America’s national incidence study of child abuse and neglect in 1996 estimated that between 20-30% of children identified as maltreated suffered a serious injury defined as long-term impairment of physical, mental and emotional capacities. Examples of such injuries included loss of consciousness, broken bones, third degree burns and schooling loss that required special educational services. In Australia the incidence of official records of child maltreatment during 2002-2003 was 198,355 reported cases. Of the 40,416 cases that were substantiated 34% of these cases accounted for neglect, 28% for physical abuse, 10% for sexual abuse and a further 34% for emotional abuse. These shocking and devastating statistics alone are reasons why the state should intervene early when families and children are at risk. We advocate that a proactive method towards child abuse should be taken rather than a reactive method to prevent abuse from even occurring in the first place.
Risk factors are defined by Kirby and Fraser as any influence that increases the probability of onset, digression to a more serious state, or maintenance of a problem condition. They range from prenatal biological, to broad environmental conditions which affect children. Risk factors can be individual including both biological and dispositional factors, contextual or environmental such as poverty, minority and race as well as family, school and neighbourhood conditions.
Identified as falling at risk are single mothers, families of low socioeconomic status, parents who abuse substances and families in which domestic violence takes place. Evidence reveals that the implementation of home visitation and numerous intervention programs alleviates the problem of abuse in those families it occurs, predicts more promising outcomes for children’s development and more importantly prevents abuse from even occurring.
Single mothers confront a wide range of adversities. They face added responsibilities of raising a child alone, often struggle financially and lack social networks for support. These demands of parenting can often become too much, placing them at risk for neglecting their children and potentially abusing them. Of course this is not true for all single mothers in fact some single mothers do a great job of parenting, what we are suggesting is that early interventions either during pregnancy or beginning from birth can assist single mothers who are at risk because of these circumstances and ensure better outcomes for their children’s development and safety.
Home interventions have shown promising results around the world. The nurse home visitation program utilized in the united states is a program designed to improve the well being of first time low income mothers and their children. Specifically, the program is designed to improve pregnancy outcomes by helping women alter health related behaviours such as smoking, alcohol consumption and drug use, to improve child health and development by teaching parents how to provide more responsible and competent care and to improve families economic self sufficiency through further education and secure employment.
When the nurse home visitation program was tested experimentally those single mothers of low socioeconomic status who received home visits for a period of two years and free transportation for prenatal child care had significantly lower rates of state verified reports of child abuse and neglect, fewer subsequent pregnancies and births, experienced a shorter time on welfare and a shorter time receiving food stamps compared to those single mothers whose home visitations were infrequent and those who did not receive home visits at all.
A study conducted by Black and his colleagues also highlights the importance of home interventions to improve single mothers parenting methods and health related issues in an attempt to reduce or prevent child abuse. Sixty drug abusing women were recruited prenatally and randomized into an intervention or comparison group. Mothers were single African American non high school graduates from low income families. Approximately 40% of the women were HIV positive and all admitted to either cocaine or heroin use.
Women in the intervention group were more likely to be drug free and were complaint with primary care appointments for their children. Their babies were healthier at birth, slightly heavier and obtained higher cognitive scores at one year compared to the babies of mothers in the comparison group. Women who received home intervention also reported more normative and positive attitudes regarding parenting and were less likely to abuse their children.
Another intervention program called the Abecedrian project is an early childhood education, healthcare and family support program that begins in early infancy for children born to low income multirisk families. Its use and outcomes have been evaluated in a study conducted by Ramey. The families mostly consisted of single African American mothers whose mean age was less than 20 years and whose education level did not exceed that of the 10th grade. Preschool intervention reduced the incidence of delayed cognitive development for children with IQ increasing 8-20 points. It significantly ameliorated the effects of some biological and risk factors including low apgar scores, difficult temperament and fetal undernourishment and mothers had an increased likelihood of completing high school and obtaining postsecondary training.
Another negative aspect of family life is the effect of domestic violence on children, as witnesses to such events. Domestic violence affects children’s internalising behaviours such as anxiety and social withdrawal, their externalizing behaviours such as aggression and delinquency, their cognitive abilities, their coping and emotional functioning and puts children at greater risk for experiencing violence and abuse for themselves.
A review of Victoria’s domestic violence legislation between 1987 and 1990 has shown some alarming results. Of the 3003 violent domestic incidents reported to the police, 92 involved the use of a gun and 65% of these cases were witnessed by children under the age of five. What is more shocking is that children were assaulted or molested in 25% of these domestic disputes. The question arises as to how many cases did indeed go unreported and whether these cases could have been prevented or improved with early interventions.
The Talera Center in Queensland provides a range of therapeutic educational, accommodation and support services for families who are victims of domestic violence, with the aim of increasing the possibility that children can live in safety within their own environment. Its goals are to enhance children’s abilities to develop safe, non violent relationships and to heighten the awareness among the parents of the impact of domestic violence on their children and to support them in developing non-violent, nurturing relationships with their parents. In addition it maintains that effective interventions should also encourage and facilitate the development of community responses to the issue of children and domestic violence in an attempt to educate them on the effect it has on children and to report known cases to prevent the abuse from happening. The Telara Center has been known to show promising results among parents and families experiencing domestic violence.
Child maltreatment has been strongly correlated with juvenile delinquency in numerous studies. It has also been found that child welfare services can lower the risk of children becoming juvenile delinquents and prevents more serious cases of abuse from occurring. Johnson-Reids study further confirms this claim. The California intervention program was evaluated and the implementation of in home child welfare services was found to decrease the risk of juvenile corrections. It was further found that child welfare intervention reduced delinquency by reducing recurrent maltreatment. Those families who did not partake in the intervention program experienced reoccurring incidences of child maltreatment and had children who were later incarcerated for their behaviour. So yet again we can clearly see that intervening early when children are at risk produces better outcomes for children.
Another advantage of early intervention stems from an economical view. For example the costs of child abuse in Michigan were estimated at 823 million dollars annually. The costs include those associated with low birth weight babies, infant mortality, special education, protective services, foster care, criminality and psychological services. The costs of prevention programming however, was estimated to be 43 million dollars annually. This yields a 19 to 1 cost advantage to intervention.
Early intervention seems the only way to go. By taking a proactive stance and intervening early when children are at risk, we can clearly see that child abuse can in fact be prevented from becoming more serious or more importantly be prevented from even occurring. If the state were to intervene only in serious cases of abuse we would only see a dramatic increase in the statistics of abused children and in the worst case scenario