Article

Interventions to Prevent Child Maltreatment and Associated Impairment

Departments of Psychiatry and Behavioural Neurosciences and of Pediatrics, and Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada.
The Lancet (Impact Factor: 45.22). 01/2009; 373(9659):250-66. DOI: 10.1016/S0140-6736(08)61708-0
Source: PubMed

ABSTRACT Although a broad range of programmes for prevention of child maltreatment exist, the effectiveness of most of the programmes is unknown. Two specific home-visiting programmes-the Nurse-Family Partnership (best evidence) and Early Start-have been shown to prevent child maltreatment and associated outcomes such as injuries. One population-level parenting programme has shown benefits, but requires further assessment and replication. Additional in-hospital and clinic strategies show promise in preventing physical abuse and neglect. However, whether school-based educational programmes prevent child sexual abuse is unknown, and there are currently no known approaches to prevent emotional abuse or exposure to intimate-partner violence. A specific parent-training programme has shown benefits in preventing recurrence of physical abuse; no intervention has yet been shown to be effective in preventing recurrence of neglect. A few interventions for neglected children and mother-child therapy for families with intimate-partner violence show promise in improving behavioural outcomes. Cognitive-behavioural therapy for sexually abused children with symptoms of post-traumatic stress shows the best evidence for reduction in mental-health conditions. For maltreated children, foster care placement can lead to benefits compared with young people who remain at home or those who reunify from foster care; enhanced foster care shows benefits for children. Future research should ensure that interventions are assessed in controlled trials, using actual outcomes of maltreatment and associated health measures.

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    • "Using Administrative Data to Evaluate Child Abuse Prevention Programs Efforts to implement and rigorously evaluate child maltreatment prevention programs have expanded considerably over the past three decades. While a number of these programs have shown promise in terms of promoting positive parenting and reducing risk factors for maltreatment, relatively few programs have examined the impact of services on rates of child maltreatment directly (Howard & Brooks-Gunn, 2009; MacMillan et al., 2009). One commonly cited reason for the absence of studies directly examining child maltreatment outcomes is the difficulty of obtaining reliable information about child abuse and neglect occurrence (Fallon, "
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    ABSTRACT: In recent years, there has been increasing interest in using administrative data collected by state child welfare agencies as a source of information for research and evaluation. The challenges of obtaining access to and using these data, however, have not been well documented. This study describes the processes used to access child welfare records in six different states and the approach to combining and using the information gathered to evaluate the impact of the Early Head Start program on children’s involvement with the child welfare system from birth through age eleven. We provide “lessons learned” for researchers who are attempting to use this information, including being prepared for long delays in access to information, the need for deep understanding of how child welfare agencies record and code information, and for considerable data management work for translating agency records into analysis-ready data sets. While accessing and using this information is not easy, and the data have a number of limitations, we suggest that the benefits can outweigh the challenges and that these records can be a useful source of information for policy-relevant child welfare research.
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    • "Cette évaluation a mis en lumière la nécessité de documenter de manière flexible et évolutive les changements qui s'opèrent au sein des familles et qui ne sont pas toujours perceptibles dans le contexte d'une visite ponctuelle effectuée dans le cadre d'un projet de recherche. Ce constat est partagé par plusieurs études qui soulignent la difficulté de démontrer les effets positifs associés aux programmes en négligence (MacMillan et al., 2009; McFarlane et al., 2012). "
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    • "Parents’ understanding of typical development patterns can better guide and discipline their child. Despite a general consensus about benefits of parenting training programs with different effects,[91011] several studies have reported some parenting training programs that failed to improve parents’ skills in the child safeguarding and welfare so that the most effectiveness of training programs is still unknown.[9121314] "
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