This fact sheet is an excerpt from Emerging Practices in the Prevention of Child Abuse and Neglect, (2003) U.S. Department of Health and Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau, Office on Child Abuse and Neglect. The findings and conclusions presented in this fact sheet do not necessarily represent the official positions or policies of the Children's Bureau's Office on Child Abuse and Neglect.

Existing knowledge about the efficacy of prevention in the field of child maltreatment is limited; clearly, all the major prevention models and strategies could benefit from more rigorous study. Based on the evidence available today, home visitation programs have demonstrated some capacity to improve family functioning and wellness, reducing the risks faced by children. While there is evidence that a few home visitation programs actually reduce the number and severity of subsequent child abuse reports, evaluations of other home visitation programs have not measured program impact on incidence of maltreatment or have found no differences over time between experimental and control groups.

The record for parent education programs, which strive to increase family wellness by improving the knowledge and skills of parents, is neither rich nor, on the whole, particularly compelling. Though numerous studies of parent education programs have demonstrated positive findings, these findings have largely been limited to short-term gains among participants in parenting knowledge, skills, and abilities. The issue of statistical versus clinical significance is an important one. Many of the studies report findings of statistically significant differences between "treatment" and comparison groups on these measures. The question to be asked, however, is whether observed differences in short-term knowledge gains are meaningful in terms of actually protecting children, i.e., are the knowledge gains correlated with fewer actual abuse incidents? Taken as a whole, little is known about the impact of these programs on child maltreatment in the long term.

Programs for children and parents that are designed to raise awareness about child sexual abuse is another area where there has been a recent and relatively concentrated research focus. Available research suggests that such programs, like parent education programs, can be successful at imparting information and changing behavior, but there is little evidence to conclude that these programs actually prevent child sexual abuse. Though a few very recent studies have examined the relationship between knowledge and behavior and subsequent incidence of maltreatment, leading to some encouraging findings, these studies have been idiosyncratic and the results, therefore, are not widely generalizable.

Very little is known about the effectiveness of universal initiatives that seek to prevent maltreatment by raising public awareness. Measurement of the effectiveness of these initiatives faces its own unique complexities. In the particular area of Shaken Baby Syndrome, for example, understanding and recognition among medical professionals of the constellation of injuries that constitutes the syndrome continues to progress, steadily increasing the reliability of the diagnosis. There is currently no national mechanism for counting cases, however, so the true incidence of the syndrome is not well understood. Until such time, evidence of the effectiveness of initiatives to prevent the syndrome will continue to be limited.

Still, in a recent discussion of the historical "waves" of prevention, Daro and Donnelly conclude that there has been substantial progress for prevention as a concept over the last three decades. Progress can be found today in stronger, more diversified partnerships, increasingly rigorous research, greater pooling of resources across agencies, and more unified thinking and sense of purpose (Daro & Donnelly, 2002).

The full report on the Emerging Practices project, Emerging Practices in the Prevention of Child Abuse and Neglect, can be found on the National Clearinghouse on Child Abuse and Neglect Information Web site:
HTML: nccanch.acf.hhs.gov/topics/prevention/emerging/report/index.cfm
PDF: nccanch.acf.hhs.gov/topics/prevention/emerging/report.pdf

A print copy of the report can be ordered by contacting the Clearinghouse at (800) FYI-3366, (703) 385-3206 (fax), nccanch@calib.com (e-mail).

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