The evidence base
Risk Factors for Child Abuse and Neglect
Risk factors associated with child abuse and neglect can disrupt a child’s developing brain, negatively influencing behavioral, educational, economic, and health outcomes for decades and even generations.
Common risk factors include caregiver substance use, unresolved mental health issues, and history of trauma; impaired parent-child relationship; intimate partner violence; and other individual and community sociodemographic factors.[1] Addressing risk factors and promoting protective factors which build on caregiver strengths can lessen the risk of child maltreatment and improve child well-being.[1]
How HealthySteps Addresses Risk Factors for Child Abuse and Neglect
Our two-generation approach aligns closely with ongoing child abuse and neglect prevention efforts and was recently cited as a prevention strategy by the U.S. Defense Health Board.
HealthySteps strengthens the parent-child relationship and addresses the full range of child and family needs, including several risk factors commonly associated with child abuse and neglect, such as caregiver substance abuse, caregiver mental illness, and exposure to violence.
Research on HealthySteps demonstrates that HealthySteps connects families with services to address child abuse and neglect risk factors, supports maternal mental health treatment, reduces the use of harsh or serve discipline, and supports the development of healthy relationships.
- Families had significantly higher rates of nonmedical referrals, including referrals for child abuse or neglect, marital or family issues, maternal depression, and other social or environmental issues[2]
- Mothers with depressive symptoms reported significantly fewer symptoms after receiving HealthySteps and those symptoms decreased at a faster rate than comparable mothers[3] [4]
- Children whose mothers reported childhood trauma scored better on a social-emotional screening after receiving HealthySteps than comparable children[5]
- Families were significantly less likely to report harsh punishment (yelling, spanking with hand) and severe discipline (face slap, spanking with objects)[3] [4]
- Parents were significantly more likely to notice behavioral cues and provide age-appropriate nurturing[3][6]
- HealthySteps participation was significantly associated with greater security of attachment and fewer child behavior problems[7]
[1] Development Services Group, Inc., & Child Welfare Information Gateway. (2015). Promoting protective factors for in-risk families and youth: A guide for practitioners. U.S. Department of Health and Human Services, Administration on Children, Youth and Families, Children’s Bureau. https://www.childwelfare.gov/pubPDFs/in_risk.pdf
[2] Guyer, B., Barth, M., Bishai, D., Caughy, M., Clark, B., Burkom, D., Genevro, J., Grason, H., Hou, W., Keng-Yen, H., Hughart, N., Snow Jones, A., McLearn, K.T., Miller, T., Minkovitz, C., Scharfstein, D., Stacy, H., Strobino, D., Szanton, E., & Tang, C. (2003). Healthy Steps: The first three years: The Healthy Steps for Young Children Program National Evaluation. https://ztt-healthysteps.s3.amazonaws.com/documents/139/attachments/2003_HS_National_Evaluation_Report.pdf?1539967.
[3] Johnston, B.D., Huebner, C.E., Tyll, L.T., Barlow, W.E., & Thompson, R.S. (2004). Expanding developmental and behavioral services for newborns in primary care: Effects on parental well-being, practice and satisfaction. American Journal of Preventive Medicine, 26(4), 356–366.
[4] Kearns, M.A., Fischer, C., Buchholz, M., & Talmi, A. (2016, Dec 7 – 9) More than the blues? Comparing changes in pregnancy related depression symptoms based on enrollment in Healthy Steps [Poster Session]. ZERO TO THREE Annual Conference, New Orleans, LA.
[5] Briggs, R. D., Silver, E.J., Krug, L.M., Mason, Z.S., Schrag, R.D.A., Chinitz, S., & Racine, A D. (2014). Healthy Steps as a moderator: The impact of maternal trauma on child social-emotional development. Clinical Practice in Pediatric Psychology, 2(2), 166–175.
[6] Caughy, M.O., Huang, K., Miller, T., & Genevro, J.L. (2004). The effects of the Healthy Steps for Young Children program: Results from observations of parenting and child development. Early Childhood Research Quarterly, 19(4), 611–630.
