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Journal Issue: Preventing Child Maltreatment Volume 19 Number 2 Fall 2009

Progress toward a Prevention Perspective
Authors: Matthew W. Stagner Jiffy Lansing

Benefits of Successful Prevention Efforts

Although researchers have documented with increasing clarity the consequences of maltreatment and have gained a better understanding of the costs of interventions and how to target, they have been less successful in identifying rigorously the benefits of various prevention interventions. Results from meta-analyses that use statistical techniques to summarize the outcomes of child maltreatment interventions are mixed.63

Measuring the costs and benefits of child maltreatment programs is complex. Reporting inconsistencies and discrepancies plague some seemingly simple-to-determine costs, such as death and treated injury. These outcomes, for example, are often attributed to other causes.64 Despite evidence linking maltreatment with longer-term, negative behavioral outcomes, it is impossible to pinpoint maltreatment as the sole or primary contributor to psychosocial problems, delinquency, educational difficulties, criminality, or engaging in risky behavior.

Some studies, however, do present findings on the cost of maltreatment. Ching-Tung Wang and John Holton, using direct and indirect costs, estimate the nationwide annual costs of child abuse and neglect at $103.8 billion in 2007 dollars.65 And Robert Caldwell performed a state-level comparative analysis of the costs associated with child maltreatment and the costs of providing child maltreatment prevention services to all first-time parents.66 Including costs associated with low-birth-weight babies, infant mortality, special education, protective services, foster care, juvenile and adult criminality, and psychological services, Caldwell estimated the cost to Michigan of child maltreatment at $823 million annually. Such costs suggest that successful prevention programs could reap significant savings.

Some prevention programs show positive results. The most promising appear to be those that focus on early intervention—identifying risk factors as early as possible in order to provide services that lessen the impact of those factors on a child’s development. These risk factors can include infant or child health or disability but can also include risk factors for maltreatment. Key assumptions of early intervention include the cognitive advantage hypothesis (increasing children’s cognitive skills early supports individual development) and the family support hypothesis (participation enhances parenting practices, attitudes and expectations, and involvement in children’s education). The function of early intervention is to identify and serve special needs early in life in order to increase the developmental and educational gains of the child and improve the functioning of the family, thereby reaping societal and cost-saving benefits in the long term.67 An evaluation of the Healthy Families Alaska Program, for example, found that it reduced parental stress and improved child development.68 The benefits possible from maltreatment prevention programs may be comparable to those of early childhood education, a specialized focus of early intervention with an increasing flow of federal funds. Participating in early childhood education, for example, has been shown to improve educational performance, raise earnings, and decrease criminal behaviors later in life.69 And the return for investing in high-quality early childhood programs and services can be substantial. Based on the gains cited above, James Heckman has calculated a cost-benefit ratio of approximately $7 for every $1 invested in high-quality early childhood experiences for at-risk children.70