Preventing Child Abuse and Neglect with Parent Training: Evidence and Opportunities

Article excerpt

Improved parenting is the most important goal of child abuse prevention. Parents maltreat their children for many reasons and combinations of reasons. In the past three decades, researchers have identified four common co-occurring issues--parental substance abuse, parental mental illness, domestic violence, and child conduct problems--that are related to parenting and that lead to child maltreatment. Understanding and responding to these issues is fundamental to designing effective parenting education programs that can help prevent abuse and neglect. One key decision facing those who design such programs is whether (and the extent to which) a parenting program should directly address these related problems or whether efforts to improve parenting should focus primarily or solely on improving parenting skills, with the expectation that the negative effects of these other problems on parenting may recede if parenting programs are effective.

A fifth risk factor for child abuse is family poverty. Every national incidence study of child abuse and neglect has shown that poor families are disproportionately involved with child welfare services. Parenting education, however, is not designed to reduce poverty, and that risk factor will not be further discussed below. See the article in this volume by Fred Wulczyn for a discussion of family poverty and child maltreatment.

What Parental Behaviors May Lead to Child Abuse and Neglect?

A description of the prevalence of the co-occurring risk factors among parents who abuse and neglect their children sets the stage for a discussion of parenting education elements that may mitigate the untoward effects of these co-occurring problems.

Substance Abuse

Substance abuse by a child's parent or guardian is commonly considered to be responsible for a substantial proportion of child maltreatment reported to the child welfare services. (1) Studies examining the prevalence of substance abuse among caregivers who have maltreated their children have found rates ranging from 19 percent (2) to 79 percent or higher. (3) One widely quoted estimate of the prevalence of substance abuse among caregivers involved in child welfare is 40 to 80 percent. (4) An epidemiological study published in the American Journal of Public Health in 1994 found 40 percent of parents who had physically abused their child and 56 percent who had neglected their child met lifetime criteria for an alcohol or drug disorder. (5)

Substance abuse has its greatest impact on neglect. In the 1994 study noted above, respondents with a drug or alcohol problem were 4.2 times as likely as those without such a problem to have neglected their children. In another study conducted during the 1990s, child welfare workers were asked to identify adults in their caseloads with either suspected or known alcohol or illicit drug abuse problems. (6) In 29 percent of the cases, a family member abused alcohol; in 18 percent, at least one adult abused illicit drugs. These findings approximate those of the more recent National Survey of Child and Adolescent Well-Being (NSCAW) that 20 percent of children in an investigation for abuse and neglect had a mother who, by either the child welfare worker's or mother's account, was involved with drugs or alcohol; that figure rises to 42 percent for children who are placed into foster care. (7) These studies have clearly established a positive relationship between a caregiver's substance abuse and child maltreatment among children in out-of-home care and among children in the general population. Among children whose abuse was so serious that they entered foster care, the rate of substance abuse was about three times higher. (8) Thus, substance abuse by parents of victims of child abuse may not be as common in the general child welfare services-involved population as often believed, but substance abuse appears to be a significant contributor to maltreatment.

The mechanism by which substance abuse is responsible for child maltreatment is not as evident (outside of the direct relationship created by the mandated reporting of children who have been tested to have been born drug-exposed). …