Acknowledgment
This fact sheet is a public service from Prevent Child Abuse America that has been made possible through a grant from the Sigma Delta Tau Sorority. Fact sheets are issued periodically on a variety of subjects as needs arise. Fact sheets may be reproduced without notice to Prevent Child Abuse America; however, we request that the author, if any, and Prevent Child Abuse America be credited as the source if reproduced in part or whole in other publications or products.

Prevent Child Abuse America is committed to preventing child abuse before it occurs. Since child maltreatment is a complex problem with a multitude of causes, an approach to prevention must respond to a range of needs. Therefore, Prevent Child Abuse America has designed a comprehensive strategy comprised of a variety of community-based programs to prevent child abuse. Reflective of the phases of the family life cycle, this approach provides parents and children with the education and support necessary for healthy family functioning. Based on what is known or believed to enhance an individual's ability to function within the family unit, several program areas contributing to the strategy can be identified. Beginning with the prenatal period, these programs offer a continuum of educational, supportive and therapeutic services for parents and children enduring throughout the school years. Although a community may not choose to offer services in all program areas, as a group they respond to the needs of all family members.

Support programs for new parents
The purpose of support programs for new parents, such as perinatal support programs, is to prepare individuals for the job of parenting. Such programs should include supports during both the pre- and postnatal periods to ease the difficulties associated with having a new infant at home. Prenatal and postnatal medical care is clearly important, particularly since low birth weight babies, drug exposed babies and babies otherwise sick in infancy are at risk for being abused. Many prospective parents now participate in prenatal care programs that go beyond the medical needs of the pregnant mother and the growing fetus to include attention to the demands of parenting. Prenatal programs can build on existing medical programs and educate about-to-be parents in child development, parent-child relationships, and adult relationships.

Currently, home visitation is the most innovative and holistic prevention program used in approaching the difficulties of educating and supporting the at-risk family, while at the same time making a wide range of community and professional services available to the family. This strategy is a comprehensive program in which services vary widely in both scope and content. An array of services may be offered, including nurse visitation to monitor the health of an infant and mother, in-home parenting education, and the intervention of a social worker for the purpose of preventing the placement of an infant in foster care. Most importantly, home visitation programs strive to create social networks for new parents by connecting them with other center-, community-, and hospital-based prevention programs. This helps break down the social isolation experienced by many new parents, especially those in poverty stricken communities. Social isolation is a proven risk factor for child abuse.

Education for parents
Since 1989, the family support movement has pointed to an increasing need among all American families for support, advice, and role models. Consequently, many parent education and support programs have encouraged the participation of all families, without regard to specified risk. By targeting all families, rather than low-income or otherwise at-risk groups, parent aducation and family support programs have achieved the broad-based backing necessary to underwrite statewide programs.

Nationally known programs that target at-risk families such as Parent Effectiveness Training (P.E.T.), the Parent Nurturing Program, and Systematic Training for Effective Parenting (S.T.E.P.) have various approaches toward parenting education and are distinct in their use of such teaching tools as reward and punishment, praise, and specific encouragement. Such parent focused interventions with well-specified training components aimed at improving child rearing competence and stress management have been supported by empirical findings as effective measures for reducing risk factors associated with physical child abuse.

Many groups that provide parenting education, such as natural childbirth groups, community-based prevention programs, and mental health services also can provide social support systems for families either at risk for or in treatment for abuse. Mutual support, or self-help groups also provide a network of support to members in adjusting to new roles, problems, or changes in family circumstances. These groups can help members expand their social contacts, improve their feelings of self-esteem, and increase their knowledge of child development.

Early and regular child and family screening and treatment
Because abusive behavior is often cyclic, many health and developmental problems in early childhood can lead to behavioral, educational, and psycho-emotional problems in later adolescence and adulthood, which could lead to the recurrence of abusive behavior. Also, many abused children at first appear acquiescent, cooperative, shy, affectionate, and "normal," but this apparent serenity may mask multiple psychological problems. For this reason, detecting and treating health and developmental problems early in life is important. Early childhood screening and treatment programs should be seen as a continuaton of the preschool screening services, such as those offered by a home visitor. The purpose of such programs should be to detect problems children may be having, including abuse and neglect, and to ensure that these children receive the necessary health, mental health, and other services that will best protect them from becoming abusive parents, while at the same time remaining sensitive to the possibility that a child may be inappropriately labeled, with long-term negative consequences.

Child care opportunities
The purpose of child care or day care programs is to furnish parents with regular or occasional out-of-home care for their children. While child care is a necessity in households in which all adults are employed, such services also are beneficial for parents who do not work outside the home but who find continuous child care responsibilities very stressful. Child care programs also provide opportunities for children to learn basic social skills. Head Start programs in particular provide a rich mix of child care and child development services.

Programs for abused children
It has been argued that prevention of abuse is in part tied to providing therapeutic treatment to children or young people who have been abused or neglected. To minimize the long-term effects of abuse, age-appropriate treatment services should be available to all maltreated children.

Treatment programs for abused children include therapeutic day school programs as well as day hospital programs, residential programs, and home and clinic setting treatment. These programs most often concentrate on improving the cognitive and developmental skills of younger children and psychodynamic treatment for children in older age groups.

Life skills training for children and young adults
The purposes of life skills training are first to equip children, adolescents, and young adults with interpersonal skills and knowledge that are valuable in adulthood, especially in the parenting role; and second, to provide children with skills to help them protect themselves from abuse. Knowledge and skills can be imparted in a variety of ways; irrespective of the specific techniques, educational classes or supports would be provided through the school systems and through adult education centers.

Skill and knowledge building should be stressed in the areas of child development, family and life management, self-development, self-actualization, and methods of seeking help. For adolescents in particular, education in sexuality, pregnancy prevention, and issues related to parenting should be provided.

Family support services
Lacking a support network in times of crisis puts families at significantly greater risk for abuse or neglect. To provide immediate assistance to parents in times of stress, crisis care programs should be available on a 24-hour basis and should include the following services: telephone hot line, crisis caretakers, crisis baby-sitters, crisis nurseries, and crisis counseling. Through these programs, parents facing immediate problems could receive immediate support to alleviate the stresses of a particular situation. Help should be available over the phone or through in-person counseling.

The program also should offer parents the options of having someone come into their homes on a temporary basis to assist with child and home care or of taking the child to a crisis nursery. Because crisis care is temporary and short-term, such programs should be equipped to refer parents to long-term services as needed.

Public information and education
While hospitals, schools, and community agencies have a critical role to play in implementing this child abuse prevention strategy, they cannot fully shoulder the responsibility. Educational campaigns are necessary to make the public aware of the seriousness of the problem and its implications as well how individuals can make a difference. The effectiveness of the preceding prevention strategy will only be realized when there is a fully aware public, committed to preventing child abuse.

Adapted from: Cohn Donnelly, A. (1997). An Approach to Preventing Child Abuse. Chicago, IL: Prevent Child Abuse America.