. Certain dwelling house visiting models take proved to exist constructive in reducing child maltreatment. Communities that have implemented the Nurse Family Partnership, for example, accept seen on boilerplate a 48 pct reduction in child corruption and fail, and a 56 percent reduction in emergency room visits for accidents and poisoning. Salubrious Families America is another example of a Home Visiting Program that emphasizes reducing child maltreatment.

Prove-Based Home Visiting

The Nurse Family Partnership is the most extensively evaluated early on domicile visiting program and has consistently been establish to be an effective intervention for preventing child maltreatment. In this program, first-time moms who choose to participate are connected with a nurse from the time of pregnancy until the child turns 2 years one-time. Nurses conduct ongoing dwelling visits to help support a salubrious pregnancy, teach new moms techniques to foster wellness and positive interactions with her infant, and aid new families in continuing their teaching or finding work.

State legislatures take been supporting home visiting programs for more than than a decade. Recently, in 2013, Hawaii enacted a law to establish a statewide hospital-based home visiting plan to provide universal screening of newborns' families to identify risk factors for poor health, kid abuse and child neglect. High-risk families are referred to the statewide home visiting programme, and can choose to participate in the plan. Other states, such equally Arkansas and Texas, require habitation visiting programs to be evidence-based, and to track outcome measurements to monitor program effectiveness. In these two states, the legislature plays a direct role in monitoring and modifying abode visiting program standards. For a full listing of Abode Visiting legislation passed between 2008 and 2014 delight visit NCSL's Home Visiting Webpage.

State Legislative Options for Early Babyhood Home Visiting

• Explore opportunities to utilize and leverage current state, federal and local funding to  back up early childhood home visiting programs. In Washington state, for instance, the Legislature established the Home Visitation Services Business relationship in 2010 to align and leverage public funding with matching private funding to increment the number of families served.
• Examine how agencies and programs coordinate dwelling house visiting services throughout the state, and consider means to minimize domicile visiting programme duplication or fragmentation. Connecticut's Early on Childhood Instruction Cabinet appointed a home visitation committee with the goal of linking home visiting with other state priorities and to study best practices.
• Ensure the state is investing in research-based dwelling house visiting models that demonstrate effectiveness and have accountability measures in identify.

Health Literacy for New Families

Wellness literacy can be idea of equally a person's ability to obtain, procedure and understand basic information and services in club to make advisable health decisions.  It is estimated that almost 36 percent of American adults are "health illiterate." Low wellness literacy among new parents creates barriers to obtaining important health and safety information during a child's life.  A 2009 study published in the Journal of the American Academy of Pediatrics found that more than than 28 percent of parents had only bones health literacy or less than basic health literacy.  Incorporating simple, piece of cake-to-sympathize child maltreatment prevention information into prenatal and pediatric care visits may subtract health literacy demands on parents, and assist new families understand like shooting fish in a barrel ways to forbid kid corruption and neglect.

Supporting Greater Admission to Positive Parenting Support

Triple P, or the Positive Parenting Program, is an bear witness-based intervention that offers parents simple strategies to manage their children's behaviors. By incorporating elementary messages to encourage parents to create nurturing environments for children and support irenic parenting skills, Triple P aims to build healthy, positive relationships betwixt parent and child. This program uses a combination of tools, such as parent local media outlets, consultation with trainers and public seminars, to spread data about positive parenting skills. Learn more almost Triple P.

According to the Centers for Disease Control and Prevention, at to the lowest degree xx states have implemented activities to address wellness literacy. Many of these activities involve collaborations between state and local governments, academic institutions and non-profit organizations. In addition to these state activities, some legislatures have addressed the upshot of health literacy in state law. Maryland law requires the Function of Minority Health and Health Disparities to work collaboratively with universities, public health and social piece of work programs, and allied wellness to create courses that focus on cultural competency, sensitivity and health literacy. In 2006, the Washington Legislature created the governor'south interagency coordinating council on health disparities, which is required to create a statewide policy to accost social determinants of health, including increasing health literacy.

Country Legislative Options for Enhancing Health Literacy

• Consider integrating child maltreatment prevention education into existing health care visit screening standards, such as prenatal care visits for new parents, or preventive care well-child screenings for children. For case, Oklahoma's Medicaid Intendance Management Department pairs nurses known as "Health Coaches" with certain new moms or young children with the goal of improving health literacy and health condition.
• Back up community education and outreach programs that inform parents most child maltreatment prevention information and resource.
• Encourage hospitals and clinics to incorporate optional specialized services that offering parenting and child behavior classes or data.
• Back up cultural competence continuing teaching credits for health intendance providers. In 2012, Maryland Firm Beak 679 required the Function of  Minority Health and Wellness Disparities to work collaboratively with universities, public wellness and social piece of work programs, and allied wellness to create courses focusing on cultural competency and sensitivity

Community Health Workers

Customs health workers (CHWs) are members of a community who piece of work with a local wellness care system to assist people in receiving necessary health care and other social services. Their function in a community is dynamic: They help connect people with services, and they likewise inform health care providers and administrators about the health and social needs of the people in their community. CHWs aid members of the customs provide social support, offer culturally appropriate health education and information, and aid advocate for individuals within the health or social services organization.

Community health workers are too referred to every bit: community wellness advisers, promotores/promotoras de salud, or lay health workers. They work for pay or as volunteers and tailor their piece of work to run into local community needs. CHW rely on a diverseness of funding sources including community health centers, grants from individual funders, and, in some states, Medicaid.

In terms of preventing child maltreatment, CHWs may play of import roles to assist new parents adopt healthy behaviors and admission positive parenting resources within a community. The Massachusetts' CHW Advisory Council plant that CHWs prioritize iv main goals including: client advocacy, health education, outreach and health organisation navigation.

By using existing programs, states may exist able to encourage CHWs to expand their goals to include educating new families about child maltreatment prevention strategies, and assist parents navigate complicated health and social systems.

Borer Community Resources to Reduce Child Maltreatment

The Durham Family Initiative began in 2002, when a grouping of government bureau directors in Durham, N.C., signed a memorandum of agreement to implement a community system of care to encourage salubrious parent-child relationships. Nether this agreement, community services were integrated for the purpose of promoting kid well-being and preventing kid maltreatment. Community service providers work with families to develop a plan that incorporates formal and informal services, such every bit parent training or organized religion-based support groups, to improve family well-beingness. The purpose of this plan and the community liaison is to ensure that a family has access to the services, resources and support that volition help facilitate positive kid-parent relationships and a nurturing family environment. The Durham Family Initiative has resulted in a 57 per centum reduction of kid maltreatment in Durham County. Learn more than nigh the programme.

Many states have passed legislation to increment the use of community health workers within the primary care organisation, and a few states encourage the employ of CHW for activities that may help prevent child maltreatment. In 2011, for example, Oregon passed House Bill 3650, which directed the Oregon Health Authority to develop training requirements and curriculum standards for nontraditional wellness workers, such as community health workers. This curriculum requires training in: health promotion and best practices, the social determinants of health, health literacy problems, and warning signs for substance corruption and mental wellness problems. The social connections and medical guidance offered by CHW may assistance reduce stress from parenting and offer new families connections to wellness and social service options in a community.

State Legislative Options to Optimize the Use of Customs Health Workers

• Establish and fund CHW programs to support prophylactic, stable and nurturing family environments. Several states take adopted legislation that defines or recognizes customs health workers, establishes standards or credentials or assesses training and certification needs.
• Support incorporating child maltreatment prevention teaching into existing state community health worker training curriculum. Arizona'south Wellness Start, for example, uses community health workers to provide pedagogy to significant women and new families to ameliorate health outcomes, increase child safety or to make referrals to other services.

Achieving Greater Admission to Loftier Quality Child Intendance

For many years, state and federal governments have been involved with licensing and regulating child care centers, and creating subsidies for depression-income families who need child care. Data from the U.Due south. Census Bureau'due south American Customs Survey emphasizes the importance of child care options for families of young children. Between 2005 and 2009, 62.three percentage of children under the age of half-dozen were living with a single working parent or two working parents, indicating that the majority of young American children accept working parents and demand access to nonfamilial care.

Admission to high quality and affordable kid care tin can influence caregivers' ability to support a family, while limiting a child'south exposure to neglect and abuse. Increasing admission to high quality kid care for all children may reduce the incidence of kid neglect, and ameliorate learning and developmental outcomes of children.

Early Head Outset

Early Head Showtime is a federally funded plan that offers low income pregnant women and families with children under the age of 3, access to early learning and teaching in a day care setting and other family support services. Many programs offer dwelling house-based services, which include weekly domicile-visits from trained plan staff to promote parent or caregivers' ability to back up the child'due south development. Abode-based programs also offer twice-monthly grouping sessions to bring parents and children from many families together to talk over their experiences.

Forth with providing high quality child care, research conducted by Columbia University and Mathematic Policy Research constitute that, compared to command groups, Early on Caput Start parents were:

• More than emotionally supportive and less detached from their children.
• Less likely to report having recently spanked their children.
• Reported to take a greater repertoire of discipline techniques, including more than mild and fewer castigating strategies.

These findings indicate that the Early Head Start Program could reduce child fail and abuse past providing high quality kid care for working, low-income parents, and encourage positive parenting techniques among parents.

All fifty states have at least ane Early Caput Start Program and are funded primarily by the federal government. Not all children who qualify to participate in Early on Head Start practise and so. Co-ordinate to the Children's Defense Fund, fewer than half of those who are eligible are enrolled in Early on Head Start. Equally of 2012, 10 states use state money to back up Early on Caput Beginning Programs. Oregon, for example, provides all federally supported EHS programs with state funding to expand the number of children served.

Early on Head Showtime Child Care Partnerships

A new federal initiative, "Early Caput Start-Child Care Partnerships," provides $500 million in new federal grants to new or existing Early on Head Start Programs. These grants will support programs to partner with local child care centers and family intendance providers serving infants and toddlers from low income families.

Source: U.Southward. Department of Wellness and Human Services, Administration for Children and Families, Assistants on Children, Youth and Families, Office of Head Start, 2012 Plan Information Study 2012. Available from http://eclkc.ohs.acf.hhs.gov/hslc/hs.

State Options to Strengthen Early Head Start

Explore the Early Head Beginning programs in your land or district. Ask the Early Head Get-go program director the questions you may take, such as:

• How many children are enrolled in the Early Caput Get-go programs in your district?
• How long are the waiting lists for Early on Caput Beginning programs in your district?
• Does your state provide supplemental funding for these federally funded programs?
• What challenges does the program confront?
• What are the primary successes of the plan?

To encourage enrollment for those who qualify, consider use existing do good enrollment systems, such equally Medicaid or TANF, to facilitate access to Early Head Start.

Kid-Parent Centers

To improve child-parent interactions, foster positive parenting skills, and encourage positive kid management strategies, Child-Parent Centers (CPC) are comprehensive educational and family back up programs for economically disadvantaged children between historic period 3 and 3rd grade. These evidence-based  programs offer school- or center-based learning activities that focus on a child's social and cognitive evolution, and crave consistent parental participation in their kid'due south education.

Responding to the lack of federal Head Start programs in high poverty neighborhoods, the Chicago Public School Systems adult the Chicago Child-Parent Centre program to expand access to quality preschool education to all neighborhoods. To be eligible for participation, families must reside in neighborhoods that receive federal Title I education funds and parents must commit to volunteering at the heart every week. Every CPC programme includes classroom didactics with trained teachers, outreach services such as home visits when families enroll and transportation to the middle, and parental volunteering at the heart for at to the lowest degree ane one-half day per week.  The Chicago CPC uses federal Title I to fund activities.

The Chicago CPC has been shown to decrease children'south exposure to abuse and fail. V percent of children who participated in the CPC grouping experienced child maltreatment, compared to 10.3 pct in the non-CPC control group. Long-term evaluation of this plan has also shown other benefits, such as college reading and math test scores among children who participated in the program.

Country Legislative Options for Child-Parent Centers

Many communities have programs or schools that provide preschool didactics. Consider strengthening these programs by:

• Encouraging existing preschools in your commune or community to adopt a Kid-Parent Center model of instruction.
• Support preschools that promote evidence-based activities to reduce child abuse and neglect by incorporating parental participation in young children's didactics.

Options for Coordinated Funding

State governments employ a multifariousness of funding sources to support child welfare systems. A small portion of these funds directly back up prevention activities. State and local agencies decide who will receive prevention services, and what types of prevention services volition be provided. Therefore, identifying funding amounts that straight support kid maltreatment prevention is difficult to discern. This section analyzes federal and country funding streams that are authorized for kid maltreatment prevention to get a meliorate idea of how states are supporting prevention activities and offer potential strategies to support prevention activities.

Federal Funding Options

Since 1974, the federal Child Abuse Prevention and Treatment Human activity (CAPTA) has provided funding to states, tribes, tribal organizations, public agencies and nonprofit organizations to address child abuse and fail. Title II of CAPTA provides Customs Based Grants for the Prevention of Child Abuse or Neglect. These grants are intended to aid community agencies support kid abuse and neglect prevention activities and emphasize family back up or parental participation. Programs supported by these grants include voluntary habitation visiting, family resource centers, parental common support and other positive parenting activities.

Several states also utilise a portion of the federal Social Services Block Grant (SSBG) to fund activities that aim to prevent child maltreatment. SSBG funds are considered nondedicated federal funds and can be used by states or territories to see the needs of its residents. Examples of SSBG funded services include mean solar day intendance, case management and health-related services for children. Funds are allocated to all states and territories.

The Affordable Care Human action's Maternal, Babe and Early Childhood Home Visiting grant provided additional federal support for child maltreatment. This federal initiative provided states with $ane.5 billion for domicile visiting between 2010 and 2014 with an option for reauthorization. It also emphasized evidence-based domicile visiting models, of which 13 models run across federal criteria, with 75 pct of the federal funding directed to such programs.

State Funding Options

Country funding back up for kid maltreatment prevention is supported by a complex and diverse source of funding streams. This section discusses a few ways state legislatures have established direct child maltreatment prevention funding back up. For more information nigh kid welfare or child protective services, delight visit NCSL's Human being Services Overview webpage.

Several states have funding streams dedicated to child abuse prevention.  In 2011, the Illinois legislature created the Child Corruption Prevention Fund, which is funded past a voluntary contribution option on the Illinois income taxation render. Like to Illinois, Oregon allows tax payers who receive a tax refund the option of contributing a portion of their refund to child abuse and fail prevention.  The Nebraska Legislature provides a direct cribbing to the Nebraska Child Abuse Prevention Fund.  This fund was established in 1986 by the legislature to identify the needs, problems and solutions of child abuse and neglect in the state.  Each state'south child maltreatment prevention funding picture is different.

State Legislative Options to Coordinate Funding

• Explore state and local programs that aim to foreclose child corruption and prevention.
  • Are these programs using several federal, state and local funding sources to sustain kid maltreatment prevention activities?
  • Can your country develop mechanisms to unify or leverage funding sources that aim to prevent child maltreatment?
• Consider creating country funding mechanisms to support child maltreatment prevention activities. Oklahoma, for instance, has established "Child Abuse Prevention" license plates. The application fee for these license plates is deposited into the state's Kid Corruption Prevention Fund to back up programs across the land.

Conclusion

Country legislatures play important roles in preventing child maltreatment. Identifying unique characteristics of each community'due south and state's child maltreatment activities is an important step to agreement existing strengths and needs in the child maltreatment prevention organisation.  Legislators can be leaders in efforts to foreclose child abuse and neglect.

Boosted Resource

NCSL Resource

• Health Programme
• Human Services Plan
• Child Welfare Webpage

Other Resources

• Child Maltreatment Prevention, Centers for Disease Control and Prevention
• Essentials for Childhood Framework: Steps to Create condom, Stable, and Nurturing Relationships and Environments for all Children, Centers for Affliction Control and Prevention

Acknowledgements

This brief was written by Hollie Hendrikson.

The National Conference of State Legislatures thanks Suzanne Friesen, CDC project officers and others at CDC for their time and commitment to make this publication every bit thorough every bit possible.

The writer also likes to give thanks the following NCSL staff who reviewed the brief and made recommendations: Nina Williams-Mbengue, Julie Poppe, Robyn Lipkowitz, Melissa Hansen and Martha King

This publication was made possible by contract number 200-2013-M-57330  from the Centers for Disease Control and Prevention. Its contents are solely the responsibleness of the author and do not necessarily represent the official views of the CDC.

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Source: https://www.ncsl.org/research/health/preventing-child-maltreatment-defining-the-problem-discussing-solutions.aspx

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