child abuse must be prevented
Child abuse is a public health crisis in the United States. Its prevalence and annual incidence in the population have reached epidemic proportions. Child abuse is also a multifaceted phenomenon: By definition it encompasses physical abuse, sexual abuse, neglect, and emotional maltreatment, each of which has a somewhat different set of underlying causes. These diverse types of abuse are by no means mutually exclusive, nor are they found only in certain population groups. While one type of abuse may predominate in a given population group, incidents involving different types of abuse cut across all groups.
Child abuse hurts. The after effects, which are well documented, are devastating. Abused children suffer a wide range of emotional, developmental and physical problems, both acute and chronic. Some children die. These problems often precipitate such social ills as teenage runaways, adolescent prostitution, drug and alcohol abuse, academic failure and school truancy, and juvenile delinquency.
Child abuse is costly, both in terms of human suffering, and in terms of the financial costs that must be borne by society to remedy the social and psychological maladies emanating from child maltreatment. The case for working to prevent child abuse before it occurs is clear. Prevention spares the hurt and can save lives and money.
Child abuse and neglect is a complex phenomenon that encompasses such individual factors as a parent’s lack of understanding of child development, and environmental factors like poverty. To be successful, child abuse prevention efforts must ultimately take into account the various causes — both personal and societal — that play a role in the evolution of this problem.
A comprehensive approach to combatting the problem would entail a public awareness campaign that educates the community about the magnitude of the problem, explores healthy attitudes toward parenting, and delineates positive methods of parenting. Key preventive and intervention services would be instituted to ensure that all new parents get off to a good start; that all parents under stress have access to crisis and support services; that all victims can obtain the therapeutic assistance necessary to break the cycle of abuse; and that all children have the guidance and information they need to learn how to protect themselves from abuse.
In addition, efforts would be directed at eliminating societal obstacles to abuse prevention, including the use of corporal punishment in schools or excessive media violence. Finally, such issues as substance abuse, poverty, and family and community violence would all be addressed. The consensus in the field is clear: No single approach, no single program is sufficient to prevent abuse; all elements of a comprehensive approach ultimately need to be in place. Yet our prevention efforts must begin somewhere.
Targeting New Parents
In 1991, The U.S. Advisory Board on Child Abuse and Neglect declared that a logical place to begin is with new parents, helping them get off to a good start before abusive behaviors are established. With new parents — especially first–time parents — there is an ideal opportunity to teach good parenting practices before destructive patterns become entrenched.
New parents are often characterized as “like sponges”–anxious to learn everything they can about their new babies and how to care for them. Most physical abuse and neglect is directed towards the youngest children under age five. By focusing on new parents, child development specialists can target the population group where the incidence of physical abuse and neglect is likely to be the highest.
While there are a variety of approaches to working with new parents, one particularly promising plan for offering assistance is a voluntary program of home visits to new parents and their infants. Home visiting has widespread appeal. It affords the professional or volunteer visitor an opportunity to respond to family members in their own environment, on their own terms, and to learn first-hand the conditions of life for parent and child. The home visiting process tailors the service to the needs and characteristics of the parent and child in their own natural setting.
Home visits present a strategy to reach isolated families, families that typically do not participate in community affairs, families that are too distrustful or too disorganized to make their way to a center-based program or a social worker’s office — in short, families at greatest risk to abuse. From this perspective, home visiting is a constructive force to engage dysfunctional families.
Surveys reveal that the public is most supportive of the home visitor concept. A public opinion poll conducted in 1991 by the National Committee for Prevention of Child Abuse indicates that 86 percent of respondents thought it appropriate to offer home visits and other supportive services to all first time parents.
There is also an expanding evaluative data base — extending over two decades — that documents the efficacy of the home visiting idea. In the early 1970s, the C. Henry Kempe National Center for the Prevention and Treatment of Child Abuse completed a controlled experimental design study focusing on nurse practitioner home visits with a sample of high-risk new parents. The study verified enhanced mother/infant relationships and a decrease in child abuse among the experimental group (Grey et al.).