On November 5, the House Education and Labor Subcommittee on Healthy Families and Communities held a hearing on preventing child abuse and improving responses to families in crisis.
In her opening remarks, Chair Carolyn McCarthy (D-NY) discussed the role the Child Abuse Prevention and Treatment Act (P.L. 93-247) has played in reducing child abuse, saying, “Over 35 years ago Congress enacted the Child Abuse Prevention and Treatment Act – or ‘CAPTA’ – with a very simple purpose: creating a single federal focus to deal with the front-end issues associated with child abuse and neglect. I like to think of CAPTA prevention programs as the first line of defense in the child welfare system. The CAPTA formula and competitive grants focus on the prevention of child abuse and ensuring continued well-being and safety of children. The CAPTA programs consist of two major grant programs, as well as targeted research, data collection and dissemination, and technical assistance to the states. These grant programs provide funding for improvements to child protective services, promising prevention efforts, and…community-based efforts to prevent abuse and neglect.” Rep. McCarthy continued, “While CAPTA has brought much needed attention and change to the issues of child maltreatment, this number remains too high. The rates of physical abuse have decreased in recent years, but the rates of neglect have remained disturbingly constant. And we know that difficult financial times can certainly aggravate violence and victims with fewer personal resources become increasingly vulnerable. For example, since the economic crisis began, it has been reported that three out of four domestic violence shelters have reported an increase in women seeking assistance from abuse. That means we have more work to do, which is why I am holding this hearing today.”
Rodney Hammond, director of the Division of Violence Prevention at the National Center for Injury Prevention and Control within the Centers for Disease Control and Prevention (CDC), discussed child abuse in the context of public health. “CDC’s public health approach emphasizes rigorous science and complements other approaches, such as those of the child welfare system, criminal justice, and mental health systems. CDC achieves these primarily through data monitoring and sharing; research on possible interventions; community implementation and evaluation of interventions; and widespread adoption of proven interventions…There is substantial evidence that parent training programs or behavioral family interventions delivered in clinical settings and focused on influencing children’s behavior through positive reinforcement are effective at influencing the child rearing practices of families. In fact, a new CDC-funded study shows that when parents have access to proven parenting interventions designed to address problems with child behavior (e.g., tantrums), key measures of child maltreatment fall. In addition, early childhood home visitation programs show strong evidence of effectiveness in reducing violence against visited children. These programs are designed to decrease the likelihood of child maltreatment by providing parents with guidance for and examples of caring and constructive interaction with their young children. This approach facilitates the development of parental life skills, strengthens social support for parents, and links families with social services.”
Dr. Hammond continued, “Nurse-Family Partnership, or NFP, is one example of an evidence-based early childhood home visitation program that was developed based on evidence from randomized, controlled trials. NFP focuses on first-time mothers during pregnancy and works to promote and teach positive health and development behaviors between a mother and her baby. Additionally, NFP is delivered by registered nurses over a period of time (typically from the mother’s first trimester to the child’s second birthday), thereby fostering a bond between nurse and mother. This early intervention during pregnancy allows for any critical behavioral changes needed to improve the health of the mother and child. Several randomized controlled trials have found this program to effectively reduce abuse and injury, improve cognitive and socio-emotional outcomes in children, and have a very favorable benefit-cost ratio. An evaluation of NFP documented a 48 percent decline in rates of child abuse and neglect at the time of a 15-year follow-up study. Furthermore, studies found reduced rates of crime and antisocial behavior among both children and mothers.”
Executive Director of the Nassau County Coalition Against Domestic Violence (NCCADV) Sandra Oliva, speaking in support of reauthorization of the Family Violence Prevention and Services Act (FVPSA) (P.L. 98-457), discussed child abuse in the context of overall family violence. “We know that intergenerational violence is perpetuated as children witness and experience violence. In fact, one study found that men exposed to physical abuse, sexual abuse, and adult domestic violence as children were almost four times more likely than other men to have perpetrated domestic violence as adults. Children who are exposed to domestic violence are more likely to exhibit behavioral and physical health problems including depression, anxiety, and violence towards peers. They are also more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution, and perpetrate sexual assault.”
Ms. Oliva continued, “One-half to two-thirds of residents of domestic violence shelters are children, and FVPSA-funded services have always provided services to the children in shelter. We know that the most important service you can give to a child is to provide safety for her/his non-abusive parent so that the child and parent can heal together. Children who witness and experience domestic violence need specialized, age-appropriate services in order to fully heal and break the cycle of violence. But these services must be provided in the context of supporting the non-abusive parent and child together. By empowering the parent to become safe and stable, we help the child. To that end, I am very excited about NCCADV’s unique partnership with the local child abuse agency, the Coalition Against Child Abuse and Neglect. This month, we are moving to a shared space, where we will offer adult, youth, and child victims enhanced, seamless services in one central location. At The Safe Place in Bethpage, NY, each organization will maintain its independent identity and mission while streamlining operations and collaborating on services provided to individuals and families. Through joint case management, the entire family’s issues (emergency housing, counseling, legal representation, and parenting skills workshops, for instance) can be addressed on an ongoing basis as they work to piece together their broken lives and build a safe supportive environment. If we had more targeted resources for specialized children’s services, NCCADV could easily serve twice as many children as we currently do. Such funding would allow programs like NCCADV to sustain and enhance the essential services provided to children and their families and would allow other domestic violence programs to develop this critical work. Therefore, we strongly support the recommendation to include a funding set-aside (25 percent of excess funding over appropriations of $130 million) for the Specialized Services for Abused Children and Their Parents [provision] in the FVPSA reauthorization.”
Advocating on behalf of alternative ways to help families in crisis, Caren Kaplan, director of Child Protection Reform for the American Humane Association said, “American Humane advocates for the implementation of Differential Response Systems in Child Welfare as an effective way to respond to reports of abuse and neglect. Differential response…encourages families to recognize their own needs and seek services to enhance parenting skills, mental health concerns, substance abuse issues, work/day care issues and/or other distinct needs of each family. Differential response encourages family participation in agency- and community-based services. By alleviating the concerns raised without a formal determination or substantiation of child abuse and neglect, these ‘alternatives’ to traditional child protection investigative response achieve or maintain child safety through family engagement and collaborative partnerships.”
“Given that the majority of families that come to the attention of the child protection agency are deemed to present low or moderate risk of maltreatment, and are not experiencing immediate child safety issues, there has been a developing trend for the past 15 years to respond to these families differentially in a manner that supports families. Differential response is based on several foundational tenets. Families are not all the same – and in particular the severity of the family situation is not identical across families who come to the attention of the child protection agency and therefore, it is important to be responsive to the differences among the families that come to the attention of the child protection agency. Another foundational tenet of differential response is based on the notion that over the many years in which we have collected data – the 2009 report of the Children’s Bureau on Child Maltreatment that examines 2007 data…many families (38 percent of victims in 2007) received no post-investigation services. After being identified and labeled as ‘child abusers’, these families refuse services and the case is closed. A significant proportion of these families will return to the CPS [child protective services] agency as there was no intervention to remediate their difficulties…Differential response systems is an approach that allows CPS to respond differently to accepted reports of child abuse and neglect. It emphasizes the value of the assessment of the child and his/her family without requiring a determination that maltreatment has occurred or that the child is at risk of maltreatment. It allows for access to available resources and services rather than solely investigating the occurrence of maltreatment. Services may be provided to families without a formal determination of abuse or neglect or labeling someone as a perpetrator and listing them in the state’s central child abuse registry. It is accompanied by greater efforts to identify, build, and coordinate formal and informal services and supports that respond to the families self-identified needs.”
Rob Sawyer, director of Child and Family Services for Olmsted County Community Services in Rochester, MN; Teresa M. Smith, coordinator and executive director of the Children’s Advocacy Center in Harrisburg, PA; and Carol Wilson Spigner, associate professor and clinician educator at the School of Social Policy and Practice at the University of Pennsylvania, also testified.