Int. J. Environ. Res. Public Health 2009, 6 3162 Each of the theories outlined above may provide a conceptual framework from which to test the effects of IPV and parental alcoholism on youth development. It is important to recognize that a single model may not account for all aspects of child risk. 3. Future Directions and Recommendations Results from epidemiological surveys indicate a significant proportion of school-aged children live in homes in which one or both parents abuse alcohol. More importantly, in addition to the damage caused by parental alcoholism, it appears that these home environments are often marked by high levels of violence and general interparental conflict. Given the prevalence of partner violence among married or cohabiting alcoholic patients, coupled with the number of children living in these homes, future investigations are needed to examine not only the link between alcoholism and partner violence, but also the individual and collective impact these behaviors have on these children. Unfortunately, alcoholism treatment providers and programs have not raised IPV and its impact on children’s adjustment as an issue, in part because it has gone undetected. Given that the majority of custodial parents who enter treatment for alcoholism are reluctant to allow their children to be involved in any type of mental health treatment, regardless of whether it is individual treatment or as part of family therapy [81], the psychosocial adjustment of a significant cohort of children who live in these homes has been largely ignored. The conspicuous lack of systematic investigations examining the independent and combined relations among parental alcoholism, violence exposure, and children’s adjustment has led Nicholas and Rasmussen [33] to question the legitimacy of continuing to research externalizing behaviors in relation to being a COA if histories of interparental violence are not controlled for in the design. The results of a recent study show that families with documented incidents of domestic violence tend to have multiple young children in the home [38]; coupled with the fact that IPV rates are highest early in the marital relationship (when children are likely to be young; [82]), there is clearly a need to elucidate the factors that influence children’s adjustment. Along with exploring the effects of parents’ alcohol use and IPV on children, examining families with children in which caregivers abuse alcohol and in which children were not exposed in utero may also present an opportunity to examine the effects of postnatal social exposure on children. Furthermore, there is currently a lack of research on the relative risk to children of male- versus female-initiated partner violence; at this time, very little is known about the differential effect [36]. In addition, investigations are also needed to examine the differential impact of violence and alcoholism on male versus female children’s adjustment. Finally, given the heterogeneity in subtypes of violence, future investigations should examine the impact of various types of violence exposure (e.g., severe, nonsevere) on children’s development. While addressing issues as complex and sensitive as the individual and combined effects of alcohol and IPV (not only between the partners, but also their children), appears overwhelming, given the seriousness and harmful short- and long-term effects of these behaviors, it is critical that the research community begin to examine these issues. For example, important questions such as “What are the interactive effects of these phenomena on children’s adjustment?” and “What is the impact of a reduction in IPV, but not in alcohol use (and vice versa)?” have yet to be explored. Further research is also needed to examine the specific mechanisms and how intervention programs might serve to