Many difficulties stem from the victims that have faced and will face child abuse and neglect on a daily basis. The research into the root causes, effects, intervention, and prevention of child abuse and neglect has become abundant to the point, that it is unclear as to which approach would be most successful in curbing the tide of child violence and neglect. A thorough analysis of the research that is currently available helped to enable finding options for addressing the problem, how early prevention works, warning signs to look out for, and effective programs developed for schools. To properly evaluate how effective the current wellness programs in preventing or treating victims of child abuse and neglect, it is important to first define what the issue entails. “Each State provides its own definitions of child abuse and neglect based on minimum standards set by Federal law. Federal legislation lays the groundwork for States by identifying a minimum set of acts or behaviors that define child abuse and neglect” (Child Welfare Information Gateway). An essential aspect of the Federal government, in this sense, is to define the laws broadly so that the states can make more stringent regulations as they see fit. “The Federal Child Abuse Prevention and Treatment Act as amended by the Keeping Children and Families Safe Act of 2003, defines child abuse and neglect as, at minimum: Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act which presents an imminent risk of serious harm” (Ibid). Uniting a movement to improve programs and literature so the issue can be prevented from occurring to a child is paramount to a youth’s development in any region of the world.
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It is therefore extremely important to note the issues early, so that possible victims and caretakers can be proactive versus reactive. Examination of child abuse and neglect victims in the field of psychology has shown that, “…problems with self-management, impulse control, frequent anger outbursts, substance abuse, developmental delays, antisocial [behavior], [as well as] difficulty with concentrating in school and symptoms of psychopathology, for example, depression, psychotic disorder” (Christoffersen & DePanfilis, 2009, p. 32). These symptoms cannot always be avoided, no matter what treatment is applied later, which is the reason that early education is crucial. Developing a holistic approach to treat such conditions early on and to continue to monitor, as well as, educate participants is definitely the best route to take, but it can also be expensive and possibly unaffordable.
Research Figures
Statistics about child abuse and neglect victims help lay a foundation of what factors are in the equation in order for appropriate policy, regulations, and campaigns to be produced. Mogans Christoffersen and Diane DePanfilis’ journal article, Prevention of Child Abuse and Neglect and Improvements in Child Development (2009), studied whether an improvement in mental development of children could be enriched by the reduction of certain abuse and neglect conditions. Their research indicated that, “70 percent of children in the study who had been exposed to physical abuse were exposed to psychological maltreatment as well, while 73 percent of the children who had not been exposed to physical abuse did not experience psychological maltreatment” (Christoffersen & DePanfilis, 2009, p. 31). Another even more concerning topic is the underreporting with some of the conditions or stimuli found in their research. They found that, “child abuse and neglect on the basis of recorded files may underestimate the number of abused children in the community,” (Ibid, p. 37) because of the ramifications of such actions. Child victims can sometimes fear reporting because of not wanting to get in trouble, as well as, adults that fear that they could cause a child to be taken away from his or her family. Preparedness for addressing these types of frequently asked questions should be a key aspect of treatment for victims. The article indicated that a “comprehensive assessment should specify the treatment because different types of abuse and neglect require different types of interventions” (Ibid, p. 38). Maltreatment of children has numerous more categories than just abuse or neglect. Therefore, a tailored treatment to the situation needs to be used; otherwise the intervention part of treatment will be inadequate.
Policymakers and researchers have found that child abuse affects the development of a number of mental and physical factors in a child, which may not be apparent at first glance. “While physical abuse might be the most visible sign, other types of abuse, such as emotional abuse or child neglect, also leave deep, long lasting scars” (Saisan, Smith, & Segal, 2010). It was found that, “our failure as a nation to implement effective policies and strategies to prevent child abuse and neglect costs taxpayers $104 billion per year and does not consider the personal toll on the victimized child” (Hmurovich, 2009, p. 12). In these studies, it became apparent that the effects of not attempting to discuss this issue more have adversely affected all of the stakeholders involved. It is therefore within the best interest of the United States, as well as, many countries around the world to be more mindful of the problem.
The old adage, “timing is everything” is crucial to the matter of early intervention and prevention services. A reason for this is, “the earlier abused children get help, the greater chance they have to heal from their abuse and not perpetuate the cycle” (Saisan, Smith, & Segal, 2010). What may shock many people about this issue is the people that are generally involved in these matters already know each other. About, “95 percent of the sexual abuse of youngsters is done by family members, those who work with children, or those who know them. Current information indicates that strangers essentially make up about 5 percent of the reported documented cases” (Friedman, 2010). The stigma that ensues for parents of child abuse victims is that they do want their child’s past to follow them around for the rest the child’s life. Caretakers and parents of many children might prefer to use alternative methods to resolve the matter in a private way so as to not have it show up anywhere on the child’s personal record (Ibid). This form of underreporting unfortunately allows the criminal to continue to repeat his or her actions and not get punished (Ibid). It is the responsibility of the community to be a sort of checks and balances to counteract this type of disregard for the greater good of their municipality.
Putting research into action, enough to make a significant difference, is the next logical step for thwarting child abuse and neglect. An abused child’s life can be and will be forever changed after the action that occurs. Much of the research in academia about the matter, “[shows] a strong correlation between child abuse and neglect and debilitating and chronic health consequences, delinquency, criminal behavior, mental health illness, drug dependency and lower academic performance” (Hmurovich, 2009, p. 12). The result is a child that has unnecessary issues, which could have been avoided with earlier treatment. In the United States, abuse and neglect is a high enough concern, for the general populace, that it justifies talking and working with families and providers about what they can do. Emotional distress from unpermitted behavior of a penalizing adult or older child always causes deep impacts in the community at large (Friedman, 2010). The community has to therefore communicate with children at different stages in the education process.
Addressing the Problems
A multifaceted approach of, “…child abuse and neglect prevention must be understood uniformly and the message must be to prevent child abuse and neglect from ever happening. To implement a national child abuse and neglect prevention policy, it is essential that funding streams be assessed and then realigned” (Hmurovich, 2009, p. 12). After finding where and how much cash will be needed to provide the solutions to the problem it is necessary to make a strategic plan of how to implement the changes. An integral part of the strategic plan should be training community members, specifically youths, in ways to be sensitive to the problems of child abuse and neglect. “Training methods can be divided into two distinct groups: information-based approaches and behavioral skills training programs. In information-based approaches information is presented verbally by the trainer or through the use of a video, play, or activity book” (Kopp & Miltenberger, 2009, p. 193). In information-based training the material that children learn include, how to prevent attacks or abuse, and then are tested to see if they retained the information (Ibid). The other approach known as behavior skills training seeks to see how well a child has retained information by having them perform specific actions. “Children in behavioral skills training programs are presented with similar information; however, behavioral skills training programs emphasize active rehearsal of skills by the participants” (Kopp & Miltenberger, 2009, p. 193). At the moment, there is no foolproof method to determining which families in communities are at higher risk for child abuse and neglect (McCurdy, 1995). There are no social, economic, gender, racial, or political barriers that can properly be correlated or connected with the type of person that will commit such behavior. Since the act of abusing a child seems to cross all barriers; it becomes paramount to find ways to strongly address this issue.
Coordinated efforts have been established to try and see if there is a connection between any particular groups of people other than by demographic. The results were definitive, but are not quite as simple to recognize as a standard indicator. A plethora of, “theoretical models exist that suggest that certain personal, familial, and environmental factors contribute to an increased likelihood of maltreatment. For example, learning theories suggest that individuals who have been raised in abusive or neglectful environments or have had limited experiences with positive relationships are likely to replicate these parenting behaviors with their own children” (Ibid). Models however are only one aspect of the comprehensive effort to reducing the epidemic of child abuse and neglect that occurs in the United States every day.
Not only is it surprising that it is usually a family member or close friend of the child that performs the malicious act of child abuse and/or neglect, but also stress can cause onset reactions towards underlying motivations to the action. “Individuals under stress or lacking the emotional or financial capacity to deal with the demands of child rearing may lash out at their children. Still others argue that social policies that fail to nurture positive human interactions and leave communities without adequate social, health, or educational infrastructures create an environment ripe for abusive and violent behaviors” (Ibid). On the neglect side of the issue, there are also many warning signs that the community needs to examine. An example could be that a home is normally empty with no adult supervision, while the children in the household cause issues in the community or the streets (Pennsylvania Family Support Alliance). Whether it is abuse or neglect that a community is dealing with, it is always crucial to start interpreting the root causes sooner rather than later.
Early Prevention
Recognizing the signs of abuse before they become a problem that can be solved without criminal or legal action can usually help people have a greater ability to cope. Moreover, it is useful to demonstrate to communities across the country that abuse and neglect are a global problem, and not just one found in the United States (Phakathi, 2009). If the issue were to hit closer to home such as a, “husband or boyfriend of the victim’s mother, than it would not be as hard for the family to notice sexual abuse, according to a study done by the United Nations Children’s Fund (UNICEF) in association with the Centers for Disease Control and Prevention (CDC) in the United States of America” (Ibid). Conversely in the same study it was found that, “emotional abuse typically came from female relatives” (Ibid). Naturally the information found from the study can be used to help recognize and prevent some of the frequently caused risk factors associated with abuse.
In order to avoid the externalities that face communities if they do not take a path towards early intervention and prevention, it is helpful to remind them of the loved ones that are in danger if appropriate actions are not taken. “Moreover, the pictures of missing children that appeared on milk cartons, billboards, and telephone books were and are constant reminders that untold numbers of children have disappeared, some possibly becoming victims of sexual abuse” (Reppucci & Haugaard, 1989, p. 1266). Reporting improper conduct can be a difficult aspect to swallow for those that are most at risk because they may not be mature enough to comprehend the gravity of the situation (Ibid). “First, the child must recognize that he or she is in an abusive situation. Then the child must believe that he or she can and should take some sort of action. Finally, the child must possess and use specific self-protective skills” (Ibid, p. 1267). According to the article Prevention of Child Sexual Abuse: Myth or Reality by Reppucci and Haugaard (1989) they found that in order for programs to be effective they must also be age appropriate.
Warning Signs
Being highly perceptive to the needs of a community or to the needs of an individual child takes training and some common sense. A greater awareness cannot only save the lives of some but improve the lives of many. The research done from the website Helpsite.org on the topic of child abuse and neglect sheds some light on the subject. The warning signs that a child might exhibit include:
“Lack of trust and relationship difficulties – Abuse by a primary caregiver damages the most fundamental relationship as a child that [they] will safely, reliably get [his or her] physical and emotional needs met by the person who is responsible for [his or her] care. Without this base, it is very difficult to learn to trust people or know who is trustworthy. This can lead to difficulty maintaining relationships due to fear of being controlled or abused. It can also lead to unhealthy relationships because the adult doesn’t know what a good relationship is” (Saisan, Smith, & Segal, 2010).
“Core feelings of being “worthless” or “damaged” – [Many are] told over and over again as a child that [they] are stupid or no good, it is very difficult to overcome these core feelings. [The child] may experience them as reality. Adults may not strive for more education, or settle for a job that may not pay enough, because they don’t believe they can do it or are worth more” (Saisan, Smith, & Segal, 2010).
“Trouble regulating emotions – Abused children cannot express emotions safely. As a result, the emotions get stuffed down, coming out in unexpected ways. Adult survivors of child abuse can struggle with unexplained anxiety, depression, or anger. They may turn to alcohol or drugs to numb out the painful feelings” (Ibid).
Prevention Programs
“Child abuse prevention efforts are of 3 general types…primary prevention efforts… [which] address a broad segment of the population (such as all new parents), secondary prevention efforts, such as the home visitation (or nurse-family partnership) program…target a specific subset of the population considered to be at higher risk for child maltreatment, [and] tertiary prevention efforts target perpetrators of child maltreatment and seek primarily to prevent recidivism” (Dias, et al., 2005). The most commonly used programs that fall under primary prevention are student education programs done in public schools. These programs are extremely popular, because they teach children at a very early age what abuse really is, and how to protect themselves against it. Because “child abuse prevention education can be a very frightening introduction to sexual issues,” (Whatley & Trudell, 1988) many of these school based programs are taught as part of a larger personal safety or health and wellness course. This also eases some parent’s objections that the subject matter is too intense for small children. In addition to arguments regarding subject matter, there are also opponents of school based abuse prevention instruction that feel these programs “implicitly challenge the sanctity of the family” (Whatley & Trudell, 1988) by taking the power to educate children away from the parents. These detractors are in the minority, however, and as of 1991, “61% of all elementary schools report[ed] offering some kind of preventive education” (Plummer, 2001). While these programs are popular with public schools nationally, Indiana itself has no law mandating sex abuse education courses, and there is no uniformity among the schools that do teach it. Some education classes are taught as aforementioned, in connection with the health and safety curriculum by the students’ teacher, while others are only taught briefly, during a special presentation for the class or the entire school. Still other public schools, and many private schools do not teach the curriculum at all, due to “limited funds, lack of staff, lack of trained staff, topic not viewed as a high priority, topic should be addressed by parents, [or] counselors handle the problem when necessary…” (Lanning & Massey-Stokes, 2006).
Another common form of primary prevention efforts focus on educating the parents about child neglect, child abuse, and sexual abuse, before an incident arises; often before a child is even born. Because the highest percentage of victims of maltreatment are under the age of one (Wu, et al., 2004), many preventative programs seek to educate parents on how to deal with excessive crying, stress, or post-partum emotions before the birth of the child. One program, utilized in 16 New York hospitals required all families to undergo a Shaken Baby Syndrome tutorial, with bilingual leaflets, a short video, and a question and answer session with a nurse before they were permitted to be discharged (Dias, et al., 2005). Each parent also had to sign a contract stating that they had received the tutorial and understood the dangers of shaking their child. Evaluation of this program revealed that there was a statistically significant reduction in infant maltreatment, and more specifically Shaken Baby Syndrome among recipients of this educational program. There are other preventative programs for expectant teenage mothers, and even parenting education courses offered at many high schools. The state of Indiana offers public high school students a course titled Child Development and Parenting, which covers all aspects of parenting from nurturing a child, to how much money is necessary to meet the needs of a child, as well as how to handle stressful situations in a calm manner (Education, 2005).
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Many other primary preventative programs “assist parents to maintain an adequate standard of parenting by providing parents with information about the challenges of parenting and the skills they need to parent effectively, and by enhancing their access to social supports” (Tomison, 1998). These programs not only offer skills training and counseling, but partner with other government and non-governmental organizations that provide welfare services such as WIC, food stamps, and job training courses to help prevent the poverty and hopelessness that can lead to child neglect or abuse. There are also programs that offer education about sex abuse to parents, to help reiterate what their children are taught in school about the subject. Many parents do want to discuss this topic with their children, but studies have shown that many are ill informed about the subject, and may pass on incorrect information to their children. Parents often believe, and tell their children that child molesters are always male, and always strangers, when in fact, most abuse is perpetrated by someone the child knows quite well, who could be either male or female (Wurtele & Kenny, 2010). Parents can also endanger their child when explaining what to do in a potential abuse situation. Many parents will tell their child to first say no or try to get away, but some parents will even tell their child to fight back against an abuser, which could have potentially life-threatening results. These educational programs can also inform parents what to do if they believe a child is being sexually abused. According to Wurtele, a study of parents who did not attend child abuse prevention workshops showed that “parents more often mentioned notifying the victim’s parents or the abuser’s employer in response to a disclosure of…” child sexual abuse, (Wurtele & Kenny, 2010) instead of notifying child protective services or the police department, which would have been the correct approach. Educating parents about sexual abuse not only gives them a better understanding of the truth about molestation, but also shows them the proper steps to take when confronted with abuse, and how to pass on correct information to their children.
Secondary preventative efforts, or programs that target a specific “at-risk” sub-population are usually in home visitation programs where a social worker or trained nurse will visit the family and “offer parent education and/or family support including information on health, nutrition and safety, and advice on the mother-child interaction…and may also monitor the child’s wellbeing and assist families to connect to other services and resources” (Kovacs, 2003). Families that are selected for secondary preventative efforts are usually either identified as high risk for possible maltreatment, or have had issues of abuse previously and are being monitored by child protective services or another non-governmental agency. In the state of Indiana, Healthy Families Indiana uses a multi-tiered assessment process using participation in WIC and other state funded assistance programs, along with other variables to determine if a family falls under the high risk category, and thus into the voluntary home visitation program (IN.Gov, 2010). These programs help to reduce the stress of the parents, while simultaneously giving them the tools needed to get out of the high risk category through career training, monetary support with WIC and other welfare programs, and development of parenting skills. These visitations also allow the social worker to carefully monitor the child and the home for any signs of neglect or maltreatment before they arise or quickly enough afterward to begin counseling and limit the emotional or physical damage.
Finally, tertiary prevention efforts are there to help families that have already suffered from a form of child abuse, and to prevent further abuse, or recidivism, from occurring. These programs are mostly state agencies such as child protective services, which monitor families much in the same way that they are monitored in the home visitation programs. The only difference is that this intervention is not voluntary on the part of the family, and the families are selected based on the specific criteria that abuse has already occurred in some form within the home, making these families even more “at risk” than any other group (Dias, et al., 2005).
While there are distinct differences in the structure, targeted audience, and accessibility of each of the types of prevention efforts, all three have a common problem: awareness. Many organizations, especially non-profit organizations, are either ill equipped monetarily or lack the necessary marketing skills to advertise their programs within the community, and therefore fail to reach families that desperately need their services (Kovacs, 2003). Marketing outlets such as brochures, flyers, television and radio ads, as well as billboards not only increase awareness about the programs in a specific area, but also about the issue of child abuse, how important it is, and how it can and needs to be prevented.
The Basics of Nonprofit Marketing
In order understand why a public education campaign would be useful, appropriate, and feasible to a nonprofit organization’s cause, one must first have some background information on how campaigns fit into the overall marketing strategy for an organization (Andreasen, 2008).
Public Education Campaigns
Public education campaigns send messages to target audiences in order raise awareness of social issues, change beliefs, and in some cases inspire a behavioral change (Tabachnick, 2001). The goal of a public education campaign is to motivate people and to “change social behaviors and norms” (Pollard, 2006). Public education campaigns are very important, because raising awareness around issues leads to behavioral and attitude changes, which leads to changes in actions and community norms (Tabachnick, 2001). For example, a child abuse and neglect prevention campaign geared towards adults could educate adults about what the signs of abuse are, then they can start to look for or identify possible signs of abuse when working with children, and eventually they will start to take action and call authorities when neglect happens, or talk with parents before the abuse even takes place.
Specifically, a child abuse and neglect prevention campaign can “translate complicated messages into specific, easily understood, messages about prevent”, they can also reach a wider audience and educate more individuals. Once the campaign is actually implemented, it can reduce the marketing and communications staff time, because the messages are out there and going viral, the research, messages, and implementation strategies can also be reused for long-term projects (Ibid).
In order to be upfront and proactive, it is important to address some of the drawbacks of public awareness campaigns. First of all, a successful and effective campaign will take many hours of staff time researching, planning and coordinating. Many organizations decide to work with a marketing and public relations firm to conduct their campaigns as to not take their staff away from every day duties (Ibid). In fact, some research suggests that it is a must for an individual to have worked with an advertising agency for a successful campaign. “An ad agency represents a concentration of creative talent, production skills and proven marketing success, and they are skilled at analyzing public trends and communicating with specific target audiences. A public institution is unlikely to have these skills” (Murray & Seabeastan). Secondly, campaigns using mass media may not connect with every audience member. Some may feel that the message is not geared toward them and are not relevant. Often times campaign messages are too complicated and confuse people with new concepts and requests. “The golden rule in this instance should be less is more” (Ibid). Another drawback is that campaigns can be very difficult to assess their effectiveness. One cannot easily judge how many drove by and actually read a billboard, watched the PSA, listened and remembered the radio ad, etc. This can be very costly to assess who was affected positively by the campaign in large communities (Tabachnick, 2001).
Best Practices in Public Education Campaigns
There are several ways to conduct public education campaigns, and in fact, there is no one “right” way. All organizations research, plan, implement and evaluate their campaigns very differently, and have different resources, inputs, and experts guiding this process. However, through research, there are several best practices that have emerged to conduct an impactful and lasting public education campaign. Some of the best practices include: identifying the scope and location, researching the target audiences, messaging, goals, implementation steps, evaluation techniques, updates on campaign, and conducting a reminder campaign.
Stop It Now!, a national child sexual abuse prevention program with affiliates in several states, did a great job creating local campaigns and identifying the correct scope for each location. Each of their public education campaigns conducted were based off of their local needs, local stakeholders and had a local look and feel in regards to messaging. Examples of focus areas and specific target audiences messaging for different state campaigns include: Georgia’s focus is on “bystanders” – caring adults in a position to help, Virginia’s focus “trusting your gut”, Philadelphia’s focus is on “warning signs”, and Minnesota’s focus is on “targeting the challenged population”. Focusing on local audiences “avoids stereotypes, while honoring stakeholder expectations and local sensitivities” and proves for a more successful campaign that effectively reaches campaign goals (Tabachnick, 2001).
One of the first full-scale public health campaigns designed to target adults for prevention occurred in Vermont, and depended upon a plethora of research to implement a successful campaign. Officials first reviewed the public’s attitudes, awareness, knowledge that adults face as obstacles to preventing child abuse (Ibid). Through research they identified several obstacles, such as “characteristics of an abuser and enabing factors”. Once this background research was conducted, the public education campaign strategies could be planned, implemented and evaluated.
When a campaign chooses a message, it is important to be consistent and to use the same one throughout all media channels in order to stick with the public. The messages may also need to be translated or re-written for diverse cultures to identify with (Ibid). An example of this comes from, Paro, a nonprofit health care provider located in San Francisco that was reaching out to a diverse group of local residents that come for low-income homes. The organization was not seeing an increase in the number of clients served and the residents that were aware of their helpful programs. Therefore, the organization made a strategic communications decision to focus on “translation services, sensitivity to cultural differences, and response to public feedback”. They began by translating their marketing materials in various venues at an appropriate reading level including outdoor billboards and posters, collateral material and their website. Then, they created separate documents for each ethnic group in their service region (Hispanics, Vietnamese and Chinese) and paid close attention to the colors of the documents to not offend any particular culture. Finally, Paro made an assertive effort to hire more multicultural employees and set up a member advisory committee. This campaign was literally designed for and by the residents benefiting from Paro services (Nastu, 2007). When planning and public education campaign, it is important to remember that thoughtful well-written messages that the target audience identifies with, need to be future oriented and support solutions that are helpful and essential for the whole community (Hughes, 2009).
Once a scope, location, target audience, and messaging is identified, then one can start to implement their campaign through a variety of steps and marketing and public relations strategies. There are many examples of way organizations implement their public education campaigns, which include: hotlines, educational vides, advertising on tv, radio, and print media, public service announcements, pocket guides, social marketing, websites, billboards, transit advertising, community action kits, posters, educational booklets, as well as promotional materials such as t-shirts, wrist
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