A recent worldwide study of child maltreatment reported that from 80 to 98 percent of children suffer physical punishment in their homes, with a third or more experiencing severe physical punishment from the use of implements. In the United States, approximately 800,000 cases of child maltreatment are reported each year. Of these cases, child neglect remains the largest single category. A disproportionate number of cases of abuse and neglect occur with mothers who have their own personal histories of maltreatment. As a result, an intergenerational pattern of inappropriate and destructive pattern is continued. As the cycle passes from one generation to the next, society—as well as the families directly involved—bear enormous costs, including mounting mental health concerns, increased medical expenses, greater needs for public assistance, and excessive burdens on the criminal justice system.
In the United States and other countries, a growing number of home-visiting parenting programs have shown positive results in reducing child maltreatment and enhancing parenting skills in high-risk populations (Olds et al., 2002; Barlow, 2006). However, studies of home-visiting programs have not found uniformly positive outcomes for parents and children. Rather, meta-analyses of these studies have produced mixed results (Layzer et al., 2001; Sweet and Appelbaum, 2004; Astuto and Allen, 2009). One barrier to achieving improved outcomes is parent participation (McCurdy and Daro, 2001). Program retention rates vary widely, and, as the prescribed duration of the programs increases, so do the programs’ rates of attrition for families—especially for the highest-risk families (McCurdy et al., 2003). When families fail to show up for their home visit or drop out of interventions early, even the most powerful interventions will have diminished effects. A second determinant of effectiveness is parent engagement—the extent to which parents carry out the behavioral or affective components of the intervention program, such as keeping up with learning activities between visits and seeking more information (Berlin et al., 1998; Korfmacher et al., 2008). Programs that are able to maintain parents’ participation and