Prevention of child abuse and neglect

Reducing the incidence and recurrence of child maltreatment are crucial initiatives, because of the resultant ill effects (49 and difficulty in instituting effective treatments, quite apart from the humanitarian prerogative. Family support—and education concerning parenting, child development, and the management of problems—has a positive impact on parental attitudes and knowledge as well as on observed behaviour. (41> Significant effects on children's behaviour, cognitive outcome, and child maltreatment rates are less clear. There is a greater impact upon physical abuse than on neglect. (4 ,42>

Brief interventions are beneficial for low-risk parents, whereas more intensive approaches are needed for higher risk groups. (4!> High-risk groups include deprived impoverished parents, young mothers, and those with a personal history of childhood abuse themselves. However, for a prevention approach to be effective it must be personalized to the needs of the individual families and include outreach components for the most negative and hard to access parents. (41> Including males, whether resident or occasional visitors, is crucial to maintaining and sustaining improvements in parenting and child care. Equally, effective programmes are more likely to be valued by the parents themselves, underlining the importance of matching the skills of staff and the contents of programmes with the families' specific needs. (42> Programmes need to be culturally sensitive if they are to be effective and accepted by parents. (49 Interventions are most effective when they impact upon a broad network of influences and relationships, ranging from those of the immediate family to broader neighbourhood and social influences on the child's welfare. (43)

Sexual abuse prevention is probably ineffective when aimed at enhancing children's capacity to protect themselves. (41 On the other hand, programmes which include parents (and increase their capacity to keep their children safe) and incorporate antibullying tactics are much more likely to be effective, although this probably stems from increasing disclosure of early sexually abusive actions rather than primary prevention. (4142» Additionally, broader social initiatives to reduce child sexual abuse within schools and institutions are essential to a comprehensive area strategy. (41>

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