Early prevention of physical child abuse and neglect: Existing evidence and future directions

Early intervention approaches to prevent physical child abuse and neglect hold great promise, seeking to avert the problem before it ever occurs, while promoting positive parenting from the outset. This article synthesizes the rapidly expanding empirical base on early prevention, examining the support undergirding this modality's overall effectiveness and directions it provides for discerning optimal prevention strategies. The 18 controlled studies in this area reveal a promising yet complex picture with regard to successful intervention designs. Several emerging trends point to (a) the essential role of parenting education support, (b) the importance of linking families with formal and/or informal supports, (c) the importance of coupling longer term interventions and those that employ paraprofessional helpers with a moderate to high degree of service intensity, (d) a clinical advantage for programs that employ universalistic intake procedures over those that screen for psychosocial risk, and (e) the importance of health education to reduce medically related maltreatment risks. Further, the review points to a number of significant directions for future program design and study, particularly with respect to adequately addressing parental powerlessness in the makeup of physical abuse and neglect risk.