Child Abuse Prevention

Evolution of Prevention Services

Over the past 30 years, efforts to prevent child maltreatment in the United States have moved through three stages-public recognition of the problem, experimentation with a wide range of prevention programs that address one or more risk factors, and the evolution of systems designed to better integrate these diverse efforts.

Programmatic efforts to prevent child abuse and neglect have followed two distinct paths-interventions targeting reductions in physical abuse and neglect (including emotional neglect and attachment disorders) and interventions targeting reductions in child sexual abuse. Programs in the first group began with an emphasis on parental knowledge or parental behavior as the “cause” of maltreatment with services [Page 98]designed to address the cause (e.g., parent education workshops). Such programs have evolved in concert with the ecological paradigm to address the broader context in which the parent-child relationship develops. It is common for today's prevention programs to focus on parental support networks, health care access, and parent-child interaction patterns, in addition to the more traditional emphasis on parental behavior or knowledge. Further, these programs tend to focus on new parents, offering assistance when a child is born or a woman is pregnant. Subsequent prevention services are then added to this universal base in response to the specific emerging needs presented by the growing child or the evolving parent-child relationship.

In contrast to these efforts, the target population for sexual abuse prevention has been potential victims, not potential perpetrators. Three factors contributed to this pattern: the social discomfort surrounding sexuality; the difficulty in developing voluntary treatment options for offenders; and the absence of clear risk factors identifying potential perpetrators or victims. Strategies within this framework include a number of educational-based efforts, provided on a universal basis, to children on the distinction between good, bad, and questionable touching and the concept of body ownership or the rights of children to control who touches their bodies and where they are touched. As children mature, these classes cover a broader range of concepts such as appropriate dating behavior, gender stereotypes, and nonaggressive conflict resolution strategies. These educational programs also offer children and youth service options or referrals if they have been abused or are involved in an abusive peer relationship.

Today, the concept of prevention is moving away from the notion of a single response agency or targeted intervention and more toward a communitywide system of shared responsibility and mutual support. The goal of altering both the individual and context provides a programmatic and policy response more reflective of the ecological theory often cited as the most appropriate in explaining the etiology of child maltreatment.

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