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.

Introduction

Child maltreatment prevention services operating in communities today generally fall within a typology that includes several major approaches or methodologies: public awareness activities, skill-based curricula for children, parent education programs and support groups, home visitation programs, respite and crisis care programs, and family resource centers. In recent years, programs have been developed and implemented in a wider array of settings including prisons, places of worship, hospitals, and schools.

Public Awareness Activities

Public awareness activities are an important part of an overall approach to address child abuse and neglect. Such activities have the potential to reach diverse community audiences, including parents and prospective parents, children, and community members. In designing prevention education and public information activities, national, State, and local organizations use a variety of media to promote these activities, including:

* Public service announcements
* Press releases
* Posters
* Information kits and brochures
* Television or video documentaries and dramas

Through these media, communities are able to promote healthy parenting practices, child safety skills, and protocols for reporting suspected maltreatment.

One of the largest child maltreatment public awareness initiatives is focused on the prevention of Shaken Baby Syndrome. A national network of State contacts for Don't Shake the Baby was established to ensure that all professionals involved in the care of children (e.g., teachers, physicians, nurses, home visitors, parent educators) became aware of the dangers associated with shaking infants. In addition to professionals, this campaign targeted parents to alert them to the dangers of shaking their babies and to provide information on positive coping skills when caring for a crying infant. Another initiative designed to capture attention and raise public awareness is STOP IT NOW!, which is a primary prevention media campaign that targets male and female sexual abuse perpetrators and other adults, calling on abusers and potential abusers to stop and seek help. STOP IT NOW! also increases public awareness about the trauma of sexual abuse. People are encouraged to call a toll-free help line for information and referrals regarding child sexual abuse.

Prevent Child Abuse America, formerly the National Committee to Prevent Child Abuse, also directs efforts to increase public awareness of the dangers and signs of child maltreatment. In collaboration with Marvel Comics, Prevent Child Abuse America developed Spider-Man comic books to address child sexual abuse and other child safety issues. In addition, Prevent Child Abuse America distributes an information packet each year to assist community groups in planning Child Abuse Prevention Month activities. Chapters in 37 States and one in the District of Columbia provide ongoing public awareness and other activities to prevent child maltreatment.

State Children's Trust Funds (CTFs) exist in all 50 States and the District of Columbia with the specific goal of preventing child maltreatment. CTFs and their local councils and affiliates coordinate prevention activities throughout each State by promoting and funding a variety of community-based programs, including public awareness campaigns, home visitation programs, skills-based curricula for children, and parent education and support activities. In addition, many CTFs develop and distribute public awareness materials for community groups, schools, and many other professionals working with children. These materials may include posters, bookmarks, magnets, and scripts for public service announcements. Many of the Children's Trust Funds also have been designated as the State lead agencies for the CBFRS program.

Skills-Based Curricula for Children

Many schools and social service organizations in local communities offer skills-based curricula to teach children safety and protection skills. Most of these programs focus efforts on preventing child sexual abuse and teaching children to distinguish appropriate touching from inappropriate touching. Other programs focus on preparing young people to function successfully in society, while still others teach or enhance protective behaviors in children. Curricula may have a parent education component as well to give parents and other caregivers the knowledge and skills necessary to recognize and discuss sexual abuse with their children. Curricula may use various methods to teach children skills, including:

* Workshops and school lessons
* Puppet shows and role-playing activities
* Films and videos
* Workbooks, storybooks, and comics

Examples of skill-based curricula include programs such as Talk About Touching, Safe Child, Good Touch/Bad Touch, Kids on the Block, and Illusion Theater.

Parent Education Programs and Parent Support Groups

Perhaps the most prominent prevention activity is parent education. Typically, these programs focus on decreasing parenting practices and behaviors associated with child abuse and neglect. Though parent education programs may serve the general community, many are directed at populations determined to be at risk for child maltreatment. These programs address issues such as:

* Developing and practicing positive discipline techniques
* Learning age-appropriate child development skills and milestones
* Promoting positive play and interaction between parents and children
* Locating and accessing community services and supports

Parent education programs are designed and structured differently, usually depending on the curriculum used and the target audience. Programs may be short-term, offering classes once weekly for 6-12 weeks, or programs may be more intensive, offering services more than once weekly for up to a year. Well-known parent education programs include Parents as Teachers, National Parent Aide Network, Meld, Effective Parenting Information for Children (EPIC), Parents and Children Together (P.A.C.T.), and the Nurturing Program.

* The Parents as Teachers program targets parents with children from birth to 5 years old and focuses on child development; recommends activities that encourage language development, intellectual growth, and social and motor skills; and strengthens the parent-child relationship. This program has 4 components, including personal home visits, group meetings, developmental screenings, and connection to community resources.

* The National Parent Aide Network, a component of the National Exchange Club Foundation, is a national network of professionally trained individuals who become friends and role models to parents and teach them how to be responsible and bond with their children. Parent aides provide support, encouragement, and genuine and caring friendships; focus on the good qualities of the parents; serve as an outside social control to stop abuse immediately; and address special needs of the family by referring them to community agencies when necessary.

* Meld offers educational and support services for parents to help them set goals and make decisions for their education, work, and family life that increase their self-confidence, self-sufficiency, and ability to manage a family successfully, and to reduce family isolation that can lead to abuse and neglect.

* Effective Parenting Information for Children (EPIC) provides a series of workshops to train parents and teachers to assist children in developing life skills and civic values leading to responsible adulthood and parenting.

* Parents and Children Together (P.A.C.T.) is a program in which parents and children participate in playtime, build family skills, and connect emotionally. P.A.C.T. also encourages parents to focus on child development and communication.

* The Nurturing Program is a family-based program that involves both parents and children in activities, focusing on building a positive regard for self and others. There are 15 Nurturing Programs that are focused on specific populations (e.g., Parents and Children Birth to 5 Years, Parents and Children 4 to 12 Years, Hispanic Parents and Children Birth to 5 Years, and Families in Substance Abuse Recovery). Programs are home based or group based and range from 1½ to 3 hours per week for 9-45 weeks.

In addition to parent education programs, parent support groups also work to strengthen families and prevent child maltreatment. Two well-known programs include:

* Parents Anonymous® Inc., founded in 1969, leads an international network of accredited organizations that implement community-based, weekly, free-of-charge Parents Anonymous® Groups for parents and other caregivers. In Parents Anonymous® Groups, co-led by parent group leaders and group facilitators, parents find a caring, mutually supportive environment where they can learn new parenting strategies and create long-lasting, positive changes in their families. Their children participate in complementary Parents Anonymous® Children's Programs that promote positive social and emotional development.

* Circle of Parents, a collaboration of Prevent Child Abuse America and the National Family Support Roundtable, provides parent self-help support groups to anyone in a parenting role. These groups offer parents a place to discuss the challenges of raising kids and to exchange ideas. Funded through a grant from the Children's Bureau, Office on Child Abuse and Neglect, this is an effort to expand and enhance parent self-help support groups across the country. Most established groups have a free program for children as well. The groups provide a place where anyone in a parenting role can discuss the successes and challenges of raising children, find and share support, and learn new parenting skills.

Home Visitation Programs

Home visitation programs have existed in the United States since the late 19th century. As a strategy for preventing child maltreatment, home visitation came to the forefront of the national agenda in 1991 when the U.S. Advisory Board on Child Abuse and Neglect recommended universal implementation of home visitation programs. Rather than a specific program or activity, home visitation is a strategy for service delivery. Many organizations and agencies in fields as varied as education, maternal and child health, and health and human services use home visitation programs to strengthen and support families.

Home visitation programs offer a variety of family-focused services to pregnant mothers and families with new babies and young children. Activities offered through home visitation programs may include structured visits in the family's home, informal visits, and telephone calls that focus on topics such as:

* Positive parenting practices and nonviolent discipline techniques
* Child development
* Availability and accessibility of social services
* Establishment of social supports and networks
* Advocacy for the parent, child, and family
* Maternal and child health issues
* Prevention of accidental childhood injuries through the development of safe home environments

As the popularity of home visitation programs has increased, so too has the number and diversity of organizations offering these services. Both large and small organizations are establishing programs and providing community-based services to a wide-ranging population. For example:

* Nurse Family Partnership, originally established as the Prenatal/Early Infancy Project at experimental sites in Elmira, New York, and Memphis, Tennessee, provides services to first-time mothers from the early stages of pregnancy through the child's first two years of life. Nurses provide home visits in accordance with a structured schedule, focusing on maternal health, parental role and life course, family and friends, and community services. The program, which is now available in numerous states, targets critical pregnancy outcomes, the prevention of child abuse and neglect, and subsequent unintended pregnancies.

* Healthy Families America (HFA), a national initiative launched in 1992 by Prevent Child Abuse America and modeled after Hawaii's Healthy Start, links expectant and new mothers to trained staff who provide home visits and referrals to community services. HFA currently has home visitation programs in over 420 communities in the United States and Canada.

* Early Head Start, an outgrowth of Head Start established in 1994 specifically for low-income families with infants and toddlers and pregnant women, promotes healthy prenatal outcomes, enhances the development of very young children, and promotes healthy family functioning. The community-based program provides parent education, comprehensive health and mental health services, and home visits.

* Home Instruction Program for Preschool Youngsters (HIPPY) is an educational enrichment program that builds on the natural bond between a parent and child. The home visitation model helps parents prepare their preschool-aged children for successful, early school experiences and strengthens the bond between schools, families, and communities.

* Parent Child Home Program (PCHP) is a home visitation program serving families challenged by the many obstacles to educational success, including poverty, low levels of education, and language difficulties. In play sessions with parents and children, the home visitor demonstrates various parenting techniques. An emphasis is placed on parent-child interaction and the development of verbal and language skills necessary to succeed in school.

* Hawaii's Healthy Start Program is a multisite program in Hawaii that screens, identifies, and provides services to families at risk for child abuse and neglect. Most participants are enrolled after the birth of a child; however, approximately 10 percent of participants enroll during the prenatal period.

* Project 12-Ways takes a comprehensive approach to prevention that uses an ecobehavioral model to teach parents new skills and knowledge regarding basic parenting, child development, and safety, while providing support to address some of the underlying problems affecting families. At intake, each family's individual needs are assessed and goals identified. Project counselors recommend services and meet with each family once or twice per week, monitoring the family's progress. Started in 1979 in Illinois, the model has since been replicated in California and is now a statewide model in Oklahoma.

Respite and Crisis Care Programs

Respite care services provide short-term care to children who have disabilities or chronic or terminal illnesses, who are in danger of abuse or neglect, or who have experienced abuse or neglect. For caregivers in stressful situations (they may be parents, foster or adoptive parents, or other relatives or guardians), respite care services provide temporary relief from the ongoing responsibilities of caring for children in the home. Crisis care is a unique form of respite. It is provided to children, with or without a disability, when the family is in crisis. Crisis care services may be referred to as crisis respite, emergency respite, crisis nursery, crisis stabilization, or shelter care (ARCH National Resource Center, 1998).

When family caregivers are not able to take a break from constantly providing care and supervision for their children, stress builds. This elevated stress can lead to increased incidences of abuse, divorce, and out-of-home placement of the dependent family member. Respite services are provided in a variety of settings, within or outside of the family home. Services are generally short term (ranging from a few hours to a few weeks), and are provided on either a planned or an emergency basis. Both respite and crisis care services can be provided by other family members, friends, neighbors, community recreation programs, child or dependent care providers or centers, home health aides, family resource centers, community human service providers and respite or crisis care agencies. In addition to care and supervision, many respite and crisis care providers also offer a variety of support services to families, including referrals to other programs, counseling, case management, meals, transportation, social activities, lodging, medications, personal care, and assistance with activities of daily living (ARCH National Resource Center, 1998).

Family Resource Center

Family resource centers are sometimes called family support centers, family centers, parent-child resource centers, family resource schools, or parent education centers. Each family resource center works with community members to develop specific services that meet the needs of the people who use the center and the community that surrounds it. This is accomplished by involving community members in design, implementation, and evaluation. Many centers require that advisory boards oversee the day-to-day operation of the centers, and that more than one-half of the board members be parents.

Family resource centers are located in a variety of community settings and serve diverse populations. Depending upon the resources available in the community, family resource centers may be located in churches, school buildings, hospitals, housing projects, restored buildings, or new structures. Based in the places where families naturally congregate, family resource centers serve as a central support within the community around which families can build their lives, regardless of the challenges they face.

Family resource centers promote both the strengthening of families through formal and informal sources of support and the restoration of a strong sense of community. Services may include parent skill training, drop-in centers, home visiting, job training, substance abuse prevention, violence prevention, services for children with special needs, mental health or family counseling, child care, literacy, respite and crisis care services, assistance with basic economic needs, and housing.

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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