To stem the maltreatment of growing numbers of children, an advisory panel has urged the federal government to develop a national program of home visits by health workers and aides to help educate and offer support to new parents.
The U.S. Advisory Board on Child Abuse, established by the Congress in 1988, called for a home-visitation program as part of a “new, national, comprehensive, child-centered, family-focused, and neighborhood-based child-protection system.”
In its second annual report to the Congress, released at a meeting in Denver this month, the panel described state and county child-protection agencies as “overwhelmed and on the verge of collapse.”
It declared the upsurge in reported child-abuse cases in recent years “a national emergency,” noting that more than 2.5 million cases of suspected maltreatment were reported in 1990, a 30 percent rise since 1985.
In the absence of a national child-protection policy, the panel concluded, existing services are “fragmented, inadequate, and often misdirected.”
“While not a panacea, the board believes that no other single intervention has the promise that home visitation has,” the panel said.
As a first step toward a “universal, voluntary neonatal home- visitation system,” the board called for a series of pilot projects drawing on existing public and private programs using nurses and community-health aides. It suggested a statewide program operating in Hawaii as a possible model.
Guided by Research
The report cited research showing that families at high risk for abusing and neglecting their children could be identified in the perinatal period, and that “lay home visitors” sent into homes to offer parents support and advice were “among the most effective” preventive measures.
It also cited research conducted five years ago by David Olds, an associate professor of pediatrics at the University of Rochester, in which public-health nurses visited high-risk adolescent parents.
Those parents, the study showed, were less likely to abuse their children and use costly emergency health services and more likely to have their children immunized and to delay subsequent pregnancies than a comparison group. They were also found to be less reliant on public assistance and more likely to pursue education and jobs.
Besides promoting a home-visitation network, the panel’s report laid out a series of recommendations calling on the federal government to strengthen and coordinate child-protective services and enact a national child-protection policy.
The report also urged the federal government to offer assistance to educational institutions to train teachers, administrators, and health personnel on the treatment of child abuse and neglect; institute school-based support services for high-risk families; and offer family-life education courses for students and parents.
The panel urged that interagency task forces assume joint responsibility for planning child-protection policies and that schools work with public and private agencies to establish interdisciplinary programs to strengthen families.
Information on how to order the report, “Creating Caring Communities: Blueprint for an Effective Federal Policy on Child Abuse and Neglect,’' is available from the U.S. Advisory Board on Child Abuse and Neglect, 200 Independence Ave., S.W. Washington, D.C. 20201; telephone (202) 245-0877.