Preventing Child Abuse
Intervening in a child's life once abuse or neglect has already happened is demanding, disruptive, and costly to all involved: the affected child, the involved family, the large number of professionals involved in the intervention, and the taxpayer, who ultimately provides financial support for the legal aspects of those intervention efforts.
Preventing child abuse holds the promise of a much more cost-effective approach to the problem, but since the risk factors for abuse and neglect are multiple, costly to address, and deeply imbedded in the US social fabric, efforts at prevention remain largely unsatisfying.
Child abuse prevention is usually divided into three categories:
- Primary prevention describes efforts aimed at whole populations. These include such activities as mass-media messages (e.g., billboards or public-service TV announcements) about abuse and talks to school or church groups. Primary prevention efforts can be effective at raising overall awareness of abuse issues, but typically have limited effectiveness in changing individual behaviors.
- Secondary prevention efforts target high-risk individuals or groups. Examples include home visitation programs (the best known are the Healthy Families and Nurse-Family Partnership initiatives) where (typically) new parents who reside in ZIP codes known to have high prevalence of abuse and neglect are followed by home visitors who work on improving parents' lifestyle choices and childrearing behaviors.
Child and family health care providers play an important prevention role when they identify and address risk factors for abuse and neglect during office visits, including failure to thrive, developmental delays, or parent risks such as substance abuse or domestic violence.
- Tertiary prevention efforts are aimed at individuals who have already abused children, and thus are highly likely to repeat abusive behaviors in the future. Currently, the most active (and potentially the most successful) tertiary prevention programs are those aimed at changing the attitudes of adolescent perpetrators of child sexual abuse, before they develop firmly established behavior patterns.
