Preventing Physical and Psychological Maltreatment of Children in Families

Key Results

1. The general term ‘maltreatment’ is now used in the literature to cover the range of adult behaviours and motivations that can cause psychological and physical injury to children. Child maltreatment covers physical abuse, sexual abuse, psychological abuse and neglect. (This report for the Campaign for Action on Family Violence focuses primarily on physical and psychological abuse.)
2. While psychological abuse of children can occur without physical abuse, physical abuse is almost always accompanied by psychological abuse. There are some common harmful and long-reaching consequences, eg learning impairments, mental health and social relationship difficulties associated with both psychological and physical abuse of children. There are also a set of distinct consequences that can follow from each type of abuse. Psychological abuse increases the risk of emotional damage, eg to self esteem, while physical abuse is more strongly associated with externalising behaviours and aggression.
3. While children of all ages can experience physical and psychological abuse, babies, toddlers and adolescents from the age of 11 are at a higher risk of being injured from physical abuse than primary school-aged children.
4. Recent research has shown clear evidence that the developing brain is damaged by prolonged, severe or unpredictable stress, such as that caused by maltreatment in a child’s early years.
5. The evidence indicates that the prevalence of child maltreatment is higher in deprived families and communities than in well-resourced families and communities.
6. Child maltreatment is best understood by analysing the complex interaction of predisposing, perpetuating and precipitating factors.
   • Predisposing factors are those that relate to the parent or caregiver’s early history. These include genetic characteristics and growing up in a violent or abusive environment
   • Perpetuating factors are those that affect the family in a continuing or ongoing way. These include:
     • the wider social context and community factors eg policies that lead to poor living standards, over-crowding, poor housing or to socioeconomic inequality or instability, social and cultural norms that promote violence and physical punishment of children and that diminish the status of the child in parent-child relationships, easy availability of alcohol in a binge drinking society and a local drug trade, social isolation and lack of appropriate or responsive supports and services.
     • the family context eg family relationship factors (such as unintended pregnancy, lack of parent-child attachment, large family; multiple births or children close in age), financial deprivation/stress, unemployment, intimate partner conflict/violence and lack of extended family support.
     • the characteristics and behavioural patterns of the parent or caregiver, eg lack of bonding with the baby, depression or other physical or mental health problems, alcohol/drug abuse, inadequate parenting skills, involvement in criminal activity, lack of impulse control, rigid thinking, low empathy, unrealistic expectations of the child.
     • the characteristics and behavioural patterns of the child, eg unwanted child, young age, disability, high needs, demonstrating personality or temperament traits perceived as problematic by adult family members.
   • Precipitating factors are those events that directly trigger an abusive episode and include incessant crying, soiling, aggressiveness by the child, or a crisis event for the parent.
7. Guided by the literature, six approaches for primary prevention efforts to reduce child maltreatment have been identified:
   • Establish a positive view of children: valuing them in their own right rather than primarily for the manner in which they meet the needs of others, respecting them as individual human beings with rights to protection and gradually increasing levels of autonomy.
   • Change attitudes and beliefs about physical punishment.
   • Reduce adult partner violence and educate about the impact of adult partner violence on children.
   • Address adult alcohol and substance abuse.
   • Create accessible and responsive support systems that parents can easily engage with.
   • Provide parent education and skills to all parents.
8. Parent education programmes are not always protective against child maltreatment. Those that have been effective have been influenced by the following findings and conclusions from the research:
   • Information about normal crying and normal child development has been shown to be helpful in reducing maltreatment.
   • There is a strong case for tailoring parent education for men and for women, taking into account the different needs of each gender.
   • The use of same ethnic group workers has been found to enhance recruitment and attendance at parent education programmes.
   • The success of parent education is more likely with programmes that include group education, individualised help and home visiting.
   • Programmes based on a combination of changing attitudes, increasing knowledge and child management skills are more likely to be effective than programmes that emphasise any one of these factors
   • Programmes aimed at changing parents’ behaviour need to be optimistic and emphasize the parents’ ability to change. Parents need to be aware that change takes time; there will be setbacks, but this does not mean the new approach is not working.
9. Providing social support without judgment and criticism as well as being sensitive to parent perceptions of judgment and criticism are important factors in lowering barriers to help-seeking.
10. For severe baby and child battering types of child abuse, public awareness and education aimed at extended family, witnesses and bystanders is more likely to be helpful than awareness and education interventions aimed directly at the parents.
11. The following steps can help to increase the likelihood that witnesses and bystanders will intervene to stop maltreatment or to report abuse:
    • Promote awareness of behaviours that constitute child maltreatment in a way that does not perpetuate stereotypes or create shame, and empowers people to take action.
    • Promote understanding of the effects of maltreatment on children.
    • Provide access to help, support and advice.
    • Give practical tips on how to intervene.
    • Provide information about all the options:
      • direct communication with the adults
      • engaging others eg family members and friends
      • consulting experts
      • referring to sources of help
      • reporting to authorities.