By Des Runyan, MD, Executive Director, The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect
Every year since 1983, the US has designated April as Child Abuse Prevention Month. This annual public awareness campaign seeks to educate the public about the problems of child abuse and neglect. Committed agencies and professionals hold public gatherings, place pinwheels and ribbons in public places, and create public service announcements to bring attention to abuse and neglect.
Usually we are preaching to the choir—our April gatherings are attended by the professionals we work with every day. And surveys of the public indicate that more than 97 percent already recognize child abuse as a problem.
Calling attention to child abuse isn’t fixing it.
We need additional substantive steps to reduce the burden of 7.2 million children reported to authorities, with 683,000 children confirmed as abused or neglected by social service agencies in 2015. The key to effective prevention is engineering the family environment to support and protect children and their parents.
Here are 7 concrete steps we must take to really prevent child abuse and neglect:
1. Advance education for girls.
The strong correlation between fewer maternal years of education and higher rates of harsh punishment and shaking of their young children is clear. We need programs and policies that keep girls in school and help them complete their education. Not only are children maltreated less by more-educated parents, they have advanced communication skills, finish school at higher rates, and have lower rates of other adverse childhood experiences.
2. Delay childbearing.
Closely related to number 1, teens who have access to long-acting reversible contraceptives and who delay childbearing until after age 20 are less likely to use harsh punishment, are more empathetic to their children’s needs, and have higher incomes. Their children are much more likely to prosper.
3. Reduce domestic violence.
Data from longitudinal studies are clear: both men and women are perpetrators and victims of intimate partner violence (IPV), and households where there is IPV are at increased risk for physical and psychological abuse committed by both the perpetrators and the victims of IPV. We are moving the needle on this one—IPV has fallen more than 70 percent in the US since 1993. Continued efforts to reduce violence between partners really benefits children.
4. Build social networks among young families.
Isolation, postpartum depression, poverty, and stress are a deadly combination. Humans are social animals. Support in the form of group well-child care, expanded community engagement, and other efforts to support new families and establish connections will reduce the risk of harm.
5. Establish family-friendly business practices.
Kids need parental investment and care. Paid maternal leave has been shown to significantly reduce shaken baby syndrome and the benefits of parents being able to attend school functions, teacher conferences, and child sports activities are well-known.
6. Get serious about reducing prenatal exposure to substances by enhancing screening and treatment.
Alcohol is a clear and established threat to the development of young children, and it interferes with effective parenting. Much less research has been done with prenatal exposure to marijuana, but the studies to date indicate increased risks to the fetus in terms of subsequent mental retardation. Both substances can interfere with parental caregiving. Screening and treatment done in a nonpunitive manner are much more likely to help children and sustain families.
7. Make access to home visitors, such as public health nurses or SafeCare counselors, routine for all new parents under 22 years of age, triggered by the registrations of births.
The Nurse Family Partnership and SafeCare are two home-visiting programs for families with young children that have been shown to have many benefits in terms of reduced use of medical care, greater child safety, and better outcomes for mothers. Both are well established in Colorado, but only about a third of families offered these services use them. We need to link these services to newborn nurseries and doctor’s offices and make the benefits clear to the participants.
So let’s make April the start of taking some very real steps to reduce child abuse. I realize that this might put our Kempe Center out of business—but won’t that be great for kids and society when we are no longer needed.