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Domestic Violence, Child Abuse, and Youth Violence: Strategies for Prevention and Early Intervention

Author: Janet Carter

Family Violence Prevention Fund
383 Rhode Island Street, Suite 304
San Francisco, CA 94103-5133
Tel: (415) 252-8900
Fax: (415) 252-8991
Email: janetc@fvpf.org

© Family Violence Prevention Fund


Abstract:
A growing body of clinical experience and research reveals that domestic violence and child abuse occur in the same families and are highly associated with similar social and economic risk factors. Data also show that children growing up in violent families are more likely to engage in youth violence. Furthermore, the social and economic risk factors for youth violence correspond to the risk factors for domestic violence and child abuse. Given these findings, an effective strategy to combat child abuse, domestic violence and youth violence would be a collaborative, community-based prevention/early intervention effort that aims to reduce the social and economic risk factors for at-risk families. This paper outlines proposed components of such a program and presents a strong argument for the development of national and local collaborative prevention efforts between the three fields.




I. Overlap and Consequences of Child Abuse, Domestic Violence, and Youth Violence

Child abuse and domestic violence often occur in the same family and are linked in a number of important ways that have serious consequences for the safety of all family members as well as for members of the larger community. First, where one form of family violence exists, there is a strong likelihood that the other one does too. Second, research shows that the impact on children of witnessing parental domestic violence is strikingly similar to the consequences of being directly abused by a parent, and both experiences are significant contributors to youth violence. Third, many of the factors highly associated with the occurrence of child abuse are also associated with domestic violence, and many of these are the same factors that put children at risk for youth violence and adult violent crime. Overlapping all these problems is substance abuse, which is associated with each form of violence as a co-factor. These linkages have important implications for intervention and prevention efforts.

The concurrent incidence of domestic violence and child abuse within the same families is well documented. In a national survey of over 6,000 families, researchers found that 50% of the men who frequently assaulted their wives also frequently assaulted their children.1 Reviewing 200 substantiated child abuse reports, the Massachusetts Department of Social Services found that 48% of the case records mentioned adult domestic violence.2 Among hospitalized child abuse cases, 59% of mothers of abused children have been found to be beaten by their male partners.3

Domestic violence and child abuse take a devastating toll on children and society at large. Early childhood victimization, either through direct abuse, neglect, or witnessing parental domestic violence, has been shown to have demonstrable long-term consequences for youth violence, adult violent behaviors, and other forms of criminality.4

Children can be killed, physically injured, psychologically harmed, or neglected as a result of either domestic violence or child abuse. From 1990 to 1994, 5,400 children are known to have died from abuse or neglect.5 Studies suggest that domestic violence was present in a large percentage of these cases: The Oregon Department of Human Resources reports that domestic violence occurred in 41% of the families in which children had been critically injured or killed.3 In fact, the U.S. Advisory Board on Child Abuse a nd Neglect suggests that domestic violence may be the single major precursor to child abuse and neglect fatalities in this country.7

Domestic violence perpetrators sometimes intentionally injure children in an effort to intimidate and control their adult partners. These assaults can include physical, emotional, and sexual abuse of the children. Children may also be injured - either intentionally or accidentally - during attacks on their mothers. An object thrown or a weapon used against the mother may hit the child. Assaults on younger children may occur while the mother is holding the child, and injuries to older children often happen when they attempt to protect the mother by intervening.

Even when domestic violence does not result in direct physical injury to the child, it can interfere with both the mother's and the father's parenting to such a degree that the children may be neglected or abused. A perpetrator is clearly not providing good parenting when he physically attacks the child's mother. The physical demands of parenting can overwhelm mothers who are injured or have been kept up all night by beatings. The emotional demands of parenting can be similarly daunting to an abused woman suffering from trauma, damaged self-confidence, and other emotional scars caused by years of abuse. In addition, abusers often - as a means of control - undermine their partner's parenting.

Children whose mothers are abused sometimes suffer at the hands of their mothers as well. One study found that the rate of child abuse by mothers who were beaten is at least double that of mothers whose husbands did not assault them.8

Children of all ages are deeply affected by domestic violence and by child abuse. Infants exposed to violence may not develop the attachments to their caretakers that are critical to their development; in extreme cases they may suffer from "failure to thrive." Preschool children in violent homes may regress developmentally and suffer sleep disturbances, including nightmares. School-age children who witness violence exhibit a range of problem behaviors including depression, anxiety, and violence towards peers.9

The impact of domestic violence and child abuse may continue through adolescence and adulthood. Adolescents who have grown up in violent homes are at risk for recreating the abusive relationships they have seen.10 They are more likely to attempt suicide, abuse drugs and alcohol, run away from home, engage in teenage prostitution and other delinquent behavior, and commit sexual assault crimes.11 A study conducted by the Office of Juvenile Justice and Delinquency Prevention found that 70% of adolescents who lived in families with parental conflict self-reported violent delinquency, compared to 49% of adolescents from households without this conflict. This study also revealed that exposure to multiple forms of violence, including domestic violence, child abuse, and general family climate of hostility, doubles the risk of self-reported youth violence.12

Researchers have also found that men who as children witnessed their parents' domestic violence were twice as likely to abuse their own wives than sons of nonviolent parents.13 A significant proportion of abusive husbands grew up in families where they witnessed their mothers being beaten. Clearly, domestic violence and child abuse are spawning grounds for the next generation of abusers, as well as for violent juveniles.

In 1994 there were an estimated 2.9 million reports of suspected child abuse and neglect.14 Data from a 1995 Gallup Poll of family violence suggest that from 1.5 million to 3.3 million children witness parental domestic violence each year. These are sobering statistics in light of the known impact of child abuse and witnessing domestic violence on each child, the social costs associated with it.15

The overlap between child abuse and domestic violence is not limited to their consequences or prevalence. Many of the risk factors that are highly associated with child maltreatment are the same factors that put women at risk for domestic violence and children at risk for juvenile violence. For example, child abuse risk factors include young age of parents, social isolation, the abuser's history of being a victim of child abuse or a witness to domestic violence as a child, and poverty, among others.16

Similarly, research on domestic violence risk factors shows that women in low-income households experience a higher rate of violence by an intimate partner than women in households with higher incomes. The rate of intimate partner violence against women generally decreases as household income levels increase. Also, younger women, aged 16-24, experience the highest per capita rates of domestic violence, and slightly more than half of female victims have children under the age of 12.17

Social isolation characterizes many families in which either domestic violence or child abuse is present,18 although it is not always clear whether the isolation causes the abuse or whether the abuse causes the isolation. A study of the social support and social network relationships of neglecting and non-neglecting, low-income, single, African-American mothers found key differences in the mothers' perceptions of their relationships and interactions. The study found that negative relationships were an important differentiating factor between neglecting and non-neglecting mothers. The relationships of neglecting mothers were characterized by conflict, distrust, and lack of mutuality, while non-neglecting mothers experienced satisfying supportive relationships which emphasized a sense of mutuality and fairness.19

Another recent study in Chicago demonstrated a strong correlation between violence rates and community cohesion. Researchers found that several neighborhoods with characteristics generally associated with high crime rates, such as poverty, unemployment and single-parent households, nevertheless had low rates of violence. The common factor in these neighborhoods was high levels of collective efficacy, a term defined as a sense of trust, common values and cohesion in neighborhoods.20 The study concludes that "the combined measure of informal social control and cohesion and trust remained a robust predictor of lower rates of violence."21

Finally, a significant portion of child abusers, domestic violence perpetrators, and violent juvenile offenders grew up being abused themselves and/or witnessing their parents' domestic violence. However, exposure to child abuse or domestic violence as a child is not the only risk factor for juvenile violence. Living in an impoverished community that is rife with drugs, guns, and crime, having parents that use harsh or erratic discipline, and being isolated from the community, family, or school - all of these also put children at higher risk.22 These factors are, again, strikingly similar to those contributing to both forms of family violence.

Child welfare and domestic violence organizations are now beginning to recognize the overlap between domestic violence and child abuse and the need for collaborative efforts between the two fields. In the few communities where child welfare agencies and domestic violence programs have developed collaborations aimed at intervening in both forms of family violence, early results are promising. These efforts have underscored the need for collaborative efforts to focus on identifying these families earlier on in the cycle of family violence, and on preventing the violence in the first place.

Moreover, there has never been a comprehensive community-based prevention/early intervention collaboration that addressed all three interrelated types of violence - child abuse, domestic violence, and youth violence. The overlap of factors that we have seen contributing to all these forms of violence provides a fertile ground for successful and urgently needed collaborative prevention efforts.

II. Need for Prevention/Early Intervention of Family and Youth Violence

The separate institutional and grassroots responses to child abuse and domestic violence which have taken place over the last two decades in the form of intensive services for battered women and abused children, while critical, have proved woefully inadequate. In fact, both of these problems continue unabated.

Despite more than 1800 domestic violence programs across the country, the media reports almost daily grisly stories of battered women doing all the right things: calling the police, obtaining restraining orders, getting divorced, moving away - only to be murdered (often along with their children) by their batterers. Almost four million women were abused in the last year alone.23

Likewise, child deaths and injuries continue to mount. In 1994, there were an estimated 2.9 million reports of suspected child abuse and neglect compared to 1.2 million in 1982. Between 1985 and 1992, the number of child maltreatment reports rose by 6% per year.24 In 1990, 143,300 children were reported with serious injuries due to maltreatment; more than three children die per day because of child abuse and 87% of these deaths are children under age five.25 Of the 2.9 million reports in 1994, about one in three were substantiated as involving maltreatment, with neglect being the most frequent type substantiated (53% of substantiated cases).26

In addition, there has been a dramatic increase in youth violence. In 1993, U.S. juvenile courts processed nearly 1.5 million juvenile delinquency cases. Juvenile courts receive an average of 55 delinquency cases for every 1,000 juveniles age 10 or above living in their jurisdiction. Statistics show that the juvenile court's caseload rose 23% between 1989 and 1993, while the juvenile population increased by less than 8% during the same period. Between 1989 and 1993, person offense cases processed by juvenile courts (including criminal homicide, forcible rape, aggravated assault, simple assault and other violent sex offense) increased by 52%, a much greater increase than in most other case types.27

As the number of child abuse reports rise, CPS continues to be the only organization mandated to respond. Thus, diminishing resources are directed more and more to only the most serious cases, leaving little or no attention being paid to the less serious cases. While primary prevention is important, it is also critical that we as a society are able to reach out to families in the early stages of escalating violence. Our current child protection system (CPS) is seriously inadequate at doing this.

Clearly, then, financial and programmatic resources must be directed to prevention, not just emergency service. In addition to saving lives, prevention efforts save dollars. In 1995, federal and state spending specifically on child welfare programs exceeded $11.2 billion. This does not include funds spent on individual cases by allied government systems such as the courts, law enforcement, schools, or the health and mental health care systems.28Cost-effective prevention programs could save millions. The current child protection system, domestic violence intervention services, and responses to youth violence devote relatively few resources to prevention/early intervention.

A growing body of evidence supports the need for early intervention into childhood development of criminal propensities. Research has shown that early intervention efforts enjoy public support and are proving to be effective in reducing criminal and delinquent behavior.29 The social factors that these successful prevention programs address are similar to those found to be associated with domestic violence and child abuse, and the contribution of family violence to later youth violence, is clear. This overlap cries out for collaborative prevention efforts between the fields of family and community violence.

III. Elements of Successful Family and Youth Violence Prevention/ Early Intervention Efforts

Both the domestic violence and child abuse fields are relatively new to prevention. Child abuse prevention programming has included public education campaigns aimed at changing the social norms that ignore and support child abuse, and mobilizing individuals to take actions that protect children. More recent prevention efforts have involved providing support to new families, such as home visitation or family support programs. Domestic violence prevention efforts are even more recent than those aimed at child abuse, and have primarily focused on changing the social norms that turn away from and/or tacitly support violence against intimate partners, either through public education campaigns or through education aimed at youth through the schools.

In contrast, more substantial efforts have been made to prevent juvenile violence. These programs include targeting high-risk youth in the 13 to 18 year old age range with after-school recreation, conflict resolution, mentoring, employment programs, and anti-violence school curricula. These efforts also include programs targeting at-risk families with young children using home visitation models, enriched preschool programs, parenting skills classes, and family therapy.30

In terms of outcomes, very little research has been done to evaluate the success of domestic violence or child abuse prevention programs over time. The exception to this are studies on the efficacy of home visitation programs on preventing child abuse or neglect, where limited success has been found with families who are most at risk for child abuse or neglect as a result of a combination of risk factors.31

However, a fair amount of research has been done on the efficacy of juvenile violence prevention programs. These studies show that programs targeting older children, which include approaches such as psychotherapy, peer counseling, or intensive social casework with juvenile delinquents, as well as employment/vocational programs without an educational component32 are for the most part unsuccessful. However, programs targeting young children and their families have demonstrated promising results. These successful early childhood violence prevention programs have a set of common characteristics. First, they attempt to ameliorate a variety of factors associated with youth violence; second, they focus on the families of young children; and third, they are long-term efforts lasting more than a few months, often several years.33

While almost no research exists on protective factors mitigating the effects of witnessing domestic violence as a child, a fair amount of research has identified several protective factors for child abuse and youth violence. These include economic opportunity, mentors and role models, organized community programs for youth and families, a school environment that promotes prevention, and adult family members who are nurturing and provide consistent, structured supervision.34

Based on preliminary research on risk factors, protective factors, and successful prevention programs, an effective prevention/early intervention project, then, should have several key elements:

First, the effort should target low-income young parents. This is the group that is not only most at risk for both forms of family violence, but also most receptive to prevention/early intervention strategies. Low-income youth who are not yet parents would not be as responsive as young parents to discussions regarding parenting strategies and issues of raising a family. On the other hand, waiting to approach low-income parents after the cycle of violence within the family has already begun renders the prevention/early intervention strategies less effective. By focusing on young parents a successful program would also reach their children at a young age, thus preventing the risk factors for juvenile violence in the child's life, as well as the risk factors associated with the child growing up to be a child abuser or a domestic violence perpetrator or victim.

Young parents should be engaged in the project voluntarily through positive, non-stigmatizing entry points. Research indicates that 75% of parents with incomes below $25,000 say they would find parenting programs aimed at preventing child abuse useful.35 This project would enable communities to strengthen current programs reaching young parents, or to develop new strategies that encourage young parents and their children to become involved in prevention/early intervention activities.

Second, the effort should be directed at breaking the isolation of these families by helping them establish supportive ties to their community, and at ameliorating their poverty by assisting them to achieve real economic independence. Because recent studies have shown social isolation to be linked to community and family violence, a successful project should work to encourage communities to mobilize against violence through "self-help" strategies of informal social control,36 and the establishment of supportive social ties and social relationships.

Third, the project should provide early, age-appropriate intervention for abused children or those witnessing domestic violence during the first ten years of life. Research shows that treatment interventions targeting children at a young age are much more effective than those aimed at adolescents who have already experienced years of maltreatment.37 While this is primarily a prevention project, early intervention with at-risk children can also play an important role in preventing child abuse, domestic violence, and youth violence for the next generation.

Fourth, a community-wide education campaign aimed at challenging social norms that ignore or support violence, and at mobilizing individuals to take action against violence in their community, should be developed. The campaign should challenge the belief that family violence is a private and not a public concern; and encourage friends, neighbors, relatives, and others to reach out to at-risk families in order to break the terrible isolation that keeps them from getting help. Campaign messages, its messengers, and the prevention/intervention activities that individuals are encouraged to undertake, should be developed by the individuals the program is trying to reach, namely young parents.

Currently, no such public education effort has focused on both child abuse and domestic violence simultaneously, let alone youth violence as a third factor. However, the education campaigns that have been successful with one or the other form of family violence indicates that messages should be non-stigmatizing, relevant to the immediate concerns of young parents, and culturally and linguistically appropriate.

Fifth, young parents, as well as indigenous community leaders, formal and informal supports,38 and other community members should be involved at the outset in the planning, development, and implementation of all elements of the project. When community members are involved in a project from the beginning, shaping it and leading it, this proffers a stamp of community ownership and commitment, facilitates involvement of others in the community, and ensures that the specific activities are designed to meet the actual needs of people in the area.

Specific project strategies should be created through a dynamic partnership between local public agencies and service providers, including CPS, domestic violence agencies, home visitation programs, fatherhood programs, early childhood development and daycare programs, the schools, the police, healthcare providers, after school youth programs, and economic development programs, to name a few. Ideally, the policies and practices of each of the partnership agencies would be reviewed and changed to integrate a strong prevention focus into services and programs.

Sixth, a local communications and policy advocacy strategy should be developed and carried out in order to garner the support of public policy makers and opinion leaders for prevention/early intervention efforts. Policymakers must be motivated to respond in ways that substantiate community-defined strategies. The young mothers and fathers who are brought in to help define the strategies should be encouraged to become dramatic, moving, and natural spokespersons in talking with policy makers, thus developing a very effective public policy advocacy strategy.

Finally, this should be a ten to fifteen-year effort, not an attempt at a "quick fix." It will take several years to develop and implement a multifaceted approach to prevention through a collaborative effort among multiple groups both on a local and national level. In order to create broad public support for prevention efforts, a longitudinal evaluation of the project's impact on families will also be necessary. Clearly, these important strategies will take a considerable investment of time and resources.

While no such community-based, comprehensive program exists to date, strong public support exists for prevention efforts and for reducing the number of fragmented responses to families suffering from multiple problems. It is time for the fields of family violence and youth violence to recognize the interconnectedness of their work and to realize the potential for developing successful collaborative prevention strategies.

� Family Violence Prevention Fund


References

1Straus, M. A., Gelles, R. J., & Smith, C. (1990). Physical violence in American families: Risk factors and adaptations to violence in 8,145 families. New Brunswick: Transaction Publishers.

2Hangen, E. (1994). Department of Social Services Interagency Domestic Violence Team Pilot Project: Program data evaluation. Boston, MA: Massachusetts Department of Social Services.

3Schechter, S., & Edleson, J. (1994). In the best interests of women and children: A call for collaboration between child welfare and domestic violence constituencies. Unpublished Manuscript.

4Widom, C. S. (1989, April 14 ). The cycle of violence. Science, Reprint Series, 244, 160-166.

5U.S. Department of Health and Human Services, National Center on Child Abuse and Neglect. (1996). Child maltreatment: Reports from the states to the National Center on Child Abuse and Neglect. Washington, DC: U.S. Government Printing Office.

6Oregon Children's Services Division. (1993). Task gorce report on child fatalities and critical injuries due to abuse and neglect. Salem, OR: Oregon Department of Human Resources.

7U.S. Advisory Board on Child Abuse and Neglect. (1995). A nation's shame: Fatal child abuse and neglect in the United States: Fifth report. Washington, DC: Department of Health and Human Services, Administration for Children and Families, p. 253.

8 Straus, Gelles, & Smith, 1990, p. 253.

13 Strauss, Gelles, & Smith, 1990, Op. cit.

14 McCurdy, K., & Daro, D. (1994). Child maltreatment: A national survey of reports and fatalities. Journal of Interpersonal Violence, 9(1), 75-94.

15 Gallup, G. H. Jr., Moor, D. W., & Schussel, R. (1997). Disciplining children in America. Princeton, NJ: The Gallup Organization.

16English, D. (1998, Spring). The extent and consequences of child maltreatment. In Center for the Future of Children, The David and Lucile Packard Foundation (Ed.), The Future of Children: Protecting Children from Abuse and Neglect (Vol. 8). Los Altos, CA: Author. also Weber, M. (1998, Spring). Four commentaries: How we can better protect children from abuse and neglect. In Center for the Future of Children, The David and Lucile Packard Foundation (Ed.), The Future of Children: Protecting Children from Abuse and Neglect (Vol. 8). Los Altos, CA: Author.

17Greenfield, L., Rand, M. R., Craven, D., Klaus, P. A., Perkins, C. A., Ringel, C., Worchol, G., Maston, C., & Fox, J. A. (1998, March). Violence by intimates: Analysis of data on crimes by current or former spouses, boyfriends, and girlfriends, (Vol. 14), NCJ-167237. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics, .

18Forte, J. A., Franks, D. D., & Forte, J. A. (1996). Asymmetrical role-taking: Comparing battered and non-battered women. Social Work, 41(1), 59-73.

19 Beeman, S. K. (1997). Reconceptualizing social support and iIts relationship to child neglect. Social Science Review, 17, 421-440.

20Butterfield, F. (1997, August 17). Study links violence rate to cohesion of community. New York Times, Sec. 1, p. 27.

21 Sampson, R. J., Raudenbush, S. W., & Earls, F. (1997, August 15). Neighborhoods and violent crime: A multilevel study of collective efficacy. Science, 277, 918-924. Available: www.sciencemag.org

22Blumstein, A. (1994). Youth violence: 1994 Task force reports. American Society of Criminology to Attorney General Janet Reno.

23Harris, L. (1993). The first comprehensive national health survey of American women. New York: The Commonwealth Fund.

24McCurdy, K., & Daro, D. (1994). Child maltreatment: A national survey of reports and fatalities. Journal of Interpersonal Violence, 9(1), 75-94.

25U. S. Department of Health and Human Services, National Center for Health Statistics. (1992). 1990 summary: National hospital discharge survey, advance data no. 210. Washington, DC: US Government Printing Office.

26U.S. Department of Health and Human Services, National Center on Child Abuse and Neglect. (1996). Child maltreatment 1994: Reports from the states to the National Center on Child Abuse and Neglect. Washington, DC: U.S. Government Printing Office.

27Snyder, H. N. (1996, Winter). The Juvenile Court and Delinquency Cases. In Center for the Future of Children, The David and Lucile Packard Foundation. The Future of Children: The Juvenile Court (Vol. 6). Los Altos, CA: Author.

28Courtney, M. (1998, Spring). The costs of child protection in the context of welfare reform. In Center for the Future of Children, The David and Lucile Packard Foundation (Ed.), The Future of Children: Protecting Children from Abuse and Neglect (Vol. 8). Los Altos, CA: Author.

29Cullen, F. T., Wright, J. P., & Brown, S. (1998, April). Public support of early intervention programs: Implications for a progressive policy agenda. Crime and Delinquency, 44(2), 187-204.

30Blumstein, 1994, Op. Cit.

31Old, D., & Kitzman, H. (1993). Review of research on home visiting for pregnant women and parent of young children. In Center for the Future of Children, The David and Lucile Packard Foundation (Ed.), The Future of Children: Home Visiting (Vol.3). Los Altos, CA: Author.

32Blumstein, 1994, Op. cit.

33 Blumstein, 1994, Op. cit.

34 Partnerships for Preventing Violence (Ed.). (1998). Definition of violence (CDC).

35 Daro, D. (1998). Public opinion and behaviors regarding child abuse prevention: 1998 survey. The National Committee to Prevent Child Abuse. Working Paper Number 840.

36Sampson,et al., 1997, p. 923.

37 Blumstein, 1994, Op. Cit.

38 Formal supports refers to community-based service providers, governmental service programs, etc. Informal supports refers to neighborhood groups, faith communities, sports clubs, social clubs, etc.

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