Nurse home visitation and the prevention of child maltreatment: impact on the timing of official reports.

This study examined the effects of the Nurse Family Partnership (NFP), a program of prenatal and infancy home visiting by nurses, on the timing of verified reports of child maltreatment. A sample of predominantly unmarried, low-income mothers and their first-born children were randomly assigned to receive either home visitation services by nurses beginning in pregnancy and lasting until the child was age 2, or comparison services. Previous studies have found that this program was effective in reducing the overall number of substantiated Child Protective Service reports by age 15. In the current study, survival analyses were used to assess temporal differences between nurse visited (n = 93) and comparison (n = 144) children's onset rates for maltreatment. The two groups' survival functions remained nearly identical until age 4, at which point the nurse-visited group's risk for onset began to significantly diminish. These results were more pronounced among the highest risk subgroup and among victims of neglect. The findings provide evidence that the NFP's success in reducing the number of maltreatment reports resulted in part from in its impact on the timing of the maltreatment process.

Ecological influences on the sequelae of child maltreatment: a review of the literature.

Numerous studies indicate that child maltreatment increases the risk for the development of internalizing and externalizing behavior problems. Great variations in outcome, however, have been noted among victims of maltreatment. From an ecological perspective, this review examines how the effects of maltreatment may be influenced by the contexts in which children develop, including their families, peer groups, schools, and communities. The literature reviewed suggests that contextual factors not only influence the incidence of maltreatment but also may moderate its developmental effects, thereby accounting for some of the heterogeneity in the outcomes associated with abuse and neglect. Closer examination of the influence contextual factors exert on the psychosocial sequelae of maltreatment will better inform the interventions, treatments, and public policies directed toward the maltreated population. Methodological considerations for conducting research in this area are also discussed.

Child maltreatment and adult socioeconomic well-being.

OBJECTIVE: Little empirical research has examined the impact that child maltreatment may have on victims' long-term socioeconomic well-being. The current study sought to address this gap by exploring the relationship between childhood experiences of abuse and neglect and several indicators of socioeconomic well-being in adulthood. METHOD: Data from the nationally representative National Comorbidity Survey (NCS) (n=5004) were analyzed using logistic regression models to examine whether maltreatment in childhood (any maltreatment, physical abuse, sexual abuse, severe neglect, and multiple types of maltreatment) affected employment status, income, and health care coverage in adulthood. Several potential confounds of this relationship were included as covariates in the models, including race, sex, age, and several indicators of childhood socioeconomic status (SES). RESULTS: The results show that adults who had experienced maltreatment differed significantly from non-maltreated adults across each of the socioeconomic domains examined. Effects were additionally found to differ depending on the number of types of maltreatment experienced. CONCLUSIONS: Increased rates of unemployment, poverty, and Medicaid usage indicate the significant long-term personal impact of early victimization. They also suggest a substantial societal cost from this problem through lost economic productivity and tax revenue, and increased social spending. Low socioeconomic status among parents has also been identified as a salient risk factor for the perpetration of maltreatment, and, as such, these results indicate a potential mechanism in the intergenerational transmission of violence. PRACTICE IMPLICATIONS: The findings from this study suggest that victims of child maltreatment are at increased risk for financial and employment-related difficulties in adulthood. Approximately one million children are identified each year by state agencies as victims of maltreatment in the United States. Many maltreated children, furthermore, go undetected by protective service agencies, indicating the high prevalence of this problem, and underscoring its large economic costs to society. By highlighting the long-term socioeconomic costs of maltreatment, this research should encourage policy makers to focus on improving prevention, intervention, and treatment efforts for victims of abuse and neglect.