More effort needed to prevent pattern of child abuse developing in families

Children who have been abused are at risk of recurrence and effective prevention strategies are urgently needed, say the authors of a randomized trial published online today by The Lancet.

Recurrence of child maltreatment is a major problem.

In a study involving 163 Canadian families with confirmed child physical abuse or neglect, Dr. Harriet MacMillan, professor of psychiatry and behavioural neurosciences at McMaster University, and colleagues tested whether regular home visits by public-health nurses prevented recurrence of abuse when compared to standard services from child protection agencies (CPA).

Standard services included routine follow-up by CPA caseworkers to assess risk of reoccurrence and provide education about parenting. Investigators found that after three years of follow-up the recurrence of physical child abuse and neglect did not differ between the groups.

About half the intervention families (47 percent) and control families (51 percent) had a recurrence of neglect. Additionally, 33 percent of the intervention group and 43 percent of the control group had a recurrence of physical abuse. The authors say that there is a high risk of abuse and neglect recurring when a child remains in the home, and there is currently no intervention proven to reduce the risk.

Dr. MacMillan concludes: “The high rates of recurrence in this study suggest that substantive efforts must be invested in prevention of child abuse or neglect before a pattern is established.”