Report of the Attorney General’s National Task Force on 

Children Exposed to Violence 
 

Members of the Task Force 

Co-Chairs 

Robert Listenbee, Jr., JD, Chief of the Juvenile Unit of the Defender Association of 

Philadelphia 

Joe Torre, Chairman of the Joe Torre Safe At Home® Foundation; Major League Baseball’s 

Executive Vice President for Baseball Operations 

Members 

The Rev. Gregory Boyle, SJ, Founder of Homeboy Industries 

Sharon W. Cooper, MD, CEO of Developmental & Forensic Pediatrics, P.A. 

Sarah Deer, JD, Citizen of the Muscogee (Creek) Nation of Oklahoma; Assistant Professor at 

William Mitchell College of Law 

Deanne Tilton Durfee, Executive Director of the Los Angeles County Inter-Agency Council on 

Child Abuse and Neglect 

Thea James, MD, Director of the Boston Medical Center Massachusetts Violence Intervention 

Advocacy Program; Associate Professor of Emergency Medicine at Boston Medical 

Center/Boston University School of Medicine 

Alicia Lieberman, PhD, Director of the Early Trauma Treatment Network; Irving B. Harris 

Endowed Chair of Infant Mental Health at the University of California‒San Francisco 

Department of Psychiatry; Director of the Child Trauma Research Program, San Francisco 

General Hospital 

Robert Macy, PhD, Founder, Director, and President of the International Center for Disaster 

Resilience-Boston; Founder and Executive Director of the Boston Children’s Foundation; CoDirector of the Division of Disaster Resilience at the Beth Israel Deaconess Medical Center 

Steven Marans, PhD, Director of the National Center for Children Exposed to Violence; 

Harris Professor of Child Psychiatry and Professor of Psychiatry, Yale University School of 

Medicine; Director of the Childhood Violent Trauma Center at Yale University 

Jim McDonnell, Chief of Police, Long Beach Police Department, California 

Georgina Mendoza, JD, Community Safety Director for the City of Salinas, California 

Retired Major General Antonio Taguba, President of TDLS Consulting, LLC; Chairman of Pan 

Pacific American Leaders and Mentors (PPALM) 
From the Task Force Co-Chairs 

We are facing one of the most significant challenges to the future of America’s children that we 

have ever known. Our children are experiencing and witnessing violence on an alarming scale. 

This exposure to violence is not limited to one community or one group of children. It occurs 

among all ethnic and racial groups; in urban, suburban, and rural areas; in gated communities 

and on tribal lands. 

Advances in neuroscience and child development have taught us that the trauma children 

experience when they are exposed to physical, sexual, and emotional violence harms their 

ability to mature cognitively and emotionally, and it scars them physically and emotionally well 

into their adult lives. 

Some of our children may grow up in safety and stability, but when millions do not, our entire 

society suffers. We pay astronomical costs to the health care, child welfare, justice, and other 

systems because we have not yet done what we know works to prevent and treat childhood 

exposure to violence. 

U.S. Attorney General Eric Holder charged this task force with recommending ways our nation 

can prevent, reduce, and treat children’s exposure to violence. We have taken this charge 

seriously. 

We have heard from dozens of people who work to prevent, reduce, and treat children’s 

exposure to violence, as well as from those who have experienced it. Their stories of what they 

had seen and lived through were sometimes horrifying but always inspired us to deeper 

commitment. What we learned from them has changed the way we think about this issue. 

The good news is that we know what works to address children’s exposure to violence. Now we 

must work courageously to find the resources to spread the solutions and implement them 

where they are needed. We must actively engage youth, families, and communities in the 

development of local solutions to these problems. 

We must protect children, and we must not look away when they are in pain. We also must not 

let our own fears and pain stop us from helping. Above all, we must give them hope that their 

future will be better and safer. 

We thank Attorney General Holder for shining a bright light on children’s exposure to violence. It 

has been a tremendous honor to serve on this task force. We stand with the Attorney General 

and you, the reader of this report, ready to begin. When our children are dying, we cannot afford 

to wait. 

Robert L. Listenbee, Jr. 

Joe Torre 
Glossary of Key Terms

American Indian/Alaska Native: As a general principle, an Indian is a person who is of some 

degree of Indian blood and is recognized as an Indian by a Tribe and/or the United States. No 

single federal or tribal criterion establishes a person's identity as an Indian. Government 

agencies use differing criteria to determine eligibility for programs and services. Tribes also 

have varying eligibility criteria for membership.

It is important to distinguish between the ethnological term “Indian” and the political/legal term 

“Indian.” The protections and services provided by the United States for tribal members flow not 

from an individual's status as an American Indian in an ethnological sense, but because the 

person is a member of a Tribe recognized by the United States and with which the United

States has a special trust relationship. (Please see http://www.justice.gov/otj/nafaqs.htm). 

Assessment: Determining the specific nature of an individual’s needs or problems using 

professional interviews, tests, questionnaires, or observations.

Child- and family-serving organizations: Agencies, facilities, and programs that provide 

children or families with services that may include education, assistance, rehabilitation, or 

treatment for medical or mental health, learning, social, financial, child protection, or legal 

needs. 

Child exposed to violence: Any individual who is not yet an adult (threshold age varies across 

jurisdictions, typically birth to either 18 or 21 years old) who is directly or indirectly exposed to 

violence that poses a real threat or a perceived threat to the individual’s or an affiliated person’s 

life or bodily integrity. Children exposed to violence are at much greater risk of developing lethal 

medical illnesses in their early adult years; to utilize disproportionately costly medical, 

psychological, and public health services; and to die prematurely. 

Ethnocultural: Characteristics of individuals or their communities that are related to race, 

ethnicity, or cultural beliefs and practices.

Evidence-based treatment: Interventions and services provided by a credentialed professional 

or paraprofessional to serve as a therapy or community-based service to promote recovery from 

psychosocial, psychological, or medical problems or to prevent these problems altogether. 

These interventions and services: (a) have been scientifically tested and demonstrated to be 

effective, (b) have clearly defined procedures that can be taught and implemented consistently 

with fidelity, (c) are feasible and useful for clinical practitioners and programs, and (d) are 

credible and acceptable to the recipients.

Screening: Asking brief questions or gathering existing information to determine if an individual 

should be identified as having a specific need or problem.

Trauma-informed care: This is a new form of evidence-based interventions and service 

delivery, implemented by multiple service providers, that identifies, assesses, and heals people 

injured by, or exposed to, violence and other traumatic events. 
Trauma-focused services: Services are considered trauma-focused when caregivers (such as 

biological, foster, or adoptive parents, mentors, spiritual advisors, coaches, or line staff in childserving programs) or professionals providing services (a) realize (understand) the impact that 

exposure to violence and trauma have on victims’ physical, psychological, and psychosocial 

development and well-being, (b) recognize when a specific person who has been exposed to

violence and trauma is in need of help to recover from trauma’s adverse impacts, and (c) 

respond by helping in ways that reflect awareness of trauma’s adverse impacts and consistently 

support the person’s recovery from them (adapted from the 2012 SAMHSA [Substance Abuse 

and Mental Health Services Administration] “Working Definition of Trauma and Guidance for a 

Trauma-Informed Approach”).

Trauma-specific treatment: Medical, physiological, psychological, and psychosocial therapies 

that are (a) free from the use of coercion, restraints, seclusion, and isolation, (b) provided by a 

trained professional to an individual, a family, or a group adversely affected by violence 

exposure and trauma, and (c) designed specifically to promote recovery from the adverse 

impacts of violence exposure and trauma on physical, psychological, and psychosocial 

development, health, and well-being. 

Violence: The World Report on Violence and Health (WRVH) 

(http://www.who.int/violenceprevention/approach/definition/en) defines violence as “the 

intentional use of physical force or power, threatened or actual, against oneself, another person, 

or against a group or community that either results in or has a high likelihood of resulting in 

injury, death, psychological harm, maldevelopment, or deprivation.”

Violence exposure: Violence exposure can be direct, where the victim or community of victims 

is the direct target of the intentional use of force or power, but it can also be indirect, where the 

victim or community of victims is witness to the intentional use of force or power or has lost a 

loved one to violence. In both cases, over 20 years of scientific literature on the impact of 

violence demonstrates that violence exposure results in significant short- and long-term 

debilitating and costly impacts on the victim’s physical, emotional, cognitive, and social health 

and well-being. 

Violence exposure variables (magnitude of impact): Scientists and health professionals 

unanimously agree that specific violence exposure variables, whether direct or indirect, 

drastically increase negative health outcomes. Primary exposure variables include duration of

exposure (being repeatedly victimized over months and years), proximity to exposure

(remaining physically close to the perpetrator during the violence), type of violence or

perpetration (combat, kidnapping, sexual assault and rape, assault and battery, torture, being 

buried alive, human trafficking, genocide, homeland displacement, and mass political violence), 

and relationship to the perpetrator (the perpetrator is a known figure of trust and protection like a 

parent, spouse, partner, or trusted authority figure).

A further critical aspect of violence exposure is the intentional selection of a victim or victims to 

do harm to that victim, that victim’s property, that victim’s family, or that victim’s tribe. When the 

intentional selection to do harm is based on a victim’s age, gender, race, ethnicity, tribal 
affiliation, or beliefs and orientations, the negative health outcomes may be even more 

significant. 

Workforce protections: Adaptations to a workplace’s environment or its policies and 

procedures or to the education, supervision, and supportive services provided to the personnel 

that are designed to foster workplace wellness and provide protection from psychological or 

physical harm. A fundamental adaptation to promote wellness and protect workers is a 

workplace that is free from the use of coercion, restraints, seclusion, and isolation.
Executive Summary 

The Attorney General’s Task Force on Children Exposed to Violence 

Exposure to violence is a national crisis that affects approximately two out of every three of our 

children. Of the 76 million children currently residing in the United States, an estimated 46 

million can expect to have their lives touched by violence, crime, abuse, and psychological 

trauma this year. In 1979, U.S. Surgeon General Julius B. Richmond declared violence a public 

health crisis of the highest priority, and yet 33 years later that crisis remains. Whether the 

violence occurs in children’s homes, neighborhoods, schools, playgrounds or playing fields, 

locker rooms, places of worship, shelters, streets, or in juvenile detention centers, the exposure 

of children to violence is a uniquely traumatic experience that has the potential to profoundly 

derail the child’s security, health, happiness, and ability to grow and learn — with effects lasting 

well into adulthood. 

Exposure to violence in any form harms children, and different forms of violence 

have different negative impacts. 

Sexual abuse places children at high risk for serious and chronic health problems, including 

posttraumatic stress disorder (PTSD), depression, suicidality, eating disorders, sleep disorders, 

substance abuse, and deviant sexual behavior. Sexually abused children often become 

hypervigilant about the possibility of future sexual violation, experience feelings of betrayal by 

the adults who failed to care for and protect them. 

Physical abuse puts children at high risk for lifelong problems with medical illness, PTSD, 

suicidality, eating disorders, substance abuse, and deviant sexual behavior. Physically abused 

children are at heightened risk for cognitive and developmental impairments, which can lead to 

violent behavior as a form of self-protection and control. These children often feel powerless 

when faced with physical intimidation, threats, or conflict and may compensate by becoming 

isolated (through truancy or hiding) or aggressive (by bullying or joining gangs for protection). 

Physically abused children are at risk for significant impairment in memory processing and 

problem solving and for developing defensive behaviors that lead to consistent avoidance of 

intimacy. 

Intimate partner violence within families puts children at high risk for severe and potentially 

lifelong problems with physical health, mental health, and school and peer relationships as well 

as for disruptive behavior. Witnessing or living with domestic or intimate partner violence often 

burdens children with a sense of loss or profound guilt and shame because of their mistaken 

assumption that they should have intervened or prevented the violence or, tragically, that they 

caused the violence. They frequently castigate themselves for having failed in what they 

assume to be their duty to protect a parent or sibling(s) from being harmed, for not having taken 

the place of their horribly injured or killed family member, or for having caused the offender to be 

violent. Children exposed to intimate partner violence often experience a sense of terror and 

dread that they will lose an essential caregiver through permanent injury or death. They also 

Children Exposed to Violence 1 
fear losing their relationship with the offending parent, who may be removed from the home, 

incarcerated, or even executed. Children will mistakenly blame themselves for having caused 

the batterer to be violent. If no one identifies these children and helps them heal and recover, 

they may bring this uncertainty, fear, grief, anger, shame, and sense of betrayal into all of their 

important relationships for the rest of their lives. 

Community violence in neighborhoods can result in children witnessing assaults and even 

killings of family members, peers, trusted adults, innocent bystanders, and perpetrators of 

violence. Violence in the community can prevent children from feeling safe in their own schools 

and neighborhoods. Violence and ensuing psychological trauma can lead children to adopt an 

attitude of hypervigilance, to become experts at detecting threat or perceived threat — never 

able to let down their guard in order to be ready for the next outbreak of violence. They may 

come to believe that violence is “normal,” that violence is “here to stay,” and that relationships 

are too fragile to trust because one never knows when violence will take the life of a friend or 

loved one. They may turn to gangs or criminal activities to prevent others from viewing them as 

weak and to counteract feelings of despair and powerlessness, perpetuating the cycle of 

violence and increasing their risk of incarceration. They are also at risk for becoming victims of 

intimate partner violence in adolescence and in adulthood. 

The picture becomes even more complex when children are “polyvictims” (exposed to multiple 

types of violence). As many as 1 in 10 children in this country are polyvictims, according to the 

Department of Justice and Centers for Disease Control and Prevention’s groundbreaking 

National Survey of Children’s Exposure to Violence (NatSCEV). The toxic combination of 

exposure to intimate partner violence, physical abuse, sexual abuse, and/or exposure to 

community violence increases the risk and severity of posttraumatic injuries and mental health 

disorders by at least twofold and up to as much as tenfold. Polyvictimized children are at very 

high risk for losing the fundamental capacities necessary for normal development, successful 

learning, and a productive adulthood. 

The financial costs of children’s exposure to violence are astronomical. The financial burden on 

other public systems, including child welfare, social services, law enforcement, juvenile justice, 

and, in particular, education, is staggering when combined with the loss of productivity over 

children’s lifetimes. 

It is time to ensure that our nation’s past inadequate response to children’s exposure to violence 

does not negatively affect children’s lives any further. We must not allow violence to deny any 

children their right to physical and mental health services or to the pathways necessary for 

maturation into successful students, productive workers, responsible family members, and 

parents and citizens. 

We can stem this epidemic if we commit to a strong national response. The long-term negative 

outcomes of exposure to violence can be prevented, and children exposed to violence can be 

helped to recover. Children exposed to violence can heal if we identify them early and give them 

specialized services, evidence-based treatment, and proper care and support. We have the 

Children Exposed to Violence 2 
 

power to end the damage to children from violence and abuse in our country; it does not need to 

be inevitable. 

We, as a country, have the creativity, knowledge, leadership, economic resources, and talent to 

effectively intervene on behalf of children exposed to violence. We can provide these children 

with the opportunity to recover and, with hard work, to claim their birthright ... life, liberty, and 

the pursuit of happiness. We invest in the future of our nation when we commit ourselves as 

citizens, service providers, and community members to helping our children recover from 

exposure to violence and ending all forms of violence in their lives. 

To prepare this report, the Attorney General commissioned a task force of diverse leaders 

dedicated to protecting children from exposure to violence and to healing those who were 

exposed. The report calls for action by the federal government, states, tribes, communities, and 

the private sector across the country to marshal the best available knowledge and all of the 

resources needed to defend all of our children against exposure to violence. The Attorney 

General’s task force asks all readers of this report to imagine a safe country for our children’s 

creative, healthy development and to join together in developing a national plan to foster that 

reality. 

The findings and recommendations of the task force are organized into six chapters. The first 

chapter provides an overview of the problem and sets forth 10 foundational recommendations. 

The next two chapters offer a series of recommendations to ensure that we reliably identify, 

screen, and assess all children exposed to violence and thereafter give them support, 

treatment, and other services designed to address their needs. In the fourth and fifth chapters, 

the task force focuses on prevention and emphasizes the importance of effectively integrating 

prevention, intervention, and resilience across systems by nurturing children through warm, 

supportive, loving, and nonviolent relationships in our homes and communities. In the sixth and 

final chapter of this report, the task force calls for a new approach to juvenile justice, one that 

acknowledges that the vast majority of the children involved in that system have been exposed 

to violence, necessitating the prioritization of services that promote their healing. 

The challenge of children’s exposure to violence and ensuing psychological trauma is not one 

that government alone can solve. The problem requires a truly national response that draws on 

the strengths of all Americans. Our children’s futures are at stake. Every child we are able to 

help recover from the impact of violence is an investment in our nation’s future. Therefore, this 

report calls for a collective investment nationwide in defending our children from exposure to 

violence and psychological trauma, in healing families and communities, and in enabling all of 

our children to imagine and claim their safe and creative development and their productive 

futures. The time for action is now. Together, we must take this next step and build a nation 

whose communities are dedicated to ending children’s exposure to violence and psychological 

trauma. To that end, the task force offers the following recommendations. 

Children Exposed to Violence 3 
Task Force Recommendations 

1. Ending the Epidemic of Children Exposed to Violence 

1.1 Charge leaders at the highest levels of the executive and legislative branches of the 

federal government with the coordination and implementation of the recommendations in 

this report. 

The executive branch should designate leadership at the highest levels of government to 

implement the recommendations in this report. Working with the executive branch, Congress 

should take legislative action on the recommendations in this report, making these 

recommendations a bipartisan priority. 

1.2 Appoint a federal task force or commission to examine the needs of American 

Indian/Alaska Native children exposed to violence. 

A federal task force or commission should be developed to examine the specific needs of 

American Indian/Alaska Native (AIAN) children exposed to violence and recommend actions to 

protect AIAN children from abuse and neglect and reduce violence. The management of this 

task force or commission, and the selection of its members, should be carried out through an 

equal collaboration between the Attorney General and the Secretary of the Interior. 

1.3 Engage youth as leaders and peer experts in all initiatives defending children against 

violence and its harmful effects. 

Local, state, and regional child-serving initiatives and agencies should be directed to involve 

youth as leaders, planners, problem solvers, and communicators and be given the support they 

need to do this. Engagement with youth is essential in order to develop effective solutions to the 

complex problems leading to and resulting from children’s exposure to violence. 

1.4 Ensure universal public awareness of the crisis of children exposed to violence and 

change social norms to protect children from violence and its harmful effects. 

Precedents exist for solving epidemic and seemingly intractable problems. Federal, state, and 

regional initiatives should be designed, developed, and implemented to launch a national public 

awareness campaign to create fundamental changes in perspective in every organization, 

community, and household in our country. 

1.5 Incorporate evidence-based trauma-informed principles in all applicable federal 

agency grant requirements. 

The federal government should lead the development of standards of care for identification, 

assessment, treatment, protection, and other crucial services for children exposed to violence 

and psychological trauma as well as the development of protocols for monitoring the quality of 

these services as measured against the national standards. 

Children Exposed to Violence 4 
1.6 Launch a national initiative to promote professional education and training on the 

issue of children exposed to violence. 

Standards and a curriculum must be developed to ensure that all students and professionals 

working with children and families are aware of the scope of the problem of children’s exposure 

to violence as well as their responsibility to provide trauma-informed services and traumaspecific evidence-based treatment within the scope of their professional expertise. 

1.7 Continue to support and sustain the national data collection infrastructure for the 

monitoring of trends in children exposed to violence. 

Continued support for the National Survey of Children’s Exposure to Violence (NatSCEV) is 

essential to ensure that the survey is conducted at frequent, regular intervals. The government 

must gather and examine additional data on a regular basis, in concert with the NatSCEV, to 

address related justice, education, health, and human services issues; to establish a clear 

picture of children’s continuing exposure to violence; and to track and demonstrate the progress 

our country makes in ending this epidemic. 

1.8 Create national centers of excellence on children’s exposure to violence. 

To ensure the success of this report’s recommendations, national centers of excellence should 

be established and fully funded to support the implementation of a sustained public awareness 

campaign, reforms to maximize efficiencies in funding, standards for professional education and 

practices, and ongoing monitoring of trends and the translation of data; and to bring together the 

scientific, clinical, technical, and policy expertise necessary to systematically ensure the 

success of each of the foregoing goals. 

1.9 Develop and implement public policy initiatives in state, tribal, and local 

governments to reduce and address the impact of childhood exposure to violence. 

Every community’s governing institutions and leaders should be provided with guidance from 

national centers of excellence to enable them to create local public policy initiatives, regulations, 

and services that ensure that children are protected against the harmful effects of exposure to 

violence and psychological trauma to the fullest extent possible. 

1.10 Finance change by adjusting existing allocations and leveraging new funding. 

The federal government should provide financial incentives to states and communities to 

redirect funds to approaches with an established record of success in defending children 

against exposure to violence and enabling victimized children to heal and recover. 

2. Identifying Children Exposed to Violence 

Every year, millions of children in this country are exposed to violence, and yet very few of these 

children ever receive help in recovering from the psychological damage caused by this 

experience. The first crucial step in protecting our children is to identify and provide timely and 

Children Exposed to Violence 5 
effective help to those who already are being victimized by violence. The recommendations 

below are offered to address identification, assessment, and screening: 

2.1 Galvanize the public to identify and respond to children exposed to violence. 

Sustained public information and advocacy initiatives should be implemented in every 

community in order to create an informed citizenry that can advocate for higher levels of 

services and support from policymakers for both prevention and early intervention for children 

exposed to violence. These initiatives are crucial to challenge the misplaced pessimism that 

makes violence seem like an inevitable part of life. 

2.2 Ensure that all children exposed to violence are identified, screened, and assessed. 

Every professional and paraprofessional who comes into contact with pregnant women and 

children must routinely identify children exposed to (or at risk for) violence, provide them with 

trauma-informed care or services, and assist them and their families in accessing evidencebased trauma-specific treatment. 

2.3 Include curricula in all university undergraduate and graduate programs to ensure 

that every child- and family-serving professional receives training in multiple evidencebased methods for identifying and screening children for exposure to violence. 

It is imperative to equip all professionals who serve children and families with the knowledge 

and skills they need to recognize and address the impact of violence and psychological trauma 

on children. 

2.4 Develop and disseminate standards in professional societies and associations for 

conducting comprehensive specialized assessments of children exposed to violence. 

Professional societies and associations of educators, law enforcement personnel, public health 

workers, providers of faith-based services, athletic coaches, physicians, psychologists, 

psychiatrists, social workers, counselors, and marriage and family therapists — and those 

representing specialists in child abuse and domestic violence prevention and treatment — 

should develop, update, and disseminate standards for training and practice in the specialized 

assessment of children exposed to violence. 

3. Treatment and Healing of Exposure to Violence 

The majority of children in our country who are identified as having been exposed to violence 

never receive services or treatment that effectively help them to stabilize themselves, regain 

their normal developmental trajectory, restore their safety, and heal their social and emotional 

wounds. But help isn’t optional or a luxury when a child’s life is at stake; it’s a necessity. Even 

after the violence has ended, these child survivors suffer from severe problems with anxiety, 

depression, anger, grief, and posttraumatic stress that can mar their relationships and family life 

and limit their success in school or work, not only in childhood but throughout their adult lives. 

Without services or treatment, even children who appear resilient and seem to recover from 

Children Exposed to Violence 6 
 

exposure to violence still bear emotional scars that may lead them to experience these same 

health and psychological problems years or decades later. 

3.1 Provide all children exposed to violence access to trauma-informed services and 

evidence-based trauma-specific treatment. 

Service and treatment providers who help children and their families exposed to violence and 

psychological trauma must provide trauma-informed care, trauma-specific treatment, or traumafocused services. 

3.2 Adapt evidence-based treatments for children exposed to violence and 

psychological trauma to the cultural beliefs and practices of the recipients and their 

communities. 

Federal, regional, and state funding should be dedicated to the development, testing, and 

distribution of evidence-based, trauma-specific treatments that have been carefully adapted to 

recipients’ cultural beliefs and practices in order to reach the millions of children currently in 

need in diverse communities throughout the country. 

3.3 Develop and provide trauma-informed care in all hospital-based trauma centers and 

emergency departments for all children exposed to violence. 

Hospital-based counseling and prevention programs should be established in all hospital 

emergency departments — especially those that provide services to victims of violence — 

including victims of gang violence. Professionals and other staff in emergency medical services 

should be trained to identify and engage children who have been exposed to violence or to 

prolonged, extreme psychological trauma. 

3.4 Share information and implement coordinated and adaptive approaches to improve 

the quality of trauma-specific treatments and trauma-focused services and their delivery 

by organizations and professionals across settings and disciplines to children exposed 

to violence. 

To be effective, trauma-specific treatments and trauma-focused services must be provided in a 

consistent manner across the many systems, programs, and professions dedicated to helping 

children exposed to violence. 

3.5 Provide trauma-specific treatments in all agencies and organizations serving 

children and families exposed to violence and psychological trauma that are suitable to 

their clinicians’ and staff members’ professional and paraprofessional roles and 

responsibilities. 

Agencies and organizations serving children and families should have access to training on and 

assistance in sustained, effective implementation of widely available trauma-specific treatments 

that have been shown scientifically to be effective with young children, school-age children, and 

adolescents. 

Children Exposed to Violence 7 
3.6 Ensure that every professional and advocate serving children exposed to violence 

and psychological trauma learns and provides trauma-informed care and trauma-focused 

services. 

Treatment providers should be made available in every setting in which children spend their 

days — schools, youth centers, even the family’s home — as well as where children receive 

care — clinics, hospitals, counseling centers, the offices of child protective services, homeless 

shelters, domestic violence programs — and where they encounter the legal system — on the 

street with police officers, in the courts, in probation and detention centers — to help children 

recover from violence and psychological trauma by providing trauma-informed care and traumafocused services. 

3.7 Grow and sustain an adequate workforce of trauma-informed service providers, with 

particular attention paid to the recruitment, training, and retention of culturally diverse 

providers. 

Trauma-informed care and trauma-focused services should be taught as a required part of the 

curriculum for all graduate and undergraduate students enrolled in professional education 

programs in colleges, universities, and medical and law schools where these students are 

preparing for careers in the health care, human services, public health, child welfare, or juvenile 

justice fields. The same recommendation applies to technical and vocational schools in which 

the students are preparing to work in similar fields. 

3.8 Ensure that professional societies should develop, adopt, disseminate, and 

implement principles, practices, and standards for comprehensive evidence-based 

treatment of children exposed to violence or psychological trauma. 

Every professional society in the United States that represents children and families should 

develop and formally adopt principles, practices, guidelines, and standards for evidence-based 

trauma-informed care, trauma-specific treatments, and trauma-focused services for violenceexposed children and their families. 

3.9 Provide research funding to continue the clinical and scientific development of 

increasingly effective evidence-based treatments for children exposed to violence. 

Research and funding infrastructures that encourage the creation and testing of innovative 

practices and programs that allow for the evolution of increasingly effective evidence-based 

treatments for children exposed to violence must be expanded or newly developed. 

3.10 Provide individuals who conduct services and treatment for children exposed to 

violence with workforce protection to prepare them for the personal impact of this work 

and to assist them in maintaining a safe and healthy workplace. 

All providers should receive training and resources in their workplace that enable them to 

maintain their own emotional and physical health and professional and personal support 

systems. 

Children Exposed to Violence 8 
3.11 Incentivize healthcare providers and insurance providers to reimburse traumafocused services and trauma-specific treatment. 

Even evidence-based treatments will fail if they are poorly implemented. Treatment providers 

must be incentivized in their practices to routinely monitor and report on the quality, reach, and 

outcomes of the evidence-based or evidence-informed services they provide using established 

methods for doing so. 

4. Creating Safe and Nurturing Homes 

Each year, millions of children in this country are exposed to violence and abuse in their homes 

or, less often, outside the home. Violence in the home can take many forms, including, but not 

limited to, physical and sexual abuse of children; intimate partner violence; and violence among 

family members, including siblings, grandparents, or extended family. In some cases, family 

members may even lose their lives because of criminal violence. 

Recognizing that the best place for children and adolescents to not only survive but also to 

thrive is in families that keep them safe and nurture their development, the task force offers 11 

recommendations that are described below. 

4.1 Expand access to home visiting services for families with children who are exposed 

to violence, focusing on safety and referral to services. 

Home visitation programs should be expanded to address the dynamics of child abuse and 

domestic violence; to provide evidence-based safety planning for parents, including pregnant 

mothers who are victims of domestic violence and sexual assault; and to strengthen the 

connections between children and their non-offending and protective parent(s), recognizing that 

every violence-exposed child’s well-being is inextricably linked to the safety of that child’s home 

and the well-being of her/his parents and caregivers. 

4.2 Increase collaborative responses by police, mental health providers, domestic 

violence advocates, child protective service workers, and court personnel for women and 

children who are victimized by intimate partner violence. 

We need to enhance coordination between law enforcement and service providers to identify 

children who are traumatized by domestic violence in order to assess immediate and 

subsequent threats and to follow up with visits to evaluate safety and other concerns of victims. 

Coordinated responses must be developed to address safety issues, basic needs, traumafocused assessment, and identification of children needing treatment, to support children’s 

recovery from the impact of exposure to intimate partner violence. 

Models for integrated planning and intervention following initial police responses to domestic 

disturbances to law enforcement, mental health, child protective services, and domestic 

violence services agencies and courts should be disseminated nationwide. 

Children Exposed to Violence 9 
 

4.3 Ensure that parents who are victims of domestic violence have access to services 

and counseling that help them protect and care for their children. 

Parents who have experienced intimate partner violence should be provided with traumainformed services and treatment themselves in order to assist them in providing their children 

with emotional security and support for healthy development. 

4.4 When domestic violence and child sexual or physical abuse co-occur, ensure that 

the dependency and family courts, the child protection system, and domestic violence 

programs work together to create protocols and policies that protect children and adult 

victims. 

When domestic violence and child abuse co-occur in a family, all victims need protection. Adult 

caregivers who are victimized, and their children involved in custody and dependency cases, 

should be provided with coordinated trauma-informed services and trauma-specific treatment 

appropriate to their circumstances and developmental stage. Every reasonable effort should be 

made to keep the violence-exposed child and non-offending parent(s) or other family 

caregiver(s) together. 

4.5 Create multidisciplinary councils or coalitions to assure systemwide collaboration 

and coordinated community responses to children exposed to family violence. 

Every city, county, or tribe should be directed and supported to establish and sustain a 

multidisciplinary network or council that includes every provider and agency that touches the 

lives of children exposed to violence, including key decision makers who affect policy, 

programs, and case management. 

Coordinated multidisciplinary teams that screen, assess, and respond to victims of family 

violence involved in the child protection and juvenile justice systems, and standards and 

procedures to prevent families and children who are exposed to violence in the home from 

becoming unnecessarily involved in those systems, are needed in every community. 

4.6 Provide families affected by sexual abuse, physical abuse, and domestic violence 

with education and services to prevent further abuse, to respond to the adverse effects 

on the family, and to enable the children to recover. 

Programs should be supported and developed to engage parents to help protect and support 

children, ideally working to stop child sexual or physical abuse before it occurs — and also 

enabling parents to assist their children in recovery if sexual or physical abuse does occur. 

Prevention programs that equip parents and other family members with the skills needed to 

establish healthy, supportive, proactive relationships with children should be available to all 

families in every community. 

4.7 Ensure that parenting programs in child- and family-serving agencies, including 

fatherhood programs and other programs specifically for men, integrate strategies for 

Children Exposed to Violence 10 
preventing domestic violence and sexual assault and include reparation strategies when 

violence has already occurred. 

All agencies, programs, and providers working with fathers who have been violent toward their 

children, partners, or other family members must provide in-depth assessment, diagnosis, 

treatment planning, and educational services that are linked to the specific problems of each 

offender. Fathers who use violence also must be held accountable and monitored, as change 

does not always come easily or quickly. 

4.8 Provide support and counseling to address the unique consequences for children 

exposed to lethal violence, both in the home as a result of domestic violence homicides 

and suicides, and in the community. 

Evidence-based treatments that have been developed specifically to help children recover and 

heal from the traumatic grief of a violent death in their family should be available to all children 

who experience a loss due to violence, in every community in this country. 

4.9 Develop interventions in all child- and family-serving agencies that build on the 

assets and values of each family’s culture of origin and incorporate the linguistic and 

acculturation challenges of immigrant children and parents. 

Evidence-based interventions should be created specifically for immigrant children and their 

families who have been exposed to violence, providing them with a network of services and 

supports that are grounded in the beliefs and values of their culture and language of origin 

rather than forcing them to renounce or relinquish those crucial ties and foundations. 

4.10 Ensure compliance with the letter and spirit of the Indian Child Welfare Act (ICWA). 

Thirty-five years after its passage, full implementation of the ICWA remains elusive. Because 

the ICWA is a federal statute, successful implementation will be best ensured through strong, 

coordinated support from the Department of Interior, Bureau of Indian Affairs; Department of 

Health and Social Services, Administration for Children and Families; and the Department of 

Justice, Office of Juvenile Justice and Delinquency Prevention. 

4.11 Initiate a nationally sponsored program similar to the Department of Defense’s 

community and family support programs that provides military families with specialized 

services focused on building strengths and resilience, new parent support, youth 

programs, and forging partnerships with communities. 

The unique challenges of military families are widely recognized, but military families are too 

frequently underserved. Family support programs developed in concert with the President’s 

“Strengthening Our Military Families” initiative should be expanded to fully provide for the safety 

and well-being of the children of military families and veterans living in civilian communities. 

Children Exposed to Violence 11 
5. Communities Rising Up Out of Violence 

Every year, community violence affects tens of millions of children in this country. This violence 

can occur in episodic incidents such as shootings in schools or other public places that cause 

children and families to feel terror in their own neighborhoods and schools and leave them to 

recover from the traumatic grief of losing friends or peers who are killed or who never fully 

recover. In addition, countless children are victimized when violence becomes part of the fabric 

of American communities as a result of gangs, or when bullying or corporal punishment is 

tolerated or sanctioned in schools or youth activities. 

To reduce the extent of this pandemic of children’s exposure to community violence, on behalf 

of children not yet exposed to community violence, and to help children who have been victims 

recover and heal from the trauma and grief caused by violence in their neighborhoods and 

schools, the task force proposes the following recommendations: 

5.1 Organize local coalitions in every community representing professionals from 

multiple disciplines and the full range of service systems (including law enforcement, the 

courts, health care, schools, family services, child protection, domestic violence 

programs, rape crisis centers, and child advocacy centers) as well as families and other 

community members, to assess local challenges and resources, develop strategies, and 

carry out coordinated responses to reduce violence and the number of children exposed 

to violence. 

Nationwide, local coalitions should be formed to increase children’s safety and well-being 

through public awareness, wraparound support services, and immediate access to services that 

are tailored to meet the individual needs of children and families exposed to violence in their 

schools, neighborhoods, or homes. 

5.2 Recognize and support the critical role of law enforcement’s participation in 

collaborative responses to violence. 

Child-serving professionals from all disciplines and law enforcement professionals should 

partner to provide protection and help in recovery and healing for children exposed to violence. 

5.3 Involve men and boys as critical partners in preventing violence. 

Initiatives must be supported and expanded to involve men and boys in using nonviolence to 

build healthy communities and to develop a network of men and boys across the country who 

are committed to creating widespread change that will help break the cycle of violence in our 

homes, schools, and communities. 

5.4 Foster, promote, and model healthy relationships for children and youth. 

Community- and school-based programs should be developed and supported to prevent 

violence within adolescent relationships, to promote healthy relationships, and to change social 

norms that tolerate and condone abuse. 

Children Exposed to Violence 12 
 

5.5 Develop and implement policies to improve the reporting of suspected child sexual 

abuse in every institution entrusted with the care and nurturing of children. 

To break the silence and secrecy that shrouds child sexual abuse, every institution entrusted 

with the care and safety of children must improve its policies on mandatory reporting, implement 

them fully, educate its employees about them, and ensure full compliance. 

5.6 Train and require child care providers to meet professional and legal standards for 

identifying young children exposed to violence and reducing their exposure to it. 

Child care providers must be trained and provided with ongoing supervision and continuing 

education so as to be able to recognize children in their care who have been exposed to 

violence and to be able to help their families to access the services and treatment that these 

children need in order to recover. 

5.7 Provide schools with the resources they need to create and sustain safe places 

where children exposed to violence can get help. 

Every school in our country should have trauma-informed staff and consultants providing 

school-based trauma-specific treatment. In addition, these professionals should help children 

who have severe chronic problems to access evidence-based treatment at home or in clinics. 

5.8 Provide children, parents, schools, and communities with the tools they need to 

identify and stop bullying and to help children who have been bullied — including the 

bullies themselves — to recover from social, emotional, and school problems. 

Trauma-informed services and support should be provided to all children who are bullies or 

victims of bullying in order to stop the spread of emotional and physical violence in our schools 

and communities. 

5.9 Put programs to identify and protect children exposed to community violence who 

struggle with suicidality in place in every community. 

Every community in the nation should have immediate access to evidence-based, traumainformed, trauma-specific, community-adaptive suicide prevention and treatment programs for 

children and youth at high risk because of their severe suicidality. 

5.10 Support community programs that provide youth with mentoring as an intervention 

and as a prevention strategy, to reduce victimization by and involvement in violence and 

to promote healthy development by youths. 

All children’s mentoring programs should provide ongoing trauma-informed training and 

supervision to their adult mentors to ensure the children’s safety and maximize the benefits of 

the mentoring relationship. 

Children Exposed to Violence 13 
5.11 Help communities learn and share what works by investing in research. 

A coordinated national initiative should be created to develop public-private partnerships and 

funding to ensure that scientific research on the causes of children’s exposure to community 

violence, ways to prevent such exposure, and methods of treating its adverse effects is 

translated into effective and efficient interventions that are available to, and used successfully 

in, every community in our country. 

6. Rethinking Our Juvenile Justice System 

The vast majority of children involved in the juvenile justice system have survived exposure to 

violence and are living with the trauma of those experiences. A trauma-informed approach to 

juvenile justice does not require wholesale abandonment of existing programs, but instead it can 

be used to make many existing programs more effective and cost-efficient. By correctly 

assessing the needs of youth in the justice system, including youth exposed to violence, and 

matching services directly to those needs, the system can help children recover from the effects 

of exposure to violence and become whole. 

As a guide to addressing the needs of the vast majority of at-risk and justice-involved youth who 

have been exposed to violence, the task force offers the recommendations listed below. 

6.1 Make trauma-informed screening, assessment, and care the standard in juvenile 

justice services. 

All children who enter the juvenile justice system should be screened for exposure to violence. 

The initial screening should take place upon the child’s first contact with the juvenile justice 

system and should include youth who meet the criteria for diversion from the system. Where 

feasible, juvenile justice stakeholders should develop trauma-informed care and treatment for 

children diverted to prevention, mental health, or dependency programs. 

6.2 Abandon juvenile justice correctional practices that traumatize children and further 

reduce their opportunities to become productive members of society. 

Juvenile justice officials should rely on detention or incarceration as a last resort and only for 

youth who pose a safety risk or who cannot receive effective treatment in the community. 

Facilities must eliminate practices that traumatize and damage the youth in their care. 

6.3 Provide juvenile justice services appropriate to children’s ethnocultural background 

that are based on an assessment of each violence-exposed child’s individual needs. 

Culturally sensitive role models, practices, and programs aimed at healing traumatized youth 

and preventing youth from being further exposed to violence in the juvenile justice system 

should be expanded nationwide and incorporated into statewide juvenile justice systems. 

Children Exposed to Violence 14 
6.4 Provide care and services to address the special circumstances and needs of girls in 

the juvenile justice system. 

Programs that provide gender-responsive services for girls healing from violence and other 

traumatic events, including sexual and physical abuse, should be supported and developed. 

6.5 Provide care and services to address the special circumstances and needs of 

LGBTQ (lesbian-gay-bisexual-transgender-questioning) youth in the juvenile justice 

system. 

Every individual who works in the juvenile justice system should be trained and provided with 

ongoing supervision in order to be able to deliver trauma-informed care while demonstrating 

respect and support for the sexual orientation of every youth. 

6.6 Develop and implement policies in every school system across the country that aim 

to keep children in school rather than relying on policies that lead to suspension and 

expulsion and ultimately drive children into the juvenile justice system. 

Successful school-based programs that help students develop better ways of handling 

emotional distress, peer pressures, and problems in family and peer relationships and that 

integrate recovery from trauma should be expanded and then embedded into existing school 

curricula and activities to increase students’ abilities to have positive experiences with 

education, recreation, peer relationships, and the larger community. 

6.7 Guarantee that all violence-exposed children accused of a crime have legal 

representation. 

We should ensure that all children have meaningful access to legal counsel in delinquency 

proceedings. Screen all children who enter the juvenile and adult justice systems for exposure 

to violence and provide access to trauma-informed services and treatment. Train defense 

attorneys who represent children to identify and obtain services for clients who have been 

exposed to violence and to help identify and prevent abuses of children in juvenile detention and 

placement programs. 

6.8 Help, do not punish, child victims of sex trafficking. 

Child victims of commercial sex trafficking should not be treated as delinquents or criminals. 

New laws, approaches to law enforcement, and judicial procedures must be developed that 

apply existing victim protection laws to protect the rights of these child victims. 

6.9 Whenever possible, prosecute young offenders in the juvenile justice system instead 

of transferring their cases to adult courts. 

No juvenile offender should be viewed or treated as an adult. Laws and regulations prosecuting 

them as adults in adult courts, incarcerating them as adults, and sentencing them to harsh 

punishments that ignore and diminish their capacity to grow must be replaced or abandoned. 

Children Exposed to Violence 15