FEATURED SPEAKERS

Lisbeth B. Schorr is Lecturer in Social Medicine at Harvard University, and director of the Harvard University Project on Effective Interventions. Ms. Schorr has woven many strands of experience with social policy and human service programs together to become a national authority on improving the future of disadvantaged children and their families. Her book, Within Our Reach: Breaking the Cycle of Disadvantage, analyzing social programs that have succeeded in improving the life prospects of disadvantaged children is in wide use in colleges and universities, and by policy makers, practitioners, and advocates for more effective human services. Her new book due out in the spring will demonstrate that the knowledge and experience exists to improve our schools, our welfare and child protection systems, and to strengthen families and communities, so that every American Child will come into adulthood prepared to become a productive part of a thriving 21st century America.

Within the Baylor College of Medicine clinical system, Bruce D. Perry serves as Chief of Psychiatry at Texas Children's Hospital. His clinical research and practice has focused on traumatized children--examining long-term cognitive, behavioral, emotional, social and physiological effects of trauma in children, adolescents and adults. This work has been intrumental in describing how traumatic events in childhood change the biology of the brain. Dr. Perry is the author of Maltreated Children: Experience, Brain Development and the Next Generation.

Evelyn K. Moore is executive director and a founder of the National Black Child Development Institute (NBCDI), a national nonprofit organization that exists to improve and protect the quality of life of African American children and families. Under her leadership, the Institute is recognized as a leading voice for children. Ms. Moore has been recognized throughout her career for her community service and national leadership. She serves many organizations including two early childhood advisory committee of the U.S. Department of Health and Human services--The Advisory Committee on Services for Families, Infants and Toddlers and the Advisory Committee on Head Start Quality and Expansion.

REGISTRATION

The registration fee includes conference materials, entrance to Preconference Session, Site Information Session, plenaries, all workshop sessions, Continental Breakfast on Monday, Evening Reception at the Museum of Contemporary Art, and Closing Luncheon.

NCPCA Establishes New Web Site

With a generous donation from WorldWide Access, NCPCA recently created a Web site to provide information about child abuse to the general public, parents, educators, and service professionals nationwide. Located at http://www.childabuse.org, the web site has been accessed over 50,000 times since its establishment six months ago, with the rate of information requests increasing rapidly. In response to this growing interest, the amount of information provided at the site has more than doubled. And the response has not been limited to the United States. People as near as Canada, and as far away as Australia and Japan have visited the site.

So what exactly is on the Web site? Information is divided into several subsections. Those who wish to learn more about NCPCA can find information under the About NCPCA section. It contains a description of our mission, goals, activities, and accomplishments. To access information and background on the Healthy Families America (HFA) home visiting initiative, one should view the Program section. Since there are over 200 HFA sites in the United States, a list of state contacts is included to locate the HFA program within that state. Similarly, in the Chapters section, a directory is provided listing our 52 Chapters located throughout the nation. Under the Research section, one can find highlights from our Annual Fifty State Survey and 1995 statistics on child abuse and neglect. Parenting information on such topics as being a new parent, discipline, and school success can be found in the Parenting Tips section. For those who are interested in supporting child abuse prevention efforts, the What You Can Do section offers suggestions. Other sections on our Web site include Advocacy, What's New, Special Features, and a Guest Page.

Despite all this information, NCPCA plans to provide more. Early in 1997, a Resources section will be added to the site. This section will offer information on our publications, internet links to other children's organizations, and the addresses and telephone numbers of organizations that provide help and information to children and families. If you have ideas for how NCPCA might improve its Web site, please email suggestions to [email protected]. You may also send your email address if you wish to be included on the mailing list for updates on NCPCA's Web site.

New Publication Addresses Monitoring
Children's Exposure to Media

Across America, children arrive home from school each afternoon to be entertained by the television, the CD player, or the radio. Violence on television is especially common. Typically, children watch more than 20 hours of television each week. By the time they finish grade school they have viewed over 8,000 murders and 100,000 acts of violence. If you know one of these children, chances are you're concerned about media violence and its effects.

In an effort to help reduce violence in the media, the National Committee to Prevent Child Abuse (NCPCA) offers a new brochure titled "Stay Tuned." This brochure provides helpful information about the effects of media violence

To request a complimentary copy of this publication, call (312) 663-3520. To order multiple copies, call (800) 835-2671.

Just Briefly...

Focus on Prevention: Study Provides Insight for Future Child Abuse Prevention Efforts

Overall, the results from this three-part study contribute valuable insights regarding the future of home visitation and child abuse prevention efforts. The findings highlight the potential for statewide, paraprofessional home visitation services to produce substantial benefits for families, especially in the domains of parental attitudes toward children, parent-child interaction patterns and rates of confirmed child maltreatment. The Healthy Start approach to preventing child abuse successfully enhanced the lives of children and reduced the stress of parenthood for participating families during the course of services. Furthermore, families retained many of these gains over time, especially in the area of positive disciplinary practices. Thus, current efforts to improve parenting and child well-being through the implementation of broadly available home visitation services appear well supported by these data and the available research on home visitation programs.

This study and others indicate, however, that home visiting cannot address every challenge disadvantaged families face or impact every family served. Some outcomes such as the cognitive development of the child and maternal social support proved resistant to change after one year of paraprofessional home visiting. To address these domains, families may be better served by home visitation models that integrate other service components such as developmental child care, parent support groups, and personal skill building. The high rates of health care utilization among both treatment and control families in Hawaii lead us to believe that states also would benefit from replicating many aspects of Hawaii's health care system such as the focus on linking families to a medical home, providing Medicaid coverage to families with incomes up to 300% of the poverty line, and offering visiting nurse services to parents with newborns.

As noted above, the positive effects of home visiting were not universal. Results from the follow-up component suggest that certain risk factors, such as low income and low maternal educational attainment, may impede program gains during or after program involvement. Parents consumed by the effort to meet basic needs may be unable to implement substantial changes in the quality of the home environment. The results would indicate that families at highest risk require more focused efforts to ensure their engagement in formal social services after home visitation terminates.

These findings also highlight contextual issues that need to be addressed to increase the effectiveness of Healthy Start services. For example, single parent status was positively related to long-term retention of gains. This relationship is particularly encouraging given that the risk assessment study suggests that single parents who don't receive services face substantial challenges during the first year of child rearing. This finding may indicate that the presence of other household members creates stress, which inhibits the effectiveness of Healthy Start. Or, as suggested by the qualitative analyses, it could indicate that other adults in close proximity may discourage non-physical child discipline and encourage mothers to act more punitively toward their children. Programs need to assess the level of family and community support for the child rearing methods being introduced by the home visitor. If low levels of support exist, at least two avenues should be pursued. First, home visitors and the participants should discuss both the likelihood of resistance to unfamiliar child rearing ideas among family and community members and constructive techniques for handling this resistance. Second, the program itself needs to identify strategies to influence community parenting norms by working with community and religious leaders. This process might well encourage the development of more comprehensive prevention systems as local entities collectively work toward providing the diversity of support families need to best care for their children.

The study also generated some key implications regarding methods for targeting and engaging families likely to benefit from home visiting. In terms of targeting services, the findings support the contention that adequately appraising an individual's parenting capacity requires multiple assessment points and a variety of measures examining various domains. No single assessment tool administered at a single point in time can be expected to correctly identify all those at risk for maltreatment. Child abuse prevention programs interested in supporting new families might be wise to identify multiple points of assessment over a child's first few years of life rather than relying solely on an identification system that assesses families only at the time they give birth. Relatedly, prevention advocates need to be cautious when assessing initial need for services, recognizing that poverty, single parent status, and limited service access will take a toll on many families regardless of their initial strengths.

As shown by the risk assessment study, the elevated level of stress observed in many of the "low risk" families during the first year of the child's life suggest that prevention advocates might consider focusing on identifying communities or neighborhoods at risk rather than limiting themselves to individual risk assessment protocols. Expanding comprehensive prevention services to those areas with high concentrations of low income, single parent families might offer greater promise in producing measurable gains at both the individual and the aggregate level.

A final issue of vital importance to voluntary prevention efforts concerns why families accept or refuse parenting services. In this study, a sizeable number of potential participants never fully engaged in Healthy Start services. Though this problem is endemic to the prevention field, little empirical work has been published to date on this topic. Future research needs to illuminate the factors that lead some families to fully participate in such programs when demographically similar families refuse, drop out of, or sporadically engage in services. For example, anecdotal data from the randomized trial component indicate that other adult family members often play a critical role in determining the extent of the mother's involvement in home visiting services. This evidence would suggest that outreach efforts need to include methods designed to gain the acceptance of the home visitor from other adult family members, particularly grandmothers and partners. The resolution of these issues would enable program planners to tailor both outreach and intervention strategies to engage and appropriately assist all families targeted by home visitation programs.