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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Available from: Jane Barlow, Sep 02, 2015
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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.
    Children and Youth Services Review 07/2015; DOI:10.1016/j.childyouth.2015.07.015 · 1.27 Impact Factor
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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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    ABSTRACT: La négligence auprès des enfants est un phénomène reconnu et largement documenté. Malgré les nombreuses études sur le sujet, il demeure difficile de bien mesurer quelle réponse la famille et son environnement offrent aux besoins des enfants. Cette difficulté pourrait expliquer pourquoi les études actuelles peinent à documenter des changements au sein des familles en contexte de négligence. L'article s'appuie sur une définition écosystémique de la négligence et présente l'élaboration d'un outil destiné à fournir une analyse des besoins de l'enfant, de la réponse qu'il obtient, ainsi que des caractéristiques de l'environnement familial et social dans lequel il grandit. L'outil préconise en outre une approche participative auprès des familles en permettant aux intervenants, mais également aux figures parentales de se prononcer sur la situation familiale. Les propos de 54 parents et de 8 intervenants ont été analysés de façon qualitative afin de connaître les avantages et les défis reliés à l'utilisation de l'outil proposé. Mots-clés : Négligence, écosystémie, approche parti-cipative, analyse des besoins. Abstract Child neglect is a well-recognized problem that has important negative consequences on children's development. Despite numerous studies on the subject, measuring changes in the response those children receive to their needs is still challenging. We present a tool that could offer a portrait of families' situation and evolution in time. The tool is based on the ecological model of neglect. It also offers a participative approach, whereby social workers, as well as parents, are engaged in the evaluation of the children's need, the parental responses and the environmental factors contributing to the family situation. 54 parents and 8 intervenors were interviewed concerning the benefit and challenges related to the usage of the tool.
    • "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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    ABSTRACT: Background:Preventing child abuse is an area of evaluation that should be deeply considered. The enhancing skill of maternal child care is also useful in this field.Aim:The aim of this study was to assess the impact of a training strategy to improve parenting in the families identified as at risk of child maltreatment.Materials and Methods:This randomized and controlled trial was conducted in 60 mothers allocated in the experimental and controlled group by a simple random allocation in Amirkola Children's Hospital in North Iran from January 2009 to December 2009. Mean score of maternal child abuse before and after intervention has been assessed by Conflict Tactics Scale for Parent and Child. Data analysis was based on the independent t-test, the paired t-test and one way analysis of variance.Results:The mean and standard deviation of maternal child abuse score in the experimental group before and after intervention were 30.21 ± 1.21 and 23.31 ± 1.52, respectively, (P < 0.001, t = 6.63), but no difference was found in the control group.Conclusions:The training program on maternal skills to prevent child abuse was a powerful resource. Therefore, healthcare providers in the field of pediatric about parenting skills should be taught with a specific consideration.
    North American Journal of Medical Sciences 08/2014; 6(8):391-5. DOI:10.4103/1947-2714.139289
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