The effects of child maltreatment and polymorphisms of the serotonin transporter and dopamine D4 receptor genes and infant attachment and intervention efficacy
Previous research has investigated the deleterious
effects of child maltreatment on child development; however, little research has examined the development of children who live with caregivers who are at risk of maltreatment on child development outcomes.
Therefore, it is important in primary research to thoroughly conduct follow - up evaluations of considerable length, as the true
effects of child maltreatment interventions may be particularly expressed in follow - up rather than in post-treatment evaluations.
Lastly, long - term
effects of child maltreatment should be studied more closely.
Mobility as a mediator of
the effects of child maltreatment on academic performance.
Boys Will Be Boys: Understanding the Impact of Child Maltreatment and Family Violence on the Sexual, Reproductive, and Parenting Behaviors of Young Men (PDF - 793 KB) Kahn & Paluzzi (2006) Describes the long - term
effects of child maltreatment and family violence on males, and discusses the roles of practitioners, policymakers, advocates, and educators in addressing these issues.
Although there are studies of home visiting that report
effects of child maltreatment on child and family outcomes, relatively few of them use rigorous methods that support drawing causal inferences about effectiveness.
This paper reviews the literature on the psychological
effects of child maltreatment.
Contextual factors, notably the family environment and wider community, are also important because they may moderate the developmental
effects of child maltreatment, thereby accounting for some of the heterogeneity in the outcomes associated with abuse and neglect (Zielinski and Bradshaw, 2006; Berry, 2007); the extent to which children who get hit experience impaired health or development depends on its frequency and whether it occurs in a low - warmth / high - criticism environment (DoH, 1995).
Children who have been abused or neglected need safe and nurturing relationships that address
the effects of child maltreatment.
Although there are studies of home visiting that report
effects of child maltreatment on child and family outcomes, relatively few of them use rigorous methods that support drawing causal inferences about effectiveness.
(NBER Working Paper No. 12171), authors Janet Currie and Erdal Tekin focus on
the effect of child maltreatment on crime using data from the National Longitudinal Study of Adolescent Health (Add Health).
As we identified seven outlying effect sizes (see above), we performed a sensitivity analysis in which we estimated an overall
effect of child maltreatment interventions using the data in which the outlying effect sizes were excluded.
In addition, we estimated the overall
effect of child maltreatment interventions excluding the results of pilot / feasibility studies, because these studies are more likely to show an effect that is larger than effects produced by well - powered trials.
Following the guidelines of Lipsey and Wilson (2001), a coding scheme was developed to code all study design and intervention characteristics that could moderate
the effect of child maltreatment interventions.
So, the effects extracted from primary studies included in this meta - analysis may not be an adequate representation of the actual
effect of child maltreatment interventions.
Not exact matches
Studies
of home visiting's effectiveness as an intervention designed to prevent
child maltreatment demonstrate some promise, but compared to the number
of studies conducted that measure
child maltreatment, risk for
maltreatment, or protective factors, there are far more findings
of no
effects than reductions in
maltreatment and improvements in
child and family well - being.
Although an NFP study conducted when
children were 4 years old showed no
effect, 18 another study found reductions in substantiated reports
of child maltreatment 15 years after enrollment.19 Across a number
of HFA studies there was no evidence
of near - term
effects on substantiated reports, 20,21,22,23 and there were no longer - term follow - up studies.
In many instances, the quality
of the research is not sufficient to draw conclusions about the
effects of a given model on
child maltreatment.8
Meta - analyses
of studies evaluating these programs show positive
effects on the competence, efficacy and psychological health
of the parents, as well as on the behaviour
of the
children.49, 50 A recent implementation study
of a strategy for parenting and family support showed that families in the treatment group had far fewer cases
of substantiated
child maltreatment, abuse injuries and out -
of - home placements.51
Although research began to accumulate in the 1970s that showed that most physical abuse is physical punishment (in intent, form and
effect), studies
of child maltreatment have since clarified this finding.
We focus on this time period because young
children have significantly higher rates
of exposure to
maltreatment compared with older
children and early
maltreatment is thought to have particularly harmful
effects on a
child's development.
Combining baseline adjustments, treatment attenuation
effects, and prior preschool attendance attenuation
effects, we assume that non-low-income
children experience 42 percent
of the reduction in the need for special education, 21 percent
of the decline in grade retention, 12 percent
of the reduction in
child maltreatment, 42 percent
of the drop in juvenile and adult crime, 26 percent
of the lessening
of depression, and 37 percent
of the decrease in smoking experienced by low - income
children.28
In general, the research shows that home visiting programs have the greatest, albeit still modest,
effect on parents» support for
children's learning and in reducing the prevalence
of child maltreatment, but that these
effects are strongest for the most disadvantaged program participants.
This includes improved birth, health and
child development outcomes, and reductions in
child maltreatment.15 A number
of SNHV programmes have also shown favourable
effects on healthcare usage, including rates
of well -
child healthcare visits.15
Results
of generalized estimating equation analysis examining the
effect of maltreatment, the 5 - HTTLPR genotype, and frequency
of contact with the
child's primary support (WALD type 3 statistic)
It should be noted, however, that Joanne Klevens and Daniel Whittaker conclude that many
child abuse prevention programs that address a broad range
of risk factors have not been carefully evaluated and that those that have been evaluated have generally been found to have little
effect on
child maltreatment or its risk factors.33
Group status (
maltreatment vs. CC), 5 - HTTLPR genotype (l / l vs. l / s vs. s / s), and social supports (high vs. low) were all significant predictors
of children's depression scores in the GEE analysis (P < 0.05, all main
effects).
Fig. 1 depicts the main
effects of maltreatment, genotype, and social supports in predicting
children's depression scores.
A diagnosis
of psychological
maltreatment is facilitated when a documented event or series
of events has had a significant adverse
effect on the
child's psychological functioning.
The second 3 columns depict the main
effects of maltreatment, controlling for ecological and
child risk factors.
He cautions that many
of the interventions have not been carefully evaluated and those that have been have shown little
effect on
child maltreatment or its risk factors.
Rutter & Quinton (1977) found that factors existing in
children's social environment were linked to health - risk behaviors later in life, and were the first researchers to describe neglect, abuse, and other forms
of maltreatment (what would later be considered adverse childhood experiences, or ACEs) in terms
of their cumulative
effect, range
of adversity, and wide - reaching impact on both mental and physical health over the course
of an individual's lifetime.
The
effect of the nurses and paraprofessionals on responsive mother -
child interaction indicates that the program was operating as intended in helping parents provide more sensitive and responsive care for their
children, which is thought to promote secure attachment and healthy emotional and behavioral development.49 The reductions in subsequent pregnancies and increases in interpregnancy intervals are particularly important as short interpregnancy intervals increase the risk
of child maltreatment (including infant homicide among teen parents) 50 and compromise families» economic self - sufficiency.51
The concentration
of beneficial nurse
effects on the emotional, language, and mental development
of children born to mothers with low psychological resources in the current trial is consistent with corresponding nurse
effects on
child abuse, neglect, and injuries among
children born to low - resource mothers in earlier trials
of this program.10, 17,19 The vulnerable and low - vitality emotion classifications are relevant to
child maltreatment.
Indeed, Jay Belsky incorporated all
of these risk factors into his process model
of parenting, 11 and data from multiple studies support links to
child well - being.12 In an experiment on the effectiveness
of a program for low - birth - weight infants, Lawrence Berger and Jeanne Brooks - Gunn examined the relative
effect of both socioeconomic status and parenting on
child abuse and neglect (as measured by ratings
of health providers who saw
children in the treatment and control groups six times over the first three years
of life, not by review
of administrative data) and found that both factors contributed significantly and uniquely to the likelihood that a family was perceived to engage in some form
of child maltreatment.13 The link between parenting behaviors and
child maltreatment suggests that interventions that promote positive parenting behaviors would also contribute to lower rates
of child maltreatment among families served.
However, for both
child abuse and parent stress, the average
effect sizes were not different from zero, suggesting a lack
of evidence for
effects in these areas.108 Earlier meta - analytic reviews have also noted the lack
of sizable
effects in preventing
child maltreatment — again citing the different intensity
of surveillance
of families in the treatment versus control groups as an explanation (though the authors did report that home visiting was associated with an approximately 25 percent reduction in the rate
of childhood injuries).109 Another review focusing on the quality
of the home environment also found evidence for a significant overall
effect of home - visiting programs.110 More recently, Harriet MacMillan and colleagues published a review
of interventions to prevent
child maltreatment, and identified the Nurse - Family Partnership and Early Start programs as the most effective with regard to preventing
maltreatment and childhood injuries.
Studies
of HFA, NFP, and PAT find
effects for certain subgroups
of their samples, but show no overall impact
of program participation on reductions in
child maltreatment.
Although an NFP study conducted when
children were 4 years old showed no
effect, 18 another study found reductions in substantiated reports
of child maltreatment 15 years after enrollment.19 Across a number
of HFA studies there was no evidence
of near - term
effects on substantiated reports, 20,21,22,23 and there were no longer - term follow - up studies.
Results indicate that childhood
maltreatment has persistent
effects on the PTSD symptoms
of IPV survivors, suggesting that
child maltreatment may need to be addressed in addition to IPV during PTSD treatment.
In many instances, the quality
of the research is not sufficient to draw conclusions about the
effects of a given model on
child maltreatment.8
To achieve safety, permanency, and well - being,
child welfare professionals can implement trauma screening, functional and clinical assessment, and evidence - based interventions to address the
effects of maltreatment or other traumatic events.
Child maltreatment in any form causes long - lasting harm to
children's health and development, and in the United States alone carries a yearly estimated direct and indirect cost
of over $ 100 billion in services to recognize the abuse, intervene, and address its detrimental
effects.
The program
of prenatal and infancy home visiting by nurses, tested with a primarily white sample, produced a 48 percent treatment - control difference in the overall rates
of substantiated rates
of child abuse and neglect (irrespective
of risk) and an 80 percent difference for families in which the mothers were low - income and unmarried at registration.21 Corresponding rates
of child maltreatment were too low to serve as a viable outcome in a subsequent trial
of the program in a large sample
of urban African - Americans, 20 but program
effects on
children's health - care encounters for serious injuries and ingestions at
child age 2 and reductions in childhood mortality from preventable causes at
child age 9 were consistent with the prevention
of abuse and neglect.20, 22
In general, the research shows that home visiting programs have the greatest, albeit modest,
effect on parents» support for
children's learning and in reducing the prevalence
of child maltreatment, but that these
effects are strongest for the most disadvantaged program participants.
Estimating the
Effects of Head Start on Parenting and
Child Maltreatment Zhai, Waldfogel, & Brooks - Gunn (2013) Children and Youth Services Review, 35 (7) View Abstract Examines the effects of Head Start participation on parenting and child maltreatment in a large and diverse sample of low - income families in large U.S. cities using data from the Fragile Families and Child Well - Being S
Child Maltreatment Zhai, Waldfogel, & Brooks - Gunn (2013) Children and Youth Services Review, 35 (7) View Abstract Examines the effects of Head Start participation on parenting and child maltreatment in a large and diverse sample of low - income families in large U.S. cities using data from the Fragile Families and Child Well -
Maltreatment Zhai, Waldfogel, & Brooks - Gunn (2013)
Children and Youth Services Review, 35 (7) View Abstract Examines the
effects of Head Start participation on parenting and
child maltreatment in a large and diverse sample of low - income families in large U.S. cities using data from the Fragile Families and Child Well - Being S
child maltreatment in a large and diverse sample of low - income families in large U.S. cities using data from the Fragile Families and Child Well -
maltreatment in a large and diverse sample
of low - income families in large U.S. cities using data from the Fragile Families and
Child Well - Being S
Child Well - Being Study.
The
effects of maltreatment and associated risk factors vary as a function
of the type
of child maltreatment.
Additionally,
EFFECT aims to increase protective factors — family functioning and resilience, social support, knowledge
of parenting and
child development, concrete support, and nurturing and attachment — to reduce the risk
of child maltreatment and to promote positive family wellbeing.
Medical costs attributable to
child maltreatment a systematic review
of short - and long - term
effects.
EFFECT aims to improve
children's wellbeing by helping fathers become more involved, responsible, and committed to their
children through parent education skills, guidance, and support systems.17 Additionally,
EFFECT aims to increase protective factors — family functioning and resilience, social support, knowledge
of parenting and
child development, concrete support, and nurturing and attachment — to reduce the risk
of child maltreatment and to promote positive family wellbeing.18 In addition to investing in fatherhood programs through
EFFECT, Texas is committed to considering a broader system
of supports for fathers.