A Cure for Child Abuse
Asked to investigate the roots of child abuse, a group of social engineers focused not on its causes but its prevention.
No one wants to be anywhere near the phrase "child abuse." Parents flee from programs that would tar them as "high risk." Teachers and child care providers fear the mistrust that comes with any hint they might call Child Protective Services. Those services don't receive children until it's too late to prevent abuse. And the public numbs to PSAs with warnings like, "Every 10 seconds, another child is abused in America …" (which is, unfortunately, about right).
"What they hear is, 'It's so bad, there's nothing you can do about it, and we should just put those bad parents in jail,'" said Judy Langford, who directs the child abuse and neglect prevention program with the Center for the Study of Social Policy. "When you work with families, it's so depressing when you look at everything in that way."
Langford, however, is a remarkably optimistic woman. She visibly rises out of her seat describing innovative local programs and new studies, which tie back to a set of ideas that CSSP has been developing to substantially alter our thinking about child abuse prevention.
The center was contacted in 2001 with a daunting request: Could it help develop an entirely new approach to the field, a strategy that wouldn't be small-bore, lead-footed, depressing? The Doris Duke Charitable Foundation, which has long focused on preventing child abuse, wasn't satisfied with existing solutions to a problem inherently difficult to resolve.
"They wanted all this stuff that we thought was just impossible," Langford recalled. "They wanted a nationwide impact, they wanted to reach millions of children, and have it be long before abuse and neglect occurred — and not connected to the child welfare system. We're thinking, 'We can't really do that.'"
CSSP set out anyway and began by reviewing more than a hundred studies on child abuse prevention, examining all of the existing assumptions about what might reduce maltreatment. Eventually, CSSP began to approach the problem from an unconventional angle: Not what causes it, but what prevents it?
"Why is it some children, some families who have everything going against them survive and thrive and are successful in spite of all kinds of risk factors and other things that would say this child really doesn't have much of a chance?" Langford asked.
Those working with children probably are adept at identifying these so-called risk factors — a child has a single parent, comes from a low-income background, was born to a teenage mother. But no program on Earth can change any of that, Langford says, and in truth, risk factors aren't really predictive.
What programs can do, she now realizes, is help families build "protective factors." Their presence — or absence — actually can help predict good or bad outcomes. A family with all the signs of risk — but also all the strength of protective factors — has a strong chance of avoiding maltreatment.
And where better to start embedding these ideas — CSSP has identified five core factors — than the places where millions of children under 5 gather each day, in early child care centers, among child care workers who have never really thought of what they did as preventing child abuse.
Among the research key to this conclusion was a longitudinal study Arthur Reynolds has been running for 30 years in Chicago. He began following 1,000 children born in 1980 — children who lived in some of the poorest neighborhoods not just in the city, but the entire country. More than half of the families in this West Side area in the early '80s lived below the poverty line. Many parents hadn't graduated high school and didn't trust social services.
These children, however, were enrolled in innovative programming at the public school system's Chicago Child-Parent Centers. The program, for low-income children expected to enter into the regular school system, emphasized early reading skills and continuous development through preschool and kindergarten, as well as heavy parental involvement.
Reynolds, now a researcher with the University of Minnesota, wanted to track the long-term effects of the program on the children's later academic success and adult outcomes. When the cohort turned 21, he translated those results into economic return for society: For every dollar invested in one-and-a-half years of preschool, $7.10 returned to society through reduced dropout rates, fewer special education needs, less strain on the juvenile justice system and increased earnings capacity.
"You name it, we've looked at it," Reynolds said. He has examined behavioral problems, mental health, remedial education placement, grade retention, graduation rates, juvenile arrests, violent offenses, later job stability and projected tax revenues.
His study was also the only one, at the time, to ask the question about reduction in child maltreatment: Did such programs affect that, too? It did, and dramatically so.
Compared to a similar group not enrolled in the program, participation in the Child-Parent Centers was associated with a 51 percent reduction in the rate of substantiated child abuse and neglect by the time the children were 18.
"We weren't expecting originally that there would be big effects on the reduction of child maltreatment, but I guess it's not that surprising," Reynolds said. He suspects this has to do with the heavy parent involvement, and with the success of the school system in drawing isolated families into a support network.
That is one of the protective factors: social connections. Reviewing the other studies, CSSP settled on four others equally rooted in the Child-Parent Centers: parental resilience (the ability of parents to cope with stress); knowledge of parenting and child development (through access to resources beyond what parents learn on the job); concrete support in time of need (unemployment insurance, for example, when a parent loses a job); and children's social and emotional development (reflecting a child's ability to interact and communicate).
"What we've learned is that [child maltreatment] is a multi-level phenomenon," said Fred Wulczyn, a research fellow at the University of Chicago's Chapin Hall. To really understand it, we have to consider both risk and protective factors.
What social capital — for instance, a child care center up the street — do parents have access to? Is it enough, on some days, just to know that it's there? Does a child's own temperament cause stress for a family? How does it change the equation when a parent and a child have a bad day on the same day?
"That's what's complicated about all this, that's what's complicated about the assessment," Wulczyn said. "Is the stuff that's right about the situation enough to offset what's wrong about it?"
As Reynolds is now wondering, is what was right about the Chicago Child-Parent Centers enough to stave off abuse even in the next generation, as his 1980 children today have children of their own?
Langford and her colleagues eventually visited two dozen child care centers across the country that seemed to be having much the same success as the Chicago Child-Parent Centers. These centers integrated family outings, adult education and social services. Some actively worked to include fathers or to provide bilingual care. All viewed their missions as doing much more than simply occupying kids while their parents were at work.
Few of these model programs, however, explicitly thought of what they did as building the type of strong families that would be less likely to mistreat children. In their minds, their missions were more focused on the children in their care than the families they went home to. In a lengthy questionnaire, CSSP asked each of them what they did to prevent child abuse and neglect.
"Every single one of them answered, 'We're mandated reporters,'" Langford said, "even though they were doing all this other stuff, all the time. But in their minds, that was how they identified what it was that they were doing."
They were, in other words, legally required to report abuse (an obligation that doesn't actually have much to do with preventing abuse).
The primary contribution of "protective factors" has been to give these already strong programs a way to re-examine their impact on families, and to give weaker programs a framework for embedding tangible and cultural changes to prop up at-risk families. No one has to talk about preventing "child abuse"; the goal instead is "strengthening families."
"This isn't a brand new idea, but what CSSP did was really make it actionable," said Kathy Goetz Wolf, project director of Strengthening Families Illinois. Similar initiatives focused on the protective factors have sprung up in two dozen states.
Their idea isn't just a bookkeeping solution, a problem solved by renaming it. Rather, the protective factors are changing the dynamic between families and their child care providers, which CSSP hopes in turn will lead to fewer cases of maltreatment.
"That whole approach — you're not just taking care of my kids, you're assisting me in parenting my whole family — that's a shift in thinking which helps empower parents," said Dara Griffin, a mother of three in Chicago who now preaches the protective factors.
Langford smiles at the memory of a woman on the other side of that equation, a family resource director in Massachusetts who had a similar "Aha!" moment after one of her presentations on the protective factors.
"Finally," the woman said, "I can tell my board why I have to take 62 parents and kids apple-picking every fall! We knew it was important, but we didn't know how to talk about it."