The United States Preventive Services Task Force (USPSTF) has declared that interventions to prevent and reduce child maltreatment, neglect, and abuse did not have enough scientific and clinical support in order to be deemed useful. Therefore, the USPSTF could not recommend these strategies as part of its aim to reduce child abuse. This determination was made nearly a decade ago, and since that time, several studies have been conducted to find out exactly what benefits or consequences result from interventions aimed at reducing child abuse. Heidi D. Nelson of the Pacific Northwest Evidence-Based Practice Center at the Oregon Health & Science University took the initiative to analyze these studies in order to compile evidence in support of child abuse counseling and interventions. She hoped that negative outcomes, such as posttraumatic stress, emotional abuse, anxiety, sexual abuse, victimization, drug or alcohol misuse, depression, suicide, and death could be decreased in this most vulnerable segment of our population.
For her examination, Nelson examined 11 studies overall and looked at rates of hospitalization, emergency care, Child Protective Services (CPS) involvement, assault, abuse, preventive child care, and immunizations. She found that although some of the results were modest, they were still positive. In sum, all of the studies Nelson examined showed reductions in CPS reports/involvement, hospitalizations, emergency services, and abuse. Also, rates of well-child care and immunizations increased for those who received early interventions. Most significantly, childhood developmental outcomes improved and child mortality rates dropped. Nelson noted that these findings provide hard evidence of the benefits of early abuse interventions as the data she reviewed was based on long-term follow-ups, some as long as 15 years after the intervention. Some areas that were not reviewed in this analysis include intimate partner violence and primary care identification of abuse. These areas should be explored in order to determine if early interventions and home visitations designed to address these can also decrease neglect and abuse. Therefore, said Nelson, “Additional research on interventions to prevent child abuse and neglect is needed.”
Selph, Shelly S., Christina Bougatsos, Ian Blazina, and Heidi D. Nelson. Behavioral interventions and counseling to prevent child abuse and neglect: A systematic review to update the U.S. Preventive Services Task Force Recommendation. Annals of Internal Medicine 158.3 (2013): 179-90. Print.
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