Perspectives on Innovative Interdisciplinary Organizations
Prevent Child Abuse America
By Anne Reiniger, M.S.W., J.D*

"If 20 million people were infected by a virus that caused anxiety, impulsivity, aggression, sleep problems, depression, respiratory and heart problems, vulnerability to substance abuse, antisocial and criminal behavior, retardation and school failure, we would consider it an urgent public health crisis. Yet, in this country alone, there are more than 20 million abused, neglected and traumatized children vulnerable to these problems. Our society has yet to recognize this epidemic, let alone develop an immunization strategy for it." Bruce D. Perry MD, PhD, CIVITAS Childhood Trauma Programs.

Mission: To prevent the abuse and neglect of our nation's children.

Core Values: Valuing children, strengthening families and engaging communities.

Guiding Principles: Leadership, collaboration, integrity, diversity and respect, and research-based

Scope of the Problem: Each year an estimated three million cases of suspected child abuse and neglect are reported to Child Protective Services agencies. More than three children die each day in America from child abuse and neglect. There is no disease or natural disaster or trauma that is killing more children under the age of four than abuse and neglect.

The annual cost to society of child abuse and neglect is estimated at $94 billion. For every dollar spent on treatment, America spends one penny on prevention.
According to a study conducted by PCA America in 2001, it is estimated that child abuse and neglect cost this country $258 million each day - equivalent to $1,461.66 per American family. For every dollar spent on child abuse prevention, at least two dollars are saved that might otherwise have been spent on child welfare services, special education services, medical care, foster care, counseling, and housing juvenile offenders. An additional survey has shown that 83% of Americans believe it is possible to prevent abuse and neglect before it starts, yet for every dollar spent on the treatment of child abuse, the U.S. spends only one penny on prevention.

In 2000, a survey conducted by PCA America found that nearly one-half of Americans with children believe that parents find themselves in situations where they are afraid they might abuse or neglect their child more than just occasionally, and 43% of parents reported hitting or spanking their child. Nearly 70% of Americans surveyed also believe that educating new parents about the developmental stages and needs of their children can be an effective tool in reducing the incidence of abuse or neglect.

Overview: In 1972 Prevent Child Abuse America (then called the National Committee for the Prevention of Child Abuse) was created to build a nationwide commitment to preventing child abuse and neglect. We are an interdisciplinary family of physicians, social workers, lawyers, law enforcement, nurses, professors, psychologists, teachers, policy makers, volunteers, donors and parents who are preventing child abuse and neglect before it starts. Since 1972, Prevent Child Abuse America has led the way in building awareness, providing education and inspiring hope to those involved in the effort to prevent the abuse and neglect of our nation's children. Working with chapters in 40 states and the District of Columbia, we provide leadership to promote and implement prevention efforts at both the national and local levels. With the help of our state chapters we're strengthening families and engaging communities nationwide.

Our many local programs, prevention initiatives and events help spread the word in communities throughout the nation, creating awareness that prevention is possible. Today, Prevent Child Abuse America is widely known for its public awareness, education, prevention programs (such as Healthy Families America and Circle of Parents), advocacy and research. In 1986 we founded the National Center on Child Abuse Prevention Research which researches the effectiveness of prevention efforts.

Chapter Network: We believe that a strong presence at both the state and national level is essential to leading child abuse prevention efforts. We have chapters chartered in 40 states and the District of Columbia and our goal is for a chapter in every state. The chapters are the child abuse prevention leaders in their state and all of them work to raise public awareness and educate the general public. They also advocate for effective laws and adequate funds to prevention services and efforts, serve as an information resource to parents and professionals, offer 1-800 help lines and provide training to professionals and parents.

Prevention Programs:

Healthy Families America: In 1992 Prevent Child Abuse America launched Healthy Families America. This innovative voluntary home visiting service seeks to prevent child abuse and neglect, promote positive parenting and encourage child health and development. The home visitors reach out to overburdened parents of newborns, and in many communities' expectant families, and offer ongoing service of support, counseling, education and referrals to help them to raise their children in a most positive way. The service is provided to families based on their needs and continues to be available to them until their child is ready for school or Head Start. The home visitors are well trained and supervised paraprofessionals and the staff includes social workers and health professionals. Sponsoring agencies include community based agencies, universities, medical centers, and public and private local social service and health agencies.

There are over 430 sites in 39 states. PCAA credentials the sites to assure they adhere to proven best practices standards that ensure the highest quality of service delivery. For more information please check our Healthy Families America website at www.healthyfamiliesamerica.org.

Circle of Parents: These mutual self-help parent support programs, a collaboration of Prevent Child Abuse America and the National Family Support Roundtable is funded through grants from the US HHS Office on Child Abuse and Neglect (OCAN) and the US Department of Justice Office of Juvenile Justice and Delinquency Prevention (OJJDP). Through this grant we have established 400 new groups and nine new state networks across the country.

These programs are a time-tested child abuse prevention approach that promotes positive parenting through open-ended weekly meetings free to anyone in a parenting role. This program model provides confidential and non-judgmental groups in which caregivers can participate. Under the guidance of a trained facilitator, parent leaders learn how to help other caregivers offer and receive insight into common problems. Some sites also provide children's programs too.

Research: The National Center on Child Abuse Prevention Research was established in 1986 to increase the understanding of the complex causes of child maltreatment and to establish an empirical base of information of the effectiveness of child abuse prevention programs. In 1994, the Center established a formal national network of prevention researcher to solidify the link between research and practice.

Public Awareness and Education: Initially, Prevent Child Abuse America focused on public education. Through a partnership with the Advertising Council we got the prevention message out to the general public. We produced and disseminated "What Every Parent Should Know", the first of many educational pamphlets. Public opinion polls indicate that the percentage of people aware of the problem of child abuse has increased significantly over the years. Prevent Child Abuse America is the leading organization in America that changes public attitudes toward child abuse and neglect in a large part through its ad campaigns with the Ad Council.

In addition to our national media campaigns, Prevent Child Abuse America produces and maintains a library of more than 70 publications, which have an annual circulation of more than two million throughout the United States, Canada, and Europe. Included is a series of Spiderman comic books. These comics have proven to be an effective tool in teaching children and adolescents about such topics as fatherhood, sexual abuse, emotional abuse and bullying.

Since 1983, the April Child Abuse Prevention month has become a national event. Prevent Child Abuse America distributes thousands of "Prevent Child Abuse" packets. This material is designed to seek the involvement of entire communities by encouraging the formation of partnerships to build a support network for families and children.

Advocacy: Prevent Child Abuse America is a leader in educating our policymakers at the federal, state and local levels about the need for laws ensuring child abuse prevention services and research and to ensure that adequate funding is provided to them. We took the lead in establishing Children's Trust Funds in almost every state. Using both public and private revenue sources, these trust funds serve as a continuous funding mechanism for child abuse prevention efforts at the state and community levels.

Prevent Child Abuse America has been instrumental in ensuring that the Child Abuse Prevention and Treatment Act is reauthorized and that funding is continued for local child abuse prevention effort through Community-Based Resource and Support grant. We also worked to ensure the enactment of the Adoption and Safe Families Act, which reauthorized the Family Preservation and Family Support grants (renamed Safe and Stable Families). Many of our Healthy Families America sites are funded in part by these monies. Prevent Child Abuse America was also instrumental in assuring the enactment of the Child Abuse Prevention and Enforcement Act (CAPE). This law gives state and local official the flexibility to use existing Department of Justice program funds to prevent child abuse and neglect, and to intervene and protect children who have been mistreated.

Prevent Child Abuse America recently adopted a public policy agenda which sets forth the important child abuse prevention issues and is a guide for policymakers and advocates to establish child abuse prevention as a national priority.

Public Policy Agenda:

Preamble
Historically, our nation largely viewed child abuse and neglect as a private family matter, best left unexamined except in the most extreme cases. Over the years, however, a new public consensus has emerged calling for the protection and nurturing of children as essential to society's health and future potential. Most Americans now agree that we all have a responsibility to protect children from maltreatment and to promote their optimal growth and development. Prevent Child Abuse America believes that the most effective and humane way to do so lies in fostering the conditions necessary for successful families, thereby preventing child abuse and neglect from developing in the first place.

When child maltreatment is not prevented children and families as well as society as a whole suffer. Taking into account mental health services, crime, medical care, and child protection services, Prevent Child Abuse America estimates that child maltreatment costs the United States $94 billion a year. Consequently, the prevention of child abuse and neglect demands the attention of policymakers because of the human toll maltreatment exacts on children and the high cost maltreatment imposes on society.

This public policy agenda represents a set of policies that, if fully implemented, will significantly reduce child maltreatment and foster the development of healthy and nurturing families. The public policy agenda does not offer pat, one-size-fits-all solutions. To do so would ignore the diversity of American families and the situations they face. Instead, it calls on policymakers to recognize the continuum of public policies that need to be in place to support American families. Such a range of policies reflects the broadened scope of child abuse and neglect prevention - taking us beyond traditional child abuse and neglect prevention approaches such as home visiting and public education - to include related policies that address economic stability, substance abuse, domestic violence, housing, healthcare, and child care.

We all have a role to play in preventing child abuse and neglect. Individually, we strive to be better parents and neighbors. As communities, we come together to create safe and healthy environments in which to raise children. Public policy shapes such efforts in fundamental ways, setting national and state level priorities, and providing and directing essential resources. Child abuse prevention and the issues surrounding it need to be a priority. This document provides the roadmap; as advocates, concerned citizens and policy-makers, we must pave the way.

Public Policy Agenda

The following public policy agenda encompasses the policies that Prevent Child Abuse America believes are essential to preventing child abuse and neglect and to fostering healthy and nurtured families. These policies fall under eleven broad categories:

• Promoting Parent Support and Parent Education
• Promoting Family Economic Stability
• Promoting Healthy and Age-Appropriate Development
• Promoting Health
• Addressing Substance Abuse
• Promoting Early Education and Child Care
• Preventing Child Sexual Abuse
• Promoting Safe and Non-Violent Environments for Children and Families
• Promoting Systems Reform
• Promoting Research
• Promoting Public Awareness and Education

POSITION STATEMENTS: Prevent Child Abuse America has issued position statements that are at the core of our work. They are as follows:

Preventing Child Neglect
Child neglect is the most common form of maltreatment and, although pervasive and sometimes life threatening, is often difficult to identify. Child neglect can lead to depression, apathy, lack of empathy, and, too frequently, to criminal behavior and in some instances death.

We, as a nation and as individuals, have the collective responsibility to promote strong and healthy families, thereby preventing neglect. To accomplish this, we must strengthen services that prevent child abuse and neglect and support children and families. And we must promote research, training, and public education to address the risk factors that can lead to child neglect and to foster the factors that protect against it.

PCA America Advocates for:

• Increasing services to families such as home visiting, early childhood education, parent education, and family planning.

• Providing mental health services to parents who need and want such services, and making mental health services available to victims of child neglect as early as possible to prevent the future perpetuation of neglect.

• Increasing efforts to address social problems such as poverty, substance abuse, and family violence which are related to child neglect.

• Increasing public awareness efforts to educate the public about child neglect and how it can help to prevent it.

Preventing Child Physical Abuse
Child physical abuse brutalizes, traumatizes, and intimidates children, and can lead to physical injury, violent behavior, mental and medical health problems, long-term physical and mental disability, brain injury, and in some instances death.
We, as a nation and as individuals, have the collective responsibility to promote strong and healthy families, thereby preventing child physical abuse. To accomplish this, we must strengthen services that prevent child abuse and neglect and support children and families. We must enact legislation to protect children from child physical abuse. And we must promote research, training, and public education to address the risk factors that can lead to child physical abuse and to foster the factors that protect against it.

PCA America Advocates for:

• Increasing funding for effective family support services such as home visiting, parent support groups, and parent education classes.

• Allocating increased resources to initiatives that address the co-occurrence of child abuse and domestic violence.

• Increasing research to enhance the effectiveness of existing prevention programs.

Preventing Child Emotional Abuse
Child emotional abuse is a misunderstood, insidious, and psychologically damaging form of child maltreatment, which can lead to low self-esteem, anxiety, depression, and self-destructive behavior.

We, as a nation and as individuals, have the collective responsibility to promote strong and healthy families, thereby preventing child emotional abuse. To accomplish this, we must strengthen services that prevent child abuse and neglect and support children and families. And we must promote research, training, and public education to address the risk factors that can lead to child emotional abuse and to foster the factors that protect against it.

PCA America Advocates for:

• Increasing research efforts to gain a clear understanding of the origins, nature, and risk factors of child emotional abuse.

• Increasing research so that family support programs can effectively address child emotional abuse.

• Raising public awareness on what is currently known about the severity, prevalence, and warning signs of child emotional abuse.

• Making mental health services available to both victims and perpetrators of child emotional abuse to prevent the intergenerational transmission and future perpetuation of child emotional abuse.

Preventing Child Sexual Abuse
Child sexual abuse exploits and degrades children, and can lead to feelings of hopelessness, depression, and to self-destructive and anti-social behaviors.

We, as a nation and as individuals, have the collective responsibility to prevent child sexual abuse. To accomplish this, we must strengthen child abuse prevention services that support children and families. We must enact legislation that protects children from child sexual abuse. And we must promote research, training, and public education to address the risk factors that can lead to child sexual abuse.

PCA America Advocates for:

• Raising awareness of the dangers of child sexual abuse, and promoting the notion that stopping child sexual abuse is everyone's responsibility.

• Educating the public, especially policymakers, about the true nature of child sexual abuse.

• Rigorously evaluating and strengthening existing child sexual abuse prevention programs.

• Shifting the prevention of child sexual abuse from children to adults.

• Exploring, evaluating, and strengthening new approaches to child sexual abuse.

Promoting Effective and Nurturing Parenting
Effective parenting and nurturing familial relationships lay the foundation for healthy children and a stable and productive society. Families need to be supported by policies and services that ensure that children live in nurturing and safe environments free from abuse and neglect, thereby enabling children to reach their full potential.

PCA America supports public policies that promote effective parenting, and that reinforce parents' aspirations to raise their children in loving, supportive, and healthy homes.

PCA America Advocates for:

• Increasing funding for family support programs and other necessary supports so that they can be established in all communities and made available to all families.

• Raising the value of parenthood among members of our society so that voters and communities agree that such services are worthy of funding.

• Conducting research to understand the best ways to reach parents and the public with messages underscoring the importance of family support programs.

*Anne Reiniger is the chair of the Board of Prevent Child Abuse America and former Executive Director of The
New York Society for the Prevention of Cruelty to Children.

Preamble
From, Suzette (2001). "Total Estimated Cost of Child Abuse and Neglect in the United States:
Statistical Evidence." Chicago, IL: Prevent Child Abuse America. Available online at http://www.preventchildabuse.org/learn_more/research_docs/cost_analysis.pdf


Editor's Note: Prevent Child Abuse America is one of the most highly regarded and respected child abuse prevention and child advocacy organizations in the world. To learn more about Prevent Child Abuse America and its many State chapters, you can click here www.preventchildabuse.org.