Perspectives on Child Maltreatment
In Harm's Way: Domestic Violence and Child Maltreatment:
A Report by The US Department of Health and Human Services

Over the last few decades, professionals and the general public have become increasingly aware of the tragic occurrence of both child maltreatment and domestic violence. A national study by the U.S. Department of Health and Human Services (DHHS) reports that nearly one million children were identified by child protective services (CPS) as victims of substantiated or indicated abuse or neglect in 1996 (DHHS, 1998). A recent study, using data from the National Violence Against Women Survey, reported that 1.9 percent of women in the United States (or 1.9 million women) were physically assaulted in the previous 12 months (Tjaden & Thoennes, 1998). Increasingly, we are recognizing that many of these maltreated children and abused women come from the same homes.

CO-OCCURRENCE OF CHILD MALTREATMENT AND DOMESTIC VIOLENCE

According to published studies, there is a 30 percent to 60 percent overlap between violence against children and violence against women in the same families. Although the studies on which these ranges are based employ different methodologies (e.g., case record reviews, case studies, and national surveys), use different sample sizes, and examine different populations, they consistently report a significant level of co-occurrence. These results point to the importance of protecting the abused parent to ensure the safety of the child.
Researchers typically employ either of two methods when trying to understand the overlap:

• Identify evidence of woman-battering in families where known cases of child abuse exist (CPS samples)

• Look for evidence of child abuse in families where abuse of the mothers is known to exist (shelter samples).

Both of these methods may underestimate the actual incidence of co-occurring child maltreatment and domestic violence as they exclude cases that have not been brought to the attention of CPS or battered women's shelters. These cases can be estimated by examining other studies that rely on broader segments of the population, including people presenting at hospitals and surveys of the general public.

In the late 1970s, several federally funded research studies investigated the efficacy of treatment and prevention of child maltreatment among families receiving child welfare services. In three of these studies, the investigators reported on the families' major presenting problems in addition to child maltreatment. The percentage of families reporting spouse abuse as a major problem ranged from 11 percent (N=1,686) in a 1977 study to 42 percent (N=903) in a 1982 study (Daro & Cohn, 1988).

In a similar study, a 1990 review of 200 substantiated child abuse reports in the Massachusetts Department of Social Services found that adult domestic violence was cited in 30 percent of the cases. In more recent studies, the number rises to 48 percent, which may also reflect better training of caseworkers to specifically ask about possible adult abuse (Dykstra & Alsop, 1996). A review of CPS cases in Washington State found that 55 percent of the physical and emotional abuse referrals involved domestic violence, and 47 percent of the emotional-abuse-only referrals of children involved domestic violence (English, 1998).

In medical settings, where the most injurious forms of child abuse or neglect are seen, a high incidence of domestic violence appears to coexist. Stark and Flitcraft (1988) examined the hospital medical records of 116 children suspected of being abused or neglected. Forty-five percent of the mothers had medical histories that indicated or suggested abuse. McKibben, De Vos, and Newberger (1989) replicated the Stark and Flitcraft study at a Boston hospital and found that 59 percent of mothers of abused or neglected children had medical records that suggested they had been battered by their partners. The incidence of woman abuse was significantly greater than in a matched sample of mothers of non-abused/non-neglected children.

The co-occurrence of child abuse and partner abuse also has been documented in non-clinical samples. Research based on the results of a study of a sample of more than 3,000 American parents interviewed for the 1985 National Family Violence Survey (Straus & Gelles, 1986) revealed that of those husbands who were physically violent toward their wives, 23 percent physically abused a child as well. In this particular sample, each additional act of violence toward the wife increased the odds of the husband physically abusing the child by an average of 12 percent (Ross, 1996).

While most studies focus on the male as the perpetrator of violence against both the woman and the child, some research suggests that women victims of domestic violence are sometimes the perpetrators of child abuse. The results of a national survey of more than 6,000 American families suggest that battered women were at least twice as likely to abuse their children physically than were women who were not abused (Straus & Gelles, 1990).

A study of more than 400 battered women revealed that 28 percent of these women abused their children when living with violence, and 6 percent threatened to abuse their children. Moreover, 5 percent of the women used physical violence against their children when angry with the abusive partner (Walker, 1984). Similarly, Ross (1996) found that among a group of women who were violent toward their husbands, 24 percent also abused their children. These rates are higher than child abuse rates of parents who were not violent toward each other.

EFFECTS OF DOMESTIC VIOLENCE ON CHILDREN

hildren in violent homes face three risks: the risk of observing traumatic events, the risk of being abused themselves, and the risk of being neglected.

Child Observes Domestic Violence

While identification of, and response to, children who observe domestic violence is not yet well developed, evidence suggests that witnessing may be as harmful to children as suffering physical abuse (Margolin, 1998). Many people think that infants and young children are too young to process domestic violence. Studies suggest that young children can be overwhelmed by their exposure to violence, especially when both the victim and the perpetrator are well known and emotionally important to the child (Osofsky, 1996). Children from violent homes exhibit both more aggressive and delinquent behavior and more withdrawn, anxious behaviors in comparison to children from non-violent homes. Additionally, they perform significantly below their peers in such areas as school performance, organized sports, and social activities (Kolbo, 1996).

Deborah Sinclair (1985) documented reactions of children at various ages who had been exposed to violence in their homes. The reactions of children from birth to 5 years ranged from sleep disturbances to bed-wetting, separation anxiety, or failure to thrive. Children ages 6 to 12 exhibited eating disturbances, seductive or manipulative behavior, or fears of abandonment or loss of control, while adolescents tended to run away, become pregnant, experience suicidal or homicidal thoughts, or engage in drug or alcohol abuse.

It should be noted that most children exhibit some of these signs at various times in their development. Child protective services practitioners should be aware that if a child manifests several of these behaviors for an extended period of time, and they continue to increase in intensity, it is possible that the child may be experiencing domestic violence.

Child Observes and Victims Abuse

In an effort to learn more about the consequences domestic violence has on the psychological adjustment of children, researchers are also exploring the confounding effects of being both an observer and victim of domestic violence.

To assess the difference between children who had observed domestic violence (non-abused witness) and those who had both observed and been a victim of domestic violence (abused witness), Hughes (1988), divided children ages 3 to 12 years residing temporarily in a shelter into groups based on self-reports and information from their mothers. Abused and non-abused child observers of domestic violence were compared with children from a similar economic background on various measures. Results showed significantly greater distress (behavior problems, anxiety, and depressive symptoms) in the abused-witness children (55) than in the comparison group (83), with non-abused-witness children (40) falling between the two groups.

Witnessing abuse should be viewed as a potential risk factor rather than conclusive evidence of child maltreatment.

In a similar study, O'Keefe (1995) also found significant differences between non-abused child witnesses and abused child witnesses. In comparison to non-abused witnesses, abused witnesses are more likely to exhibit more aggressive behaviors. Abused witnesses perceive the quality of father-child relationship as more negative and are more likely to live in families where there is a greater frequency and severity of marital violence and less marital satisfaction.

Child Victims of Neglect Due to Domestic Violence

Parents who are victims of domestic violence may neglect their children for a number of reasons. They may give full attention to the abusive partner in an effort to appease and control the level of violence, or they may be unresponsive to children due to their own fears. In either case, the children can be seriously affected. According to Sykes and Symons-Moulton (1990), children who are neglected may show physical signs including failure to thrive, developmental delay, and listlessness. Behavioral problems may include begging for or stealing food and eating inappropriate objects; erratic school attendance; poor social relationships with peers; and delinquent acts such as vandalism, drug use, and drinking.

At the other extreme, some victims of domestic violence are so fearful of the abusive partner's focusing their anger on the children that they overdiscipline them in an effort to control the children's behavior and protect them from what they perceive as greater abuse.

Given the consequences of domestic violence for children, many professionals in the field are grappling with whether or not exposure to domestic violence is itself a form of child maltreatment. Research in this area initially focused on the documentation of the co-occurrence of domestic violence and child maltreatment. Subsequently, the focus of research shifted to the effects on children of witnessing domestic violence. Recently, some researchers have drawn the conclusion that exposure to domestic violence is in fact a form of child abuse (Rossman and Rosenberg, 1997).

Edleson (1997) advises caution in interpreting findings regarding the impact of witnessing domestic violence on the basis that each child will experience adult domestic violence in unique ways depending on a variety of factors including the child's gender, age, and relationship with adults in the home. In addition, many studies of child witnesses have drawn samples primarily from children residing in shelters thereby contributing more extreme findings than actually exist. Many children may, in fact, demonstrate a resilience to the violence by learning to cope with it in a number of constructive ways (Peled, 1993).

Thus, while witnessing abuse may at times rise to the level of psychological abuse of the child, for many children in such circumstances, this is not the case. Many battered women do attend to the psychological needs of their children. Witnessing abuse should be viewed as a potential risk factor rather than conclusive evidence of child maltreatment (Schechter and Edleson, draft due 1999).

RESPONSE TO DOMESTIC VIOLENCE AD CHILD MALTREATMENT

Researchers and practitioners have recognized the overlap between child maltreatment and domestic violence for more than a decade, yet the delivery of coordinated services to abused women and maltreated children has continued to be fragmented. Historically, several factors have contributed to this fragmentation: domestic violence and child protective services are at different points in their development; they have different philosophies and mandates; they use different professional terminology; and they generally see themselves as having different missions.

Recently, however, a number of new initiatives are providing a coordinated response to domestic violence and child abuse. These efforts frequently involve an approach that looks carefully at the strengths and needs of the entire family with the goal of developing a system response to protect both the child and the abused parent. Often, the approach includes a vision for community involvement to turn what has been viewed as a private family matter into an issue of community concern and community responsibility.

The primary focus of domestic violence and child protection programs has been on providing services for the battered woman and the child. Little information is available about services for the male perpetrator. What is known is that there is a lack of batterer intervention programs, an ongoing debate about their effectiveness, and a high rate of re-offending among batterers. Much work is needed to increase our knowledge about the effectiveness, availability, and quality of programs and services for male batterers. At the same time, community involvement from the courts and others is needed to get more men into intervention programs and to hold them accountable for attending and completing the programs (Carter & Schechter, 1997). An evaluation of the court review process for men referred to batterer counseling from the Domestic Violence Court in Pittsburgh found that court review dramatically increases compliance with batterer counseling and that court review and batterer counseling together lower recidivisim (Gondolf, 1998).

Aron and Olson (1997) studied five federally funded communities in which the child welfare agencies have made broad systemic changes to more effectively serve their child protection cases that are also affected by domestic violence. While each of the communities adopted different strategies for addressing domestic violence among the families in their caseloads, five key elements for success were found in all sites: awareness, understanding, motivation, tools, and other resources. Approaches employed by the communities included staff training and consultation; screening and assessment tools to aid in determining risk to the family unit and evaluating the family's ability to accept and use services; and the establishment of linkages with outside experts and partners to support caseworkers and families. The study provided recommendations for policy and practice changes to facilitate the coordination of services between CPS and domestic violence programs, including holding the violent partner, not the victim, responsible for "failure to protect" the child.

Collaborations between child abuse and domestic violence advocates and members of the community can make families safer.

Carter and Schechter (1997) described a four-step approach that enables child protective services and domestic violence programs to collaborate for the safety of the entire family: screening, investigating, assessing, and intervening. Intake/assessment procedures incorporate questions about both child abuse and domestic violence, and interventions are crafted for the family unit, not just the child or just the woman. Around this approach, the two workers from different service perspectives can organize their separate but related activities.

While new forms of collaboration enable child protective services and domestic violence staff to work together to reduce family violence, community partnerships bring neighborhood residents together to reach out to families experiencing child abuse and/or domestic violence. The Community Partnerships for Protecting Children, funded by the Edna McConnell Clark Foundation, demonstrate that collaborations between child abuse and domestic violence advocates and members of the community can make families safer. The partnerships enlist the community to respond to domestic violence and child abuse by adopting and funding prevention and intervention efforts that use the resources of neighbors, friends, churches, and other non-traditional supports for families (Carter, 1998).

There have been several Federal and local initiatives designed to address the overlap between child maltreatment and domestic violence and to build a collaborative response. In 1995, for example, the Children's Bureau funded five training grants in the priority area of working with families contending with domestic and/or community violence. The grants encouraged the development of training packages for in-service education to improve practice in child welfare. As part of the Office of Community Services (OCS) Family Violence Prevention and Services program, OCS funded domestic violence and child protective services collaboration grants. These grants encourage collaboration between child protective/child welfare agencies and independent domestic violence advocacy and services organizations. Between 1994 and 1996, 26 Domestic Violence/CPS Collaboration grants were awarded to support the development of training, intervention protocols, and screening tools that could be applied when domestic violence is encountered during investigation by CPS. A number of other Federal agencies, including the Office of Justice Programs and the Centers for Disease Control and Prevention, administer grant programs that focus on the relationship between domestic violence and child abuse. Additionally, the Children's Bureau funds several ongoing research projects examining the co-occurrence of child abuse and domestic violence. 1

Clearly, resources and expertise of both child protective services workers and domestic violence advocates are increasingly being blended to ensure the safety of all family members affected by violence and to provide comprehensive services. In both the federally supported initiatives and local programs, new and innovative solutions are evolving. Curricula for cross-training of domestic violence advocates and CPS workers have been developed, risk assessment protocols are in use to identify and intervene in cases of co-occurrence of domestic violence and child maltreatment, and services to parent victims and maltreated children increasingly are integrated. Following are a few examples of specific programs that address the overlap between violence against children and domestic violence. 2

These programs can be categorized by the following:

• Institutional change
• Training and curricula for child welfare
• Protocols
• Co-location of staff
• Multidisciplinary collaboration
• Support groups
• Other responses.

Institutional Change

• Aware that they shared an overlapping caseload of child abuse and domestic violence, Michigan's family preservation program, Families First, began a dialogue with the Governor's Domestic Violence Prevention and Treatment Board in 1993. After learning about each other and establishing common goals, Families First staff requested a domestic violence in-service training seminar for family preservation workers. This led to co-sponsorship with the Family Violence Prevention Fund of a national curriculum on domestic violence for family preservation workers. In 1995, Michigan became the first state to institutionalize mandatory training, provided jointly by Families First trainers and domestic violence advocates, for all family preservation managers, supervisors, and workers. This cooperation led to the first family preservation effort within domestic violence programs when family preservation teams were placed in battered women's shelters. Since 1995, the collaboration has been expanded to include Child Protective Services, with mandatory training on domestic violence for all CPS supervisors and workers, and CPS policy on how to handle child abuse and neglect cases where there is domestic violence.

• The Massachusetts Department of Social Services (DSS) began a joint effort between children's services and domestic violence advocates more than a decade ago through a Family Violence Prevention and Services Grant. In 1987, DSS began meeting regularly with battered women's organizations and in the early 1990s, the agency hired its first domestic violence advocate to provide education and consultation to CPS staff. Subsequently, DSS implemented two interdisciplinary pilot teams to staff difficult cases involving domestic violence and child abuse issues, eventually creating a statewide domestic violence unit with domestic violence specialists placed in local DSS offices. The Domestic Violence Unit provides case consultation, training, and information on community resources, and assists in implementing the Domestic Violence Protocol for CPS. Domestic violence working groups support the work of the unit's specialists by reviewing system-wide practices that might be changed to be more sensitive to issues of domestic violence.

Training and Curricula for Child Welfare

• The Family Violence Prevention Fund collaborated with several domestic violence programs to develop two training curricula: "Domestic Violence: A National Curriculum for Family Preservation Practitioners," and "Domestic Violence: A National Curriculum for Child Protective Services." Their goals were to foster collaboration between the fields of domestic violence and family preservation and domestic violence and child protection to provide training and assessment tools to help workers identify and treat victims of domestic violence.

• The Partnership Project on Domestic Violence includes the Simmons College School of Social Work, Massachusetts Department of Social Services (DSS), and two projects at Boston Medical Center: the Child Witness to Violence Project and the Family Nurturing Center. Working in one inner-city DSS area office, the Partnership Project developed and delivered training for supervisors in working with domestic violence situations and prepared training materials for DSS supervisors statewide. Project staff also supported an interdisciplinary domestic violence team meeting at the area office, and produced a periodic newsletter reviewing the content of the supervisory training sessions. In addition, the Project developed two new master's level courses for Simmons College School of Social Work, one on interagency collaboration and the other on domestic violence and child welfare.

• The Domestic Violence In-Service Training Program improves practice in child welfare and expands the scope of the partnership between the Social Work Program at Tennessee State University and the Tennessee Department of Human Services (DHS). The major goal is to enhance DHS child welfare workers' knowledge of effective clinical intervention skills with families contending with domestic violence.

• UCLA's School of Public Policy and Social Research, Department of Social Welfare, Center for Child and Family Policy Studies, developed an innovative domestic violence training for a select group of Los Angeles Department of Children and Family Services workers. The project provides innovative multidisciplinary, experiential, and solution focused training to child welfare workers.

• Columbia University School of Social Work in New York City created a 2-day training on domestic violence for child protective service workers. On the first day, participants complete exercises that help them become aware of their feelings regarding victimization and empathize with the position, plight, and peril of battered women and their children. On day two, participants learn how to assess, intervene and use the laws, protocols and resources.

Protocols

• Columbia University School of Social Work completed a study of a new protocol to identify and serve battered women developed and implemented by the New York City Child Welfare Administration. The study, entitled Evaluation of a Protocol to Identify Battered Women During Investigations of Child Abuse and Neglect, examined the effectiveness, beneficial outcomes, and possible obstacles to implementation through in-depth interviews and the collection of case record data.

• The Artemis Center for Alternatives to Domestic Violence in Montgomery County, Ohio authored Domestic Violence Protocol: A Guide for Child Protective Service Workers and Domestic Violence Advocates, which provides guidelines for assessing the co-occurrence of child maltreatment and domestic violence. The protocol describes potential indicators of domestic violence and child abuse; provides interview questions; and includes information on risk assessment, safety planning, and worker safety.

• The Massachusetts Department of Social Services created a Domestic Violence Protocol for CPS that outlines the procedures for risk assessment and intervention in cases of domestic violence. Collaboration among CPS, battered women's programs, the criminal justice system, and offender treatment programs is emphasized. Safety is a key issue within the provided guidelines for interview procedures, intervention strategies, and service plans.

• The National Woman Abuse Prevention Project published the manual Child Maltreatment and Woman Abuse: A Guide for Child Protective Services Intervention to provide CPS workers with guidelines for identifying and working with battered mothers of abused children who are already on their caseloads. The manual includes information on the co-occurrence of spouse and child abuse, the dynamics of domestic violence, the effects of witnessing domestic violence on children, as well as theoretical approaches and intervention strategies.

• New Hampshire's State Office of Victim/Witness Assistance has developed two publications addressing domestic violence protocols. The first, Division for Children, Youth and Families: Domestic Violence Protocol focuses on the identification of domestic violence within child protective services. A second publication, Domestic Violence: Multidisciplinary Protocols to Promote Effective Community Intervention in Response to Domestic Violence, includes protocols for law enforcement, mental health, clergy, medical, education, and superior court, in addition to child and family services.

Co-Location of Staff

• Child protective services in Jacksonville, Florida, is working together with the Hubbard House domestic violence program on cases that involve the co-occurrence of child abuse and neglect and domestic violence. A member of each child protection team has been assigned as a domestic violence consultant to focus on this issue.

• Domestic violence advocates from the YWCA are brought in to consult with the child protective services workers in Cedar Rapids, Iowa. The advocates provide counseling services, accompany CPS workers on home visits involving domestic violence, and attend CPS case consultation meetings.

• Several county child protective services in Oregon have hired a part-time domestic violence advocate who also works part-time in a shelter, while other counties include a domestic violence worker in weekly case-staffing meetings.

Multidisciplinary Collaboration

• Northeastern University's School of Law and College of Nursing in Massachusetts, in collaboration with the Dorchester Community Roundtable, has developed innovative prevention programs providing interdisciplinary training on intimate partner violence to Roundtable members and sectors of the community potentially important in coalitions for battered women, such as job training, day care, and public housing. The coalition established a Partner Violence Prevention Program and Advocacy Training Institute to train advocates and service providers, developed a program for protecting young children from the negative effects of witnessing intimate partner violence, provided an adolescent education outreach program delivered through school-based programs, expanded services for battered women, and enhanced batterer treatment programs to focus especially on youthful offenders.

• The Children's Institute International and the Wilshire Division of the Los Angeles Police Department work together to provide the youngest victims of domestic violence with help through Project Emergency Response Intervention Network (ERIN). Trained staff can provide 24-hour help, including crisis intervention and follow-up services to children who have witnessed, or are injured in, a domestic violence situation.

• The Women's Center and Shelter of Pittsburgh (WC&S), and the Children's Mental Health Project have joined forces to provide counseling services to children who have been exposed to domestic violence. WC&S helps to bring psychiatrists, social workers, and other professionals to children at six shelters in Allegheny County to provide evaluation, family counseling, and group services in hopes of preventing these children from becoming victims or abusers.

• The Child Development-Community Policing Program in Connecticut, created through a partnership between the New Haven (Connecticut) Police Force and Yale's Child Study Center, was developed to train law enforcement officials to identify child witnesses at the scene of violence and refer them to mental health professionals for services. The Program has also developed confidentiality protocols protecting the privacy of those who receive services.

• The Pennsylvania Bar Association, Pennsylvania Lawyer's Auxiliary, and Pennsylvania Coalition Against Domestic Violence worked together to produce Children of the Lie, a video that focuses on the children in families affected by domestic violence.

• The Children Who Witness Violence Project, in cooperation with Addison County (Vermont) Women in Crisis Parent/Child Center, Counseling Service of Addison County, and Middlebury Community Television, produced The Silent Victims, a video addressing the effects of witnessing domestic violence on children.

Support Groups

• The Albuquerque (New Mexico) Area Indian Health Board, in collaboration with the Albuquerque Indian Center, developed a community-based primary intimate partner violence prevention project using a framework developed by American Indians to mobilize, plan, and work toward preventing community problems. The project includes women's and children's support groups and a wellness group for men. Women's support groups will focus on women affected by intimate violence. Children's support groups will help children cope with family violence through activities planned in coordination with the Albuquerque Public Schools Indian Education program.

• Children in Crisis, sponsored by the Birmingham (Alabama) YWCA, is a support group that helps children who have witnessed domestic violence to understand and cope with the dynamics of living in violent, abusive, and/or neglectful homes. The program focuses on self-esteem, family violence, anger, divorce, and good and bad touches.

• The Liberty House Child Cope Program is administered by the Liberty House of Albany (Georgia) Women's Crisis Center and provides children exposed to domestic violence the opportunity to learn about issues related to family violence and to understand that many children have had similar experiences. Activities include play therapy, modeling, creative projects, and group discussions.

• The Center for Battered Women, the Austin (Texas) Independent School District, and the University of Texas developed a primary prevention program targeted to elementary schools entitled Expect Respect. Expect Respect is a comprehensive program specifically designed for elementary school students and their parents to educate children about equality, respect, and non-violence, and to present messages about relationships and violence to children that are consistent with those that they receive from adults. In addition to support groups for children and educational information for parents, a six-session intimate partner violence prevention curriculum is provided to 5th grade classes that stresses equality, respect, and non-violence.

Other Responses

• The Resource Center on Domestic Violence: Child Protection and Custody is operated by the National Council of Juvenile and Family Court Judges. The Resource Center is a source of information to those working in the field of domestic violence and child protection and custody. The Council recently published a guide to innovative programs: "Domestic Violence: Emerging Programs for Battered Women and their Children." In early 1999, the Council will publish a set of recommendations addressed to child protective services, domestic violence services, and juvenile and family courts. The book will be called: Effective Intervention in Woman Battering and Child Maltreatment Cases: Guidelines for Policy and Practice.

• The Domestic Intervention Assistance Line (DIAL) program is a service of the Kernersville Police Department and Family Services of Forsyth County, Inc. in North Carolina. The program provides a mobile phone, free of charge, to victims of domestic violence who meet criteria for participation in the program. In the event the victim is confronted by an abusive partner, they can immediately dial 911 for emergency assistance, from any location in the State. Priority for inclusion in the program is given to applicants who are pregnant, who have children, or whose abusers have been physically violent to the children.

• The National Center for State Courts operates the Families and Communities Research Division, which oversees a number of projects addressing the overlap between child maltreatment and domestic violence within a court setting. Current projects include a program expansion that focuses on families affected by both child maltreatment and domestic violence to document how these factors influence the service plans and delivery, and researching court responses to custody disputes that involve domestic violence. The Center also has developed Domestic Violence and Child Custody Disputes: A Resource Handbook for Judges and Court Managers, to assist court professionals in determining whether a custody dispute also involves domestic violence, and the most effective way to approach these cases. The handbook addresses issues including the best interest of the child, safety for battered women, and collaboration among government and community service agencies.

• The Department of the Navy Family Advocacy Program (FAP) developed a Navy-specific Risk Assessment Model to address the intake, investigation, and delivery of individualized services in response to reports of child maltreatment and family violence. Modifying the traditional process of investigating all calls without distinction, the model provides tools, such as a risk assessment matrix, to help prioritize the calls with greater need, and match the response and family services appropriately. Each of the risk domains in the matrix includes factors that address child abuse and neglect, spouse abuse issues, or both, paying particular attention to the overlap between child abuse and domestic violence

CONCLUSION

Research studies clearly document that children are affected by domestic violence and that, not infrequently, child maltreatment and spouse abuse occur in the same families. Children in abusive families may be seriously affected by the violence found in their homes. Studies show that the effect of both experiencing maltreatment and witnessing family violence may produce greater negative effects than either factor alone. More and more, battered women advocacy groups and child welfare agencies/CPS are recognizing the need to provide coordinated services to families experiencing violence. Research and service projects are being funded at the local and Federal level to address the overlap between child maltreatment and spouse abuse. Each effort adds to the field's knowledge and expertise in serving families where children are involved in domestic violence situations. The potential for true reform in service delivery is found in a small but growing number of battered women services, batterer intervention programs, and child welfare agencies that represent balanced collaboration between the fields, with each learning from the other while working together. These projects and others like them represent new opportunities to protect both women and children from violence while also preserving family ties and promoting mother and child well-being.

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U.S. Department of Health and Human Services, Children's Bureau. (1998). Child Maltreatment 1996: Reports from the States to the National Child Abuse and Neglect Data System. Washington, DC: U.S. Government Printing Office.

U.S. Department of Justice, Bureau of Justice Statistics. (1995). Violence against women: Estimates from the redesigned National Crime Victimization Survey. [Press release, on-line]. Available: www.ojp.usdoj.gov/bjs/press.htm.

Walker, L. E. (1984). The Battered Woman Syndrome. New York, NY: Springer Publishing Company, Inc.

SELECTED RESOURCES FOR CHILD MALTREATMENT
AND DOMESTIC VIOLENCE INFORMATION

The Battered Women's Justice Project (800) 903-0111
Offers training, technical assistance, and resources on legal issues related to domestic violence.

The Health Resource Center on Domestic Violence (800) 313-1310 or
(888) 792-2873
Provides information, technical assistance, and library services to strengthen the health care response to domestic violence.

Institute on Domestic Violence in the African American Community
(612) 624-5357
Provides information on research, services, and responses to prevent and reduce family violence in the African American community.

National Clearinghouse for the Defense of Battered Women (215) 351-0010
Offers assistance, resources, and support to battered women charged with crimes, and to their attorneys, advocates, and expert witnesses.

Resource Center on Domestic Violence: Child Protection and Custody
(800) 527-3223
Provides information, materials, consultation, and technical assistance related to child protection and custody within the context of domestic violence.

Sacred Circle National Resource Center to Stop Violence Against Native Women
(877) 733-7623
Offers specialized training institutes, on-site technical assistance, and culturally specific materials addressing domestic violence in tribal communities.

Texas Council on Family Violence National Hotline (800) 799-SAFE
Operates a multilingual 24-hour hotline to provide crisis intervention, information and referrals to local programs.

The National Resource Center on Domestic Violence (800) 537-2238
Provides information, resources, policy development, and technical assistance designed to enhance community response to, and prevention of, domestic violence.