U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Administration for Children and Families 

U.S. Advisory Board on Child Abuse and Neglect 

Neighbors Helping 

Neighbors: 

A New National Strategy 

for the Protection of Children 
The views expressed in this report are those of the members of the U.S. Advisory Board on 

Child Abuse and Neglect and do not necessarily reflect the views of any part of the U.S. 

Department of Health and Human Services. 

This document may be reproduced without pennission. 

For information concerning the 1993 Board Report, please contact 

U.S. ADVISORY BOARD ON CIDLD ABUSE AND NEGLECT 

200 Independence Avenue, S.W. 

Washington, D.C. 20201 

(202) 690-8137 

Please contact the U.S. GOVERNMENT PRINTING OFFICE, Superintendent ofDocuments, Mail Stop: SSOP, Washington, D.C. 20402-9328; Telephone: 

202-783-3238, in order to obtain copies of the: 

1990 Board Report: 

Child Abuse and Neglect: Critical First Steps in Response to a National 

Emergency (August 1990); 

Stock No. 017-092-00104-5 

Cost: $7.50 

1992 Board Report: 

The Continuing Child Protection Emergency: A Challenge to the Nation (April 

1993) 

Stock No. 017-092-00105-3 

Cost: $14.00 

Copies of the Executive Summary of the 1991 Board Report: Creating Caring Communities: 

Blueprint for an Effective Fetkral Policy on Child Abuse and Neglect (September 1991), may be 

obtained from: 

U.S. ADVISORY BOARD ON CHILD ABUSE AND NEGLECf 

200 Independence Avenue, S.W. 

Washington, D.C. 20201 

(202) 690-8137 
Department of Health and Human Senices 

Administration for Children and Families 

U.S. Advisory Board on Child Abuse and Neglect 

NEIGHBORS HELPING NEIGHBORS: 

A NEW NATIONAL STRATEGY 

FOR THE PROTECTION OF CHILDREN 

Fourth Report 

U.S. Advisory Board on Child Abuse and Neglect 

September 1993 
V.S. ADVISORY BOARD 01\ CHILD ABUSE Al\D NEGLECT 

Deanne Tilton Durfee, Chair 

Yvonne \1. Chase, Vice-Chair 

Members 

Frank D. Barry 

Enid A. Borden 

Jane Nady Burnley 

Howard A. Davidson 

Richard D. Krugman 

Gary B. Melton 

Joyce L. Mohamoud 

Lawrence F. Potts 

Prince Preyer, Jr. 

Diane J. 'Willis 

Former Members 

Betsy Brand 

Earl L. Dunlap 

James H. Egan 

H. Gordon Evans 

Judith C. Frick 

Donna N. Givens 

Brenda G. Meister 

Jeanne D. Rodriguez 

Dehnrah M. Walsh 

B}'roo D. Metrikin-Gold, Executive Director 
TABLE OF CONTENTS 

Acknowledgments .............••••.......................................•••..................•................•..•••..................•••..............•••• iv 

Executive Summary ....................................................................................................................................... vii 

Mission and Composition ofthe lJ.S. Advisory Board on Child Abuse and Negiect. ........................... xv 

Preparation and Structure of this Report ................................................................................................. xvi 

I. The Traged'y of the Present, and the Hope for the Future .......................................................•.•........... 1 

A. Child Ahuse and Neglect: A Prohlem of Families and Neighborhoods .............................................. , 1 

B. Child Maltreatment as a National Policy Issue ......................................................................................... 3 

C Summary: The Elements of the New National Strategy ......................................................................... 3 

1. Strengthen Neip:hhnrho()ds .......................................................................................................................... 3 

2. Reorient the Delivery of Human Services, Including Justice Services ..................................................... 4 

3. Improve the Roll.: of Government in Addressing Child Maltreatment ..................................................... 4 

-to Rcuricnt Societal Values That May Contrihute to Child Maltreatment .................................................. 5 

5. Strengthen and Broaden the Knowledge Base About Child Maltreatment ........................................... 5 

II. l'he Need for a New National Strategy ................................................................................................... 6 

A. Not Just More But Ditferent ...................................................................................................................... 6 

B. The Nature ofContcmp()raI)' Family Life ................................................................................................ 6 

C. The Nature and Causes of Child Maltreatment ..................................................................................... , .. 7 

D, The Inadequaq of the Current Strategy for Addressing Child Maltreatment ..................................... 9 

1. A Central FOCUS{ln Investigati(ln ............................. ".,"', ............. , ... ,., .................. ,", .................................. 9 

2. The Root:-, of the Emergency .................................................................................................................... 10 

3. Conceptual Mh.take<, That Have Accompanied the Development of the Current Systcm ................... 10 

III. The New National Strategy ................................................................................................................... 16 

A. Intn)duction ................................................................................................................................................ 16 

B. Characteristics ............................................................................................................................................ 16 

1. Comprehensive ........................................................................................................................................... 16 

2. Ncighhnrho()d-hased .................................................................................................................................. 16 

3. Child-centercd ........... . ................................ ,... . ................................................................... 17 

-I. Family-f(lCused ....................................................................... , .. , ................................................................. 17 

C. Element I: Strengthening Ncighhorhood~ .............................................................................................. 17 

1. The Relation Between Child Maltreatment and Neighborhood Ouality ............................................... 17 

2. Environmental Standardt. ............. . ....................... , .......................................................................... 18 

3. InV()lving Residcnb ....................... . ................................................................................................. 19 

-I. Strengthening Neighborhood Info>tirutions ........................ ................... .. .......................................... 19 

5. Economic Opportunity and Development from Within ......................................................................... 20 

6. Housing as a Critical Factor ..................................................................................................................... 21 

7. ReCt)mmcndations ......................................................................................................................................... 23 
-_._-_._. __ .. _---_._ .. _------_ .. _._- --.~-

D. Element 2: Reorienting the Delivery of Human Services, Including Justice Services ....................... 24 

1. Making Treatment for Maltn:atl'd Children a Priority................ .............. . .......................... 24 

2. Providing Material SUppUTh ............... ........................................... . ............................................ 25 

3. Strengthening the Delivery of Family Pn:selY'ation Scrvicc~ .......... . ................................. 27 

4. Developing New Models of Foster Care .......... .......................... . ................................................ 27 

5. Creating New Roles for the Justice System .................................... .......................... . .................. 3U 

a. BuilJing Neighhorhood Re~pon~ihility . . .................................. 3D 

h. l·.xpanding the Role of 1.11\\ Fnfnrccment ..................................... 31 

c. Avoiding Undue Fmphasis on Investigation ..................... .. ... 33 

d. Making the l.ega! Process (:hild-(:CntereJ ................. . ........ 34 

e. Rc!lmning the State Court.~ ... ............ ...... . ........ ................... . ........................ 34 

f. Rcrorming the l'cderal ('uurts ...................................................... .................................. ...... . ...... 36 

g. Improving ~y~tem Accountahility on Behalf of Maltreated (:hildn.:n . . . .................................. 37 

6. Recommendations......... ............... . .................................................................................... 38 

E. Element 3: Improving the Role of Government in Addressing Child Maltreatment ......................... 40 

1. The Need for Leade~hir. ....................................... ................ ............................... . ....................... 40 

2. The Need for Change in Financing .... .......................................... ............... . .............................. 41 

3. The Need for Involvenlent ....................................................................................................................... 43 

-I. Recommendatiom, .............................................. ,............................................................... . ................. .:)-1 

F. Element 4: Reorienting Societal Values That May Contribute to Child Maltreatment ..................... 45 

L Preventing Violence Against Children ... ............... .............. . .......................................... 45 

2. Preventing Sexual Exploitation of Children ...................................................................... 48 

3. Accepting and Valuing the Cultural Heritage of the Child and Family ............................................... -18 

-I. Rcconlmendations....................................... . ................................................................................... 50 

G. Element 5: Strengthening and Broadening the Knowledge Base Ahout Child Maltreatment .......... 51 

l. The Need f()r Federal Leadership in Re~carch ................ . ............................................... 51 

2. The Need for a Chikl-Centcrt..'d Approach to Research.. ................ ....................... . .. 52 

3. Recommendations..... ........................ '.. .......................... ................. . ... 53 

IV. Con'iistency of the New National Strateg)' with Other Reform Efforts ........................................... (}3 

V. Principles to Guide Implementation of the New National Strategy .................................................. (}S 

A. Help necded to prevent child ahu~e and neglect must he ca~ily availahk and acce~sihk ................. 65 

B. Child protection activities should increase connectedness among people ........................................... 66 

C. Child protection activities ~hould include a focus on development of competl'Oce of parents ......... 67 

D. Child protection activities should include a focus on development of competence ()f neighhors as 

helpers .................................................................................................................................................. 68 

E. A focus on prevention of ehild maltreatment should occur at developmental transitions, e~peciaHy 

hirth and adolescence ....................................... , ................................................................................. 6H 

VI. A Comprehensive Approach to the Implementation of the New National Strategy ...................... 72 

A. Health Services ......................................................... , ................................................................................. 72 

B. Mental Health Scrvice!> .............................................................................................................................. 72 

C. Substance Ahuse Program~ ..................................... , ................................................................................. 73 

D. lhe Sehoob ............................................................... , ................................................................................. 7~ 

E. Business and Lahor ................................................................................................................................... 75 

F. V()lunteer~ and Civic Organization!> ......................................................................................................... 76 

G. Religious Organizations ............................................................................................................................ 77 

H. Cooperative Extension ............................................ , ................................................................................. 78 

I. Interagency Councils ................................................. , ................................................................................ 78 

-
.~---.-----

VII. Conclusion: Creating Caring Communities ..................................................................................... 81 

VIII. Appendices .....................................•••.••...............•••••••••...............•••••.............••...........•.•••••.•.................. 84 

A. Recommendations .. ,." ................................................ , .............................................................................. 84 

B. Proposed National Child Protection Policy .............. , .............................................................................. 94 

C. Executive Summaries of Six Papers Commissioned hy the Board ...................................................... 102 

1. Neighborhood-Based Programs ............................................................................................................. 102 

2. Sociocultural Factors in Child Maltreatment ........................................................................................... 104 

3. Child Protection and Out-nf-Home Care: System Reforms and Regulating Placements ................. 106 

4. The Role of Material Factors in Child Abuse and Neglect .................................................................... 110 

5. Social Support and the Prevention of Child Maltreatment .................................................................... 1].t 

6. The Role of Intervention and Treatment Service~ in the Prevention of Child Abuse 

and Neglect ....................................................................................................................................... 118 

D. U.S. Advisory Board on Child Abuse and Neglect ........................................................................................... 133 

1. Membership ............................................................................................................................................. 133 

2. Staff and Other Per:.onnei Rcsourcl's ...................................................................................................... 136 

3. Committees ................................................................................................................................................ 137 

4. Activities since the 1992 Report (including Hearings) ............................................................................ 138 

E. Recommendations of the 1990 Board Report ...................................................................................... 1-t6 

F. Recommendations of the 1991 Board Report ....................................................................................... 155 

G. Excerpts from the 1992 Board Report ................................................................................................... 191 

'" 
ACKNOWLEDGMENTS 

This Board report would never had been possible without the incredihle dedication of several of its 

members. Although most members during the past several years provided creative ideas and suggestions 

for the content of this rcport, three in particular must he given special mention. Gary B. Melton spent a 

huge amount of time over the past three years to help conceptualize this report, develop a plan for its 

production (including an ambitious hackground research effort), and prepare numerous drafts of it. The 

successful and timely completion of this report would never have heen possible without Gary's personal 

commitment and sacrifice. The fact that this report is so well-annotated is a trihute to Gary's staff and 

student assistants who worked countless hours in finding relevant supportive literature and checking the 

voluminous citations contained herein. 

If there is a spiritual Board "father" of this report, it is member Frank D. Barry whose four-year tenure 

on the Board has heen marked hy a constant attention to neighborhood quality and its relation to child 

maltreatment. Frank's concept paper "A Neighborhood Based Approach -- What Is It?" (published as 

part of the Board's 1992 Report) helped his fellow Board memhers, and the child protection community 

nationally, hetter understand why the Board's focus on a new neighhorhood-basedchild protection system 

is so critical. 

One of the Board's newest memhers, Enid A. Borden, quickly hecame an invaluable part of the core 

report-production "team" with her considerable editorial assistance and drafting of the report's Executive 

Summary. Enid's puhliceducation skills have helped this Board take a potentially esoteric and theoretical 

report and assure that it will speak to the heart, as well as the mind, ofhoth child protection professionals 

and American citizens generally. 

There arc a numher of members who left the Board during the preparation of this report but whose ideas 

and enthusiasm for this project helped chart oureourse. They arc Earl L. Dunlap,Judith C. Frick, Jeanne 

D. Rodriguez, and especially H. Gordon Evans (whose commitment to the improvement of America's 

fostercare fI')'stem is unsurpassed). More recently, as a result of the change of Presidential administrations, 

we lost two Board memhers who served as representatives from the Federal Interagency Task Force on 

Child Ahuse and Neglect. We want to acknowledge our gratitude to Donna N. Givens and Brenda G. 

Meister whose work on hehalf of America's maltreated children in their Federal agencies made them 

invaluable participants in our deliberations and helped us hetterunderstand the workings of government 

hurcaucracy. 

As of the completion of this report, the tenns of three of the Board's original members arc about to end. 

Since 19R9, Richard D. Krugman (the Board's first chair), Joyce London Mohamoud, and DianeJ. Willis 

have given freely of their time and ener.bl)' to help the Board in ways too numerous to mention here. All 

threc aided in the development of this report through their leadership with special issue-focused Board 

~')'mp(lsia. 
The American child protection community as a whole has given us valuable feedback on our work 

generally -- and our conceptualization of this report in particular. We would like to especially thank 

members of the Inter~Agency Task Force on Child Abuse and Neglect and the member organizations of 

the National Child Abuse Coalition for their time in reviewing, under tight Board deadlines, a draft of 

this report. 

The Board wishes to express its appreciation to the many individuals who contributed in diverse and 

important ways to the successful accomplishment of the Board activities during this past year, with 

particular thanks extended to the Staffs of Frank Barry, Enid Borden, and Deanne Tilton Durfee. The 

Board also commends the many individuals who testified at the hearings and participated in Board 

meetings. 

Finally, no Advisory Board could have accomplished the goals we have set for ourselves since 1989 without 

an extraordinary committed staff. In particular, for being our Board "warhorse" for four years, four major 

annual reports, and many other Board work products, we want to salute EiJeen H. Lohr, our Board 

Program Assistant, for exemplary performance far above and beyond the call of duty. 

The Board will soon lose, to retirement, its stellar Executive Director, Byron D. Metrikin~Gold. Byron's 

heroic work on our behalf dates back almost five years. His departure from the U.S. Department of Health 

and Human Services will mark the end of a long and distinguished career of public service. Through times 

of success and times of crisis for the Board, he nurtured and guided us through the thicket of laws, 

Departmental poJicies, and advisory board protocol. This Board, his Department, and those who strive 

to improve public policy for abused and neglected children will miss his presence greatly. 

Finally, the Board and staff express deep and sincere appreciation to Howard A. Davidson, Chair of the 

Board for the past two years. During his tenure, Howard never lost sight of the mission of the Board and 

never ceased to direct his considerable energy toward making this nation a safer and healthier place for 

children and families. His nationally recognized expertise in the laws and legal issues surrounding the 

abuse and neglect of children, his consistent good nature and good humor, his notable patience and 

fairness with his colleagues, and his dedication to excellence distinguish him as one ofthe most important 

child and family advocates in the country. The hours he spent in meetings, phone calis, writing, editing, 

and speaking on behalf of the Board could never be counted. He never compromised his standards or his 

commitment, even while experiencing his own personal challenges. 

During his tenure, Howard became a new father. We all feel a personal attachment to Roberto, age 2, 

who came into Howard's life and who, along with Roberto's loving mother, Lory, shared his Dad with us 

for this demanding and important period of time. We continue our work in the hope that all children rna)' 

have the opportunity to become as healthy and live as joyfully as Roberto. 
EXECUTIVE SUMMARY 

"A child is a person who is going to carry Oil what you have started. He is going to sit 

where you are sitting, and when you are gone, attend to those things which }"OU think 

are important. You may adopt all the policies you please. hut how they are camed out 

depends on him He will assume control ofyourdties, states. and nations. He isgaing 

to move in and lake over your('hun·he.\~ schools, universities, and corporatiom ... the 

fate oj humanity is in his hands. " 

Abraham Lincoln 

vii 
"llle Amcrimn dr('(/flI heKim ~l'ith the AmericanIamify. " 

U.S. Senator Barhara Mikulski 

July 20,1988 

For an incn:a:.ing numner of children and famili(;s, the 

dream i~ a nightmare. Twenty years ago, law enforcement and socia! service authorities nationwide received a total of 60,(M)O reports of suspected child 

maltreatment. Last year, there were nearly three 

million sllch reports. Child ahuse and neglect is a 

growing national crisis, one that won't he sufficiently 

addressed until national poliqmakers understand and 

acknowlcdg\.' the severe threat facing millions of American children. 

The system that is intended to help and protect ahused 

and neglected children docs little to mitigate the nightmare. Instead of emphasizing prevention of maltreatment, America's child protection system usually steps 

in when damage has already heen done. Instead of 

casing telL'~ions within families ami hringing them closer 

together, the system too often exaeerhates those tensiems. Instead of helping children, the system tends to 

funnd children into a proce~s over which they have no 

control and that doesn't necessarily act in their hest 

intcrests. 

Child maltreatment is a severe societal illness. The 

cure we are currentl} using, however, is not alleviating 

the ailment. Tragically, in many cases, it is actually 

making it worse. 

The United States Advisory Board on Child Abuse and 

Neglect helieves this ineffective and counterproductive status quo must be changed in order to reverse the 

continuing escalation in child maltreatmcnt. In its 1993 

report, Neighbors Helping Neighbors: A New National Stmtegy for the Protection of Children, the 

Board argues forcefully that America needs to take a 

new look at the multiple and eomplex factors that lead 

to incident~ of child ahuse and neglect, to critically 

examine the serious faults in the current child protection system, and to implement a new strategy to hetter 

protect children from harm. 

With 34 ~pecific policy reeommendations, Neighbors 

Helping Neighbors is a groundbreaking blueprint for a 

strategy tharean help millions of children lead healthier, 

happier lives. 

V]11 ---

UNUERSTANDlNGCHILUABlJSEANUNEGLECI' 

"Knoll' yo/{ what it L~ 10 he a chiLd? ... il is to heLiere in [ore, 

10 heliel'e in loveliness, to be/iel'l' in helicf; it is 10 he so lillie 

that the elres rnn rearh to whisper in YOllr ('ar; it is to tllrn 

pumpkins into coaches, and mice into horses, iowne.H 

into lojiiness, and nothing inlo el 'el)'lhing, for each child 

has it:; flli!)' godmother in its SOIlI. " 

Percy Shelley. 

In The Duhlin Review (July, 19(8) 

Child maltreatment in our society ismueh more pervasive and stems from more complex causes than most 

people would hclicve. Based on the nearly thrt:e 

million incidences of suspected child ahuse reported 

last year as well as the many cases that are never 

reported, the best evidence is that at least 2.5 percent 

of American children are ahused or neglected each 

year. That is a ~taggering figure and it puts a lie to the 

idt:a that child maltreatment is committed by a few 

"had" parents who take out their hostilities on their 

kids. 

In fact, physical ahusc isn't even the most prevalent 

child maltreatment problem. Although serious cases 

of physical and sexual ahuse occur with disturhing 

frequency, the majority of reported cases involve a 

primary allegation of neglect or emotional mistreatment. Children are being left home alone for long 

periods of time. Children are suffering the consequenees of being part of families that are economically 

pressured and socially isolated. Children are growing 

up without positive, traditional support mechanisms 

that were readily available to previous generations. As 

much as anything, maltreated children are victims of 

profound changes in our s(x:icty. 

To hetter understand the prohlem of child maltreatment, one ha~ to understand the environment in which 

so many of today's children are growing up. Since 1960, 

family life in America has changed dramatically. Our 

prohlems are more complex and our economic and 

social support structures arc less effective. 

Since 1960, there has been a four-fold increase in the 

numher of births occurring outside of marriage. Traditional two-parcnt families arc dwindling in numher. 

And there has heen a three-fold increase in the pcr-
, 

centage of mothers with young children who work 

outside the home. The same parental support mechanism that previous generations of children enjoyed is 

found in a shrinking numher of today's homes. 

And, not only arc fewer adults present in families, but 

there is less meaningful time being spent by parents 

with their children. Parents arc working longer hours, 

driving longer commutes to and from work and arc 

faced with increasing demands outside the family. The 

idea of the dose-knit, mutually supportive family is in 

increasing peril. 

Families, particularly those living in cities and some 

sparsely populated areas, arc increasingly living in a 

state of social isolation. Studies have found that isolation is a major contributing cause of child maltreatment. As more people migrate tothc suburbs, they are 

leaving behind neighborhoods and communities that 

are left with fewer resources and an increasing severity 

of poverty among those not able to move. 111is flight 

resultsin decreasing population, decreasing home uwnership, an increa~ing proportion of single-parent families and increasing family and community violence. 

Traditional neighborhood social netv,lorks arc being 

disrupted and isolation is becoming a reality of everyday life. 

The increasing stress of family life and diminishing 

economic and social supports are combining to make 

a situation in which the family itself as an institution 

may be in peril. If we recognize that cases of ehild 

maltreatment usually involve multiple personal, social, 

and economic problems and often stem from economic pressure and social isolation, then we must also 

recognize that a successful approach toward child protection must bccomprehcnsivc and multifaceted. Our 

current system is neither. 

A MISDIRECTEU CHILU PROTECTION SYSTEM 

"A simple child, 

That lightly draws ils hreath, 

AndfeeLI' its life in el'O)' limn. 

What should it t.:now of death ?" 

William Wordsworth 

If the nation's child protection system were a private 

corporation, it would have gone into bankruptcy years 

ago. We arc utilizing outdated policies that do not and 

will not generate positive results. Taxpayers have spent 

literally billions of dollars on law enforcement, social 

services, foster care, investigators and court costs to 

address the issue of child abuse. With every dollar 

spent, thc number of reported child maltreatment 

incidence continues to spiral upward. And as those 

numbers increase, the nation will spend billions of 

dollars to pay for the consequences of child maltreatment. 

Ours is a system of diminishing returns for the simple 

reason that itis a system with()ut a sense of direction or 

purpose. It is more punitive than rehahilitative in 

nature. I tcmphasizcs after -the-fact investigation rather 

than preventive treatment. Rather than give the children involved empowerment, confidence and emotional support, it makes them part of a cold, impersonal, often confusing legal process. 

The most serious shortcoming of ()lIr nation's system of 

intervention on behalf of children is that it is reactive 

and investigatory in nature inskad of proactive and 

preventive. We devote massive resources to investigate allegations and preciolls little to assist at-risk 

families and prevent child maltreatment from taking 

place. 

State and county child welfare programs arc not designed to provide immediate help to familicswho need 

or request assistance. The only time our child protection apparatus responds quickl), is when suspected 

maltreatment is reported. Child protective system 

workers, instead of devoting their time to treatment 

and prevention, too often spend most of their hours 

gathering evidence against suspected ahusive parents 

and preparing to tl'stify in court. Without adequate 

resources devoted to prevention and treatment, then: 
is little hope of preventing recurrence of maltreatment 

in troubled homes. And there is virtually no possihility 

of preventing abuse of children who have a great 

likelihood of being maltreated. 

Ironically, we are ostensibly trying to aid children with 

a system that, by its very nature, is often hostile to 

families. By stressing investigation over positive assistance, the child protection system may actually bc 

increasing the possibility of maltreatment in some high 

risk cases. By entering overstressed households with 

charges and warnings, investigators may very well 

weaken parental self-esteem and strain family bonds 

already frayed by multiple problems. Also, the system 

is geared toward removing the maltreated child from 

the family even in cases in which proper treatment and 

professional support could lead to reunification and 

adequate functioning as a family. 

The hottom line is that the child maltreatment crisis in 

this country is not being alleviated. It isworsening. We 

will not reverse current trends until, one, we recognize 

the inherent failures in a child protection system driven 

by investigation; two, we engage in careful analysis and 

research to better understand the causes of child maltreatment; three, we acknowledge and begin to change 

the conditions that pennit the occurrence of child 

abuse and neglect; and, four, we realize that this is a 

problem that affects society as a whole and, therefore, 

an effective solution must he broad-based in nature. 

THE PARAMETERS OF A NEW NATIONAL 

STRATEGY 

"So long as little children are allowed to su.ffer, there is no 

true love in the world. " 

Isadora Duncan 

American dancer and educator, 1924 

A new national strategy to prevent child abu5e and 

neglect must be one that offer5 children hope of attaining familial love and emotional support. Such a strategy must involve all scgments of society in offering help 

and hope to individual children, parents, and families. 

There are four components to the foundation for such 

a strategy, each of equal importance. First, a national 

strategy must be comprehensive. It must include contributions from social service, legal, law enforcement, 

health, mental health and education professionals as 

well as government policymakcrs. In order for such a 

strategy to work, it must inelude adequate resources 

not only for investigation and adjudication bascd on 

effective risk assessment, but also for prevention and 

treatment. 

Second, a national strategy must be neighborhoodbased. In fact, it must address the viability of the 

neighborhood it~elf. Ifwc are to have healthy families 

we must become sensitive to the quality of the neighborhood environments in which our families live. 

Third, a national strategy must he child-centered. A 

child protection system will not work if the child is 

treated a& a benign object of conccrn. Children must 

be taken seriously as individuals. Attention must be 

given to their best interests. Children of adequate age 

and development must be given an opportunity to be 

heard and to he represented on matters that affect their 

lives and fuhrres. 

Fourth, a national strategy must be family-focused. 

Removal of children from the home and the possible 

resultant destruction ofthe family unit must be a last 

resort, used only when children are faced with genuine 

danger to their health and well-being. Policies ~hould 

be aimed at ~trengthening families to minimize or 

eliminate the circumstances that can precipitate child 

abuse and neglect. We should work to improve the 
functional competency and self-sufficiency of families. 

And we should make all reasonable efforts to reunite 

families when abuse or neglect has led to removal of 

children. 

With the foundation components in place, we can 

begin erecting the elements of a strategy that will truly 

benefit America's at-risk children. The five clement'i 

proposed by the Board are as follows: 

ELEMENT ONE: STRENGTHENING NEIGHBORHOODS 

Research has made it painfully clear that the rate of 

child maltreatment in a neighborhood is tied to the 

quality of life in that neighborhood. Neighborhoods 

that are considered dangerous and frightening by its 

residents have higher rates of maltreatment than neighborhoods that residents regard more positively, even 

when those neighborhoods have equivalent income 

levels and similar ethnic composition. 

The likelihood of child maltreatment is heightened 

when fear, isolation, tension, and depression are part of 

everyday life. In neighborhoods that have low maltreatment rates, one is likely to find friendship among 

neighbors, watchfulne&.'i for each other's families, physical safety, common knowledge of community resources, 

visible leadership, and a sense ofbclonging, ownership, 

and collective responsibility. Offering people respect, 

involvement, and support can hclpovercome the isolation and depression that can result in abuse and neglect. 

The prohlems in our neighborhoods arc both sociological and economic. In neighborhoods mostsevercly 

affccted by flight to the suburhs, the average age of the 

remaining re~idcnts rises. Older residents are more 

likely to remain in place. That means young parents in 

declining neighborhoods arc increasingly unlikely to 

have peers with sufficient resources to he available for 

mutual advice and support. Special efforts need to be 

made to ensure that connections are made among 

those young parents who remain. 

Economic development is a key to alleviate the negative ramifications that accompany migration away from 

cities and sparsely-populatcd rural areas. Jurisdictions 

need to assess their neighhorhoods and communities 

and work with economic developers and business leaders to develop local development strategies to create 

jobs and opportunities. In some instances this may be 

accomplishedthroughcommunity-ownedcooperatives 

and credit organizations that keep scarce capital within 

the community. 

Housing is another critical factor in child maltreatment 

propensity. Among families receiving Aid to Families 

with Dependent Children, studies have shown that 

children who live in overcrowded, dilapidated and 

underfumished housing are more susceptible to abuse 

and neglect than those who live in safe, clean facilities. 

Jurisdictions must work to make housing adequate and 

affordable, and to make all aspects of a neighborhood's 

physical environment safe and a source of pride for 

residents. Ncighhorhoods must he safe havens for 

children and families, places in which parents and 

children can gather, interact, support and learn from 

each other. 

ELEMENT 'fWO: REORIENTING THE DELIVERY OF HUMAN SERVICES 

If the child protection apparatus, as it exists today, is a 

public service, there has heen a distinct lack of emphasis on the word "service." By emphasizing investigation and punitive action, somc children are being rescued from threatening situations. Manyotherchildren 

and families, however, arc not receiving the service 

they need to repair damage that has taken place or to 

prevent harm from occurring in the first place. 

Where damage has already heen done, treatment for 

maltreated children needs to be given greater priority. 

Today, even when the state takes custody of a maltreated child, it does little to ameliorate the harm, or 

prevent long-term effects that may occurwithout treatment, or to mitigate the harm that comes from intervention itself. 

The current crisis in foster care is a prime example of 

the lack of priority given to harmed children. The 

foster care system is troubled by several different 

dilemmas. The nwnber of available foster homes has 

decreased as the incidence of child maltreatment has 

exploded upward. Foster families do not receive adequate resources to help alleviate the effcet<; of abuse, 

neglect, and separation from biological families. There 
has been little study or examination of the experiences 

of children within the foster care system to determine 

if the system serves a child's best interests. There is 

simply no clear goal, purpose, or definition of what 

foster care should be. There has been a deplorable lack 

of attention given to the fate of a child who enters the 

child protection process. 

Likewise, too little priority has heen given to :-,ervices 

that can make parents feel more empowered, more 

able to gain control over their own lives, less prone to 

alienation, hostility, and abusiveness. Rather than the 

current investigation-centered process that exists today to protect children, there should be a thrcc-ticrcd 

scrvice system. One level would promote child developmcnt and healthy family function through community-based family support net'W'Orks with access and 

referrals to human services. A second level would 

assist families and children with specific, imperative 

needs, and a third level would protect abused and 

neglected children through more comprehensive child 

protective services. 

Our judicial system also needs to he reoriented toward 

the needs of children and families. There could be, for 

example, a greater emphasis on using alternative dispute resolution techniques rather than formal 

adversarial court proceedings in cases where there is 

no clear risk of serious harm to the child. A process that 

resolves problems and promotes family responsibility 

would help parents feel that they had a voice in developing the solution to family difficulties. 

There also needs to be greater attention given to what 

a child experiences in the legal process. Thcre has been 

little study into ways in which children can he more 

involved in legal proceedings and have their say in 

determining their future. The norm in many communities is that children are more objects than participants in child protection proceedings and are given 

little orno explanation about the nature of the proceedings or the reasons for the decisions reached. Children 

need to be better represented in judicial affairs that 

affect their interests. 

There is a role here, as well, for the law enforcement 

community. Police officcrs and sheriffs can play much 

broader roles than simply to investigate allegations of 

neglect and abuse. There should be a greater emphasis 

xii 

- -----~---

on the concept known as community policing. Officer~ 

work with communities to generate greater watchfulness for children and to develop greater mutual support hetween neighbors. They work with housing and 

social services agencies and community organizations 

to create safer environments for children and families. 

ELEMENT THREE: IMPROVING GOVERNMEN]'S ROLE IN CONTROLLING CHILD MALTREATMENT 

Children have a right to protection of their personal 

security. Governmcnt~, however, have allowed the 

perpetuation ofa ~ystem so full offaults and misguided 

policies that little guarantee of protection from continuing serious harm can he given even to children 

recognized as alrcady ahused or neglected. Even 

children who have heen taken into state custody have 

no guarantee that their interests will he well served. 

Government must rectify this problem and protect a 

child's right to personal security. 

That necessitates the establishment ofa national child 

protection policy. Such a policy should have a clear 

goal, to facilitate comprehensive community efforts to 

ensure the safe and healthy development of children 

and youth. This policy should be the driving force in all 

government child protection-related actions. 

There is also a need for change in government financing of child protection efforts. First, the currentfinancing system offers incentives for out -of-home placement 

of children without similar incentives for use of prevention services, early intervention, and intensive crisis 

intervention. Greater financial incentive should he 

given to preventing prohlems before they happen. 

Also, "strings" placed on government funds are often 

so rigid that they discourage the development of comprehensive neighborhood-based services for families 

and children. Direct grants should be provided to 

neighborhood programs for the specific purpose of 

prevention and treatment of child abuse and neglect. 

Finally, federal and state governments need to coordinate regulations to make it easier for community-based 

agencies to build comprehensive services using funds 

from more than one source. 
 -

ELEMENT fOUR: REORIENTING SOCIETAL 

VALUES ll1AT CONTRIBUTE TO CHILD MALmEATMENT 

It is difficult to dj~ouragechild abuse in families when 

violence is widespread in our society. Community 

violence and family violence arc strongly correlated in 

their prevalence, and they both arc n:Jatcd to the 

cultural acceptance of violence. 

Leaders in education, government, the media, business, and civic organizations can do much to dcglamo rizc 

violence and send the message that violence is wrong, 

including the specitic message that violence against 

children is inappropriate and that alternative means of 

discipline arc available. 

Schools have a particularly important role in teaching 

parents and children that effective nonviolent means 

aTC available to resolve conflict. 'There is value in 

parenthood education and school mediation program~ 

that are aimed at preventing violence against children. 

A corollary message concerns sexual exploitation and 

abuse of children. There is good reason to believe that 

one answerto reduction of the high frequencyofsexual 

abuse of children lies in changes in societal values. The 

message must be simply given that sexual abuse is 

wrong. The entertainmentmedia, which too frequently 

promotes the sexualization of children, has a significant responsibility to transmit this message and correct 

the societal distortions that some programming has 

encouraged. 

Acceptance and appreciation of cultural differences is 

an important element in preventing and rcsponding to 

child maltreatment, especially in high-risk neighborhoods. Ifchild protcction workers donot recognize the 

cultural significance of communication patterns and 

ehildrearingpractices, thc services they offcr are likely 

to seem literally foreign and relativclyunhelpful. Likewise, schools, churches, communitydevclopment agencies and other neighborhood institutions should take 

special care to reflcet the culturcs thcy scrve in their 

teaching materials, staff composition, visual displays, 

meals, and festivals. Respect for different cultures can 

help alleviate isolation, low self-esteem, and bitterness 

and, thereby, reduce family instability and other problems associated with child maltreatment. A failure to 

understand and respect cultural differences also deprives our society of the richness we would have if we 

\\erc bettn ahll' to incorporate --or at least not destroy 

-- some ofthc traditional methods for resolving family 

crises that those from other cultures may bring. 

ELEMENT FIVE: STRENGTHEN AND BROADEN 

KNOWLEDGEABOUTCHILDMALTREATMENT 

Reviews by leatling scholars in thc field have shown 

that there is an alarming lack of knowledge about the 

factors that can affect propensity for child maltreatment. 

There is little known, for example, about the perceptions that maltreated children and their parents have of 

the child protection systcm. In fact, few studies arc 

available regarding maltreated children·s experience 

of their environment. There is little research on the 

effect of neighborhood quality on rates of child maltreatment. Few studies have assessed thc kinds of 

social support that arc most likcly to prove beneficial to 

at-risk families. 

Not only docs thcrc need to be a greater quantity at 

knowledge in this area, butthequality and the direction 

of our research needs to hc altered as well. Rescarchcrs and policymakers should adopt a more child-centered approach to research. They should learn about 

children's experiences in both existing and demonstration programs and systcms, and they should eonsidcr 

the effects of child protection policies and practices on 

relationships important to children. 

Child protection is important enough to demand extraordinary study and rescarch. Evaluation of existing 

systems should be done routinely, and state and communitychild protection plans should be regularly finetuned in response to those evaluations. 

CONCLUSION 

Implementing this strategy will not he easy. It means 

altering long-held beliefs on how best to address the 

prohlem of child abuse anti neglect. It means a wholesale reorientation of thinking, with less emphasis on 

after-the fact investigation and more on treatment and 

prevention. 

xiii 
In deveiopingthisstrategy, though, the Advisory Board 

kept foremost in mind the United Nations Declaration 

ofth(' Right., of the Child: "Mankind owes to the child 

the hest it has to gil'e," We believe in giving our children 

the hcstwe have, hut first we must give them something 

hasic -- a society in which they need not live in fear. 

To that end, we as a nation must overcome the isolation 

and tensions created by the demands of modern life. 

We must create caring communities that support families and shelter and nurture children, We must take the 

time to see the need and to lend a hand. Above all, we 

must put the interests of children first and take steps 

that will allow them to grow, achieve their potential and 

become contributing members of society. A proper 

child maltreatment strategy will not only protect children from harm. Itwill help them thrive. This must be 

our goal. We must ensure the safety of all of our 

children for all time. As writer/philosopher Albert 

Camus stated so well: 

"Perhaps we cannot prerent this world 

from being a world in which children 

are tortured. 

But we can reduce the number of iOltured 

children. 

And if you belieJ:ers don't help us, who el~e in 

the world can help U~ do this?" 
A New National Strategy for the Protection of ('hildrcn 

Mission and Composition 

of the U.S. Advisory Board on Child Abuse and Neglect 

The U,S. Advisory Board on Child Abuse and Neglect was established under Section 102 of the 

Child Abuse Prevention and Treatment Act (CAPTA) amendments of 19XK It consists of fifteen memhers 

appointed hy the Secretary of Health and Human Services. Members represent a wide range of legislatively mandated disciplines, as well as various regions of the country and diverse personal perspectives, The 

names, titles, addresses and subject areas of Board members arc listed in the appendix. 

The explicit provisions of CAPT A creating the Board require it to prepare an annual report to the 

Secretary of Health and Human Services, appropriate committees of the Congress, and the Director of the 

National Center on Child Ahuse and Neglect (NCCAN). In its reports, the Board is charged with evaluation of the nation's efforts to accomplish the purposes of CAPTA, and development of recommendations 

about ways those efforts can be improved. 

In its first report in 1990, the Board concluded that the problem of child maltreatment in the U.S. 

had reached the proportions of a National Emergency, based on the alarming increase in reports and the 

consequences for our society, It argued that a broad and comprehensive approach was required, and it 

offered 31 recommendations for implementation at all levels of society. The Board's second report focused 

on recommendations for the federal government. A primary recommendation was implementation of 

universal voluntary neonatal home visitation as a means of early prevention. 

The 1992 report was devoted largely to recording Board activities in preparation for the current 

report, as well as positions and statements issued during the year. This report also included a concept 

paper on Neighborhood Based Approaches, which serves as the basis for part of the current report. 

The current report (1993) offers a broad analysis and approach, including steps that must be taken 

at federal, state, local and societallcvels to make families and communities safer for children in this country. It presents a comprehensive new strategy which the Board believes will not only reduce the incidence 

of child maltreatment, but will reduce incidence of other social problems as well. 

u.s. Advisory Board on Child Abuse and Neglect ------------------------
Neighhors J Iclping Neighbors 

Preparation and Structure of this Report 

This report rcpre~ent~ the culmination offour years of work by the Board. It extends, refines and weaves 

together information, ideas and proposals offered in earlier report'> in order to propose a comprehensive 

national strategy. However, this report goes farther than prior efforts because it is based on far more 

information than was previously available. In order to base its conclusions on relevant research, the Board 

commissioned qualified researchers to review and summarize findings from scientific literature in six major 

subject areas. The authors and their topics included: 

· James Garharino and Kathleen Kostelny, Neighhorhood-Based Programs 

· Jill Korhin, Social and Cultural Factors in Child Maltreatment 

· Paul Lerman, Child Protection in Out-of-Home Care 

· Leroy Pelton, Material Supports as a Factor in Child Protection 

· Ross Thompson, Social Support as a Factor in Child Protection 

· David Wolfe, Treatment Related to Child Ahuse and Neglect 

Executive summarie~ of thcsc papers arc included in the appendix. 

This report is abo based on input received from scholars, administrators, policymaker~, practitioners, front 

line \\'orkers, parents and youths at risk, offered at hearings, symposia and meetings conducted by the 

Board in variolls parts of this country. These events and other activities of the Board during 1992-93, arc 

detailed in the appendix. 

The r~port is structured to allo',\ the reader to gain the most essential information quickly. Section I is a 

brief overview of the Board's proposed national strategy and the five elements of which it is comprised. 

Section II identifies conditions in American society which led to the current crisis, analyzes the response of 

the child protective system and discusses the need for rdonn. Section III offers an in-depth discussion of 

each of the five clements of the proposed national strategy. Section IV compares the Board's proposed 

strategy with related recommendations from other groups and institutions. Section V presents five guiding 

principles to he followed in implementing the national strategy, and Section VI outlines the potential 

contribution of major sectors and institutions in societ)·. Thc report (lifers 34 recommendations, which arc 

presented at the end of relevant subsections in section II, and arc later consolidated in the appendix. The 

appendix also includes the Board's proposed national child protection policy. 

-------------------------- u.s. Advisory Board on Child AblL~C and NcglcL1 
A New National Strategy for the Protection of Children 

I. TIlE TRAGEDY OF THE PRESENT AND TIlE HOPE FOR TIlE FUTURE 

A. CHILD ABUSE AND NEGLECT: A 

PROBLEM OF FAMIUES AND 

NEIGHBORHOODS 

We begin by describing three families. Their stories 

are not dramatic. They are not the sort that appear 

on the front pages of newspapers or the covers of 

news magazines. The adults involved are not evil 

people. 

But the families in the stories are people in real 

trouble who have many problems, few resources, 

and little access to help. The children are at significant risk, the community has failed to provide the 

help necessary to ensure their safe and healthy 

development, and the child protection system as 

currently designed may even interfere with the help 

that is needed. 

. Mary is a single parent of Native American heritage. Aged 25, she has three children under age six, 

and she receives Aid to Families with Dependent 

Children. She dropped out of high school, and she 

has no employment history or job skills. The family 

lives in a declining urban neighborhood. Mary does 

not know her neighbors, and there are no human 

selVice agencies located in the neighborhood itself.l 

Mary is an alcoholic, and she wants help in dealing 

with the problem, but she does not want to enter a 

residential treatment program if the cost of doing so 

is placing her children in foster care. No outpatient 

or day treatment services are available in her area of 

the city, and she lacks transportation to go elsewherc. Because she herself is a "graduate" of the 

foster care system, she does not want to put her 

children through a similar experience, and she distrust<; Child Protective Services (CPS) workers. The 

hygiene of the children is often poor, and meals --

especially near the cnd of the month -- are provided 

on an irregular schedule. 

. Sam is a nine-year -old boy who was reported to 

have been involved in inappropriate sexual behavior 

(fondling of genitals) with younger children. Interviewed by a sheriff's deputy in a rural County, Sam 

said that he sometimes showers with his father , but 

the deputy did not question Sam further about his 

experiences in his family. Deciding that Sam was a 

"perpetrator," the deputy immediately placed him 

in foster care pending a court hearing. Anxious to 

find out more about the situation, provide assistance 

to the family, and determine the risk involved if Sam 

were to return to his home, the CPS worker confronts distraught and angry parents who have been 

advised by their attorney to talk to the worker only 

in the attorney's presence. 

. Jean and Joe Brown live in a small, dilapidated 

house that they rent in a rural village. There are 

holes in the floor of the front porch, and rusted fann 

tools litter the yard. The Browns have custody of six 

children, who have three fathers (one child is the 

biological child of both Jean and Joe). They range 

in age from six months to eight years. One of the 

children (Joe's child by a previous marriage) is an 

18-month-old hoy with failure-to-thrive syndrome, 

and the family physician in the County seat reported 

his suspicion that the child was neglected. Jean's 

brother George lives with the family, and he is 

suspected of having sexually abused lean's fiveyear-old daughter, but the allegation was not proven. 

Teachers have complained that the older children's 

attendance is irregular. Whcn they are present, 

their appearance is unkempt and sometimes dirty, 

they have trouble sitting still in class, they have no 

close friends, and their educational achievement 

already is substantially delayed. The family receives 

food stamps and Medicaid services. Joe works 

intermittently at low wages in a meat-packing plant 

in the County seat. Neither he nor his wife has more 

than a tenth-grade education. 

Families like the ones described are being reported 

to Child Protective SeIVices and law enforcement 

agencies in ever greater numbers -- nearly three 

million times ayearin the United States.2 Although 

serious physical and sexual abuse occur with disturbing frequency, the vast majority ofreporled roses 

involve a primary allegation of neglect or eTTwtionai 

maltreatment. 3 The problems presented are complex, 

U.S. Advisory Board on Child Abuse and Neglect ------------------------ 1 
Neighbors Helping Neighbors 

2 

and the threat to children's safe and healthy development is often substantio.l -- just as in cases of serious 

physical and sexual abuse. 4 

Bul in the face of such problems, the investigation 

itselfis the only "service" provided in about 40% of 

substantiated cases (i.e., cases in which public child 

protection authorities believe that the evidence shows 

thatabuseorneglectdidoccur).5 Unfortunately, the 

proportion of substantiated cases in which no ser~ 

vices are provided is steadily increasing. 

When each year hundreds of thousands of children 

are identified as maltreated but provided no help, 

both common sense and empirical research lead to 

the conclusion that the child protection system is 

failing disastrously. Indeed, the fact that so many 

children and families reach such a point ~~ that they 

lacked the help they needed before abuse or neglect 

occurred ~- is itself catastrophic. 

No problem can be more basic than threats to 

personal security. No social and governmental 

responsibility can be more fundamental than assuring the safety of the nation's children. 

This responsibility has not always been given the 

attention it'> seriousness merit". Yet surely the 

American people and their elected representatives 

never intended to create a situation in which the 

personal security of so many children is at risk. 

Indeed, the millions of reports made each year 

clearly demonstrate the public's awareness and 

concern for the safety of children. Moreover, the 

Nation spends billions of dollars each year in response to the problem of child abuse and neglect. 

This report describes the nature of the flaws in the 

child protection system and the ways in which they 

developed. In response, the Board offers a vision of 

a new system that would take children's own experience seriously and would strengthen families and 

neighborhoods by facilitating neighbors' help for 

each olher. 

Through new connections among families and support for each other, we must build a safety net that 

is woven so tightly in every neighborhood that children cannot fall through. The development of safe 

environments for children will require: 

· easy availability of hoth social and material support, 

· redesign of the human service and justice systems 

to promote neighbors' perceived responsibilit), to 

watch and care for children and their capacity to do 

so, 

· the commitment of every adult to join in building 

environments that are safe for children and their 

families, 

· changing attitudes that inadvertently increase the 

risk of hann to children, and 

· the leadership of public officials in promoting such 

a commitment and fostering the generation and 

planned application of the knowledge necessary to 

fulfill it. 

The challenge to all sectors of American society to 

secure the safety of children is enormous and complex. Its fulfillment will require a new way of thinkingamong policymakers, the public, and professionals. It will also demand broader efforts and better 

infonned and more careful planning than has ever 

occurred in the child protection system. 

But the safety of children is an achievable goal. Itis 

made easier by the lessons learned in current Federal, State, and local initiatives to rcfonn child and 

family services, as well as by current and historic 

efforts to build a sense of community in neighborhoods most at risk. And it is made possible by our 

heritage of neighbor helping neighbor. 

Although current social realities may make the 

neighborliness needed for the protection of children 

seem less "natural" than itwas in the past, it is no less 

important. Federal, State, and local policymakers 

and program administrators must take the steps 

necessary to facilitate the development of caring 

communities with strong nonns of mutual assisu.s. Advisory Board on Child Abuse and Neglect 
tance and adult care, conccrn, and respect for children. This report provides the framework for doing 

so. 

B. CHILD MALTREATMENT AS A 

NATIONAL POLICY ISSUE 

The U.S. Advisory Board on Child Abuse and Neglect is charged, among other tasks, with reviewing 

the Nation's progress in protecting its children. 

When the Board first responded to it~ charge in 

1990, we concluded that the scope of the problcm of 

child maltreatment was so enormous and serious, 

and the failure of the system designed to deal with 

the problem was so catastrophic that the crisis had 

reached the level of a national emergency. The 

Board noted the astronomical increase in the number of cases of child abuse and neglect, the inability 

of the child protection system to protect the children 

involved, and the billions of dollars being spent 

annually on a failing system and countless billions 

more that are lost as a result of the consequences of 

child maltreatment. The Board proclaimed a moral 

crisis, not just in the degradation thatchildren experience as a result of abuse and neglect but also in the 

Nation's tolerance of the widespread maltreatment 

of children. Tragically, the state of emergency 

remains in effect and may in fact be even more dire 

today than it was in 1990. 

In its 199) report, the Board issued thirty-one recommendations designed to "plug the holes in the 

dike" and alleviate the emergcncy conditions facing 

many of the Nation's children. The Board also 

noted inherent problems in the existing child protection system and promised to develop a proposal for 

anew national comprehensivechild-centered, neighborhood-based, and family-focused child protection system. 

This report contains that proposal. The Board 

presents it to the Secretary of Health and Human 

Services, the Director of the National Center on 

Child Abuse and Neglect, and the Congress in the 

bcliefthat it is time to respond with due urgency to 

the catastrophic conditions in the current child proA New National Strategy for the Protection of Children 

tection system by replacing it with a new system 

which will far more effectively assure children of 

protection from harm. 

The proposal reflects a mixture of emotions. It 

results from horror -- the continuing tragedy of 

catastrophic failures in the child protection system. 

But it has been developed with hope -- the yearning 

for communities that care enough aboutthciryoungest members to protect them from serious harm. 

C. SUMMARY: THE ELEMENTS OF THE 

NEW NATIONAL STRATEGY 

The Board believes that protection ofthe Nation's 

children requires significant changes in the nature 

of our society. We must take five key steps: (1) 

strengthen neighborhoods; (2) reorient the delivery 

of human services, including justice services; (3) 

improve the role of government in addressing child 

maltreatment; (4) reorient societal values that may 

contribute to child maltreatment; and (5)strcngthen 

and broaden the knowledge base about child maltreatment. 

1. Strengthen Neighborhoods 

We must strengthen ourneighborhooos, both physical1y and socially, so that people care about, watch, 

and support each other's families. Child protection 

must become a partof everyday life, a function of all 

sectors of the community. 

In that connection, the Board's top-priority recommendation is for the creation of Prevention Zones-

- model neighborhoods in which intensive efforts 

arc made to facilitate neighbors helping neighbors 

and to promote economic and social development 

for the purpose of preventing child abuse and neglect. Prevention Zones will offer opportunities to 

test the effectiveness of child protection efforts in 

neighborhoods of differing population density, ethnic and cultural composition, and social and economic resources. 

Every neighborhood should have a Child Protection 

Plan to strengthen families and prevent harm to the 

children residing there. The plan should be constructed and implemented by neighborhood resiu.s. Advisory Board on Child AblL.<;C and Neglect ------------------------ 3 
r 

l 

Neighbors Helping Neighbors -----------------------------__ 

4 

dents and local interagency councils with access to 

whatever external resources, including technical 

assistance, are necessary. Community Development Block Grants should be augmented to facilitate this work. 

Among the specific programs that should be planned 

and implemented are: 

· family resource centers to provide easily accessible, highly integrated services to promote parental 

competence, meet the diverse needs of children and 

families, and facilitate sense of community and 

networks of social support in the neighborhood; 

· youth programs to enhance parent-adolescent 

relations, treat the effects of abuse, offer youth 

positive and challenging roles in thcircommunities, 

and opportunities for positive networking in order 

to assist them in their transition to adulthood and 

parenthood; 

· economic development programs to diminish poverty and its effects and to promote residents' selfesteem and sense of community and their resources 

to help each other; 

· housing programs to increa<;e the physical safety of 

the neighborhood and to promote residents' interaction with each other; 

· Adopt-a-Neighborhood programs hy which businesses and other institutions (e.g., churches, synagogues, and civic clubs in affluent neighborhoods) 

assist in strengthening neighborhoods with few resources. 

2. Reorient the Delivery of Human Services, 

Including Justice Services 

We must expand and reform our human service 

system so that it becomes as easy to provide services 

to prevent child maltreatment and other forms of 

family disintegration as it is to place a child in foster 

care after the fact. Prevention and treatment. including both social and material supports, should be 

integrated into neighborhood settings, such as 

schools and neighborhood centers. Mental health 

services should bewidely available and easily accessible for children and families affected by child 

abuse and neglect. 

We must also reform the law and the justice system 

to promote neighborhood responsibility and to ensure government accountability for the protection 

of children. The resources consumed through investigative processes that prccede legal decision making should not detract from the far greater priorities 

of preventing and treating child abuse and neglect. 

Civil and criminal investigation, adjudication, and 

disposition must be conducted with due respect for 

children and parents as individuals, and we should 

ensure that children have effective advocates for 

their interests and views. 

We must reform foster care, so that it becomes part 

of a neighborhood-based system of services. We 

should experiment with alternatives to traditional 

family foster care that may provide children with 

consistent family environments, promote permanence in children's relationships, and ensure 

children's safety. We should give foster parents the 

respect and resources they deserve. 

3. Improve the Role of Government in 

Addressing Child Maltreatment 

We must care enough about the quality of efforts to 

protect the safety of our children that we insist that 

child protection programs are planned so that they 

are neighborhood-based, child-centered, family-focused, and culturally and ethnically relevant. A 

National Child Protection Policy should be adopted 

to provide a comprehensive neighborhood-based, 

child-centered, and family-focused foundation for 

efforts to protect children. 

We must ensure that government does not inhibit 

community efforts to protect children and strengthen 

their families. We must reorient fiscal policies that 

make it easier to fund foster care than prevention 

and that deter community agencies from combining funds from sever.ll sources to provide badly 

needed sen'ices. We must develop more flexible 

approaches to financing that encourage communities to develop comprehensive, integrated approaches to families with multiple needs. 

u.s. Advisory Board on Child Abuse and Neglect 

-
,. 

4. Reorient Societal Values That May 

Contribute to Child Maltreatment 

We must reorient ourvalues so that violence ceases 

to be an acceptable response to conOict within 

families and cOIllJllunities. We must also develop 

greater understanding and appreciation of the 

strengths ortbe various ethnic cultures that make 

up our society, so that cultural differences become 

recognized as sources of strength rather than "problems." We must work to change attitudes toward 

sexuality that result in the exploitation and 

sexualization of children. 

We must regard children as full members of the 

community, whose personal security must be protected, whose interests mustbe respected, and whose 

views must be heard and adequately represented, 

especially in connection with the courts and other 

institutions that have control over their lives. As an 

affinnation of the value of children as persons and a 

framcworkforpolicydevelopmentthe United States 

should ratify the Convention on the Rights of the 

Child. 

5. Strengthen and Broaden the Knowledge 

Base About Child Maltreatment 

We must strengthen our program of research to 

generate knowledge sufficient toguide policymakers, 

program administrators, and front-line practitioners in the creation of caring communities and the 

protection of individual children. Funding for research on child maltreatment should be increased 

substantially, and the Federal capacity for managing the programs that result should be improved to 

comport with scientific norms. 

Evaluation studies should become an ongoing part 

of policy ronoation and services delivery, and programs and policies should be regularly modified in 

response to the results. In that connection, Prevention Zones can be ongoing laboratories for refinement of programs that may be applied to prevent 

ehild abuse and neglect or treat its effects in diverse 

communities. 

Whatever the specific topic of research related to 

child abuse and neglect, it should be child-centered 

so that the experiences of children are learned. 

Similarrespcct should be exhibited for caseworkers, 

u.s. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

parents, foster parents, and others in the child protection system, so that they are consulted in the 

design of research and given feedback about its 

result<;. 

The five steps noted above are the keys to a national 

strategy. Each step has been thoroughly considered 

by others, and most have been proposed individually 

from other quarters. Some have actually been 

implemented in particular communities and programs. But taken together, they constitute a new 

and comprehensive approach to the problem of 

child maltreatment. We tum now to the rationale 

for a new system. 

ENDNOTES 

IThe neighborhood in which Mary lives was one of the ones 

identified in research by Garbarino and his colleagues as both 

economically and socially impoverished and as having a high 

rate of child maltreatment, relative even to other neighborhoods of comparable social class. James Garbarino & Deborah 

Sherman, High-Risk Neighborhoods and High-Risk Families, 

51 CHILD DEV, 188 (1980). 

lKaren McCUrdy & Deborah Daro, Current Trends in Child 

Abuse Reporting and Fatalities: The Results of the 1992 

Annual FiftyState Survey2(Apr.1993) (report of the National 

Ccnteron Child Abuse Prevention Research). The numhcrof 

rep:>rtsof suspected maltreatment in 1992showed a continuing 

dramatic inerease--7.8% between 1991 and 1992. Id. 

3Jd. at 9. 

'See generally PANEL ON RESEARCH ON CHIlD AnvSE AND NEGlECT ch. 4 (prepub, ed., 1993) [hereinafter PANEL] (report of 

the National Research Council); U.s. ADVISORY BoARD ON 

CHHl)ARUSE AND NEGlEC1', CHILD ABUSE AND NEGU,cr: CruI1-

CALFtRS'l' STEPS IN RESPONSE TO A NATIONAL EMERGENCY 17-21 

(19'Xl) [hereinafter EMERGENCY] and citations therein; Jay 

Hel.,ky &Joan Vondra,Lessonsfrom ChildAbwe: The Determinants of ParenJing, in Omn MALTREATMENT: THFORY AS[) 

RESEARCH ON 11-IE CAUSES AND CoNSEQUENCES OF QlUn ABUSE 

AND NEGlECT 153 (Dante Cicchetti & Vicki C.-arlsoneds., 1989) 

[hereinafter THEORY AND RESEARat). 

~McCurdy & Daro, supra note 2, at 8. 

5 
Neighbors Helping Neighbors -------------------------------

6 

II. TIlE NEED FOR A NEW NATIONAL STRATEGY 

A. NOT JUST MORE BUT DIFFERENT 

Some ask why the Board advocatcs a new stratcgy.6 

Such commentators generally acknowledge the 

emergency in the child protection system, but they 

attribute the continuing crisis to insufficient resources. If more dollars were appropriated, they 

argue, the crisis would evaporate. 

Although the Board agrees that funds available for 

some efforts related to child protection have been 

grossly inadequate,' the Board also believes that the 

problem lies in the way that resources have been 

used as much as in the magnitude of the resources 

that have been available. The Nation needs not just 

more but different investment in child protection. 

The Board continues to believe that a response to 

the emergency without fundamental changes in the 

child protection system will not prevent its recurrencc. 

To understand the need for radical change in child 

protection, it is necessary to know some facts about 

the eurrentnature offamily life, child maltreatment, 

and the child protection system. 

B. THE NATURE OF CONTEMPORARY 

FAMILY LIFE 

Since 1960, family life has changed dramaticaUy --

often in the direction of more serious and complex 

problems and less consistent economic and social 

support. Unfortunately, the service system has not 

changed at a comparable ratc. 

The changes that have occurred in the structure of 

American families are extraordinary: a 50% dedine in the fcrtility rate, a marc than four-fold 

increase in births outside marriage, a four-fold increase in the divorce rate, and a nearly three-fold 

increase in the proportion of working mothers of 

young children. 8 Although there are of course many 

well-functioning single parent families, and families 

with two working parents, the needs of these families 

for child care, and the difficulties they face in managing extremely limited time, can be very stress 

producing. Although there is some cultural variation (both within the United States and across national borders) in the magnitude of this transfonnation in family structure, it is present to some degrce 

in every developed country and appears therefore to 

be a byproduct of economic and technological 

change.9 

Other changes exacerbate the decreasing availability of adults for many children. Not only are fewer 

adults present in families, but their time -- and often 

that of their children -- for family life has been 

shrunk by increasing demands outside the family,lO 

Moreover, social supports often are disrupted by 

moves. One in every four young childrcn lives in a 

home different from the one that the family occupied a year earlier.ll 

Tragically, social networks have become so disrupted that, for many families, isolation is one of the 

realities of everyday life. As one commentator has 

lamented: 

What is most striking about parents today is how 

isolated many of them are from other families and 

from each other, and how hungry they are fornew ways 

of making contact. "Sometimes I feel like the last 

person on emth, "one PTA president told me. Isolation among parents creates isolated kids -- or more 

speci{lCally, kids isolated from the adult world, more 

vulnerable to their peers. Why are parents so isolated? 

Longer commutes; both parents working ever longer 

hours; the new urban fonn; the fading of older networks -- coffee klatches, churches, neighborhood 

schools. In the work place, parents seldom discuss 

parenting because parenting is too often considered a 

career hindrance. Instead of support from the society, 

weget advice, a boominghow-to-parent industry. "I'm 

afraid of other parents, "said one mother. ''You never 

know what kind of weirdos are rai~ing your child's 

friends. " As lonely parents fear their environment and 

doubt their own competence, community -- the real 

preventer of child abuse and other violence -- diminishes. 12 

u.s. Advisory Board on Child Abuse and Neglect 
,.. 

Although such a diminution of social support is 

common in American society as a whole, it is most 

pernicious in impoverished neighborhoods. A fam· 

ily move is disruptive under the best of circumstances, but the aggregate trends in the direction of 

migration have had broader social effects. As inner 

cities and many rural areas and small towns lose ever 

greaternumbers of young families;3 economic stratification also has been increasing. The rich have 

gotten richer, and the poor -- especially women and 

children living in poverty --have gotten poorer. In 

the 1980s, income for the lowest 40% of families on 

the economic ladder in the United States declined in 

real dollars, while income for the top 20% rose by 

28.9%, and income for the top 1 % rose by 74%.14 

Not only has the gap widened, but poverty also has 

become more sustained. The proportion of families 

moving out of poverty declined by almost 40% in the 

last decade.ls As the economic outlook for young 

adults has declined,16 so too has the welfare of 

children, who are now the poorest Americans.17 

The combination of migration from neighborhoods 

with few resources and increasing severity of povertywithin them has resulted in increasing numbers 

of unstable, "drained" neighborhoods that appear 

to be in the throes of negative social momentum --

decreasing population, decreasing home ownership, increasing proportion of single-parent families, and increasing family and community violence 

and other crime. IS Poverty has become not only 

more sustained but also more concentrated. For 

example, the proportion of poor families in Cleveland living in high-poverty neighborhoods rose from 

21 % in 1970 to 50% in 1988. 19 Social networks are 

constantly being disrupted by out-migration as families who are sufficiently competent or lucky obtain 

the resources to move. They leave behind families 

who havc less and less, on average, with which to 

hclp each other. 

Unfortunately, the decline in infonnal social support-- a decline that is most severe in impoverished 

neighborhoods -- has not been matched by an increase in the availability, accessibility, or responsiveness of the formal scrvice system. The nature of 

services has changed little while families and their 

social context have changed enormously. Indeed, 

A New National Strategy for the Protection of Children 

the trends have been toward increasing 

professionalization, bureaucratization, and 

privatization of services.20 

As the National Commission on Children summarized: 

Most poorchildren inAmerica are indouble jeopardy. 

They experience the most health problems but live in 

the least heaUhful environments and have the least 

access to medical care. They are at the highest risk of 

academic failure, but often attend the worst schools. 

Their families experience the most stress but the fewest 

social sUpporlS. 21 

Indeed, those services that are available are increasingly"two-tier": a private service system for economically advantaged families and a public, often 

more restrictive system for those who are poor, 

especially those who are also of color. Thus, children of color fill more than half of the beds in 

training schools and detention centers, while white 

youth who enter the juvenile justice system obtain 

most of the private placements.22 Racial and class 

divisions are found in child mental health services.23 

Of even more direct relevance to the child protection system, such a phenomenon can also be observed in public social service agencies in which, as 

a practical reality, child welfare services often have 

become synonymous with CPS.24 In parallel with the 

trends in other systems, families of color are strikingly overrepresented in CPS,25 and children from 

poor families, many of whom are children of color, 

fill most of the slots on the foster care rolls.2ti 

C. THE NATURE AND CAUSES OF 

CHILD MALTREATMENT 

The increasing stress of family life and the diminishing economic and social supports combine to make 

a situation in which the family as an institution may 

be in peril. Even if such a conclusion is overly 

broad,27 there can be no doubt that socioeconomic 

change has resulted in unraveling of the social fabric 

in many neighborhoods. The danger in some neighborhoods is so great that the physical environment 

presents hazards for children and the social environu.s. Advisory Board on Child Abuse and Neglect ------------------------ 7 
Neighhors Helping Neighbors ----------------------------------

8 

ment breeds violence, both within and among famiIics, and fails to provide sufficient support to dampen 

family stress. 

Within such a context of threats to family life, the 

number of reports of suspected child maltreatment 

has grown at an explosive rate -- from an estimate of 

a few hundred cases in the early 1960s to reports of 

6O,OOOcasesin 1974 (when the Child Abuse Prevention and Treatment Act was enacted), 1.1 million 

cases in 1980, 2.4 million cases in 1989, and nearly 

three million cases in 1992.28 The proportion of 

unsubstantiated cases has remained relatively constant across time (approximately 60% of report.,:n). 

Althougha substantial proportion of cases arc never 

substantiated, underreporting also remains a serious problem.30 The best evidence is that at least 

2.5% of American children are abused or neglected 

each year.31 

Cases of serious physical injury -- even death -- occur 

with shocking frequency.32 Nonetheless, neglect 

remains the most commonly reported form of child 

maltreatment33 -- a fact that has too often been 

ignored in cries for reform of the child protection 

system. 

Whether one looks at the cases of infants shaken or 

beaten to death, older children who simply lack 

adequate care, or adolescents who are raped and 

sodomized, the picture is enormously complex. 

Whatever their form (neglect, physical abuse, sexual 

abuse, or emotional abuse), cases of child maltreatment usually involve a multiplicity of personal, social, and economic problems. When that impression is combined with knowledge about the increasing complexity of family life and the diminishing 

supports for families, the difficulty of preventing and 

treating child abuse and neglect becomes obvious, 

regardless of the cause of the extraordinary increase 

in suspected child abuse and neglect. 34 So too does 

the need for a comprehensive, multifaceted approach. 

The complexity of the problem is not simply that 

there are multiple factors involved in the causation 

of child maltreatment; the complexity also reflects 

the fact that almost every one of the specific factors 

has a myriad of causes and effects. Accordingly, 

child maltreatment is often just one of a multitude of 

impUlsive, irresponsible acts,35 often including violence toward multiple family members.36 Perhaps 

an even better illustration of the principle of complex causation is the fact that the single most important factor is poverty. Although most pronounced in 

cases of neglect, povcrty is a strong predisposing 

factor for all forms of child maltreatment. 

Of course, most poor families protect their children, 

but parents in poverty face a heroic task in doing so. 

As the National Commission on Children observed: 

Poverty and economic instability are associated wiih 

well-documented negative effects on children. Many 

poor children go undernourished, are inadeqllately 

clothed, and live in substandard hOlL~ing. For them, 

the world is often a dangerous and threateningpiace to 

grow up. It is cnOme-ridden streets where schools and 

playgrounds are the domain of gangs and dmgdealer.\~ 

orit is desolate mral areas without adequate roads and 

mnning water. It is dilapidated homes with broken 

windows, poor heating, lead paint, rats, and garbage. 

II is a world in which children grow up afraid and 

ashamed of the way they live, where they learn basic 

survival skiiLl" before they learn to read. 37 

Even the psychological variables that are associated 

with child maltreatment -- depression, low selfesteem, sense of powerlessness, general inadequacy, 

impulsivity, substance abuseJ8 -- relate directly to 

ability to cope with poverty.J8 So too arc the related 

demographic factors, such as family size,40 and the 

individual-child characteristics, such as disability,41 

which stretch already thin family budgets. 

If such circumstances -- poverty combined with 

personal difficulties incoping -- arc to be overcome, 

assistance must be available where families arc 

whcn they need it, and there must be reason for 

hope. Creating such ingredients requires attention 

to the neighborhood environments in which people 

live. Child maltreatment reporting rates vary according to ncighborhood quality even when income 

levels and cultural composition are similar.42 In 

ncighborhoods in which children are protected, 

there is fricndship among neighbors, watchfulness 

for each other's families, physical safety of the enviU.s. Advisory Board on Child Ahuse and Neglect 
,. 

mnment, common knowledge of community resources, visible leadership, and, perhaps most critically, a sense of "belonging," ownership, andcollcctive responsibility. By contrast, some neighborhoods have been so drained of these qualities that 

they are disastrous for children and families. Neighborhoods with high rates of maltreatment often so 

lack cohesion that their residents cannot even identify a name for the ncighborhood,43 

A British scholar recently descrihed residents' lack 

of identification with a neighborhood as home as 

psychological homelcssncss and noted the perniciousness of such isolation in affecting family safety: 

By psychologicalhomelessness I mean two things:first 

that they do not have a home which confers on them 

the beneftts and physical resources that they consider 

necessary for the tasks that are expected of them. 

Secondly, they do not have a home in the sense of 

havinga place which is a "safe hm'en" -- a place where 

they feel they belong, a place where they 1000W and tnlSt 

people, a place where they want their children to grow 

and develop. 44 

Ifchild maltreatment is to he prevented and treated 

effectively, research on its prevalence and causes 

leaves an unescapable message: efforts must be 

made to eliminate the circumstances -- both personal characteristics and socioeconomic contexts--

that cause or permit families to be isolated from 

each other.4s The task is sufficiently complex and 

difficult that it is likely that efforts must be both 

multifaceted and sustained; single-factor, one-shot 

interventions arc unlikely to be successful in either 

prevention or treatment of child ahuse and neglect. 

Unfortunately, the child protection system has far to 

go if it is to operate according to such principles. 

D. THE INADEQUACY OF TilE 

CURRENT STRATEGY FOR 

ADDRESSING CHILD MALTREATMENT 

1. A Centra] Focus on Investigation 

The most serious shortcoming of the nation's system of 

intervention on behalf of children is that it depends 

upon a reporting and response process that has puniu.s. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

live connotations, and requires massive resources dedicated to the investigation of allegations. State and 

County child welfare programs ha ve not been designed 

to get immediate help to families based on voluntary 

requests for assistance. As a result it Iws become far 

easier to pick up the teleplwne to reporl one's neighbor 

for child abuse than it is for that neighbor to pick up the 

teleplwne to request and receive help before the abuse 

happens. If the nation ultimately is to reduce the 

dollars and personnel needed for in !'-'estigating reports, 

more resources must be allocated to establishing voluntary, non-punitive access to help. 46 

Investigation now drives the child protection systemY Stated differently, the system acts in response to allegations -- not needs for help. CPS 

workers report spending much of their time in evidence gathering and court appearances,48 In turn, 

CPS consumes an ever greater proportion of child 

welfare budgets.49 Moreover, whenever an expose 

occurs in the child protection system (for example, 

after a child dies as a result of maltreatment), the 

usual clamor is to blame CPS or call for more CPS 

investigative workers. 

To he elear, the Board is not satisfied with the quality 

of investigation of cases of suspected child maltreatment --investigation thatean have seriously harmful 

consequences if it leads to either undue alann or 

undue complacency. An investigation may result in 

unnecessary removal of children and even unjustified incarceration -- or conversely, it may overlook 

preventable danger -- sometimes grave danger -- to 

children, ineluding children other than the ones 

reported. Too often, workers have minimal training 

in evidence gathering and, even if their training is 

adequate, their caseloads are too great to invest 

sufficient time to investigate reports thoroughly. 

Moreover, even if workers are trained and have 

manageable caseloads, research is insufficient to 

guide their assessments of risk to a level of validity 

much beyond that which can he obtained by clinical 

experience and intuition alone.so 

The result of the current design of the child protection system is that investigation often seems to 

occur for its own sake, without any realistic hope of 

meaningful treatment to prevent the rel:urrence of 

maltreatment orto ameliorate its elTects, even if the 

9 
Ncighhors HeJping Neighbors -------------------------------

10 

report of suspected maltreatment is validated. 

Obviously investigation cannot be removed alto~ 

gether, but it should no longer be the centerpiece of 

child protection. 

Whatever the skills and motivation of individual 

workers, the child prote<:tion system appears to lack 

the sense of mission with which it started. Ironically 

and tragically, the child often has been lost in the 

system. CPS workers and others in the child prote<:~ 

tion system have found their job seemingly defined 

as checking off boxes: Did parents engage in partieular behavior that justifies coercive government 

intervention? If so, have they complied with each 

element of a dispositional plan? The result of this 

focus is that the child is the party least likely to be 

meaningfully represented, the child's wishes and 

perceptions of the situation are often unheard or 

ignored, and the child is often the least likely to 

receive treatment. 

The ultimate results of the central focus on investigation may in the end diminish the effectiveness of 

the overall effort to prevent and treat ehild abuse. 

Workl:n, who are charged with prevention and treatment of child abuse and neglect too often find most 

of their time spent on investigation and preparation 

of cases for court. 51 Even if sufficient time is left, the 

role conflicts engendered by the law enforcement 

functions of CPS workers52 may diminish not only 

the fairness of the system53 but also the effectiveness 

of workers when they do attempt to offer help. 

Increasingly, such role conflicts are also being expe~ 

rienced by other professionals whose helping role 

historically has been less ambiguous.s.! The implicit 

assumption that investigation by itsclfwill result in 

protection of children has prevented the assumption 

of responsibility to offer help to prevent child maltreatment or ameliorate its effects. Of particular 

significance in theeontext of this report, the fact that 

it has become much easier to report one's neighbor 

forchild maltreatment than to offer them direct help 

may have weakened the kind of neighboring that 

held communities together and strengthened families in the past. 

In fact, in the absence of meaningful help, investigation may weaken parental self-esteem and perceived control. Moreover, itmay strain family bonds 

already frayed by multiple problems. 

2. The Roots of the Emergency 

Clearly, the child protection system is broken. To 

appreciate the need for fundamental change if it is 

to fulfill its original purpose of protection of children 

from harm, it is useful to examine how the system 

reached its current state. 

In its current form, the child protection system isnot 

very old. 55 After the publication of The BatteredChild Syndrome by C. Henry Kempe and his col~ 

leagues in 1962,56 every State soon adopted a man· 

datory reporting law. With the adoption of the Child 

Abuse Prevention and Treatment Act (CAPT A) in 

197457 and the corollary establishment of the Na~ 

tional Center on Child Abuse and Negle<:t 

(NCCAN), the Federal Government also focused 

its initial efforts on establishment and implementa~ 

tion of State laws to require reporting of suspected 

child maltreatment. The "strings" established by 

CAPT A for Federal funds to States to address the 

problem of child maltreatment thus focused on 

provisions for identification and investigation of 

suspected cases, not for prevention and treatment. 

At the time, this strategy seemed reasonable. Child 

maltreatment was thought to be an uncommon 

although egregious problem,58 and the major ob~ 

stacie to an effe<:tive solution was uncovering the 

cases. It is unlikely that anyone foresaw either the 

complexity of the cases thatwould ultimately emerge, 

or the stunning and continuing increase that would 

occur in their numbers. 

3. ConL-eptual Mistakes That Have 

Accompanied the Development of the 

Current System 

Although it is difficult now to separate ideas that 

stimulated the growth of a child protection system 

focused on investigation from those that resulted 

from it, it is clear in retrospect that several conceptual mistakes accompanied the development of the 

system. 

u.s. Advisory Board on Child Ahuse and Neglect 

------------
p 

First, public policy has been driven by the response 

to the wrong question. With the fOCUSOD investigation as a prelude to court action and, ultimately, 

separation of maltreated children from abusive or 

neglecting parents, the policy debate has focused on 

the question, "Under what circumstances is coercive government intervention justifiable to protect 

children?" This question tends to elicit legalistic 

discussion about the definition of abuse and neglect, 

the standards for gathering and introducing evidence about parental behavior, and the relative 

strength of rights of parents and children. Remarkably little discussion occurs about the far broader 

question, "What can government and social and 

neighborhood institutions do to prevent or ameli()o. 

rate harm to children?" 

This report responds to the latter question -- a 

question that turns the focus away from symbolic 

debates toward provision of prevention and treatment, and design of environments for children that 

are psychologically and physically safe. 

Second, the idea that"doing something" about child 

maltreatment means initiating an investigation has 

become ingrained among professionals and the 

public. As a result, policymakers disturbed by the 

crisis in child protection commonly fail to look 

beyond the "solution" ofhiting more CPS workers, 

and the professions and the public as a whole 

generally do not assume responsibility for action to 

protect children. 

Third, in the same vein, at least in part because 

investigation has been primarily the function of 

CPS, child maltreatment has bloen identified as a 

social services problem. 59 Perhaps as a result, other 

sectors of the child protectwn system -- elements thai 

are necessary (Q address the multiple dimenswns of the 

problem oj child abuse and neglect -- often have been 

absent from active involvement in plo.nning and implementing a response. 60 

FOUl1h, the narrowness of the question asked and 

the responsibility assigned has contributed to the 

lack of comprehensive, conceptually coherent planning in the child protection system. This vacuum 

has facilitated piecemeal governmental responses 

to the problem of child abuse and neglect and the 

A New National Strategy for the Protection of Children 

ever-worsening crisis in the child protection system.61 Unfortunately, one result has been to increase the workload of CPS agencies and NCCAN 

through expansion of the range of specific problems 

under their aegis without a commensurate increase 

in support. 

In short, current knowledge about the naturc of 

child maltreatment and the societal response to it 

suggests that the child protection emergency will 

continue or recur unless 

· the perceived responsibility for child protection is 

broadened substantially, 

· investigation is not pursued for its own sake, 

· concerted efforts are made to change the conditions that pennit the occurrence of child abuse and 

neglect, and 

· those efforts are based on careful policy analyses 

and empirical research. 

ENDNOTES 

6As elaborated in Section IV infra, the Board recognizcs, of 

course, that some of the elements of the strategy that it is 

proposing have been advocated by other groups. Certain!ythe 

values and beliefs that underlie the proposed strategy are found 

in val)'ing degrees throUghout the United States. 

To our knowledge, however, some of the specific ideas in· 

cluded in this report (for example. our reconceptualizatioru of 

the roles of the justice system and foster care) are original. So, 

too. is the emphasis on strengthening neighborhoods for the 

purposeof child protection. Regardless, the Board's advocacy 

for a new strategy for child protection is based not so much on 

a claim of originality as a conviction that the strategy that is 

currently in place is not working and that the child protection 

system cannot be mended simply by infusion of additional 

resources. 

7See• e.g., GENERAI.A=uNTINO On'lCE, ClIlll,AflUSE; PRI'YENnON PROGRA.\fS NEED GREATER EMPHASIS (Aug. 1992); EMER' 

GENcY,supra note4, at SO-51 and citations therein (Federal and 

State support for categorical programs on child abuse and 

neglect has risen at a far slower rate than the number of 

reported cases); PANEL, supra note 4, at 8:7-8:17 (research 

funding); U.5. ADVISORY BoARDON Omn ABIJSE ANI) NEGLECf. 

CREA1lNG CARING ('nMMlJNmES: IktJEPRfNT FOR AN EFFECTIVE 

u.s. Advisory Board on Child Abuse and Neglect -------------------------- 11 
Neighbors Helping Neighbors --------------------------------

12 

FFDERAL POlICY ON CHIw ABUSE AND NEGl.ECT 25 (1991) 

[hereinafter [CREATING CARING C...oMMUNn1ES] (fundingforthc 

National Center on Child Abuse and Neglect). 

~David Popenoe,Famio/ DeclineinAmerica, in REBUIWINGTHE 

NESf: A NEW Cow.rrrMENTTOTHE AMERICAN FAMILy39,40-43 

(David Blankenhorn ct al. cds. 1990) [hereinafter REBUILDING]. 

9/d. at 43; see, e.g., Alisa Bums, Mother·headed Families: An 

Imemationai Perspective and the Case of AustlUlia, Soc. POL. 

REP., Spring 1992, at L 

lOMark Mellman ct ai., Family TlITU', Family Values, in REBUnnING, supra note 8, at 88-91. 

IIBlJREAlJOFTHE CENsus, STATISTICALABSTRACTOFTHE UNITED 

STAIT,s W( 112th ed. 1992) [hereinafter CEN~US], at table no. 22. 

'2Richard Louv, Weavinga New Web, FAM. AFFAIRS, Winter/ 

Spring 1991, at 6, 6. Similar observations were made by the 

NATIONAL CoMMISSION ON Om.DREN, BEYOl<iD RHETORIC A 

NEW AMERICAN AGENDA FOR CHiWREN AND FAMTUES 70-71 

(1991) [hereinafter BEYOND RHETORIC]. See genelUlJy ROBERT 

N. BEllAH ET AL, liABm; OF niE HEART (1985) (discussing the 

nature and consequences of individualism and related social 

isolation in contemporary life in the United States). 

llAlthough overaJl nonmetropojitan outmigration is less pronounced than in some earlier time, it persists from agricultural 

regions in the Midwest and the Deep South. Kenneth M. 

Johnson, Recent Population Redistribution TrelUfs in 

Nonmetropolium America, 54 RURAL Soc. 301, 315 (1989). 

Although most pronounced for whites, outmigration from 

central cities by most ethnic groups continues at a rapid pace, 

espcciallyamongyoungfamilies. John L. GoodmanJr. & Mary 

L. Streitwieser, Explaining Rarial Differences: A Stwly of Cityto-Suburb Residen.tial Mobility, 18 URB. AFF. Q. (1983); Joochul 

Kim, ChlIracteristics of Mig1W1lS Within the Framework of 

Cunent Migration Direction in the Un.ited States: SomR Evidence 

jrvmMicro-Da/aAnalysis, 12 POL. SCTs. 335 (1980). Cf CENSUS, 

supra note 11, at 20, table no. 21 (net domestic migration 

decreased from the industrial Northeast throughout the 1980s). 

Young families are the most mohile segment of the population; 

one in four preschoolers, one in five elementary-school-age 

children, and two in five 20- to 24-year..ald adulL~ move each 

year. /d. at 20, table no. 22. 

I"James Garbarino, 1he Meaning of Poverty in the World of 

Children, 35 AM. BEHAV. ScrEl'mST22O, 223 (19'Xl). 

,5/d. at 225. 

!(iBEYOr>;D RHEtoRIC, supro note 12, at S. 

171d. at 24. See Patricia Voyndanoff, Eronomic Distress and 

Family &lations: A Review of the Eighties. in Co/'m,~I'ORARY 

Ft.MIUES: LooIaNG FORWARD: I..ooKiNGBACK429(AlanBooth 

ed.1991). 

18 James Garbarino & Kathleen Kostelny, Neighborhood-Based 

Programs 75·76 (1992) (report to the U.S. Advisory Board on 

Child Abuse and Neglect). 

19C1audiaJ. Coulton & Shanta Pandey, GeographicCon.centrationaf Powrty and /Wk to Children in Urban Neighborlwods, 35 

AM. DEflAV. ScreNTIST238 (1992). 

20See Gary B. Melton, Child.ten, Families, and the Courts in lite 

21st CefllUly, _So CAL. L. REV. ---> __ (forthcoming 1993) 

(report to the Committee on Family Relations, 2020 Vision 

Project, Judicial Council of California). 

21BEYOND RHETORIC, supro note 12, at 29. 

El.See, e.g., BARBARAAllEN·HAGEN, PUBllCJUVESllEFACIUTIE.S: 

OmnREN IN O;sroDY 1989 (1991); Barry Krisberg et ai., The 

lru:arceraJioI1 of Minority youth, 33 CRIME & DEUNQ. (1987); 

Katherine Hunt Federle & Meda Chesney-Lind, Specia1/ssues 

in Juvenile Justice: Gender, Race, and Ethnicity, in JUVENItE 

JUSOCE AND PUBlIC POlIcY; TOWARD A NATIONAL AGENDA 165, 

177-84 (Ira M. Schwartz ed., 19(2). 

DFedcrle & Chesney-Lind,supra note 22, at 187-89. Actually, 

the system is "double two-tier" in that childrcn of color arc 

more likely to go into the public ratherthan the private mental 

health system, but they also are less likely to be diverted from 

the juvenile justice to the mental health system. See, eg., 

Dorothy lewis et al., RD.(¥! Bills in thR Diagnosisand Disposilioll 

ofVwlentAdoJescents, 137 AM. J. PSYCHIATRV 1211 (1980). 

2<Sheila B. Kamerman & Alfred J. Kahn,lfCPS Is Driving Child 

Welfare, Where Do We Go From Here?, PUR. WELF, Winter 

1993, at 41 (originaJlyappeared in the Winter 1990 issue); 

Sheila B. Kamerman & Alfred J. Kahn, The Problems Facing 

Social Servicesfor Children, Youth, and Families, 12 (No. 1-2) 

OIIIDREN & Youm SFRVS. REV. 7, 7-9 (1990). 

"}!;See, e.g., Federle & Chesney-Lind, supra note 22, at 184-87. 

2tiLEROY H. PELTON, FOR REASONS OF Pm-'1'RIT: A CRmCAL 

ANALYSIS OFTHE PUIlUC CHilD WElFARE SYSTEM INTIIE UNITED 

STATES 62-64 (1989), and citations therein. 

n Although the divorce rate skyrocketed in the past three 

decades, marriage remained popular. About one-half of female divorcees remarry. CENSUS,SUPro note 11, at 92, table no. 

131. Moreover, opinion polls have shown the family to be of 

sustained central importance to Americans. Mellman, supra 

note 10, at 74-77. 

lIIEME'RGENCY, supra note 4, at 15, and citations therein; McCUrdy 

& Daro, supra note 2. 

:/9DEBORAIl DARO, CoSFROl'<~G CHilD ABUSE; RESEARol FOR 

EFfficnVE PROORA.'.l. DESIGN 22-23 (1988). The Board docs not 

wish to imply that failure (at least as the systcm is currently 

structured) to sub~tantiate more than half of the reports is a 

good thing. In such cases, the intrusion on the family is almost 

sure to result in substantial disruption without additional 

u.s. Advisory Board on Child Ahuse and Neglect 
, 

services or other support.~, regardless of whether the original 

report wasvalid. (Of course, failure to substantiate suspected 

child maltreatment does not necessarily mean that it did not 

occur.) Our point instead is that the relatively constant substantiation rate in the face of skyrocketing frequency of reports 

of suspected child maltreatment suggests that the increase in 

number of reports is not the product of reckless or capricious 

reporting. It is also important to note that many of the families 

in which reports are not substantiated do have serious problems, even if the decision ultimately is made that there is no 

ground for coercive intervention. 

-'OSee generally PROFESSIONAL RESPOMlBtUTIES IN PROTECIlNG 

OmDREN: A PuBliC lIF.ALTH ApPROACH 1'0 Om.n SEXUAL 

ABUSE (Ann Maney & Susan Wells cds. 1988). 

31NAll0'lAL Q'NJ'ER ON CHIlD ABUSE AND NEGlECT, STIJDY 

FINDrNGS: STIJDY OFTHE NATIONAL INODFNLcAND PREVAlENCE 

oFOmDABusEANDNEGtEcrxiii (1988). This figure docs not 

include cases that never become known to professional service 

providers. 

31EMERGENCY, supra note 4, at 15 nn. 2-3 and accompanying 

text; McCurdy & Daro, supra note 2, at 13-16 (noting nearly 

130) deaths of children as a result of maltreatment in 1992). 

11Supra note 2. 

:<lIt is clear that a substantial proportion of the increase can be 

accounted for by increased awareness. For example, the 

"discovery" of sexual abuse led to a huge increase in reports in 

the mid·1980s. Kelly Weisberg, The "Discovery" of Sexual 

Abuse: F.xperu'Roie inLegalPolicy Formulation, 18 u.e. DAVIS 

L. REv. 1 (1984). Nonetheless, when combined with knowledge 

about factors involved in the causation of child maltreatment, 

data on the downward trends for family welfare suggest that at 

least some of the increase reflects real prevalence. 

l'Frequent impulsive behavior, such a.~ putting one's children 

at risk, tends to be part of a syndrome that generalizes across 

contexts. See, e.g., D. Wayne Osgood et al., The Generality of 

Deviance in Late Adolescence and Early Aduuhood, 53 AM. 

SoaOLOGICAI. REV. 81 (1988). 

Ibe relationship hetween substance abuse and child maltreatment is illustrative of this general phenomenon. In more than 

two-fifths of child protection ca<;es in the Boston Juvenile 

Court in 1985·86, parents had a documented history of substance abuse. Michael S. Jelli ne k et al., Serious Child Maureatmerit inMassachusetts: 1heCourseof206 L"'hildren Through the 

Courts, 160uwABUSE& NEGLECT 179, 181 (1992). Only about 

one-cighth of cases in the CPS ca.'>Cload were referred to 

juvenile court. /d. at 180. More than one-fourth had used 

cocaine or heroin; of them, 82% refused court-ordered services, and 91 % lost the custody of their children. !d. at 181. 

U.S. Advisory Board on Child AbLL~e and Neglect 

A New National Strategy for the Protection of Children 

J6See, e.g., GERAlD R. PAITERSON, CoERaVE FAMILY PROCESS 

(1982); Gerald T. Hotaling et al., Intnlfamily Vwlence, and 

Crime and Vw.lence Outside the Family, in 11 CRIME AND 

VIOlENCE: AREVIEWOF RESEARCH: FAMILY VIOiENCE315,334-

43 (Lloyd Ohlin & Michael TOni), eds., 1989). 

l1BEYOND RHETORIC, supra note 12, at 29. 

lIISee EMERGENCY, supra note 4, 100 nn. 20-22, accompanying 

text at 19-20, and citations therein. Although the etiological 

picture is even more complex in sexual abuse than in other 

forms of child maltreatment, such psychological variables also 

are important in sexual abuse. Jll. at 100 nn.21-22. 

19Leroy H. Pelton, The Role of Material Factors in Child Abuse 

and Neglect 41-44 (1992) (paper prepared for the U.S. Advisory Board on Child Abuse and Neglect). 

WId. at44. 

01 Although the direction of causality is not clear, the proponion 

of children with disabilities who are maltreated appears to be 

somewhat higher than among children in general. SeegeneralJy 

SPECiAL CmwREN, SPEC1AL RISKS: THE MALTREATMENt' OF 

OnWREN WITH DISAJl!lII1ES (James Garbarino et al. cds. 1987). 

For a critical analysis of the relevant epidemiological studies, 

sec Raymond H. Starr & Kathleen Kurtz, Does Childhood 

Disability Cause Abuse? A Critical Review (Aug. 1991 ) (paper 

presented at the meeting of the American Psychological Association, San Francisco). 

42See, e.g.) James Garbarino & Ann Crouter, Defining the 

Community ConJexJ of ParerIJ-Chi/d Relations: The ComlaJes 

of Child MaltreatmerIJ, 49 CIUW DEV. 604 (1978); James 

Garbarino & Kathleen Kostelny, Child MaltreatmerIJ as a 

CommuniJy Problem, 16 CmwABUSE & NEGlECI"455 (1992); 

Garbarino & Sherman, supra note 1. 

Research shows that lack of social support is related to puni· 

tivenes.~ in low-income parents alone, although social support 

is related to the level of emotional support given children by 

parents of all income levels. Patricia A. Hashima & Paul B. 

Amato, Poverty, Social Support, and ParenJal Behovior, _ 

CHnn DF,v._ (forthcoming). This research thusalso suggests 

the significance of the combination of social and economic 

poverty in the causation of child abuse. 

"Garbarino & Kostelny, supra note 42;see Gary B. Melton, It's 

Ttme for Neighborlwod Research ann Action, 16 Cmw AmJSE 

& NEoucr 909 (1992). 

400WEN Glu.., PARENTING UNDER PRESSURE: A STIJDYOF FORTY 

FAMIllF.5 uvrsG IN ONE STREET 99 (1992) (report of Bamados 

South Wales and South West, Bristol, England). 

.SSocial isolation is "one of the dominant presenting problems 

cutting across all formsofmaltrcatment." DARO,Supra note29, 

at 56-57. See, e.g., Edward Zigler & NancyW. Hall, Physirul 

ChildAbuse in America: Pmt, Present, and Future, in THEORY 

ANn RESEARCH,SUpra note 4, at 38, 61. 

13 
Neighbor8 Helping Neighbors ----------------------------------

14 

~/iEMERGENcY, supro note 4, at 80 (emphasis added). No prose 

from the Board's several reports has been quoted as much a.-; 

the noted paragraph. It summarizes the Board's view of the 

crux of the problem in the child protection system--a problem 

thatwe believewill not disappear without fundamental change 

in the system. 

'7SeeSupra note 24. 

~8See, c.g., Child Protective Servires: 1992, VA. Cmw PROTEcTION NEWSLETllOR, Spring 1992, at 1 (reporting a survey of CPS 

workers in Virginia). The majority of caseworkers re]X)rted 

spending more than thirty percent of their time in inve8tigations and related paperwork, and about thirty percent of 

workers said that they .so 8pent the majority of their time. 

Moreover, the majority said that they spent more than half of 

their time in court preparation and case management. Insome 

local offices, the caseloads exceeded one hundred cases per 

worker. The resultofsuch time allocation is that: investigation, 

[Xlperwork, case numagement, court arui making referrals take 

mo.~t of!he available hours of the workers' day, leaving very little 

time for direct treatmetU or prevention work with the abusive 

families. /d. at 4. 

49Publicchild welfare administrators often report that most of 

their non-CPS child welfare budget is consumed by foster care, 

so that funds for prevention and treatment are scant. Kamerman 

& Kahn, The Problems Facing Social Services for Children, 

Youth, and Families,supra note 24, at 8. Federal funding has 

followed a similar path. Federal \:hild welfare funding grew by 

78.7% from FY 1984 to FY 1993, while Federal support for 

foster care increased by 486.5%. The Federal foster care 

expenditure ($2.6 billion in FY 1993) is now nearly nine times 

that for child welfare services. HOUSE SELECT CoMM. ON 

CHilDREN, YOlITH, & F AMIllE5, FEDERAL PRCXJRAMS AFFECTING 

QUlDREN AND FAMIUES, 1992 (1992), at CRS-3, tab. 3. 

>OSee generally LOUIS F. acaIINEU.I, SYMPOSIUM ON RISKAssESSMENT {10.' aUlD PROTECflVE SERVICES (1991) (reporting the 

discussions at an NCCAN symposium); Michael S. Wald & 

Maria Woolverton, Risk Assessment: The Emperor's New 

Clothes, 690UlD WEIF. 483 (1m). 

"See, e.g., supra note 48. 

"See PELTON, supra note 26, at 118-25. 

,1See generally David W. Lloyd, Models for an Effective Child 

Protection System: Legal Perspectives (Sept. 1m) (paper 

presented at the Summer Institute on Mental Health Law, 

Law/Psychology Program, Univer8ity of Nebraska-Lincoln) 

(applying a substantive due-process analysis to the legal process in child protection cases). 

'><See generally Gary B. Melton & Susan Limber, Psychologists' 

InvolvemenJin CasesofChild MaltreaJmenJ: The LimitsofRoJe 

arui F..xpenise, 44 AM. PSYCHOLOGISI" 1225 (1989). 

55For a history of State and Federal efforts to prevent and treat 

child abuse and neglect, see BARBARA J. NEL'iON, MAKING AN 

ISSUE OF Q.rn.n ABUSE AND NEGl.ECT: POlrnCAL AGENDA SETTING !'OR SocrAr. PROBlEMS (1984); see also PELTON, supra note 

26, at 23-45 (arguing that the policy debate obscured public 

understanding of the nature of child maltreatment and its 

relation to poverty). 

>lie. Henry Kempe et al., The Battered Child Syruirome, 181 

JAMA 17 (1962). 

"Pub. L. 93-247, 88 Stat. 4, codified aJ 42l1.S.C. §§ 5101-5106. 

5SSee EMERGENcY, supra note 4, at 15 and citations therein. 

59Such a definition was not planned. Shortly after the Child 

Abuse Prevention and TrcatmentAct was signed into law, the 

lead sponsor of the bill in the Senate .stated that one of the 

principal conclusions of the Subcommittee on Children and 

Youth was that: a ttulyeffeaivechild abuse program requires a 

multi-disciplinaryapprooch. The medica~ /ega~ andsocial ramifications of child abuse are terribly complex. No social worker, 

lawyer,ordoctorcanorshouldbeexpeC/e(ilOdealwithallofthese 

problems without the cooperalion arui assistance of various 

agencies arui experts in several disciplines. Walter Mondale, 

Child Abuse: Issues arui Answers, PUB. WElF., Winter 1993 

(reprint of article originally published in Spring 1974), at 24, 24. 

Noting the influential testimony of Jolly K. (the founder of 

Parents Anonymous), Senator Mondale and his colleagues 

concluded that a multifaceted response was needed because 

"abusers tend to be ... people under pressure from other problems. These maybe related to alcoholism, druguse, poverty,or 

marital conflict." Id. 

Senator Mondale further lamented that state child protection 

laws existing in 1974--laws providing primarily for mandated 

reporting and resulting legal action --were not working because 

"they do not provide forpositive programs. The focw is almost 

entirely on the criminal side---on reporting of cases and prosecution of abusers." /d. 

60lln the Board's 1991 report, it noted the manifestation of this 

perspective at the Federal level, where the existence ofN CCAN, 

a small agency on the social service side of the Department of 

Health and Human Services, has seemed to result in the 

underinvolvement or absence of other Federal agencies from 

major activities in the fieJd of child protection. 

The National Child Abuse Coalition, an association of nearly 

forty organizations in the field of child protection, recently 

joined the Board in calling upon the new President "to develop 

a new federal role in protecting children and preventing child 

abuse." National Child Abuse Coalition, Child Abuse and 

Neglect: A Challenge to the Nation 6 (Jan. 1993) (briefing 

papersubmiued to the President). The Coalition noted 8pecifically that: /t J he new Administration must go beyond the cwrent, 

limited federal effort 10 address child maltreatment focused on 

the NationalCenteron ChildAbuseandNcglect (NCCAN). For 

u.s. Advisory Board on Child Abu...;;e and NegJcct 
,.. 

almost twenty years, the fetieraigOl'emmems aJJention Iws concentratedon a restricted approach 10 1M issues of child abuse arui 

neg1ed, in many ways preventing the develvpment of a major 

federal aUack on 11Ie problem .. 

We are al a (XIint now where we must improve upon and go 

beyondlhe[ederaJsuppoHond/eadershippossib/ewithNCCAN 

To console ourselves with the false sense of seCUrity tlwJ NCCAN 

is the final answer inlerferes with our resolw to mourn truly 

effective measures ... 

The Clinion Administration slwukl investigate the appropriate 

roles tobeplayed by various federalagencics, in HHS [lleohl! and 

Hunwn Se1Vices] and mher departmenL~, reflecting a 

multUiisciplinary responsibility that includes social sen.ices, education, public heauh, menial health, developmental disabilities, 

subsumce abuse, community development, klw enforcement, 

and the judiciary, among mhers, worldng colJaboratively /0 promote the integration of selVices arul coordination among the stale 

arui loc£I.J agencies they serve. There is 100 much at stake to ignore 

such a rolledive process. !d. at 5-6. 

ilIn its 199:) report, the Board observed: As If!ports of child 

maltreatment began to climb throughout the 1970's and to 

skyrocket in the 1980 's, public officials across the nation missed 

the opportunity to ffUlke fundamental changes in the structUlf! of 

the child protection system. Instead, the govemmentallf!sponse 

to increased reporting was and continues to be fragmented. often 

Simplistic. ill-conceive(i, and crisis oriented. Response toahused 

uTld neglected children and theil families at alilel'Els of govcmment has lOOoften beensymbolirarul drit'l'n by poWicai expedienry. EMERGE:-lCY, supra note 4, a14O. 

A New National Strategy for the Protection of Children 

u.s. Advisory Board on Child Ahuse and Neglect ---------------------------- 15 
p 

Neighbors Helping Neighbors 

16 

III. THE NEW NATIONAL STRATEGY 

A. INTRODUCTION 

It is time for a comprehensive new strategy -- for 

design of a system that comport~ with ethical norms 

about the importance of protection of personal 

integrity and with empirical research about the 

nature and causes of child maltreatment. A problem that stems in part from broad socioeconomic 

difficulties, and that has fundamental moral significance, demands a society-wide response. At the 

same time, a problem that is caused in part by 

psychosocial factors and that creates personal distress, also requires availability ofhclp for individual 

children, parents, and families. 

Discussion of the strategy proposed by the Board 

begins with an outline of its general characteristics. 

This is followed by a detailed elaboration of each of 

the five e1ement~ of the strategy, which are: 

1. Strengthening Neighborhoods 

2. Reorienting the Delivery of Human 

Services, Including Justice Senrices 

3. Improving the Role of Government in 

Addressing Maltreatment 

4. Reorienting Societal Values that may 

Contribute to Child Maltreatment 

5. Strengthening and Broadening the 

Knowledge Base about Child 

Maltreatment 

The &~cussion of each element concludes with a set 

of recommended steps for implementation. (A complete list of all recommendations appears in the 

appendix.) 

In addition to the material presented here, Section 

V offers a set of general principles that can be used 

by policymakers, State and community planners, 

program administrators, and practitioners to design 

programs consistent with the strategy proposed here. 

B. CHARACTERISTICS 

1. Comprehensive 

As the Board uses the term, a comprehensive child 

protection strategy would: 

· integrate the contributions of social service, legal, 

law enforcement, health, mental health, and education professionals; 

· provide for coordinated roles of (a) private child 

welfare and mental health agencies, (b) civic, religious, self-help, and professional organizations, and 

(c) individual volunteers; 

· assure the protection of children while in each of 

the relevant service systems; 

· providcfor coordinated roles of alllevelsofgovernment, in cooperation with the private sector, and 

· ensure that adequate provision is made in the child 

protection system for prevention, investigation, adjudication, and treatment. 

2. Neighborhood.based 

A neighborhood-based child protection strategy is 

one in which: 

· primary strategies would be focused at the level of 

urban and suburban neighborhoods and rural communities; 

· social and economic supports for troubled families 

and children would be developed at the neighborhood level, where neighborhood is defined by geographic boundaries, 

· policies and systems wouldbe designed to strengthen 

the neighborhood itself by encouraging local improvement efforts that make the environment more 

supportive of families and children, and 

u.s. Advisory Board on Child Abuse and Neglect 

_~~c-.=~~======"""""""", ____ _ 
f' 

· both formal and informal services (e.g., self-help 

programs) that are based on the principle of voluntary help by one citizen for another would he widely 

available, regardless whether access to such services 

is determined hy place of residence. 

In other words, neighborhood is conceptualized in 

both geographic and psychological terms. 

3. Child ..... ntered 

A child-centered child protection strategy would: 

· take children seriously, accepting them as individuals with their own identities; 

· protect their personal integrity; 

, recognize their relationships as important; 

· be willing to "walk in their shoes" and appreciate 

their experiences; 

· give primary attention to their best interest, as 

reflected in their needs and experiences; 

· regard theirviews as important, and provide opportunities and representation as necessary for children 

to be heard in matters pertaining to them (when 

children are capable of such expression); 

· provide developmentally and culturally appropriate means for them to express themselves, and 

· respond flexibly to the diversity of their cultural 

backgrounds and the circumstances in which they 

find themselves. 

4. Family-focused 

A family-focused child protection strategy is one 

which recognizes the paramount importance of the 

family for the development of children.62 Actions 

consistent with such a strategy aim toward: 

· strengthening families in general to minimize the 

circumstances that may cause or precipitate child 

abuse and neglect; 

A New National Strategy for the Protection of Children 

· supporting and enhancing family functioning in a 

manner which increases the competency and selfsufficiency of families; 

· providing intensive services to avoid the removal of 

children from family environments at times of crisis, 

and 

· making all reasonable efforts to reunify families 

when abuse or neglect has resulted in removal of a 

child. 

In most instances, a child-centered strategy would 

imply afamily-focused approach in which relationships important to children are protected. The 

Board recognizes, however, that there are instances 

in which children's safety is so compromised in their 

families that those relationships must be intruded 

upon or severed. 

Acknowledging that such coercive intervention is 

sometimes necessary, the Board has nonetheless 

conceptualized a voluntary system of prevention 

and treatment. It has done so in the belief that a 

focus on the question of when coercive intervention 

is justified leads to an overemphasis on investigation. 

C. ELEMENT 1: STRENGTHENING 

NEIGHBORHOODS 

In one afterschool program in a Chicago puhlic housing de~'elopment that we visited, the children played 

funeral evel).!dayforweeks. They would build a casket 

with blocks and take turns lying in the casket. The 

children took on roles of preacher, family members, 

and mourners. They would weep and cry out for Ihe 

person who died, saying, "Don 'I take him!" Who will 

bring peace to these children?63 

1. The Relation Between Child 

Maltreatment and Neighborhood Quality 

With the continuing shifts of population from inner 

cities and many small towns and rural communities, 

traditional sources of informal help have become 

increasingly unavailable. Although this decline in 

neighborliness is part of broader changes in family 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 17 
, 

Neighbors Helping Neighbors 

18 

and community life, it has been hastened by increases in migration rates and the proportion of 

families living in poverty. Far too many urban, rural, 

and small-town neighborhoods have been drained. 

Families faced with a struggle merely to survive not 

only have few material resources to share, but they 

also may have exhausted their emotional resources. 

When people feci that they have minimal control 

over their lives, they are likely to have little motivation to sustain the community. Fear also can push 

people away from each other, and the search for a 

safe haven can deplete the remaining energy of 

people facing nearly continuous grave challenges. 

In neighborhoods that provide a dangerous physical 

environment and that have high rates of crime, 

parents face an exceptionally difficult task to keep 

their children safe. Too often they do so virtually 

alone. 

If we are to solve the prohlem of child maltreatment, 

it is critically important that we view it from an 

environmental perspective rather than strictly as an 

individual phenomenon. Research has made clear 

that the rate of child maltreatment in a neighborhood is inversely related to its quality of life, as 

defined by its residents and others in the broader 

community. Neighborhoods that residents regard 

as scary, bad places to live have higher rates of child 

maltreatment than do neighborhoods that residents 

regard more positively, even when income levels 

and ethnic composition are similar.64 

Child maltreatment is part of a constellation of 

social problems that escalate as a neighborhood 

deteriorates. For example, rates of violence in the 

streets and violence in the home are highly correlated.os As the National Commission on America's 

Urban Families recently summarized, "strong families make strong communities," and "strong communities make strong families."66 The success of 

families in rearing their children in safety depends 

not only on their own efforts but also very much on 

the environment in which they live. 

2. Environmental Standards 

Environmentalists have developed legal procedures 

and standards to preserve individual species offish 

and wildlife. Standards have been established for air 

and water quality to ensure the survival of those who 

depend on it. If a river or lake or the air in a 

metropolitan area fails to meet environmental standards, somebooy is required to take action. Government agencies must identify the sources of pollution, prosecute illegal polluters, and develop and 

implement plans to reduce the pollution. Environmental impact studies are required before any major construction project can go forward, and major 

projects have been stopped completely because 

they threatened the environment of a particular 

species of bird or fish. 

The children who live in dangerous neighborhoods 

are surely no less important to the survival of our 

civilization than the snail darter fish or spotted owl. 

The Board believes that it is now time to ensure at 

least minimally suitable environments for ourfami~ 

lies and children. Neighborhoods should be rated 

on their adequacy as environment<; for rearing children. Neighborhoods in which children are at high 

risk should receive special attention, just as the 

discovery of a high level of pollution brings special 

attention to a body of water. 

Although this approach is obviously germane to 

declining inner-city neighborhoods,~7 it is not limited to them. Consider, for example, the situation 

that might occur in a small-town trailer park with a 

high rate of child maltreatment. County planners 

would survey the trailer park and examine social 

indicators to identify the conditions that foster so 

many reports. These might include poverty, high 

mobility, crowded and dilapidated housing, and 

absence of a safe play area. Social isolation and 

disorganization might well be additional factors. 

Although people in trailer parks live in close proximity, they often have no institutions that pull them 

together and no structured context for interacting. 

Typically, there is no organization comparable toan 

urban block association that encourages people to 

work together and no place for such a group to meet 

if it were desired. Many of the parents arc young, 

poor, mobile, and lacking in material and social 

supports. Their social isolation may be compounded 

by the lack of a telephone and transportation. 

In such a context, the response designed to prevent 

child maltreatment might include home visits, educational programs, visits by a mobile health team, 

u.s. Advisory Board on Child Abuse and Neglect 
,. 

, 

repairs to substandard housing, and provision of a 

"community trailer" for meetings and social activities to help family members develop their social 

skills. The strategy might include paying a local 

resident to work part-time asan organizer -- perhaps 

in collaboration with a local civic group, church, or 

community action agency -- to establish sports teams, 

play-groups for small children, and clubs for parents, children, and youth. Various activities could 

be designed to increase parents' practical knowledge ahout parenting and to develop their informal 

networks, in order to reduce both isolation and 

stress and to increase neighbors' watchfulness for 

each other. The specific interventions to strengthen 

the trailer park community would be chosen with 

close consultation and involvement of those who live 

there, and their implementation would depend on 

their involvement and support as well, 

3. Involving Residents 

It is important to empower people by giving them 

the means to define and meet their needs and 

aspirations as individuals, families, and members of 

a neighborhood and community, Offering people-

- including older children and youth themselves --

respect, involvement, support, and hope can help 

them to overcome the isolation and depression that 

can result in child maltreatment. 

Neighborhood residents should be participants in, 

planners of, and, whenever possible, managers of 

neighborhood services, including activities to 

strengthen and improve the neighborhood environment. Children and youth need to see their parents 

and other adults they know actively participating in 

neighborhood life and the decisions that affect their 

families, Such an approach builds role models, 

offers opportunities for direct youth participation, 

and instills a sense of hope and personal control as 

weJl as respect for and connectedness with adults.(,fl 

Those who plan and provide services need to develop ways to draw on the knowledge, insights, and 

expertise of those who utilize their services. Failing 

to dose robs consumers ofthcir dignity and prolongs 

the dependency that services attempt to end. 

Hope -- a scarce commodity in many declining 

neighborhoods -- grows when the people who live 

there begin to unite to strengthcn and improve their 

A New National Strategy for the Protection of Children 

community. Such a step may seem an impossible 

goal in many violent, drug-ridden neighborhoods, 

but there are many examples in which individuals or 

groups have managed to make significant improvements through patience, faith, banding together, 

and persistence.69 Recognizing and encouraging 

such efforts is an important means of counteracting 

depression and despair, qualities that are often 

associated with child maltreatment and substance 

abuse, 

Reliance on -- or development of -- neighborhood 

organizations also can address other factors related 

to child maltreatment. For example, the history of 

international development teaches the usefulness of 

pooling the talents of neighborhood residents as a 

meansofeconomicdevelopmentandresultingdiminution of poverty. 70 In that regard, needs offamilies 

in the neighborhood -- e.g., child care; home repair 

-- can be the foci for development of small businesses owned by and employing neighborhood residents, 

Similarly, efforts to prevent child maltreatmentfrequently seem to ignore the roles of fathers, stepfathers, grandfathers, and other men in the safe and 

healthy development of children.71 Concrete programs to foster the skills and participation of adult 

and adolescent males to enhance the welfare of their 

neighborhood and their own families can serve 

multiple purposes in that regard --strengthening the 

social structure and economic well-being of the 

neighborhood and the families within it, while increasing or sustaining the involvement and responsibility of fathers,n Such an emphasis assumes 

particular significance when it is recognized that 

much of the increase in poverty among children has 

come as a result of fathers' absence and failure to 

assume support for their children.73 

4. Strengthening Neighborhood Institutions 

A neighborhood's institutions help to detennine its 

viability for children and families. It is important to 

learn about the institutions and traditions that bring 

people together, because these make up the medium in which people develop basic social and 

leadership skills. Churches, mosques, synagogues, 

clubs, unions, civic associations, and athletic leagues 

have typically fulfilled these functions. Where no 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 19 
Neighbors Helping Neighbors 

21l 

such institutions exist, this lack can contribute to 

isolation, inadequacy, and fear of involvement with 

others-- factors related tochild maltreatment. When 

people have no opportunity to function in groups in 

their own community, they may find group situations elsewhere uncomfortable and intimidating.74 

Under these conditions, it can be very difficult for 

parents to develop and maintain the kind of support 

network that researchers and practitioners believe 

is necessary to rear children successfully. 

Neighborhood-based organizations can work to 

improve the quality of neighborhoods in both physical and psychological terms. Such outcomes have 

beenaccomplished by family resource centers, settlement houses (which place great emphasis on forming clubs), cultural centers, social clubs, and even 

community action agencies and Head Start programs. Forchildren, 4-H clubs, Scouting, and neighborhood service clubs can meet the same needs, but 

gangs may arise where they fail to do so. The most 

impressive and perhaps most important efforts in 

prevention of child maltreatment have been those 

that link families not just with agencies but with 

other families, so that they can build their own 

support networks. 

A key to increasing families' connections to each 

other may be accommodation to the demographic 

changes that have occurred in many neighborhoods 

in which social and economic trends have been 

negative. The average age of the population continues to rise; that trend is especially pronounced in 

economically declining communities. 75 As the birth 

rate in the population as a whole has dropped, 

relatively affluent and educated young adults have 

migrated to suburbs from inner-city, rural, and smalltown communities, Accordingly, young parents in 

declining neighborhoods have become increasingly 

unlikely to have peers who have sufficient resources 

to be available for mutual advice and support -- a 

trend that exacerbates the broader social changes 

diminishing social and material supports available 

forfamities. This is true even in low income neighborhoods with large numbers of very young single 

parents. 

Given this trend, special elTorts need to be made to 

ensure that connections are made among those 

young parents who remain. Programs focused at 

developmental transitions are made to order in 

that regard. For example, inCant home visitation 

programs could serve as a base Cor organizing 

parents ofchiJdren of the same age in clubs, groups, 

or activities in which they fonn a "natural" support 

network. So could school-based family resource 

centers. 

At the same time, inter-generational programs 

(building, for example, from Foster Grandparents 

programs) mayoffermeansoCengagingolderadults 

so that they are available as sources of support --

including infonnal education about child rearing -

- for young parents and their children. Such programs could be a feature of neighborhood family 

resource centers, whatever their specific auspice.7ti 

5. Economic Opportunity and Development 

from Within 

By itself, construction of a social network in a highrisk neighborhood may not be enough to prevent 

child abuse and neglect. Numerous scholars, including some of those whose policy analyses were 

commis..<;ioned by the Board,77 have noted the relationship among child maltreatment, poverty, and 

unemployment, especially in communities with 

chronically high levels of unemployment. Others 

have linked maltreatment to substance abuse, teen 

parenthood, and other self-destructive behavior. It 

is becoming apparent that many teens are growing 

up in some neighborhoods with little hope of being 

ahlc to provide for a family, In such circumstances, 

too many fathers find little incentive to become 

husbands or to prepare adequately for the future. It 

is easier and may even seem more logical to take 

one's pleasures now -- through indiscriminate sex or 

abuse of alcohol and other drugs. Under these 

conditions, it is very difficult to form stable families, 

and maltreatment is only one of a number of negative outcomes for children. In economically depressed areas, economic development is critically 

important in the prevention of child maltreatment. 

It is important to mobilize resources and energy at 

every level to provide opportunity and hope in 

disadvantaged communities. Every jurisdiction 

u.s. Advisory Board on Child Abuse and Neglect 
p 

1 

should assess its neighborhoods and work with economic developers and business leaders to design 

local development strategies. Jobs are needed not 

only for income but also to provide successful role 

models for the young. Most of all, they arc needed 

to provide the foundation for the hope and sense of 

personal control needed for formation of healthy 

families. 

High unemployment has become a seemingly intractable problem in many poor communities, both 

urban and rural. In the past, local leaders and 

economic planners have attempted to attract outside industries that would supply many jobs and 

bring in outside investment, but this approach seems 

less and less realistic for most communities. Any 

corporation wishing to establish a new plant has 

many options (often including options abroad) and 

probably will not look favorably at a declining community. A more realistic strategy is to encourage the 

development of small businesses as that is wherc the 

growth is. Furthennorc, small businesses can morc 

easily be developed by local residcnt~. For young 

people who are unlikely ever to hold the factory jobs 

their fathers or mothers did, the possibility of a small 

business and the independence of self-employment 

may provide hope that is now lacking. Small businesses can begin as home businesses -- in which a 

service OJ product is produced or offered directly 

from one's home. This takes very little capital. but 

can be a prelude to more intensive economic activity 

later. Apprenticeship or mentor relationships can 

help make such a future achievable. 

Economic development should empower those who 

live in the community and have at least potential 

ability, although they may lack opportunity and 

knowledge. Focusing on economic development 

within the community will make it more likely that 

jobs and profits remain there --something that often 

does not happen when development involves bringing in chain stores or plants whose top management 

is located elsewhere. Locally owned credit unions, 

farmers market and other community cooperative 

ventures provide an alternative that keeps capital in 

the community, builds local management expertise 

and may attract outside dollars as well, through 

tourism and supplier contracts. 

u.s. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

In fact, economic development in depressed areas 

may require a conscious strategy by resident~ to use 

their own funds to strengthen their communities. In 

an inner-city neighborhood in Washington, D.C., 

residents have placed their funds in the Consumers 

United Group, Inc., a locally owned credit union 

that invests in local housing, rather than outsideowncd banks that invest their profits elsewhere. The 

result is locally controlled and improvcd housing as 

well as bettcr financial setviees. In Custer County, 

a jeopardized rural area in the Nebraska Sandhills, 

residents of neighboring towns have banded together to patronize each other's businesses rather 

than cheaper shopping malls in the nearest city. As 

a result, there is more economic and social opportunity in their community than ifindividuals continued 

to think only of their own financial interest. 78 

6. Housing as a Critical Factor 

Besides the overall economic status of a neighborhood, its physical infrastructure also may relate to 

risk of child maltreatment. Relative to other families receiving Aid to Families with Dependent Children, families in which maltreatment (especially 

neglect) occurs are more likely to live in overcrowded, dilapidated, and underfurnished housing. 79 Such an association is strongest for the families in which the most serious maltreatmentoccurs.8J 

It is an association that probably has grown in 

significance as housing affordable hyyoung families 

has become less available.81 

Several factors appear to account for this link between inadequate housing and child maltreatment~ 

First, parents who lack adequate housing -- or any 

housing -- face an unusually difficult task to keep 

their children safe, because the hazards of every day 

life become more frequent and more senous. Nearly 

twelve million childrcn under age seven live in 

homes with lead paint; three to four million have 

unsafe levels of lead in their blood.s3 Even more 

fundamentally, homelessness is a major factor in 

rates of child neglect and foster placement.84 

Second, poor housing itself is a stressor that may 

make coping with the demands that children pose 

more difficult. Notably, when homes arc overcrowded, conflict'> may escalate faster, because physical confrontation may be inevitable. 

21 
r 

Neighbors Helping Neighbors 

22 

Third, housing costs account for a sufficiently large 

proportion of household budgets, especially for families in poverty, that housing policy may have adirect 

effect on the level of poverty that disadvantaged 

families experience and, therefore, the prevalence 

of child maltreatment. 85 

Fourth, housing is a major marker of social status 

and community integration. People living in dilapidated housing may be especially prone to regard 

themselves as unworthy. High levels of absentee 

ownership and building vacancies may be Important factors In residents' feelings of loss of control 

and their unwillingness to invest their energy in 

caring for their neighborhood and the children 

within it. 

Conversely, home ownership may give residents a 

sense of control and a stake in their neighborhood. 

In that regard, it is interesting to note that home 

repair classes were principal attractions of the his· 

toric neighborhood settlement house~ Such classes 

provided opportunities for development of personal 

competence in the service of students' own families 

as well as the neighborhood as a whole. 

Also, in neighborhoods where residents commonly 

do not have strong local family and social tics, 

people who join neighborhood improvement asso· 

ciations tend to be home owners.S7 Accordingly, 

subsidization of home ownership may help to stem 

the tide of neighborhood decline, in regard to the 

development of social ties and an economic base. 

Fifth, regardless of the particular state of repair of 

the homes in a neighborhood, housing patterns can 

promote or inhibit interaction and watchfulness 

among neighbors. Accordingly, housing designed in 

a manner that impedes such interaction may in· 

crease social isolation and foster zones of violence. 88 

In short, inadequate housing can result both directly 

and indirectly in increased risk of child maltreat· 

menr. Conversely, careful behavioral design and 

government housing subsidies may increase both 

the physical and the social safety of neighborhoods 

and, therefore, may diminish the risk of child maltreatment. 

Low population density is one reason that potential 

elements of broad child protection programs may 

be absent in some neighborhoods. Another reason 

is that some neighborhoods have become suffi· 

ciently impoverished, both economically and so· 

dally, that few resources of any kind are available. 

In such neighborhoods, not only is there no major 

industry, but there also may be no Rotary Club or 

Kiwanis Club and indeed no grocery stores, banks, 

and other basic amenities. The neighborhood may 

lack grassroots organizations of any sort, and indi· 

vidual neighbors also may feel drained of both 

emotional and economic resources that might be 

shared. 

The potential difficulties are obvious. The MiitonS. 

Eisenhower Foundation project for community 

policing, for example, showed the difficulty of effe.c· 

tive community action in declining neighborhoods. 

Requests for technical assistance (especially from 

organizations that employed economic..development 

strategies) were more frequent and persistent than 

the Foundation had expected, even though a signifi. 

cant proportion of the program budget (20%) was 

allotted for such a purpose.1l'} Development of neigh. 

borhood organizations also sometimeswas impeded 

by involvement of residents who were viewed by 

their neighbors as part of the problem (e.g., sus· 

peeted drug dealcrs). 

The unfortunate irony of this situation is that the 

neighborhoods in most need may have the most 

difficulty in implementing a neighborhood·based 

child protection system. The Board believes that 

this problcm usually is tractable, but that the rever· 

sal of negative social momentum requires diligent 

efforts to inject resources and to facilitate the devel· 

opment of neighborhood leadership. The private 

sector can help in that regard through economic 

development strategies, for example, but Federal 

and State Governments ultimately should reduce 

the disparity between neighborhoods with many 

resources and those with few, through need·based 

funding fonnulae and direct assistance to neighbor. 

hoods at high risk. The safety of children should not 

be a function of geography; children in declining 

neighborhoods are just as entitled to protection as 

are their peers in neighborhoods with more Ie· 

sources. 

u.s. Advisory Board on Child Abuse and Neglect 
p 

Ultimately, each neighborhood will require assess~ 

ment to detennine the impediments to helpfulness 

by neighbors for one another. Similarly. each neighborhood should examine the resources within it --

for example, competencies that could be used for 

economic development and sites that could be used 

for child care. Perhaps most important, each neighborhood must gather together to express its determination to ensure the safety of the children within 

it. 

Although this discussion has focused on low-income 

and drained neighborhoods where problems leading to child maltreatment are likely to be especially 

serious, the environmental focus should not be limited to them. People aflow income are not the only 

ones challenged by the complexity of family life 

tooay. Leaders and concerned citizens throughout 

the Nation should consider what can be done to 

make their neighborhoods places where itis easy for 

families to ensure the safety of their children. 

7. Recommendations 

Recommendation 1 

The Federal Government and private foundations 

should establish a large-scale demonstration program 

of Prevention ZoIUS -- comprehensive efforts to improve the socwl and physical environments in declining neighborhoods wiJh high rates of child maltreatment. These model neighborhoods should be diverse 

in geography, population density, and ethnicity. The 

lriiIls should be closely moniJored and rigorously evaluated. Principles learned should be widely disseminated 

ami, wiJh such modifications as suggested by evaluation studies, should lead to a large-scale national effort 

within five years. 90 

Recommendation 2 

With provision of research, consultation, training and 

technical assistance by the Departments of Agriculture 

and Housing and Urban Development and other 

relevant Federal agencies, City and County planners 

should work with interagency council~ and neighborhood grassroots organizations to develop a Neighborhood Child Protection Plan forevel)' neighborhood in 

their jurisdiction. To that end: 

A New National Strategy for the Protection of Ch.ildren 

· Planners should work closely with civic, business, 

labor, and religious leaders, arut most importantly, 

neighborhood residents them~elves and their leaders. 

· Planners should consider public safety, municipal 

services, housing, economic opportunities, health care, 

family planning, education, and social and recreational opportunities for children and families. 

· Particular auention should be given to providing 

constructive opportunities for youth to network with 

each other, with positive adulJ role models, arut to {md 

positive roles for themselves in their community. 

· Care should be taken to ensure representation of all 

segments of the neighborhood (including diverse ethnic groups) arut to facilitate the involvement of mothers, fathers, grandparents, arut children and youth 

themselves. 

· "Where child abuse coordinating and prevention councils are not present, planners should assist in their 

establishment and support. 

Recommendation 3 

Congress and the Administration should ensure that 

recipients of Community Development Block Grants 

use at least a portion of these funds in ways that will 

strengthen families as a means of preventing child 

abuse and neglect. Selling aside a small percentage of 

such funds to plan and implement ncighborhoodbased strategies for strengtheningfamilies arut preventing child maltreatment would accomplish this, particularly if the appropriation for the Block Grant 

program is increased by a commensurate amount. 

Analogous programs fordevelopment and implementation of neighborhood plans for protection of children 

should be instituted in Federal economic development 

programs (e.g., the Appalachwn Regional Commission) and other programs (e.g., the Bureau of Indwn 

Affairs; the Cooperative ExJension Service; and the 

OfflCe of Rural Health Policy) thatsen;e Tribesormral 

communities. 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 23 

• 
Neighbors Helping Neighbors 

24 

Recommendation 4 

Support should be provided for family resource centers 

and similar organizations that respond to the social, 

cultural, and economic needs of children andfamilies 

at the neighborhood level. Federal support should be 

provided through full funding of the title on family 

resource centers in the Claude Pepper Young Americans Act. State legislatures, foundations, private busi~ 

nesses, and civic, philanthropic, and religious organizations should offer support, too. ~enever feasible, 

State and local agencies should integrate their existing 

services into such centers, which shoukl involve active 

partnerships wiih parents. The rust priority should be 

to support centers that knit people togetherin neighborhoods with few or declining community institutiollS. 

Recommendation 5 

The Department of l/ou.';ing and Urban Development, ~na/ogous State, regional, and local agencies, 

and philanthropic organizations should support housing programs that increase neighborhood stability by 

reducing the necessity for frequent moves and facilitating interaction among families (incfuding adults' invoh'~n~nt with children in their neighbors' families), 

providmg safe physical environments for children, and 

enhancing ownership and personal investment in the 

neighborhood. 

Recommendation 6 

Large bu~inesses and civic and religious organizations 

should "adopt" a particular high-ri~k neighborhood 

that they make a commitment to strengthen. This 

commitment must be fulfilled in collaboration with 

neighborhood residents in ways that empower rather 

than patronize. Implementation of the commitment 

might involve providing financial, human, or other 

resources directly to assist isolated children atul families, promoting economic and other fomls of del!eiapment. It a/:.;o might include mobilizing volunteers from 

the company's employees or the organization's memfJer:J; prumoting (xanomu: and other fo,-ms of development, and support and technical assistance to neighborhood leaders and institutions. 

D. ELEMENT 2: REORIENTING THE 

DELIVERY OF HUMAN SERVICES 

INCLUDING JUSTICE SERVICES 

1. Making Treatment for Maltreated 

Children a Priority 

Much of this report focuses on the steps that can be 

taken to prevent harm to children. However this 

emphasis on prevention should not cause us to lose 

sight of the need for effective treatmcnt to prevent 

furthcr hann after abuse or neglect has actually 

occurred. 

Ina paper commissioned by the Board, David Wolfe 

summarized the current state of practice in the field 

of treatment related to child abuse and neglect 

AlJhough intervention models have greatly improved 

and have contributed to encouraging gains in treatment outcomes, the [teld remains split between promising research findings, on the one hand, and the 

realities of child protection and welfare, on the other 

hand .... To assess any gains made over the past two 

decades in treatment outcome, it is necessary to separate what is tmly "treatment" from what is actually 

delivered to identified families in practice .... 91 

The shift in the state of the art, if not necessarily the 

state of typical practice, has becn away from a "badparent," pathology-based model to "a more encompassing ecological model, with an evolving emphasis 

on t~e importance of the parcnt-child relationship 

and Its context."n The result of this shift in the 

conceptualization of the problem -- a shift stimulated by increasing knowledge about the factors 

causing or precipitating maltreatment -- has been to 

plac~ "greater emphasis on the importance of promotmg parental competence and reducing the burden on families .... The focus of intervention can be 

shifted away from identifying misdeeds of the parent 

and more toward promoting an optimal balance 

between the needs of the child and the abilities of the 

parent. "93 

Too often, though, as we have noted, "treatment" is 

limited to investigation and foster care or packaged 

interventions that do not correspond to the multiple 

u.s. Advisory Board on Child Abuse and Neglect 
l 

needs of the family and that, curiously, omit the 

child.94 At the same time, those services that are 

available typically are notavailable soon enough. In 

many places, entry into CPS has become, in practice. a strange eligibility requirement for those child 

welfare setvices that are available. 95 

A major challenge to the field is to develop an array 

of treatment services in each community so that 

those families in which child maltreatment occurs 

can receive treatment suitable for their needs and 

abilities. Typically, the services that are offered, or 

imposed are based on the availability of services 

rather than the needs and desires of the consumer. 

In the commercial world, no company could survive 

ifitfollowedsuch a policy. Human service agencies 

are able to do so in part because their customers 

often do not pay for their services or choose them 

voluntarily. Even when they do pay for them, their 

choices are limited by the reimbursement policies of 

third-party payers. 

Perhaps the most unfortunate fact about the child 

protection system as it currently exists is that it 

typically does little to ameliorate the harm that 

maltreatment is likely to have caused, even when the 

State takes custody or otherwise intervenes in the 

life of a child found to be maltreated.96 Typically 

little is done to prevent longer -term effects that may 

occur if the child is not provided treatment or to 

mitigate the harm that results from State intervention itself.97 Not only is treatment seldom provided, 

but there also has been far too little attention even 

to how treatment might best be delivered. 

Wolfe's comprehensive review showed the scant 

scientific foundation for design of treatment programs for maltreated children: 

An program models that addressed the child's needs, 

and which presented adequate outcome data, were 

predominantly preschool-based. The preliminary results of these programs designed to treat the victims of 

abuse and neglect seem favorable in meeting some of 

their intervention need~. Across studies, parlil;ipants 

showed improvement in socw[ behavior, cognitive 

development, self concept, and reduction in aggressive 

and coercire behaviors. No mention has been made of 

the applicability of these intervention strategies to older 

A New National Strategy for the Protection of Children 

children and adnkscenlS. however, and the information is sketchy at best regarding effectiveness with 

different forms of maltreatment. Even though these 

child-focused treatment programs hare incorporated 

parent treatment components, no information was 

provided as to the effectiveness of these programs in 

meeting the needs of the parents involved. Similarly, 

no mention is made of the contribution of these approaches to the improvement of family resources and 

weU-being. Thus, at present, child-centered inteIVenlion programs have provided only JimiJed indications 

of their usefulness. The potential of these methods, 

however, meritsfurther investigation because se",ices 

for child victims have imporlant implications both for 

the development of the children involved a.<; wen asfor 

intenupting the inter-generational transmission of 

child maltreatment.98 

There can be no doubt about the need for major 

initiatives: 

· to increase knowledge about treatment of abused 

and neglected children, 

· to diffuse knowledge among clinicians and agency 

administrators when it becomes available, 

,to expand the capacity of the mental health system 

to serve abused and neglected children, and 

· to integrate such services into a system of support 

for maltreated children in their homes (including 

foster and adoptive homes), schools, and other neighborhood institutions (e.g., Hcad Start centers; child 

care programs; recreation centers; churches and 

synagogues). 

2. Providing Material Supports 

Early child protection programs responded to child 

maltreatment as primarily an intrapsychic problem, in its causation as well as its effects. In practice, 

especially when budgets are tight, CPS agencies 

(typically and ironically without the assistance of 

mental health centers) often still act as if such a view 

were valid, by emphasizing psychologically oriented 

programs to change parent behavior. 

u.s. Advisory Board on Child AbLL~ and Neglect ------------------------ " 
r 

! Neighbors Helping Neighbors 

Although psychological issues certainly should not 

be ignored, they also should not be the exclusive 

focus of prevention and treatment programs related 

to child maltreatment. We have already noted the 

relationship between poverty and child maltreatment. Many poor parents protect their children 

admirably, even in the most dangerous and the most 

drained neighborhoods. As Leroy Pelton has argued, however, the reality remains that being poor 

makes the job of childrearing much harder: 

[TJheconditions of poverty, such as healih andsafety 

hazards in the home and neighborhood, may cause 

direct danger to children, and the parents may be 

blamed for not sujJicienJly guarding their children 

from such conditions. Here, our system sets up a 

double standard, in that we implicitly ask impoverished parents to be nwre diligent in their supervisory 

responsibility than middle-class parents, because greater 

protection is required to guard children from the dangerOl.s conditions of poverty than from the relatively 

safer conditions of middle-class homes and neighborhoods. Yet the system offers the parents few resources 

to aid in such protection. Moreover, although many 

children are at risk of harm due to deprivation of such 

necessities as proper nourishment, the system we have 

developed promotes a tendency to resolve the question 

of responsibility for such deprivation in terms of parental fault, and this "verdict" leads to individual treatment to try to change parents' behavior, rather than to 

provision of needed resources. It can also lead to foster 

care placement. In addition, even catastrophes befalling the familyas a whole, such as homelessness, can be 

reintepreted as child neglect, sometimes ironically 

based on observation of psychological debilitation, 

such as depression, that such circumstances may 

generate. It is ftuitless, of course, and an extreme form 

of "blaming the victim" to treat homeless parents as 

perpetrators of child neglect. 99 

Because of the need to cope with what sometimes 

seem to be overwhelming odds, poverty threatens 

family stability. Poverty also reduces the social 

resources available (not just the material unes), 

because social isolation is more probahle when, for 

example, families lack a telephone. 100 

~, 

At root, as we discussed in Section C(5), the answer 

to this problem is probably one of economic development. If the residents of an impoverished neighborhood are to rise above JXlverty, economic opportunities usually must increase. 

In the meantime, though, it must be recognized that 

there are variations in degree of poverty and inskills 

of coping with poverty and that family resources 

usually must increase if serious problems are to be 

alleviated. Not only should economic development 

occur at the neighborhood level, but material supports also should be available to the particular 

families at highest risk of maltreatment. Even 

intensive social services have little sustained effect if 

attention is not given to families' basic needs for 

income support, housing, food, clothing, jobs, and 

job training. 

In that regard, it is important to recognize that 

effective setvice design is not an "either-or" situation (i.e., either traditional social services or material supports). Indeed, effectiveness may depend 

almost as much on how support is provided as on 

what is provided. 

Concrete services can serve as avenues for counseling, education, and linkage with neighborhood and 

volunteer advocates; the Women, Infants, and Children (WIC) nutrition program is an excellent example. Economic support programs can be designed to ensure that vocational counseling, job 

training, and jOb-search counseling are included. 

On the other hand, social services can include access 

to concrete services that enable clients to make use 

of the skills and insights that they acquire and the 

relationships that they establish. Forexample, horne 

visitors in Hawaii's model program of support for 

young families have a primary mission of education, 

support, and monitoring, but they always bring gifts 

(e.g., baby clothes), many of which have been donated by local businesses, and they offer a toy lending library. 

u.s. Advisory Board on Child Ahuse and Neglect 
3. Strengthening the Delivery of Family 

Preservation Services 

Historically, social service agencies have been at the 

center of child protection efforts, and CPS has been 

at the ccntcr of such efforts within social service 

agencies. By history, social service agencies should 

be especially well suited to integrate counseling and 

"hard," economically oriented services. As we 

emphasized in Section II(D), however, public child 

welfare agencies' work too often has been dominated by investigation, and dispositional plans too 

often have involved a choice between nothing and 

foster care. 

Professionals in the child welfare field arc nearly 

unanimous in their conviction that the array of 

services available for prevention and treatment of 

child abuse and neglect must increase. The American Public Welfare Association and the National 

Commission on Children have adopted nearly identical recommendations for a three-tier service system: 

· Promoting child development and healthy family 

function through locally controlled and coordinated, 

community-based family support networks that offer access and referrals to a broad range of services, 

including health and mental health care, education, 

recreation, housing, parenting education and support, employment and training, and substance abuse 

prevention and treatment.. .. 

· Assisting families and children in need in order to 

strengthen and preserve families that voluntarily 

seek help before their problems become acute. 

Human service programs, including health and 

mental health, juvenile services, substance abuse 

programs, education, and economic and social supports, must collaborate to provide prevention and 

early intervention services that offer practical solutions to problems faced by families in crisis .... 

· Protecting abused and neglected children through 

more comprehensive child protective services, with 

a strong emphasis on efforts to keep children with 

their families or to provide permanent placement 

for those removed from their homes.101 

A New National Strategy for the Protection of Children 

The Board welcomes the general thrust of the 

APW AlNational Commission approach to child 

welfare reform: emphases on expansion of the 

service system (especially in regard to prevention 

and early intervention), implementation of mare 

intensive services for families in the "deep end" of 

the continuum of services, and alteration of funding 

streams to accommodate such reformed priorities!02 

We also acknowledge the critical role that child 

welfare agencies can play in the development, integration, and implementation of prevention and treatment for maltreated children and their familics in 

general and for particular children and families. In 

that regard, the Board renewsits general support for 

child welfare reform legislation dcsigned to implement the wider availability of services under the 

auspices of the child welfare system, as recommended by APW A. The Board further urges states 

to utilize newly authorized federal funds for Family 

Support and Family PresetVation Services to support neighborhood based service development cansistentwith the principles and rccommendations set 

forth in this report. 

4. Developing New Models of Foster Care 

The child-protection-related crisis in child welfare 

agencies is not limited to CPS. Amid the national 

emergency in child protection, perhaps no element 

ofthechild protection system is in more trouble than 

the foster care system, which seems to be on a 

collision course with itself. The number of foster 

children issteadily and dramatically increasing (from 

ahout 245,(0) in 1985 to approximately 429,CW in 

1991), while the number of foster homes is dwindling (from about 137,(0) to 100,(0) in the same 

period), as State social service agencies struggle just 

to replace the 30,(0) foster families who leave the 

system each year. 103 At the same time, the problems 

that foster children bring to their new homes arc 

more serious and complex, and they often remain in 

the system for long periods of time and in a series of 

homes. I04 

The difficulty of the task of foster care reform is 

indicated by the fact that the problem is not necessarily one of insufficient funding, at least in the 

aggregate. Federal expenditures for foster care 

have risen at a substantially faster rate than the 

number of children in foster care,l05 even as payu.s. Advisory Board on Child Abuse and Neglect ~----------------------- 27 
Neighbors Helping Neighbors 

2& 

ment<; to foster parents remain well under their 

actual expenses in many instances, 106 Moreover, the 

complexity of the economic contcxt for foster care 

and for the child protection system as a whole is 

further illustrated by the fact that reimbursement 

for foster parents -- regarded by almost everyone as 

inadequate -- usually at least equals and often exceeds allotments for AFDC (aid to families with 

dependent children), 107 

The foster care crisis is the product of several problems deeply embedded in the foster care system per 

se and the child protection system more broadly, 

First, the foster care system, perhaps even more 

than other part~ of the child protection system, is 

drowning in the explosive growth of identified cases 

of child maltreatment. 

Second, foster care also reflects the ehild protection 

system as a whole in its definition as a component of 

the social service system, with relatively little support from other elements of the child protection 

system. Foster families sometimes have lacked the 

resources available from the State for biological 

familics, and fosterchiIdren themselves often do not 

receive services necessary to alleviate the effects of 

abuse and neglect and of separation from their 

biological families. Specialized services for foster 

children within mental health and education are 

rare. 

Third, just as child maltreatment cases often are the 

foci of investigation with minimal provision of child 

welfare serviccs, foster care oftcn has bcen isolated 

and neglected even within the child welfare system. 

An officer of the National Foster Parents Association (NFPA) who spoke before the Board lamented 

the "attitude of many, at the federal, state and local 

levcl[s], who regard foster care as little more than a 

necessary evil and foster parents as little more than 

glorificd baby sitters and moncy hungry individuals."los Consistent with that view, surveys by NFPA 

and others have shown that the greatest needs of 

foslt:r part;lllS art; (1) respt:ct from agem.), ~taff, (2) 

respite care, and (3) increased reimbursementY)9 

Although the reimbursement problem is serious,110 

the most powerful factor in the poor retention rate 

is the perceived lack of emotional and training 

support for foster parents.l1l 

Fourth, these attitudinal problems and limited supports reflect considerable confusion about the purpose of foster care, just as ehild protection policy in 

general has been poorly developed, The National 

Commission on Family Foster Care, a collaborative 

effort of NFPA and the Child Welfare League of 

America, noted that the progression from the nineteenth-century model of foster care as a permanent 

home for orphaned and abandoned children to the 

current reality of foster care as a social service for 

troubled, maltreated children has occurred without 

establishment of a clear goal for family foster care: 

Is it a service to children and youth? Is it a service 

to children, youth, and their families? Is it part of 

child protective services? Is family foster care a 

family preservation service -- the last resource offered prior to termination of parental rights? How 

does family foster care relate to adoption services? 

Is it a time-limited or a lifelong service?112 

The National Commission report itself illustrates 

the problem. Although the report is, overall, an 

excellent blueprint for reform of the foster care 

system, the Commission dealt with the problem of 

the system's mission simply by saying that the role of 

foster parents ought to be defined -- without saying 

what that definition should be.113 

Fifth, the lack of planning has resulted in a system 

that has failed to adapt to extraordinary change in 

the de facto purposes of foster care and the social 

and legal contexts in which it is provided --just as the 

child protection system in general has been slow to 

respond to the rapid change in not only the number 

but the complexity of the cases in the system. As the 

National Commission on Family Foster Care observed, the foster care system is built on century-old 

premises that no longer are valid: 

. that children needing care are primarily dependent 

and neglected and can be helped through love alone; 

. that there are sufficient numbers of families with 

wage-earning fathers and at-home mothers willing 

and able to donate their time and money to "fix" 

these children by the age of 18; and 

u.s. Advisory Board on Child Abuse and Neglect 
f 

'that caseworkers have the time and skill to supervise foster home placements. 

We can't serve twentieth century children and youth 

with nineteenth century assumptions. It is not surprising that there is a "crisis" in family foster care. 114 

Sixth, as with the child protection system as a whole, 

the foster care system has suffered from misdirection 

of funds. To avoid the continuing decline in quality 

of care simply because of the growing ratio of foster 

children to foster parents, investment needs to occur 

at the front end. Families in crisis often can be 

preserved if intensive services arc delivered. 

Seventh, like the child protection system as a whole, 

the fostercare system has grown with little attention 

to the experiences of children within it. Too often, 

pennonence for foster children has been perceived 

as a dichotomy: reunification or adoption. That 

conceptualization ignores the reality of children's 

relationships, in which most foster children "care 

deeply about their [biological] parents"1l5 and extended family, siblings, and foster families also usually are important. Too often also, children's own 

voice simply is not heard, because of failure to ask 

children about their experiences, a lack of effective 

and continuing representation, or both. 

As with the national emergency in the child protection system as a whole, the foster carc crisis calls for 

both immediate and long-tenn responses. Immediately, in order to recruit and retain foster parents 

who will provide appropriate care for abused and 

neglected children whose homes of origin are too 

dangerous for them to remain, a new commitment 

is needed to treat foster parents with the respect that 

they deserve. That commitment should be reflected 

in professionalization of family foster care: 

'adoptionofperfonnancestandards and other means 

of quality assurance;1l6 

. provision of appropriate training and consultation 

for foster parents; 

. implementation of public relations campaigns to 

improve the image of foster care and to show appreciation of outstanding foster parents; 

U.S. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

· provision of respite care and day care for foster 

families; 

· provision of 24-hour emergency mental health, 

medical, and legal services for foster families, as well 

as ongoing supportive services; 

· increase in the compensation to foster parents to 

reflect their actual expenses and investment of time 

and expertise; 

· support for foster parent associations and peer 

consultation; 

· joint training of foster parents and agency staff in 

their separate and joint responsibilities. 

Establishment of professional nonns and collegial 

respect for foster parents -- the approach recommended by the National Commission on Family 

Foster Care -- is likely to go far toward recruitment 

and retention of adequate numbers of qualified 

foster parents. So too will provision of sufficient 

support, including appropriate training, for care of 

children with complex and often frustrating problems. So too will development of a network of 

services, including intensive crisis services, that will 

reduce the number of children entering faster care, 

so that foster parents are not faced with an unrealisticallydifficult or even impossible task of caring for 

a large family of troubled children and youth and so 

that children's relationships are not disrupted unnecessarily. 

For the long tenn, though, such refonns -- although 

important -- are notenough. Fostercare needs to be 

conceptualized and planned as part of a constellation of neighborhood-based supports for children 

and families. Such an approach makes sense not 

only hecause of the need to integrate foster care into 

the child protection system as a whole but also 

because of the practical reality that changes in 

family structure and job opportunities for women 

arc likely to continue to constrict the pool of individuals available for 24-hour foster care. 

Within such a reconceptualization, foster care might 

be considered as an analogue to the practice in some 

cultures of extended family members or neighbors 

29 
r Neighbors Helping Neighbors 

caring for children when families reach a point of 

crisiS.117 Accordingly. experimentation is needed 

with partial or "open" foster care in which children 

may go to a second home during after -school hours 

but still live with their biological families. Similarly, 

children might be in 24-hour foster care only when 

their families are under unusual stress, but they and 

their parents might have ongoing involvement with 

foster families in the interim. Such blending of 

biological and foster families may provide sufficient 

support to ensure children's safety ...vithaut total 

separation of children from their biological families. 

It also may enable partnerships in which foster 

parents serve as teachers, monitors, listeners, and 

practical aides for their foster children's biological 

parents. 

Experimentation is also needed with models of 

foster care that involve 24-hour care but that preserve relationships within foster children's families 

of origin whenever such an approach can be undertaken safely. Examples would be whole-family foster care1l8 and incentives for care of all siblings in a 

family. In that regard, research is needed on kinship 

care (foster care by relatives), an option that is 

becoming increasingly available,119 to determine the 

circumstances under which it results in appropriate 

care and sustained relationships and to identify 

spccialassessmentsand supports that may be needed 

to detenninc its applicability. In addition, child 

welfare agency policies related to kinship care should 

be clarified through appropriate changes to statutes 

and regulations. 

S. Creating New Roles for the Justice System 

a. Building Neighborhood Responsibility 

Although even most substantiated cases of child 

maltreatment never reach the courts in most Statd~ 

the legal system looms large in the child protection 

system as it is currently structured. For example, to 

link to the preceding section, courts serve as 

gatekeepers for foster care. Through Federally 

mandated post-placement reviews, court~ also potentially serve as monitors of foster care. 

More to the general point, the real or perceived 

demands of the legal system dominate professionals' behavior in deciding even the intensity of services offered to particular children and their families. CPS caseworkers and law enforcement officers 

exert much of their effort for the protection of 

children in the gathering of evidence and preparation for court. Increasingly, this function is also 

being performed byprofessionals( e.g., mental health 

clinicians) who fonnerly had relatively unambiguous roles as helpers. 

When coercive action (whether civil, criminal, or 

both) is contemplated, then it is undeniably important to assure carefu] collection and preservation of 

evidence (like other elementsofdue process). Those 

functions will continue to be of importance in any 

child protection system. Some homes are so unsafe 

that children can be protected only through exercise 

of government authority, and the behavior of some 

adults who abuse or neglect children is so outrageous that the community understandably wishes to 

express its outrage through criminal punishment. 

Nonetheless, the question remains how the justice 

system can play a more effective role in a new 

neighborhood-based child protection system. The 

justice system may playa particularly important part 

in promoting neighborhood responsibility for the 

safety of children. For example, courts can apply the 

authority that they already have to ensure that 

children's interests are fully considered and thatthe 

accountability of the local child protection system is 

assured. Courts can be leaders in protecting the 

interests of groups that are vulnerable or 

disempowered; surely abused and neglected children arc among them. 

The use of law to promote neighborhood responsibility can occur in other, less traditional ways than 

fonnal judicial intervention. [n that regard, some 

other countries have developed decisionmaking 

procedures that are intended to foster neighborhood and family involvement in the protection of 

individual children who have been abused or neglected. For example, in 1989 New Zealand replaced its judicial dispositional hearings in child 

protection cases with family group confercnces. 121 

The conferences, which integrate Western legal 

norms with traditional Maori procedures for dispute resolution, involve the entire "family group," 

including not only the nuclear family but also extended family and others, such as coaches, friends, 

u.s. Advisory Board on Child Abuse and Neglect 

• 
f 

l 

and human service professionals who are important 

to the family. With the assistance of a care and 

protection coordinator, who convenes the meeting, 

a consensual plan is reached in nearly all cases, even 

when out-of-home placement (often with an extended family member) is the result. More than 

two-thirds of the plans provide for social casework 

ormentai health services, and three-fourths provide 

for financial assistance. The family group has responsibility for implementing the plan with the supervision and aid ofthe care and protection coordinator. 

A somewhat older innovation (begun in 1968) occurred in Scotland, which replaced its juvenile court 

with a hearings system, in which dispositional and 

post-dispositionai decisions are made by a panel of 

volunteers (of whom there arc I,m in a country of 

five million people).122 Although there has been no 

evaluation of the system using social science meth· 

ods, the system's proponents believe that the dispo· 

sitionsare better accepted than in traditional adver· 

sary proceedings because the parties had a hand in 

shaping them. They also believe that the develop· 

ment of a cadre of volunteers chosen in part because 

of their representation of the community fosters 

understanding and caring in the community as a 

whole. That involvement also contributes to the 

parties' acceptance of the hearing panel's judg. 

ments. 

These models have arisen in countries with a legal 

and political heritage similar to that in the United 

States. There may be room for their adoption, at 

least with the agreement of the parties, in some 

communities as alternatives to formal legal pro· 

ceedings in cases in which there is consensus that 

there i~ a problem that needs to be corrected. In fact, 

"talking circles" used by some Native American 

Tribes to involve extended family members in re· 

solving difficult family problems are similar in some 

respects to the Native New Zealand Maori ap· 

proach which has been incorporated into the New 

Zealand lcgal system. In any event, the experience 

in New Zealand and Scotland suggests that ahema· 

tive means of dispute resolution may foster greater 

family and neighborhood responsibility for the safety 

of children. 

U.S. Advisory Board on Child Abuse and Neglect 

A New NationaJ Strategy for the Protection of Children 

Even if such substantial reforms do not occur, there 

is a need for experimentation with structures and 

procedures to facilitate dispute resolution and dis· 

positional planning in the cases in which the risk of 

harm to children is not so serious that formal court 

involvement is warranted or, if the court is involved, 

that progress is "stuck" because of disagreements 

between caseworkers and parents or other parties 

involved. Mediation shows promise in providing a 

means by which parents can "own" the resulting 

plans and feel less alienated from those who wish to 

help them.l23 When part of neighborhood pro· 

grams, such programs also may decrease families' 

isolation and increase the likelihood of culturally 

appropriate plans that make use of natural helpers. 

Virtually all commentators disapprove of altema· 

tive forms of dispute resolution in child protection 

cases in which there is clear risk of serious harm to 

children. However, that principle still leaves a large 

proportion of cases in which an alternative to tradi· 

tional coercive court·based approaches may be ap· 

propriate. In particular, creative structures and 

procedures may be especially useful in stimulating 

parent participation and neighborhood involvement 

in development of workable plans in many of the 

cases of multi·problem families in which child ne· 

glect (such as failure of adequate parental supervi· 

sion) is suspected or substantiated. Such an ap--

proach is consistent with the Board's preference for 

easily accessible voluntary help whenever possible. 

b. Expanding the Role of Law Enforcement 

Although they arc especially central, courts are not 

the only justice·system entities of concern in devel· 

opment of a national strategy for the protection of 

children. Law enforcement agencies have obvious 

roles in investigation of cases of child maltreatment 

(at least when criminal charges are contemplated), 

assurance of safety of children in emergency situa· 

tions, and apprehension of defendants accused of 

criminal child abuse. Consistent, though, with trends 

in the field of law enforcement, police officers and 

shcriffs may have much broader roles to play in the 

development of neighbors' support for each other 

and their watchfulness for children in the neighbor· 

hood. On their beats, law enforcement officers are 

in a position to become allies of children and fami· 

lies, to observe when something is amiss, and to 

31 
r 

Neighbors Helping Ncighhors 

32 

enlist neighborhood resources in such instances. 

Law enforcement can work with housing and social 

services agencies and community organizations to 

assist residents to "take back their neighborhoods" 

and to build safe environments conducive to family 

welfare. 

In that regard, virtually all over the developed world, 

leaders in law enforcement have been drawn in 

recent years to the concept of community poIicing.124 

Some of the most successful programs have relied in 

part on home visits by police officers. Others have 

used neighborhood mini-stations -- sometimes in 

ways that mimicked historic settlement houses. Such 

centers in Scandinavia, for example, have been 

described as "espccially attractive, warmly furnished, 

inviting places, where neighborhood residents talk 

to police about a variety of problems -- such as a 

husband's excessive drinking or a child's failure to 

mcet school obligations -- that may not bear on 

crime."125 

Perhaps the best known examples of community 

policing arc Neighborhood Watch programs. Such 

programs have had limited success in meeting their 

primary goal of crime reduction, but they have 

shown promise in increasing neighborhood cohesiveness and diminishing fearl26 -- responses that are 

consistent with safer environments for children. 

Forexample, the Milton S. Eisenhower Foundation's 

demonstration program for community-based organizations to reduce crime in high-crime, innercity neighborhoods failed to achieve the program's 

ultimate goal, but the organizations attracted relatively high levels of participation (about one in five 

adult residents), reduced fear of crime, and increased sensitivity to problems of youth in the neighborhood. 127 The positive effccts of the Eisenhower 

Foundation program were greatest when the organizations did not focus their efforts on youth problems per sc but instead cmphasized community 

organizing(e.g., block clubs) with regular opportunities for citizen involvement. Success in building 

community cohesiveness also was more likely to 

occur when groups did not focus on crime per se but 

instead dealt with the most pressing social needs as 

the residents themselves perceived them: finding a 

new use for a vacant school building, provision of 

tutoring for schoolchildren, or development of programs to stimulate youth jobs. 

The Eisenhower Foundation's own summary of its 

community dcvelopment projects suggests the need 

to go beyond Neighborhood Watch programs to 

more extensivc involvemcnt of policc and othcr 

agencies in supporting neighborhood development: 

[CJonventional community crime prevention tactics 

[fail to J pay sufficient attention to domestic violence. 

Domestic violence and child abl/se are woven like a red 

thread through many low-income urban communities; they are a criiical part of the community's crime 

problem, and one that is especially troubling because 

oflis potential to generate further violence in the future 

as children in violent and abusive families grow up. 

Like drug use and drug dealing, an effective community response to violence in the family must, in our 

experience, address the social fabric of inner-city communitie.~ and the fntstration and anger that result from 

blocked economic opportunity. 128 

As thc Eisenhower Foundation continued, citizen 

patrols "can help support a broader strategy of 

youth empowerment and economic development in 

disadvantaged communities."I29 Building from the 

lessons learned in its recent projects, the 

Foundation's current project'> adopt several strategies that, although focused on crime prevention, are 

also relevant to neighborhood development for the 

purpose of child protection (as the Foundation itself 

has recognized): 

. Employ or mentor high-ril"k youth with sufficient 

exiended-family-like discipline and socialsupport (including remedial education) to reduce crime and drug 

abuse while they increase school completion and future employability; 

. Empower inner-city neighwrhood nonprofit groups 

to operate the programs, organize local residents, 

integrate crime prevention with economic develnpment, bring in creative support from the police and link 

up with schools; 

u.s. Advisory Board on Child Ahuse and Neglect 

.... 
. Develop financial self-sufficiem.y in order to ensure 

that program activuies can continue. 130 

c. Avoiding Undue Emphasis on 

Investigation 

The discussion of the place of the justice system in 

the broader child protection system has focused 

thus far the functions and form of the justice system 

itself, as it is applied to both dispute resolution and 

lawenforcement. Consideration needs to be given, 

though, to reform not only of the justice system but 

also the law.l3l 

The de facto definition of child protection as limited 

to CPS and, implicitly, the legal apparatus that 

provides its authority has resulted from an assumption that every case is potentially a case for coercive 

inteJVcntion. From thc time that a call is heard, 

caseworkers typically must act as if they are gathering evidence for a legal proceeding even when the 

allegation is such that there is little if any chance that 

the case will ever proceed to court. i32 

As we discussed in Section 11(0), this emphasis on 

investigation has served in two ways to undermine 

the purported goal of child protection. First, although there are impressive exceptions (such as the 

child protection system in Hennepin County, Minnesota), the focus on investigation too often so 

absorbs child welfare agencies that no one has time 

to be of much help to the families reported. Second, 

the emphasis on investigation has created such intractable role conflicts that families may be deterred 

from accepting the help that is available. 

Involvement in the legal process does earry some 

risks for children whose cases do progress through 

the courts, especially the criminal COUrts.133 Although harm is not inevitable,l34 the reality remains 

that, even for those cases where court involvement 

does occur, participation in the legal process is 

sometimes incompatible with the goal of child protection. 

Given these facts, if thc child protection system is to 

move from its current misplaced emphasis, the 

grounds for coercive legal intervention with families 

may need to be narrowed. Caseworkers need to be 

able to take calls and proceed in many cases simply 

A New National Strategy for the Protection of Children 

to pose the question, "What can we do toheJp?" In 

that regard, the primary question is not whether law 

enforcement officers, CPS caseworkers, or both 

should perfonn investigations -- or, for that matter, 

who should offer help.13S Rather, the need is to limit 

the range of cases in which the primary response is 

to gather evidence against parents -- to the degree 

that this is possible without jeopardizing the safety of 

the child. 

At the same time, the Board believes that there are 

circumstances under which legal intervention is 

justified and desirable: 

· when danger to the child is so extreme that it is 

simply not safe for the actual or would be offender 

to have access to the child; 

· when the probability of effective intervention to 

prevent the recurrence of child abuse or neglect is 

greater if the "hammer" of the court is available; 

· when the behavior of the offender is so wrongful 

that society must exaet retribution.l36 

Development of policy based on the firstr.vo grounds 

is hampered for the immediate future by the lack of 

research. The empirical foundation for risk assessment remains scant.137 Knowledge about the effectiveness of court-ordered intelVentions is limited; 

the research that is available has obtained mixed 

findings in regard to the question of when, if ever, 

coercion facilitates treatment. us Knowledge also is 

limited about the ways that judges and the various 

officers of the court could act to enhance whatever 

therapeutic effects court involvement docs have, 

although essays on the new therapeutic jurisprudence have raised some provocative hypotheses. ,39 

Research also is minimal on the question whether a 

change in standards for reporting and investigation 

would actually result in a change in behavior of 

mandated reporters or CPS agencies so that voluntary services would become more easily available 

and that the proportion of time spent on investigation would decrease.l4D 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 33 
Neighbors Helping Neighbors 

34 

d. Making the Legal Process Child-Centered 

Regardless of the specific legal forum in which child 

protection matters are considered, questions remain about whether the process is child-centered, 

As a result, Congress and the State legislatures have 

enacted many statutes to prevent harm to children 

during the legal process,141 Too often, though, such 

laws have been enacted with little consideration of 

the meaning of various procedures to the child, 

Moreover, statutory reforms commonly have focused on trial procedure. Much less attention has 

been given to the child's experience of the legal 

proccss as a whole. Similarly, some consideration 

has been given to avoidance of long-term hann to 

children, but little study has taken place of ways that 

children can be involved so that they believe that 

justice was done and that they had their say,142 

Unfortunately, the nonn in many communities is 

that children are more objects than participants in 

child protection proceedings, so that they may not 

even be given feedback about the progress of the 

cases in which they are involved or explanations 

about the nature of the proceedings and the nature 

and reasons for the decisions reached in them. 

Often guardians ad litem arc not appointed or, if 

they are, they fail to undertake even the most basic 

preparation -- i.e., talking with their child c1ients.143 

Systematic efforts to ensure that children's interests 

arc at the center at least of civil Guvenile or family 

court) proceedings show that special systems for 

ensuring that consideration of children's interests is 

careful can work. In a demonstration project in 

Genesee County, Michigan, lawyers, law students, 

and volunteers with special training all perfonned 

better as advocates for children in child protection 

cases than did the average lawyer appointed to such 

cases.l44 The specially trained advocates were more 

likely to be actively involved in development and 

implementation of service plans, with the results 

that (1) court processing time decreased and orders 

were more detailed, regardless whether the child 

entered foster care, and (2) both dismissals and 

orders for state custody decreased, 

Similarly, a study of advocacy for children in child 

protection cases in nine counties across the United 

States found lay volunteers (Court-Appointed Special Advocates; CASAsI45) and staff attorneys to 

provide more intensive and stable representation 

for children than did court-appointed private attorneys.l46 CASAs were particularly effective in facilitation of services for children, 

Although these studies provide promising directions for program development, research is needed 

to provide the infonnation that attorneys and lay 

advocates can use to help to ensure that the legal 

process comports with children's dignity.147 The 

model programs for representation of children also 

should be applied more broadly, perhaps through 

the efforts of State and local bar associations and 

affiliated groups,l48 

e. Refonning the State Courts 

Almost by definition, abused and neglected children are a vulnerable population. Those who are 

entrusted with their care have been unable orunwilling to provide them with protection from harm. 

Sometimes this behavior is fully culpable. Sexual 

abuse involves the exploitation of children for one's 

own gratification, need for control or sense of inadequacy. Physical abuse requires the use of force 

against children in ways that adults know or should 

know not only can cause bodily hann but that ma~r 

also leave deeper and more lasting psychological 

scars. At other times, the maltreatment of children 

(especially in cases of neglect) derives more from a 

combination of a lack of resources and the caretaker's 

own inadequacy and feelings of being overwhelmed.149 

Whatever the motive or cause for child maltreat· 

ment, however, it surely represents a breach at least 

temporarily of the expectation that parents and 

other caretakers for children are dependable guardians of the children's interests. Such an assumption 

is even more problematic for children removed 

from their parents' custody, whose legal guardians, 

who are often State social workers, may be charged 

with the care of many children, some of whom they 

rarely even see.l50 The guardians themselves (however motivated they may be) often have not been in 

the position long enough to know their wards' interu.s. Advisory Board on Child Abuse and Neglect 
, 

ests151 and, in any event, may hold jobs that sometimes place them in conflicts with their wards' interests as individuals,lS2 

In such a context, there can be little doubt that a 

child-centered policy requires effective ongoing 

advocacy for abused and neglected children. Such 

a requirement emanates not only from the need to 

protect the interests of vulnerable children, but also 

from the right of all children -. as people worthy of 

respect -- to he heard about matters that pertain to 

them,153 

Unfortunately, though, there is widespread acknowledgment that the quality of advocacy on behalf of 

abused and neglected children often has been poor 

or even nonexistent. This problem was illustrated, 

for example, by the examination by several national 

legal and child welfare organizations of the level of 

fulfillment of the requirement in the Adoption Assistance and Child Welfare Act of 1980 that regular 

reviews are held to detennine whether State agencies have undertaken reasonable efforts to preserve 

or reunify families of State wards. lS4 The national 

organizations concluded that advocacy for State 

wards often is sorely lacking but that, if taken seriously, it could help to ensure not only that individual 

children are not caught in "foster care drift" but also 

that the child protection system is made more rcsponsive: 

Many juvenile and family court judges remain unaware of their obligation to detelmine if reasonable 

efforts to preseIVe families were made. Other judges 

routinely "rubber stamp" assertions by social seIVice 

agencies that reasonable efforts to preseIVe families 

were provided. 

Similnrly, many child welfare workers are unaware of 

their own obligations and unsure of the nature and 

extent of seIVices that should be provided. Many feel 

abandoned by the judiciary and legislature and left to 

care for an ever-increasing population without adequate support and resources. Many feel that they are 

scapegoated for the entire government's failure to deal 

effectively with children and families in crisis. 

A New National Strategy for th.e Protection of Children 

Attorneys for children and parents are often at a loss 

about the seIVices to which their children are entiJled 

and how they can most effectively secure those seIVices 

through agencies and the courts. 

Htnen judges fail to ensure that reasolUlbie efforts are 

made, when agency personnelfail to provide necessary 

seIVices, when attorneys fail in theirob/igations to their 

clients, families and society pay the bill Not only are 

parents arui children denied a real chance to "make it 

work" but taxpayers must bear the expense of unnecessary foster care placements. 

The reasolUlbie efforts requirement Treed not be a 

burden on judges, agency personnel, and attorneys. It 

can be an opportunity Jor effective advocacy for children and their families, an occasion/oropen examination a/community options and a tool forsensihle fiscal 

policy in which scarcefunds are spenton the most costeffective and appropriate seIVices. 155 

The justice system can play important roles in providing a voice for individual abused and neglected 

children and exercising community leadership, including oversight over administrative agencies, in 

ensuring the accountability of the child protection 

system. Although the State juvenile and family courts 

often have failed to fulfill their responsibility in this 

regard, they already have such roles in law pursuant 

to the Adoption Assistance and Child Welfare Act 

and many State juvenile codes. l56 

Increasingly, the judiciary itself has recognized the 

need forjuvcnile and family court judges to be active 

in fostering the development of the service system, 

building a sense of responsibility in the community, 

evaluating the perfonnancc of administrative agencies, and requiring reliable, zealous advocacy by 

attorneys and guardians ad litem for children involved in child protection proceedings, including 

post-dispositional reviews. IS? 

The Board believes that in many parts of the country 

the range of cases potentially brought before the 

juvenile and family courts should be narrowed, but 

that provision, including necessary fiscal and human 

resources, 158 should be made available forthc courts 

to exercise their leadership and oversight roles with 

US. Advisory Board on Child Abuse and Neglect ------------------------ 35 
I 

I 

Neighbors Helping Neighbors 

due care and intensity,159 In other words, many 

courts should be involved with a narrower range of 

child protection cases,100 but they should exercise 

closer oversight in those cases that do come before 

them than has been typical, especially in the dispositional and post-dispositional stages. 

Courts should use their case reviews as means of 

monitoring the child protection system. as a whole, 

and they also should regularly examine systematic 

data about the progress of children under the court's 

jurisdiction and the responsiveness of particular 

clements of the service system. Courts also should 

usc their moral and legal authority to develop community responsibility through neighborhood meetings, support for neighborhood leaders, and creative dispositional plans that build on the support 

available from natural helpers, volunteers, and extended families. 

Such a model assumes the availability of dedicated 

and skilled representatives of maltreated children, 

both individually and as a class. Such representatives (ideally, attorneys in combination with volunteers, such as CASAs, or paraprofessionals) should 

be continuously accessible to and by their child 

clients. Attorneys for children also should have 

standing to bring actions on their clients' behalf 

(e,g" tofile fortermination of parental rights) and to 

appeal decisions to higher courts. 

f. Reforming the Federal Courts 

The Federal eourts also have a role to play, No right 

can be more fundamental than the right to personal 

security .1~1 Unfortunately, however, in theDeShaney 

case, the Supreme Court has construed this right so 

narrowly that it is not implicated even in those cases 

in which CPS agencies become involved but in which 

custody is not transferred to the State.1b2 Similarly, 

the Court subsequently denied children's access to 

the Federal courts to ensure compliance with the 

Adoption Assistance and Child Welfare Act --even 

when the "reasonable effort" being demanded is 

simply appointment of a caseworkcr!163 

Justice Blackmun's eloquent, passionate dissent in 

DeShaney is worth reading and re-reading, because 

it shows an exemplary appreciation of the stakes 

involved in recognition of responsibility for the 

protection of children: 

Today, [in holding that no Iinbility for violation of civil 

rights occurs when a child known to CPS is not 

protected,] the Court purports to be the dispassionate 

oracle of the law, unmoved by "natural sympathy. " 

But, in this pretense, the Court itself retreats into a 

sterile fonnalism which prevents it from recogni2ing 

eiiher the facts of the case before it or the legal nonns 

that should apply to those facts .... 

Like the antebellum judges who denied relief to fugiJive 

slaves, the Court today claims that its decision, however harsh, is compelled by existing legal doctrine. On 

the contrary, the question presented by this case is an 

open one, and our FourteenthAmendment precedents 

maybereadmorebroadlyornarrowlydependingupon 

how one chooses to read them. Faced with the choice, 

I would adopt a "sympathetic" reading, one which 

comports wiih dictates of fundamental ju.stice and 

recognizes that compassion need not be exiled from the 

province of judging. ... 

Poor Joshua! Victim of repeated attacks by an irresponsible, bullying, cowardly, and intemperate father, 

and abandoned by respondents [State officials} who 

placed him in a dangerou~predicament and who knew 

or learned what was going on, and yet did essentially 

nothing except, as the Court revealingly observes, "dutifully recorded these incidents in [theirJ files." It is a 

sad commentary upon American life, and constiJutional principles -- so full of patriotic fervor and proud 

proclamations about "liberty and justice for ail, "that 

this child, Joshua DeShaney, now is assigned tolive out 

the remainder of his life profoundly retarded. 1M 

Tragically, "child protection" too often is confused 

with investigation and the "dutiful recording" of 

incidents in files. By itself, access to the Federal 

courlS will not fc~olve lhi~ fundamental problem. It 

may not even lead to significant change in the 

specific system atissue in any particular case. Nonetheless, if Congress acts to overturn the Supreme 

36 ----------------------.- U.s. Advisory Board on Child Abuse and Neglect 

, 
Court decisions denying children access to the Federal courts to ensure that their right to protection is 

vindicatcd,165 such action will signal the seriousness 

oftbe rights involved, and itwill provide a vehicle for 

change in perceptions and motivation of the public 

and the professions about what needs to bc done to 

build a child-centered child protection system.l66 

g. Improving System Accountability on 

Behalf of Maltreated Children 

OfcoUIse, advocacy need not and indeed should not 

be limited to the courts. Other structures may be 

better suited to provision of ongoing opportunities 

for advocacy of children's wishes and interests and 

for oversight of State, County, and community programs. In that regard, the Board is pleased to note 

tbatin its last session Congress provided the Department of Justice with authority to provide challenge 

grants to States that develop ombudsman programs 

for children in out-of-home care. 167 Such programs 

have the potential not only to offcr a direct voicc for 

children to express their concerns but also to prevent, uncover, and remcdiate institutional abuses. 

Althoughfunding tofulfill the Congressional authorization for support to States for ombudsmen for 

children in out-of-home care would be an important 

first step, the Board encourages States to expand 

such programs to provide advocacy and monitoring 

on behalf ofall children, not just those in out-oj-home 

care. Experience abroad suggests that ombud~men for 

children can provide them with a sense oj empowerment and that such specifllized ombudsmen can stimulate attention by policymakers and the general public 

to conditions that endanger children. 168 

Beyond the formal structures for advocacy that 

government may provide or support for children 

who have been maltreated or who are at risk of 

maltreatment, private organizations also can play 

an important role. Through Child Watch and Kids 

Count programs and othcr citizen surveys and reviews of agencies in the child protection system 

(such as those sponsored by the Children's Defense 

Fund, the Junior League, the Annie E. Casey Foundation, and other private advocacy groups and foundations), volunteers can indicate collective responsibility and concern for the protection of children. 

Through citizcn oversight and monitoring of local 

u.s. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

courts, volunteers also can substantially increase the 

accountability of the juvenile and family courts and 

the various associated service systems. A1so, professional associations can assist in the establishment of 

standards that minimize the likelihood of child maltreatment, and they can conduct periodic reviews of 

facilities to determine their compliance with such 

standards. 

Indeed, regardless whether maltreatment occurs in 

families, community facilities (e.g., schools and day 

care centers), or out-of-homecare, closure to public 

scrutiny may be a necessary condition for its occurrence and recurrence.l69 Experimentationis needed 

with diverse regulatory strategies that may focus 

public or professional attention on the quality of 

care in facilities and programs (both residential, 

including family foster care, and non-residential) 

for children: 

· standards and procedures for licensing that focus 

on quality assurance and that provide guarantees of 

safety that go beyond the safety of the physical 

environment; 

· structures and procedures for investigation of complaints of child maltreatment in out-of-home settings (including community facilities); 

· structures and procedures for identification of 

conditions that may escalate into abuse or neglect in 

community facilities; 

· standards for unacceptable practices (c.g., psychological abuse) in facilities that are broader than 

those applied to families; and 

· statutes and regulations providing protection for 

staff who "blow the whistle" on deviations from 

established standards for care of children in facUities. l70 

Keeping in mind the central theme of taking children seriously, regulators should not overlook the 

need to ask children themselves about their experiences in various facilities. Administrators at Boys 

Town have reported an exemplary approach to such 

inquiries.17l Researchers conduct regular audits 

designed in part to uncover questionable caregiver 

37 
Neighbors Helping Neighbors 

38 

behavior, regardless of whether it fits legal definitions of abuse and neglect. All residents are interviewed periodically about staff behavior. Five hundred children are interviewed each year; such confidential interviews elicit an average of eighteen 

claims of impropriety, of which sixty percent are at 

least partially substantiated. The interviews are part 

of a much broader program of quality assurance, 

including staff performance evaluations based on 

child outcomes, and related training and supervision of staff. 

Even in confidential interviews, though, children 

may be reluctant to reveal misconduct of staff who 

are involved in their supervision and care. Accordingly, exit interviews when children leave care and 

retrospe<:tive surveys of fonner foster children and 

institutional residents may provide additional information about circumstances associated with out -ofhome abuse or neglect. 172 

Federal agencies that directly or indirectly support 

residential and non-residential programs for children could do much to promote the safety of children outside their homes by sponsoring or conducting studies of the effe<:tiveness of various regulatory 

strategies and diffusing such information among the 

States and the various professional associations. 

Al though evidence about the level of risk to children 

in various types of facilities and programs has been 

accumulating, 173 research on means of prevention of 

institutional child maltreatment is virtually nonexistent. [n that regard, experience with licensing of 

day care programs gives reason to believe that 

increased regulation of the social aspects of care 

(apart from assurance of the safety of the physical 

environment) may improve the quality and safety of 

children's care.174 On the other hand, studies of 

professional licensure more generally have provided little evidence that it promotes the quality of 

services.175 Other bodies of research, such as studies 

of professionals' (non)compliance with reporting 

laws,l7<i also may suggest hypotheses about the effectiveness of various regulatory strategies in various 

contexts. 

Federal agencies also should develop and evaluate 

standards for their own care of children in order to 

prevent maltreatment of children under Federal 

jurisdiction.177 Although such care has not always 

been exemplary, 17B Federal agencies are in positions 

to develop model programs for prevention of institutional abuse and neglect of children in communities of diverse ethnicity. Programs implemented 

and evaluated as a result of such efforts, when 

combined with the results of research comparing 

the effectiveness of various State models, would go 

far toward the development of a system to prevent 

maltreatment of children in out-of-home settings. 

6. Recommendations 

Recommendation 7 

Child protection programs at all levels should place 

increased emphasis on preventing child abuse and 

neglect and providing treatment for those involved. 

The ChildAbuse Prevention and TrealmenlAct, which 

requires investigatory mechani'ims but does not expressly require prevention and treatment as a condition 

of State grants, should be amended 10 mandate all 

three. 

Recommendation 8 

Federal, State, and County Governments should take 

all steps necessary to ensure that effective mental 

health treatment is available and accessible to abused 

andneglected children and theirfamilies. Care should 

be taken to ensure that such coverage is included in any 

new national health care program. 

(Specific options for fulfilling this recommendation 

can be found in CREATING CARlNG COMMUNrrIFS, 

supra note 7, at Recommendation D-3a.) 

Recommendation 9 

The Secretary of Health and Human SelVices should 

direct the NationallnstiJute of Mental Health and the 

Center for Mental Health SelVices to undertake a 

major initiative to generate knowledge about effective 

treatment and related selVice systems for abused and 

neglect children and to disseminate such information 

to mental healJh programs throughout the Nation. 

u.s. Advisory Board on Child Abuse and Neglect 

.. 
Recommendation 10 

Consistent with recommendations of the National 

Commission on Children, support should be provided 

/orexperimentation with various strategies/or increasing income support for impoverished families. In the 

short tenn, support should be provided for testing the 

effect of proViding flexible, individualized, material 

supports in ways that encourage selJ.sufficiency for 

impoverIShed families at high ri~k 

Recommendation 11 

Wah support by the Children's Bureau for testing and 

dissemination of effective models for recmitment and 

retention of foster parents of diverse elhnicity, States 

should take all steps necessary to professionalize family 

foster care. States should provide commensurate 

quality assurance, trainin& consultation, support services, payment, involvement in decision makin& and 

recognition for foster parents. 

Recommendation 12 

The Secretary of Health and Human Sen,ices should 

direct the Children '.'I Bureau, in collaboration with 

other relevant Federal agencies (e.g., health, mental 

health, and justice programs), to support research 

demonstration projects on alternative modeL~ of foster 

care. Such models (including kinship care, open 

adoption, whole-family foster care, and partial foster 

care) should involve accommodations to contemporary social realities andshould fit into a broadersystem 

of neighborhood-based support for troubled families 

and for children who have been maltreated orwho are 

at high risk of abuse and neglect. 

Recommendation 13 

The various agencies in the child protection system 

should give due respect to children's right to a family 

environment, as defmed in the u.N. Convention on the 

Rights of the Child. Specml efforts should be made to 

avoid separating children from theirfamilies unnecessarily. If a child is placed in out-ol-home care, special 

care should be taken, consistent with the child's safety, 

to maintain relationships the child regards as important sources of support. These may include biological 

parents and siblings, foster parents, adoptive families, 

or unrelated adults such as schoolteachers. 

U.S. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

Recommendation 14 

The Secretary of Health and Human SelVices and the 

Attorney General should encourage experimentation 

wiJh alternatives for pemtanency, including kinship 

care, guardianship, and long-term foster care, that do 

not require returning foster children to unsafe homes 

but that maintain relationships important to them. 

Recommendation 15 

Congress should amend the Child Abuse Prevention 

and Treatment Act to permit the Secretary of Health 

and Human SelVices to issue waivers to allow States to 

experiment with new standards for investigative responses to cases of suspected child maltreatment. The 

Secretary should direct the National Center on Child 

Abuse and Neglect or the National InstiJute of Mental 

Health, in collaboration with the Office of Justice 

Programs, 10 evaluate the effects of these experimental 

efforts. To the extent that changes prove successful, 

they should be incorporated into new standards for 

reporting and responding to cases of suspected child 

maltreatment. 

Recommendation 16 

State and Tribal courts and legislatures should seek to 

develop aliernative means of dispute resolution in 

cases related to child protection so that the process may 

stimulate or enhance family and neighborhood responsibility. The Attorney General should direct relevant unitsofthe Officeof Justice Programs, in consultation with the National Center on Child Abuse and 

Neglect, to support evaluation of such innovations. 

Results should be disseminated, especially among State 

and Tribal legislators, judges, and justice system administrators. Whenever appropriate, experimentation 

should be coordinated with work by multidisciplinary 

task forces established by Children's JusticeAct grantees. 

Recommendation 17 

The Attorney General should direct the OfflCe of 

lustice Programs to support research and demonstration programs to increase understanding of the way 

that children experience the legal process, and to find 

ways to increase their satisfaction with it. The goal 

39 
Neighbors Helping Neighbors 

40 

should be to make children ''partners in the pursuiJ of 

justice." Slate and local bar associations should use 

this knowledge to enhance the training of atlomeys and 

lay advocates who represent children in child protection proceedings. 

Recommendation 18 

State and Tribal legislatures should ensure that children have legal standing to file actions or appeal 

deci~ions, including dispositional orders, in matters 

pertaining to their protection and care. Congress 

should act to provide children with access to Federal 

courts to remediate any failure by States to exercise 

reasonahle efforts to protect children from hann and 

to promote stability in their lives. 

Recommendation 19 

In collaboration with the President of the Legal Services Corporation and relevant associations of lawyers 

and judges, the Attorney General should provide research, training, and fmancial support to improve the 

quality of representation of children in civil child 

protection proceedings. Such efforts should include 

development and dissemination of model court rnles 

and standards of practice to guide attorneys and guardums ad litem in their work. 

Recommendation 20 

With appropriation of necessary jwuis, Congress should 

require the States to establish an office of ombudsman 

for children, especially those in out-oj-home care, as a 

condition of receiving funds under Tille IV-E of the 

Socini Security Act. State legislatures should ensure 

that ombudsmen have Jullaccess to children in out-ofhome care and other public programs and facilities 

and that children have access to the ombudsmen. 

Legislatures also should ensure that ombudsmen have 

the independence necessary to represent children '5 

interests effectively. 

Recommendation 21 

Federal agencies that directly or indirectly support 

facilities providing out-oI-home care forch ildren should 

collaborate in gathering and disseminating knowledge 

about good practice, regulation, and other mechanisms that effectively prevent child maltreatment in 

these facilities. lhese agencies, including the Departments of Education, Justice, and Health ami Human 

Services, should then collaborate indeveloping, implementing. and evaluating standards and procedures to 

prevent instiJutional child maltreatment. 

EELEMENT 3: IMPROVING THE ROLE 

OF GOVERNMENT IN ADDRESSING 

CHILD MALTREATMENT 

1. The Need for Leadership 

In order to protect its children, the Nation must 

change in ways that are both broad and profound. 

When rdonn is needed in so many sectors of society, the task cannot be limited in totality or even in 

large part to a single agency, sector, or level of 

government. Indeed, as this report elaborates, the 

child protection system 119 might be best conceptualized 

as sodety as a whole. ISO Everyone has the opportunity and the responsibility to assist in theprotection 

of children from harm. The protection of children 

goes beyond the social service office, the police 

station, the courtroom, and the foster home. Child 

protection should become a part of everyday life so 

that every p/nce where children are is a safe haven. 

There can be disagreement about the limits of the 

responsibility of government and society as a whole 

to enhance the developmcnt of children. Everyone 

must agree, though, that children have a right, at a 

minimum, to protection of their personal security. 

That premise implies building a society in which the 

social and physical environments are so safe that 

they "demand" the protection of children. Sadly, 

however, the child protection system now has so 

many holes that often little guarantee of protection 

from continuing serious hann can be given even to 

those children whom the State has recognized as 

already abused or neglected -- sometimes even to 

those children whom the State has taken into its own 

care. 

A finn commitment should be made to adopt a 

National Child Protection Policy (see Appendix B) 

that would provide a framework for coherent and 

comprehensive government action to protect children from abuse and neglect. In partiCUlar, a focus 

U.S. Advisory Board on Child Abuse and Neglect 
on child protection should be adopted in the range 

of Federal agencies concerned with children and 

families. When the Federal Government itself has 

jurisdiction, child protection programs should be 

exemplary. More broadly, the Federal Government 

should establish a goal offacilitation of community 

efforts to protect children. 

Such action by Federal leaders is critical. As the 

Board noted in 1991, "Federal action alone is insufficientforthe social transformation that is necessary 

for the protection of children, (hut] it is also clear 

that such fundamental change cannot occur on a 

national scale without a reformation of Federal 

policy. Indeed, it is clear that community change -

- even more basically, comprehensive services for 

individual maltreated children and their families --

will remain difficult to accomplish without Federal 

refonn."181 

Federal leadership is needed for rescarch, training, 

and program development. The Federal Government also is active in financial support, and care 

must be exercised to ensure that funding is consistent with the proposed National Child Protection 

Policy. 

2. The Need for Change in Financing 

Thekinds of change that the Board is advocating arc 

hampered by inefficiency in the ways that funds 

currently are allocated. Leroy Pelton has made the 

point well: 

.. .{OJur child protection system, due to its CIJ.ffent 

orientation and structure, is incapable of providing 

much in the wayof preventive and supportive services. 

More funding, it is tme, is neededfor such services, but 

/imiJed funding has not been the only problem. '[he 

system has actually grown over each of the past two 

decades, with billions offederal, state and local dollars 

now flowing into foster care each year, and staffs 

having increased. Having started with an inappropriate orientation, the ~ystem 's budget is tied up in investigation and fosiercare, with little left for sen'ices. But 

then, due to lack of services, children are placed in 

fostereare, and a vicious cycle isgenerated, since more 

money is then needed for Jaster care. WiJhin this 

system, we never do get to a point at which much 

A New National Strategy for the Protection of Children 

money for selVices can be wrested from the sizable grip 

that investigation and foster care functions have on the 

budget. lin 

The problems with the financing f>ystem are of four 

types. First, as the preceding quote illustrates, the 

financing system offers substantial incentives for 

use of out-of-home placement without parallel incentives for provision of prevention senices, early 

Inten-ention, and intensive crisis interventionWhen 

the Federal Governmentprovides billions of dollars 

in reimbursement for foster care (under Title IV-E 

of the Social Security Act) but provides only a few 

million dollars a year for the whole country for 

community programs intended to prevent child 

maltreatment, the message is obvious for State and 

County program administrators, especially in a time 

of increasing fiscal f>train on State and County Governments. A similar message comes to health and 

mental health administrators who find that payers 

favor treatment over prevention and residential 

treatment over traditional outpatient treatment, 

and that payers favor home- and school-based services even less. 

Although most conscientious administrators endeavor to provide the most appropriate services fOT 

each child and family, the desire to do so can result 

in serious conflicts in tight fiscal times like those 

currently being experienced in many parts of the 

country. The present system not only provides 

perverse incentives in this context, but it also inevitablyfunnels much administrative time into figuring 

out how to get the most reimbursement from the 

Federal Government. Unfortunately, this endeavor 

distracts from the more important question of what 

is best for children and families. 

A recent additional example of misordered incentives came with thc 1992 amendment.;; to the Child 

Abuse Prevention and Treatment Act. 183 In those 

amendments, Congress required States to spend 

85% of their Federal fonnula grant for child protection on CPS improvement. Although the Board 

believes that funds for such efforts ultimately should 

be made available, CPS improvement should not be 

the first priority for use of limited Federal support. 

Congress should amend CAPT A so that States are 

not only free but indeed encouraged to spend their 

U.S. Advisory Board on Child Abuse and Neglect ------------------------ 41 
Neighbors Helping Neighbors 

42 

CAPT A allotment on prevention and treatment 

programs. Such an amendment should apply at least 

until funds are appropriated for broad-based prevention and treatment efforts in various sectors 

(e.g., public health, education) and full funding is 

provided for the CAPTA prevention program. 

Second, both public and private third-party payers 

tend to direct reimbursement toward easily countable services -- a day of foster care; an hour of 

psychotherapy -- rather than the individualized, flexible services that generally are most effective in 

families with multiple needs. Accountants may look 

in horror at services inVOlving multiple and non 

traditional components, delivered atwhatever place 

and time they are needed, that utilize non-professional providers, or vest expenditure authority in 

line workers. Nonetheless, that accountant's nightmare is the state of the art in prevention and treatment of child abuse and neglect, and a financing 

system that is structured arbitrarily for administrative ease is inefficient when it fails to produce positive results. 1M 

Third, the paths on which funds now flow impede 

neighborhood-based services. Although the rationale for the merger of funding streams into block 

grants was to reduce administrative costs and to 

bring decision making closer to the front lines, a 

major effect in human services was to move allocation of funds to a more remote leveL As State 

agencies became the primary grantees, community 

agencies lost their discretion in expenditures. Community health and mental health centers, for example, no longer were direct recipients offunds, and 

State agencies were relatively morc inclined to support programs of the type traditionally administered 

by States (e.g., institutions) for populations that they 

traditionally served (e.g., people with chronic mental disorders).185 Although categorization within 

fields was reduced, States had no incentives to merge 

funds across fields (e.g., to blend child welfare, 

mental health, maternal and child health block 

grants), and local administrators had no means to do 

so. 

Fourth, the "strings" placed on receipt of funds 

often are so rigidly categorical that they impede the 

development of comprehensive neighborhood-based 

services. In many communities, agency heads 

struggle to combine funding from multiple categories in order to offer integrated setvices. Multifaceted services needed forfamiJies with multiple problems, and anyone stream of categorical funds may 

be too small to develop effective programs in areas 

with low popUlation. 

Unfortunately, the integration of funding streams is 

not easy. Each has its own set of requirements, 

procedures, and regulations, which sometimes conflict For example, one Board member heard from 

a runaway shelter director who was trying to blend 

funds in order to establish a counseling program for 

young substance abusers. One source required 

payment by the client for setvices; the other prohibited the establishment of client fees. 

The maze of different and sometimes conflicting 

regulations interferes with coordination offrontline 

agencies. Much time is wasted by program administrators and their attorneys in attempts to discern 

whether and how they can work together to help 

particular families. 

At the same time, there is some utility in establishment of particular emphases in multiple Federal 

and State agencies. As the Board noted in its 1991 

report, the professions look to their "home" agencies for establishment of priorities, and they typically will not develop an emphasis on child maltreatment unless their agency counterparts do SO.I86 The 

strategy, as outlined in the 1991 report, must be to 

provide for special emphases in establishment of 

funding streams but to make it easy for neighborhood-level organizations to blend funds forcomprehensivc programs.1!!7 There ought to be child protection programs in the schools, for example, but neighborhood leaders should be left free to plan how they 

are established and integrated with other programs. 

In that regard, the history of service integration is 

that it has been successful when implemented 

through funds invested directly in neighborhoodlevel programs (e.g., Head Start) but not when 

attempted through negotiation across Federal and 

State agencies.l8S 

With varying levels of comprehensiveness and effectiveness, service integration, including coordinated 

funding, is the focus of numerous efforts in various 

U.S. Advisory Board on Child Abuse and Neglect 
domains at both Federal and State levels.189 Most 

notably, some States already have begun to take the 

steps that they can to reduce obstacles that funding 

"strings" place on the development of neighborhexxi-bascd services. An example of such efforts is 

New York State's Neighborhood-Based Alliance 

(NBA), which provides support for community 

projects to offer comprehensive crisis intervention 

ami/or case management services and at least two 

other specific neighorhood-based services.1

'Xl The 

law establishing NBA pennits State agency commissioners to approve waivers of any State regulations that impede NBA project~, authorizes a committee of the State Department of Social Services to 

identify existing categorical funding streams that 

might be blended in a single contract with the local 

projects and to fund programs to fill service gaps 

with the NBA appropriation, requires neighborhood-level planning with resident involvement, and 

provides for development of public-private partnerships.191 

If service integration is to work, local agencies need 

funds that are earmarked for such flexible programs.m Federal and State authorities must be 

willing to take a chance and to relinquish some 

control over decisions about how to deliver services 

most efficiently and comprehensively at the local 

level. The block-granting principle is sensible, but 

the recipientoffunds should be moved closer to the 

neighborhood level, or strings should be added to 

provide incentives for coordinated State-level allocation of funds in a manner consistent with neighborhood plans. Regardless of the level at which 

blending occurs, there also should be provision for 

integration of funds across sectors (e.g., education 

and mental health) as well as categorical programs 

residing within single agencies. 

Unfortunately, the political obstacles to a more 

sensible financing system are fonnidable. The various Congressional committees with legislative responsib iii tyfor the different programs affecting children and families generally guard their jurisdictiun 

with zeal. 1g3 That approach makes development of 

comprehensive solutions tocomplexproblems nearly 

impossihle, and it inevitably results in fragmented 

programs with sometimes conflicting rules. The 

options suggested by the Board in its 1991 proposal 

for Federal programs that would pennit developA New National Strategy for the Protection of Children 

ment of the strategy outlined in this report, 1"4 involved at least 11 committees and 17 subcommittees 

in the House. Twe~ve committees and 22 subcommittees would be involved in the Senate. A comprehensive strategy might require referral to all of 

them. 

Moreover, committee jurisdiction conflicts not only 

within but also across houses of Congress. For 

example, programs that would provide for integration of health and mental health services into the 

schools might be handled by a single committee in 

the Senate, but multiple committees probably would 

be involved in the House. Conversely, bills aimed at 

both the justice system and the child welfare (social 

services) system may fall within a single committee 

in the House but not in the Senate. Actually, even 

the child welfare system itself is the inevitable target 

of fragmented solutions, because categorical, problem-oriented programs lie in the committees with 

jurisdiction over humanscrvices, butthe "big-ticket" 

entitlement programs (e.g., foster care) are in the 

province of the committees whose primary focus is 

on taxation. 

Although the Board recognizes that wholesale reorganization of Congress is outside its reach, it does 

implore Congress to take the necessary organizational steps to develop a comprehensive new approach to child maltreatment, a problem of extraordinary significance and urgency. It should do so in 

a manner that avoids unduly fragmented and incfficientfinancing and that provides fiscal incentives for 

development and implementation of neighborhoodbased programs that are consistent with the National Child Protection Policy proposed by the Board 

(reprinted in Appendix B). 

3. The Need for Involvement 

The Board continues to believe that the Nation 

needs Federal child protection programs that are 

"sufficiently intensive and diverse to provide communities with the support that they need to develop 

a comprehensive neighborhood-based, child-centered, and family-focused approach to child protectioO."195 At the same time, the Board has been 

gratified by some of the steps taken in various parts 

of the country to attempt to create caring oommun;-

ties. Infonnal hearings and informal discussions, we 

u.s. Advisor)" Board on Child Abuse and Neglect ------------------------ 43 
Neighbors Helping Neighbors 

44 

also have been struck by the degrec of consensus 

about the national emergency in child protection 

and the need for a new neighborhood-based strategy. 

Accordingly, although the crisis in child protection 

is grave and worsening, we have seen signs of action, 

especially in the voluntary sector, that give some 

reason for optimism. Notably, althoughnoStateyet 

has fulfilled the Board's previous centerpiece recommendation for universal voluntary neonatal 

home visitation for the purpose of prevention of 

child abuse and neglect, 196 the majority of States 

have made progress toward such a goal The Healthy 

Families America initiative of the National Committee for Prevention of Child Abuse (funded by the 

Ronald McDonald Children's Charities) has been 

an important stimulus for such efforts and probably 

the most important direct result of the Board's 

previous work. l97 Moreover, several national religious (e.g., the Southern Baptist Convention), civic 

(e.g., Kiwanis International), and professional organizations (e.g., the American Bar Association and 

the American Psychological Association) have 

placed child protection at or near the top of their list 

of priorities -- in some instances as a direct response 

to the Board's recommendations in its 1990 report. 

Leadership by public officials would go far toward 

making such efforts commonplace. The Board calls 

on the President, the Members of the Cabinet, the 

Governors, the Mayors, and other public officials to 

guide Federal and State agencies in the facilitation 

of community efforts and to promote grassroots 

action to protect children. 

4. Recommendations 

Recommendation 22 

The Federal Government should establish a National 

Child Protection Policy (seeApperuiixB). Thegoalof 

the policy should be to facilitate comprehensive community efforts to ensure the safe and healthy development of children arui youth. The policy should be 

incorporated into the United States Code as an intrinsic part of the Child Abuse Prevention and Treatment 

Act. The policy should drive the child protectionrelated activities of aUFederal agencies. State Governments should establish aMlogous State Child Protectum Policies. 

Recommendation 23 

Congress should act to build a financing system consistent with a comprehensive child-centered, neighborhood-based, family-focused child protection system. 

To that end: 

· The CongressioMlleadership should work to minimize fragmented committee jurisdiction that impedes 

integration of funding streams. 

· Congress should reaUocate existing resources from a 

focus on supporting the costs of out-oi-home placement to a focus on prellentive, ''front-erui,'' intensive, 

aruf comprehensive sen:ices, with emphasis on neighborhood-based sen:ices. 

· Congress should provide for increased flexibility for 

blendingfunds across sources and categories, provided 

that such integration is consistent with State and Neighborhood Child Protection Plans. 

· Until Congress provides substantinl funds in various 

sectors for prevention and treatment of child abuse and 

neglect, the Child Abuse Prevention and Treatment 

Act should be amended to permit -- arui indeed to 

encourage -- States to spend their allotments for the 

purpose of prevention and treatment, not CPS improvement. 

· Wheneverfeasible, Congress should provide for direct 

grants, rather than reimbursement for unit-based services, to neighborhood programs for the purpose of 

strengthening families arui prevention aruitreatmen! 

of child abuse and neglect. Accountability should be 

ensured through evaluation based on outcome rather 

than simple quantifICation of sen:ices provided. 

U.S. Advisory Board on Child Abuse and Neglect 
F. ELEMENT 4: REORIENTING 

SOCIETAL VALUES THAT MAY 

CONTRIBUTE TO CIIILO 

MALTREATMENT 

1. Preventing Violence Against Children 

Much of the discussion thus far has been related to 

social and political structure -- the ways that governments relate to neighborhoods, that services are 

organized and financed, and that roles arc defined 

for various sectors of society. The challenges involved in accomplishment of the structural changes 

necessary for an effective, comprehensive child protection system arc great. 

If the political consensus required for such sweeping 

change is to be achieved and jfthc structural reforms 

arc to have their optima! effect, then there also must 

be a refonnation of values in OUf culture. The idea 

that children ure persons deserving of respect must 

become a fundamental premise guiding not only 

public policy but also our daily life. Whatever its 

specific form, maltreatment involves a violation of a 

child's integrity as a person; assault, exploitation, or 

deprivation of the necessities of life is a personal 

violation. The lack of a concerted societal response 

-- in particular, the lack of a response that shows an 

appreciation of the seriousness of the problem and 

a sensitivity to children 'sown needs and experiences 

-- compounds the violation. 

In both public and private life, adults must learn to 

listen to children, to give the support necessary to 

enable children to recover from maltreatment, and 

to organize neighborhood life so that the probability 

of maltreatment is minimized. This reorientation 

will be facilitated by clear public policy that shows 

due concern for the right" of children. In that 

regard, the Boardurges President Clinton promptly 

to sign the U.N. Convention on the Rights of the 

Child and theSenate then tomtify itwithduespeed. 

That the United States stands nearly alone among 

the world's democracies in its lack of formal 

affirmation of the human rights of children should 

be regularly on the front page of every newspaper-

- but this lapse in Federal policy has failed to elicit 

even a mention in most of the Nation's newspapers 

A New National Strategy for the Protection of Children 

and broadcast media. As far as we arc aware, 

reporters never asked any of the candidates in the 

1992 Presidential election about whe ther theywould 

sign the Convention. The need is clear for a transfonnation of public attitudes -- and of the media that 

help to shape such attitudes. 

The inadequate concern for the dignity of children 

may reflect insufficient regard for humanity and 

community. In particular, it is hard to discourage 

child abuse in families when violence is widespread 

in the society. Community violence and family 

violence are strongly correlated in their prevalence, 

and they both probably are related to the cultural 

acceptance of violence. Marian Wright Edelman 

has starkly described the significance of this relationship for America's children and families: 

The evil /mit of .. unchecked tra frICking in guns abound::.' 

all around IlS. More than 400,000 students were 

victims of violent crime at school during a six-month 

period in 1988-1989. Funerals of young men -- victims 

and victimi::ers -- and unlucky, innocent, child and 

adult casualties of random violence have become 

weekly rituals in inner-city churches. Some public 

hospital trauma centers on Saturday nights resemble 

MASH units as black and Latino youths seek solace in 

death from their living helL~ of hopelessness and welessness in an uncaring nation. More young black men 

die each yearfromgunshotwounds than from aliofthe 

lynchings throughoutAmerican history. The sound of 

gunfve is so common that in too many neighborhoods 

young children can divcriminate between the soundsof 

semi-automatic weapons hefore they can discriminate 

between colors. 

Our inner-city war zones are jw't a microcosm of the 

larger American worship of violence that has become 

a leading national pastime and primetime obsession. 

Guns exceed television sets as American playthings. 

The Wild West has turned into the wild streets in an 

American culture that hawks violence over the airwaves as adults kill children and children kill each 

other in movies and in real life. VIOlent acts are the 

daily fare of millions of children who watch IV an 

average 0/21 hours a week. IV Guide report'! a violent 

incident is shown, on (l\'erage, eve'), six minutes. In real 

life, a child is reported ahused or neglected every 13 

seconds, mostly at home. 19R 

U.S. Advisory Board on Child Ahuse and Neglect -------------------------- ·15 
Neighhors Helping Neighbors 

As Edelman concluded, the moral and social costs 

of such violence are likely to be enormous: 

I can only imagine andguess at the fear, anxiety, daily 

burden of stress, and loneliness of huge numbers of 

ymmg children who each day navigate a dangerous no 

man's land peopled byamledgangs, drng dealers, and 

nelVOUS youthful gunslingers seeking to preempt death 

by [lTst strike. While human beings can learn toaccom· 

modate some degree of threatened violence and fear if 

there is purpose and hope of change, the chronic, 

unrelenting assault we are subjecting our children to 

and lettingothers subject them to is unprecedented atui 

profoundly immoral. And we'll pay now and later as 

theypaywilh their childhoods, with their dreams, and 

with their lives. 199 

The answer is both local and cultural: 

.. 1M/ost urgently and importantly, if we want our 

children to grow up re5pecting and valuing human life, 

we must begin by respecting arul valuing theirs by 

making their neighborhoods and schools zones of 

safety and nurturance rather than zones of fear. We 

must stop the proliferation of guns in the hands of 

children and adults alike. We must encourage every 

school to adopt anti-violence arul conflict resolution 

curricula and begin study groups in our re[jgioLL~ 

congregations and work plnces to find ways to staunch 

the violence rampant in our Iwmes. And we must 

address the underlying causes as well as the destrnctive 

symptoms of violence: the lack of hope and opportunity, the lack of strong families and communiJies and 

a sense of future. 2OO 

As a society, we havc the power to tum away from 

violence, just as many of us have turned from smok· 

ing, drunk driving, and use of illicit drugs. A generation ago, smokers had free reign in most public 

places, and people who did not like cigarette smoke 

usually suffered in silence. Today, however, smoking is no longer widely perceived as glamorous; 

instead, itis viewed as a threat to the public health, 

and smoking is prohibited or rcstricted in many 

public places.wl 

lbis shift in public attitudes did not occur by chance. 

It happened as a result of extensive, multifaceted 

public awareness campaigns by advocacy groups, 

educators, and government leaders and of regulation of advertising of tobacco products. 

The messages about violence in the mass media and 

society at large are much more complex and confusing. Obviously, it is against the law to perlorm 

violent acts, and those who do so may be arrested. A 

foreign viewer of American television and movies 

might wonder, however, whether we really view 

violence negatively. The vivid, lurid portrayals of 

violence and the high box office receipts and advertising dollars that they command indicate that many 

people apparently enjoy watching violence, even 

though a huge body of research tells us that violent 

movies and TV programs increase the tendency 

toward aggression by some people.202 Violence is a 

major public health problem, at least as dangerous 

as smoking (especially among youth), and it is far 

more likely than smoking to harm someone else 

seriously. 

During periods in American history when the Nation was threatened by war, glorification of violence 

may have seemed justifiable as a means ofmotivating young men to defend our country. Such a need 

is not present today. On the contrary, our national 

survival is threatened not by a foreign power but 

instead by violence among our own citizens·· adult 

against adult, adult against child, child against child, 

and child against adult. 

It is time to generate the same kind of effort to 

deglamorize violence as we have applied to smoking 

and drinking of alcohol. We urgently need leaders 

in government, the mass media, the arts, the schools, 

the churches, mosques, synagogues, and other institutions important in shaping public opinion to guide 

our society in the replacementofviolencewith more 

creative and less destructive means of resolving 

cDnflict·- to offer role models who are smarter and 

more humane than the gun·toting, brute·force examples of the past. We are no longer a frontier 

U.S. Advisory Board on Child Abuse and Neglect 

JIll"" 
society; we have become a complex, highly urbanized, multicultural society in which our collective 

survival depends on being able to teach effective, 

civilized ways to cope with frustrations and to resolve differences. 

Some steps toward removal of gratuitous violence 

from the airways already have been taken in response to legislation waiving antitrust law for three 

years so that the three major networks could plan 

jointly to reduce violence on television.203 The 

networks have agreed to a Statement of Principles 

that obligates them to take special care to avoid 

mixing sex and violence, depicting violence as glamorous or an acceptable response to conflict, or 

showing violence during times that children are 

likely to be watching. 

The Board applauds Congress for providing the 

nudge to the broadcast industry to take these steps 

and the major networks for responding. We call on 

the remaining networks, cable systems, and independent producers to join in the Statement ofPrinciples. We hope that Congress and the public at 

large will continue to advocate for a national consensus that violence -- especially violence against 

children -- is unacceptable and to monitor the media's 

performance in promoting such a view. 

Meanwhile, the media themselves, in collaboration 

with leaders of religious, civic, and professional 

organizations, can do much to communicate the 

message that violence against children is wrong and 

that alternative means of discipline are available. 

Such efforts should be directed toward organizations' own members as well as the general public.204 

There are numerous potential opportunities to educate and mobilize the public to take creative action 

related to reduction of violence: e.g., school, business, and civic-club newsletters; church pulpits; 

media public service announcements, editorials, 

and feature stories; speeches by government and 

professional leaders. Mad Dad::;, a grassroots community organization in Omaha, recently joined with 

the police and the business community in a particularly creative effort in which an amnesty occurred 

A New National Strategy for the Protection of Children 

and a reward was paid not only for working firearms 

but also for toy guns that were turned into the 

police.205 

With the extraordinary level of violence in our 

society, the United States should be a leader in the 

worldwide movement to end violence against children. Five European countries now ban corporal 

punishment altogether, and most European countries do so already in the schools.:XX; In those countries, campaigns are underway to educate the public 

about such prohibitions and to attempt to expand 

them. In the United Kingdom, for example, a 

coalition of more than thirty national organizations, 

including the pediatricians and home health visitors, 

have united to sponsor national No Smacking 

Weeks.'lff7 

Although intolerance of violence against children 

ought to become a value throughout the culture, a 

special focus on the schools is warranted. Such a 

focus is consistent with the Board's general thrust 

toward development of neighborhoods safe forchildren, Nowhere are youth more likely to be physically assaulted than at school.208 It is not surprising, 

therefore, that many students report often being 

afraid at school.209 Schools that are unsafe are 

typically not only in unsafe neighborhoods that lack 

cohesion, but they also tend to be punitive, impersonal, and unresponsive to the community and the 

needs of their students.210 

Moreover, schools have an important role in modeling and directly teaching parents and children that 

effective nonviolent means are available to resolve 

conflict. 211 Parenthood education and school mediation programs may have long-term effects in prevention of violence against children. 

The American public may be ready for such messages, in that the trend over the past several years has 

been toward decreasing acceptance of both corporal punishment and verbal attacks on children. AJthough the majority (53% in 1m) of American 

parents report having hit their child in the past year 

(8% with an object). the proportion has been 

showing a steady decline in recent years. 212 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 47 
48 

2. Preventing Sexual Exploitation of 

Children 

The message to be communicated is les,,<; c1ear213 

and, therefore, the task is more difficult, but there 

also is good reason to believe that the answer to 

reduction of the high frequency of sexual abuse of 

children lies in changes in societal values. The 

message must be simply given that sexual exploita· 

tion of children is wrong. Although direct evidence 

is lacking, it is plausible that this message, if it were 

repeated frequently by cred ible sources (as occurred 

with smoking),214 would at least weaken the cognitive distortions (analogous to rape myths) that underlie the actions of many sexual offenders against 

children. 215 Indeed, it is plausible that the 

sexualization of children in some entertainment 

media has sometimes contributed to those distortions. One thing is clear however; much still remains 

to be learned about the causes and means of preventing sexual abuse. 

The ultimate shift in values that the Board believes 

is required may require a more complex message, 

though, than simply that sexual abuse is wrong. It 

also may require diverse means of communicating 

new values. In speculating why known sexual abusers usually are men but the majority of child victims 

are female, David Finkelhor has noted four points: 

· Women learn earlier and milch more completely to 

distinguish between sexual and nonsexual forms of 

affection. 

· Men grow up seeing heterosexual success as much 

more important to their gemier identities than women 

do. 

· Men are socwlized to be able to focus their sexual 

interest aroumi sexual acts isolated from the contexJ of 

a relationship. 

· Men are socialized to see as their appropriate sexual 

partners persons who are younger and smaller than 

themselves, while women are socwli::ed to see as their 

appropriate sexual partners persons older ami larger. 216 

Finkelhor has described several i m plicati ons of these 

observations: 

First, men might benefit from the opportunity to practice affection and dependency in relationships that did 

not involve sex, such as male-to-male friendships and 

nwturant interaction wiJh children. Second, the accomplishment ofheJerosexualsamight bede-emphasized as the ulJimate criterion of male adequacy. Third, 

men might learn to enjoy sexual relationships based on 

equalily. Men who are comfortable relating to women 

at the same level of maturity and competence will be 

less likely to exploiJ children sexually. As men's relations wah women change, so will/heir relations with 

children. 217 

Although research is needed to detennine how best 

to prevent the sexual exploitation of children, 

Finkelhor's general approach is consistent with developmentand monitoring of media messages about 

sexuality and gender roles so that childrcn are not 

perceived as objects of sexual pleasurc. It also is 

compatible with the Board's broader neighborhoodbased approach. As Finkelhor has argued, as men 

take more responsibility for children, "men may 

well come to identify more closcly with children's 

well-being and learn how to enjoy deeply affectionate relationships that have no sexual component. 

This step may be one of the most important we need 

to take toward transfonning men from offenders 

against children to defenders of their well-being. "218 

3. Accepting and Valuing the Cultural 

Heritage of the Child and Family 

Part of the richness of our society stems from the 

variety of peoples that have contributed to our 

nation's collective culture throughout our history. 

Our land has been, and continues to be populated by 

people with very different backgrounds, who have 

brought different languages, music, foods, values 

and traditions, While many cultural groups have 

been assimilated over time, their arrival has often 

generated conflict and misunderstanding, and racism and prejudice have often been serious obstacles 

to assimilation when different races are involved. 

Often children in minority or immigrant families 

may experience substantial conflict between the 

traditional culture of their parents and the dominant 

culture they see all around them in the larger community. This can cause stress, depression and feelings of low self worth. 

U.S. Advisory Board on Child Abuse and Neglect 
It is essential for child protective and other human 

service agencies serving multicultural areas to develop and demonstrate a sense of cultural competence -- a sensitivity, appreciation and understanding of traditions, values and childrearing practices 

among the cultural groups with which they work. 

Cultural competence is in fact important as a matter 

of ethics. A child-centered child protection system 

takes cognizance of individual differences, including those related to cultural background. It also 

shows appreciation of diversity in the range of relationships that children and parent') of various cultural backgrounds are apt to regard as fundamental. 

Even if respect for cultural differences were not an 

ethical mandate for workers in the child protection 

system, it would be important as a practical matter. 

Design of effective prevention and treatment requires great sensitivity to cultural differences and 

ability to incorporate such experiences and perspectives into one's own behavior and world-view. 

Indrawing that conclusion, the Board does not want 

to leave the impression that child maltreatment is a 

pattern of behavior endemic to particular cultural 

groups. Families of color are overrepresented in 

child protection caseloads,219 but ethnicity (apart 

from social class) appears not to be an important 

causal factor in child abuse and neglect. 220 Rather, 

families of color are more susceptible to intrusive 

interventions,221 and ethnic-minority families also 

are substantially more likely than white, non-Hispanic families to be subject to poverty.222 

Concern with culture is an important element of 

service design for several reasons. First and most 

obviously, if workers do not recognize and accommodate to the wltural Significance of communication patterns, family and community boundaries, 

and helping, disputing, and childrearing practices, 

senices are likely to seem foreign and to be relativelyunhelpful. Withoutan appreciation of clients' 

experience, workers are apt to find even the initiation of interventions to be difficult. 22J 

This general point is likely to have special significance in a neighborhood-based service system. Such 

efforts are more likely to be successful if residents 

A New National Strategy for the Protection of Children 

believe that they "own" them -- in terms of both 

decisionmaking control and definition of community needs -- and the means that are chosen to 

facilitate neighbors' help for each other are culturally compatible. 

A good analogy is to segmented marketing.224 Just 

as businesses find their message to be more persuasive if they match it to the experiences and needs of 

particular communities, so too will messages about 

child protection. 

Second, failure to recognize the richness that comes 

with diversity may result in overlooking potential 

solutions to problems of child protection. An interesting example of the possibilities comes from 

New Zealand's family group conferences, which we 

discussed in regard to justice-system reform. In 

responding to the particular needs of Maori families 

and communities, the government discovered a process that has proven also to stimulate family and 

community responsibility for families of European 

origin. Similarly, ethnic-minority communities' traditional involvement of extended families and neighborhood institutions (e.g., churches) in childrearirif 

may provide clues to workable alternatives to foster 

care that may fit current socioeconomic conditions 

in the society as a whole better than the nineteenthcentury model on which family foster care is nO\\o' 

built. There may be other lessons in some ethnic· 

minority groups' traditional approach to reconciliation and healing, such as Native Hawaiian 

ho 'oponopono and American I ndianta/king circles. 22Ii 

The latter provide a way to bring members of an 

extended family together in a manner that allows 

each person to contribute to a solution and to be 

heard with respect. 

Third, because of the central significance of low 

neighborhood quality and low self-esteem in the 

factors causing child abuse and neglect, appreciation of wltuml diversity may have a direct link to 

prevention and treatment. As suggested in statements to the Board, = an understanding of their 

cultural heritage can be an important step for young 

minority men and women struggling to overcome 

feelings of disconnectedness, lack of hope, and low 

self-esteem. Such a step can help to overcome onc 

U.S. Advisory Board on Child Abuse and Neglect ------------------------ 49 
Neighbors Helping Neighbors 

50 

of the greatest tragedies of prejudice, which is that 

its victims too often begin to believe its negative 

messages. 

Accordingly, schools, churches, community development agencies, and other neighborhood institutions should take special care to reflect the strengths 

of the cultures they serve in their teaching materials, 

staff composition, visual displays, meals, and festivals. Parents and neighborhood leaders of different 

cultures should be encouraged to share their backgrounds and stories. Reductions in the isolation, 

low self-esteem, and bitterness that result from 

racism can be expected also to reduce family instability, alcoholism, and other problems associated 

with child maltreatment. 

Founh and most subtly (but perhaps also most 

fundamentally), national and local commitments to 

substitute community fordi~ision among racial and 

ethnic groups may go far toward enhancement of 

economic opportunities in ways that facilitate growth 

of a sense of persona) control and that provide 

neighbors with sufficient resources that they are 

enabled to help each other. The dominant culture 

tends to judge minorities by the degree of their 

"Americanization" -- how well they speak English 

or whether they speak it at all, and how much they 

are like "us" in various other ways. The tcndency to 

interpret differences in skin color, appearance, custom, and outlook as "problcms" often prevents 

recognition of differences that could make the society as a whole far richer and more effective. It is 

plausible that such a perception also deters the 

investment of money and human resources necessary for economic viability of ethnic-minority neighborhoods. 

Cultural competence must be viewed from both an 

agency and an individual perspective. At an agency 

level,cuitural competence involves more than merely 

training the staff of one culture to understand the 

clients of another; it means building a staff which 

incorporates the major cultures served. Cultural 

competence is nota substitute for affirmative action 

in employment; rather it requires such affinnative 

action. The Board believes cultural competence at 

an individual level is most likely to resultwhen staff 

members representing different cultures have the 

opportunity to sensitize and learn from each other. 

4. Recommendations 

Recommendation 24 

The new President should act promptly to sign the 

Convention on the Rights of the Child and should 

submiJ iI to the Senate wilh appropriate reseroations, 

understandings, and declarations to adapt the Convention to theAmerican federalist system. The Senate 

then should act wilh aU deliberate speed to ratify the 

Convention. Evenbefore the Convention issigned and 

ratified, States, Tribes, Counties, and municipaliJies 

should adopt iJ as a set of principles to guide their 

policies affecting children. 

Recommendation 25 

The various television networks and producers should 

join in resolving to diminish the level of violence on 

television. Congress, relevant professional associations, and the general public should join in advocacy 

for such change. 

Recommendation 26 

Civic, poliJical, and religious leaders should unite in 

proclaiming the message that violence, especially violence against children, is an unacceptable means of 

resolving conflict. Professional associations should 

join in this message and in education of their members 

and the general public about nonviolent means of 

discipline and dispute resolution. 

Recommendation 27 

Congress should make receipt of Federal funds by any 

program or facility contingent on prohibition of corporal punishment wilhin iI. 

(The Board reiterates us strung endor:sement of Recommendation B-3 in CREATING CARING COMMUNITIES, 

supra note 7.) 

U.s. Advisory IkJard on Child Abuse and Neglect 

" 
Recommendation 28 

Every school should emphasize, facilitate, and teach 

rumviolent approaches to conflict resolution. This 

philosophy should be reflected in the school's discipline policies, Us COlUSes, and Us athletic programs. 

Relevant Federal and State agencies, including the 

u.s. Department of Education, should stimulate the 

development, evaiulltion, and broad-scale implementation of such approaches. 

Recommendation 29 

The Secretary of Health and l/uman Sen;ices should 

direct the National Institute of Mentaillealth, or the 

Nationaiinstitute of Child llealth and Human Development, to undertake an initiative for research on ihe 

relation of public allitudes to the problem of sexual 

abuse and on means of community change consistent 

with its prevention. In the meantime, civic, professiona~ and religious leaders, as well as celebriJies in 

entertainment and sports, should join to promote 

healthy attiludes toward sexuality and 10 promote 

respect between the sexes, particularly by men for 

women. 'lhe media also should make speciaL efforts 

not to communicate messages that condone or encourage child sexuality or the sexual exploilation of 

children. 

Recommendation 30 

Schools, churches, community development agencies, 

and other community organizations should strengthen 

their efforts to represent and celebrate the cultures they 

serve by enlisting parents and community leaders of 

diverse backgrounds in planning various cultural appreciation events. The goal should be to foster greater 

appreciation for cultural diversity, inchuling both pride 

in one's own culture and respect for the cultural 

backgrounds of others. 

Recommendation 31 

In all child protection activiJies, including graduate 

and professional education, cultural competence should 

bean emphasis. Efforts should be made to incorporate 

tradilional means of helping and dispute resolution 

whenever appropriate. Cultural competence should 

not be a substilute for affirmative action in employA New NationaJ Strategy for the Protection of Children 

menl; diligent efforts should be exercised to build a staff 

that represents the neighborhoods and cultures served. 

G. ELEMENT 5: STRENGTHENING AND 

BROADENING THE BUILDING OF 

KNOWLEDGEABOUTCIDLD 

MALTREATMENT 

1. The Need for Federal Leadership in 

Research 

Research to guide child protection policy and practice has been so limited that important decisions-· 

decisions that sometimes are oflife-or -death significance -- often are based "on mere hunches."228 The 

lack of strong Federal leadership in research on 

child abuse and neglect --as manifested by problems 

in both the level of investment and the quality of 

research management -- has been a matter of continuing concern to the Board. The Board has emphasized that a high priority should be placed on the 

improvement of the Federal effort in the generation 

and diffusion of knowledge about child abuse and 

neglect, including: 

· the establishment of new, appropriately funded 

programs for research and research training; 

· the development of a data system sufficient to 

provide an accurate, uninterrupted, comprehensive 

picture ofthe problem of child maltreatment, aswell 

as the response to it, throughout the Nation, and 

· the implementation of structures and procedures 

for research managementconsistent with the expectations of the scientific community.229 

In preparation for this report, the Board commissioned six comprehensive reviews and analyses of 

empirical research relevant to the creation of a 

comprehensive child-centcred, family-focused, 

neighborhood-based child protection system.no In 

the summer of 1991, the Consortium on Children, 

Families, and the Law, a group of interdisciplinary 

centers affiliated with universities and professional 

associations across the United States, conducted a 

symposium to consider the key elements in the 

Board's strategy.131 Meanwhile, the American Psyu.s. Advisory Board on Child Abuse and Neglect ------------------------ 51 
r 

Neighbors Helping Neighbors 

52 

chological Association commissioned several work 

groups to study the state of knowledge and practice 

in different domains related to child protection.232 

These reviews by leading scholars in the field have 

produced a dismaying list of gaps in knowledge 

germane to the strategy that the Board is proposing: 

· Evaluations of neighborhood-level interventions 

are largely unavailable. 

· The mechanisms for effects of neighborhood quality (apart from social class) on rates of child maltreatment are largely unstudied. 

· Little research is available on the effects of different neighborhood patterns (e.g., "old," often ethnically homogeneous urban neighborhoods in the 

N ortheastversus more diverse and often less densely 

populated neighborhoods in Western metropolitan 

areas) and community composition on family functioning and support in general and child maltreatment in particular. 

· Few stlldies of cultural issues related to child 

maltreatment disentangle race or ethnicity from 

social class, examine cultural groups within racial 

groups, or link particular cultural practices or values 

to child maltreatment, including "protective factors" that diminish the likelihood of maltreatment. 

· Few studies have directly assessed "the nature of 

the social isolation of maltreating families, the dimensions of social support that arc likely to prove 

most beneficial tothem, the interpersonal resources 

they can draw on, or the efficacy of social support 

interventions."lli 

· Little is known about the perceptions that maltreated children and their parents have of the child 

protection system; indeed, few studies are available 

of maltreated children's experience of their environment at all. 

Some of these gaps in knowledge have remained 

huge because of Federal policy that in practice 

virtually excluded support in recent years for research on cultural, social, and economic factors 

related to child maltreatment and other important 

social problems. The Board is pleased to note that 

there are some signs of reversal of this policy (e.g., 

greater breadth and sophistication in the research 

priorities of the National Center on Child Abuse 

and Neglect234; pending initiatives in the Public 

Health Service for research on violence). Much 

larger strides are needed, though, and the Board 

hopes that the new Administration will place due 

emphasis on generation of knowledge necessary for 

effective provision of social and material supports 

for prevention and treatment of child abuse and 

neglect. 

2. The Need for a Child-Centered Approach 

to Research 

AI though societal and neighborhood research should 

be emphasized, researchers and policymakers also 

should adopt a more psychologically-minded (childcentered) approach. They should learn about 

children's experiences in both existing and demonstration programs and systems, and they should 

consider the effects of child protection policies and 

practices on relationships important to children and 

on other variables identified as important by children themselves. 

In consideration of research topic, design, and conclusions, care should be taken to ensure the consultation of neighborhood residents. Although there is 

special reason to learn about children's own experi· 

ences in the child protection system, that fact should 

not obscure the need to consider the opinions of 

other constituencies who might be affected by research -- caseworkers, parents, foster parents, and 

so forth. 

More generally, an experimental attitude should be 

adopted. Although existing knowledge gives ample 

reason to believe that fundamental change is needed 

in the child protection system, the gaps in knowledge 

are large enough that the process of refonn should 

be incremental. In that connection, the Board's 

recommendation in regard to Prevention Zones--

our # 1 recommendation in this report -- is impor. 

tant in part because such model neighborhoods 

would offer opportunities to test ideas about the 

critical steps in preventing child maltreatment. 

u.s. Advisory Board on Child Abuse and Neglect 
Dramatic action is neressary to alleviate the national emergency, but diligence and zeal need not 

preempt care. Child protection is important enough 

to demand extraordinary effort, including extraordinary care to ensure the quality of programs for 

child protection. Evaluation should become routine. Resources should be setaside forthatpurpose, 

and "fine-tuning" of State and community child 

protection plans to respond to evaluation findings 

should be ongoing. 

3. Recommendations 

Recommendation 32 

Federal agencies should ensure that child protection 

activities supported with Federal funds are subjected to 

rigorous evaluation, that funding decisions about demonstraUon grants are based in part on the proposed 

projects'potential contribution to knowledge, and that 

findings of such studies are applied in the design and 

implementation of programs in the child protection 

system. 

Recommendation 33 

In collaboration with other Federal agencies as relevant, the National Institute of MentallfeaiJh should 

solicit research, including research demonstrations, to 

clarify the rekltionships among social support, material support, cuiJure, and child maltreatment. 

Recommendation 34 

Relevant Federal agencies should encourage research 

that assesses (1) children's, parents', neighbors', and 

workers' own experience of the contexJ in which child 

maltreatment occurs and (2) their perceptions of the 

systemic responses to the problem. 

ENDNOlES 

"%e &ard's emphasis in this rcgard is compatible with the 

broader fanrilysupport, family preservation, and child welfare 

reform movements currently occurring within American social 

welfare. See infra Section IV. 

A New National Strategy for the Protection of Children 

6JJAMES G.-IRIJARINOETAL, NOPL4CETOBEA CHlW: GROWING Up 

INA WAR ZONE 149 (1991). 

"'See, e.g., Garbarino & Shennan, supro note 1; Garbarino & 

Kostelny,suptU note 42. 

MSee genero1Jy JAMES GARBARINO ET At., CHrrDREN IN DANGER: 

CoPING wrrn TIlE CoNSEQUENCES OF CoMMUNnY VIOlENCE 

(1992); seealso Eleanor E. Macooby et aI., Community InugratUm and the SodaJ Control of Delinquency, in PREVENTION OF 

DElINQUENCY: PRoBlEMS AND PRCXJRAMS 300 (1968) (showing 

relation between neighborhood cohesiveness and the rate of 

juvenile delinquency). 

66FAMIUES FIRST: REPORT OF TIlE NATIONAL CoMMISSION ON 

AMERICA's URBAN FAMIUES 1 (Jan. 1993). 

67f'or example, Parents Anonymous of New Jersey and the 

Urban Women's Center are collaborating with support from 

the New Jersey children's trust fund to establish a safety zone 

in the west ward of Trenton. 

68Unrelated adull~ can have a powerful effect on children's 

development. See MONCRIEFF CocHRAN ET AL., ExTENDING 

F AMIUES: THE SacrAL NEIWORKS OF PARENTS AND 1lfEIR Om.-

DREN (1990); Moncrief{ Cochran & Jane Brassard, ChildDeveIopmenl and Personal Social Networks, 50 CHrrD DEV. 609 

(1979). 

6'JThe importance of stable and cohesive neighborhoods with 

strong leadership was demonstrated during the riot in Los 

Angeles. Hispaniccommunities in cast LosAngeles effectively 

mobilized to prevent the spread of violence and looting to their 

neighborhoods. Ruben Castaneda & Al Kamen, Roots Were 

FASt Side's Rim Shield: &tablished Hispanic Neighborhoods 

Mobilized toAvert LA. VIOlence, WASH. POST, May 5, 1992, at 

At. Local civic and business leadcrs "took up not guns but 

telephones" and called residents "to urge them to keep themselves and their young people inside and to call others with the 

same message." ld. at All. 

1IlClarence Schubert, Testimony I3cfore the U.S. Advisory 

Board on Child Abuse & Neglcct at a Hearing in Chicago on 

IntemationalPerspectivel'onaNewStroregyforChildProtection 

in the UniJed States (Aug. 29, 1992). 

Neighborhoods in the United States also have a history of 

p<X)ling resources to develop a foundation for economic development. See Murray Levine & Adeline Levine, The llislOrical 

CoI1/eXt: Lessons from the Settlement Ilouse Movemenl and the 

War on Poverty. in TOWARD A CUILD-CENTERF.D, NEIGHBORHOOD-BASED O-nw PROTEcnoN SYSTEM (Gary B. Melton cd., 

forthcoming). 

71David A. Wolfe, The Role of Intervention and Treatment 

Services in the Prevention of Child Abuse and Neglect 81 

(1992). Cf Timothy F. J. Tolson & Melvin N. Wilson, The 

Impact ofT wo- and Three-Generational BwkFamily StlUCture 

U.S. Advisory Board on Child Abuse and Neglect -------------------------- 53 
Neighbors Helping Neighbors 

54 

on Perceived Family ClinwIe, 61 Omn DEV. 416 (1990) (show. 

ing signitjcance for child development of a second adult in the 

home in African-American families). 

12'fhe historic settlement house programs used clubs that fo. 

cuscd on men's interests in vocations and skills (e.g., home 

repairs) useful in building investment in their homes and 

neighborhoods. Levine & Levine, supra note 70, at_, 

1Yfhe majority of female-headed households with children 

present live in poverty. CENsus,supra note 11, at 458, table no. 

m. Cf Richard J. Gelles, ChiJdAbuseand Vwlencein SinglePwenJFamilies: ParenJAbsenceandEconomicDeprivatiorJ,59 

AM. J. ORTI-IOPSYCHlATRy492 (1989) (poverty is related to abuse 

by single mothers but not single fathers). 

7<See JANET M. FITCHEN, ENDANGEREO$PACES, ENDURINGP~CES: 

CHANGE, IDENTITY, AND SURVIVAL IN RURAL AMERICA 40-43 

(1991), 

75The median age of Americans rose by almost 10% during the 

1980s. CENSUS, supra note 11, at 14, table no. 12. 

7°Organization of activities around developmental transitions 

is discussed in more detail in Section V inftu. 

nGarbarino & Kostelny, supra note 18; Pelton, supra note 39. 

7liDirk Johnson,As Town Fights to Live, Experts Get a Lesson, 

N.Y. TtMES (Aug. 1, 1992), at 1. 

Am RN, a national association begun in Arkansas to organize 

impoverished communities, is an interesting example of the 

principle of economic development coupled with social welfare. ACORN has sustained itself in large part through the 

development of small businesses and other member-run fundraising activities. 

For an overview of the effect5 of various development strategies on community economy, see CHRIsroPHER GUNN & HAzEL 

DAYl'ON GUNN, Democratic INITIATIVES AND O:>MMUNITY DEVEWPME~'T 25-36 (1991). 

7'>Isabel Wolock & Bernard Horowitz, ChiJdMaltreatmentand 

Material DeprivaJionAnumgAFDC Recipient Families, 53 Scx::. 

SERvo REV. 175 (1979). 

SIlBernard Horowitz & Isabel Wolock, Material Deprivation, 

Chj/dMallreatment,andAgencyImeTVentionAmongPoorFamilies, in TIIf' S<x:rAr. CoN'I1'.XT OF OmnAIJUSE Al'lD NEGlECT 137 

(Leroy H. Pelton ed. 1981 

BICHILDREN'S DEFENSE FUND, THE STATE OF AMERICA's Om.-

DREN 1992 (1992), at 35·37. 

82See Pelton, supra note 39, at 24-27. 

8JCHTLDREN'S DEFENSE FUND, supra note 81, at 37-38. 

IWLeroy Pelton, Povenyand ChiidProtection, PROTECI1NG CHn--

OREN (Winter 1990-91), at 3, 4 and citatioru therein. 

~Pelton,supm note 39, at 1fj-27, and citations therein; cf Alan 

Meyers et al., Public Housing Subsidies May Improve Poor 

Children's NwrWon, 83 AM. J. PuB. HEALTH 115 (1993). 

8liLevine & Levine, supra note 70, at_, 

a1Wesley G. Skogan, Community Organizations and Crime, in 

10 CluME AND Jusna;:: A REVIEW OF RESEARCH 39 (Michael 

TonI}' & Norval Morris eds., 1988); Wesley G. Skogan, Com· 

nwniJje;s, Crime, and Neighborlwod Organization, 35 CRiME & 

DEllNo. 437 (1989). 

8l!lSee AlBERT J. REISS&JEffREY A. Ram, UNDERSfANDlNGAND 

PREVENTING VIOlENCE 147-51 (1993) (report of the National 

Research Council). 

89Susan F. Bennett & Paul J. Lavrakas, C..ommuniJy-&sed 

Crime Pn?wnJion: An Assessment of the Eisenhower 

FoundaJion's Neighborlwod Program, 35 0uME& DEUNO. 345 

(1989), 

9OTIu! &xur1 notes thai. the Empowerment Zone conct'pt j'Nfr 

posed by the u.s. Departnrent of Housing and Urban Devel0pment appeaa to contain important elemenJ.\' relaJed to this 

reronvnendntion and may have fXJtential as a vehicle for its 

impIemeniation. 

9lWolfe, supra note 71, at Executive Summary 2 (included in 

app. C, this report). 

<rZld. 

'JJId. at 2-3. 

~Parentingclasses become the disposition of choice as caseloads 

rise. Kamerman & Kahn, ffCPS Is Driving Child Welfare, Whem 

Do We Gofrom Here?, supra note 24, at 42. 

9:5Pelton, supra note 84, at 4; see also supra note 24. 

!l6See, e.g., THE EFFEcrs OF Omn ABUSE AND NEGLEct: ISSUES 

AND RESEARCH (Raymond H. Starr Jr. & David A. Wolfe eds. 

1991); THEORY A."D RESEARCH, supra note 4, at 3n-721; JEFFREY J. HAUGAARD& N. DICKON REPPUCCI, THE SEXUAL ABUSE 

OF Oill.DREN 60-100 (1988) 

"'See, e.g., PANEl, supra notc 4, at 7:16; AnthonyM. Graziano 

& Joseph R. Mills, T matment for Abused Children: When Is a 

Partial SoIu1ionAm:'ptable?, 16 Ornn ABUSE & NEGlECf217 

(1992), 

~olfe, supra note 71, at 4 (emphasis added). A panel of the 

National Research Council reached similar conclusions. a .. El., 

supra note 4, at 7:3-7:4. 

99PeJton, supra note 84, at 3-4. 

u.s. Advisory Board on Child Abuse and Neglect 

Jill 
r 

[roSeto, e.g., Howard Dubowitz et at, Inj1ictedand Noninflkted 

Injuries: Differences jn Child and Familial CluJracteristics, 57 

AM. J. ORl1{OPSYrnIATRY 525, 528 (1987). 

IOI&YOND RHETORIC, supro note 12, at 295-96. 

10000e Board does disagree with some of the specific provisions 

of the APWA/NationaJ Commission plan. Notably, families 

would need to enter CPS in order to obtain intensive crisis 

services, which then would be mandatory. Jd. at 297. This 

approach seems to negate the preference for easy access to 

voluntary services. 

The commissions al'lO seemed to rely on the existence of less 

restrictive, voluntary services to decrease the emphasis on 

investigation that exists in the current system, As indicated in 

Section IJI(D) inj'ro, the Board believes that justice-system 

reform is also needed if child welfare reform is to work. 

lroeJordon Evans, Foster Care Facts and Figures (Jan. 1993). 

1IMIn Nebraska, for example, about one-third offostcr children 

have spent the majority of their lives in foster care. Ed Russo, 

Stress and Lack of Support Are Driving Foster Parents Away, 

liNcoU'J JOURNAL-STAR, Dec. 22, 1991, at IA. 

'lI>Charles Gersheruon, Statement Before the U.S. Advisory 

Board on Child Abuse and Neglect at a Symposium on Family 

Foster Care (Jan. S, 1992). 

I06Foster care reimbursement rates are typically ahout $300 per 

month, although several States fail to reimburse even $200 for 

infants and toddlers. Gordon Evans, Foster Care Monthly 

Maintenance Rates (n.d.). By contrast, the average expendi· 

ture on a child by middle-income parents in 1991 was between 

$533 and $648 per month, depending on the child's age. F AMfL Y 

EcuNOMlCS RESEAROI GROUP, EXP£NDlTURES ON A Omn BY 

FAMlUES, 1991 (1992) (publication ofthe U.S. Department of 

Agriculture). 

11l1'fh.is disparity has been the subject of litigation as kinship 

care has increased. See, e.g., Millerv. Youakim, 440 U.S. 125 

(1979); lipscombv. Simmons, 962 F.2d 1374 (9th Cir. 19(2); 

King v. McMahon, 230 Cal. Rptr. 911 (App. 1986); Waits v. 

Swoap, 524P.2d 117 (Cal. 1974); Inre Doe Children, 827 P.2d 

1144 (Hawaii 19(2). Should an aunt caring for her niece or 

nephew as a foster child receive the AFDC payment that the 

child's mother received orthe reimbursement that other foster 

parents m:eive? That the question arises raises stark questions 

about the significance of poverty in families in which maltreatment occurs and ahout public attitudes toward foster families 

and poor and maltreated children and their parents. 

lOJIISue Dondiego, Statement at a Symposium on Family Foster 

Care (Jan. 8,19(2), at 4. 

To facilitate a more positive relation with foster parents, New 

Jersey's Division of Youth and FamilyServices contracted with 

the State's foster parents association to employ foster parent 

support workers in their district offices. 

A New National Strategy for the Protection of Children 

1000Evans, supra note 103. 

mSee supra note 106. 

lIlGordon Evans, America's Foster Care System: In Crisis 3 

(n.d.). 

1''lNATIONAL CoMM'N ON FAM. FOSTER CARE, A BWEPRINT FOR 

FOSI"ERING INFANTS, OmDREN, AND Yourns IN THE 19905 (1991), 

at 30. In this and subsequent quotes from the Commission 

report, ''youths'' has been changed to ''youth.'' 

113Jd. at 39-41. 

1141d. at 3, 

mId. at 31. 

116For a model of such procedures, see Daniel L. Daly & 

Thomas P. Dowd, Characteristics of Effective, Hann-Free Enl'i-

'1JI1l11entsfor Children in Out-ofHOI1U! G.m>, 71 QUill WEll'. 

487 (1992). 

II1See Miriam Longino, Kinship Core: Keepinglt in the Family, 

THE CoNNEcnON [newsletterofthe Nat'l CASAAss'n] (Spring 

1991), at 1; Mary Ann Takas, Developing Child Protection 

Systems wiJh F..xJendeti Family Strengths, CmwREN'S LEGAL 

RTS. J. (Swnmer 19(2), at 27. See also Kathleen J. Sternberg, 

Child Mabreatmem: Implic-'ltions for Policy from Cross-CulturoJ Research, in Ci-mD ABUSE, Ginn DEVELOPMENT, AND 

Socw. POllCY 191, 206·.Q7 (Dante Cicchietti & Sherrce L. Toth 

eds., 19(3) (describing Isreali "afternoon clubs," a form of 

partial foster care). 

U 8Krista M. Nelson, Fostering 1l0l1U!less Children and Their 

Parents, Too: The EmergenceofWho1e-FamilyFoster Core, 71 

Omn WElF. 575 (1992). 

"9Jn Los Angeles County, over half the 34,000 children in 

placement because of abuse or neglect arc placed with relatives. 

L2OlAcommittce ofthe National Council of Juvenile and Family 

Judges hasestimated that 18% ortotal child protection cascloads 

result in court action. MErROPOlITAN CoURT JUDGES CoMMITTEE, DEPRrVED OmnREN: A JUDrClAL RESPONSE--73 RECOM· 

MENOATIONS 6 (1986). 

121See Gary B. Melton, Foreign Innovations in Dispute Resolution in Matters Related to Juvenile Justice and Child Protection 11-19(1992) (reportto the1udicial CouncilofCalifomia), 

and citations therein. Practical descriptionsofthe New Zealand 

famity group conferences can be found in RICHARD WILCOX ET 

.u .. , FAMILY DECISION MAKlNG/E~MILY GROUP CoNFERENCES: 

l'RACITI10NERS' VEEWS (1991). 

122See Melton,supra note 121,at7-11 and citations therein. The 

system is succinctly described in a monograph by the ScornSH 

OFFlCE, TwENTY ONE YEARS OF O-rrwREN'S liEAruNGS (1992). 

U.S. Advisory Board on Child Abuse and Neglect ~------------------------- 55 
Neighbors Helping Neighbors 

WSee, e.g., Howard A. Davidson, Improving the Judicialllandling of Civil Child MalJreatment Cases, in FAMlI.lF-S IN CoURT 

78-80 (Meredith Hafford ed., 1989); Bernard Mayer, Mediation in Child l7otection Cases: The Impact of Third-Pany 

InJelVf:711:ion on Parental Compliance Attitudes, MEDIA nON Q., 

Summer 1989, at 89; Margaret Shaw & W. Patrick Phear, 

Innovation in Dispwe ResoluJion: Case Status Conferences for 

Child ProIection and Placement Proceedings in the SIiJie of 

ConnecticuJ, 29 FAM. & CoNOlJATION Crs. REV. 270 (1991); 

Nancy Thoenes, Mediation and tlu! Dependency Court: The 

Controvel:§}' and Three Courts' Experience, 29 F AM. & CoNClllAllON CIs. REV. 246 (1991). 

I,~ SeegeneroJiy NAT'LINST. JUST. J., Aug. 1992 (symposium issue 

on community policing); Jerome H Skolnick & David H. 

Bayley, Theme and Variation m Community Policing, in 10 

CRruEANDjUsncr: A REVIEW OF RESEARCH (pp.I-37) (Michael 

Tonry & Norval Morris eds., 1988) (describing community 

policing efforts in various jurisdictions in the United States and 

abroad). 

125Skolnick & Bayley,supro note 124, at 10. 

12bId. 

m&nneU & l.,avrokas, supra note 89. 

12'lMILTON S. EISENHOWER FOIJNDATION, YOIJIH INVESTMENT 

AND CoMMUNrIY RECONSfRUCTION: STREET LESSONS ON DRUGS 

AND CRIME FOR TIlE NINETIES: EXECUllVE SUMMAR .... 10 (1990). 

1l!1Id. (emphasis in the original). 

1J(JId. at 11. Consistent with the general strategy proposed by 

the Foundation, it proposed establishment ofa Youth Investment Corporation with $500 million startup. 

lJ1See, e.g., DoUGlASJ. BESHARov, OmnABusE ANDNEGlECf 

REfDRTING AND INVESTIGATION: POllCY GUIDEUNES FOR DEOSION MAKlNG6-7 & 15 (1988) (report of aconscnsusconference 

sponsored by the American Bar Association, the American 

Enterprise Institute, and the American Puhlic Welfare Association, rerommendinggreater specificity in standards for child 

abuse and neglect, with a limitation of reports to cases in which 

serious harm has or could have occurred). 

1l7fhe Board recognizes that the helping function of CPS has 

been rejuvenated insome jurisdictions, aswas il!ustrated byour 

visit to Hennepin County, Minnesota. At the same time, 

though, the Board believes that the policy structures that result 

in the overemphasis on investigation must be changed if sustained, large-scale improvement in the level of protection for 

children is to occur. 

!3JSee, e.g., Gail S. Goodmanet aI., Testifyingin Crimina/Coutt, 

57 (No.5) MONOORAPHSOFTIIESoc'y FOR RESEARCH IN CHILD 

DEV. 1 (1992); Gail S. Goodman et al., Child WllrJesesand the 

ConfrontationCIause: TheAmericanP.sychoJogicalAssocUllion 

Briefin Maryland v. Craig, 15 L\w & HUM. BEHAV.13 (1990); 

Desmond K. Runyan et al., Impact of Legal InJervenlion on 

5exudJJy Abused Children, 113 J. PEmATRICS 647 (1988). Although the civil (family court) process appears to be relatively 

benign, the dispositions that the court may adopt aIso cany 

risks. SeJ! Gary B. Melton, Child Pmtection: Making a &it 

SiIuaIWn Worse?, 35 CoNTEMP. PSYCHOL 213 (1990) (reviewing 

PROTECTING OnwREN FROM ABUSE AND NEGlECf (Doug.las 

Besharoved., 1988) and MICHAELS. WAlDET AL, PROTECIlNG 

ABuSED AND NEGlECI"ED CHnnREN (1988». 

134 SeJ!, e.g., Gary B. Melton, ChiltJ.mtas Partners for Justici"!: NexJ 

Steps for DewlopmeruaJislS, 57 (No.5) MONOGRAPHS OF TIlE 

Soc'YFOR RESEAROIIN OnwDEv.153 (l992);James M. Peters 

et aI., Why ProseCUJe Child Abuse?, 345. OAK. L. REV. 649 

(1989). 

1J5As noted supra, law enforcement officers involved in community policing often know families on their beats well enough 

to knowwhcn help is needed, and theyoften are trusted enough 

that they can offer considerable direct support to children and 

families. As also discussed supra, the justice system can play an 

important role in building neighborhood responsibility and 

cohesion. 

IJ6In cases of the third type, the principal purpose of court 

action is topursue the societal intercst in retribution. It is likely, 

however, that such serious cases of abuse are ones in which the 

societal interest in the pursuit of justice is compatible with the 

child victim's interests. See Peters et al., supra note 134. 

1l1See supru note SO. 

138See, e.g., Richard Famularo et aL, Parental CompIianre in 

Cowt-Ordered T reaJment Il1Ierventions in Glses of Child MaJ· 

veaJment, 13 Om.o ABUSE & NEGlECf 507 (1989); Ana M. 

lrucste-Montes & Francisco Montes, CoW1-0rd.eff!d Venous 

Voluntal)' Treatment of Abusive and Neglectful Parents, 12 

Cmr.o ABUSE & NEGlECf 33 (1988); David Wolfe et aI., The 

lmponance of Adjudication in the Treatment of Child Abusers: 

Some Preliminary Findings, 4 Cmw ABUSE & NEGlECf 127 

(1980). 

139See, e.g., DAVID B. WEXlER & BRUCE J. WINICK., EssAYS IN 

THERAPEunC JURL~PRUD£NCE (1991); Jeffrey A. Klotz et aI., 

Cognitive Restrocturing Through Law: A TherapeuticJurisprudence Approach to Sex Offerwkno and the Plea Proce5s, 15 U. 

PUGET SoUND L REV. 579(1992). 

1"'lBw see Seth Kalichman & Cheryl L Brosig, The EffeClS of 

SlaJuJory Requirements on Child Maltreatment Reportillg: A 

Comparison of Two State Laws, 62 AM. J. ORniOPSYOIlATRY 

2S4 (1992). 

141See Ross EA"IMAN & JOSEPHINE BUlKLEY, PROTEC'J"fNG Cmw 

VIC'IlMJWITNESSES: SAMPlE L\ws AND MATERIALS (1986). 

142Melton, supra note 134. 

U.S. Advisory Board on Child Abuse and Neglect 

,. 
l<Yfhe controversy about the proper role of guardians ad litem 

is discussed and guidance for attorneys working with chlldren 

is provided in JOHN E. B. MYERS & NANCY W. PERRY, CHtw 

WrINESS lAw AND PRAcnCE 1-52 (1987). Cf Gary B. Melton & 

Susan Limber, Psychologists' Involvement in Cases of Child 

MalI!wtment: Limits of Role and Expertise, 44 AM. PSYCHOLOGIST lill (1989) (discussing the psychology and ethics of 

interaction. with parties in child protection cases). 

Seetllio Beth Waid, Perspective, THE CoNNEcnON [Newsletter 

of the National CASA Association] (Spring 1991), at 2 (lamenting tne frequency with which, contrary to law, guardians 

ad litem are not appointed in civil child protection cases). 

''''Donald N. Duquette & Sarah H. Ramsay, Re~sentation of 

ChiJdn?nin ChildAbuseandNeglecl Cases: An EmpirirulLook 

at Jf'haJ Consdtutes Effective Representation, 20 U. MIOi. J. L. 

REFORM.341 (1987). 

141See Office of Juvenile Justice and Delinquency Prevcntion, 

CiSA: Court AppoinJed Special Adl.'OCate for ChiJdren .. .A 

Child's Voicein Coutt, Juv.JUSI'. BulL. No. NO 111392 (1987 

& update). 

!46Larry O:mdelli, National Evaluation of the Impact of Guardians ad Litem in Child Abuse or Neglect Judicial Proceedings: 

Executive Summary (n.d). 

"'Much has been learned about children's understanding of 

legal coJ\~pts and their skills as witness. Unfortunately, 

though, experimental research on the effects of various procedures or programs on children's satisfaction with the legal 

process is nonexistent. For a review, see Gary B. Melton, 

Children as Legal Actors, in HANUllOOK OF PSYOIOLOOY AND 

lAw 275 (Dorothy K.. Kagchiro & William S. Laufer cds., 

1991);seeaisoMelton,supro note 132. Legislative authority for 

such work now exists in the Missing Childrcn'sAs..~istance Act, 

42 U.S.c. § 5775(,)(6). 

For a discussion of the significance, pursuant to the U.N. 

O:mvention on the Rights of the Child, for child protection 

efforts of a concern with children's dignity, see Gary B. Melton, 

Preserving the Dignity of Children Around the World: The UN 

Convention on the Rights of the Chiki, 15 Ornn ABUSE & 

NEGlECT 343 (1991). 

148Sft? AMERICAN BARAss'N PRESIDENT'S WORKrNG GRI'. ON 111E 

UNMET UGALNEEDSOF Ci-nlDREN & ThEIR F AMJUES,AMERICA'S 

OnwREN AT RISK: A NATIONAL AGENDA FOR lEGAL ArnON 

(1993). 

1<90f course, such factors also often are involved even in 

maltreatment that is fully intentional. 

!SOlSee, e.g., Malcolm Bush &AndrewC. Gordon, ClienJ Choice 

and BureaucraJic AccounJilbiJiry: Possibilities for Responsiveness in a SodaJ Welfare Bureaucracy, 34 (No.2) J. &x:. IssuES 

22 (1978); Malcolm Bush ct aI., EvaluClting Child Welfare 

SeMceS: A ConJribution{rom Jhe Clierus, 51 Soc. SERVo REV. 

491 (1977). Highcaseloads, combined with the need to spend 

U.S. Advisory Board on Child Ahuse and Neglect 

A New National Strategy for the Protection of Children 

most time on investigations and related paperwork, often 

prevent caseworkers from frequent contact with children in 

their charge. See HOUSE SELEcr CoMM. ON OrnDREN, YOU'IH, 

& F AMIUES, AoosEDCmwRENIN AMERICA: VICIlMSOFOFFlCIAL 

NEGLEct 84-87 (1987). 

151Although turnover is reduced by strong training, supervision, and other staff support programs, staffvacancies in CPS 

as a resu.ltofworker resignations are a major problem in many 

States. See, e.g., Letter from Jane Mellgren, personnel officer, 

Nebraska DepartmentofSocial Services (Dec.l5, 1992) (indicating that turnover in CPS in Nebraska has averaged about 

50% higher than in other DSS units, although the discrepancy 

may have been eliminated after an intensive pre-service training program was instituted). 

152'J'he child's guardian is also often the parents' caseworker, so 

that the guardian has muJtipJe"c1ients." Moreover, the guardian may be constrained by agency policy from obtaining or even 

advocating for particular services that he or she believes to be 

in the child's best interests. Even when there is no conflict in 

principle, the fact that guardians sometimes have many wards 

and other responsibilities means that they often cannot devote 

the time needed to know individual children well. See supra 

note ISO. 

15Yfhis right has been recognized by the international community in the U.N. Convention on the Rights ofthe Child, art. 12. 

It underlies the need for redesign of the justice system to ensure 

that children are partners--ratherthan objccts--in legal actions 

that result in whole or in part from the maltreatment that they 

are known or alleged to have experienced. 

1~The requirement that States exercise reasonable efforts to 

achleve permanency for the child is found in 42 U.S.c. § 

671(,)(15). 

1S5NATIONAL CoUN. OF Juv. & FAM. Cr. JUDGES, CHtw WEIF. 

LEAOUEOFAM. Yourn LAw CrR., &NATlCrR FOR YournL., 

MAKING REASONABlE EFFORTS: STEPS FOR KEEPING FAMIUES 

TOOE11IER 8 (n.d,) (hereinafter NATIONAL O:>UNaL]. 

!3liSee Mark Hardin, Reinventing the Juvenile Court Dependency unit (June 1992) (paper presented in San Francisco at a 

symposium of the Consortium on Children, Families, and the 

Law and the Committee on Family Relations, 2020 Vision 

Project, Judicial Council of California). 

I57See, e.g., Standardsof JudicialAdministration Recommended 

by the Judicial Council ofCaJifornia, CAL Cr. R. app. div.1 R. 

24 (West 1993); NATIONAL CoUNCll, supro note 153, at 41-59; 

NATIONAL CoUNOL OF JUVENILE AND FAMIl.Y CoURT JUDGES, 

PROTOCOL FOR MAxING REASONABlE EFFORTS TO PRESERVE 

FAMIUES IN DRUG-RElATED DEPENDENcY CAsES (1992); Families in Coul't: Rerommendations from a Nationdl Symposium, 

in FAMIllES IN CoURT 1, 6 Recommendation 8(B) (Meredith 

Hafford ed., 1989) (symposium sponsored by the National 

Council of Juvenile and Family Court Judges, the American 

Bar Association Centeron Children and the Law, the National 

Center for Slate Courts, and the National Judicial Council); 

57 
Neighbors Helping Neighbors 

58 

Leonard P. Edwards, The JuvenUe Cowt and the Role of the 

Juvenile Coun Judge, 43 Juv. & FAM. Cr. J., No.2 (1992), at 1, 

25·32. See also Melton, supra note 20, at _ (recommending 

anactiviststanceofcommunityleadershipandcorollarychanges 

in court structure as means of development of community 

responsibility for the welfare of children). 

L58'Jbe support for the courts included in proposed family 

preservation legislation, H.R. 2141 (1993), tit. 13212, would be 

a step in the right direction. 

L5'lOf course, provision also needs to be made for accountability 

oCthe court itself. For example, Judge Betty Friedlander ohhe 

New York Family Court (Ithaca) has instituted a series of 

procedures in her court that are designed 10 build citizen 

confidence in the court, ensure its accountability, and provide 

for vigorous advocacy for children. With as much openness as 

JX>SSible, she has provided for ongoing citizen review of her 

court (in part through a formal advisory board), and she has 

maintained frequent reviews of all children in foster care, 

including those who had been placed voluntarily by their 

parents. She insists on zealous representation of children, 

including continuing access by and to an attorney as long as the 

child is under court jurisdiction. Although the increased cost 

ofrepre.sentationwas resisted initially by State authorities, the 

legislature ultimately instituted full hearings, including rmtdisposition reviews, on allvoiuntary placements, because such 

hearings and the advocacy that they engendered appeared to 

reduce the use of foster care and, therefore, the expenditures 

by the State. Betty Friedlander, Remarks to a Symposium of 

the Consortium on Children, Families, and the Law at the State 

University of New York at Buffalo (July 11, 1992). 

lOOA preference for diversion of most child protection cases 

from thecourts has been expressed by many judicial commentators. SH,e.g., Edwards,supro note 157, at 13, 27,andcitations 

therein. Advocates of that position tend also to argue, however, that the court should supervise or at least monitor the 

alternative system of dispute resolution and the dispositions 

that result from it. /d. Accordingly, a policy promoting diversion can facilitate the investment of time necessary for courts 

to assume roles of leadership and monitoring in the child 

protection system. At the same time, such a policy should 

diminish the allocation of an unduly large proportion of caseworkers' time to court proceedings and related investigation 

and preparation. 

l6lSee Youngberg v. Romeo, 457 US. 307 (1982); see also 

Melton, supra note 147 (discussing the significance for child 

protectionofthe UN. Conventionon the Rights of the Child). 

l62])eShaney v. Winnebago Co. Dep't of Soc. Servs., 489 U.S. 

189 (1989). 

163Suterv. Artist M., 112 S.O. 1360 (1992). 

"'<489 US. at 212-13 (B1ackmun, J., dissenting). Justice 

B1ackmun's righteous approach to the problem of child maltreatment was seen again in his dissent in Artist v. Suter M. , in 

wh.ichhe reminded hiscoJleaguesthat "after all, weare dealing 

with children." 112 S.O. at 13n. 

'"'Such a provision was included in the family preservation bill 

that Congress passed inconjunction with the urban aid package 

and other costly programs late in 1992, but President Bush 

vetoed the bill (primarily because of objection to other provisions). Perhaps even more disturbing than the decision inArmt 

M. was that the United States (under the Bush Administration) 

and the Attorneys General of many of the States filed amicus 

curiae briefs urging the Supreme Court to find no private right 

of action under the Adoption Assistance and Child Welfare 

Act. 

l66Perhaps the most important functions of the Federal courts 

have been to protect the rights of powerless and vulnerable 

groups and to express the moral values embedded in the 

Constitution. See, e.g., JOHN ELY, DEMOCRACY AND D[SJlIUST 

(1980); RobertA. Burt, Pennhurst:A Parable, in IN mE INTERESfOFQ.mnREN: ADVOCACY, LAw REFORM, ANDPUBllC Poucy 

264,336-51 (Robert H. Mnoolcined., 1985); cf Gary B. Melton 

& Michael J. Saks, The Law as an Instrument of Socialization 

and Social Sttucture, in 33 NEB. SYMP. ON MOTIV AnON: THE L\ w 

AS A BEHAVIORAL INSTRUMENT 235, 251-68 (Gary B. Melton ed. 

1985) (describing the effects of law as a moral educator announcing the nonns of the community). Recognizing this point 

in other oontext~, CJ)ngrf'.K~ ha.~ a.cted to e.<;tahli.~h legal advocacy groups and to provide such agencies or the US. Department of Justice with standing to file actions on behalf of 

vulnerable populations. E.g., Civil Rights of Institutionalized 

PersonsAct,42 u.S.c. §§ Imetseq.; Developmental Disabilities Assistance and Bill of Rights Act, 42 U.S.c. §§6(XXletseq.; 

Protection and Advocacy for Mentally III Individuals Act, 42 

US.c. §§ 10801 et seq. 

161Pub. L. No. 102-586, § 285(b)(2)(F), 106 Sial. 4891, 5008 

(1992) (to be codified at 42 U.S.C § 5667c(b)(2)(F». 

16llSH, e.g., MAlFRroGRUDE FlEKK0Y, A VOICE FOR OnwREN: 

S!'EAIDIG Our AS TI-lElR OMBUDSMAN (1991); Gary B. Melton, 

Lessons from Norway: The Children s OmbudslNJ/'I as a Voia:> 

forChildren, 23 CASE W. RES.J. INT'LL 197 (1991); Models for 

Monitoring the Protection of Children's Rights (M1Ufrid Grude 

FJekk0Y ed., 1991) (reporting the work of a UNICEF study 

group). 

lMIn th.at regard, the Supreme Court's assumption that school 

disciplinary practices are fully open to public scrutiny--an 

assumption that underlay the Court's holding that severe 

corporal punishment by school officials does not violate the 

Eighth Amendment; Ingraham v. Wright, 430 U.S. 651, 670 

(1975)--may have been disingenuous. 

l10Paul Lerman, Child Protection and Out-of-Home Care: 

System Refonns and Regulating Placements 90-137 (1992) 

(paper prepared for the U.S. Advisory Board on Child Abuse 

and Neglect). The Board recognizes that the rate of child 

US. Advisory Board on Child Abuse and Neglect 

,. 
maltreatment in out-of -home settings appears to be lower than 

in familie.'l. Nonetheless, the State bears an affirmative duty to 

ensure the safety of settings in which children are in State 

custody (e.g., foster care) or in which State care or control is 

exercised (e.g., schools and day care centers). 

"'Daly & Dowd, supm note 116 .. 

inLerman, supra note 170, at 128-32. See, e.g., David Fanshcl 

el al., Foster Children in Life-Course Perspective: The Casey 

Family Program Experience, 68 CHIlli WEIF. 467 (1989); David 

Fanshel et al., Modes of Erit from FamilY Foster Care and 

Adjustment aJ Time of DepanU1"e of Children with UnsUlb1e Life 

Histories, 68 Q-I[ll) WElF. 391 (1989). 

11lSee, e.g., DAVID FINKElHOR ET AL, NURSERY CRIMF.s: SEXUAL 

ABUSE IN DA) CARE (1988); Leslie Margolin, In their PWf!nls' 

Absence: SexuoIAbusein Child Care, VIOlENCE UPDATE, May 

1993, at 1; Nolan Rindfleisch & Michael Nunno, Progress and 

Issues in the Implementation of the 1984 Out-of-llome Care 

ProIectionAmendment, 16 ClllwABUSE & N EGtEcr693 (1992); 

Lerman,supra note 170, at 105-09. The majority of States do 

not report data on suspected child abuse and neglect and its 

rate of substarttiation in institutional settings. /d. at 99-100. 

I"Broadening the standards for licensure of day care programs 

ha.'l been shown to increase the quality of care. Deborah 

Phillips et aJ., The Socio1 Policy Contcrt of Child Care: Fifects 

on Quality, 20 AM. J. CoMM1JNm' PSYCHO,," 25 (1992). 

17SDaniei Hogan, The Effectiveness of Licensing: History, Evidence and Recommendations, 7 LAw & HUM. BEHAV. 117 

(1983). 

1l6See, e.g., PROFESSIOl'iAL RESPO:-;SIB.lUI1ES, supra note 30. 

177Programs of concern include, among others, educational and 

child care programs for military dependents and Native Americans, detention facilities for minors who are undocumented 

aliens, and correctional facilities for juveniles accused or convicted of Federal offenses. 

l7lISee, e.g., Amcsv. Meese, 681 F. Supp. 665 (CD. DeL 1988), 

rev'dsubnom. F10resby Galvez-Maldonada v. Meese, 934 F.2d 

991 (9th Cir. 1991), reinstated en bane, 942 f,2d 1352 (9th Cir. 

1991),rev'dsubnom. Renov_F1ores, 113S.0.1439(1993). See 

especially 681 F. Supp. at 666-67 (describing routine strip 

searches of juvenile aliens detained by the Immigration and 

Naturalization Service)and 113 S.O. at 1460 (dissenting opinion) (noting concession by the INS that juvenile aliens had been 

confined in "deplorable" conditions). 

'

19k the Board uses the term, thechild protection system includes 

but is not limited to Child Protective Services (CPS) or State 

and County child welfare agencies. Other components of the 

child protection system include law enforcement (including 

prosecutors), education, public health, mental health, court, 

and private non-profit agencies and organizations--all of the 

sectors of so;;iety that are or should be involved in (a) the 

U.S. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

prevention, investigation, adjudication, or treatment of child 

abuse and neglect or (b) the development and diffusion of 

knowledge necessary to fulfill such functions. 

lSOlEy recognizing collective responsibility [or the protection of 

children, the Board took steps in the first two recommendations of its first report toward a conceptualization of the child 

protection system as ultimately coextensive with socicty as a 

whole: 

1. The &xud wges each citizen to recognize that a serious 

emergency reliued JO the TrUlltreaJment of children etists within 

Amerirun society and JO join with all other citizens in resolving 

thai Us rontinued etistence is intolerable. 

2. The &xud urges each citizen to demand thai his or her elected 

officials aJ all1evels publicly acknowledge thaJ theAmerican child 

proJection emergency etists and, having so acknowledged this 

emelgency, trJke whateVer steps are necessary ... to rehabilitate the 

naJion 's child protection system. EMERGENCY ,supra note 4, at 44. 

Consistent with its view of the personal responsibility of all 

adults, the Board's recommendations extended beyond government and the formal service system to the media and 

voluntary, religious, civic, philanthropic, and business organizations. 

lSlCRF-ATING CARING CoMMUNmES, surpa note 7, at 147. 

lS2Pelton, supra note 84, at 4_ 

lS3Child Abuse, Domestic Violence, Adoption, and Family 

Services Act of 1992, Pub. L. 102-295, 106 Stat. 187_ 

l~This situation would be rectified in part by adoption of 

pending Federal legislation for support offamilypreservation 

services. 

ll5See David S. Hargrove & Gary B. Melton, Block Grants and 

Rwal Menial lIeahh Services, 8 J. RURAL CoMM. PSYCHOL 4 

(1987). 

l80CREATING CARP.'oIG CoMMUNmES, supra note 7, at 151. 

'87'Jbe Board's own recommendation, ill. at 130-34, was for 

mUltiple funding streams that are blended at the Federalleve! 

as the product of a single State plan ("one-stop shopping") 

integrating diverse elements of a comprehensive child protection system. 

l8SGENERAL ACCOUNTING O~TIa" INTEGRATING HUMAN SERVICES: lINKING AT-RISK F AMlllES WITlI SERVICES MORE SUCCESSfUL TIlAN SYSTEM REFORM EFFORTS (Sept. 1992). 

'8'lSee, e.g., FAMn.Y IMPAcr SEMINAR, CooRDl!'olAllON, CollADORATION,ISUOGRAllON: STRATI'GlF.-S FOR SF-RVISG FAMIUESMORE 

EFFEcnVEL Y (1990); INSPECTOR GEN., DEP'T OF HEALTII & HUM. 

SERVS., SERVICES Il'<TIGRAllON: A TWENTY-YEAR RErROSPECllVE(Jan.1991); EUEWARD,SERVICEIlI.'TEGRAllON: CHAllENG59 

, 
Neighbors Helping Neighbors 

60 

ING SYSTEMS 10 MEEr FAMlllES' NEEDS (1992); Patricia Schene, 

CootdinationofFundin§PROTIlcrINGCHllDREN(Summerl991), 

at 17; Martha R. Burt et al., Comprehensive SeIVice Integration Programs for At Risk Youth: Final Report (Dec. 1992) 

(report by the Urban Institute pursuant to Contract No.llliSl00-92-OO(5). 

IfIOStoJe Agencies Join Forces to Strengthen Families and Children: NBI Program toBeginlhis Fail, PREVENTIVET'RENDS: NEW 

DmECTIoNs rn FAM. & OmnREN SERVS. [N.Y. State Dep't of 

Soc. Servs. newsletter], Oct. 1990, at 1. 

!

91N.Y. ExEC. LAw §§ 548a-548h (McKinney 1993). This 

program was initially called the Neighborhood Based Initiative, but was changed to Neighborhood Based Alliance in 1993. 

l'"The InspectorGeneral,suprtJ note 187, ha~ noted that "[t]he 

history of the many SI [services integration] demonstration 

projects funded over the years is that once the demonstration 

funding has run out, the integrative clements have receded or 

disappeared altogether." Id. at 5. 

19] Seegene1lllJyHARornSEIDMAN, Pouncs, PosmoN, AND POWER: 

THE DYNAMICS OF FEDERAL ORGANIZATION (3d ed. 1980). 

1~Cru:.ATlNG CARING CoMMUNmES,supro note 7. 

19SId. at 148. 

196/d. at 141-46. 

1975ee Anne Cohn Donnelly, Heahhy Fami/iesAmerica, 21 (No. 

2) CHILDREN TODAY 25 (1992). 

19!1Marian Wright Edelman, Leave No Child Behind, UI 

a-mnRF..N'S DEFENSE FUND, THE STATE OF AJdERICA's CHIlDREN 

1992 (1992), at vii, xii. 

lWId. at xiii. 

ZOOId. at xiv (emphasis added). 

lJllResearch on the dramatic decline in tobacco use in the 

United States also suggests the diflicultyofthe challenge ahead 

if the Nation is to adopt safer attitudes and behavior in relation 

to children. Although the prevalence of smoking has decreased, that drop has occurred to the greatest extent among 

educated people, and the rate of smoking has changed least 

among the people with the most other problems. Karl E. 

Bauman, On the FuJUreof Applied Smoking Research: Is It Up 

in Smoke?, 82 AM. J. PUB. HEALTII 14 (1992). For example, 

three-fourth!; of school dropouts smoke. Phyllis L Pirie et aI., 

Smoldng Pmulence in a Cohort of Adolesa:nts, Including Absentees, Dropouts, and Transfers, 78 AM. 1. PUB. HEAL"Ilf 176 

(1988). The decline in smoking among pregnant women has 

been specificto college-educated women. Joel C. Kleinman & 

AndreaKo~tein,SmokingDuringPregnancy, 1967-80,77 AM. 

J. PUB. HEALTH 823 (1987). In short, research on smoking 

indicates that broad change in attitudes about a particu.lar 

practice is possible, but it also suggests that such change is 

difficult to engineer among the grou~ lea.~t advantaged. 

lll2Aum-tA C. HUsroN lIT AL, BIG WORU), SMAlL ScREEN: THE 

ROlEol' TElEVISION IN AMERICAN SoctErr52-57 (1992) (report 

of a task force oftheAmerican Psychological Association), and 

citations therein. 

llll(;ox News Service, Networlcs Wdl LinUJ VIOIenre, liNco~ 

JOURNAL-STAR, Dec. 12, 1992, at AI. The statement by the 

major networks can be found in THE PROBlEM OF MElxA 

VIOI.1'.Nrn AND CmwREN'S BEHAVIOR 3 (1993) (Occasional 

Papers of the Harry Frank Guggenheim Foun., No. 7). 

~The need for education of professionals is illustrated by a 

recent survey of physicians, which showed that a large proportion of primary care physicians recommend corporal punishment. K. F. McCormick,AUiJudes of Primary c::tm Physidons 

Towani Corporal PwUshmeru, 1h7 JAMA 3161 (1992). 

lOS AnotherfJood Goat GunAmnesty, LiNCOLl'l JOURNAL, May 5, 

1993, at 17.As asymbolofpeace, the gunstumed into the police 

have been melted down and are being sculpted into a fountain 

twenty-five feet high. /d. 

2!I00uJrightprohibitionsofrorporaIpunishmeruhaveoro.uredin 

Austria, Denmark, FinItuJd, Norway, and Sweden, and similar 

legislatWn is being considered in Bolivia, Ct:mada, the European 

C.ommunity, Gonnany, and Scotland. PeU'r NI'W('U, Teslimolly 

Before the us. Adviwry Board on Child Abuse & Neglect at a 

Hearing in Chirogo on 1nJematioruJ Perspectives on a New 

StmJegy for Child Protectionin the United StaleS (Aug. 29, 1992). 

Wid. SeegenerallyCAwuSTEGuUlENKlAN FoUN., ONEScANDAL 

Too MANY: THE CAsE FDR CoMPREHENSIVE PRarnenON FDR 

CHILDREN IN AlL SFmNGS (1993) (proposing child protection 

reform, including measures against corporal punishment, in 

the United Kingdom). 

2OIIROBERT J. RUBEL & NANCY C. AMES, REDUCING ScHOOL 

CRrMEANDSruDENTMlsBEIiAVlOR: APROIlLEM-SoLVlNGSTRATEGY (1986), at 2 (National Institute of Justice publication citing 

the Safe School Study sponsored by the National Institute of 

Education). 

209Id. at 13 and 15. Students who report fear at school typically 

have experienced violence themselves. UsA D. BASTIAN & 

BRUCE M. TAYLOR,ScHOOl C!uME: A NATIONAL C!uME VICIlMIZAll0N SURVEY REPORT9 (Sept. 1991 ) (report of the Bureauof 

Jw;tice Statistics, u.S. Department of Justice). 

~1"RUBEL & AMES, supra note 208, at 18-20. 

2U A remarkable decrease in student aggression--along with a 

decrease in truancy and vandalism and an increase in student 

satisfaction--was achieved by a national campaign against bullyi1lg in Norway that included curricular materials and mental 

heillth consultation in the schools and a booklet sent to every 

household in the country. See Dan Olweus, VJCtimization 

U.S. Advisory Board on Child Abuse and Neglect 

p 
Among SchooIcJUJdren: Jntervention and Pnwnlion, in IMPRovING CmwREN's LrvEs: GLOBAL PERSPECI1VES ON PREVENTION 

(George W. Albee et a1. eds. 1991). 

21lNational Committee for Prevention of ChildAbuse, NCPCA 

Releases New Data from Annual Fifty State Survey and Public 

Opinion Poll, NCPCA Memorandum (Apr. 1992), at 1. 

21YJ1te ambiguity emanates from both the especially complex 

causation of sexuaI abuse and the particularly acute conflicts in 

policy in regard to punishment of scxual offenders (but not 

other offenders) against children and protection of children 

from harm. 

mIn a discussion that the Board held with news and entertainment producers in Los Angeles (Apr. 1992), one producer 

spoke with some exasperation about his efforts to develop such 

public service announcements, which teb·ision station:s refused to play. 

215&e Klotz, supra note 139. 

216DAVID FtNKEIHOR, Omn SEXUAL ABUSE: NEW THEORY AND 

RESEARCH 12-13 (1984). 

2111d. at 11. 

213Jd. 

n9Abna5t one-hal[ of cases in the second NaJiona/ Incidence 

Szu1.fy involwd families of color. Elizabeth D. lones & Kan?n 

McCUJdy, TheLinks Between TypesofMa/JreatmenJand DemogmpIric Cluuuc1eristics of Children, 16 OUID ABUSE & N EGIFrI' 

2D1,208 (1992). 

:OOJiJ] Korbin, Sociocultural Factors in Child Maltreatment 27-

40 (1992) (paper prepared for the U.S. Advisory Board on 

Child Abuse and Neglect); Pelton, supra note 39, at 30-31; cf 

Melvin N. Wilson, Child MaitreaJment in the Afriam-American 

Commwtity in CHrw ABuSE, OUlD DEVELOPMENT, AND SoctAL 

POUCY 213 (Dante Cicchetti & Sheree L Toth cds., 1993) 

(arguing that extended-family ties scrve as a buffer against 

child ma1treatment among African-American:s). 

12ISee, e.g., Robert L. Hampton & Eli H. Newberger, Child 

Abuse Jncidenc£ and &porting by Hospitals: The Significance 

ofStverity, Class, and Race, 75 AM. J. PUB. REALm 56 (1985). 

Discriminatory patterns have been particularly acute in State 

authorities' response to problems of childrearing associated 

with parental substance abuse. In a prevalence studyin Pinellas 

County (St. Petersburg), Florida, black women were found to 

be ten times more likely than white women to be reported to 

authorities when they were shown to be using illegal substances 

while pregnant. IraJ. Chasnoffet al., The PrevalenceofJlJkiJDrug or AlcohoJ Use During Pregnancy and DisCTr!pancies in 

Mand4Jory Reporting in Pinellas County, Florida, 322 NEW ENG. 

1. MEm. 1202 (19S0). Similarly, twenty-two of the first twentythree pregnantsubstance-abusingwomen arrested in Greenville 

County, South Carolina (one of the jurisdictions using that 

U.S. Advisory Board on Child Abuse and Neglect 

A New Nationa1 Strategy for the Protection of Children 

approach most frequently), were black, and the twenty-third 

gave birth to a biracial child. Cindi Ross Scoppe, Subcommittee 

DeJaysActinnonDrng-AddicJed &by Bill, THE STATE (Columbia, S.c.), Mar. 15, 1993, at 2B. Cf CARrCE WAUffiR Fr AL, 

PARENTAL DRUG ABUSE AND AFRICAN AMERICAN O-m.nREN [N 

FoSlER CARE: ISSUES AND STUDY FlND[NGS (1991 ) (showing that 

black children of substance abusing parents typically stay in 

foster care for long periods of time). 

222CENsus,supm note 11, at 3941, tables no. 41, 42, & 44. 

WFor useful examples of ways that child protection activities 

can build on "natura1" communication patterns, helping networks, and activity settings, see Susan P. Limber & Patricia Y. 

Hashima, The Social ConJext: What Comes Naturolly in Child 

Protection, in TOWARD A Omn-CENTERED, NEIGHBORHOODBASED Onw FR0TECf10N SYSTEM (Gary B. Melton ed. forthcoming) [hereinafter 5YsrEM 1; Clifford R. O'Donnell et al., The 

Cross-CulJuroJ Co111eU: What Can Be Learned from CommuniJy Developmem Projects, in SYSfEM, supra. 

224Levine & Levine,supra note 70, at _-_. 

225See Algea O. Harrison et al., Family Ecologies of Ethnic 

MincJrity Children, 61 0i1lD DEV. 347 (1m). 

~See, e.g., Theresa D. LaFromboise et al., Counse/ingJnterventionandAmericanJndian Tradioon: An IrUegrotiveApproach, 

18 CoUNSElING PSYCHOLOGIST 628 (1990). 

'lllSee generaJiy U.S. ADVISORY BoARD ON CHIU> ABUSE AND 

NEGlECT, THE CoNTINU[NG CHiLD PROTECI10N EMERGENCY: A 

OiAUENGETOTIfE NATION 138-70 (1993) (summary of a Board 

symposium on A New Child Protection Strategy: Creating and 

Maintaining Caring and Inclusive Communities). 

1281d. at 31. 

m See, e.g., CREATiNG CARING CoMMUNITlES,Supra note 7, at 105-

16, 123-24. A recent panel ofthe National Research Council on 

reached similar conc1usion:s about problems in Federa1 capacity and responsiveness to needs for research on child ma1treatmen!. PANEl~ supra note 4, at 8:1-8:22. 

13Uf'he executive summaries of these papers are included in 

Appendix C to this report. The authors were (1) James 

Garbarino and Kathleen Kostelny (neighborhood programs), 

(2) Jill E. Korbin (sociocultural factors), (3) PauJ Lerman 

(institutional regulation), (4) Leroy H. Pelton (materia1 support), (5) RossA. Thompson (social support), and (6)David A. 

Wolfe (treatment). 

llISYST'EM, supra note 223. 

D2J'hese reports are forthcoming in a special issue of J. CllN. 

Oru.n PSYCHOL 

DlRoss A. THOMPSON, Scx:1ALSUPPORT ANDlliE PREVENTiON OF 

Gmn MALTREATMENT 11 (1992) (PAPER PREPARED FOR llfE U.S. 

ADVISORY BoARD ON Ornn ABUSE AND NEGLECT). 
r 

Neighbors Helping Neighbors 

62 

~SEE, E.G, lEITER FROM DEANNE TlLTDN DURFEE, CHAiRPERSON, U.S. ADVISORY BoARD ON Cmw ABUSE AND NEGLECf, TO 

JOSEPH MOTIOLA, ACT1NG O:>MM1SS[O!,;ER, ADMINISTRATION ON 

CHIlDREN, YOUTH,ANOFAMlllES (JULY 12, 1993) (COMMENTll'IG 

ON AoMINlSfRAllON FOR Om.nREN AND FAMlUES, CHlUJABUSE 

AND NEGLECT PREVENl10N AND TREATMENT PRlORIT1ES FOR FISCAL 

YE4R 1993, 58 FED. REG. 28021 (1993)). 

JI 

u.s. Advisory Board on Child Abuse and Neglect 
A New National Strategy for the Protection of Children 

IV. CONSISTENCY OF THE NEW NATIONAL STRATEGY WITH 

OTHER REFORM EFFORTS 

Although the Board is advocating large·scale change, 

the approach is consistent with that employed in 

local programs that have become nationally recog· 

nized for their work. Researchers at the Center for 

Youth Research at the University of Hawaii sur· 

veyed a panel of nationally recognized experts to 

detennineexemplarycommunityprogramsforfam· 

ily support, most commonly for the purpose of 

prevention of child abuse and neglect.23s The 21 

programs identified had many features in common. 

They typically offered both prevention and treat· 

ment services that: 

· strengthen family and community supports and 

connections; 

· treat parents as vital contributors to child growth 

and development; 

· create opportunities for parents to feci empowered 

to act on their own behalf; 

· respect the integrity of the family unit and serve it 

holistically; 

· enhance parents' capacities to foster the optimal 

development of their children and themselves; 

· are programmatically sensitive to the cultural, 

ethnic, religious, social, and economic characteris· 

tics ofthe community; 

· establish linkages with community support sys· 

terns; 

· provide settings where parents and children can 

gather, interact, support, and learn from each other; 

· enhance coordination and integration of services 

needed by families; 

· enhance community awareness of the importance 

of healthy parenting practices; 

· provide 24·hour emergency support when parents 

and children need help.236 

Most of the programs studied by the University of 

Hawaii group were not only neighborhood-based 

and family.focused but also child-centered. They 

involved direct services to children and adolescents 

themselves as well as parents and whole families. 

The views of children and adolescents themselves 

were solicited in the design of programs and family 

service plans. 

Although the University of Hawaii study is particu· 

larly notable for its analysis of particular neighborhood·based programs, the general approach of the 

programs studied typifies service integration in a 

variety of domains.237 It also is consistent with the 

recommendations of a myriad of national commissions and initiatives in recent years.238 

Perhaps most notably, the general emphasis on 

broad-based family support and easy accessibility 

and availability of primary and secondary prevention is compatible with the thrust of the recommendations of the National Commission on Child Wei· 

fare and Family Preservation,239 an initiative of the 

American Public Welfare Association (APWA) •• 

recommendations that were incorporated in principle into the report of the National Commission on 

Children.240 Such an emphasis is also consistentwith 

longer -standing community development initiatives, 

many newer early childhood education programs 

(including preschool programs for young children 

with disabilities and their families), and new initiatives for school-based services. 

ENDNOTES 

lliKathleen Wilson, Exemplary NeighborluxJd-basedProgn:uns, 

in SYSffiM, supra note 223, at _. 

2J6Jd. at 

2J?Sa! supra notes 1S8-89 and accompanying text. 

2J8Sa! WOthng TowaniAnAgendaforCJwnge: A Surnmmy, 

PROTECIlNG DnwREN (Summer 1991), at 21. 

U.S. Advisory Board on Child Abuse and Neglect ------------------------ 63 
Neighbors Helping Neighbors 

64 

ZJ9NAUONAL CoMM'N ON CHnn WElF. & PAM. PRESERVATION, 

A CoMMIlMENT TO OiANGE: RECOMMENDATIONS (n.d.). 

'~"BEYONO RHITORlC, supra note 12, at 21)4..97. 

u.s. Advisolj' Board on Child Abuse and Neglect 
I 

1 

A New National Strategy for the Protection of Children 

V. PRINCIPLES TO GUIDE IMPLEMENTATION OF THE NEW 

NATIONAL STRATEGY 

Throughout this report, we have emphasized the 

importance of strengthening neighborhoods, ensuring material supports, and promoting the involvement of families, including fathers; in watchfulness 

for each other's families. Assuming these points, we 

now provide five general principles for program 

development consistent with the new national strategy for child protection. The five principles presented here arc discussed in detail below. 

A. The hallmark of the child protection 

system should be that help needed to prevent 

child abuse and neglect or ameliorate its 

effects is easily available and accessible. 

B. Child protection activities should include 

a focus on increasing connectedness among 

people. 

C. Child protection activities should include 

a focus on development of actual and selfperceived competence of parents. 

D. Child protection activities should include 

a focus on development of actual and selfperceived competence oCneighbors as 

helpers. 

E. A special focus on prevention of child 

maltreatment should occur at developmental 

transitions, especially birth and adolescence. 

A. THE HALLMARK OF THE CHILD 

PROTECfION SYSTEM SHOULD BE 

THAT HELP NEEDED TO PREVENT 

CHILD ABUSE AND NEGLECf OR 

AMELIORATE ITS EFFECfS IS EASILY 

AVAILABLE AND ACCESSIBLE. 

lhis principle is one that should be self-evident but 

that unfortunately has long been missing from the 

child protection system. It is based on the definitional premise that the purpose of the child protection system should be to protect children from harm 

and the nonnative beliefs that (1) fulfillment of this 

purpose should be a matter of high priority and (2) 

parents should not have to be subjected to procedures that are or seem punitive when they seek help. 

The principle of easy availability and accessibility 

also is based on several general findings of empirical 

research. First, most troubled families accept help 

when it is consumer-oriented -- when families are 

provided with choices of services delivered where 

they are (in "natural" neighborhood settings like 

home and school) in a manner that is culturally 

compatible, nonstigmatizing, and related to the problems and goals identified by the families themselves.241 Although such freedom may not be appropriate for a parent who seriously injures a child, it 

may be the most effective means of engaging parents overwhelmed with problems and reported for 

lack of supervision of their children or families with 

mUltiple problems who are at high risk. 

Second, the most successful responses to complex 

human problems have featured such an approach. 

In other words, easily accessible and available services not only are preferred by familieswith multiple 

problems, but such consumer -oriented services are 

also most likely to be effectivc.242 

TItird, the number of affected children and families 

by itself requires a "public health" approach in 

which child protection cfforts are integrated into 

neighborhood settings. So many children are abused 

u.s. Ad'1sory Board on Child Abuse and Neglect ------------------------ 65 
Neighbors Helping Neighbors 

66 

or neglected that it is reasonable to consider the 

development of psychosocial "inoculation" programs administered in schools, for example. that 

might mitigate the effects of the psychological, physical, and sexual assaults that many will experience, 

regardless of whet her such events are ever identified 

as incidents of abuse. In the same vein, support 

should be easily available in schools, 4-H clubs, 

Scouting, churches, and other settings in which help 

would be easily accessible for children who may 

experience maltreatment, and such organizations 

also should reach out to involve children who are 

troubled or isolated. The same principle demands 

broad availability and accessibility of adult-oriented 

prevention programs (e.g., televised public service 

announcements; workplace-or heal th -center-based 

parent support and education programs). 

The number of families already seeking help who 

are not receiving it from the formal service system 

also suggests the need for broad-based programs. 

For example, the experience of Parents Anonymous 

of New Jersey has been that parents calling a State 

reporting hotline often have their calls rejected 

because the situation is not "serious enough." In 

New Jersey, Parents Anonymous itself operates a 

helpline that handles over 1,()(X) calls per month to 

request infonnation, support, and help. Even more 

dramatically, Parents Anonymous chapters across 

the nation received 7D,()(X) calls after the showing of 

the Scared Silent documentary by all of the television 

networks in September 1992 (other helplines and 

agencies received many other calls).243 

B. CHILD PROTECfION ACfIVITIES 

SHOULD INCLUDE A FOCUS ON 

INCREASING CONNECfEDNESS 

AMONG PEOPLE.'" 

Professionals in the field of child protection long 

have been concerned with social isolation as a factor 

in the incidence of all forms of child maltreatment. 

Recent research on the significance of neighborhood cohesiveness has given further evidence of the 

importance offamilies' "belonging" to acommunity 

as a preventive factor. Parents' social networks 

provide emotional support, infonnation about resources and access to them, and monitoring and 

control. They also offer direct emotional support to 

children and additional mooels from whom children 

may learn. Moreover, positive relationships enhance parents' sense of personal competence and 

control. 

Even if the strategy of strengthening ties between 

neighbors did not appear to be important in itself in 

the prevention of child abuse and neglect, it would 

be a necessity as a practical matter. The problem of 

child maltreatment is too large to leave entirely to 

human service agencies. Unfortunately, there are 

too many people who need helpand notenough paid 

helpers. Moreover, the greatly increased need for 

help in part represents a breakdown of infonnal 

helping systems such as extended families, churches, 

clubs, and groups of friends, which worked well in 

the past but no longer seem as strong tooay, particularly in economically deprived communities. If we 

are to prevent child maltreatment, we must find 

ways to reinvigorate these helping systems where 

possible and in other instances to heIp develop 

alternative systems. 

In building informal helping systems, it is important 

to build a sense of reciprocity into such relationships.245 People who are helped need to be given the 

challenge and the opportunity to help others. Receiving help may be necessary, but it can actually 

work to weaken one's self-esteem if the help flows 

only one way. Alternatively, giving help as well as 

receiving it can empower people and strengthen 

their self-esteem. Reciprocity can occur through 

fonnal mutual-assistance and self-help groups like 

Parents Anonymous and the Family Cooperative 

programs developed with NCCAN support in several Northeastern states. It also can occur through 

volunteer programs and service plans thatrecogni2e 

helpers' need occasionally to receive positive feedback from the people whom they are assisting and 

that enable consumers of services to graduate to 

helpers. England's Parent-Infant Network program 

in London provides an excellent example of this. 246 

Consistent with the general principle of neighbors 

helping neighbors. all programs and policies related 

tochild protection should include a focus on promotion of relationships. For example, infant home 

u.s. Advisory Board on Child Abuse and Neglect 
visitation programs might be structured so that the 

visitors organize parents of children of the same age 

sothat the parents can get to know each other, share 

babysitting, and generally provide support. Churches 

and civic groups might encourage their members to 

"adopt" another family and structure social activities to promote interaction and mutual assistance. 

C. CHILD PROTECfJON ACTMTlES 

SHOULD INCLUDE A FOCUS ON 

DEVELOPMENT OF ACTUAL AND SELF· 

PERCEIVED COMPETENCE OF 

PARENTS. 

Although efforts to construct "profiles" of abusive 

adults generally have revealed weak correlations 

between psychological traits and maltreatment of 

children, there may be no psychological variable 

that has a stronger relation to child maltreatment 

than does parental self-esteem. When parents perceive themselves unable to adapt to the demands of 

parenthood (which inevitably change as children 

grow 0Ider),247 they fail to foster social competence 

in their children, who in tum respond aversively, 

confirm the parents' low self-esteem, and evoke 

rejection (emotional abuse), withdrawal (neglect), 

or aggression (physical abuse).248 Lack of a clear 

sense of oneself also can diminish empathy and 

sensitivity to children's feelings.249 It also can cause 

parents to withdraw from ongoing interaction with 

other adults who can offer direct assistance, modeling, and monitoring,Bl 

Some well-known programs for prevention and treatmentofchild abuse and neglect (e.g., Parents Anonymous) build from such knowledge by placing an 

emphasis on enhancement of parents' sense of competence.2S1 In other instances, such a result can 

occur from successful involvement in activities 

related to childrearing (rather than discussion leading to insight about one's competence or to success 

in dealing with hypothetical situations). 

School-based programs have special potential to 

build parents' actual and perceived competence. 

For example, a rural school in New York State 

noticed that some academic and emotional probA New National Strategy for the Protection of Children 

lems diminished among children whose parents 

became involved in volunteering for work in afterschool programs and related efforts. In at least one 

instance, a mother who once had been reported for 

maitreabnent played a major role in organizing 

services and providing leadership in the community 

as a result of her volunteer involvement in the 

school.Z52 

Because of the close relation between child maltreatment and parental self-esteem, such approaches 

by schools can be expected to reduce child maltreatment, especially among families "on the edge." 

Whengiven encouragement and support, such families often will manage and perhaps even flourish, but 

otherwise they may become consumed by problems 

and fall over the edge in ways that result in maltreatment and other serious problems. 

These examples illustrate approaches that have been 

used for many years in Head Start programs to 

involve and empower parents. Too often, though, 

when Head Start children enter elementary schools, 

their parents find that parental involvement is not so 

welcome. Most schools do not have family workers 

on their staffs as do Head Start programs, and few 

schools perceive work with parents to be a central 

part of their mission, as it is in Head Start. Schools 

that do find ways to build on and extend the parent 

involvement initiated with Head Start programs will 

contribute to the competence of both parents and 

children. 

School-based programs may be useful in one other 

way. Although direct evidence for long-tenn prevention of child maltreatment is lacking, studies of 

school-based parenthood education suggest that 

such programs can facilitate adolescents' empathy 

and their sense of competence as future parents.Z53 

Accordingly, schools can facilitate students' acquisition of skills needed to cope with the demands of 

parenthood. 

Of course, schools do not need to do all this themselves. Mostofthe examples thatwe are giving (here 

and in a subsequent subsection on schools' role in 

child protection) were developed in concert with 

another organization, and in some instances the 

latter led the initiative. Schools can perfonn a major 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 67 
r , 

Neighbors 1 Ielping Neighbors 

68 

service by providing facilities for family activities 

and encouraging the development of programs that 

are administered by other agencies. 

Whatever the site and auspice for prevention programs aimed at parents, staff should respect and 

build on the knowledge that parent'i have, and they 

should design programs in a manner that is responsive to parents' questions and concerns. Viewing 

parents as clients, who have only problems and 

needs but few strengths, does not strengthen their 

self-esteem and maypcrpetuate orcven exacerbate 

their problems rather than resolve them. It is time 

to move beyond the traditional deficit-based model, 

which provides services only to those who can prove 

that they have the most severe problems. 

This point is significant in treatment as well as 

primary prevention. Provision of choice communicates respect and heightens efficacy of treatment.254 

In its visit to Minneapolis, the Board noted an 

experiment funded by the McKnight Foundation 

program which, in preliminary data, showed that 

CPS clients would take advantage of vouchers enabling them to purchase those services that they 

believed would be helpful. 255 The Board also has 

noted experiments with flexfunds and other direct 

provision (e.g., gifts by home visitors) of small but 

significant material support to families under stress. 

Such programs appear to be key to development of 

parents' sense of efficacy and their actual capacity to 

protect their children when multiple serious problems affect the family. 

D. CIDLD PROTECfION ACTIVITIES 

SHOULD INCLUDE A FOCUS ON 

DEVELOPMENT OF ACTUAL AND SELF. 

PERCEIVED COMPETENCE OF 

NEIGHBORS AS HELPERS. 

Although a measure of self-confidence is necessary 

for parents to seek help, even greater self-esteem 

may be necessary for parents to assume important 

roles in providing assistance to others. If such a 

proces"i is to occur, neighbors must believe that they 

have a sufficient stake in the neighborhood to motivate them to help their neighbors, and they also must 

perceive sufficient control over the neighborhocx:l to 

believe that they can make a difference if they do 

reach out. 

Volunteer helpers (including those who are "natural" helpers not involved in organized volunteer 

programs) offer a reality check when parents have 

questions about matters related to childrearing --

whether, for example, a particular disciplinary practice is "over the edge." They also provide infonnation about resources for help, whether fonnal or 

infonnal. Such roles are particularly important in 

some ethnic communities in which elders serve as 

the conveyors of community norms and the sources 

of advice and counsel. 

Programs should give due deference to these ongoing sources of help. Programs should ensure that 

infonnation is available to them so that they in turn 

can be useful infonnal referral points when parents 

seek their help. 

E. A SPECIAL FOCUS ON PREVENTION 

OF CHILD MALTREATMENT SHOULD 

OCCUR AT DEVELOPMENTAL 

TRANSITIONS, ESPECIALLY BIRTH AND 

ADOLESCENCE. 

Preventive activities designed to strengthen parenting 

should be focused on predictable transition points 

when parent receptivity is likely to be highest. Such 

points begin with the most significant transition of 

all -- birth -- when parents may find practical 

assistance, emotional support, and parent education especially useful. In that regard, pre- and 

postnatal home visitation programs like the Healthy 

Start program in Hawaii have been demonstrated to 

be effective in preventing child maltreatment, especially among first-time parents and families at high 

risk. 

The Board continues to give strong support to efforts to develop universal access to voluntary programs of infant home visitation. We also recommend research to determine the critical program 

u.s. Advisory Board on Child Abuse and Neglect 

,. 
I 

, 

I 

i 

elements of such programs and to test the effectiveness of various administrative and fiscal structures 

in neighborhoods of different characteristics. 

In addition to birth, transition points include entrance to school, the onset of adolescence, and the 

transition from school to work. Although the top 

priority should be for prevention efforts aimed at 

families of infants and preschoolers,2S6 a focus on 

this age range alone will not ensure protection of 

children. Parents who may successfully meet the 

demands of a crying infant may be unprepared for 

later challenges, particularly in the teenage years. 

Similarly, parents who cope well with their infant 

child may divorce and remarry by the time of later 

transitions, and the child may become more vulnerable. 

As children enter adolescence, the stakes increase. 

The transition from childhood toyouth -- the substitution of peer for family relationships -- can be a 

period of high vulnerability for both youth and their 

parents. lbis is a time when youth approach physical maturity but remain emotionally far more dependent on their parents than either the youth or the 

parents may realize. £t is a time when many youth 

rebel against their parents, some of whom may 

abuse or neglect them in response. It also is a time 

when youth may become involved in hannful behavior, such as substance abuse, gang activity, teen 

pregnancy, running away, delinquency, and even 

suicide _. all of which are likely to occur with greater 

frequency when teenagers are being maltreated.257 

For these reasons, the consequences of adolescent 

abuse are more serious than is generally realized, 

and reports of it should be treated more seriously 

than is usually the case. Moreover, the incidence of 

suspected maltreatment is as high or higher than in 

most other age groupS.258 

Becauseofthe difficulties encountered in parenting 

adolescents, their parents need help and support as 

much as the parents of newborns. Hotlines, discussion groups, support groups, and counseling should 

be made available for these parents, just as they are 

offered for parents of young children. 

A New National Strategy for the Protection of Children 

A speciaJ focus on adolescents also makes sense as 

an element of prevention, because work with adolescents potentially is important in preparation for 

parenthood. Such a focus also has more immediate 

significance in the field of child protection, because 

the prevalence of maltreatment of adolescents is 

high and the factors involved in it appear to be 

somewhat different from those involved in the maltreatment of children. 2'i9 

Because children begin to separate from their families as they grow into adolescence, it is essential that 

positive opportunities exist for them in their communities. The increase in single-parent households 

and families with two working parents often means 

less supervision for children after school and sometimes translates into less attention from any adult. 

Every community must address this issue, because it 

is frequendy beyond the means ofindividual parents 

to resolve on their own. 

Obviously teenagers do notrequire the same level of 

care that infants do, but they do need constructive 

challenges, opportunities, and guidance from adult 

mentors and role models outside their immediate 

families. Such positive experiences provide the 

foundation for hope and self-esteem. 

Some communities have organized after-school activities for children. Others provide mentoring and 

apprenticeship programs. Some have linked older 

people with younger people, when people in both 

generations would otherwise be alone. Others have 

developed community volunteer opportunities, cultural programs, and athletic activities -- programs 

that provide youth with opportunities for positive 

interaction with adults outside their own families 

and, therefore, for experiences that build self-esteem and enrich social networks. Like their parents, 

children need something that offers hope -- to which 

they can belong, of which they can be a part, and 

through which they can find meaningful roles for 

themselves. The absence of such a sense of belonging can have cancerous effects as the consequences 

of low self·esteem, isolation, and alienation multiply. 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 69 
Neighbors Helping Neighbors 

70 

Like adults, teens also need opportunities to give as 

well as to receive, The Peer Helpers National Asscr 

ciation is an excellent example of how adolescents 

can become involved in helping their fellow students 

with problems ranging from depression and suicide 

to child abuse, neglect and molestation. 

The teenage Jears fonn a bridge between two generations; teens may be victims of child maltreatment, perpetrators, or both. For many, this period 

represents the last opportunity to resolve (or avoid) 

underlying problems thatcan lead to child maltreatment when they become parents themselves. 

ENDNOTES 

2A1In a pilot project (Family Options in Hennepin County, 

Minnesota) preparatory to a controlled study currently underway (both funded by the McKnight Foundation), voluntary 

he[pwasaccepted by about IXJ% of CPS-referred families given 

the option of receiving $3500 worth of services from a menu 

offered them. Almost all of them actively participated in 

services. Letterfrom PhilipAuCiaire, Project Director, Family 

Options, to Phillip Lyons, Senior Graduate Assistant, Center 

on Children, Families, and the Law, University of NebraskaLincoln (July 26, 1992). 

l<2See, e.g., Molly A. Brunk et al., Comparison of MuiJisystemk: 

Therapy and Parenl TrWning in the Brief Tl'f?tUmenl of Child 

Abuse and Neglect, 55 J. CoNSULTING & 0lN. PSYOiOL 171 

(1987); seegenerally Wolfe, supra note 71. 

l<lSee Patricia Rowe, Child Abuse Telecast Floods NaliorKd 

Hotline, 21 CmwREN TODAY, No. 2, at 11 (1992). 

UOA focus on Increasing connectedness among people was a 

primary focus of a pioneer tn the fteld of child protection, 

the late Ray Helfer, In hls vision of the future. Ray E. 

Helfer, Cltild ANse and Negl«t: Assessment, TreotwwnJ, 

and PNNmtiott, lJdober 21, 2007, 15 CHILD ABUSE & NEGLECT 

5 (Supp. I, 1991). 

2<5See Thompson, supra note 233, at 42-44, 48-49, & 91-94. 

WiIn testimonybeCore the Board (Aug. 29, 1992, in Chicago), 

Eitchne Sharp described an interesting program in London, 

England, that incorporates such elements. A community 

center provides a Parent-Infant Network (PIN) program that 

focuses on provision of mutual assistance and 24-hour support 

andenhancementofclientself-esteem. "Users"ofservicesare 

trained to become "befrienders." 

l<70f rourse, such perceptions can reflect actual deficits in 

coping abilities and interpersonal skills. Failure can stimulate 

a vicious cycle in which parents fail to respond adaptively 

because they have learned that they cannot--often an 

overgeneralization of aversive experiences and sometimes a 

rellection of situational lack of control more than personal 

traits. The relation between social class and rate of maltreatment mayrel1ect such a process, in which parental depression 

is evoked by overwhelming and chronic family crises without 

the meansto betterthe family'ssocial and economic situation. 

See Pelton,supra note 39, at 42-54. 

l<8J)A\1I) A. WOlFE, Omn ABuSE: IMPUCAll0NS FOR C'HnD 

DEVElOPMENT AND PSVaiOPA'ffiOLOGY 37 (1987). Research 

shows that, contrary to the conventional wisdom, maltreating 

parents tend to establish expectations that are unrealistically 

high for themselves, not their children. Mindy Rosenberg & N. 

Dickon Reppucci, Abusive Mothers: Perceptions of th£ir Own 

and theirChiidren 's Behoviot; 511. CoNSULTING& CuN. PSYCHOL 

674 (1983). Thus they respond from frustration at their own 

perceived inability to elicit appropriate behavior by their children. 

14~orma D. Feshbach, The Constn.4ct of Empathy and the 

Phenomenon of Physical MahreatmenJ of Children, in C'HnD 

MALTREATMENT: THEORY AND RESEARCH ON 11iE CAUSES AND 

CoNSEQUENCES OF Cmw ABuSE AND NEGLECf 349, 356 (Dante 

Cicchetti & Vicki Carlson eds. 1989). 

:Z:;OSee generally Thompson, supra note 233. 

2SISee Virginia Murphy-Berman & Gary B. Melton, Communily-Based Parenting Support Systems: The MutuaJAssistance 

Model, in SYSTEM, supra note 223, and citations therein. 

l:'i'The potential generalization of leadership in school activities byparents without a history of involvement in community 

activities was also demonstrated in efforts to develop magnet 

programs to ease transitions to desegregated schools--efforts 

that in some instances resulted in African-American parents' 

entrance into higher education and their development into 

important leaders in the community as a whole. JAMES E. 

TEELE, EVALUATING ScHOOL BUSING: BoSTON'S PROJECf ExoDUS 105-14 (1973). 

2S>sarah L. Cool; & N. Dickon Reppucci, The Na/w'e and 

Efficacy of ChiJd-CenJered, Neighborltood-Based Child ProtectionPrograms: The Record Thus Far, in SYSTEM,supra note 223. 

l:'ioO Seegenerall}CHolCEANo PERCElVEoCoNTROL(L. C. Perlmuter 

& R.A. Montyeds., 1979); Charles R. Tremper & Morgan P. 

Kelly, The Mental HealJh RaJinnaJe for Policies Fostering Minors'Autonomy, 10 INT'LJ. L. & PSYCHIATRY 129 (1987). 

155 See supra note 241. 

l:'ibCf Edward Zigler et ai., Early Childhood InJervention: A 

Promising Preventative for Juvenjle Delinquency, 47 AM. PSYOfOLOGIST 997 (1992). See generally E. Wayne Holden et ai., 

Preventing Child Maltrea1menl During th£ PrenauUIPerinatal 

U.S. Advisory Board on Child Abuse and Neglect 

p 
I 

I 

I 

, 

I 

I 

L 

Period,inPREVENI10NOFCmwMALTREA'I'MENT: DEVELOPMENTALANDEcot.ooICALPERsPECllVES 17 (DianeJ. Williset aI. eds. 

1992) [hereinafter PREVENTION]; Jan L. CuJbertson & Cynthia 

L. Schellenbach, Prevention of MaltreatmenJ in Infants and 

Young Citiltiren, in PREVEImON, supra, at 47. 

157See generWIy JAMBS GARBARINO & GWEN GnJ.lAM, UNDERSTANDING ABuslVE FAMIUES 167-84 (1980). 

25IIAccording to the second National Incidence Study, onefourth of all children and youth beli~ed to have been maltreated were teenagers (physical abuse, 29.7%; sexual abuse, 

28.4%; emotional abuse, 42.1%; physical neglect, 14.1%). 

Jones & McCurdy, supra note 219, at 208. 

2)'/See James Garbarino, ~nting Adolescent Makret11r1umt, 

in PREvENTION, supra note 256, at 94. Compared to maltreatmentofchildren, maJtreatment of adolescents involves a greater 

proportion of girls and is less linked to poverty. 

A New National Strategy for the Protection of Children 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 71 
Neighbors Helping Neighbors 

72 

VI. A COMPREHENSIVE APPROACH TO THE IMPLEMENTATION OF THE 

NEW NATIONAL STRATEGY 

Given the multiplicity of problems faced by families 

in which maitreabnent occurs or is at risk of occurring, services must be widely available, easily accessible, and comprehensive --in effect, integrated into 

daily life. Child protection should be conceptualized as everyone'sjob. Every sector of society ought 

to be involved. 

Some examples follow. In offering them, the Board 

does not intend toimply either that the examples are 

the only -- or even primary -- tasks that a given sector 

should undertake in order to protect children. Conversely, we also do not intend to imply that the tasks 

indicated should be performed by a particular sector 

and not another. Rather, we are suggesting some of 

the tasks that various groups or agencies can fulfill; 

the point is not to assign roles but instead to suggest 

possibilities. The actual division oflaborought to be 

matched to use local resources optimally through 

State and neighborhood plans. 

A. HEALTH SERVICES 

As a nearly universal system,260 health care is another key component of the child protection system. 

Although the primary role that health care providers have played in child protection historically has 

been forensic (i.e., diagnosis and reporting), the 

potential role is substantially broader. 

Perhaps the most important example of the expanded role that could be played is infant home 

visitation, which has typically (but not necessarily) 

been based in public health (analogous to visiting 

nurse programs). Advice-giving and support rela ted to well child care are other obvious entry points 

for prevention and treabnent of child abuse and 

neglect. 

In that regard, evidence that the emergency room is 

the major perceived source of help for many parents 

in declining neighborhoods indicates the potential 

importance of emergency-room social services, especially in children's hospitals,201 in helping to build 

connections for parents who believe that they have 

nowhere else to go when family crises occur. It is 

likely that health care reform will induce a reduction 

in the use of emergency rooms in favor of community health centers and other primary health care 

providers. Regardless of whether such a change 

occurs, community health centers could be useful 

sources of support through, for example, call-in and 

drop-in services for parents seeking advice in dealing with disciplinary problems and other child-care 

issues.1ti2 If history-taking is sufficiently careful, 

primary health care also can be an entry point to 

more specialized services (e.g., support groups for 

survivors of child abuse). 

Another important health-system-based element of 

a comprehensive effort to prevent child abuse and 

neglect is family planning. As a recent urban-policy 

analysis by the RAND Corporation concluded, few 

interventions have effects as well documented in 

regard to family cohesion and child well-being.263 

Although the Board is not aware of research directly 

showing that family planning programs prevent child 

abuse and neglect, studies of the pediatric-health 

consequences of family planning,2M the relation of 

family size to child maltreatment, 265 and the familyplanning effects of some programs for prevention of 

child maltreabnent266 suggest that such a protective 

effect is likely. 

B. MENTAL HEALTH SERVICES 

In the Board's own deliberations and its discussions 

with professionals in the field, a general perception 

has been that the mental health professions have 

been underinvolved in prevention and treabnent 

related to child abuse and neglect. This underinvolvement is unfortunate for several reasons. First, 

given the well-established risk to the mental health 

of children who have been subjected to any form of 

maltreabnent, there is a great need for services to 

prevent or remediate such harm. Second, as experts 

in behavior change, mental health professionals 

should be able to apply research about the nature of 

u.s. Advisory Board on Child Abuse and Neglect 
+ 

child maltreatment to the design and implementation of conceptually based and empirically tested 

programs to prevent the occurrence and recurrence 

of maltreatment. 'Third, because the boundaries of 

catchment area.~ of community mental health centers (CMHCs), especially in urban areas, often 

approximate the geographic limits of neighborhoods, 

CMHCs have the potential to lead in the development and implementation of neighborhood plans 

for child protection.267 Fourth, in rural areas in 

many parts of the country, CMHCs are the only 

multi-disciplinary programs available. Thus, in these 

areas, too, CMHCs can lead the service system in 

design of multifaceted prevention and treatment 

programs. Accordingly, a key role of mental health 

professionals in the child protection system is consultation --for example, to teachers trying to support 

a maltreated child in school. 

In arguing for an expanded role for mental health 

professionals in the child protection system, the 

Board is mindful of limitations in such advice. Little 

is known about the effectiveness of treatment for 

older children and adolescents who have been abused 

or neglected. Moreover, some CMHCs have become so dependent on fees for services to individuals and so focused on needs of adults with chronic 

mental disorders that they may be unmotivated to 

make services related to child protection a high 

priority. 

It is clear that providers of mental health services 

must not only do more in the prevention and treatment of child abuse and neglect but that they also 

must behave differently. Traditional mental health 

services are ill-suited either to primary prevention in 

families in which maltrea truent has not yet occurred 

or to treatment of the multi-problem families who 

are the principal clients in the child protection 

system as it currently exists. To be effective, mental 

health providers must be willing to leave the office 

and to shape interventions to respond to multiple 

needs, including needs for economic support, when 

and where clients can best respond. Mental health 

clinicians (and other service providers in the child 

protection system) need to reverse the present tendency to fit clients to packaged services. 

A New National Strategy for the Protection of Children 

Wolfe's swnmary is instructive: 

INJo particuln.r method of intervention is likely to lead 

to desirable outcomes for even a majority of families, 

e.~pecin.l1y by thi' time chiM maltreatment hlL~ been 

identified .... I Research suggests the need to place J greater 

emphasis on preparing parents for their childrearing 

roleweU in advance of the emergence of problems, and 

having a wider range of appropriate services available. 

Such a model requires staff who are trained to assist 

with families at a level that is most beneficial, rather 

than attempting to detect and intervene after the fact. 

Staffwould have to be sensitive to individual, community, and cultural preferences, as well as socioeconomic limitatinns, that constitute the majority of disadvantaged families, and be willing to tolerate such 

differences for the purpose of establishing a basis for 

improving the parent-child relatinnship. This approach requires more investment in family development at an earlierpoini in time, but holds considerable 

promise in reducing the costs and jaihlres of the current 

reactive system. 268 

c. SUBSTANCE ABUSE PROGRAMS 

An element that now is widely acknowledged to be 

an integral part of the child protection system is the 

substance abuse treatment system. With greater 

acknowledgment of the frequency of substance abuse 

among maltreating parents and the potential hann 

of fetal exposure to alcohol and other drugs, the link 

between substance abuse and child maltreatment 

has become a "hook" for funding of new programs?>9 

An important point, though, is that ehild protection 

programs based in substance abuse treatment agencies look like well conceptualized programs in other 

agencies. There is little that is unique about programs based in substance abuse services. This point 

is illustrated by examination of the characteristics of 

most of the scores of demonstration projects that 

were funded by the Pregnant and Postpartum 

Women and Infants program of the Center for 

Substance Abuse Prevention: 

U.S. Advisory Board on Child Abuse and Neglect ------------------------ 73 
Neighbors Helping Neighbors 

74 

· an array .. ,[of) services that includes education and 

services to meet the diverse and complex needs of 

families; 

, practical help, including transportation, child care, 

job seeking, emergency assistance, housing, food, 

and fun; 

, recognition and use of extended family, neighbors, 

friends, and tribal members who seem to have natural ability to understand and help; 

'locations (and times) that arc convenient for participants; 

· novel approaches to education and counseling 

tailored to special needs and usually developed from 

earlier efforts that were less successful that was 

hoped; 

· support, being there, even after program services 

are complete, an ongoing network of help, support, 

and advice; 

, collaboration across boundaries that previously 

had not been crossed, whether a tribal community 

and a dominantly European-American town or businesses, human services and law enforcement. 270 

Recognition of the similarity of integrated services, 

regardless of auspice, does not minimize the necessity for substance abuse programs to recognize the 

needs of their clients' families (and the risk that they 

sometimes experience) and to respond creatively, 

flexibly, and intensively. A program in San Francisco for mothers of substance abusing mothers that 

provided support in caring for grandchildren and 

that stimulated advocacy and empowennent was 

illustrative,271 

At the same time, other agencies may have much to 

learn from substance abuse agencies, The movement among substance abuse programs for development of community coalitions for prevention of 

chemical dependency may be instructive to programs designing programs for prevention of child 

maltreatment. 

D. THE SCHOOLS 

In its 1991 report, the Board noted the virtual vacuum 

in child protection efforts in the U,S. Department of 

Education,m Analogously, researchers have found 

underreporting of suspected child maltreatment to 

be especially acute in the schools,273 

Thc Board continues to believe, however, that "the 

educational system has the potential to be the linchpin of community-based efforts to protect children 

from maltreatment."274 Schools playa key role in 

detennining the quality of the social environment in 

neighborhoods, for both children and their parents. 

Indeed, they often serve as the center of the community, particularly in rural areas. As a result, school 

issues and activities often bring the community 

together in ways that nothing else does. 

Moreover, there are signs that professionals in education are ready to assume a larger role in child 

protection, Many schools have adopted child sexual 

abuse education programs,275 Although the effec· 

tiveness of this approach is controversial,276 it does 

indicate the willingness of schools to assume a larger 

role in the prevention of child abuse and neglect.277 

So too does the creative response by some schools to 

the need to build supportive networks for children 

and families, 

Florida, along with a number of other states, is 

funding "Full Service Schools" which arc evolving 

locally through interagency collaboration to meet 

local education, medical and/or, social and human 

service needs of children and youth and their families. The ideais to bring needed services onto or near 

the school grounds to be easily accessible. Full 

service schools are seen as potential onc stop shopping centers for students and their families. Community and parent involvement in setting priorities 

and developing services is an important part of this 

effort. It is hoped that this will improve school 

community relations so thatfamilics will support the 

school's mission, and that schools in return, will 

support the family's mission.278 

In New York State, the Liberty program uses interdisciplinary teams to provide special attention to 

children and families at high risk, And through the 

u.s. Advisory Board on Child Abuse and Neglect 
, 

L 

Community Lifelines prevention demonstration 

project funded by NCCAN, four schools in Elmira, 

N.Y. are experimenting with part-time outreach 

workers who seIVe as parent partners -- an inexpensive but effective means of involving parents in 

building a sense of community and sUp(Xlrt for each 

other through child-and parent centered activities 

based atthe school. SchooIsin Elmira and Cortland, 

N.Y. also have succeeded in gaining the cooperation 

and involvement of parents of children with academic and emotional problems (including problems arising from maltreatment) by reaching out 

effectively and by marketing special activities as 

privileges rather than a stigma. 

Although such programs still are not as common as 

they should be, there has been a growth in school~ 

based health, mental health, and social service pro~ 

grams ~~ often through partnerships between schools 

and community agencies.279 Indeed, one of the 

products of school restructuring in some States has 

been the development of "full~service" schools 

equipped to meet children's social and emotional 

needs as well as their cognitive needs.28) When such 

a development occurs with an emphasis on neigh~ 

borhood and parent involvement, it can result in 

strengthened neighborhoods and families ~~ impor~ 

tantresults for the prevention of child maltreatment 

~- as it offers support to children and youth that is 

likely to be therapeutic when maltreatment has 

occurred and, in the long tenn, preventive of maltreatment when children grow up to be parents 

themselves. 

In agrowing numberof Counties in New York State, 

local departments of social services are placing 

workers in the schools. These workers visit families 

and children when problems first surface -- long 

before they become serious enough to justify a CPS 

hotline report. As a result, DSS officials are reporting reduced foster care placement rates, and school 

officials are noting fewer behavior problems and 

better academic achievement. Apparently the program is averting problems that might have led to 

child maltreatment and the fear and humiliation 

involved in CPS investigations. 

u.s. Advisory Board on Child Abuse and Neglect 

A New National Strategy for the Protection of Children 

Although recognition and acceptance of their role 

in child protection are first steps that are yet to be 

achieved in some ..chools, the obstacle for many 

educators may be a lack of knowledge about how to 

fulfill a broader role. Among the various roles that 

schoolteachers might play in child protection, nonc 

is more widely endorsed by them than "providing 

support, encouragement, and understandingtochildren who have been abused," but teacher training 

remains limited largely to identification and reporting.281 Similarly, many educators believe that they 

lack skills or time to involve parents whom they 

regard as unresponsive. Therefore, an important 

element in development of school-based programs 

for prevention and treatment of child abuse and 

neglect should be training, with emphases on sup~ 

port for children who may have been traumatized 

and on development of partnerships with parents 

who may have had minimal fonnal involvement in 

their children's education. 

Whatever the specific focus of school programs, an 

important step is to go beyond the "we-they" view of 

parents. Although school staff often complain about 

parents who "don't care" about their children, some 

of these parents say that the school makes them feel 

uncomfortable. Many themselves have had bad 

experiences in school, and they are hardly eager to 

return. Such feelings often evaporate when someone -- a teacher, a principal, a counselor, a nurse, or 

an outreach worker -- takes the time to contact 

parents personally and positively. As an example, 

one teacher made it a point to contact every parent 

in her class over several weeks to tell them of 

something positive their child was doing .. For most 

parents this was a new, and very welcome experience which made them feel closer to the school. 

E. BUSINESS AND LABOR 

Although the roles of business and labor in child 

protection may not be obvious to many, the Board 

hasencountered impressive examples of support for 

families and neighborhoods by corporations and 

their workers.282 Indeed, the business sector potentially can be the linchpin of the neighborhood development that the Board believes is critical to the task 

of child protection. 

75 
Neighbors Helping Neighbors 

76 

Perhaps the most direct way that a business can 

contribute is to "adopt" a neighborhood. The Board 

observed such arelationship in its visit to Minneapolis, where the Honeywell Corporation has adopted 

the neighborhood in which its corporate offices are 

located. When a community organization needed 

space toestablish a special school for teenage moth· 

ers, Honeywell renovated an under~utilized portion 

of its office building to meet day care standards, and 

the mothers now attend classes there every day 

while their babies are cared for on site. Honeywell 

supplies utilities and janitorial services, and it also 

encourages office and executive staff to become 

mentors tothe young mothers. Thisapproach estab· 

lishes not only personal support but also a close 

connection between the school and the workplace· 

- a connection that may in itself help to promote 

economic stability and to prevent child maltreatment.w 

Fel-Pro, an automobile-parts manufacturer in 

Skokie, Illinois, provides a number of other creative 

approaches to family support and neighborhood 

development. For example, money that the corporation donates to charitable organizations is pooled 

for distribution by an employee committee to groups 

and organizations in which employees serve as volunteers. Such a strategy provides direct support for 

neighborhood development through funds for program administration and contribution of volunteer 

services, but it also builds employees' sense of personal control and value and their own investment in 

their community. 

Fel-Proalso bas an unusual array oifamily benefits, 

including Father's Day and Mother's Day obser· 

vances, bonuses for marriages and births, and day 

care, summer camp, tutoring, summer jobs, and 

college tuition for employees' children. This example illustrates the ways in which benefit packages 

can be shaped to respond to family needs and to 

diminish family stress. 

As the growth of employee assistance programs 

(EAP), illustrates, businesses can provide direct 

voluntary assistance to employees when they have 

"everyday" family problems, when they are in crisis, 

Of even when maltreatment has occurred. Labor 

unions can be useful partners in promoting employee faith in the confidentiality and quality of 

family services available through an EAP. Business 

and labor also can join in provision of educational 

programs not only on family matters directly but 

also onways of helping co-workers and neighbors to 

support and strengthen their families. 

Besides providing or financing family services, businesses can and often do contribute in-kind services 

such as use of their meeting rooms for neighborhood groups, provision of technical assistance (e.g., 

accounting services), and sponsorship of activities 

that boost the neighborhoods of which they are a 

part. They also may use printing or duplicating for 

neighborhood activities, donate their own product 

or services to neighborhood groups, or contribute 

part of their advertising space for prevention messages. 

Although the principal focus of this subsection has 

been on philanthropic activities, the importance of 

businesses' direct contribution to the economy should 

not be overlooked. In an era when capital is being 

moved from many economically distressed urban 

and rural communities, the value of a business that 

stays put should not be underestimated, especially 

given the links among poverty, unemployment, pa· 

rental self~steem, and child maltreatment. Large 

businesses also can assist by adoption of policies that 

favor purchases from suppliers that are based in 

impoverished neighborhoods or even by assistance 

to neighborhood residents in establishment of small 

businesses that can serve as such suppliers. 

F. VOLUNTEERS AND CIVIC 

ORGANIZATIONS 

There may be no value as deeply embedded in 

American culture as is vol unteerism. Strengthening 

the neighborhood often can be accomplished by 

reliance on small local organizations, a strategy that 

combines easy accessihility with neighborhood participation and responsiveness to the particular needs 

of ethnic-minority communities. With volunteers to 

deliver services or to supplement professional activities, neighborhood-based organizations can provide youth activities, child care, after-school activi~ 

u.s. Advisory Board on L.'hijd Abuse and Neglect 
+ 

ties, outreach, recreational and cultural activities, 

mutual assistance (self-help) groups, and support by 

big brothers, big sisters, or parent partners. 

Manyofthe model programs studied bytbe University of Hawaii (see Section IV) had been initiated by 

a civic organization after a neighborhood needs 

assessment. The range of groups undertaking such 

projectswas remarkable for its breadth: "tbeJunior 

League, the League of Women Voters, a neighborhood association, an ethnic or cultural association, .. a 

citizens' interest group. "284 

Civic organizations not only can assess neighborhood needs and respond with volunteer assistance, 

but they also can serve as advocates and monitor the 

work of professional services and government in 

prevention and treatment of child abuse and neglect. For example, the Children's Defense Fund's 

Child Watch Visitation Program in thirtycommunities across the United States incorporates volunteers from local chapters of six national civic and 

religious organizations.285 

In that regard, civic organizations can capitalize on 

the unique skills and experiences of their members 

and in so doing integrate professional, citizen-advocate, and consumer perspectives. For example, at 

the urging of a member who was a former foster 

child, the Honolulu Rotary Club made foster-parent recruitment and retention one of its principal 

projects, and the club greatly increased the pool of 

volunteers to be foster parents. Volunteer programs 

also can offer inter-generational modeling (e.g., 

FosterGrandparents and RSVP) and pointers about 

coping strategies from parents and children who 

have "been there" (e.g., Parents Anonymous and its 

affiliated children's program) that may not be available through professional services atone. 

Parent aides and facilitators of Parents Anonymous 

groups do much to assist parents who have abused or 

neglected their children or who have been at risk of 

doing so. Other volunteers act as mentors or counselorstochildren themselves and in so doing provide 

easily accessible services without the barriers that 

professional titles sometimes erect. 

A New National Strategy for the Protection of Children 

Volunteer programs also can have preventive effects on the volunteers themselves and their families, through enhancement of self-esteem and development of social competence and other skills. Such 

a proccsshas been recognized, for example, through 

the adoption of the National and Community Service Act of 199()28ti and its school-based program, 

Serve-America, which has placed particuJar emphasis on neighborhood service by youth themselves.287 

G. REliGIOUS ORGANIZATIONS 

Churches, mosques, and synagogues have at least 

three kinds of roles in the child protection system: 

neighborhood service, personal healing and reconciliation, and moral leadership. 

As societies ror service that are present in virtually 

every neighborhood, religious organizations have 

adopted creative strategies for assistance to families 

in which maltreatment has occurred or is at risk of 

occurring. For example, Covenant to Care, a program located in Texas, Connecticut, and California, 

features "adoption" of a social worker by a congre· 

gation.288 Partnership for Empowerment (PEP), a 

program in Lincoln, Nebraska, grew from an Interfaith Council effort to pair volunteers in member 

congregations with families in crisis. In Washington 

State, a church served as a center for recruitment of 

foster parents. Other churches provide child care, 

crisis counseling (phone warm-lines), parent support groups, food banks, parent education, and even 

classes on job-hunting skills. Refugee resettlement 

programs, most of which are operated by religious 

groups (e.g., Catholic Charities; Church World Service), offer a model for comprehensive services --

economic, educational, vocational, and social-- that 

churches and synagogues can offer to families in 

great need, who usually begin without a niche in the 

neighborhoods in which they settle. 

Religious organizations also can provide places of 

acceptance for maltreating parents and their children. aergy are virtually unique in the unlimited 

confidentiality that they offer to people voluntarily 

seeking help. More broadly, congregations potenu.s. Advisory Board on Child Abuse and Neglect ------------------------ 77 
Neighbors Helping Neighbors 

78 

tially offer a sense of belonging to members who 

otherwise may be isolated or alienated and who lack 

a sense of personal worth. 

Of course, the roles of service and healing flow from 

the role that is most central to religious organiza. 

tions: moral leadership. Religious organizations 

thus can lead in the affirmation of personal and 

collective responsibility to respect the dignity and 

worth of children and to ensure their protection 

from harm. The pulpit is an obvious forum for 

proclamation of such a message. So too are church· 

sponsored public discussions, lectures, and media 

programs. Community interfaith councils may be 

particularly helpful in developing neighborhood·, 

city-, or county-wide initiatives to prevent child 

maltreatment and ameliorate its effects. 

H. COOPERATIVE EXTENSION 

The Cooperative Extension Service (CES) also has 

the potential to playa special role in prevention and 

treatment related to child maltreatment. With a 

heritage in non-formal education rather than social 

services or mental health, CES workers may be less 

likely than more traditional social-service agencies 

to engage in deficit-model approaches, and the 

public is likely to regard CES services as non-stigmatizing. 

CES also can build from other traditions. Its heritage of work with mothers on nutrition, household 

management and parent education provides a good 

base from which to work with parents with special 

needs .. Its heritage of encouragement and strong 

support of volunteerism provides a good base from 

which to recruit and prepare volunteers to become 

active partners in supporting maltreated children's 

needs. 

CES also can build from its tradition of youth de vel· 

opment CES's 4-H clubs for rural children are well 

known, but 4-H activities have been increasing in 

urban areas, where 4-H programming offers con· 

structive roles for youth in their neighborhoods. 

Regardless of their location, 4-H clubs provide a 

sense of belonging, personal development, and hope 

that can ameliorate the effects of child maltreatment and counteract the isolation and low selfesteem that may otherwise impair children's competence as future parents. 

Another important feature is CESs tradition of 

diffusion of innovations and encouragement of their 

adoption. Under the guise of community education, 

CES can bring people representing diverse interests 

together and can playa facilitating role in development of new programs. [n New York State, extension agents in several counties have played pioneering roles in the development of family resowce 

centers. Others have developed parent support 

groups and numerous parent education activities. 

[n recent years, many CES offices have begun to 

focus greater attention on the needs of youth and 

families at risk. Such an emphasis is particularly 

critical to the Expanded Food and Nutrition and 

Education Program (EFNEP), which provides nu· 

trition education and counseling for low-income 

families with young children .. With its expertise in 

education and volunteerism, CES is in a good position to work with families "on the edge" who with a 

little help, can avoid maltreatment. It is also in an 

excellent position to help to repair the damage to 

youth who may have suffered maltreatment. 

Given these substantive strengths, as well as its 

presence and accessibility in every county in the 

country, Cooperative Extension is an important 

resource for preventing child maltreatment .. and 

ameliorating its effects. Because of its reputation as 

a dependable, non-stigmatizing source of information and assistance, CES can be a key actor in child 

abuse prevention and treatment, without the "baggage" of an agency involved in coercive measures 

against parents. 

I. INTERAGENCY COUNCILS 

Neighborhood planning provides a means for agencies and residents to come together to make help 

more easily available and better integrated into 

daily life. Interagency councils can often playa key 

role in making this happen. In larger communities 

especially, formal structures such as an interagency 

council may be necessary to accomplish the necesUS. Advisory Board on Child Abuse and Neglect 
sary planning and coordination. The establishment 

of councils can help to overcome fragmentation, 

agency competition, and perceived regulatory barriers. Such councils can work at State, County, and 

neighborhood levels to plan new initiatives, commission needs assessments and evaluations, and to 

facilitate collaborative action including blending of 

funding to remediate problems. 

For example, in Los Angeles County, the InterAgencyCouncilonChildAbuseandNeglect(ICAN) 

has spawned a County-wide interdisciplinary focus 

on issues such as review of child deaths, prenatal 

substance abuse, comprehensive neighborhood 

treatmentcenters, collection of multiple-agency data, 

teen pregnancies, youth suicide, and interdisciplinary training. Because of the size of Los Angeles 

County. fourteen community child abuse prevention councils represent specific geographical areas 

of the County, ethnic groups, and special populations (e.g., children with disabilities). The local 

councils plan neighborhood-level activities and offer recommendations to the County council. In 

other areas of the Nation, child abuse prevention 

and coordinating councils have met a critical need 

for developing consensus and bridging gaps among 

agencies, disciplines, and the public and private 

sectors. 

Regardless of community size, neighborhood-level 

organizations are needed to stimulate grassroots 

concern and mobilize citizen action. At the same 

time, councils covering larger areas (e.g., State or 

County) can be used to undertake policy initiatives 

as needed. 

ENDNOTES 

260Although insurance coverage is far from universal and frequency and site of physician visits varies with resources, almost 

all familieswith children have occasional involvement with the 

health care system. OmCE OF TECHNOLOGY ASSESSMENT, 

HEAt.nrY OmnREN: INVESTING IN 1liE FlmJRE 53-57 (1988). 

Z<llIV.1HlEEN M. WHmlETAL., TREATING FAMILY VIOLENCE IN A 

PErxATRIC HosPITAL: A PROORAM OF TRAINING, RESFARQt, AND 

SERVICES (1987). 

A New National Strategy for the Protection of Otildren 

2>llPhone consultation services have been built into some pri· 

vate pediatric clinics and hospitals. Such a service could be 

especially useful forparents frustrated by their sense offailure 

in care of infants--the age group most at risk for serious physical 

harm as a result of abuse and neglect. See Michael Durfee et 

al, Origins and Clinical Relevance of Child Death Review 

Temns, 21 (No.2) OmnREN TODAY 29, 30 (1992). 

~Ju1ie DaVanzo,FamiJi.es, Children, POl-t.'ny, Policy, in URBAN 

AMERICA: POUCY Q-iOlCES FOR los ANGElES AND lllE NATION 

83,102 (James B. Steinberg et aI., eds., 1992). 

261See, e.g., Jill M. Rabin et al., The Long Term BenefiJs of il 

Comprehensil-t.' T~ Pregnancy Program, 30 Om. PEDIAT' 

RICS 305 (1991). 

2>l'iSee, e.g., Martin Da1y & Margo Wilson, Child Abuse and 

Other /fuks of Not Living wiJh Both PareNs, 6 ETIfoLOGY & 

SoaomOI- 1 en (1985); JanineJason, Centers for Disease Cbntrol 

and the Epidemiology of VIOlence, 8 OUlD ABusE & NEGlECf 

279 (1984); Jonathan B. Kotch & Thomas L Parke, Ftl111ilyanti 

Social Facton Assodtued wi1h SubstantiatUm of Child Abuse 

and Neglect, 1 FAM. VIOL. 167 (1986); Susan J. Zuravin, 

UnplannedChiJdbearingandFamilySize: TheiTReJationshipllJ 

Child Neglect and Abuse, FAM. PlANNING PERSPS. (July-Aug. 

1991), at 155. 

266Among many other positive effects, infant home visitation 

has been shown to result in greater spacing of births, increased 

use of preventive health services, and decreased frequency of 

accidents as well as decreased incidence of child maltreatment. 

David L Olds, The Prenatal/Early Infancy Project, in 140UNCES 

OF PREVENTION: A CAsEOOOK FOR PRACITIlONERS 9 (1988); 

David L Olds et aI., Pm.>enJing Child Abuse and Neglect: A 

Randomiz.ed Trial of Nurse Home VISitation, 78 PmxATRICS 65 

(1986); David L Olds et al.,Improving lhe DeliveryofPrenotal 

Careand OuJcom.esof Preg11d11C)': A Rilndomi2ed T rialoJ Home 

VISitation, 77 PEDIATRICS 16 (1986); David L Olds & H. Kitzman, 

Can Home VISitation Improve lhe Hea1Jh of Women and Chilo 

dren at Environmerual /fuk?, 86 PEDIATRICS 108 (1m). 

Z<I"Prior to the enactment of the Omnibus Budget Reconcilia· 

tion Act of 1981, Federal funds for mental health services went 

directly to CMHCs. Since then, State mental health agencies 

have served as grantees responsible for disbursement of the 

mental health and substance abuse block grant, 42 USc. §§ 

3())x - 3COx-64. See ADAMHA Reorganization Act, Pub. L. 

102-321, 106 Stat. 323. 

lMWolfe, supro note 71, Exec. Summ. at 16. 

-rite EmergenC)' Services program underCAPTA, 42 USc. 

§ 5106a-l, is illustrative of the Federal programs for substance 

abusing parents and their children. 

ZlDMary Fran flood, Innovative (and Successful!) Programs: A 

Presentation for Rural Nebraska Communities on Program 

Options for Helping Substance Using Pregnant Women and 

U,S. Advisory Board on Child Abuse and Neglect ------------------------ 79 
Neighbors Helping Neighbors 

80 

Parents 13-14 (1992) (unpublished manuscript, Center on 

Children, Families, and the Law, Urnversity of NebraskaLincoln). 

VlMindyS. Rosenberg & Daniel J. 8onkin, The Prevention of 

r.hilA MaiJrenJmRn1. in Srhnol-Age Child"m, in PREVENTION, 

supra note 256, at 78, 84-86. 

lllC:itFATING CARINo CoMMUNmES, supra note 7, at 86. 

:mNATIONA[. CENTER ON Om.n ABUSE AND NEOlECf, St1JDY 

FINDfNos: St1JDY OFnIE NATIONAL INODENCE AN'O PREVAlENCE 

OF CmwAauss AND NEGlEcr 6-17 (1988). 

V'CREATING CARINa CoMMUNITIES, supra note 7, at 86. 

Z75See, e.g., JDL DUERR BEilRICK& NEIL GII .BERT, Wmt THE BESI' 

OF ISTENTlONS: THE CHnD SEXUAL ABUSE PREVENTION MOVEMENT 16-29 (1991) (describing the implementation of the Maxine 

Waters Child Abuse Prevention Training Act). 

276For diverse interpretations of research on point, see, e.g., 

BERRfCK & Gn.BERT, supro note 273; SANOY K WURTELE & 

CINDY L MaLER-PERRIN, PREVENTING CHlw SEXUAL ABUSE: 

SHARING TIlE RESPONSlllHIJY (1992); David Finkelhor & Nancy 

Strapko, &xua1 Abuse Ptr!venJion Education: A Review of 

Evaluation Studies, in PREVENTION,Supra note 256, at 150; Gary 

B. Melton, The ImprobabiliJy of Ptfi.oel1lionofSetualAbuse, in 

PREVENTION OF Omn MALTREATMENT, supra note 256, at 168; 

N. Dickon Reppucci &Jeffrey J. Haugaard, PreventionofChl1d 

Sexual Abuse: Myth or ReaJi.ly?, 44 AM. PSYCllOLOOI.ST 1266 

(1989). 

2'nSchools can work to prevent child maltreatment by assistance with socialization into adulthood (e.g., parenthood education), support for families under stress, advocacy for children, and SUpfK!rt for ma1treated children. GARBARINO & 

GIUlAM, supro note 255, at 97-105. 

27iInteragcy. Workgrp. on Full Serv. Schools, Dep'ts of Educ., 

Health & Rehab. Servs., & Labor & Employ. Security, Florida 

Full Service Schools, Concept Paper (Feb. 1993); Orange 

County, Fla. Pub. Schools, Full Service Schools: Summary of 

Activities (1993). 

Z7'JSee, e.g., JANE KNCIZER fIT AL, ATl1m ScHooUiOUSE DOOR: 

AN ExAMINATION OF PR<XJRAMS AND POUClES FOR CmwREN 

WITH BEHAVJORALANDEMcmONALPROBlEMS (1990); ATELIA I. 

MELAVil..J..EET AL, TommfER WE CAN: AGUIDEFORCRAFflNG 

A PaOF AMILY SYSTEM OF EDucATION AND I lUMAN SERVICES (n.d.) 

(refK!rt of task force sponsored by the Office of Educational 

Research and Improvement, U.S. Department of Education, 

and the Office of the Assistant Secretary for Planning and 

Evaluation, US. Department of Health and Human Services); 

Howard S. Adelman & Linda Taylor, MentalHealth Facets of 

the School-Based Heakh Center Movemenl: Need and Opportunity for Reseatdt and Dewlopmeru, 18 1. MENT. liEALrn 

ADMIN. 272 (1991); Joy G. Dryfoos, School-Based Sociol and 

HealJh SeTVicr!s for At-RiskSwdents, 26 URB. EDUC. 11,11 (1991). 

~See, e.g., CAL. Eouc. CoDE §§ 8800-8807 (Wellt 1993); CAL. 

WSLF. & INIT. CoDS §§ 4343-4352 & 4370-4300 (West 19(3); 

FlA. STAT. ANN. § 402.3026 (West 1993); Ky. REV. STAT. ANN. 

§ 156.497 (Brudwin 1993). 

2S! Nadine Abrahamset al., T eache1'$' Knowledge,Attitudes, and 

Beliefs about ChiJdAbuse and lIS Pm.>ention, 16 CHnD ABuSE & 

NEGIECr 229, 232 (1992). Reporting of child maltreatment by 

teachers does remain often inadequate, but that particular 

problem seems more related to systemic policiell and practices 

than a deficit in training. Most teachers do report suspected 

child maltreatment, but they commonly make their reports to 

school personnel (e.g., principals) rather than the legally designated authorities. It! at 233. 

282See, e.g., SYLVIA ANN HEwurrr, WHEN "mE BoUGH BRF.AK5: 

THE CosT OF NEGLECI1NG OUR CmwREN 245-92 (Harper Perennis) ed. 19(2) (originally published 1991). 

2ilin that regard, because of the link between unemployment 

and child maltreatment, it would be useful tostudythe preventive effects of other kinds of programs that combine job 

training and social support and that build both economic selfsufficiency and interpersonal skills. In the same vein, consistent with the principle of easy availability and accessibility of 

services, programs that integrate workplace-related (e.g., employee assistance) and school-based services with a family 

orientation may be useful means of prevention and treatment. 

-Wilson, supra note 235, at_. 

mRevealing the Face of Child Poverty: Child Watch VISitation 

Moves People toAct, CDFRI'I'S., Mar. 1992, at 8. The participating organizations include the Child and Family Justice 

Committee of the National Council of Churches, the Association of Junior Leagues, the American Association of Retired 

Persons, Kiwanis International, the National Council of La 

Raza, and the National Council of Negro Women. 

28642 U.s.c. §§ 12571-12580. 

1J1See Commission on National and Community Service, DiscretionaJy Funds, 57 Fed. Reg. 30,724 (1992); Youth Services 

&a!ive $63 MiJ1ion Boost, Yourn TODAY, Sept./Oct. 1991, at 

22. 

2S8Bernard J. Bwh, S. J., The Role oflhe Religious CommunUy 

in AMressing a National Disaster (Sept. 14, 1991) (statement 

before the U.S. Advisory Board on Child Abuse and Neglectin 

Denver). 

U.S. Advisory Board on Child Abuse and Neglect 
• A New National Strategy for the Protection of Children 

VII. CONCLUSION: CREATING CARING COMMUNITIES 

Because of the centrality of child maltreatment 

among the Nation's social problems, adoption of the 

Board's strategy is apt to have many positive side 

effects. Because child maltreatment itself is a powerful causal factor in other personal and social 

problems, prevention of child abuse and neglect is 

likely to result in reduction of other social ills. In 

addition to these positive downstream effects, the 

Board's strategy is likely to have direct positive side 

effects. For example, neighborhood quality is related to prevalence not only of child maltreatment 

butalsoofcrime and delinquency. Similarly, a sense 

that one has little control over one's life -. that few 

resources are available with which to improve the 

outlook for the future -- is negatively related to 

mental health, educational achievement. and family 

planning. Accordingly, a comprehensive neighborhood-based, child-centered, and family-focused 

approach (although derived from an analysis of the 

factors causing child abuse and neglect orsignificant 

in its remediation) is likely to have positive effects on 

community safety, mental health, education, family 

welfare, and even the local economy. Because of the 

common factors, prevention isin a sense "generic.!89 

In part because of the centrality of child maltreatment. however, fulfillment of the Board's strategy 

will not be easy. It will require reversal of powerful 

social trends, within neighborhoods at highest risk 

(those that have been "drained") and the nation as 

a whole. The problem of child maltreatment is so 

complex --increasingly so -- that the strategy necessarily includes many elements, and the science and 

technology of neighborhood development are only 

minimally developed. Careful research and planning will be necessary to refine the strategy and 

adapt it to the diverse communities in the United 

States. 

Moreover, a focus on the social conditions that 

undennine the safety of children means that the 

responsibility for change must be shared not only by 

the individual families involved but also by service 

providers, the community, and alileveis of government -- in fact. by society itself. This approach is 

more difficult than remediation, in which the buru.s. Advisory Board on Child Abuse and Neglect 

den of change falls chiefly on the client. 290 The 

Board's strategy thus requires us all to change -- a 

concept never easy to implement The need for 

broad allocation of responsibility if prevention is to 

occur may be one reason why we as a society have 

seemed content to respond to crises in child protection rather than to prevent them. In the short run at 

least. crisis response is less threatening to the status 

quo, even if it lacks effectiveness in the long run. 

AJ though the magnitude of the challenge should not 

be underestimated, the Board believes that its strategy can be accomplished. The proposed strategy is 

based on a vision of a "neighborly" society. Such a 

vision is consistent with themes long dominant in 

American culture (e.g., volunteerism and mutual 

assistance) and emphasized by bothPresidentsBush 

and Clinton. Although the Board's strategy builds 

on such historic values of our society, it does so with 

recognition of the need to accommodate to trends in 

the post-industrial age that have weakened the expectation of voluntary help by neighbors for each 

other and that have reshaped not only neighborhoods but also the families within them. 

The difficulty of the task inevitably will result in false 

starts and missteps along the way, but the Board 

believes that the Nation must act with vigor, speed, 

care, and commitment to weave a new social fabric 

inwhich the personal security of children is assured. 

Nothing less than the character of the Nation is at 

stake. 

As the Board noted in the conclusion to its 1991 

Report: 

When the nation is willing to tolerate the degradation 

and exploitation of hundreds of tho usandsofits youngest members, whosedeperuiency it enforces by law and 

custom, it can make no claim of character .... 

... Failure to provide the most basic protection to children is a grievous collective assault that communicates a lack of respect for the dignity of children as 

people. Atlhe same time, the nature and complexiJyof 

81 
~~~~~---~.-----------~~~~~~~~~----~~~-

Neighbors Helping Neighbors 

82 

child maltreatment are such that the problem negatively affects every member of American society. No 

other problem may equal its power to cause or exacerbate a range of social ills. In short, the national 

emergency in the child protection system represents not 

only a moral lapse but also the threat of disintegration 

of the nation's social fabric. 291 

The United NationsDeclaration of the Rightsofthe 

Child established the principle of children first: 

"Mankind owes to the child the best it has to give." 

Ultimately the Nation should aspire to fulfill such a 

goal, which the global community has incorporated 

into international law through the Convention on 

the Rights of the Child. Fornow, though, the Boanl 

is pleading not for the best but instead for the most 

basic -- a society in which children need not live In 

fear·- whether in their homes or elsewhere. 

To that end, the Nation must strive diligently to 

overcome the isolation created by the demands of 

modern life and exacerbated by the ravages of 

poverty. We must tear down the walls that divide us 

by race, class, and age, and we must create caring 

communities that support the families and shelter 

the children within them. We must take the time to 

see the need and to lend a hand. 

The image that is presented is not of utopia but 

instead of a society that cares enough about children 

as people to permit childhood: 

U'hat is the essence of childhood? .. Our concept of 

childhood hinges on safety. Initially, the child inside its 

mother's womb is safe from Ihe elements. Once born, 

Ihe child is kept safe, fed, sheiJered, and nurtured so 

thai it can grow and develop, fulfilling its potential In 

the first year of life, children become auached to 

parents, and the safety of these attachments pennits 

children to explore the environment with confidence, 

knowing that they can always return to a safe haven. 

As children pass through the first decade of life, they 

should be able to broaden this "safe haven"to include 

the home, lhe neighborhood, and the school. When 

childrenfeelsafeatlwme, they are ready to grow. When 

safe in the neighborhood, children are ready to play 

and explore and fonn relationships with other children. When they feel safe at school, they are ready to 

learn and to become confident and competent adultS?2 

To achieve this simple vision, we must strengthen 

neighborhoods so that people are involved with 

each other as a community and that adults feel 

competent as parents, empowered to protect the 

safety of their own children, and responsible for 

supporting each other. A "quick fix" or "band-aid" 

is not enough. Programs must be constructed in a 

manner that they facilitate sustained development 

of neighborhoods that are safe environments for 

families. People must have sufficient resources and 

sense of control over their own lives that they can 

help each other and that they can do so over the long 

term without feeling drained. Government at all 

levels can do much to facilitate such requisites for 

continuing safety for children and families; so too 

can private agencies, business, the religiouscommunity, and civic and philanthropic organizations. The 

Nation'schild protection system must be redesigned 

to support even the most troubled and impoverished 

neighborhoods and families .- and to nurture and 

protect even the most vulnerable children within 

them. 

In 1991, the Board dedicated its report "tothe many 

thousands of American chiJdren and families 

trapped in the throes of abuse and neglect who are 

waiting for our society, and its governments, to 

respond to their plight with more than just a report, 

and more thanjust an investigation. Fortheir sake, 

and for the welfare of our nation, we hope they are 

reached in time."293 In this report, intended to 

provide the design for a new national strategy for 

child protection, the Board renews that dedication. 

The Board challenges not just the new Federal 

leaders but also the leaders both inside and outside 

government in States and communities throughout 

the Nation to consider the proposed strategy. It 

issues a special challenge to the field .- to child 

protection professionals·· tojoin with it in advocating policies and practices consistent with the strat· 

egy. Finally, it challenges an American adults to 

resolve to be good neighbors·- to know, watch, and 

support their neighbors' children and to otTer help 

when needed to their neighbors' families. 

u.s. Advisory Board on Child Abuse and Neglect 

-
ENDNOTES 

289W1UJAM LoFQUISI', DISCOVERING TIlE MEANING OF PREVENTION 133 (1983). 

ZlKJld. at 12. 

2\lICREATING CARING CoMMUNITlES, supro note 7, at 152. 

192GARBARINO ET AL., supra note 65, at 1 (emphasis added). 

~11NG CAllING CoMMUNfl1ES,supra note 7, at Dedication. 

A New National Strategy for the Protection of Children 

u.s. Advisory Board on Child Abuse and Neglect ------------------------ 83 
VIII. APPENDICES 

APPENDIX A 

List of Recommendations in the 

1993 Report of the U.S. Advisory Board on Child Abuse and Neglect 

Neighbors Helping Neighbors: 

A New NatiolUll Strategy for th£ Protection of Children 

III.e. ELEMENT 1: STRENGTHENING NEIGHBORHOODS 

Recommendation 1 

The Federal Government and private foundations should establish a large-scale 

demonstration program of Prevention Zones -- comprehensive efforts to improve the social 

and physical environments in declining neighborhoods with high rates of child maltreatment. 

These model neighborhoods should be diverse in geography, population density, and 

ethnicity. The trials should be closely monitored and rigorously evaluated. Principles 

learned should be widely disseminated and, with such modifications as suggested by 

evaluation studies, should lead to a large-scale national effort within five years. 1 

Recommendation 2 

With provision of research, consultation, trammg and technical assistance by the 

Departments of Agriculture and Housing and Urban Development and other relevant 

Federal agencies, City and County planners should work with interagency councils and 

neighborhood grassroots organizations to develop a Neighborhood Child Protection Plan for 

every neighborhood in their jurisdiction. To that end: 

• Planners should work closely with civic, business, labor, and religious leaders, and 

most importantly, neighborhood residents themselves and their leaders. 

'The Board notel tbat the Empowerment Zone concept proposed by the U.s. Department of Housing and Urban 

Development appears to contain important elements related to tbis recommendation and may have potential as a 

vehicle for its implementation. 

84 
• 

• Planners should consider public safety, municipal services, housing, economic 

opportunities, health care, family planning, education, and social and recreational 

opportunities for children and families. 

• Particular attention should be given to providing constructive opportunities for 

youth to network with each other, with positive adult role models, and to find positive 

roles for themselves in their community. 

• Care should be taken to ensure representation of all segments of the neighborhood 

(including diverse ethnic groups) and to facilitate the involvement of mothers, fathers, 

grandparents, and children and youth themselves. 

• Where child abuse coordinating and prevention councils are not present, planners 

should assist in their establishment and support. 

Recommendation 3 

Congress and the Administration should ensure that recipients of Community Development 

Block Grants use at least a portion of these funds in ways that will strengthen families as 

a means of preventing child abuse and neglect. Setting aside a small percentage of such 

funds to plan and implement neighborhood-based strategies for strengthening families and 

preventing ehild maltreatment would accomplish this, particularly if the appropriation for 

the Block Grant program is increased by a commensurate amount. Analogous programs for 

development and implementation of neighborhood plans for protection of children should 

be instituted in Federal economic development programs (e.g., the Appalachian Regional 

Commission) and other programs (e.g., the Bureau of Indian Affairs; the Cooperative 

Extension Setvice; and the Office of Rural Health Policy) that serve Tribes or rural 

communities. 

Recommendation 4 

Support should be provided for family resource centers and similar organizations that 

respond to the social, cultural, and economic needs of children and families at the 

neighborhood level. Federal support should be provided through full funding of the title on 

family resource centers in the Claude Pepper Young Americans Act. State legislatures, 

foundations, private businesses, and civic, philanthropic, and religious organizations should 

offer support, too. Whenever feasible, State and local agencies should integrate their 

existing services into such centers, which should involve active partnerships with parents. 

The first priority should be to support centers that knit people together in neighborhoods 

with few or declining community institutions. 

85 
l 

Recommendation 5 

The Department of Housing and Urban Development, analogous State, regional, and local 

agencies, and philanthropic organizations should support housing programs that increase 

neighborhood stability by reducing the necessity for frequent moves and facilitating 

interaction among families (including adults' involvement with children in their neighbors' 

families). providing safe physical environments for children, and enhancing ownership and 

personal investment in the neighborhood. 

Recommendation 6 

Large businesses and civic and religious organizations should "adopt" a particular high-risk 

neighborhood that they make a commitment to strengthen. This commitment must be 

fulfilled in collaboration with neighborhood residents in ways that empower rather than 

patronize. Implementation of the commitment might involve providing financial, human, or 

other resources directly to assist isolated children and families, promoting economic and 

other forms of development. It also might include mobilizing volunteers from the company's 

employees or the organization's members, promoting economic and other forms of 

development, and support and technical assistance to neighborhood leaders and institutions. 

I1I.D. ELEMENT 2: REORIENTING THE DELIVERY OF HUMAN SERVICES 

INCLUDING JUSTICE SERVICES 

Recommendation 7 

Child protection programs at all levels should place increased emphasis on preventing child 

abuse and neglect and providing treatment for those involved. The Child Abuse Prevention 

and Treatment Act, which requires investigatory mechanisms but does not expressly require 

prevention and treatment as a condition of State grants, should be amended to mandate all 

three. 

Recommendation 8 

Federal, State, and County Governments should take all steps necessary to ensure that 

effective mental health treatment is available and accessible to abused and neglected 

children and their families. Care should be taken to ensure that such coverage is included 

in any new national health care program. (Specific options for fulfilling this 

recommendation can be found in CREATING CARING COMMUNITIES, supra note 7, at 

Recommendation D-3a.) 

86 

--
;. 

Recommendation 9 

The Secretary of Health and Human Services should direct the National Institute of Mental 

Health and the Center for Mental Health Services to undertake a major initiative to 

generate knowledge about effective treatment and related service systems for abused and 

neglect children and to disseminate such information to mental health programs throughout 

the Nation. 

Recommendation 10 

Consistent with recommendations of the National Commission on Children, support should 

be provided for experimentation with various strategies for increasing income support for 

impoverished families. In the short term, support should be provided for testing the effect 

of providing fleXIble, individualized, material supports in ways that encourage self-sufficiency 

for impoverished families at high risk. 

Recommendation 11 

With support by the Children's Bureau for testing and dissemination of effective models for 

recruitment and retention of foster parents of diverse ethnicity, States should take all steps 

necessary to professionalize family foster care. States should provide commensurate quality 

assurance, training, consultation, support services, payment, involvement in decision making, 

and recognition for foster parents. 

Recommendation 12 

The Secretary of Health and Human Services should direct the Children's Bureau, in 

collaboration with other relevant Federal agencies (e.g., health, mental health, and justice 

programs), to support research demonstration projects on alternative models of foster care. 

Such models (including kinship care, open adoption, whole-family foster care, and partial 

foster care) should involve accommodations to contemporary social realities and should fit 

into a broader system of neighborhood-based support for troubled families and for children 

who have been maltreated or who are at high risk of abuse and neglect. 

87 
Recommendation 13 

The various agencies in the child protection system should give due respect to children's 

right to a family environment, as defined in the U.N. Convention on the Rights of the Child. 

Special efforts should be made to avoid separating children from their families unnecessarily. 

If a child is placed in out-of-home care, special care should be taken, consistent with the 

child's safety, to maintain relationships the child regards as important sources of support. 

These may include biological parents and siblings, foster parents, adoptive families, or 

unrelated adults such as schoolteachers. 

Recommendation 14 

The Secretary of Health and Human Services and the Attorney General should encourage 

experimentation with alternatives for permanency, including kinship care, guardianship, and 

long-term foster care, that do not require returning foster children to unsafe homes but that 

maintain relationships important to them. 

Recommendation 15 

Congress should amend the Child Abuse Prevention and Treatment Act to permit the 

Secretary of Health and Human Services to issue waivers to allow States to experiment with 

new standards for investigative responses to cases of suspected child maltreatment. The 

Secretary should direct the National Center on Child Abuse and Neglect or the National 

Institute of Mental Health, in collaboration with the Office of Justice Programs, to evaluate 

the effects of these experimental efforts. To the extent that changes prove successful, they 

should be incorporated into new standards for reporting and responding to cases of 

suspected child maltreatment. 

Recommendation 16 

State and Tribal courts and legislatures should seek to develop alternative means of dispute 

resolution in cases related to child protection so that the process may stimulate or enhance 

family and neighborhood responsibility. The Attorney General should direct relevant units 

of the Office of Justice Programs, in consultation with the National Center on ChiJd Abuse 

and Neglect, to support evaluation of such innovations. Results should be disseminated, 

especially among State and Tribal legislators, judges, and justice system administrators. 

Whenever appropriate, experimentation should be coordinated with work by 

multidisciplinary task forces established by Children's Justice Act grantees. 

88 
Recommendation 17 

The Attorney General should direct the Office of Justice Programs to support research and 

demonstration programs to increase understanding of the way that children experience the 

legal process, and to find ways to increase their satisfaction with it. The goal should be to 

make children "partners in the pursuit of justice." State and local bar associations should 

use this knowledge to enhance the training of attorneys and lay advocates who represent 

children in child protection proceedings. 

Recommendation 18 

State and Tnbal legislatures should ensure that children have legal standing to file actions 

or appeaJ decisions, including dispositional orders, in matters pertaining to their protection 

and care. Congress should act to provide children with access to Federal courts to 

remediate any failure by States to exercise reasonable efforts to protect children from harm 

and to promote stability in their lives. 

Recommendation 19 

In collaboration with the President of the Legal Services Corporation and relevant 

associations of lawyers and judges, the Attorney General should provide research, training, 

and financial support to improve the quality of representation of children in civil child 

protection proceedings. Such efforts should include development and dissemination of 

model court rules and standards of practice to guide attorneys and guardians ad litem in 

their work. 

Recommendation 20 

With appropriation of necessary funds, Congress should require the States to establish an 

office of ombudsman for children, especially those in out~of-home care, as a condition of 

receiving funds under Title IV ~ E of the Social Security Act. State legislatures should ensure 

that ombudsmen have full access to children in out-of~home care and other public programs 

and facilities and that children have access to the ombudsmen. Legislatures also should 

ensure that ombudsmen have the independence necessary to represent children's interests 

effectively. 

89 
Recommendation 21 

Federal agencies that directly or indirectly support facilities providing out-of-home care for 

children should collaborate in gathering and disseminating knowledge about good practice, 

regulation, and other mechanisms that effectively prevent child maltreatment in these 

faciHties. These agencies, including the Departments of Education, Justice, and Health and 

Human Services, should then collaborate in developing, implementing, and evaluating 

standards and procedures to prevent institutional child maltreatment. 

I1I-E_ ELEMENT 3: IMPROVING THE ROLE OF GOVERNMENT IN ADDRESSING 

CHILD MALTREATMENT 

Recommendation 22 

The Federal Government should establish a National Child Protection Policy (see Appendix 

B). The goal of the policy should be to facilitate comprehensive community efforts to 

ensure the safe and healthy development of children and youth. The policy should be 

incorporated into the United States Code as an intrinsic part of the Child Abuse Prevention 

and Treatment Act. The policy should drive the child protection-related activities of all 

Federal agencies. State Governments should establish analoguus State Child Protection 

Policies. 

Recommendation 23 

Congress should act to build a financing system consistent with a comprehensive childcentered, neighborhood-based, family-focused child protection system. To that end: 

90 

• The Congressional leadership should work to minimize fragmented committee 

jurisdiction that impedes integration of funding streams. 

• Congress should reallocate existing resources from a focus on supporting the costs 

ot out-of-home placement to a tocus on preventive, "front-end," intensive, and 

comprehensive senices, with emphasis on neighborhood-based senices. 

• Congress should provide for increased flexibility for blending funds across sources 

and categories, provided that such integration is consistent with Slate and 

Neighborhood Child Protection Plans. 
• Until Congress provides substantial funds in various sectors for prevention and 

treatment of child abuse and neglect, the Child Abuse Prevention and Treatment Act 

should be amended to permit -- and indeed to encourage -- States to spend their 

allotments for the purpose of prevention and treatment, not CPS improvement. 

• Whenever feasible, Congress should provide for direct grants, rather than 

reimbursement for unit-based services, to neighborhood programs for the purpose 

of strengthening families and prevention and treatment of child abuse and neglect. 

AccountabHity should be ensured through e\,aluation based on outcome rather than 

simple quantification of services provided. 

III.F. ELEMENT 4: REORIENTING SOCIETAL VALUES THAT MAY CONTRIBUTE 

TO CHILD MALTREATMENT 

Recommendation 24 

The new President should act promptly to sign the Convention on the Rights of the Child 

and should submit it to the Senate with appropriate resetvations, understandings, and 

declarations to adapt the Convention to the American federalist system. The Senate then 

should act with all deliberate speed to ratify the Convention. Even before the Convention 

is signed and ratified, States, Tribes, Counties, and municipalities should adopt it as a set 

of principles to guide their policies affecting children. 

Recommendation 25 

The various television networks and producers should join in resolving to diminish the level 

of violence on television. Congress, relevant professional associations, and the general 

public should join in advocacy for such change. 

Recommendation 26 

Civic, political, and religious leaders should unite in proclaiming the message that violence, 

especially violence against children, is an unacceptable means of resolving conflict. 

Professional associations should join in this message and in education of their members and 

the general public about nonviolent means of discipline and dispute resolution. 

91 
Recommendation 27 

Congress should make receipt of Federal funds by any program or facility contingent on 

prohibition of corporal punishment within it. (The Board reiterates its strong endorsement 

of Recommendation B-3 in CREATING CARING CoMMUNITIES, supra note 7.) 

Recommendation 28 

Every school should emphasize, facilitate, and teach nonviolent approaches to conflict 

resolution. This philosophy should be reflected in the school's discipline policies, its courses, 

and its athletic programs. Relevant Federal and State agencies, including the U.S. 

Department of Education, should stimulate the development, evaluation, and broad-scale 

implementation of such approaches. 

Recommendation 29 

The Secretary of Health and Human Services should direct the National Institute of Mental 

Health, or the National Institute of Child Health and Human Development, to undertake 

an initiative for research on the relation of public attitudes to the problem of sexual abuse 

and on means of community change consistent with its prevention. In the meantime, civic, 

professional, and religious leaders, as well as celebrities in entertainment and sports, should 

join to promote healthy attitudes toward sexuality and to promote respect between the sexes, 

particularly by men for women. The media also should make special efforts not to 

communicate messages that condone or encourage child sexuality or the sexual exploitation 

of children. 

Recommendation 30 

Schools, churches, community development agencies, and other community organizations 

should strengthen their efforts to represent and celebrate the cultures they serve by enlisting 

parents and community leaders of diverse backgrounds in planning various cultural 

appreciation events. The goal should be to foster greater appreciation for cultural diversity, 

including both pride in one's own culture and respect for the cultural backgrounds of others. 

92 
:y , 

Recommendation 31 

In all child protection activities, inc1uding graduate and professional education, cultural 

competence should be an emphasis. Efforts should be made to incorporate traditional 

means of helping and dispute resulutiun whenever appropriate. Cultural competence should 

not be a substitute for affirmative action in employment; diligent efforts should be exercised 

to build a staff that represents the neighborhoods and cultures served. 

III.G. ELEMENT 5: STRENGTHENING AND BROADENING THE BUILDING OF 

KNOWLEDGE ABOUT CHILD MALTREATMENT 

Recommendation 32 

Federal agencies should ensure that child protection activities supported with Federal funds 

are subjected to rigorous evaluation, that funding decisions about demonstration grants are 

based in part on the proposed projects' potential contribution to knowledge, and that 

findings of such studies are applied in the design and implementation of programs in the 

child protection system. 

Recommendation 33 

In collaboration with other Federal agencies as relevant, the National Institute of Mental 

Health should solicit research, inc1uding research demonstrations, to clarify the relationships 

among social support, material support, culture, and child maltreatment. 

Recommendation 34 

Relevant Federal agencies should encourage research that assesses (1) children'S, parents', 

neighbors', and workers' own experience of the context in which child maltreatment occurs 

and (2) their perceptions of the systemic responses to the problem. 

93 
APPENDIXB 

u.s. ADVISORY BOARD ON CHIW ABUSE AND NEGLECT 

PROPOSED NATIONAL CHILD PROTECTION POLICY 

DEJi1NITIONS, 

Child protection system refers to the entire system that serves children and their families 

in cases where: 

• risk of child maltreatment exists, 

• maltreatment has been reported, or 

• maltreatment has been found to exist. 

The child protection system includes but is not limited to chi1d protective 

services (CPS), the State or County child welfare agencies mandated by law 

to protect abused and neglected children. Other components of the child 

protection system include law enforcement, education, health and public 

health, mental health, developmental disabilities, and court agencies. The 

system includes pUblic, private, and voluntary agencies and organizations. 

A comprehensive child protection system is onc that incorporates the [relevant] provisions 

identified [in the FINDINGS section] infra. 

A child-centered child protection system is one that: 

• takes children seriously as individuals, 

• gives primary attention to their best interest, as reflected in their needs and 

expenences, 

• provides opportunities and such representation as may be necessary for children 

to be heard in matters pertaining to them (when children are capable of such 

expression), and 

• responds fleXIbly to the diversity of their cultural backgrounds and the 

circumstances in which they find themselves. 

Adoption of the perspective of the child will lead in most instances to a 

concern with strengthening families. 

A family-focused child protection system is one that, consistent with [the third dec1aration 

in the DECLARATIONS section infra and the relevant tenet in fhe TENETS section infra], 

recognizes the paramount importance of the family for the development of children. 

94 
A neighborhood-based child protection system is one in which: 

• primary strategies are focused at the level of urban and suburban neighborhoods 

and rural communities, 

• social and economic supports for troubled families and children are developed at 

the neighborhood level, where neighborhood is defined by geographic bound.aries, 

and 

• both fonnal and informal services (e.g., volunteer, professionally-facilitated self-help 

programs) that are based on the principle of voluntary help by one citizen for another 

are widely available, regardless of whether access to such services is determined by 

place of residence. 

DECLARATIONS:' 

Respect for the inherent dignity and inalienable rights of children as members of the human 

community requires protection of their integrity as persons. 

Children have a right to protection from all forms of physical or mental violence. injury or 

abuse. neglect or negligent treatment. maltreatment or exploitation including sexual abuse. 

while in the care of parent's), legal guardian's) or any other person who has the care of the 

child. including children residing in group homes and institutions.2 

Children have a right to grow up in a family environment. in an atmosphere of happiness. 

love and understanding.3 

The several Governments of the United States share a profound responsibility to ensure that 

children enjoy, at a minimum, such protection of their physical, sexual, and psychological 

security. 

The several Governments of the United States bear a special duty to refrain from subjecting 

children in their care and custody to harm. 

Children have a right to be treated with respect as individuals, with due regard to cultural 

diversity and the need for culturally competent delivery of services in the child protection 

system. 

Children have a right to be provided the opportunity to be heard in any judicial and 

administrative proceedings affecting them,4 with ample opportunity for representation and 

for provision of procedures that comport with the child's sense of dignity. 

1 Underlined language i.s drawn from the United Nations Convention on the Rights of the Child, sometimes with minor 

revision for grammaticaJ form. 

lid., art. 19, subsection 1. 

lid., preamble. 

;Id., art. 12. 

95 
The duty to protect the integrity of children as persons implies a duty to prevent assaults on 

that integrity whenever possible. 

FINDINGS; 

Each year, hundreds of thousands of American children are subjected to abuse, neglect, or 

both. 

Often the child protection system fails to protect such children from further maltreatment 

or to alleviate the consequences of maltreatment. 

The child protection system has developed largely in unplanned fashion, with resulting 

failure <a) to reach many of the children in need of protection and (b) to provide effective 

services to them and their families. 

Substantial gaps exist in knowledge about child abuse and neglect, the diffusion of that 

knowledge, and the development of a pool of trained professionals who are specialized in 

child protection. 

Tolerance of child abuse and neglect threatens the integrity of the nation because of its 

inconsistency with core American values: regard for individuals as worthy of respect, 

reverence for family life, concern for one's neighbors (especially those who are dependent 

or vulnerable), and competence in economic competition. 

Failure to provide an effective system of child protection also imperils the nation by 

increasing the risk of crime and physical and mental disability, diminishing the level of 

educational achievement, and threatening the integrity of the family. 

Such consequences of child abuse and neglect cost the nation billions of dollars each year 

in direct expenditures for health, social, and special educational services and in long-term 

loss of worker productivity. 

Deterioration in the quality of urban neighborhoods and rural communities increases the 

isolation of families from their neighbors and, therefore, the rate of child abuse and neglect; 

child maltreatment itself tears the social fabric of the community and thus escalates the 

decline of neighborhoods and communities in crisis. 

Although the family remains the most fundamental unit in American society, the family has 

undergone substantial change in recent decades, and the nature of child maltreatment has 

become more complex. The complexity of the task of child protection has increased 

commensurately. 

96 
An effective response to the problem of child abuse and neglect requires a comprehensive 

approach that: 

• integrates the contributions of social service, legal, health, mental health, and 

education professionals, 

• provides for coordinated roles of (a) private chi1d welfare, mental health, and 

advocacy agencies, (b) civic, religious, self-help, and professional organizations, and 

(c) individual volunteers, 

• assures the protection of chi1dren while in each of the relevant service systems, 

• provides for coordinated roles of all levels of government, in cooperation with the 

private sector, and 

• ensures that adequate proVIsIon is made in the child protection system for 

prevention, investigation, adjudication, and treatment. 

The prevention and treatment of child abuse and neglect are most effective when organized 

and delivered at a neighborhood level. 

Failure to provide a comprehensive child protection system integrated across and within 

levels of government (in cooperation with relevant private-sector organizations) results in 

waste of many of those resources now allocated for child protection. 

Substantial reduction of the prevalence of child abuse and neglect and alleviation of its 

effects when it occurs are matters of the highest national priority. 

97 
THE FOLLOWING TENETS ARE HEREBY DECLARED TO BE THE CHILD 

PROTECTION POLICY OF THE UNITED STATES: 

The child protection system should be comprehensive, child-centered, family-focused, and 

neighborhood-based. 

The principal goal of governmental involvement in child protection should be to faciHtate 

comprehensive community efforts to ensure the safe and healthy development of children. 

Federal authorities should exercise due care to ensure that standards and procedures for 

public financing of child protection efforts promote and do not inhibit fleXIble, integrated 

approaches to child protection in all of the systems of service (e.g., education, mental health) 

for children and families. 

Because of (a) the link between poverty and some forms of child maltreatment and (b) the 

limited resources available in impoverished communities, Federal aid for child protection 

should be distributed with due regard to relative financial need of States, their political 

subdivisions, Tribes, and community health and mental health catchment areas. 

Recognizing the complex nature of child maltreatment, Federal authorities should stimulate, 

integrate, and coordinate leading child protection programs, at least in those public, private, 

and voluntary agencies that have responsibility for carrying out Federal efforts in social 

services, health, mental health, advocaq, educatiun, law enfurcement, currections, housing, 

cooperative extension, volunteer action, and the administration of justice. 

Federal authorities should ensure that direct child protection services to children and 

families within Federal jurisdiction (e.g., military families; Native Americans) are exemplary 

in quality and that relevant Federal agencies provide models of culturally competent child 

protective strategies that may be adopted in other communities. 

98 
,. 

L 

The child protection system should incorporate all appropriate measures to prevent the 

occurrence or recurrence of child abuse and neg1ect. 

The child protection system should incorporate all appropriate measures to promote physical 

and psychological recovery and social fe-integration of a child victim of any form of neglect. 

exploitation Of abuse: such recovery and fe-integration should take place in an environment 

which fosters the health, self-respect and dignity of the child.' 

As the fundamental group of society and the natural environment for the growth and wellbeing of aU its members and particularly children, the family should be afforded protection 

and assistance necessary for it to assume its responsibilities fully within the community,6 The 

several Governments of the United States, in cooperation with private organizations, should 

act: 

• to strengthen families in general to minimize the circumstances that may cause or 

precipitate chiJd abuse and neglect, 

• to provide intensive services to avoid the removal of children from family 

environments at times of crisis, and 

• to make all reasonable efforts to reunify families when abuse or neglect has 

resulted in removal of a chiJd. 

Comprehensive child protection plans should be developed regularly at all levels of 

government and should show due sensitivity to the cultural diversity and individual needs of 

children and families. 

Child protection efforts should be integrated with broader child and family policy, pursuant, 

e.g., to the recently-enacted Claude Pepper Young Americans Act. 

SId., art. 39. 

6 Id., preamble. 

99 
Federal agencks are hereby direcled /0 use aU means practicable, including financial and 

technicol assistance ~- in cooperatWn with State, Tribal, and local governments and other 

concerned public and private organizations -- 10 fuJjiU lhis policy and 10 acl with due U11:ency in 

doing so. 

To that end, the several agencies of the Federal Government with responsibility for child 

protection should take all steps necessary to ensure that every community in the United 

States has the resources -- fiscal, human, and technical -- required to develop and implement 

a child protection strategy that will: 

100 

• ensure the safety of children, 

• prevent child maltreatment, whenever possible, 

• result in timely, sensitive, and accurate investigation and assessment, whenever child 

maltreatment is suspected or known to have occurred, 

• result in treatment to ameliorate the effects of abuse and neglect on children and 

family members, 

• aim, whenever possible, to rebuild the families whose ties have been frayed by 

maltreatment, and 

• assure safe, stable, and nurturing substitute family environments when children are 

temporarily or permanently unsafe in their biological families. 

p 
Among the steps that should be taken by the Federal Government to assist communities in 

their child protection and family strengthening efforts are the following: 

• facilitation of community planning; 

• generation and diffusion of knowledge relevant to child protection, including 

models for prevention and service delivery; 

• strengthening of States' capacities to assist communities, particularly with respect 

to moving toward more voluntary preventive services as opposed to emphasizing 

investigation and foster care; 

• stimulation of the growth of human resources (professional, paraprofessional, and 

volunteer) that communities may use in fulfillment of their plans for child protection; 

• sharing of financial resources necessary to implement community plans; 

• leadership in uniting caring communities unwilling to tolerate the abuse and neglect 

of their youngest members. 

101 
APPENDIXC 

Executive Summaries of Six Papers Commissioned 

by the 

U.S. Advisory Board on Child Abuse and Neglect 

1. NEIGHBORHOOD-BASED PROGRAMS 

Executive Summary 

James Garbarino 

Kathleen Kostelny 

Erikson Institute 

Chicago, Illinois 

Families live in neighborhoods. Some of these neighborhoods enhance parent-child 

relations; others exacerbate problems in families. Research conducted in communities across 

the country highlights the fact that socioeconomic and demographic risk factors tend to 

cluster in neighborhoods. The trend in many areas is for increasing negative social 

momentum: more concentration of poverty, less active neighborhood cooperation, fewer 

social support systems functioning on behalf of families. Poverty is the most powerful 

predictor of such negative trends, but these trends are evident even in some areas with 

adequate income. 

Research identifies many influences on the ability and willingness of neighborhoods to 

function in support of families to prevent child maltreatment and protect children. These 

influences include: 

102 

• the role of community violence in suppressing neighborhood functioning; 

• the lack of neighborhood-based models for child and family-oriented human 

servIces; 

• the difficulty involved in coordinating the efforts or "indigenous" and 

paraprofessional staff with professional activities; 

• the need for outside interventions to reverse inertia and negative momentum in 

many high-risk neighborhoods. 
The existing research implies a program of well designed and funded demonstration projects 

to test empirically the potential of neighborhood-based projects to address child 

maltreatment. The highest priority for these demonstration efforts is the creation of 

"prevention zones" in which enhanced law enforcement, social service and economic 

development efforts are coupled and coordinated to produce simultaneously basic safety and 

security, employment opportunities, and family psycho-social support. 

Such a demonstration project (with perhaps 20 sites set in contrasting communities across 

the United States) would permit a much needed empirical test of emergent hypotheses 

regarding neighborhood-based efforts_ Specifically: 

L Full employment serves as a critical factor in stabilizing neighborhoods and 

permitting family support to function on behalf of children; 

2. Professional leadership is critical, but insufficient alone. Heavy reliance on 

well-trained paraprofessionals who are supervised by professionals to reach 

large numbers of families is essential. 

3. "Community policing" in which law enforcement is neighborhood oriented 

(local substations, stable assignment of officers, special training in community 

relations, etc.) is an essential component. 

4. Schools can serve as a focal point for "prevention zones," but only to the 

degree that the schools are themselves neighborhood-based (i.e., draw their 

students from the immediate geographic area of the school). 

In sum, this paper can serve as a "user's guide" for neighborhood-based and 

neighborhood-oriented programs. Combining these principles of operation with the results 

of systematic (and well evaluated) social experimentation should lead us to make real 

progress in utilizing the potential of neighborhoods as social support systems in preventing 

and responding to child maltreatment. 

103 
2. SOCIOCULTURAL FACTORS IN CHILD MALTREATMENT 

Executive Summary 

Jill E. Korbin, Ph.D. 

Associate Professor Department oC Anthropology 

Case Western Reserve University 

Cleveland, Ohio 

Neighborhoods, and the individuals that comprise them, must be empowered to identify and 

meet their needs and to provide the best possible environment for their children. The 

challenge in culturally competent child protection is to respect cultural differences while 

ensuring equitable standards of protection for all children. Accommodating the multicultural 

nature of our nation is critical to the success of neighborhood-based child protection. 

However, ensuring equitable responsiveness to all children, regardless of their cultural 

background, is equally critical. 

Definitions of child abuse and neglect must be culturally-informed and culturally-competent. 

The cultural context and continuum of acceptable and unacceptable behavior must be well 

understood. Culture and child maltreatment are both difficult to define. They are political 

as well as social and scientific terms and their meanings have changed over time. The 

importance of incorporating culturally-informed definitions of child abuse and neglect in a 

neighborhood- based strategy is in the identification of cases of child maltreatment. The 

goal should be congruence on definitions that provide a basis for differentiating what is 

cultural and what is maltreatment (or the components of each) such that prevention, 

identification, and intetvention can be accomplished on a consensus, rather than an 

adversarial, basis. 

Cultures and ethnic groups are not homogeneous and substantial diversity exists within any 

group. Culture and ethnicity are too often defined on the basis of large groupings of people 

based on skin color or geographic area from which descent can be traced. Broad racial 

designations do not accurately identify the cultural composition of a neighborhood. There 

is diversity within any cultural group, and this intracultural diversity must be well-understood 

for a successful neighborhood-based child protection strategy. 

No cultural, ethnic or racial group in the United States has been demonstrated to have 

greater rates of child maltreatment. Incidence and prevalence studies do not indicate a clear 

and consistent pattern of cultural, ethnic, or racial differences in maltreatment rates that are 

not seriously confounded with socioeconomic status. Inadequate definitions and reporting 

bias further complicate this issue. 

104 

.. 
The impact of culture on child abuse and neglect is poorly understood and more research 

must be undertaken. Even though there are not clear differences among racial, cultural or 

ethnic groups in rates of maltreatment, culture and ethnicity are important in prevention, 

treatment and policy. That is, just because culture is not significant in rates of reported 

child abuse and negJect does not mean that it can be dismissed in a neighborhood-based 

strategy. The balance of cultural risk and protective factors must be considered in examining 

the impact of culture on child maltreatment. 

There have been few published examples of culturally- specific prevention efforts or 

therapeutic interventions. Nevertheless, culture permeates virtually all aspects of individuals' 

lives and must be incorporated into a neighborhood-based strategy. 

Suspicion of a child protection system that has been investigative and punitive may be 

particularly strong among culturally and ethnically diverse populations. This suspicion must 

be addressed by empowering neighborhoods to identify their needs and strengths. 

A successful neighborhood-based system must adopt a difference model rather than 

assuming a deficiency in some cultural and ethnic groups. 

The cultural and ethnic composition of a neighborhood must be represented in research and 

practice. This may be accomplished through increasing the proportion of culturally-diverse 

professionals and/or through advisory or citizen review boards. Research proposals should 

include samples that are culturally representative of the neighborhood being studied. 

All neighborhood child protection workers should be encouraged and rewarded for spending 

time in the neighborhood unrelated to child abuse and neglect investigation and intervention. 

This wiII afford a better understanding of the cultural continuum of behaviors and the point 

at which deviance in child care is defined from within the culture. 

Neighborhoods cannot be defined on the basis of socioeconomic status or cultural 

composition alone. All poor neighborhoods are not alike in the risks posed and protective 

factors present. All White neighborhoods are not alike, nor are al1 Black or Hispanic or 

Asian neighborhoods. Culture and ethnicity must be self-defined, not identified from the 

outside. 

105 
Introduction 

3. CHILD PROTECTION AND OUT·OF·HOME CARE: 

SYSTEM REFORMS AND REGULATING PLACEMENTS 

Executive Summary 

Paul Lerman 

Distinguished Professor of Social Work and Sociology 

Rutgers University 

New Brunswick, New Jersey 

Children and youth who have experienced abuse or neglect can be found in substantial 

numbers in out-horne-placements associated with the fields of mental health, chi1d welfare, 

and juvenile corrections. While residing in residential treatment centers, group homes, or 

detention centers, they are at risk of once again experiencing abuse or neglect by staff or 

other peer residents. In addition, there exists evidence on a national scale that children and 

youth without a prior experience of abuse or neglect are at-risk of becoming a victim of 

abuse or neglect in an out-horne-placement. 

The diminution of abuse or neglect in out-horne-placement is an important aim of any broad 

children protection strategy. Reducing out-of-home placements in the three major systems 

dealing with children and youth (i.e., mental health, child welfare, and juvenile corrections) 

is a logical target of any abuse-prevention policy. In addition, improving the regulatory 

oversight of placements-if placement cannot be prevented-is a second target of any abuseprevention policy. This paper assesses the research and service literature for insights 

regarding the reduction of placements and the regulation of out-horne-settings. Specifically, 

these twin goals are pursued by: 

1. Descnbing and examining leading examples of comprehensive service systems reforms 

that possess the potential-by design and implementation·to yield services that can provide 

care, protection, and treatment while reducing placements, or providing alternatives to 

restrictive out-of-home settings. 

2. Describing and examining leading examples of regulatory reforms that possess the 

potential-by design and implementation-to symbolize and enforce the goals of child 

protection for children at-risk of placement or in a placement of any duration. 

At a minimum, a national strategy of reducing and/or preventing institutional abuse neglect 

during a single year would need to target 1 to 1.4 million youth under the 18 years of age-or 

1.5 to 2.0 per cent of the under 18 youth population. The usual figure of half a million atrisk youth·often cited by officials·is off the mark by at least 100 per cent. 

106 
Service System Reforms: Mental Health 

Programs that are components of service systems have historically attracted the greatest 

amount of evaluation resources and attention. But service system reforms that attempt to 

incorporate program innovation, within a broader, more closely coordinated, network of 

services may offer a unique contribution to a national child protection strategy. Three types 

of service system reforms were examined: 1) an ideal system, implemented at Fort Bragg, 

North Carolina, and funded by national military funds on behalf of civilian families of 

militruy setvice personnel; 2) a cost-offset system, implemented in Ventura County, and 

funded by special funds connected to reductions in state placements; and 3) an 

individualized, non-program component, model in Alaska, funded by state funds formerly 

allocated to out-of-state placements. 

While each system reform was guided by a distinct philosophy, target population, referral 

sources, and coordinating mechanisms, each system shared a critical design feature-the 

creation and implementation of special control mechanisms to screen all out-of-home 

placement decisions. These distinct placement controls insured that placements were, in 

practice, actually reduced to achieve system-wide goals. Besides monitoring the decisions 

of judges, clinicians, and social workers, each system devised mechanisms for securing high 

degrees of flexibility in spending funds for a mixture of seIVices. 

Existing evaluations tend to focus major emphases on out-of-homes placement reductions, 

and fiscal savings per capita served, but there is insufficient evidence that youth are really 

''better off' for having been clients of the reform systems. The Ventura County model has 

made the strongest effort to assess improved school behaviors, but more empirical research 

is necessary to yield convincing evidence that families function more smoothly, youth are less 

deviant, and that presenting psychiatric symptoms have been reduced. 

Service System Reforms: Child Welfare and Juvenile Corrections 

Two additional models of system reform were assessed-one from child welfare and one from 

juvenile corrections. The child welfare system reform involved the decategorization of 30 

distinct funding streams in Iowa for four demonstration counties, and the allocation of a 

single funding package-provided that counties engaged in a local planning effort that yielded 

a "bottom-up" design of services. The plan had to be co-signed by three local officials-the 

presiding juvenile court judge, the county Board of Supetvisors, and the County Human 

Services Director. The juvenile corrections reform focused on the state of Massachusetts, 

where a system of community-based services had been created and implemented over a 20 

year period by State Officials. 

Both models emphasized the proVISIOn of a broad array of services to replace more 

restrictive out-of-home placements, coordination mechanisms, and flexible funding. Both 

models, in practice, reveal an inability to provide evidence that all forms of placements were 

indeed, reduced. One county in Iowa was unable to demonstrate whether local detention 

107 
and local secure residential placements substituted for any reductions in state-administered 

placements. The Massachusetts system reform was unable to demonstrate that "intermittent" 

confinement of youth on parole may have substituted for "court arraignments" as indicators 

of system effectiveness. A complete assessment of the ability of these system reforms to 

reduce out-of-home placements of all types, while demonstrating an ability to improve the 

functioning of youths and their families, requires further detailed studies. 

The Regulation of Out-of-Home Placements 

If placements can not be prevented, then improvements in the design and implementation 

of regulatory statutes and organizational mechanisms can also be used to reduce the 

likelihood of institutional abuse andlor neglect. Five regulatory strategies were assessed: 

1) devising statutory protection for minors entering inappropriate forms of out-of-home care, 

treatment, and custody; 2) specifying definitions of out-of-home care abuse andlor neglect 

that is congruent with non-familial settings; 3) upgrading licensing capabilities and 

responsibilities; 4) improving the monitoring and enforcement of statutory standards; 5) 

subsidizing and supporting child advocates capable of monitoring and investigating suspected 

cases of abuse and/or neglect; and 6) using research surveys of youthful clients to monitor 

actual placement experiences by potential victims of sexual and physical abuse or neglect. 

A broadened statutory approach to child protection could legislate a "statutory presumption" 

against institutional placements. The use of this standard could require placement decisionmakers to document that less restrictive placement alternatives were unsuccessful, and that 

imminent danger of harm does, in fact, exist. The use of such a standard could provide a 

measure of consideration in balancing the potential harm of a placement prior to a nonemergency removal and the potential harm to self or others by remaining in the current 

residence. 

A majority of states do not have statutes that clearly distinguish between the broad levels 

of permissible physical, social, and emotional behaviors engaged in by parents and the 

narrow levels of tolerance permitted under the authority of publicly funded andlor 

administrated placements. The absence of clear distinctions between types of abuse can 

make it more difficult to enforce licensing standards. Clearer standards of behavior could 

assist administrators to educate and socialize child care and professional staff regarding 

impermissible behaviors. 

Many licensing standards tend to emphasize physical features of foster care homes and 

institutional facilities. Studies of the health status of foster children indicate that additional 

standards that emphasize nutrition and health needs may be useful in insuring equal access 

and use of medical services. One legal scholar has cited the "woeful inadequacy" of medical 

care for foster children as an integral part of an argument for an expanded constitutional 

protection of children and youth. Rather than wait for court decrees, it might be more 

appropriate to expand licensing statutes to require that health care services for out-of-home 

children meet the standards set forth by the Academy of Pediatrics and the American Dental 

108 
Association. Quality assurance units within licensing organizations-independent of 

placement units could be mandated to operate utilization and peer reviews of health records 

of children in placement. 

The enforcement of institutional abuse statutes and regulations involves assessing the scope 

of enforcement jurisdiction, so that it can allocate major investigative resources to monitor 

the most restrictive fonns of placement as a top priority. In order to engage in enforcement 

activities in a strategic manner, it is important that investigative units be independent of 

placement organizations and staff on distinguishing legal and social concerns about 

allegations of abuse and/or neglect. 

The adult systems of mental health and developmental disabilities are provided with federal 

subsidies to engage in protection and advocacy activities. If a comparable federal statute 

were provided for children and youth then a "Protection and Advocacy System" for minors 

would receive up to $21 million-the level provided to the "Protection and Advocacy System" 

for persons with developmental disabilities. 

A recently completed survey of former foster care children, funded by a national 

organization with high professional standards, revealed an unusual number of unknown 

reports of sexual and physical abuse and neglect. A sustained effort to include social science 

survey research as independent fact gatherers from children leaving placement could yield 

crucial information in monitoring and assessing all placements. 

109 
4. THE ROLE OF MATERIAL FACTORS IN 

CHILD ABUSE AND NEGLECT 

Executive Summary 

Leroy H. Pelton 

School of Social Work 

Salem State College 

Salem, Massachusetts 

There is overwhelming and remarkably consistent evidence--across a variety of definitions 

and methodologies, and from studies performed at different periods of tirne--that poverty 

and low income are strongly related to child abuse and ncgJect and to the severity of child 

maltreatment. Children from impoverished and low-income families are vastly 

overrepresented in the incidence of child abuse and neglect. The strong relationship 

between poverty and low income and child abuse and neglect holds not only for child abuse 

and neglect in general, but for every identified form of child abuse and neglect, including 

emotional abuse, emotional neglect, and sexual abuse. 

In fact, there is a strong funneling effect in regard to child abuse and neglect and their 

severity, with the poorest children in our society being at greatest risk (having the highest 

incidence rates) and the wealthier children being at least risk (having the lowest incidence 

rates). Approximately 40 to 50% of all child abuse and neglect incidents occur within the 

less than 15% of all American families with children that live below the poverty level. More 

than 90% of all incidents occur in families below the median income, meaning that another 

40·50% of all incidents occur within the roughly 35% of families with incomes above the 

poverty level but below the median income. 

Thus the incidence rate is less than half for children in such families than it is for children 

living in families below the poverty level. Finally, less than 10% of all incidents occur within 

families with incomes above the median. Thus children in families with incomes above the 

poverty level but below the median income are at five to seven times greater risk than 

children in families with incomes above the median, and children in families below the 

poverty level are at 13 to 17 times greater risk. 

There is substantial evidence to indicate that this strong income relationship is not merely 

an anomaly of reporting systems or personal biases. Moreover, this relationship is blind to 

race and ethnicity. 

AFDC families involved in child abuse and neglect incidents have been found to be existing 

at lower material levels of living than other AFDC families. Their comparatively greater 

material hardships include more overcrowded and dilapidated housing, not enough beds for 

their children, less likelihood of having basic amenities such as air conditioners and 

110 
+ 

telephones, and greater likelihood of at least occasional hunger. There is an astoundingly 

high prevalence of a wide range of serious health problems among both parents and children 

in AFDC families involved in child abuse and neglect, but there is no evidence yet that this 

prevalence is higher than among other AFDC families. 

Unemployment is strongly related to child abuse and neglect, but not independently of the 

extent of the material hardship it might cause. That is, job loss is more strong1y related to 

child abuse and neglect among families who are already poor and do not have the financial 

resources to cushion the additional blow of job loss (and therefore loss of income) upon 

their material circumstances. 

Most impoverished parents do not abuse or neglect their children. Both evidence and logic 

suggest that the relationship between material hardship and child abuse and neglect is 

mediated by an interaction between individual differences in the cognitive ability to cope 

with poverty and the extent of the dangerousness and inadequacy of the material conditions 

of one's environment. 

For people living in poverty, adequacy of child care is dependent upon one's abiJity to cope 

with poverty. But adequacy of care is also relative to the adequacy of the environment. 

What is adequate child care in one environment may be inadequate in a more dangerous 

one. The diligence of care necessary to protect a child in a dangerous environment is 

greater than in a safer environment. To the extent that their environments and living 

conditions are made less dangerous, the quality of care that parents with the least ability to 

cope with poverty are capable of giving, although the same as before, will now be less 

inadequate. Such parents will be less susceptible to a judgment of neglect, and will be less 

likely to resort to abuse of their children in desperate attempts to control their behavior to 

keep them away from the hazards of their environment--hazards which include the sexual 

abuse that may occur within a dangerous neighborhood environment. 

Evidence pertaining to the provision of a wide variety of material supports and concrete 

services--including higher AFDC benefits, employment, day care, window guardrails, and 

emergency cash assistance--suggests that such supports and services may reduce the 

incidence of child abuse and neglect and the need for foster care placement. It is 

recommended that future research should include experimentally controlled studies designed 

to assess the separate effects of a variety of different material supports, independently of 

other types of services, in regard to the prevention of child abuse and neglect. 

Moreover, it is recommended that more efforts should be made to study impoverished 

parents who provide excellent care and nurturance to their children despite the context of 

an adverse environment, in order to discover the specific strengths that enable them to do 

so. However, although in the long term, we must increase the individual competencies and 

inner resources of all who are deficient, this goal is most likely to be achieved through the 

opening up of opportunities for decent education, jobs, and careers, and through ensuring 

the hea1th and safety of children to allow them to take advantage of such opportunities as 

111 
they grow up. We must address the poverty conditions that leave children abused, neglected, 

or otherwise harmed in the short run, if we are to increase individual competencies and 

inner resources in the long run. 

The unavoidable conclusion is that the most effecLive way to reduce child abuse and neglect 

is to reduce poverty and its material hardships by increasing the incomes of families to at 

least above the poverty level. Various proposals have been put forth previously for reducing 

child poverty. They include setting AFDC benefits nationally at or above the poverty level 

and indexing them to cost-of-living increases; providing a guaranteed minimum annual 

income, at the poverty level or up to one-half the national median income; assuring a 

full-employment economy through the creation, if need be, of government jobs programs; 

establishing an unconditional right to employment at wages compatible with an adequate 

level of living; increasing mandated minimum wages; creating a universal children's 

allowance in the form of a direct cash payment or a refundable tax credit, as is done in all 

western European countries; promoting full utilization of the Earned Income Tax Credit; 

and creating a national child support enforcement program coupled with a 

government-insured minimum benefit plan to address instances in which absent parents do 

not meet their child support obligations. 

The concern here is simply that there is a direct and intimate relationship between 

magnitude of famny income and incidence rate of child abuse and neglect, and that the most 

effective way to reduce child abuse and neglect would be to increase family income, 

especially at the lowest regions of the income scale, no matter what means are employed to 

increase income levels. 

Child abuse and neglect are directly and intimately related to material hardship. Deficient 

material conditions and circumstances form the context in which child abuse and neglect 

occur, and in the absence of which child abuse and neglect are less likely to occur, and less 

likely to result in severe harm to children. If child abuse and neglect are to be reduced, 

material supports must be provided to impoverished and low-income families. Some of these 

supports can best be provided through national policies. Thus, it is contended here, 

recommendations for a national universal health care system, a universal day-care system, 

and renewed federal efforts to provide public housing are directly relevant to a national 

strategy to reduce child abuse and neglect. Likewise, recommendations for full funding of 

WIC, expansion of Head Start and public prekindergarten programs, and the development 

of parental-leave policies are also consistent with such a strategy. 

Our current child abuse and neglect prevention strategies have helped to create the 

erroneous impression that many impoverished parents (those accused of child abuse and 

neglect) do not care much about their children's welfare. This false assumption, in turn, has 

reinforced the coercive approach to child protection that guides our current child welfare 

system. Current public child welfare agencies are not adequately equipped to deliver 

concrete services and programs to address the material hardships of impoverished and 

low-income families, and are not designed to do so. Large parts of the budgets of these 

112 
t 

agencies are devoted to foster care and the investigation of child abuse and neglect 

complaints, and few social se:rv:ices are provided in child protection cases. Moreover, 

because of the prospect of being stigmatized as abusers or neglecters, and the possibility of 

having one's children taken away, and perhaps because of the unlikelihood of receiving 

needed concrete selVices, few parents involve themselves with the agencies voluntarily, or 

through self-referral. 

Therefore it is recommended that, in every state, a state child welfare agency be established 

whose sole function would be to provide social services and programs on a voluntary 

acceptance basis, to all families who want and need such services and cannot afford to 

purchase them on their own. Such an agency would not be involved in any way in foster 

care placement and investigative functions. The new state chi1d welfare agency 

recommended here would develop and offer a wide and attractive array of services wanted 

and needed by families experiencing child we1fare difficulties, with the mix or balance of 

services appropriately weighted toward material supports. The wise allocation of resources 

within such an agency would target areas of the state with high concentrations of 

impoverished and low·income families, allowing the agency to intensify its service delivery 

there through well-funded neighborhood service centers. 

The foregoing proposals are closely consistent with the weight of the evidence. The 

presence of material hardship is so pervasive in child abuse and neglect cases that it is clear 

that any strategy aimed at significantly reducing the incidence of child abuse and neglect 

must centrally address this bedrock context in which harm to children thrives. Without a key 

focus on material hardship, other additionally desirable approaches will not succeed in 

significantly reducing the incidence and severity of child abuse and neglect within our nation. 

113 
5. SOCIAL SUPPORT AND THE PREVENTION 

OF CHILD MALTREATMENT 

Executive Summary 

Ross A. Thompson 

Department of Psychology 

University of Nebraska 

Lincoln, Nebraska 

Consider the living circumstances of a family at risk for chi1d mal treatment, or in which 

parents have already abused or neglected offspring. If current profiles of maltreating 

families are accurate, parents are economically impoverished, unemployed or 

underemployed, living in substandard housing and possibly in a dangerous neighborhood, 

have not lived long in the community, and may also be characterized by domestic violence, 

a substance abuse problem, or psychological disorders. Moreover, the family is likely to be 

socially isolated within the local community: neither parents nor offspring have strong, 

enduring relationships with neighbors or other families who live nearby, have little awareness 

of the local community resources they can use, and may also be regarded with wary 

uncertainty by others who live near them. 

How can informal, neighborhood-based social support resources help prevent child 

maltreatment in a family like this? At its (idealized) best, social support can be provided 

by a neighbor who can enlist his or her own experiences in the community to provide 

emotional sustenance to parents and counseling about parenting dilemmas and problems, 

work-related issues, and life stress. It might involve the parent's access to community 

programs that provide education, training in job skills, material assistance and -- in the 

course of doing so -- offer an opportunity to strengthen social ties with others in the 

community. Social support might entail school-based services that enable the victims of child 

maltreatment to develop social skills, enhance se1f-esteem, strengthen academic competence, 

and also develop relationships with supportive peers and alternative adult role-models. 

Social support might also inc1ude community-based day-care services that are affordable, of 

high quality, and which assist parents and offspring alike through informal peer networking 

for parents, quasi-therapeutic programs for children, and the availability of a neighborhood 

resource for advice about parenting and life stress. Informa1 social support in high risk 

neighborhoods might also be enhanced by church, community, and recreational organizations 

that have, as part of their explicit mission, the goal of extending their services to families 

such as these by integrating them into a broader network of untroubled families through 

cooperative, mutually beneficial activities. In such neighborhoods, social support is thus 

well-integrated with a variety of other public and private services that needy families rely 

upon, and which offer opportunities for social integration in the context of receiving welfare 

benefits, obtaining treatment for substance abuse, developing educational or job skins, or 

simply socializing with others on the street, the store, or the front porch. Neighborhood114 
based social support also recognizes the importance of nonMneighborhood sources of social 

support for such families, and fosters access (through transportation, telephone service, and 

other means) to these additional support agents. Perhaps most important, informal, 

neighborhood-based social support provides both emotional support and also monitoring of 

parental conduct in a manner that is esteemMenhancing, nonstigmatizing, and welcomed by 

recipient families. 

Such a vision is well worth pursuing, and this paper reviews extensive research literatures 

concerning what social support is and does in the lives of parents and children. Almost 

necessarily, this review emphasizes that the tenn "social support" encompasses a far broader 

range of processes and phenomena than intuitive portrayals might inc1ude. As suggested 

above, for example, social support encompasses not only emotional sustenance and 

counseling but also access to information and services, referrals to other support agents, skill 

acquisition, developmental remediation of victimized children, and M_ perhaps most important 

-- social monitoring and social control of parenting practices to prevent future maltreatment. 

These various affirmative, informational, socializing, instrumental, and control functions may 

not easily be encompassed by the same social support agents because they involve potentially 

conflicting roles and relationships to families at risk, and thus multifaceted social support 

resources must be enlisted for troubled families. Social support is additionally complicated 

by <al the fact that the support needs of parents and children vary significantly but must be 

coordinated in family interventions, (b) that social support for preventing maltreatment in 

high risk families (secondary prevention) has somewhat different goals and functions from 

support to prevent reabuse (tertiary prevention), (c) that social networks that provide 

support to needy families are also commonly sources of social stress, and that a careful 

analysis of social network agents and their functions in the lives of troubled families is thus 

necessary, and (d) that the nature and functions of social support vary depending on the 

broader socioeconomic and ecological circumstances of the family. Fina1ly, it is important 

to recognize that enhanced social support does not derive simply from adding additional 

people to an individual's or family's social network -- instead, less tangible factors such as 

one's expectations that others will assist when needed, a history of previous support, shared 

values and viewpoints among social network members, and reciprocity in helping 

relationships better define one's experience of social support in a neighborhood or 

community. Thus the task of enhancing informal, neighborhood-based social supports is a 

complex challenge. 

The importance of designing social support interventions for families at risk for child 

maltreatment is enhanced by the consensual conc1usion of researchers that these families are 

"socially isolated" within their neighborhoods and communities. While this review of the 

research concludes that considerably less is known about the nature of their "social 

isolation" than is commonly assumed, it is also reasonable to believe that enhanced social 

support will nevertheless be a va1ued asset to troubled families. Consequently, this review 

concludes with a series of recommendations for the design of informal, neighborhood-based 

social support intervention programs: 

115 
• Neighborhood-based social support alone is not sufficiently broadly-based to 

strengthen supportive resources to high risk families. Social support agents extend 

considerably beyond a family's geographical locale, and consequent1y both 

neighborhood-based and non-neighborhood sources of social support should be 

enlisted. 

• Different maltreatment subpopulations have different social support needs. Even 

though there is considerable overlap in different forms of maltreatment, to assume 

that the support functions that are most needed for physically abusive families are the 

same as those needed by physically neglectful or sexually abusive families neglects 

important differences in the origins, characteristics, and sequelae of these different 

forms of child maltreatment. Social support must be tailored to the specific needs 

of troubled families. 

• Social support alone is unlikely to be an effective preventive intervention. If 

maltreating families are multiproblem families, they have needs that extend beyond 

those that can be addressed through informal social supports. This may include 

social skills training to enhance access to natural support resources, substance abuse 

programs, assisted access to social service benefits, child-care support, and various 

interventions for the developmental remediation of child victims. 

• The integration of social support interventions into preexisting service programs to 

high risk families provides useful avenues for effective assistance. Because needy 

families have instrumental ties to some community resources, social support 

interventions should useful1y build on these tics in efforts to foster greater social 

integration with the neighborhood. These include the organization of social services, 

school -based resources, and church, recreational, and community organizations. 

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'f' 

• Coordination of social support to children and parents within high risk families is 

essential to helping each. Because family members are affected, directly and 

indirectly, by support interventions intended for anyone member, carefully-designed 

social support interventions will take this into account by advancing programs that 

mutually benefit multiple family members in compatible ways, andlor which reduce 

negative reactions of family members to support provided to one of its members. 

This is especially important when children are in out-of-home placements and the 

coordination of home-based and out-of-home social support resources is important 

for the child's well-being. 

• Social support is often best achieved by targeting support providers rather than 

recipients alone. One of the important features of informal, neighborhood-based 

socia1 support is its reliance on nonprofessiona1 helpers, who often experience 

personal exhaustion in their efforts to aid troubled families in needy communities. 

EnJisting professional social service workers and other resources to support these 

helpers is essentia1 to well-designed interventions. 

• Considering the complexity of recipient reactions to aid will enhance the efficacy of 

social support interventions. Receiving assistance provokes gratitude but also 

perceptions of vulnerability, incompetence, indebtedness, and other negative reactions 

that can limit one's willingness to obtain help in the future. Insofar as socia1 support 

is meant as an ongoing resource in the lives of troubled families, careful1y -designed 

social support programs should benefit from research that describes recipient 

reactions to aid and how to undermine negative reactions to help-giving. 

• Effective social support interventions can involve simple as well as complex strategies. 

Although complex interventions will oftcn be necessary, access to social support may 

be enhanced by strategies as simple as providing free telephone service, access to 

transportation, financial assistance to impoverished families, and access to meaningful 

employment. 

• Much more research is needed. This review highlights areas of much-needed new 

study, including greater specification of the nature of the "socia] isolation" 

experienced by maltreating families and their social support needs. 

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6. THE ROLE OF INTERVENTION AND TREATMENT SERVICES 

IN THE PREVENTION OF CHILD ABUSE AND NEGLECT 

Executive Summary 

David A. Wolfe 

Professor, Department of Psychology 

The University of Western Ontario 

Senior Fellow 

The Institute for the Prevention of Child Abuse 

London, Ontario 

The Development of Theory-Based Interventions for Child Maltreatment 

Psychologica1Jy-based intervention with reported maltreating parents has developed gradually 

from an individual-focused pathology model to a more encompassing ecological model, with 

an evolving emphasis on the importance of the parent-child relationship and its context. 

Simultaneously, the orientation toward the treatment issue, i.e., how such behavior is viewed, 

has shifted gradually away from a parent-focused, deviance viewpoint and more toward one 

that accounts for the vast number of stress factors that impinge on the developing 

parent-child relationship. This shift toward a more process-oriented, contextual theory of 

maltreatment places greater emphasis on the importance of promoting parental competence 

and reducing the burden of stress on families. 

Although intervention models have greatly improved and have contributed to encouraging 

gains in treatment outcomes, the field remains split between promising research findings, on 

the one hand, and the realities of child protection and welfare, on the other hand. 

Unfortunately, the dominant theme in most services to maltreating families remains that of 

protection, not treatment. To assess any gains made over the past two decades in treatment 

outcome, it is necessary to separate what is truly "treatment" from what is actually delivered 

to identified families in practice. The present child welfare system is designed primarily for 

protection rather than assistance, which leaves inadequate setvices available to a significant 

number of parents who are "at-risk" of losing control with their chi1dren and who could 

benefit from early intervention. 

The developmental course of children from abusive and neglectful family environments 

typically proceeds unabated. They are more likely to associate with delinquent peers and 

engage in antisocial behaviors, which further serves to impair their ability to master 

important developmental tasks. Moreover, such associations perpetuate attitudes, 

motivations, emotions, and beliefs that encourage the likelihood of coercive behavior. This 

course, combined with added cultural stereotypes for men and women, may lead to both 

sexual and nonsexual forms of acting out during adolescence and young adulthood in 

attempts to control and coerce others. Accordingly, a developmentally guided intervention 

and prevention strategy was presented in this review, which works on the principle of 

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providing the least intrusive, earliest assistance possible, instead of relying on aversive 

contingencies. The focus of intervention can be shifted away from identifying misdeeds of 

the parent, and more toward promoting an optimal balance between the needs of the child 

and the abilities of the parent. 

Following is a summary of the major findings and conclusions drawn from this review of 

intervention and prevention efforts directed at identified or at-risk adults and children. The 

criteria for inclusion in this review was primarily based on the ability to draw scientifically 

sound conclusions from the data presented in written form by the researchers. Due to the 

presence of methodological limitations, many of the conclusions are couched in cautionary 

terms. No effort was made to include reports or studies that did not include control groups, 

comparison groups, adequate measuresj or similar limitations (although some exceptions 

were made concerning new, emerging areas). 

The review is presented in three major sections. The first section covers 43 studies dealing 

with parents or children who had been identified (usually by authorities) as being the 

offenderslvictims of physical child abuse and/or neglect. These studies are subdivided into 

three areas: (a) programs aimed at children, (b) programs aimed at parents, and (c) 

comprehensive/multiservice programs for families. Theoretically-based methods designed 

to address various aspects of identified needs of this population (e.g., childrearing; 

knowledge of children) are presented within each subsection. 

The second major section covers 30 studies addressing components of child abuse and 

neglect prevention, but which did not involve identified maltreating populations. Rather, 

these studies were intended primarily to explore the benefits of prevention that may emerge 

from early intervention programs aimed at the pre- or postnatal periods, or early childhood. 

This section is further subdivided into studies focusing on parental competence, and parentchild support programs for new and for teen parents. 

Finally, programs designed to treat victims or offenders of child sexual abuse are presented, 

although the findings from these studies are very preliminary at the present time. 

The review concludes with a summary of the major findings, and recommendations that 

emerge from these findings. Two tables are included in the principal review that match the 

ability of each form of intervention in addressing the identified needs of parents and 

children who have been identified (Table 1) or who are considered to be at-risk (Table 2) 

of child maltreatment. 

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Section I: Treatment Programs for Identified Abusive and Neglectful Parents and Their 

Children 

A Child-focused Intervention 

The review of treatment programs begins with efforts to assist identified child victims. All 

program models that addressed the child's needs, and which presented adequate outcome 

data, were predominant1y preschool-based. The preliminary results of these programs 

designed to treat the victims of abuse and neglect seem favorable in meeting some of their 

intervention needs. Across studies, participants showed improvement in social behavior, 

cognitive development, self concept, and reduction in aggressive and coercive behaviors. No 

mention has been made of the applicability of these intervention strategies to older children 

and adolescents, however, and the information is sketchy at best regarding effectiveness with 

different forms of maltreatment. Even though these child-focused treatment programs often 

incorporated parent treatment components, no information was provided as to the 

effectiveness of these programs in meeting the needs of the parents involved. Similarly, no 

mention is made of the contribution of these approaches to the improvement of family 

resources and well-being. Thus, at present, child-centered intervention programs have 

provided only limited indications of their usefulness. The potential of these methods, 

however, merits further investigation because services for child victims have important 

implications both for the development of the children involved as well as for interrupting the 

inter-generational transmission of child maltreatment. 

B. Parent-Focused Interventions 

1. Behavioral and Cognitive·Behavioral Programs. The review found several 

features that make cognitive-behavioral intervention approaches attractive in working with 

parents who may abuse or neglect their children. First of all, these procedures have 

demonstrated a relatively greater degree of effectiveness in modifying those parental 

characteristics that are most relevant to child maltreatment (e.g., parenting skills; perceptions 

and expectations of children). Several studies also showed reduced recidivism of 

maltreatment, rather than just changes in specific attitudes or behaviors, and used randomly 

assigned control groups. 

Many of the psychological characteristics of abusive caregivers make behavioral skills-based 

learning approaches quite attractive. Behavioral strategies are concrete and 

problem-focused, and thus may be more appropriate for assisting the less intellectual client. 

Interventions based on social learning theory are high in face validity and permit clients to 

work on the problems that are of most urgency and importance to them. Moreover, because 

behavioral treatments are often perceived as more "educational" and problem-focused in 

nature, they may be less threatening to such families and make cooperation a bit easier to 

achieve. 

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Despite these streqgths, there are ]imitations to cognitive-behavioral intervention programs. 

Most notably, these methods are not cJinicalIy effective for assisting those parents who may 

suffer from long-standing personality or psychiatric disorders, nor are they useful in 

improving the social or economic conditions of maltreating families. Furthennore, such 

skills-based educational methods require that parents practice new skills with their children, 

which poses some degree of resistance or difficulty (i.e., when children are in care). Given 

that a wide range of different problems often must be addressed with each family, it was 

concluded that cognitive-behaviora1 services may offer the greatest benefit in conjunction 

with other types of seIVices. 

2. Social Network Intenrentions. At present, little information is available 

regarding the efficacy of social network interventions (i.e., where efforts are made to expand 

and strengthen the identified family's social resources and supports, usually through in-home 

visits). However, this approach remains popular with many communities and child welfare 

agencies, perhaps because of the low cost and intangible benefits not measured by these 

reports. Nevertheless, adequate evaluation of their benefits is needed, especially as the 

programs pertain to the delivery of multiple services. 

C. ComprehensiveIMultiservice Programs. 

Comprehensive programs attempt to address the multiplicity of needs identified among 

maltreating families by providing services that are fleXible and wide-ranging. These services 

may be selectively chosen from existing methods of individual or group support, skills-based 

coping and child management techniques, homemaker services, etc., in order to tailor the 

program to the needs of each family. In this manner, they attempt to deal separately or 

simultaneously with each aspect of a family's particular situation, within the context in which 

the problems occur. Two major programmatic efforts have emerged over the past decade, 

which were reviewed in this section: (a) family-centered home-based interventions, and (b) 

ecobehavioral programmatic efforts. 

Overal~ the emerging findings from comprehensive services for families are encouraging, but 

very preliminary at present. Based on the findings, it was argued that intervention initiated 

during crisis situations may benefit from heightened family motivation for change and 

willingness to try new options ("the teachable moment"). The intensive contact between 

clients and therapists may allow for more accurate and complete assessment of family 

situations, and may facilitate maximum responsiveness of the treatment program to the 

changing needs and resources of the families involved. There is an expanded potential for 

therapist modelling of appropriate behaviors in the environment in which they occur, and 

intervention can be tailored to build on the strengths of all family members concerned. 

Finally, initial costs estimates, especially for the home-based programs designed to deter 

child placements, are very favorable compared to alternative placement costs. Thus, 

comprehensive programs warrant further study to determine their specific strengths and 

potential for treatment of abusive populations. 

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Section II: InteITention Methods for Non-Identified Families Exhibiting Risk 

Characteristics 

The next section of this review looks at the expanding number of programs designed to assist 

families that may be at risk of maltreatment, but that have not been identified or have not 

yet committed such behaviors. By and large, these programs have built upon some of the 

more promising approaches noted in the tertiary intervention literature, and appJied them 

to a much broader segment of the parenting population at an earlier point in time. 

Although methodological issues remain with many of these studies as well, several important 

conclusions may be drawn that have implications for intervention and prevention planning. 

Intervention programs for parents who have not been specifically identified as abusive or 

neglectful are founded primarily on the premise that promoting a positive and responsive 

parent·child relationship is both a desirable intelVention target as well as a viable child abuse 

prevention strategy. The rationale for such programs is straightforward: many families with 

very young children (under 24 months of age) are not yet experiencing the serious child 

behavior management problems that bring their counterparts with preschool and school age 

children to the attention of child protection agencies. Parent-child interactions are still 

relatively benign although subtle indications of future problems may be present. If parents 

can be assisted in their role at this early stage, the chances of influencing patterns of 

parenting and promoting healthier parent·infant relationships are improved. Ipso facto, the 

likelihood of relational failure and signs of child abuse and neglect are diminished. 

A. Parental Competency Programs for Select Target Groups. 

In general the findings of programs aimed at enhancing parental competency support the 

short-term efficacy of family support. Taking child and parental outcome results together, 

no approach to service delivery with these families emerges as preferred. The pattern that 

does emerge is that fairly intensive group and home-visit intelVentions providing parental 

support and instruction in child management andlor child cognitive stimulation exert their 

main benefits in the domains of parental attitudes and behavior and overall maternal 

adjustment. Positive child cognitive results seem to emerge in studies involving large 

samples and consistent delivery of child development-focused intelVentions, although these 

seem to be short-term in nature. Similarly, positive child behavioral gains are found in 

studies with larger samples and sounder assessment methods. 

From a prevention perspective these results are encouraging, because theorists have placed 

an emphasis on parental characteristics and the interactional quality between parent and 

child as important determinants of parental behavior. While positive gains were found for 

indirect measures of abuse and neglect prevention (e.g., parenting attitudes and behavior), 

few investigations attempted to measure abuse prevention directly (e.g., agency reports). 

thereby highlighting the need to include both types of measures. Also, given the increased 

cost of home visitation, the comparability of home versus group parenting education 

approaches merits further study. 

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B. Parent-child Support Programs for New Parents. 

Considering child and parental outcome results together, these results echo the findings 

reported previously with identified at-risk parents. That is, greater gains were shown in 

measures of parental rather than child adjustment, and the etlicacy of fairly intensive 

home-visitation (1-3 years) is supported. The finding that positive results were reported for 

horne visits following both a consultation model and a more formal curriculum suggest that 

parenting information and support garnered from either approach is beneficial. What did 

not seem to work as well was when home-visits were brief and/or conducted in the absence 

of clearly specified program objectives and content. 

The present findings indicating greater gains for subjects possessing more initial risk factors 

and receiving fairly intensive intetventions argue for the matching of treatment length to the 

need of each participant. This is supported in the first instance by the positive results of 

brief home visitations for low risk subjects (Le., new parents who were 18 years of age and 

older, and not excluded on the basis of any demographic factor, such as education level, 

income, or marital status). These findings, although preliminary, lend support to the utility 

of a community-wide prevention approach in which such services are offered routinely as 

part of prenatal and postpartum care. 

In the second instance, the importance of matching treatment length to subject need or risk 

is supported by the findings indicating that high-risk parents benefit more from intensive, 

long-term involvement. Brief intetventions of early and extended contact appear insufficient 

for producing lasting beneficial effects among identified risk populations. More intensive 

efforts may be needed to ensure the development of a stable and enduring helper-family 

bond, because these families may be more socially isolated and mistrustful of service 

providers. 

C. Parent-child Support Programs for Teen Parents 

Despite the small number of studies and methodological weaknesses, results with adolescent 

parents setve to reinforce the conclusions drawn from the previous sections on procedurally--

defined at-risk parents and new and expectant parents. Specifically, relatively intensive 

home-visit intetventions with at-risk mothers yield modest short-tenn child cognitive gains, 

and greater gains in child behavior and parental outcome measures. A supervised 

interactional component that improves parenting and socioeconomic status may be 

particularly useful with low income adolescent parents. An important contnbution of these 

studies is the finding that brief, education·oriented group classes are useful for enhancing 

parenting-related knowledge with expectant fathers. Further, the finding that fathers who 

had greater total knowledge scores were more likely to report supportive behaviors towards 

the mother suggest that enlisting the father may not only improve his parenting skills, but 

may potentially improve maternal skills through increased support. 

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The comparative effectiveness of group versus home visit interventions remains at issue 

because no study directly contrasted these approaches. Moreover. the true preventive 

potential of these intelVentions remains unknown until chiJd abuse reports or chi1d health 

variables (e.g., emergency admissions, number of accidents) are collected in future studies. 

Because a number of parenting programs with teen mothers are approaching the evaluation 

stage, these next years wiII offer an important opportunity to judge the preventive impact 

of support programs with this population. 

Summaxy of Prevention Programs 

Family support studies ranging in definition of at-risk parents have found short-term positive 

outcomes, particularly for parental outcome measures and for those mothers deemed at 

greatest risk (e.g., poor, single, young). While positive gains have been found in terms of 

indirect measures of parental behavior (knowledge and attitudes), several studies have also 

found improvements in observed parental behavior and, to a lesser extent, indicators of 

maltreatment (child abuse reports). Also, these studies show that family support programs 

improve general maternal functioning rather than specific dimensions of personal 

adjustment. There is initial, yet persuasive, evidence to suggest that multi-leveled programs 

(i.e., offering additional services as parents require them over a longer period of time) are 

worth the additional effort and expense, compared to less intensive services for higher risk 

families. 

Overall, those programs that span from one to three years and provide a personalized 

approach (e.g., home-visits) stand out as most successful in achieving the desired outcomes 

and most successful with higher risk individuals. This apparent intervention-population 

matching may be best understood by considering the often isolated, unskilled, and 

impoverished characteristics of these mothers. That is, their need for support, parenting 

instruction, and resource linkage seems to be fulfilled by the more personalized, outreach 

nature of the home visitor approach. 

Section III: Emerging Directions for Child Sexual Abuse Intervention 

A. Intervention with Child Sexual Abuse Victims or Potential Victims 

Particular characteristics of sexual abuse warrant consideration in seeking an understanding 

of the wide range of problems shown among these children. Unlike other forms of child 

maltreatment discussed above, incestuous sexual abuse is less related to caregivers' attempts 

to control or manage child- or family-related stress. Rather, it represents a most distinct 

form of maltreatment that involves both betrayal of trust and physical violation, accompanied 

by some degree of coercion or deceit. Private and specific fears related to aspects of the 

abuse may develop, which the child is often unable to discuss due to the fear itself, as well 

as developmental limitations in expression. Abrupt or gradual changes in the child's 

psychological well-being and behavior may occur, but others (including professionals) may 

not identify these changes as being a function of sexual abuse. 

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1. Legal-based intenrentions to Prepare Children for the Role of Witness. 

Increased recognition of the difficulties children experience in a courtroom setting, in 

particular their fear of the accused and confusion about the process, has led many states and 

provinces to implement new evidentiary procedures. Most notably, these changes have 

included the use of closed-circuit television to physically remove the child from the 

courtroom, videotaping of children's disclosure and investigative interviews, and the use of 

a screen to block the child's direct view of the accused in court. The impact of these 

changes, however, is still under evaluation, particularly in terms of how they may attenuate 

the child victim's level of stress and long-term adjustment problems. A prominent 

pioneering study in this regard is discussed in the full report. 

2. Psychological and educational programs. Therapeutic programs for 

sexually abused children and family members have expanded rapidly over the last decade, 

as well as school-based prevention programs. Treatment has been extended to victims, 

parents, siblings, and offenders, and has involved many different moda1ities (e.g., behavioral, 

psychodynamic, family therapy). The goals of treatment vary considerably, given the 

diversity of this popUlation and the preliminary nature of current investigations, but most 

programs emphasize group/individual support for the victim and non-offending parents, 

management of anxiety and fear symptoms, and/or empowerment strategies. At the present 

time, however, scientific evidence regarding the benefit or impact of such programs is very 

limited, primarily due to methodological concerns that have not been overcome (Le., use of 

control groups, proper measures of outcome, etc.), and the relatively recent focus on this 

issue. 

Child sexua1 abuse prevention programs, on the other hand, are directed at the general 

population of school·aged children. Most programs have emphasized gains in knowledge 

about potential abuse situations, "touch" discrimination, and behaviora1 strategies to 

avoid/escape abusive situations. As a whole, evaluations provide some limited support for 

the efficacy of sexual abuse prevention programs, particularly in terms of a slight increase 

in knowledge about sexual abuse following a prevention program. However, no evidence 

exists that links such changes in knowledge to changes in behavior. Questions were raised 

regarding whether programs that are useful for school-aged children are appropriate for 

younger children as well. 

B. Intervention Methods with Child Sexual Abuse Offenders 

Certain psychologically-based approaches to treatment are beginning to emerge as having 

a significant impact on the recidivism of known child molesters. The comprehensive 

cognitive-behavioral programs are the most effective, especially for child molesters, incest 

offenders, and exhibitionists. However, considerable methodological advancement must be 

applied to this area to establish the parameters of what form of treatment works for whom. 

Issues regarding the identification of high-risk or accomplished child molesters who would 

benefit from this fonn of intervention arc complex, yet the emerging literature is 

encouraging in tenns of desired change for those individuals who are identified. 

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" 

CONCLUSIONS AND RECOMMENDATIONS 

I. Research and Methodology: Gaps and Recommendations 

A. Theoretical and Conceptual Advances. A conceptual model to guide inteIVention 

and outcome evaluation necessitates that the common antecedents of the categorical 

problem behaviors (Le .• abuse, neglect, etc.) be identified. This identification procedure may 

be informed by empirical findings, clinical observations, and theoretical applications. Thus, 

if it is proposed that parents maltreat their children due to the direct effects of poor 

knowledge and skill in childrearing, as well as improper support and assistance, then the 

strategy for prevention should address these specific needs. IntelVention and measurement 

should be directly connected to the hypothesized causal model. An important addition to 

presumed direct effects is the identification of mediators of the relationships between 

antecedents and abuse. Intervention that targets both indirect and direct influences would 

be expected to be more efficacious than those addressing either alone. 

A.l. Recommendation #1: There is a critical need for prevention programs to be 

driven by an underlying conceptualization of the processes involved in child abuse and 

neglect. 

B. Research Design and Program Evaluation. Although research designs have 

improved significantly since the first reviews of intervention studies, recent studies still 

contain methodological inadequacies common to the field of child maltreatment that must 

be taken into account in interpreting their findings. For example, research designs are often 

inadequate to draw firm conclusions, because most studies are naturalistic correlational field 

research that does not permit true experimentation. Many studies involve subject samples 

that in all likelihood contain mixed forms of maltreatment (e.g., physical, sexual, 

psychological abuse), which confounds the findings that may relate to physical abuse alone. 

In addition, child abuse researchers face a major challenge in attempting to control for 

related factors that may have direct or indirect effects on children's adjustment, such as 

marital discord, socioeconomic disadvantage, poor social supports, etc. Finally, it is 

worthwhile to note that the newly emerging prevention-focused programs (designed for 

families who have not yet been identified as abusive or neglecting), although promising, have 

yet to demonstrate actual prevention, if one limits such criteria simply to the occurrence of 

an incident. On the other hand, the burgeoning evidence that such programs enhance 

parental effectiveness and child competence argue for the preference of such outcome 

variables over the unreliable and somewhat arbitrary official reports of maltreatment. 

There is a critical need for appreciable follow-up periods so that maintenance of gains and 

"sleeper" effects (i.e., those emerging after program completion) may be assessed. Other 

design issues include the need to conduct more controlled evaluations through 

randomization procedures and to incorporate greater sensitivity into program design in an 

effort to maximize the likelihood of finding true effects. Such efforts as calculating 

necessary conditions (e.g., number of subjects) to meet adequate levels of statistical power, 

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monitoring the consistency, conten~ and quality of seIVice delivery, and utilizing more 

psychometrically sound and multi-method measurement procedures would facilitate accurate 

evaluation of program effects. Although it is recognized that some treatment target areas 

may not have sufficient evaluation devices current1y available, greater utilization of existing 

knowledge bases are in order. 

B.1. Recommendation #2: The importance of testing promising intelVention models 

through the use of prospective designs is underscored. 

B.2. Recommendation #3: Prevention programs aimed at child maltreatment, in 

particular home-visitation programs, have matured to the point where specificity issues 

should be addressed as part of outcome. The question of which programs work for whom, 

and under what circumstances must be addressed. 

C. Selection of Participants. Currently, a major roadblock to the implementation of 

effective early intervention and prevention programming is the lack of information pertaining 

specifically to the nature of the population. Although there was some evidence supporting 

each of the interventions reviewed, little specificity is provided that allows one to match 

intervention type to individual needs of persons or families. The comprehensive/multiservice 

programs come closest in this regard, yet conclusions cannot be drawn under more complete 

evaluation is available. 

C.l Recommendation #4: Alternative approaches to targeting subjects with specific 

risk indicators should be explored, in which general indicators (e.g., first-time parenthood) 

may serve as entry criteria for prevention programs. 

D. Participation of Fathers and Male Partners. Almost without exception, the 

studies reviewed herein include only female participants. No matter what conclusions one 

draws from these studies, it is necessary to keep in mind that the results apply primarily to 

women. Regrettably, many of the factors that have been identified by the ecological model 

of child maltreatment implicitly or explicitly highlight the importance of the man's role in 

either contributing to or preventing such events. At this point in time, however, there is 

little information by which to design and implement services to fami1ies that will best meet 

the needs of men who are at-risk of becoming violent toward children or partners. This 

finding of underrepresentation of fathers compared to mothers is consistent with the 

literature on developmental psychopathology in general. Despite the growing knowledge 

that fathers playa significant role in the development of child and adolescent problems and 

in the etiology of physical and sexual abuse, intervention programs have generally not 

included men in their programs. 

0.2 Recommendation #5. There exists an urgent need to recognize and address the 

male role in the occurrence and the prevention of child maltreatment. Program additions 

and modifications that encourage male participation and improve family functioning hold 

promise for expanding the impact of early intervention services. 

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II. Program Development and Social Policy: Gaps and Recommendations 

E. The Importance of Matching Services to the Needs of Parents. Children. and 

Families: What Works for Whom? A major finding to emerge from this review is that no 

particular method of intervention is likely to lead to desirable outcomes for even a majority 

of families, especially by the time chi1d maltreatment has been identified. From a costbenefit perspective, the cost of remediating serious childrearing concerns is prohibitive. 

These costs may be reduced by placing greater emphasis on preparing parents for their 

childrearing role well in advance of the emergence of problems, and having a wider range 

of appropriate services available. Such a model requires staff who are trained to assist with 

families at a level that is most beneficial, rather than attempting to detect and intervene 

after the fact. Staff would have to be sensitive to individual, community, and cultural 

preferences, as well as socioeconomic limitations, that constitute the majority of 

disadvantaged families, and be willing to tolerate such differences for the purpose of 

establishing a basis for improving the parent-child relationship. This approach requires more 

investment in family development at an earlier point in time, but holds considerable promise 

in reducing the costs and failures of the current reactive system. 

An issue that emerged from this review was the need to match interventions to the needs 

of each famHy as best as possible. The literature shows repeated attempts to design and 

implement a particular strategy to any given sample of maltreating parents, with little regard 

to the needs of each participant (especially cultural and ethnic minorities). Whereas some 

parents require information and assistance in basic child rearing, many others require social 

support, chi1dcare respite, and/or personal counselling. Yet, the interventions persist in 

attempting to "fit" the patient to the "cure," rather than the reverse. Although the expanding 

multiservice programs are promising in this regard, they lack thorough evaluation and followup, and tend to have weak or inadequate research designs. 

Moreover, few programs have been directed at the developmental needs of abused and 

neglected children. Rather, treatment has been predominately aimed at adults. Although 

our understanding of the developmental impact of these problems has grown, efforts to 

remediate andlor prevent such problems have been slow to develop. Neglected children, in 

particular, suffer major psychological consequences that have been inadequately addressed 

by current approaches. 

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E.l. Recommendation #6: The current review supports the utility and cost-benefit 

of (aJ home visits, especially those begun prior to the onset of maltreatment, (b) specific 

skills training that addresses parental misperceptions and false expectations of young 

children, (c) specific skills training that promotes alternatives to physical punishment and the 

use of more prosocial, developmentally relevant activitjes for the parent to engage in with 

his(her child, (d) parental competency programs broadly aimed at non-identified individuals, 

a strategy that reduces concerns due to labelling and detection, and (e) preschool-based 

programs for child victims, which emphasize developmental gains and prosocial peer 

interactions. The theme of matching relevant services to the changing needs of families was 

highlighted throughout these findings. 

E.2. Recommendation #7: Major efforts should be launched to determine the 

impact on child maltreatment of an incentive-based program of child development screening 

and child development prescriptions and resources offered to the general public from 

conception through 5 years of age. This program could be offered through the local school 

system and serve as a bridge to similar services in the schools when school age is reached 

(this model is compatible with and could be a core element of the "neighborhood based 

services" model being recommended by the U.S. Advisory Board on CAN). 

E.3. Recommendation #8: Program development should focus on providing child 

development and parenting information that is easily understood, practical and accessible 

to all present and potential parenting populations. 

E.4. Recommendation #9: Early inteIVention programs to assist child victims of 

abuse and neglect should be expanded. In conjunction with efforts to assist the parents in 

their caregiving role, such programs offer additional developmental stimulation and peer 

contact for children. 

F. Marital/partnership Issues and Children Who Witness Wife Assault. The findings 

from this review point to some important areas of intervention that have been identified but 

rarely addressed. Based on the most popular ecological view of the causes of child 

maltreatment, a number of treatment targets were identified at the family, child, and parent 

level (community and cultural issues were beyond the scope of this review). Many of the 

methods noted above showed some success in addressing issues associated with the parentchild relationship (which is, of course, a central concern); however, the findings point to a 

lack of information concerning issues related to family functioning. 

F.l. Recommendation #10: Programs that address male violence against female 

partners, as well as those that address marital disharmony, need to be considered as 

necessary components of intervention and prevention for identified high-risk families. 

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G. Finding Effective Ways to Address Corollary Family Problems. To date, the 

potentiating effects of socioeconomic stress, family disadvantage, and substance abuse on 

abuse and neglect have not received adequate attention. Although most researchers 

acknowledge the presence and impact of these contextual factors, few approaches actually 

were designed to address these problems in a systematic manner. The comprehensive and 

social network programs are, again, promising in this regard, but have as yet provided 

limited evaluation data. Similarly, the influence of the parent's competing (negative) lifestyle 

and habits, which is often cited as a major concomitant factor among maltreating families, 

was addressed only serendipitously, rather than systematically. Like the male offenders, 

perhaps such individuals rarely participate in treatment outcome studies. 

G.I. Recommendation #11: Expansion of service delivery to include multiservice 

capabilities to address the negative influence of major contextual stress factors on effective 

family functioning. Subsidized daycare and housing, respite programs, homemaker seIVices, 

etc. show promise in this regard, but require systematic implementation and evaluation. 

H. Programs to Address the Needs of Ethnic Minorities. Attention must be directed 

to societal influences that playa role in child abuse and neglect, especially in circumstances 

where famiHes are exposed to major effects of poverty, health risks, and environmental 

conflict. Research needs to identify the special risks and strengths of diverse cultural and 

ethnic groups, and to be sensitive to ethnic and cultural issues in the planning of seIVices. 

Such a cross-cultural perspective to child abuse and neglect inteIVention and prevention 

would re-direct the focus away from individuals and families, and explore societal and 

cultural conditions that attenuate or exacerbate these problems. 

H.I. Recommendation #12: Although there is a general lack of research with 

maltreated children from ethnic and minority communities, adequate information exists to 

recommend the implementation and evaluation of culturally relevant inteIVention and 

prevention methods. 

I. Programs Aimed at Adolescents. Youth represent a sizeable proportion of child 

maltreatment reports, yet they typically receive less than adequate assistance. From an 

intervention perspective, there is reason to support the extension of programs that have 

shown effectiveness with clinically-referred youth to an at-risk youth population. The most 

effective programs for parent-adolescent conflict, which have been in existence for several 

years, involve several components, such as effective communication, parent training, 

contingency management, and family therapy. Although such methods may not be capable 

of overcoming very longstanding parent-adolescent conflict and abuse, they may be effective 

in addressing the emerging issues of that accompany adolescent development, especially for 

families with a limited history of protective seIVice involvement. Moreover, prevention 

seIVices for youth populations could integrate educational concepts (e.g., attitudes and 

knowledge issues affecting healthy versus violent relationships) with practical skills aimed at 

non-controIling conflict resolution. 

130 

p 
I 

i 

i 

l 

1.1. Recommendation #13: Educationally-focused prevention programs targeted to 

low- and high-risk adolescents merit development and evaluation in schools, communities, 

and service agencies, on such topics as control and power in relationships, sexual and 

physical violence, and family and childrearing values. 

J. The Need for a Multiservice, Public Health Model of Ongoing Support for 

Families 

In the long run, the causes of these phenomena should be addressed from a public health 

vantage point, rather than through tertiary intervention, because many of those causes affect 

the health and functioning of the majority of families. 

J.1. Recommendation #14: A public health approach to the prevention of child 

abuse and neglect is a promising strategy that merits serious consideration. Such a strategy 

should not undermine existing efforts at treatment and early intervention, but rather would 

be designed to approach the widespread problem of child maltreatment from a broader, 

more fundamental vantage point. 

III. Child Sexual Abuse 

Treatment and prevention activities directed at the underestimated problem of child sexual 

abuse have emerged rapidly over the past decade. Although there are beneficial therapeutic 

programs both for child victims and for offenders, it is still too early to draw conclusions 

regarding their overall impact. However, legal~based services to assist children in preparing 

to testify in court merit careful evaluation and dissemination, as do group and individual 

programs for children that address their anxiety, fears, and symptoms of post-traumatic stress 

that may emerge in the aftermath of disclosing sexual abuse. Perhaps because child abuse 

prevention programs have emerged so rapidly, it was concluded that there is insufficient data 

at present to either promote or deter such efforts. The initial findings presented herein 

point to the considerable gap in knowledge related to determining which methods work to 

teach what types of skills to which children. Because these gaps must be addressed before 

conclusions can be drawn about such prevention efforts, the following recommendations 

point to several of the more basic issues facing research and program development. 

K. Therapeutic and Educational Programs to Assist Children 

K.l. Recommendation #15: Prevention programs need to expand beyond the focus 

on potential victims (i.e., children). There is a conspicuous absence of programs that target 

other adults who come into contact with children, with either a detection or primary 

prevention goal in mind, yet these adults are the most likely candidates to whom children 

will report abuse. 

131 
K.2. Recommendation #16: Several areas of program curriculum development and 

clarification for child sexual abuse prevention merit improvement and expansion, if such 

child-focused programs are to expand. Program content should extend beyond a discussion 

of the touch continuum, to include related topics of importance (e.g., personal safety, 

assertiveness, problem-solving). Moreover, affiliated staff should be trained to continue 

providing opportunities for students to discuss the issues brought forth during training. 

K.3. Recommendation #17: Chi1d sexual abuse prevention must tum its attention 

toward some of the underlying social and cultural issues that are suspected to be at the root 

of such exploitation and abuse. To date, little research has been conducted on the 

motivating factors involved in child sexual abuse. Because almost all of the offenders are 

male, a long term strategy should be developed that addresses some of the suspected roots 

of such behavior from a socialization perspective. More responsibility for prevention should 

be directed at socialization agents (e.g., schools, parents, clubs, etc.) in an effort to heighten 

society's awareness of the problem and to attack the roots of sexism that exist at all levels. 

K.4. Recommendation #18: Legal-based services for child victims, such as the 

availability of non-standard evidentiary procedures (e.g., screen; videotaped testimony), and 

the use of educational/therapeutic services to prepare children for the stress of testifying in 

court, warrant investigation as to their possible role in decreasing the long-range negative 

impact of sexual abuse and its disc1osure. 

K.5. Recommendation #19: Treatment services for child victims and for sex 

offenders have shown promise in assisting victims and in reducing recidivism. Well-designed 

investigations should be launched on a wide-scale basis to determine the most effective 

forms of intervention for offenders and victims. 

132 

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T 

I 

I APPENDIX D 

U.S. ADVISORY BOARD ON CHILD ABUSE AND NEGLECT 

1. Membership 

In accordance with the provisions of the 1988 Amendments to the Chi1d Abuse Prevention 

and Treatment Act, the U.S. Advisory Board on Child Abuse and Neglect comprises 15 

members, each of which "is recognized for expertise in an aspect of the area of child abuse." 

Of the 15 members, two are Federal employees who are also members of the Federal 

Inter-Agency Task Force on Child Abuse and Neglect, and 13 are members of the general 

public. 

Following is a list of Board members. Each list identifies the beginning and ending dates 

of a member's term of appointment and specific expertise mandated by statute which a 

member brings to the Board. 

CURRENT MEMBERS 

Deanne Tilton Durfee, Chair 

Executive Director 

Los Angeles County Inter·Agency Council 

on Child Abuse and Neglect (ICAN) 

4024 Durfee Avenue 

EI Monte, California 91732 

818-575-4362 

Yvonne M. Chase, Vice-Chair 

Vice President 

Child Welfare Services 

Lockheed Information Management Systems 

626 Columbia Street, NW, Suite #IA 

Olympia, Washington 98501 

206·352-1544 

Frank D. Barry 

Senior Extension Associate 

Family Life Development Center 

Cornell University 

Ithaca, New York 14853-4401 

607·255-7794 

• Appointmentlrenppointment pending. 

Representing: At·large 

Term Beginning: May 30, 1989 

Term Ending: May 29, 1995 

Representing: Social Services 

Term Beginning: May 30, 1989 

Term Ending: May 29, 1995 

Representing: Organizations 

Providing Services to Adolescents 

Term Beginning: May 3U, 1989 

Term Ending: • 

133 
Enid A. Borden 

President 

The Borden Group 

101 North Alfred Street, Suite 200 

Alexandria, VA 22314 

703-548-3692 

Jane Nady Burnley 

Executive Director 

VALOR 

P.O. Box 862 

McLean, VA 22101-0862 

703-538-6898 

Howard A. Davidson 

Director 

ABA Center on Children and the Law 

American Bar Association 

1800 M Street, N.W., S-300 

Washington, D.C. 20036 

202-331-2250 

Richard D. Krugman 

Dean 

School of Medicine 

University of Colorado 

4200 East 9th Avenue 

Denver, Colorado 80262 

303-270-7563 

Gary B. Melton 

Carl A. Happold Professor of Psychology and Law 

Center on Children, Families, and the Law 

University of Nebraska 

Lincoln Square, 121 South 13th Street 

Lincoln, Nebraska 68588-0227 

402-472-3130 

• Appointment/reappointment pending . 

Representing: Teachers 

Term Beginning: October 25, 1992 

Term Ending: May 29, 1995 

Representing: Voluntary Groups 

Term Beginning: October 25, 1992 

Term Ending: May 29, 1996 

Representing: Law 

Term Beginning: May 30, 1989 

Term Ending: • 

Representing: Medicine 

Term Beginning: May 30, 1989 

Term Ending: • 

Representing: Psychology 

Term Beginning: May 30, 1989 

Term Ending: .* 

•• Appointment pending upon release of 1993 Board Report 

134 
Joyce L. Mohamoud 

Executive Director 

State Resource Office 

Parents Anonymous of New Jersey 

12 Roszel Road, Suite A-103 

Princeton, New Jersey 08540 

609-243-9779 

Lawrence F. Potts 

Director, Administrative Group 

Boy Scouts of America National Office 

1325 West Walnut Hill Lane 

P.O. Box 152079 

Irving, TX 75015-2079 

214-580-2225 

Prince Preyer, Jr. 

Commissioner, District Six 

Madison County Commission 

3210 Hi Lo Circle, Suite B 

Huntsville, AL 35811 

205-532-1505 

Diane J. Willis 

Director of Psychological Services 

Child Study Center 

Department of Pediatrics 

1100 Northeast 13th Street 

Health Sciences Center 

1100 Northeast 13th Street 

Oklahoma City, Oklahoma 73117 

405-271-5700 

(Seat currently vacant; appointment pending) 

(Two Federal seats cu"entiy vacant; 

appointments pending) 

* Appointment/reappointment pending. 

Representin~: Parent Self-help 

organizations 

Term Beginning: May 30, 1989 

Term Ending: • 

Representing: At-Large 

Term Beginning: October 25, 1992 

Term Ending: May 29, 1996 

Representing: State and Local 

Government 

Term Beginning: October 25, 1992 

Term Ending: May 29, 1996 

Representing: Organizations 

Providing Services to Disabled 

Persons 

Term Beginning: May 30, 1989 

Term Ending: • 

Representing: Parent's Groups 

Representing: Inter-Agency Task 

Force on Child Abuse and Neglect 

135 
2. Statr And Other Personnel Resources •• 1991·1992 

Byron D. Metrikin·Gold (December 1988)' 

Executive Director 

U.S. Advisory Board on Child Abuse and Neglect 

200 Independence Avenue, SW 

Washington, D.C. 20201 

202·690·8332 

Eileen H. Lohr (December 1989)' 

Program Assistant, U.S. Advisory Board on Child Abuse and Neglect 

202·690·6053 

Joan M. Williams (September 1991)' 

Special Projects Specialist, U.S. Advisory Board on Child Abuse and Neglect 

202·690·8178 

Other Personnel Resources 

Preston Bruce (November 1992 -- )+ 

Acting Deputy Director, U.S. Advisory Board on Child Abuse and Neglect 

202·690·7059 

Shawn A. Jackson (June 1992 to October 1993)' 

Secretary, U.S. Advisory Board on Child Abuse and Neglect 

202·690·7036 

Marilyn J. Gosdeck (January 1993 .. )' 

Management Analyst, U.S. Advisory Board on Child Abuse and Neglect 

202·690·8604 

Marla Brin (November 1992 to May 1993)' 

Social Sciences Analyst, U.S. Advisory Board on Child Abuse and Neglect 

Anneke Rndin (June 1993 to Augnst 1993)' 

Field placement from the University of New York at Geneseo 

* Date of appointment to Board staff 

136 

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T 

3. Committees and Work Groups -- 1992-1993 

EXECUTIVE COMMIlTEE 

Deanne Ti1ton Durfee, Chair 

Frank D. Barry 

Enid A Borden (appointed 2/93) 

Yvonne M. Chase 

Howard A Davidson 

Richard D. Krugman (served until 2/93) 

Gary B. Melton 

RESEARCH COMMITTEE 

Gary B. Melton, Chair 

Yvonne M. Chase 

Richard D. Krugman 

Diane J. Willis 

NEW NATIONAL STRATEGY WORKGROUP 

Gary B. Melton, Chair 

Frank D. Barry 

Yvonne M. Chase 

Joyce L. Mohamoud 

Diane J. Willis 

FATALmES WORKGROUP 

Deanne Tilton Durfee, Chair 

Enid A Borden (appointed 2/93) 

Jane Nady Burnley (appointed 2/93) 

Yvonne M. Chase 

Howard A. Davidson 

Donna N. Givens (served until 1/93) 

Richard D. Krugman 

Brenda G. Meister (served until 7/93) 

137 
• 

4. Activities of the Board •• January I.September 30, 1993 

During the first nine months of 1993 the Board devoted most of its attention to the 

development of a proposed new national child protection strategy (the subject of this, its 

1993 repon) as wen as a proposed national policy on the prevention of child maltreatmentrelated fatalities (the subject of its 1994 report). A third major activity involved completion 

of lbe Board's 1992 report, The Continuing Child Protection Emergem;y: A Challenge to 

the Nation. released to the public in early April 1993 at a press conference held in the U.S. 

Capitol. 

THE 1993 REPORT 

The shape of the 1993 report emerged through discussions at the thirteenth meeting of the 

Board in February 1993 and at the fourteenth meeting in May 1993, both meetings held in 

McLean, Virginia. The specific content of the 1993 report including its recommendations 

was honed through a series of iterative drafts. 

As in past years, most of the work in preparing those drafts was undertaken by the Board. 

With substantial assistance from Frank Barry and Enid Borden, Gary Melton led this effort. 

THE 1994 REPORT 

On May 28, 1992, CAPT A was amended to require the Board to prepare a report on child 

maltreatment-related fatalities. The report is to contain recommendations on (a) a national 

policy designed to reduce such fatalities, (b) changes needed to achieve an effective Federal 

role in the implementation of that policy, and (c) changes needed to improve data collection 

about such fatalities. 

In both its 1990 and 1991 reports the Board had made recommendations regarding child 

maltreatment-related fatalities. In April 1992 the Board met in Los Angeles during which 

it decided to satisfy the imminent CAPT A amendments by devoting its entire 1994 report 

to the subject. 

In reaching this decision, the Board elected to make the focus of the report the prevention 

of child abuse and neglect. The report would use fatalities as a vehicle for explaining the 

national child protection emergency to the nation. 

138 
"f 

The report will emerge through a series of events and iterative documents including a series 

of: field hearings; technical papers; interviews; discussions at Board meetings; and drafts of 

the report. While the full Board has ultimate responsibility for the entire content of the 

report, it has delegated responsibility for the development of the report to a Work Group. 

A major aim of the Work Group will be to ensure that, throughout the development of the 

report, all relevant information generated by corollary non-Board efforts will, to the 

maximum extent possible, be utilized. 

During the past year, the Board's principal activities related to the 1994 report involved the 

laborious but necessary process of information-gathering. To that end, members of the 

Board and Board staff: 

• in March 1993 met in Denver with a group of experts who were presenting at a 

Colorado Child Fata1ities Conference to test the Board's preliminary thinking about 

the report. 

• in May 1993 (during a Board meeting): 

- heard three witnesses during a mini-hearing on the "religious exemption" 

under which the U.S. Department of Health and Human Services provides 

States flexibility in defining whether the intentional denial of appropriate 

medical care to a child by persons responsible for that child due to religious 

beliefs constitutes child maltreatment; and 

- heard a presentation on the relationship of confidentiality requirements to 

child maltreatment-related fatalities. 

• in June 1993 held a field hearing in Chicago in connection with a conference of the 

American Professional Society on the Abuse of Children. 

• in September 1993 held a field hearing in Salem, Oregon. 

• in September 1993 commissioned a set of Technical Papers on: 

- the prevention of child maltreatment-related fatalities; 

- child death review teams; 

- the identification and investigation of child ma1treatment-related fatalities; 

- ensuring consonance between child safety and family preservation; and 

- the collection of data on child maltreatment-related fatalities. 

139 
CHANGES IN OFFICERS, MEMBERSHIP, AND STAFF 

At its May meeting the Board elected Deanne Tilton Durfee as its Chairperson, Yvonne 

Chase as its Vice-Chairperson, and Enid Borden to a seat on the Executive Committee. 

Under the rules of the Board, they wiH seNe in those capacities until May 1995. Three 

additional members of the Executive Committee will be elected at the Board's Fall 1993 

meeting. 

In late 1992, five new members were appointed to the fonowing seats on the Board: 

Enid A. Borden (Teachers); Jane Nady Burnley (Voluntary Groups); James H. Egan 

(Parents' Groups); Lawrence F. Potts (At·Large); and Prince Preyer, Jr. (State and Local 

Government). They replaced the following members: Dcborah M. Walsh (Teachers); Judith 

C. Frick (Voluntary Groups); H. Gordon Evans (Parents' Groups); Jeanne D'Agostino 

Rodriguez (At-Large); and Earl L. Dunlap (State and Local Government). 

During 1993 Donna Givens and Brenda Meister, Federal officials who were appointed to 

the Board from the ranks of the Federal Inter-Agency Task Force on Child Abuse and 

Neglect, as well as James Egan, holder of the Parents' Groups seat, resigned from the 

Board. In addition, Gary Melton, holder of the Psychology seat, indicated his intention to 

resign from the Board following the release of the 1993 report. Appointments to those four 

seats as well as five appointments/ reappointments to the Medicine, Law, Services to 

Adolescents, Services to the Disabled, and Parent Self-Help Organizations seats are currently 

under consideration within the Department of Health and Human Setvices. 

In late 1992-early 1993 the Board staff was markedly strengthened by the detail of: Preston 

Bruce from the Administration on Children, Youth, and Families to selVe as Acting Deputy 

Executive Director; Marla Brin from the Environmental Protection Agency to selVe as Legal 

Advisor on Child Maltreatment·Related Fatalities; and Marilyn Gosdeck from the Office of 

the Assistant Secretary for Children and Families to serve as Management Analyst. 

140 
A list of the names and affiliations of individuals who addressed the Board during its 

meetings follows: 

Joseph A. Mottola 

MEETING OF FEBRUARY 9-12, 1993 

McLean, Virginia 

Deputy Commissioner, Administration for Children, Youth and Families 

Administration for Children and Families 

Department of Health and Human Services 

David W. Lloyd 

Director, National Center on Child Abuse and Neglect 

Administration on Children, Youth and Families 

Administration for Children and Families 

Department of Health and Human Services 

Interagency Task Force Fatalities Workgroup Members: 

Federal Inter-Agency Task Force on Child Abuse and Neglect 

U.S. Department of Health and Human Services 

Emily Cook, NCCAN 

Gary Lyle, Indian Health Service 

Marti Speights, Department of Justice 

Jane Sponberg, Department of Defense 

Joseph A. Mottola 

MEETING OF MAY 25-27, 1993 

McLean, Virginia 

Deputy Commissioner, Administration for Children, Youth and Families 

Administration for Children and Families 

Department of Health and Human Services 

David W. Lloyd 

Director, National Center on Child Abuse and Neglect 

Administration on ChiJdren, Youth and Families 

Administration for Children and Families 

Department of Health and Human Services 

Robert Horowitz 

Associate Director 

American Bar Association Center on Children and the Law 

Washington, D.C. 

141 
A list of the names and affiliations of all individuals who testified before the Board during 

one of its hearings, or submitted a written statement to the Board, fonows: 

HEARING OF MARCH 11, 1993 

Denver, Colorado 

Fatalities Workgroup 

Members of the Public 

HEARING ON 

CHILD MALTREATMENT·RELATED FATALITIES 

June Beveridge 

State of Colorado 

Division of Child Welfare Services 

Denver, Colorado 

Michael Durfee, M.D. 

Child Abuse Prevention Program 

Department of Health Services 

Los Angeles, California 

Michelle Kelly, Ph.D. 

The Children's Hospital 

Child Advocacy and Protection Team 

Denver, Colorado 

James L. Kramer 

Pueblo Coroner's Office 

Pueblo, Colorado 

Donna Rosenberg, M.D. 

Pediatrician 

Denver, Colorado 

JiII.EII)u Stmns 

Deputy District Attorney 

Adams County District Attorney's Office 

Brighton, Colorado 

Harry Wilson, M.D. 

The Children's Hospital 

Pathology Department 

Denver, Colorado 

142 

.... 
MINI-HEARING OF MAY 26, 1993 

McLean, Virginia 

Members of the Board 

Members of the Public 

MINI-HEARING ON RELIGIOUS EXEMPTION 

Madeline Nesse 

Office of General Counsel 

Department of Health and Human Services 

Ellen Mugmon 

Child Protection Advocate 

Philip G_ Davis 

Federal Representative 

The First Church of Christ, Scientist 

American Academy of Pediatrics 

1331 Pennsylvania Avenue, N.W. 

Washington, D.C. 

(Written Testimony) 

Rita Swan 

Children's Healthcare Is a Legal Duty, Inc. 

Sioux City, Iowa 

(Written Testimony) 

143 
HEARING OF JUNE 25, 1993 

Chicago, Illinois 

Fatalities Workgroup 

Members of the Public 

HEARING ON 

CHILD MALTREATMENT-RELATED FATALITIES 

Coleen Kivlahan, M.D. 

Medical Director 

Department of Social SeMces 

Jefferson City, MO 

RandeU AJexander, M.D. 

University of Iowa 

Iowa City, IA 

Jan Bays, M_D. 

Emanuel Hospital 

Portland, OR 

Robert Reece, M.D. 

Case Western Reserve University 

Rainbow Babies and Children's Hospital 

Oeveland, OH 

Linda Williams, Ph.D. 

University of New Hampshire 

Family Research Laboratory 

Durham, NH 

Barbara Bonner, Ph.D. 

University of Oklahoma 

Health Science Center, Psychiatry 

Oklahoma City, OK 

Thomas Curran, MSW, JD 

Defender Assoc. of Philadelphia 

Child Advocacy Unit 

Philadelphia, P A 

Deborah Darn, DSW 

National Center on Child Abuse Prevention Research 

Chicago, IL 

144 
Robert Kirschner, M.D. 

Deputy Chief Medical Examiner 

Cook County Office of the Medical Examiner 

Chicago, IL 

Sharon OConner 

Office of the Medical Examiner 

Cook County 

Chicago, IL 

William Weil, M.D. 

Department of Pediatrics and Human Development 

Michigan State University 

(Representing the American Academy of Pediatrics) 

Paul DerOhannesian, JD 

Albany County Office of the District Attorney 

Albany, NY 

Patrick Murphy 

Public Guardian 

Cook County Office of the Public Guardian 

Chicago, IL 

Bernardin Dohrn 

Director, Children and Family Justice Center 

Northwestern University Legal Clinic 

Chicago, IL 

Harry Elias, JD 

North County Municipal Court 

Vista, CA 

Bill Hammond 

2101 Wilson Boulevard 

Arlington, VA 

Patricia Toth, JD 

Nationa1 Center for Prosecution of Child Abuse 

Alexandria, VA 

145 
APPENDIX E 

List of Recommendations 

in the 

1990 Report or the U.S. Advisory Board on Child Abuse and Neglect 

Child Abuse and Neglect: 

Critical First Steps in Response to a National Emergency 

A. RECOGNIZING THE NATIONAL EMERGENCY 

Recommendation #1: 

The Board urges each citizen to recognize that a serious emergency related to the 

maltreatment of children exists within American society and to join with all other 

citizens in resolving that its continued existence is intolerable. 

Recommendation #2: 

The Board urges each citizen to demand that his or her elected officials at all levels 

public1y acknowledge that the American child protection emergency exists, and, 

having so acknowledged this emergency, take whatever steps are necessary --

inducting the identification of new revenue sources -- to rehabilitate the nation's child 

protection system. 

Recommendation #3: 

The Board urges the U.S. Congress, State legislatures, and local legislative bodies to 

view the prevention of child abuse and neglect as a matter of national security and, 

as such, to increase their support for basic necessities, such as housing, child care, 

education, and prenatal care for low income families including the working poor, the 

absence of which has been linked to child abuse and neglect. 

B. PROVIDING LEADERSHIP 

Recommendation #4: 

146 

The Board urges the President to become the visible and effective leader of a 

renewed Federa1 effort to prevent the maltreatment of American children and to help 

the nation better serve those children who have been abused and neglected. 
Recommendation #5: 

The Board urges each Governor to become the visible and effective leader of a 

renewed State effort to prevent the maltreatment of children and to assure that child 

victims of abuse and neglect receive appropriate services. 

Recommendation #6: 

The Board urges each Mayor and County Executive to become personally involved 

in improving the delivery of services related to the prevention and treatment of child 

abuse and neglect. 

Recommendation #7: 

The Board urges legislative bodies at aI1levels to join with the President, Governors, 

and County Executives and Mayors in a renewed national commitment to child 

protection by providing the funds necessary to prevent and treat child abuse and 

neglect. 

Recommendation #8: 

The Board urges national scientific socIetIes and professional asSOCIatIOns to 

undertake major initiatives to stimulate the development of knowledge about child 

abuse and neglect and the improvement of the child protection system and to diffuse 

such knowledge to their members, policymakers, and the general public, 

C. COORDINATING EFFORTS 

Recommendation #9: 

The Secretary of Health and Human Services, in conjunction with his counterparts 

within the Federal Government (working through the U.S. Inter-Agency Task Force 

on Child Abuse and Neglect), and the Governors of the several States should identify 

and eliminate barriers which stand in the way of providing coordinated community 

seIVices related to the protection of children. 

147 
Recommendation #10: 

The Secretary of Health and Human Services, in conjunction with his counterparts 

in the Federal Government (working through the U.S. Inter-Agency Task Force on 

Child Abuse and Negle<:t), and the Director of the Ottice of National Drug Control 

Policy in the White House should take steps to assure that all relevant aspects of the 

national effort to control substance abuse are coordinated with efforts to prevent and 

treat child abuse and neglect. These steps should begin immediately and should be 

made apparent to the public. All steps taken at the national level should be 

coordinated with relevant State and loea1 "front-line" programs. 

Recommendation #11: 

The Secretary of Health and Human Services and the Attorney General (working 

through the U.S. Inter-Agency Task Force on Child Abuse and Neglect) should 

undertake joint efforts to address the issue of fatal child abuse and neglect caused 

by family members and other caretakers. These efforts should include the 

identification and vigorous dissemination to State and local governments of models 

for: (a) prevention of serious and fatal child abuse and neglect; (h) multidisciplinary 

child death case review; and (c) identification and response to child abuse and neglect 

fatalities by the social services, public health, and criminal justice systems. 

D. GENERATING KNOWLEDGE 

Recommendation #12: 

148 

The Secretary of Health and Human Services and the Attorney General (working 

through the U.S. Inter-Agency Task Force on Child Abuse and Neglect) should take 

whatever steps are necessary to establish a Federal data collection system that 

provides a comprehensive national picture of child ma1treatment and the response 

to it by the several governments of the United States. This new system should insure: 

accurate, annual, uninterrupted, consistent, and timely data collection; mandatory 

participation from the States; and a focus on actual incidence, reported incidence, 

and the operation and effectiveness of al1 aspects of the child protection system. This 

new system should be designed and implemented either by the Bureau of the Census 

or the Centers for Disease Control, working in collaboration with leading experts on 

ehild maltreatment. 

-
Recommendation #13: 

The Secretary of Health and Human Semees should launch a major coordinated 

initiative involving all relevant components of the Department of Health and Human 

Services to promote the systematic conduct of research related to child abuse and 

neglect. 

Recommendation #14: 

The Secretary of Health and Human Services, in conjunction with his counterparts 

in the Federal Government (working through the U.S. Inter-Agency Task Force on 

Olild Abuse and Neglect), should launch a major initiative to use multidisciplinary 

knowledge about what works as the cornerstone of Federal efforts to rehabilitate the 

quality of the child protection system. This initiative should include the translation 

of what is already known about interventions that produce positive results. It should 

also include the evaluation of possible systemic improvements the value of which has 

not yet been established. 

Recommendation #15: 

The Secretary of Health and Human Services, in conjunction with his counterparts 

in the Federal Government (working through the U.S. Inter-Agency Task Force on 

Child Abuse and Neglect), in concert with the nation's private foundations that have 

an interest in children, should launch a major initiative to increase both the number 

and the professional qualifications of individuals conducting knowledge-building 

activities on child abuse and neglect. The initiative should include the active 

encouragement of noted researchers from other fields in the social, behavioral, and 

health sciences to do work in this area. 

E. DIFFUSING KNOWLEDGE 

Recommendation #16: 

The Secretary of Health and Human Services, in conjunction with his counterparts 

in the Federal Government (working through the U.S. Inter-Agency Task Force on 

Child Abuse and Neglect), should take whatever steps are necessary to assure that 

practitioners, po1icymakers, and the general public (especially parents) have ready and 

continuous access to comprehensive, consistent state-of-the-art information on child 

abuse and neglect. Such steps should include establishing a permanent governmental 

unit from which this information is avaiJable. 

149 
Recommendation #17: 

Leaders of the media should join in a campaign to promote public understanding of 

the child protection emergency and the most effective ways of addressing it, including 

coverage of the complexity and seriousness of the emergency and the alternatives for 

dealing with it. 

F. INCREASING HUMAN RESOURCES 

Recommendation #18: 

The Secretary of Health and Human Services, the U.S. Congress, their counterparts 

in State governments, and the Governors of the several States, in concert with 

professional associations and organizations~ should take concrete steps to establish 

the position of public agency Ilchild protective seIVices caseworker" as a professional 

specialty with commensurate minimum entry-level educational requirements, salary, 

status, supervision, administrative support, and continuing education requirements. 

Recommendation #19: 

The Secretary of Health and Human Services, the U.S. Congress, and their 

counterparts in State governments should take the necessary steps to establish 

minimum educational requirements for the position of public agency CPS caseworker 

in agencies which receive Federal financial support. Such requirements should 

provide for the substitution of appropriate experience for education. 

Recommendation #20: 

150 

The Secretary of Health and Human Services, the U.S. Congress, and their 

counterparts in State governments should take the necessary steps to assure that all 

public agency CPS caseworkers systematically receive adequate pre-service and inservice continuing training for the proper performance of their duties. Such training 

should be offered at different levels in keeping with the differing needs and 

responsibilities of CPS caseworkers, and should reflect emerging issues in the field. 
h 

Recommendation #21: 

The Secretary of Health and Human Semces, the u.s. Congress, and their 

counterparts at the State and County levels, in concert with private sector support 

should take the necessary steps to establish acceptable caseload standards so as to 

reduce the caseload sizes of public agency CPS caseworkers in agencies which receive 

Federal financia1 support. A part of this initiative should be the recruitment and 

maintenance of a sufficient number of qualified staff so that services can be provided 

at the acceptable caseload level. 

Recommendation #22: 

State and local social services officials should launch an aggressive campaign to 

recruit new CPS caseworkers representative of the racial, ethnic, and cultural 

composition of the child maltreatment caseload population. 

Recommendation #23: 

The Secretary of Health and Human Semces and the Secretary of Education 

(working through the U.S. Inter-Agency Task Force on Child Abuse and Neglect) 

should take concrete steps to assure a steady increase in the total number of the 

nation's professiona1s who possess the necessary competence and skin to participate 

effectively in the protection of children. Such :steps should include: the development, 

introduction and expansion of curricula and clinical programs concerned with child 

abuse and neglect in all the nation's institutions of higher learning; the replication 

and institutionalization of models for the interdisciplinary training of graduate 

students preparing for work in child protection; and the establishment of a new 

program of Presidential or Secretarial Child Maltreatment Fellowships for graduate 

students willing to commit themselves to entering the field. 

G. PROVIDING AND IMPROVING PROGRAMS 

Recommendation #24: 

The Secretary of Health and Human Services, in conjunction with his counterparts 

in the Federal Government (working through the U.S. Inter-Agency Task Force on 

Child Abuse and Neglect), and the Governors of the several States should ensure that 

comprehensive. multidisciplinary child abuse and neglect treatment programs are 

available to all who need them. 

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Recommendation #25: 

The Secretary of Health and Human Services, in conjunction with his counterparts 

in the Federal Government (working through the U.S. Inter-Agency Task Force on 

Child Abuse and Neglect), and the Governors of the several States should ensure that 

efforts to prevent the maltreatment of children are substantially increased. Such 

efforts, at a minimum, should involve a significant expansion in the availability of 

home visitation and follow-up services for all families of newborns. 

Recommendation #26: 

The U.S. Congress and State and local legislative bodies should ensure that, in any 

expansion of programs concerned with child abuse and neglect, resources devoted to 

prevention and resources devoted to treatment do not come at the expense of each 

other. 

Recommendation #27: 

152 

The headquarters or regional units of private sector organizations -- voluntary, 

religious, civic, philanthropic, and entrepreneurial -- should take the necessary steps 

to increase significantly the involvement of their local affiliates and outlets, members, 

or employees in efforts to support and strengthen families as well as to prevent and 

treat child abuse and neglect. At a minimum the efforts for which increased 

involvement is encouraged should include: participation in neighborhood home 

visitation networks; participation in formal volunteer programs; the introduction of 

workplace measures aimed at reducing familial stress; participation in programs 

aimed at increasing greater accountability within the child protection system; and the 

promotion of greater awareness of the child protection emergency, as wen as 

advocacy for more enlightened public policies in response to it. Government at all 

levels should facilitate the development of public/private partnerships aimed at 

enhancing the role of the private sector in the prevention and treatment of child 

abuse and neglect. 
Recommendation #28: 

The Attorney General, the U.S. Congress, the State legislatures, the Chief Justice of 

each State's highest court, and the leaders of the organized bar should assure that all 

State and local courts handling the large numbers of civil and criminal child abuse 

and neglect cases coming before the court system promptly and fairly resolve these 

cases. Prompt and fair resolution will require sufficient resources inc1uding: (a) 

adequate numbers of wen-trained judges, lawyers, and court support staff, as wen as 

manageable caseloads that take into account the complex and demanding nature of 

child abuse and neglect litigation; (b) specialized judicial procedures that are sensitive 

to the needs of children and families; (c) improved court-based diagnostic and 

evaluation services; and (d) greater educational opportunities for all professional 

personnel involved in such proceedings. Courts hearing child maltreatment cases 

must also be given the funding and status befitting these most important of judicial 

tribunals. These officials should also take steps to assure that every child has 

independent advocacy and legal representation, and every CPS caseworker is 

effectively represented by counsel throughout the judicial process. 

Recommendation #29: 

The Secretary of Education and his counterparts in State and local educational 

agencies, in concert with the leaders of all relevant national educational organizations 

and their State and local affiliates, should launch a major initiative to establish and 

strengthen the role of every public and private school in the nation in the prevention, 

identification, and treatment of child abuse and neglect. 

H. PLANNING FOR THE FUTURE 

Recommendation #30: 

The U.S. Congress should direct an appropriate research agency to determine the 

cost of developing and implementing a comprehensive national program for the 

prevention and treatment of child abuse and neglect, as well as the projected cost of 

not developing and implementing such a program. 

153 
Recommendation #31: 

154 

The Secretary of Health and Human SeIVices, in conjunction with his counterparts 

in the Federal Government (working through the U.S. Inter-Agency Task Force on 

ChiJd Abuse and Neglect), in concert with the National Governors Association, the 

U.S. Conference of Mayors, and the National Association of Counties, should 

develop a model planning process aimed at generating plans for the coordinated, 

comprehensive, community-based prevention, identification, and treatment of abuse 

and neglect, and take appropriate steps to assure that the model process is 

implemented throughout the nation. 

... 
APPENDIX F 

List of Recommendations and Options for Action 

in the 

1991 Report or the U.S. Advisory Board on Child Abuse and Neglect 

DEVELOPING AND IMPLEMENTING 

A NATIONAL CHILD PROTECTION POLICY 

Recommendation B·l: PROMULGATING A NATIONAL CHILD PROTECTION 

POLICY 

The Federal Government should establish a national child protection policy. The goal of 

the policy should be to facilitate comprehensive community efforts to ensure the safe and 

healthy development of children and youth. The policy should be incorporated into the 

United States Code as an intrinsic part of the Child Abuse Prevention and Treatment Act. 

The policy should drive the child protection-related actions of an Federal agencies. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Until a national child 

protection policy is enacted, explore the possibility of using existing statutory authority to 

promulgate elements of that policy in the form of Federal regulations . 

• CONGRESS: Use the next CAPTA reauthorization to enact a national chi1d protection 

policy. 

Recommendation B·2: RELATING A NATIONAL CHILD PROTECTION POLICY TO 

POLICY REFORMS IN CHILD WELFARE SERVICES AND FAMILY RESOURCE 

AND SUPPORT SERVICES 

The Federal Government should assist in building a supportive setvice delivery system for 

all families, troubled or otherwise, thereby providing a critical foundation for the prevention 

of child maltreatment and the protection of children. To the extent possible, any statutory 

or regulatory reforms of the child protection system should be sensitive to and harmonized 

with the purposes and contcnt of statutory or regulatory reforms of child wc1farc scrviccs 

and family. 

155 
OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Until child welfare reform 

legislation is enacted and the Young Americans Act is adequately funded, use existing 

statutory authority to begin the process of building a suppurtive seIVice delivery !!o"ystem for 

all families. 

• CONGRESS: Enact legislation to reform child welfare and family resource and support 

services. Two bills introduced in the 102nd Congress, S. 4 and H.R. 2571, amended 

appropriately so that they are harmonized with the national child protection policy descnbed 

in Recommendations B-1, are likely vehicles. 

• CONGRESS: Appropriate necessary funds so that full implementation of the Young 

Americans Act of 1990 can begin. 

Recommendation B·3: ELIMINATING THE USE OF CORPORAL PUNISHMENT IN 

ACTIVITIES SUPPORTED WITH FEDERAL FUNDS 

Consonant with the intent of the National Child Protection Policy proposed by the Board, 

the Federal Government should take al1 necessaI)' steps to eliminate the use of corporal 

punishment in all activities, programs, institutions, and facilities which receive Federal 

financial support of any kind. 

OPTIONS FOR ACTION 

• HEADS OF RELEVANT CABINET-LEVEL AGENCIES: Write to the Governors 

requesting that they take whatever action is necessary to eliminate the use of corporal 

punishment in all activities, programs, and facHities receiving Federa1 financia1 assistance. 

• Develop and disseminate information on non-violent methods of discipline for children 

receiving care through or in activities, programs, and facilities receiving Federa1 financia1 

assistance. 

• SECRETARY OF EDUCATION: Write to all school superintendents, in those States 

in which corporal punishment has not yet been prohibited by law, requesting that they 

eliminate the use of corporal punishment. 

• CONGRESS: Enact legislation to prohibit the use of corporal punishment in all activities, 

programs, and facilities receiving Federal financial assistance. 

• CONGRESS: Enact legislation to prohibit the use of corporal punishment in all school 

systems receiving Federal financial assistance. 

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Recommendation B-4: DETERMINING THE COST OF IMPLEMENTING A 

NATIONAL CHILD PROTECTION POLICY 

An appropriate Federal research agency should be commissioned to determine the cost of 

implementing a nationa1 child protection policy and the cost of not implementing such a 

policy. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct that an appropriate 

component(s) of DHHS contract for a study to detennine the cost of implementing a 

national child protection policy and the cost of not implementing such a policy. 

• CONGRESSIONAL SUBCOMMITfEES WITH JURISDICTION OVER CAPTA: 

Communicate to the Office of Technology Assessment the need for a study to determine the 

cost of implementing a national child protection policy and the cost of not implementing 

such a policy. 

PREVENTING AND REDUCING CHILD MALTREATMENT 

BY STRENGTHENING NEIGHBORHOODS AND FAMILIES 

Recommendation C-I: IMPROVING THE QUALITY OF DETERIORATING 

NEIGHBORHOOD ENVIRONMENTS 

The Federal Government should take all steps necessary to facilitate the development of 

neighborhood improvement initiatives to prevent child maltreatment, including 

neighborhoods in urban, rural, and Native American communities. 

OPTIONS FOR ACTION 

• SECRETARY OF HOUSING AND URBAN DEVELOPMENT: Encourage the 

recipients of Community Development Block Grants to devote more existing resources to 

child maltreatment-related and family strengthening activities. Because of its emphasis on 

community planning (including social planning), the Community Development Block Grant 

is well suited to provide a structure for attention to the relationship between neighborhood 

quality and child maltreatment, especially in urban communities. 

• SECRETARY OF HOUSING AND URBAN DEVELOPMENT: Explore ways in which 

other existing HUD legislative authorities (e.g., the McKinney Amendments; Public and 

Indian Housing) can be used to prevent child maltreatment through improvements in the 

quality and quantity of low-cost housing. 

157 
• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that the Office of Rural Health Policy encourages the incorporation 

of child protection into public health planning in rural communities and stimulate the 

development of capacity for such an integration. 

• HEADS OF RELEVANT CABINET-LEVEL AGENCIES: Expand the responsibilities 

and training of Community Health Representatives working with Native American 

communities to encompass work with multi-problem famiJies, including transportation of 

such families to community mental health, guidance, or human services programs for 

intclVcntion setvices. 

• HEADS OF RELEVANT CABINET-LEVEL AGENCIES AND CONGRESS: Develop 

child maltreatment-related and family strengthening activities in rural communities, especially 

those with a high proportion of families in poverty. The Area Development Districts in the 

various Federal economic development programs may provide avenues for rural community 

planning to protect children. Where targeted programs for rural community planning do not 

exist in a given region, Community Action Programs may be the avenue for planning and 

implementation of neighborhood.based strategies in rural communities. 

• CONGRESS: Require recipients of Community Development Block Grants to set aside 

five percent of such funds for the purposes of (a) planning and implementing neighborhoodbased strategies for strengthening families and the prevention and treatment of child abuse 

and neglect and (b) the integration of housing programs and child protection efforts. 

Increase the authorization and appropriations for the Community Development Block Grant 

Program commensurately. 

Recommendation C-2: ENHANCING VOLUNTEER EFFORTS FOR THE 

PREVENTION AND TREATMENT OF CHILD ABUSE AND NEGLECT 

The Federal Government should take all steps necessary to facilitate the development of 

volunteer programs for the prevention and treatment of child abuse and neglect. 

OPTIONS FOR ACTION 

• DIRECTOR OF ACTION: Establish a new program priority on child maltreatment. 

• SECRETARY OF AGRICULTURE: Undertake a major initiative to give a greater focus 

to child maltreatment-related activities (including prevention) in the programs of the 

Cooperative Extension Service. 

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• HEADS OF OTHER RELEVANT CABINET-LEVEL AGENCIES: Undertake 

initiatives to emphasize the roles of volunteers in child maltreatment-related activities 

(especially prevention activities). 

• CONGRESS: Establish a new program priority on child maltreatment within relevant 

programs of ACTION and provide additional funding for this purpose. 

• CONGRESS: Amend Serve-America to provide support for school volunteer programs 

aimed at the (1) prevention of child maltreatment, (2) provision of social supports for 

maltreated children and their families, and (3) development of additional peer counseling 

and peer mediation services. This amendment would complement existing emphases in 

Serve-America on substance abuse prevention and school drop-out prevention. 

• CONGRESS: Specifically charge the Cooperative Extension Service to give a greater 

focus to child maltreatment-related activities (including prevention) and provide additional 

funds for it to do so. 

Recommendation C-3: MOBILIZING RELIGIOUS INSTITUTIONS IN THE 

PREVENTION OF CHILD MALTREATMENT 

The Federal Government should provide the religious community with information about 

ways that it can assist in the prevention of child maltreatment. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET-LEVEL AGENCIES: Convene a series of meetings with the heads 

of the national organizations of religious institutions -- a10ng with the heads of other 

nationa1 voluntary organizations concerned with the quality of neighborhood and community 

life -- aimed at exploring ways in which the Federal Government can provide information 

which might be of assistance in community-based efforts focused on the prevention of child 

maltreatment. 

159 
• 

PROVIDING A NEW FOCUS ON CHILD ABUSE AND NEGLECT AND 

STRENGTHENING FAMILIES IN ALL RELEVANT FEDERAL AGENCIES 

The Collective Federal Effort 

Recommendation D-I: REDEFINING THE MISSION OF THE NATIONAL CENTER 

ON CHILD ABUSE AND NEGLECT 

The Federal Governmen! should redefine the mission of the National Center on Child 

Abuse and Neglect so that the exclusive focus of the agency becomes either: (1) providing 

leadership for all Federal efforts to strengthen the State and local CPS function; or (2) 

planning and coordinating the entire Federal child protection effort. Either choice 

necessarily entails restructuring the agency and moving it to another location within the 

Executive Branch; either choice probably means renaming the agency. Whichever choice 

for the redefinition of the National Center's mission is made [(1) or (2) above], a program 

to carry out the focus not chosen must also be established. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Appoint a high-level ad hoc 

Work Group to study and make recommendations on the appropriate mission of NCCAN. 

• CONGRESSIONAL SUBCOMMITTEES WITH JURISDICTION OVER CAPTA: 

Hold hearings on the appropriate mission of NCCAN and develop amendments to CAPTA 

reflecting the conclusions reached as a result of those hearings. 

Recommendation D-I: ASSURING A FOCUS ON CHILD MALTREATMENT AND 

STRENGTHENING FAMILIES THROUGHOUT THE FEDERAL GOVERNMENT 

The administrators of all Federal agencies operating programs which are or could be 

relevant to addressing one or more aspects of child abuse and neglect should ensure that 

those programs are capable of making full, meaningful, measurable, and visible contnbutions 

to the total Federal effort. 

OPTIONS FOR ACTION 

• HEADS OF RELEVANT CABINET-LEVEL AGENCIES: Explore the development of 

a common Federal approach to the problem of child maltreatment. 

160 
• SPEAKER OF THE HOUSE OF REPRESENTATIVES; PRESIDENT PRO 

TEMPORE OF THE SENATE; MAJORITY AND MINORITY LEADERSHIP OF 

BOTH CHAMBERS OF CONGRESS: Convene meetings of the Chairs and their Minority 

counterparts for all Committees and Subcommittees with jurisdiction over any Federal 

programs that are, or could be, relevant to the total Federal effort. The purpose of these 

meetings would be to devise a legislative strategy for assuring a focus throughout the Federal 

Government on strengtheningJamilies and preventing and treating child maltreatment. Such 

a strategy might involve the drafting and introduction of a l1chain bi)]" that links the various 

Federal programs in a common approach to the problem of child maltreatment. 

Child Protection and the Child Welfare System 

Recommendation D-2: STRENGTHENING CHILD PROTECTION EFFORTS IN THE 

CHILD WELFARE SYSTEM 

The Federal Government should take all necessary measures to ensure that, within the 

nation's system of public social services, State, Tribal, and local CPS agencies deliver high 

quality seIVices. These measures should include knowledge building, program development, 

program evaluation, data collection, training, and technical assistance on: 

• the development of linkages with other se:rvice providers and community resources 

to ensure that children and families are receiving coordinated, integrated se:rvices; 

• the development of a focus on prevention and early intervention with high-risk 

families; 

• the prompt, thorough, and family-sensitive investigation of cases of suspected 

maltreatment; 

• the appropriate use of risk assessment in cases of suspected or substantiated child 

abuse and neglect; 

• the assessment and management of such cases (including in-home crisis services 

and other services designed to increase children's safety, strengthen families in crisis, 

and prevent unnecessary out-of-home placements); 

• the relationship of CPS to respite and other out-of-home carc for the purpose of 

chi1d protection; and 

• the relationship of CPS to permanency planning and adoption services for children 

who have been removed from their families due to maltreatment. 

161 
OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Clearly assign NCCAN 

responsibility for Federa1Jeadership with regard to the CPS function -- in coordination with, 

or as part of, the Children's Bureau -- and measurably strengthen the capacity of the agency 

to assume that responsibility. 

• CONGRESS: Statutorily assign NCCAN clear responsibility for Federal leadership with 

regard to the CPS function, but, in doing so, legislatively strengthen NCCAN's capacity to 

assume that responsibility. 

Child Protection and the Mental Health System 

Recommendation D-3a: STRENGTHENING CHIlli PROTECTION EFFORTS IN THE 

MENTAL HEALTH SYSTEM 

The Federal Government should take all steps necessary to ensure (a) that effective mental 

health treatment is available and accessible to abused and neglected chi1dren and their 

families (including biological, adoptive, and foster families) and (b) that mental health 

programs for children and families collaborate with other agencies and community groups 

in the prevention of child maltreatment. 

OPTIONS FOR ACTION 

To stimulate capacity-building efforts: 

• CONGRESS: Require recipients of grants under the Alcohol, Drug Abuse, and Mental 

Health Block Grant to set aside an appropriate percentage of such funds for communitybased mental health seIVices for abused and neglected children and their families and for 

programs to prevent chHd maltreatment among families at risk. If such an action is taken, 

the Block Grant should be increased by a commensurate amount, and grantees should be 

required to demonstrate their collaboration with health, social seIVice, and justice agencies, 

as well as private non-profit voluntary organizations. 

• CONGRESS: Establish a new formula grant program for such a purpose. Such a grant 

program could be directed (1) to State mental health or health agencies (as designated by 

the Governors) for competitive distnbution to community agencies, or (2) directly to 

community mental health or health centers (as designated by the Governors). 

162 

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To increase the involvement of the mental health system in child protection: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to establish a new unit within the Alcohol, Drug Abuse, and Mental Health 

Administration for the prevention and treatment of child abuse and neglect. The unit would 

have responsibility for leadership in activities related to child protection in the child mental 

health system, including program development, program evaluation, data collection, training, 

technical assistance, and administration of pertinent grant programs. 

• CONGRESS: Statutorily mandate the establishment of such a unit. 

To increase the involvement of State and community mental health agencies in child 

protection activities: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Dircct the Assistant Secretary 

for Health to ensure that the relevant Federal mental health agency provides technical 

assistance and guidelines for State mental health plans so that such plans include provisions 

for making mental health services to prevent or treat child abuse and neglect available and 

accessible. Such guidelines should address the handling of reported chHd maltreatment cases 

as well as the reporting of such cases. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct thc Assistant Secretary 

for Health to ensure that the National Institute of Mental Health (NIMH), through 

technical assistance and guidelines for discretionary grants, encourages its Child and 

Adolescent SeMces System Program (CASSP) grantees to build their capacity for effective, 

accessible mental health services related to child abuse and neglect. 

To decrease real or perceived obstacles to use of existing financing systems for effective 

mental health services related to child abuse and neglect. including treatment of State wards: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Dircct the Assistant Secretary 

for Children and Families to ensure that NCCAN and the Children's Bureau, through the 

provision of technical assistance and the issuance of guidelines for fonnula grants under 

their respective jurisdiction, encourage their grantees to make use of provisions for mental 

health services under EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) and 

other Federal health programs, and, in general, to coBaborate with State and community 

mental health agencies in the development of effective, accessible prevention and treatment 

services related to child abuse and neglect. 

163 
• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Administrator of 

the Health Care Financing Administration (HCF A) and the Assistant Secretary for Health 

to ensure that HCFA and the relevant Federal mental health agency collaborate in a study 

of fiscal barriers to effective mental health setvices related to child abuse and neglect, 

including non-traditional (c.g., intensive home-based) service models. After the study is 

completed, the Secretary should direct the Administrator of HCFA to take any 

administrative action necessary to eliminate such obstacles, including making 

recommendations for statutory changes when necessary. 

• CHAIRPERSON AND RANKING MINORITY MEMBER OF THE HOUSE WAYS 

AND MEANS COMMITTEE; CHAIRPERSON AND RANKING MINORITY MEMBER 

OF THE SENATE FINANCE COMMITTEE: Request that the General Accounting Office 

or the Office of Technology Assessment conduct such a study. Congress could further take 

any legislative action, including usc of its oversight authority, necessary to eliminate such 

obstacles. 

To improve the Quality of mental health setvices related to child abuse and neglect: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that the relevant Federal mental health agency sets aside discretionary 

funds for demonstration grants for the development and application of models and 

techniques of mental health services related to child abuse and neglect. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that the relevant Federal mental health agency sets aside discretionary 

funds for graduate, professional, and continuing education of child and family mental health 

professionals in services related to child abuse and neglect. Such a program should be 

compatible with the various training models associated with the major mental health 

professions (clinical psychology, psychiatric nursing, psychiatric social work, and psychiatry), 

but it should require grantees to demonstrate an interdisciplinary approach, including 

education about the contributions of professionals outside the mental health professions and 

those of parent self-help groups. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that the Indian Health Service hires a substantial number of additional 

masters and doctoral level psychologists and social workers to work with Child Protection 

Teams, Indian child welfare workers, and families who have abused their children, as well 

as to provide families who have abused their children with in-home services. 

• CONGRESS: Authorize and appropriate funds for such purposes. 

164 

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Recommendation D-3b: ADDRESSING THE CONNECTION BETWEEN SUBSTANCE 

ABUSE AND CHILD MALTREATMENT 

The Federal Government should take all steps necessary to ensure that substance abusing 

parents have access to both effective programs for the prevention and treatment of child 

abuse and neglect as well as substance abuse itself. To be effective, Federal efforts must 

include initiatives to increase (1) the availability and accessibility of prevention and 

treatment programs and (2) knowledge about the relationship between substance abuse and 

child maltreatment, including the effects of variolls policies and programs designed to 

prevent children's prc- and postnatal exposure to alcohol and other harmful drugs. 

OPTIONS FOR ACTION 

To increase the availability and accessibility of prevention and treatment programs for 

substance abusing parents: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that the ADAMHA Office of Substance Abuse Prevention and Office 

of Treatment Improvement as well as the relevant Federal mental health agency (see 

Recommendation D-3.a) set aside discretionary funds for an expanded program of joint 

demonstration grants on the prevention and treatment of chi1d maltreatment resulting from 

or complicated by substance abuse. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Children and Families to ensure that NCCAN continues to issue grants under its 

Emergency Services Program that promote the availability of comprehensive prevention and 

treatment services. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct components ofDHHS 

to promote collaborative activities between parent self-help programs for substance abuse 

and parent self-help programs for child maltreatment in order to facilitate remediation of 

both problems. 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET-LEVEL AGENCIES: Direct the agencies with responsibility for 

programs related to criminal justice (including probation), health, legal services, substance 

abuse, special education, child care, public housing, and child welfare, through the provision 

of technical assistance and the issuance of guidelines for fonnula and demonstration grants 

under their respective jurisdictions, to encourage their grantees to collaborate in the design 

and implementation of comprehensive community services aimed at the prevention and 

treatment of child maltreatment resulting from or complicated by substance abuse. 

165 
• CONGRESS: Require recipients of grants under the Alcohol, Drug Abuse, and Mental 

Health Block Grant to set aside an appropriate percentage of such funds for communitybased seIVices aimed at the prevention and treatment of chi1d maltreatment resulting from 

or complicated by substance abuse. Staff providing such services, including staff providing 

services to Native Americans, should include degreed mental health specialists, 

paraprofessionals, and volunteers. 

• CONGRESS: Statutorily mandate the establishment of a new formula grant program for 

this purpose. 

• CONGRESS: Statutorily mandate the establishment of a new demonstration grant 

program and/or expansion of existing programs for this purpose. 

To enhance the state-of-the-art in the prevention of children's pre- and postnatal exposure 

to alcohol and other harmful drugs and to treat the effects of such exposure: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that the ADAMHA Office of Substance Abuse Prevention and Office 

of Treatment Improvement as weI1 as the relevant Federal mental hea1th agency manage 

their demonstration grants in a manner designed to increase knowledge about programs and 

policies related to the prevention and treatment of child maltreatment resulting from or 

complicated by substance abuse. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Children and Families to ensure that NCCAN manages the grants under its Emergency 

Services Program in a manner that increases knowledge about programs and policies related 

to the prevention and treatment of child abuse resulting from or complicated by substance 

abuse. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that the National Institute on Alcohol Abuse and Alcoholism (NIAAA) 

and the National Institute on Drug Abuse (NIDA) establish programs for extramural 

research on (1) the relationship between substance abuse and child maltreatment and (2) 

the effectiveness of programs and policies for (a) the prevention and treatment of child 

maltreatment caused or precipitated by substance abuse and (b) the treatment of substance 

abuse caused in part by a history of child maltreatment. Research on treatment should 

include studies of the effectiveness of parent self-help groups. 

166 
• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that NlAAA and NIDA collaborate with the National Institute of Child 

Health and Development, the Children's Bureau, and the National Institute on Disability 

and RehabiHtation Research of the Department of Education to stimulate research about 

(1) the long-term effects of pre- and postnatal exposure to alcohol and other harmful drugs, 

and (2) the treatment and education of children of substance abusing parents, including 

those children who have been removed from the care of their parents . 

• CONGRESS: Statutorily require the Executive Branch to take the steps set forth above. 

Child Protection and the Schools 

Recommendation D-48: STRENGTHENING THE ROLE OF ELEMENTARY AND 

SECONDARY SCHOOLS IN THE PROTECTION OF CHILDREN 

The Federal Government should take all necessary measures to ensure that the nation's 

elementary and secondary schools, both public and private, participate more effectively in 

the prevention, identification, and treatment of child abuse and neglect. Such measures 

should include knowledge building, program development, program evaluation, data 

collection, training, and technical assistance. The objective of such measures should be the 

development and implementation by State Educational Agencies (SEAs) in association with 

Local Educational Agencies (LEAs) and consortia of LEAs, of: 

• inter-agency multidisciplinary training for teachers, counsellors, and administrative 

personnel on child abuse 1.nd neglect; 

• specialized training for school health and mental health personnel on the treatment 

of child abuse and neglect; 

• school-based, inter-agency, multidisciplinary supportive seIVices for families in 

which child abuse or neglect is known to have occurred or where children are at high 

risk of maltreatment, including self-help groups for students and parents of students; 

• family life education, including parenting skills and home visits, for students andlor 

parents; and 

167 
• other school-based inter-agency, multidisciplinary programs intended to strengthen 

families and support children who may have been subjected to maltreatment, 

including school-based family resource centers and after-school programs for 

elementary and secondary school pupils which promote collaboration between schools 

and public and private community agencies in child protection. 

OPTIONS FOR ACTION 

• SECRETARY OF EDUCATION: Direct appropriate components of the Department 

to develop protocols for child abuse reporting, case management, resource referral, 

interagency case management, and maintenance of data management information systems 

within SEAs and LEAs. 

• SECRETARY OF EDUCATION: Direct appropriate components of the Department, 

in collaboration with appropriate components of DHHS, to provide technical assistance to 

the SEAs, based on such protocols, in the development of child abuse prevention and 

intervention programs in LEAs. 

• SECRETARY OF EDUCATION: Direct appropriate components of the Department, 

in collaboration with NCCAN and the Office of National Drug Control Policy, to develop 

and distribute model curricula for grades K-12 that include alcohol and substance abuse 

prevention, understanding child abuse, and accessing community resources. 

• SECRETARY OF EDUCATION: Direct appropriate components of the Department 

to develop a national data collection system -- sensitive to the protection of confidentiality -

- to monitor and evaluate implementation of the protocols and to track numbers of reports 

and their pattern over time within school districts and entire States. These data would 

include, at a minimum, the number of reports made by schools each year, categorized by 

types and severity of maltreatment al1eged. A more comprehensive system would include 

data on victim age, sex, and ethnicity, as well as data on follow-up, outcome, and interagency 

involvement in each case. (The system should be coordinated with the activities called for 

in Recommendation E-1.a.) 

• SECRETARY OF EDUCATION: Direct appropriate components of the Department, 

in collaboration with appropriate components of DHHS, to undertake an initiative aimed 

at encouraging State, Tribal, and local school, health, and social services officials to increase 

the number of coordinated service delivery programs aimed at adolescents. 

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• CONGRESS: Establish a program of grants for the development and implementation of 

school-based efforts to address child maltreatment. Funds would be allocated by formula 

to SEAs which would then distribute them competitively to LEAs and consortia of LEAs. 

SEAs would retain a limited percentage of funds for the cost of providing technical 

assistance to LEAs and consortia of LEAs and for statewide inter-agency multidisciplinary 

training of school personnel. This program would be administered by the Department of 

Education, in collaboration with D HHS, or vice versa. Program collaboration should also 

include, where applicable, Bureau of Indian Mfairs-operated schoo1s. 

• CONGRESS: Establish a program of grants for the development and implementation of 

public-private school-based efforts which focus on bringing community resources and services 

-- including child care centers for teen mothers as well as relevant parent support/education 

services -- into the schools to serve at-risk children and their families. 

• CONGRESS: Establish a program of special grants for the employment of psychologists 

and social workers (including masters-level psychologists and social workers) by schools in 

rural areas heavily populated by Native American children as well as on reservations for the 

purpose of providing treatment services to maltreated children. 

Recommendation D·4b: ENHANCING FAMILY LIFE EDUCATION OPPORTUNITIES 

FOR ADOLESCENTS AND YOUNG ADULTS TO PREPARE FOR RESPONSIBLE 

PARENTHOOD 

The Federal Government should stimulate new family life education initiatives specifically 

aimed at adolescents and young adults which have as their underlying purpose the 

prevention of child maltreatment. 

OPTIONS FOR ACTION 

• SECRETARY OF AGRICULTURE: Undertake a major initiative to give a greater focus 

to child maltreatment-related activities (including prevention) in the programs of the 

Cooperative Extension Service. 

• HEADS OF OTHER RELEVANT CABINET-LEVEL AGENCIES: Undertake 

initiatives to promote family life education programs. 

• CONGRESS: Specifically charge the Cooperative Extension Service to give a greater 

focus to child maltreatment-related activities (including prevention) and provide additional 

funds for it to do so. 

169 
Child Protection and Health 

Recommendation 0-5: STRENGTHENING THE ROLE OF THE HEALTH SYSTEM IN 

THE PROTECTION OF CHILDREN 

The Federal Government should take al1 necessary measures to ensure that the nation's 

health care system plays a more effective role in the prevention and treatment of child abuse 

and neglect. Such measures should encompass knowledge building, program development, 

program evaluation, data collection, training, and technical assistance on the role of the 

health system in the prevention, identification, investigation, and treatment of child abuse 

and neglect. In planning for involvement of the health care system in child protection, 

attention should focus on the roles of community health centers, public health authorities 

(including visiting nurse programs), general and pediatric hospitals, primary health care 

providers, self-help support networks, and alternative health delivery systems. Federal 

programs potentially involved in child maltreatment include the National Institute on Child 

Health and Development, the National Center on Nursing Research, the Center for Hea1th 

Services Research, the Centers for Disease Control, the Health Care Financing 

Administration, the Office of Rural Health Policy, and the direct-service programs of the 

Public Health Setvice including the Indian Health Service. AIl of these agencies should 

participate in the design and implementation of the new effort. In addition, attention should 

be given to reducing the prevalence of ehild maltreatment among children with disabilities, 

amelioration of the health consequences of child maltreatment, and provision for 

coordinated responses to child maltreatment fatalities. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to require, through regulation, all health professional schools and training 

programs receiving Public Health Semce (PHS) funds to include child abuse and neglect in 

their curricula . 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to require PHS Commissioned Corps Officers who are providing direct setvices 

to children, especially PHS Indian Health Service personnel, to participate in appropriate 

continuing education on child abuse and neglect. 

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• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Children and Families to ensure that NCCAN devotes sufficient resources to the 

implementation of that portion of CAPT A which addresses resource centers so that a 

national network of State and regional resource centers would come into being, with each 

center to include a clinical consultation component as well as training for health 

professionals (see Recommendation E-4). 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct all DHHS Components 

focused on assistance for persons with developmental disabilities, sensory impairment, 

physical handicaps, and chronic illness to develop and implement a special emphasis on the 

prevention, identification, and treatment of child abuse and neglect. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to encourage organizations of health professionals to inc1ude child abuse and 

neglect material in their continuing education efforts. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to test the feasibility of using the AFDC, wrc, and CDC immunization programs 

to provide child abuse prevention and parenting education materials. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to develop an administrative unit to plan and coordinate all PHS knowledge 

building, program development, program evaluation, data collection, training, and technical 

assistance activities related to the diagnosis, prevention, and treatment of child abuse and 

neglect. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to set aside and focus a fixed percentage of total PHS funds on addressing child 

maltreatment issues. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct appropriate 

components of the Department to develop a national data collection system -- sensitive to 

the protection of confidentiality -- to track data from all hospitals and medical clinics 

receiving DHHS funds on numbers of child abuse reports and their pattern over time within 

cities, counties, and entire States. These data would include, at a minimum, the number of 

reports made by the hospitals and clinics each year, categorized by types and severity of 

maltreatment alleged. A more comprehensive system would include data on victim age, sex, 

and ethnicity, as well as data on follow-up, outcome, and interagency involvement in each 

case. (The system should be coordinated with the activities called for in Recommendation 

E-!.a.) 

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• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the PHS Indian Health 

Service to require the participation of at least one health care professional with specialized 

training in child maltreatment in all Indian Child Protection Team meetings . 

• CONGRESS: Statutorily require the Executive Branch to take the steps set forth above. 

Child Protection and the Justice System 

Recommendation D-6: STRENGTHENING CHILD PROTECTION IN THE JUSTICE 

SYSTEM 

The Federal Government should take al1 necessary measures to ensure that the nation's 

courts, attorneys, law enforcement agencies, probation departments, parole agencies, and 

correctional institutions provide a prompt, sensitive protective response to all forms of child 

maltreatment. Such a response should involve knowledge building, program development, 

program evaluation, data collection, training, and technical assistance aimed at improving 

the administration of civil and criminal justice related to child maltreatment, advocacy on 

behalf of maltreated children, treatment for and monitoring of offenders both in 

communities and correctional settings. The response should be reflected in improved 

handling of child protection cases by: 

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• Federal, State, and Tribal judges and other court personnel handling civil and 

criminal cases related to child maltreatment; 

• attorneys involved in child maltreatment cases, both civil and criminal, including 

prosecutors, lawyers representing CPS agencies, court-appointed counsel and 

guardians ad litem for children, attorneys representing parents, as well as volunteer 

lay advocates (court appointed special advocates); 

• law enforcement personnel involved in the investigation of child maltreatment 

cases; 

• probation and parole officers involved in the supervision of juvenile and adult 

offenders in cases of child maltreatment; and 

• administrators and staff of Federal, State, Tnbal, and County correctional 

institutions where offenders in child maltreatment cases are confined. 

The response should ensure that cases involving allegations of child maltreatment in 

family settings, in the community, and within residential institutions are all given an 

adequate focus. 
OPTIONS FOR ACTION 

• ATIORNEY GENERAL: Convene an ad hoc Work Group, consisting of agency 

personnel from within aJ] relevant entities in the Department of Justice, to explore ways of 

coordinating a Department-wide response to the strengthening of child protection efforts in 

the justice system nationwide. 

• A TIORNEY GENERAL: Convene -- together with the Secretaries of Health and 

Human Services, Defense, and the Interior, as well as the heads of the State Justice Institute 

and the Legal Services Corporation -- an Inter-Departmental Work Group, consisting of 

agency personnel from all relevant Federal entities, to plan a collaborative, coordinated 

response to the strengthening of child protection efforts in the justice system nationwide. 

The Work Group would function under the aegis of the Inter-Agency Task Force (see 

Recommendation F-I). 

• ATIORNEY GENERAL: Direct appropriate components of the Department to set aside 

discretionary funds for research and demonstration grants focused on the improvement of 

treatment for juvenile and adult offenders in cases of child physical and sexual abuse, both 

as part of the probationary period and within correctional facilities. 

• ATIORNEY GENERAL: Direct appropriate components of the Department to develop 

a national data collection system -- sensitive to the protection of confidentiality -- to track 

data from all courts, probation departments, correctional facilities, and parole agencies on 

numbers of child abuse cases and their pattern over time within cities, counties, entire States, 

and the Federal system. These data would include, at a minimum, the number of cases 

handled each year, categorized by types and severity of maltreatment alleged. A more 

comprehensive system would include data on victim and perpetrator age, sex, and ethnicity, 

as well as data on outcomes and interagency involvement in each case. (The system should 

be coordinated with the activities called for in Recommendation E-1.a.) 

• EXECUTIVE DIRECfOR OF THE STATE JUSTICE INSTITUTE: Establish, as a 

new priority area, grants to improve the response by State civil and criminal court systems 

to cases involving allegations of child maltreatment. 

• PRESIDENT OF THE LEGAL SERVICES CORPORATION: Establish, as a new 

special priority area, grants to improve the legal representation of children and parents in 

civil child protective judicial proceedings. 

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• CONGRESS: Direct the Department of Justice to develop a planned and coordinated 

focus for all justice system activities related to child maltreatment, and authorize and 

appropriate funds for this purpose. This focus should include but not be limited to the 

activities of: the Criminal Division; the Office of Justice Programs; the Federal Bureau of 

Investigation; the Executive Office of the U.S. Attorneys; the Administrative Office of the 

U.S. Courts; the Federal Judicial Center; the State Justice Institute; the Immigration and 

Naturalization Service; the Nationa1 Institute of Corrections; and the Bureau of Prisons. 

• CONGRESS: Mandate, as part of the reauthorization of, or amendments to, Federal 

crime and juvenile justice legislation, a new program of research and demonstration grants 

focused on the improvement of treatment for juvenile and adult offenders in cases of child 

physical and sexual abuse, both as part of the probationary period and within correctional 

facilities. 

• CONGRESS: Mandate, as part of the reauthorization of juvenile justice legislation, a new 

program focus on the improvement of legal representation provided to all children in the 

nation's juvenile and family courts. 

Funding Child Protection Efforts 

Recommendation D·7: PROVIDING ADEQUATE FUNDING FOR THE NEW 

SPECIALLY TARGETED EFFORTS 

For each new specially targeted effort recommended in this report, Congress should 

authorize and appropriate an amount necessary to implement the effort at a reasonable 

level. 

OPTIONS FOR ACTION 

• OFFICE OF MANAGEMENT AND BUDGET: Undertake, in consultation with the 

chief financial officers of all relevant Federal agencies, a special review of the Fiscal Year 

1992 and Fiscal Year 1993 Federal Budgets with the objective of redirecting substantial 

resources toward child protection and strengthening families and, once such resources are 

redirected, expedite program implementation. 

• OFFICE OF MANAGEMENT AND BUDGET: Establish a "fast·track" process for the 

review and approval of all regulations, announcements, sUIVey instruments, etc. related to 

child protection program initiatives. 

• CONGRESS: Reallocate existing resources for child welfare seIVices from a focus on 

supporting the costs of out-of-home placement to a focus on preventive, "front-end," 

intensive and comprehensive seIVices, including home-based seIVices. 

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• CONGRESS: In providing any new funding for child protection, establish a formula that, 

whenever feasible, takes into account the size of the child population, the proportion of that 

population living in poverty, and the proportion of that population that is homeless. 

Staffing Child Protection Efforts 

Recommendation D-8: ASSURING ADEQUATE STAFFING FOR THE NEW 

SPECIALLY TARGETED EFFORTS 

For each new specially targeted effort recommended in this report, all program staff, 

excluding clerical and grants management staff, should have demonstrated professional 

competence in the field of child abuse and neglect Moreover, program staff should possess 

at least those professional credentials generally recognized as necessary for competent 

practice or research in their disciplines. The number of program staff and the support 

available to those staff, induding funds for travel, should be sufficient to fulfill their 

technical assistance mission and to achieve the visibility necessary for national leadership in 

the various disciplines in the child protection field. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET-LEVEL AGENCIES: Devote a larger percentage of salaries and 

expenses appropriations to staffing and staff support for the administration of programs 

related to child abuse and neglect. 

• CO~'GRESS: Authorize Executive Branch agencies administering child abuse and neglect 

related programs, including those under CAPT A, to set aside up to 10 per cent of funds 

appropriated for those programs for Federal administration of those programs (comparable 

to the authority provided by Congress in the Young Americans Act). The authorization 

should require the agencies, before using set-aside funds, to spend from their salaries and 

expenses appropriations no less than the amount they are currently spending for 

administration of those programs. 

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ENHANCING FEDERAL EFFORTS RELATED 

TO THE GENERATION, APPLICATION, AND DIFFUSION 

OF KNOWLEDGE CONCERNING CHILD PROTECTION 

Need for More and Better Knowledge 

Recommendation E-la: IMPROVING THE COLLECTION OF DATA 

The Federal Government should create a comprehensive, mandatory, 50-State and Tribal, 

aggregate and case-specific child abuse and neglect data collection system. This system 

should be administered collaboratively by several Federal agencies. In total, it should yield 

an accurate, uninterrupted, comprehensive picture of child abuse and neglect, as weB as the 

response to it, throughout the nation. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Agree with the Director of 

the Bureau of the Census to establish an ad hoc Work Group, consisting of staff from 

appropriate components of both agencies, to explore the possibility of using existing 

statutory authority to begin the design of a new national child protection data collection 

system . 

• CONGRESS: Use the next CAPTA reauthorization to enact the statutory authority for 

a new data collection system -- sensitive to the protection of confidentiality -- designed and 

implemented by the Bureau of the Census in coordination with other data-gathering agencies 

and include in that legislation authority to provide necessary financial assistance to States 

and Tribes so that they can develop or enhance their capacity to collect and report data in 

a manner consistent with Federal standards. 

Recommendation E-lb: IMPROVING FEDERALLY-SUPPORTED RESEARCH 

The Federal Government should take all steps necessary to promote systematic research 

related to child abuse and neglect. Such steps should include: 

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• establishing a new program within the National Institute of Mental Health (NIMH) 

as the primary Federal research effort concerned with the causes, precipitants, 

consequences, prevention, and treatment of child abuse and neglect; 

• vesting responsibility in that program for the provision of Government-wide 

leadership concerning research; 

• substantially increaliing funds available for research in all relevant agencies; 

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• launching initiatives to increase the number and professional qualifications of 

scientists involved in studies of child abuse and neglect; 

• making peer review and grants management in all relevant agencies consistent with 

scientific norms; 

• engaging in long-range Government-wide planning for stimulation of knowledge on 

critical topics related to child maltreatment (including cultural and social factors); and 

• when feasible, developing means for reducing obstacles to the generation of 

knowledge about child abuse and neglect. 

OPTIONS FOR ACTION 

To increase general knowledge about the causes, precipitants. consequences. prevention. and 

treatment of child abuse and neglect: 

• SECRETARY OF HEALTH AND HUMAN SERVI CES: Direct the Assistant Secretary 

for Health to establish a Center for Research on Child Abuse and Neglect in the National 

Institute of Mental Health and to provide it with adequate funding. 

• CONGRESS: Using the next CAPT A reauthorization, amend the Public Health Act to 

provide the statutory authority for such a Center and, following authorization, appropriate 

adequate funds for its activities. 

To increase knowledge about the child protection system: 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET·LEVELAGENCIES: Establish programs or priorities for research 

on the response respectively of the child welfare, health, mental health, education, and 

justice systems to the problem of child abuse and neglect and the means of improving those 

responses. 

• CONGRESS: Statutorily mandate the establishment of such programs or priorities. 

To increase specific knowledge about the social and cultural factors related to child 

maltreatment: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to establish within NIMH a priority for the systematic development of knowledge 

about the social and cultural factors in the causes, effects, identification, prevention, and 

treatment of child abuse and neglect. 

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• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct all components of the 

Department supporting or conducting research on any aspect of child maltreatment to 

require applicants for research grants to justify their failure to include culture or ethnicity 

as a variable in research on child abuse and neglect. 1 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Attempt to persuade the 

heads of other relevant agencies to impose the same rule. 

• SECRETARY OF HEALTH AND HUMAN SERVI CES: Direct the Assistant Secretary 

of Health to ensure that NIMH conducts workshops on cultural competence for prospective 

applicants for research grants on child abuse and neglect. 

• SECRET AR Y OF HEALTH AND HUMAN SERVI CES: Direct the Assistant Secretary 

of Health to ensure that NIMH makes affirmative efforts to increase the number of ethnicminority researchers on child abuse and neglect. 

To increase human resources in the field of research on child abuse and neglect: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to set aside an appropriate percentage of funds allocated under the National 

Research SeIVice Award program and other NIMH programs for research training and 

career development related to child abuse and neglect. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that NIMH sponsors workshops for investigators entering the field to 

assist them in the preparation of scientifically sound proposals in the area of child 

maltreatment. 

• CONGRESS: Amend the Public Health Service Act to mandate the set-aside of funds 

allocated under the National Research Service Award program and other NIMH programs 

for research training and career development related to child abuse and neglect. 

[This nJe would be a brvtU1ened ve~ion of an existing nJe of the Nationol Institutes of Health that applicants justify 

the exclusion of ethinic groups from study samples. 

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To ensure that procedures for stimulation and analysis of research on child abuse and 

neglect are scientifically credible: 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET-LEVEL AGENCIES: Instruct the heads of relevant research 

programs to establish standing review panels of leading experts in the field of child abuse 

and neglect and, absent a compe11ing justification for any contrary action, to adopt their 

priorities for the funding of proposed projects. When standing panels have been established, 

ensure that information about their composition and the process of reviews is spread 

throughout the research community. 

• CONGRESS: Statutorily mandate that such action be taken. 

To facilitate the planning of research: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to establish a Research Advisory Committee within NIMH to provide ongoing 

advice to relevant Federal agencies about (1) priorities for research and means of increasing 

the national capacity for generation of knowledge about child abuse and neglect and (2) 

coordination of Federal efforts in research on child abuse and neglect. Such a Committee 

should consist of Federal experts appointed by the Directors of the National Institutes on 

Alcohol Abuse and Alcoholism, Child Health and Human Development, Drug Abuse, 

Education, Justice, and Mental Health as well as the DHHS Assistant Secretaries for 

Children and Families and Planning and Evaluation, the Assistant Secretary of Interior for 

Indian Affairs, and non-Federal experts appointed by the U.S. Advisory Board on Child 

Abuse and Neglect fonowing consultation with relevant scientific societies. 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to contract for a study to identify Government-wide priorities for research on 

child abuse and neglect and to provide recommendations for development of the nation's 

capacity to conduct such research. 

• CONGRESS: Statutorily mandate that such action be taken. 

To reduce obstacles to the generation of knowledge about child abuse and neglect: 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct the Assistant Secretary 

for Health to ensure that NIMH, in collaboration with the Office for Protection from 

Research Risks of NIH, sponsor (1) studies of methodological solutions to political, legal, 

and ethical problems in research on child abuse and negJect and (2) workshops and other 

activities to diffuse such knowledge within the research community. 

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• CONGRESS: Using the next CAYf A reauthorization, amend the Public Health Act to 

clarify the scope of confidentiality certificates. 

Recommendation E·lc: IMPROVING THE EVALUATION OF PROGRAMS 

The Federal Government should ensure that child protection activities supported with 

Federal funds are subjected to rigorous evaluation and that findings of such studies are 

applied in the design and implementation of programs in the child protection system. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET·LEVEL AGENCIES: Direct that all components administering 

demonstration grants related to the prevention, identification, investigation, adjudication, or 

treatment of child abuse and neglect allocate funds in the manner most likely to increase 

knowledge important to the field. 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET·LEVEL AGENCIES: Direct that all components administering 

demonstration grants related to the prevention, identification, investigation, adjudication, or 

treatment of child abuse and neglect require applicants to present a scientifically sound plan 

for evaluation as a condition of receipt of funds. 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET-LEVEL AGENCIES: Direct that all components administering 

such grants make diligent efforts to diffuse knowledge gained from evaluation of 

demonstration projects (see Recommendation E-5) and, in collaboration with the research 

planning effort described in Recommendation E-1.b, use such findings as the foundation for 

developing new research priorities. 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF OTHER 

RELEVANT CABINET·LEVEL AGENCIES: Direct that all components administering 

such grants take significant steps to improve the overall quality of evaluation research, such 

as working closely with the Resource Centers described in Recommendation E-4 on the 

development of training and expertise in effective evaluation processes. 

• CONGRESS: Use the next CAYfA reauthorization to mandate that recipients of all 

Federal funds related to any aspect of child protection set aside an appropriate percentage 

of such funds for evaluation research. 

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j 

Need for More Skilled Professional Staff 

Recommendation E-2: INCREASING THE QUALIFICATIONS AND NUMBERS OF 

PROFESSIONALS IN CHILD PROTECTION 

The Federal Government should significantly increase incentives and grant programs to 

expand the numbers and qualifications of professionals available to work in the child 

protection system. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND SECRETARY OF 

EDUCATION: Direct appropriate components of the two Departments to devise and 

implement a program, using existing resources, of Presidential or Secretarial Fellowships on 

Child Protection for advanced study by students in schools of social work, medicine, nursing, 

law, graduate programs in clinical, school, and counseling psychology, and other graduate 

programs in professions serving chHdren and families. 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND SECRETARY OF 

EDUCATION: Direct appropriate components of the two Departments -- in addition to 

the program of fellowships for advanced study in each of the professions represented in 

child protection -- to use existing resources to increase the number of opportunities for 

interdisciplinary training throughout the nation. 

• SECRETARY OF INTERIOR: Direct the Bureau of Indian Affairs to require that a 

significant percentage of Indian Child Welfare workers, and all of their supervisors, possess 

a Masters degree in social work or psychology. 

• CONGRESS: Use the next CAPTA reauthorization to legislate a new program of 

incentives through grants/loans to university students in return for work in the field of child 

protection, similar to the National Health Service Corps Program. 

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Need for Implementation of Standards of Practice 

Recommendation E-3: DEVELOPING AND IMPLEMENTING STANDARDS OF 

PRACTICE 

The Federal Government should take all necessary measures to ensure that each Federal 

agency directly providing services in the child protection system (e.g., the Indian Health 

Service, the Bureau of Indian Affairs, the family advocacy programs in the military, the U.S. 

Attorneys. and the military courts) meets standards of competent practice, including but not 

limited to standards for: 

• staff qualifications and training; 

• staff-la-client ratios; 

• timeliness of response; 

• protection of client rights; 

• legal representation of all parties (including the child) In relevant judicial 

proceedings; 

• cultural competence; and 

• quality assurance. 

The first of these measures should be commissioning the development of national standards 

of competent practice for the various professionals and agencies involved in child protection 

cases at the State, Tribal, and local levels. 

OPTIONS FOR ACTION 

• HEADS OF RELEVANT CABINET-LEVEL AGENCIES: Collaboratively support --

through the venue of the Task Force -- the development of a set of standards of practice for 

use in child protection cases by Federal personnel directly involved in such cases (such as 

physicians, law enforcement officers, social workers, attorneys, judges, and psychologists) as 

well as by Federally-operated programs rendering direct services in such cases (such as CPS 

agencies, law enforcement agencies, hospitals, courts, and mental health clinics). If possible, 

this effort should be built around an updating of the NCCAN Guidelines . 

• CONGRESS: Use the next CAPT A reauthorization to mandate individual Federal 

agencies, especial1y the Bureau of Indian Affairs, to develop appropriate standards of 

practice in child protection cases by a date certain. 

182 

¢ 
Need for the Provision of Technical Assistance 

to State and Tribal Child Protection Efforts 

Recommendation E-4: ESTABLISHING STATE AND REGIONAL RESOURCE 

CENTERS 

The Federal Government should establish a mechanism to stimulate development of State 

or regional resource centers for training, consultation, policy analysis, and research in the 

field of child protection. Such centers should be interdisciplinary and should involve 

collaboration between universities and relevant State and Tnbal agencies, including 

opportunities for university-based sabbaticals for senior State and Tnbal officials and agencybased sabbaticals for university professors. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Direct that appropriate 

components of the Department, working with other relevant agencies, use existing resources 

to develop a network of State or Regional Resource Centers on Child Abuse and Neglect 

throughout the United States. As a first step, building a system of ten Federal regional 

resource centers should be considered. 

• CONGRESS: Use the next CAPT A reauthorization to authorize a $50 million nationwide 

network of State and Regional Resource Centers and, following the authorization, 

appropriate funds for implementation. 

Need for the Diffusion of Knowledge 

Recommendation E-5: IMPROVING THE FLOW OF INFORMATION 

The Federal Government should develop a highly visible entity that takes whatever steps are 

necessary to ensure that practitioners, policyrnakers, and the general public (especially 

parents) have ready and continuous access to comprehensive, state-of-the-art information 

on child abuse and neglect. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Establish a permanent 

information diffusion entity within a component of the Department already carrying out 

similar functions such as the National Library of Medicine. 

183 
• SECRETARY OF HEALTH AND HUMAN SERVICES: Establish a permanent 

information diffusion entity within the component of the Department in which the Federal 

planning and coordination responsibility will be located (see Recommendation F-l) . 

• CONGRESS: Use the next CAPTA reauthorization to mandate the establishment of a 

permanent information diffusion entity within a component of the Department. 

IMPROVING COORDINATION AMONG FEDERAL, STATE, TRIBAL, 

AND PRIVATE SECTOR CHILD PROTECTION EFFORTS 

Recommendation F-l: ESTABLISHING A STRUCTURE FOR PLANNING AND 

COORDINATION AT THE FEDERAL LEVEL 

A11 of the activities which comprise the collective Federal child protection effort should have 

the same goal: the reduction in the prevalence of chiJd abuse and neglect, primarily through 

assistance to State, Tribal, and local authorities in their efforts to protect children from 

abuse and neglect, especially their efforts to build services for child protection at the 

community level. 

The Federal Government should establish an agency or entity to plan and coordinate the 

accomplishment of that goal. The agency or entity should be mandated to develop -- in 

concert with the agencies throughout the Federal Government whose programs constitute 

the collective Federal effort -- both a long-range strategy for accomplishment of the goal as 

well as short-term approaches leading toward that end, and to set forth that strategy and 

those approaches in the form of a readily achievable, comprehensive plan. 

In addition to developing the plan, the agency or entity should: 

184 

• assist the President, the Secretary of Health and Human Services, and the heads 

of other relevant agencies in enlisting opinion leaders in efforts: 

- to reduce societal influences (such as the acceptability of violence in the 

media, the schools, and other social institutions) that may increase the 

probability of family violence, child abuse and neglect, and violent crime; 

- to increase social and material support for families that will decrease child 

abuse and neglect and other forms of family dysfunction; and 

- to increase social support for children that will ameliorate the effects of 

abuse and neglect when maltreatment does occur; 
,.. '4i/IIf 

• identify problems related to chi1d abuse and neglect that are receiving inadequate 

national attention; 

• convene meetings of leaders in business, labor, religious, civic and philanthropic 

organizations, the media, professional associations, scientific societies, and volunteer 

and parent organizations to facilitate their active and constructive response to such 

problems: 

• support educational campaigns designed to increase the sophistication of citizens -

- especially the over two mi11ion employed by the Federal Government -- of the 

nature and complexity of child abuse and neglect and to inform them about 

alternative steps (beyond reporting suspected maltreatment) that they may take to 

increase the safety of children; 

• develop public/private partnerships aimed at enhancing the role of the private 

sector in the prevention and treatment of child abuse and neglect; 

• coordinate the provision of technical assistance to Federal, State, and Tribal 

agencies; 

• coordinate the multi-agency review of the single comprehensive State and Tribal 

plans described in Recommendation F-2; 

• monitor policy and program implementation at all levels of government; and, as 

necessary; 

• convene key actors from throughout the Federal Government for collaborative 

policy formulation, program design, and investment in joint funding ventures. 

The agency or entity should be located at an appropriate organizational level. It should be 

vested with authority commensurate with the nature of its responsibilities. It should be given 

adequate resources. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Designate NCCAN as the 

planning and coordination agency or entity, locating it at an appropriate organizational level, 

vesting it with authority commensurate with the nature of its responsibilities, and giving it 

adequate resources . 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Designate the Inter-Agency 

Task Force on Child Abuse and Neglect as the planning and coordination agency or entity, 

locating it at an appropriate organizational level, vesting it with authority commensurate with 

the nature of its responsibilities, and giving it adequate resources. 

185 
• CONGRESS: Use the next CAPT A reauthorization to mandate the designation of 

NCCAN or the Inter-Agency Task Force on Child Abuse and Neglect as the planning and 

coordination agency or entity, locating it at an appropriate organizational level, vesting it 

with authority commensurate with the nature of its responsibilities, and giving it adequate 

resources. 

• CONGRESS: Alternatively, use the next CAPTA reauthorization to establish a new 

agency or entity at a high level of the Executive Branch. If this option is selected, the 

agency or entity should be headed by a Director appointed by the President with the advice 

and consent of the Senate. The agency or entity should be located at an appropriate 

organizational level, should be vested with authority commensurate with the nature of its 

responsibilities, and should be given adequate resources. 

• CONGRESS: Whichever option is chosen, use the next CAPTA reauthorization to 

mandate the strengthening of the Inter-Agency Task Force on Child Abuse and Neglect by: 

186 

- reconstituting it as an Inter-Agency Policy Council consisting of Cabinet officers and 

other relevant agency heads with responsibility for implementation of Federa1 child 

protection policy and development of related policies of the Administration; 

M making the Secretary of Health and Human Services the chair of the Council with 

his/her authority to delegate that responsibility limited to the head of the planning 

and coordination agency or entity; 

M including as members of the Council the Secretaries of Agriculture, Defense, 

Education, Health and Human Services, Housing and Urban Development, and 

Interior, the Attorney General, and the Directors of ACTION and the Office of 

National Drug Control Policy, with their authority to delegate their responsibilities 

within the Council limited to no more than one layer; 

- requiring that the Council meet at least three times per year; 

M encouraging the Council to set up MM for purposes of planning and implementation -

- both pennanent and ad hoc work groups and task forces consisting of technica1 

experts drawn from member agencies; 

- providing staff and other resources for the operation of the Council; and 

- integrating and coordinating the work of the Council with the work of the Federal 

Council on Children, Youth, and Families authorized by the Pepper Young 

Americans Act. 
Recommendation F-2: ESTABLISHING A STRUCIURE FOR PLANNING AND 

COORDINATION AT THE STATE AND TRIBAL LEVEL 

The Federal Government should require any State or Tnbe receiving any formula grant for 

child protection (including -- but not limited to -- any grants legislated in response to this 

report, grants pursuant to CAPTA, the existing Social Services Block Grant, and Titles IV-B 

and IV-E of the Social Security Act) to submit a comprehensive three-year plan for 

multidisciplinary investigation, prevention, and treatment of child abuse and neglect. This 

single comprehensive plan should be a major eligibility requirement for these Federal 

formula grants, providing States and Tribes with the opportunity to make a single application 

to the agency or entity descnbed in Recommendation F-l for funds from several agencies. 

That agency or entity should be authorized to exercise discretion in waiving discretionary 

grant requirements that may impede the blending of Federal funds. As an alternative to 

fun-scale implementation of the comprehensive State or Tnbal planning requirement, the 

Federal Government should initiate a multi·year series of pilot projects aimed at testing the 

core concepts underlying the requirement. 

OPTIONS FOR ACTION 

• SECRETARY OF HEALTH AND HUMAN SERVICES: Explore the possibility of 

using existing statutory authority to initiate the State and Tribal planning requirement. 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF 

RELEVANT CABINET-LEVEL AGENCIES: Launch the pilot projects, using fleXIble 

funding sources, without specific Congressional approva1. 

• CONGRESS: Use the next CAPT A reauthorization to legislate the State and Tribal 

planning requirement and, following legislation, appropriate the necessary funds for initial 

planning grants. 

• CONGRESS: Use the next CAPT A reauthorization to authorize the pilot projects. 

187 
Recommendation F-3: PROVIDING FOR COMPREHENSIVE FEDERAL PLANNING 

AND COORDINATION IN RESPONSE TO CHILD MALTREATMENT FATALITIES 

The Federal Government should ensure that issues related to child deaths resulting from 

abuse or neglect are properly addressed by all relevant Federal agencies, acting 

collaboratively. The Federal entities involved in such collaboration should include, but not 

be limited to: such DHHS entities as NCCAN, the Children's Bureau, the Centers for 

Disease Control, the Health Resources and Services Administration, the Office for 

Substance Abuse Prevention, and the National Institute of Mental Health; such Department 

of Justice entities as the Criminal Division, the Office of Juvenile Justice and Delinquency 

Prevention, the National Institute of Justice, and the Federal Bureau of Investigation; and 

the Department of Education. Also involved should be Federal entities that have direct 

service provision responsibilities for families and children, such as the Department of 

Defense, the Indian Health Service of DHHS, the Bureau of Indian Affairs of the 

Department of the Interior, and the Office of Victims of Crime of the Department of 

Justice. 

Such collaborative efforts should address such issues as: 

• the review of Federal statutes and regulations that may create barriers to interagency, multidisciplinary collaboration at the Federal, State, Tribal, and community 

level in the investigation, intervention, and review of suspected child fatalities; 

• the development of model protocols and procedures for both individual State, 

Tnbal, and local agencies, as well as for inter-agency, multidisciplinary collaboration 

in the investigation, intervention, and service provision in cases of child fatalities; 

• the development of uniform national data gathering and analysis related to child 

fatalities; and 

• the on-going funding of research and training relating to the responses of the 

Federal, State, Tribal, and local governments to the problem of child fatalities, 

including how such responses contribute, if at all, to the prevention of child 

maltreatment in general as well as child maltreatment fatalities. 

OPTIONS FOR ACTION 

• PRESIDENT BUSH: Convene the National Commission on Child and Youth Deaths that 

was authorized by Pub. L. 100-294 in 1988. 

188 
j 

• SECRETARY OF HEALTH AND HUMAN SERVICES AND HEADS OF 

RELEVANT CABINET-LEVEL AGENCIES: Convene an inter-agency work group under 

the aegis of the Inter-Agency Task Force: (1) to address the Federally imposed barriers to 

the necessary sharing of information within inter-agency, mUltidisciplinary child death review 

teams at the State, Tribal, and local levels; (2) to survey and support State, Tnbal, and local 

efforts to build child death review teams; and (3) to address the development of data 

gathering, research, and technical assistance efforts related to child maltreatment fatalities. 

• CONGRESS: Appropriate the necessary funds for the work of the National Commission 

on Child and Youth Deaths. 

• CONGRESS: Usc the next CAPT A reauthorization to establish within relevant agencies 

throughout the Federal Government a funding priority for research, demonstration projects, 

technical assistance, and training on child maltreatment fatalities. Specific elements to 

facilitate the coordination and expansion of State, Tribal, and local death review teams 

should be included in this funding priority. 

IMPLEMENTING A DRAMATIC NEW FEDERAL INITIATIVE 

AIMED AT PREVENTING CHILD MALTREATMENT --

PILOTING UNIVERSAL VOLUNTARY NEONATAL HOME VISITATION 

Recommendation G-1: PILOTING UNIVERSAL VOLUNTARY NEONATAL HOME 

VISITATION 

The Federal Government should begin planning for the sequential implementation of a 

universal voluntary neonatal home visitation system. The first step in the planning process 

should be the funding of a large series of coordinated pilot projects. Instead of reaffirming 

the efficacy of home visiting as a preventive measure -- already well-established -- these 

projects should aim at providing the Federal Government with the information needed to 

establish and administer a national home visitation system. 

OPTIONS FOR ACTION 

• SECRETARY FOR HEALTH AND HUMAN SERVICES: Direct the Administration 

for Children and Families, the Public Health Service, and the Health Care Financing Agency 

(HCF A) to launch the pilot projects. Possible sources of funding for the pilots might be the 

NCCAN Demonstration Grants Program, the Maternal and Child Health Block Grant 

Program, and the Medicaid Program. 

• SECRETARY FOR HEALTH AND HUMAN SERVICES: Direct appropriate 

components of the Department, in collaboration with ACTION and the Points of Light 

Foundation, to stimulate the development of "Caring Community Programs." 

189 

-
• SECRETARY FOR HEALTH AND HUMAN SERVICES: Direct appropriate 

components of the Department, in collaboration with the American Academy of Pediatrics 

and the National Child Abuse Coalition, to attempt to persuade insurers, including those 

serving Federal employees, to cover the costs of home visiting. 

• SECRETARY FOR HEALTH AND HUMA'I SERVICES: Direct the Assistant 

Secretary for Health to ensure that home visitation services are provided through the health 

care programs of the Indian Health Service. 

• SECRETARY FOR HEALTH AND HUMAN SERVICES: Direct the Assistant 

Secretary for Health to attempt to persuade the Department of Defense to provide home 

visitation services to miJitary families. 

• CONGRESS: Use the next CAPT A reauthorization to authorize the sequential 

implementation of a universal voluntary system of neonatal home visitation services as well 

as to require DHHS to launch the pilot projects, to develop Caring Community Programs, 

to approach insurers aggressively, especially the insurers of Federal employees, to provide 

home visitation through the Indian Health Service, and to work with the Department of 

Defense on the provision of home visitation to military families. 

190 

p 
APPENDIX G 

Excerpts from the 1992 Board Report 

of the U.S. Advisory Board on Child Abuse and Neglect 

The Continuing Child ProtectUJn Emergency: 

A ChtJUenge to the Nation' 

EXCERPT 1: NATIONAL CHILD PROTECTION POLICY 

The Board believes that the time has come for a national child protection policy that makes 

it possible for children to live safely in a family environment. Thus, as a second priority, 

the Board has called upon the federal government to establish a national child protection 

policy which will drive all of the child protection-related actions of the federal, state, and 

local governments. 

Current policy within all levels of government is too narrowly focussed on crisis response. 

Under current policy -- dearly not intended to produce such results -- maltreated children: 

• rarely receive therapeutic services; 

• often are given minimal information about the decisions affecting their lives; 

• often are essentially unrepresented in legal proceedings and other official actions; 

• find themselves the subjects of well-intended but fragmented and misdirected reform 

efforts that often seem isolated from the matters most significant to the children themselves; 

and 

• are too often left in unsafe homes. 

A1though in some instances parents are so unable to provide a secure and safe environment 

for their children that those children must be removed from their homes, such removal 

should not be the centerpiece of the child protection system as it currently is. An effective 

child protection system should begin with the general question of how best to promote the 

security of children and their families. 

1U.S. Advisol)' Board on Child Abuse and Neglect. The Continuing Child Protection Emergency: A Clwllenge to the 

Nation, 1992,71-80. 

191 
[Early in 1992] Congress amended the Child Abuse Prevention and Treatment Act and the 

President signed it into law. This should have been the occasion for adoption by both the 

Congress and the White House of a national child protection policy. While the legislation 

contained some important improvements, it fell far short of establishing the coherent policy 

which the national child protection emergency demands. Surely, a nation which can enact 

a comprehensive environmental policy that protects snail darters can enact a comprehensive 

policy that protects children. 

The Opportunity To Make a Personal Difference 

Because child maltreatment affects all voters, all taxpayers, it is in their interest to take 

responsibility for ending it. Votcrs and taxpayers can usefully be involved in efforts to help 

their elected officials understand the full magnitude of child abuse and neglect. 

Elected officials need to understand that adult violence against children leads to childhood 

terror, childhood terror leads to teenage anger, and teenage anger too often leads to adult 

rage, both destructive toward others and self-destructive. Terror, anger, rage -- these are 

not the ingredients of safe streets, strong families, and caring communities. Unless 

American political leaders pay greater attention to the child protection emergency, all 

Americans will continue to suffer financially and all Americans will live in a more frightened 

and violent society. 

Elected officials need to understand that the time to do something about child maltreatment 

is now. If the nation's leaders continue to look the other way, the present generation of 

abused children may reach adulthood before effective action is undertaken. Many of these 

children will perpetuate the cycle of abuse. 

Elected officials need to understand that something significant must be done about child 

maltreatment. Doing something significant means doing something more than just increasing 

the reporting of child abuse and neglect, more than simply causing child abuse investigations 

to be better coordinated, more than setting up new bureaucratic mechanisms to centralize 

records of known child abusers. 

Doing something significant means reform of the nation's existing child protection system, 

and the eventual replacement of that system with a new, comprehensive, child-centered, 

family-focused, and neighborhood-based approach that emphasizes prevention rather than 

investigation. That approach should be carried out at the level of urban and suburban 

neighborhoods and rural communities and should be concerned not only with the 

development of social and economic supports for troubled families and children but also 

with the provision of seIViccs that are based on the principle of neighbor helping neighbor. 

192 
"I 

Elected officials need to understand that, if nothing significant is done about the child 

protection emergency, hundreds oCthousands of American children each year will have their 

childhoods destroyed. With each chBdhood that is destroyed, the nation loses a piece of its 

soul. 

[ .... JThe Board believes that voters and taxpayers should engage all candidates for public 

office in a dialogue about child protection in America. To facilitate that process, the Board 

suggests that all candidates be asked the following questions: 

• What policies, programs, and funding initiatives will you propose to make it as easy for 

a parent to pick up the telephone and get help before abusing a child as it is now for a 

neighbor to pick up the phone and report that parent for abusing that child? 

• Will you help make child abuse and neglect treatment programs available to all children 

and families that need them, and how will you do this? 

• Will you work to ensure that efforts to prevent child maltreatment are substantially 

increased, including a major expansion of: 

- home visitation services? 

- parenting education programs? 

- attempts to strengthen neighborhoods in which the safety of children is endangered? 

- increases in material supports such as housing, child care, and prenatal care for low 

income families including the working poor? 

• Will you work to ensure that family preservation services arc made available to all 

families that merit them? 

• What steps will you take to assure that the medical, mental health, justice, education, and 

social seMces systems collaborate so that all abused and neglected children receive the 

protection they need and al1 at-risk families the treatment they need? 

• What actions will you take to ensure that the deaths of children from abuse and neglect 

are reviewed by state and/or county comprehensive mUlti-agency teams? 

• What steps wi11 you take to assist communities in developing better ways to help youth in 

making the transition from childhood to adulthood, and in finding their place in society as 

parents and productive citizens? 

• What efforts will you undertake to facilitate public-private partnerships aimed at 

enhancing the role of the private sector in the prevention and treatment of child abuse and 

neglect? 

193 
While government must provide leadership and resources in the struggle to control child 

maltreatment, making government more responsive is not the only way -- or even the best 

way -- for citizens to takc responsibility for ending it. The Board urges all citizens to 

consider taking one or more of the following actions .... 

• Decide, if you are hurting your children, 

- to stop; 

- to reach out for help. 

• Determine, if you know children who are hurting -- children within your extended family, 

children of friends, children of neighbors -- to reach out to help them 

- by providing resources; 

- by providing support; 

- by providing safety. 

• Undertake to help friends and neighbors who have children 

- by offering to care for the children of a single parent for a few hours; 

- by reaching out to a family that has just moved to your neighborhood; 

- by taking an interest in the activities of a child in your neighborhood. 

• Pledge, if you are able to give some of your free time, to 

194 

- become a volunteer with a local home visitation program; 

- serve as a Court Appointed Special Advocate (CASA) for a child m the court 

system; 

- enlist as a Big Brother or a Big Sister, or as a foster parent; 

- assist in facilitating a Parents Anonymous group; 

- become a mentor for a child in a residential group home; 

- volunteer at a crisis nursery; 

- serve as a mentor for a teen mother or a drug-addicted mother; 

- help mothers and children at a domestic violence shelter; 

- respond to calls to a local crisis line; 

- assist with public awareness campaigns; 

- participate in fundraising activities; 

- usc your personal or professional skills to provide technical assistance, in such areas 

as finance, law, marketing, and program development; 

- promote and organize parenting seminars in the workplace or conferences on 

children's or family issues; 

- encourage your place of worship to become involved in child abuse and neglect 

prevention and treatment activities. 
• Be an advocate for 

- better staffing in local child protection services agencies; 

- enlightened change in public policy; 

- increased funding for child maltreatment programs; 

- expanded treatment for children and families. 

In 1991 the U.S. Advisory Board on Child Abuse and Neglect dedicated its report to 

the many tlwusands of American children and families trapped in the throes of 

abuse and neglect who are waiting for our society, and its governments, to 

respond to their plight with nwre than just a report, and nwre than just an 

investigatiolL 

On behalr or them, the Board challenges all Americans to resolve 

• that the abuse, neglect, molestation, and murder or our nation's youngest and most 

vulnerable citizens by those entrusted with their care will be ended; 

• that this will be the last American generation in which millions or children experience 

child maltreatment first-hand; and 

• that no child will suffer or die because America did not care enough to become involved, 

because America did not make children's health and safety a priority, or because America 

was scared silent. 

EXCERPT 2: BOARD STATEMENT ON THE CONVENTION ON THE RIGHTS OF THE 

CHILD 

Support for U.S. Ratification of 

the Convention on the Rights or the Child 

The Convention on the Rights of the Child was unanimously adopted by the United Nations 

General Assembly on November 20, 1989, after a decade-long process of development. The 

Convention is an impressive statement of an international consensus that children are valued 

as persons, that their human dignity deserves protection as a matter of right, and that their 

full participation as members of the human community must be ensured. 

The U.S. Advisory Board on Child Abuse and Neglect has found the Convention to be 

useful as a guide to the development of an American child protection policy. In 1991, the 

Board incorporated relevant tenets of the Convention into its proposed National Child 

Protection Policy [see Appendix B]. 

195 
Drawing from the Convention, the Board's proposed Policy recognizes the nation's 

obligation to prevent child maltreatment whenever possible and, when maltreatment does 

occur, to 1tpromote physical and psychological recovery and social re-integration in an 

environment that fosters the health, self-respect, and dignity of the child," The Policy also 

asserts that children should have the right to a family environment and that "national policy 

should strengthen families to remedy the causes of child abuse and neglect, provide support 

for intensive services to prevent the unnecessary removal of children from families, and 

promote the reunification of families if removal has taken place." Consistent with the 

Convention, the Policy also acknowledges the importance of providing opportunities for 

children to be heard in any judicial and administrative matters pertaining to them and with 

ample opportunity for representation. 

To date/ the United States has neither signed nor ratified the Convention. It remains under 

study within the Executive Branch. The Board believes that, once the Convention is signed 

by the President and ratified by the U.S. Senate, it can become a powerful instrument to 

protect the physical and psychological integrity of our nation's children. 

Therefore, the U.S. Advisory Board on Child Abuse and Neglect strongly urges the 

President of the United States: 

• to direct those agencies studying the Convention on the Rights of the Child to conclude 

their analysis rapidly; 

• thereafter, to sign the Convention promptly; and 

• thereupon, to submit the Convention quickly to the United States Senate with appropriate 

resen'ations, declarations, and understandings to adapt the Convention to the American 

federalist system. 

Further, the U.S. Advisory Board on Child Abuse and Neglect strongly urges the United 

States Senate, following the submission of the Convention by the President, to ratify it with 

.n deliberate speed. 

Finally, the U.S. Advisory Board on Child Abuse and Neglect strongly urges that -- until 

these actions are taken -- States, Tribes, counties, and municipalities adopt the Convention 

as a set of principles to guide their policies affecting children. 

2ntis assertion, set forth on August 29, 1992, remains true as of the present date, September, 1993. 

196 

". u.s. GOVERNMENT PRINTING OFFICE:1993·715·032186856 
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