What Is Child Maltreatment and How Can It Be Prevented?
Child maltreatment broadly refers to instances where a child sustains harm due to abuse or neglect by a caregiver. There are numerous types of child maltreatment, and states have authority to determine exact definitions of what constitutes child maltreatment. Child maltreatment is associated with many risk and prevention factors and is a complex problem with neither a singular cause nor solution that prevents child maltreatment from occurring.
In 2021, child protection agencies received nearly 4 million referrals alleging maltreatment of 7.2 million children. Two-thirds of the calls came from mandatory reporters, including teachers, police officers, lawyers and social services staff. Fifteen percent of child maltreatment reports in 2021 were confirmed as child maltreatment. The same year, more than 391,000 children were in the foster care system.
The problem of child abuse and neglect has serious, long-term consequences for victims and high costs to society. In 2012, a study by Prevent Child Abuse America estimated the annual nationwide cost to society of child abuse and neglect was more than $80 billion. The Centers for Disease Control and Prevention used 2015 data to estimate lifetime economic costs of child maltreatment of more than $830,000 for a single nonfatal case and up to $16.6 million for a fatal child maltreatment case. Beyond the financial costs, being the subject of a child protective services investigation due to a child maltreatment allegation can also be traumatic for families and children.
While some types of child maltreatment have declined substantially over the last three decades, the field of child welfare is currently wrestling with how to balance preventing child maltreatment before it happens and protecting children from harm when it does occur.
Over the last decade, research on risk factors for child maltreatment, protective factors that can mitigate risks, and how certain policies can prevent child abuse and neglect have pointed policymakers in a new prevention-oriented, family-centered direction. This research provides insights into the myriad of policy levers available to state legislators.
Evidence suggests that by significantly reducing child abuse and neglect at the population level, child, family and community well-being will improve across many societal domains, and states will realize significant cost savings over time when compared to the long-standing reactive, crisis-oriented approach.
Family First Prevention Services Act
The child welfare field in recent years has seen a marked shift toward preventing child maltreatment before it occurs, in addition to responding to both suspected and substantiated cases of maltreatment. This shift was bolstered by the passage of the Family First Prevention Services Act in 2018. The goals of Family First are to keep families intact and significantly reduce out-of-home placement of children.
To incentivize reforms in state child welfare systems, Family First uses funding criteria to make funds available to states for prevention through and limits the use of congregate care services. When group or institutional placements are necessary, Family First allows the use of Title IV-E funds for Qualified Residential Treatment Programs rather than traditional congregate care.
Though Family First encourages states to adopt upstream strategies for preventing maltreatment, the law is widely regarded as a historic move in the right direction rather than a gold standard. The child welfare field broadly recognizes that additional efforts farther upstream are still needed to more fully prevent child maltreatment. As of February 2023, 35 states, the District of Columbia and several tribal jurisdictions have federally approved Title IV-E plans under Family First.
Levels of Prevention Policy
Policies for preventing child abuse and neglect can be designed and implemented at several levels. One common framework for prevention recognizes three basic levels of prevention strategies.
- Primary prevention strategies include interventions or resources available to the public aimed at preventing child maltreatment before it occurs. Public awareness and education campaigns and universally available early childhood education programs are examples of primary prevention strategies.
- Secondary prevention strategies are designed for a targeted population with known risk factors for child maltreatment who are at risk of child welfare system involvement. These strategies also help prevent child maltreatment from occurring by recognizing that certain family and community risk factors such as poverty, substance misuse or parental mental health challenges can make a child more vulnerable to maltreatment.
- Tertiary prevention strategies focus on families where child maltreatment has occurred with a goal of preventing reoccurrence. Intensive family preservation services offered through child welfare systems or parent support groups to help strengthen protective factors and parenting practices are examples of tertiary prevention strategies. This level of prevention can be useful in reducing the need for a child to be removed from their home or to support safe reunification of families. Family First seeks to shift focus and funding from tertiary to secondary prevention.
Experts believe the most effective approaches to child maltreatment prevention require a variety of strategies implemented at each level of prevention. Effective approaches to child maltreatment prevention also recognize families are impacted by the community they live in and the individual histories of each family member. Community, family and individual risk factors are important considerations for child maltreatment prevention.
This report presents a high-level summary of current evidence of the effectiveness of prevention strategies, along with over 30 policy levers for state lawmakers to consider. Each of the levers detailed below can be designed and implemented in different ways to better meet specific state needs for child maltreatment prevention and reducing family involvement in child welfare systems.