Unfortunately, depression often goes hand in hand with poverty, substance abuse, and other factors that place early development at risk (Campbell et al., 1995; Seifer, 1995; Zeanah et al., 1997).
The role of marital discord and of fathers is especially noteworthy in this regard. When maternal depression occurs in a family experiencing marital harmony, mothers are better able to sustain healthy interactions with their children and the children are less likely to display adverse consequences (Cummings and Davies, 1999; Teti, 1999; Teti et al., 1996b). In fact, the occurrence of marital discord in a child's family may predict certain developmental problems more accurately than maternal depression. Relatedly, involved, psychologically healthy, and supportive fathers can buffer children from the detrimental effects of maternal depression, whereas absent or psychologically unhealthy fathers can amplify the effects (Goodman and Gotlib, 1999).
Beyond its direct effects on children, maternal depression can be a major barrier to the effectiveness of early interventions. The high rates of depression among low-income mothers combined with emerging evidence that depression can be a major deterrent to enrollment and full participation in intervention programs, such as home visiting, highlights the critical importance of this relatively hidden issue for those who design, implement, and evaluate early childhood programs (Teti, 1999). Maternal depression can also undermine the intended benefits of early intervention, as illustrated by the New Chance Demonstration. Mothers who participated in this comprehensive program for poorly educated teenage mothers on welfare not only felt more stressed than mothers who did not participate in the program, but the program actually had negative effects on the children of the depressed participants (Quint et al., 1997). It appears that New Chance overwhelmed the capacity of depressed mothers to cope with their situations, with detrimental consequences for their children (Lennon et al., 1998). Early intervention is clearly a complex undertaking for depressed mothers who are also experiencing other sources of stress and for whom mental health services may be a more appropriate first step (see Teti, 1999).
Child abuse and neglect can be devastating for children's development (Cicchetti and Carlson, 1989; Cicchetti and Toth, 2000; Goodman et al., 1998; Kolko, 1996; National Research Council, 1993). In 1996, nearly 1 million children were involved in substantiated reports to child protective services agencies (National Center on Child Abuse and Neglect, 1997), and, based on reports from just 21 states (National Committee to Prevent Child Abuse, 1997), over 64,000 children were removed from their homes and placed in alternate care. Extrapolating from data from 40 states that