National Academies Press: OpenBook

Understanding Child Abuse and Neglect (1993)

Chapter: FRONT MATTER

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
×

Understanding
Child Abuse
and Neglect

Panel on Research on Child Abuse and Neglect

Commission on Behavioral and Social Sciences and Education

National Research Council

NATIONAL ACADEMY PRESS
Washington, D.C. 1993

NATIONAL ACADEMY PRESS • 2101 Constitution Avenue, N.W. • Washington, D.C. 20418

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
×

Page ii

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

This report was undertaken with the sponsorship of the Administration for Children, Youth, and Families of the U.S. Department of Health and Human Services.

Library of Congress Cataloging-in-Publication Data

National Research Council (U.S.). Panel on Research on Child Abuse and Neglect.
Understanding child abuse and neglect / Panel on Research on Child Abuse and Neglect, Commission on
Behavioral and Social Sciences and Education, National Research Council.
p. cm.
Includes bibliographical references and index.
ISBN 0-309-04889-3
1. Child abuse—United States—Prevention. 2. Abused children—United States—Psychology. I. Title.
HV6626.52.N38 1993
362.76'0973—dc20
93-29640
CIP

Cover: Photograph by Eric Futran, copyright 1993.

Printed in the United States of America

Copyright 1993 by the National Academy of Sciences. All rights reserved.

First Printing, October 1993
Second Printing, November 1994
Third Printing, April 1996

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
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Page iii

Panel On Research On Child Abuse And Neglect

ANNE C. PETERSEN (Chair), Vice President for Research and Dean of the Graduate School, Professor of Adolescent Development and Pediatrics, University of Minnesota

J. LAWRENCE ABER, Associate Professor of Clinical and Developmental Psychology, Barnard College, Columbia University

ANDREW BILLINGSLEY, Professor and Chair, Department of Family and Community Development, University of Maryland-College Park

JEANNE BROOKS-GUNN, Virginia and Leonard Marx Professor of Child Development, Teachers College, Columbia University

DONALD J. COHEN, Director, Child Study Center, Yale University

MICHAEL I. COHEN, Chairman, Department of Pediatrics, Albert Einstein College of Medicine

JON ROBERT CONTE, Associate Professor, School of Social Work, University of Washington

BYRON EGELAND, Irving B. Harris Professor of Child Psychology, Institute of Child Development, University of Minnesota

E. MAVIS HETHERINGTON, James Page Professor of Psychology, University of Virginia

SARAH McCUE HORWITZ, Associate Professor of Public Health, Department of Epidemiology and Public Health, Yale University

JILL E. KORBIN, Associate Professor, Department of Anthropology, Case Western Reserve University

DOROTHY OTNOW LEWIS, Professor, Department of Psychiatry, New York University

RODERICK J. A. LITTLE, Professor, Department of Biomathematics, University of California-Los Angeles

MURRAY A. STRAUS, Professor of Sociology, Founder and Co-Director of the Family Research Laboratory, University of New Hampshire

CATHY SPATZ WIDOM, Professor in the School of Criminal Justice and Director of the Hindelang Criminal Justice Research Center, State University of New York-Albany

GAIL WYATT, Clinical Psychologist and Professor in the Department of Psychiatry and Biobehavioral Science, University of California-Los Angeles

ROSEMARY CHALK, Study Director

JESSICA BACKER, Research Assistant

DEBBIE MacGUFFIE, Senior Project Assistant

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
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Page iv

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Bruce M. Alberts is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Robert M. White is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Bruce M. Alberts and Dr. Robert M. White are chairman and vice chairman, respectively, of the National Research Council.

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
×

Page v

Preface

The abuse or neglect of a child is a human tragedy. The print and broadcast media have been flooded in recent years with stories of babies abandoned by their mothers; toddlers who are beaten by their parents or who are deprived of essential forms of nutrition, compassion, emotional and physical comfort; school-age children who are sexually abused; and adolescents who run away from homes after they have been subjected to years of neglect or abuse.

Although these stories attract tremendous interest and empathy for the victims of abuse and neglect, media accounts fail to reveal the complex interplay of factors that influences the origins and consequences of child maltreatment. Simple answers are often proposed for cruel behaviors against children, and easy-to-identify factors such as psychopathology, poverty, alcohol, drugs, and society itself are often blamed for destructive behaviors. Yet, after decades of research, we now recognize that no single risk factor provides the overriding catalyst for child abuse and neglect. Indeed, we have only recently discovered that a complex interplay of multiple risk factors paves the path to abuse and neglect, a discovery that challenges our search for the origins of maltreatment, but one that encourages us to recognize multiple opportunities for intervention.

As scientists, we have too long neglected the study of child maltreatment. For decades, social workers, clinicians, lawyers, and others have documented the pain of child victimization. But daunting obstacles inhibit the scientific study of this topic: the nature of the subject itself is emotion-

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
×

Page vi

ally overwhelming, the field lacks consistent definitions and valid instrumentation, data collection efforts are cumbersome and often unreliable, and the presence of multiple cofactors in the study populations—including poverty, violence, and other forms of victimization—makes it exceedingly difficult to isolate key factors.

In three decades of research with abusive and neglectful families, remarkable progress has been achieved. Theoretical assumptions have been revised and expanded to incorporate research findings about characteristics of individuals, families, neighborhoods, and social and cultural values that affect child maltreatment. The importance of the developmental cycle of the child has been recognized in studying the consequences of child maltreatment and in designing interventions and prevention programs. And the relationship between experiences with child abuse and neglect and a broad range of health and behavioral disorders has been explored through longitudinal studies with increasingly larger samples.

Despite this progress, we still lack a solid base of research information that can guide and enhance society's efforts to intervene and prevent child abuse and neglect. The existing scientific literature on child maltreatment, though extensive, is not definitive. It lacks cohesion and organization. The literature base is highly specialized and reflects the fragmentation of the field. Some scholars have focused exclusively on physical abuse of children within their family environments. Others have concentrated on the phenomenon of sexual abuse. Still others have studied the often hidden dimensions of child neglect or the more recently recognized forms of emotional abuse and neglect. The interdisciplinary nature of the field also fosters fragmentation and uncertainties. Health professionals tend to emphasize the physical manifestations of abuse or neglect: psychologists stress the internal dynamics that may foster maltreatment or protect an abused child from the more destructive consequences of abuse. Social workers concentrate on the factors and services that foster family strengths or risks to the child, while lawyers examine the effects of laws on outcomes, among other issues.

The fragmentation of the research literature, and the absence of research priorities in a field that is gaining increased attention, are the catalysts that stimulated our study. In 1991, the Commissioner for Children, Youth, and Families in the U.S. Department of Health and Human Services asked the National Academy of Sciences to convene an expert panel to develop a research agenda for future studies of child maltreatment. The charge to the panel was to examine the quality of the existing research, determine areas of strength and weakness, and offer guidance regarding ways in which current and future research resources might be directed to improve the development of this field.

The panel was set up by the Commission on Behavioral and Social

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
×

Page vii

Sciences and Education (CBASSE) of the National Research Council in response to this request. This is the first study on child abuse and neglect undertaken by the National Research Council, but it was developed at a time of expanding activities in areas of violence and youth. For example, in early 1993 the Academy published the results of a major study on research on the causes, prevention, and control of violent behavior (Understanding and Preventing Violence, National Academy Press, 1993). The National Research Council was also engaged in developing a report on high-risk youth (Losing Generations: Adolescents in High-Risk Settings, National Academy Press, 1993), although the results of that effort were not available at the time that our study was in progress.

In carrying out its task, the panel undertook a number of activities. The panel formed three subpanels to help organize the research literature and to identify primary themes and initial recommendations. Review materials prepared by panel members and staff, as well as a set of background papers prepared by others, guided the initial discussions and, in some cases, were incorporated into draft chapters of the report. The panel is grateful to the many presenters, consultants, authors, readers, workshop participants, and federal agency officials who provided materials on specialized topics; they are listed individually in Appendix A. A few who deserve special recognition are Diana Baumrind, Jay Belsky, Jeanne Bertolli, Rosemary Bolig, Debroah Daro, Howard Dubowitz, Richard Gelles, Jeanne Giovannoni, David Kolko, John Leventhal, Howard Morgenstern, Joan Sieber, Susan Sorenson, Penelope Trickett, and Michael Wald. In addition, the panel developed outreach activities to a broad group of scholars and organizations through two working group sessions and a national survey of more than 170 professional, educational, and advocacy groups concerned with child abuse and neglect (listed in Appendix A).

With such a diversity of effort, disagreements were common, but the panel was able to achieve a consensus of views through discussions and analysis of research findings. This volume also includes two brief supplementary statements prepared and endorsed by three panel members (Appendix B). Although these members support the interactive approach taken in the panel's report, they wish to emphasize two of the risk factors identified as potential contributors to child maltreatment.

To ensure that this study could both build on what is currently known about child maltreatment and develop informed insights into related fields that may contribute theroetical and methodological research, the panel was composed of experts in child maltreatment as well as others who are notable for their work in other areas of epidemiology, biostatistics, child development, and pediatric medicine. Biographical sketches of panel members and staff appear in Appendix C.

Rosemary Chalk served as the study director for this project. Her

Page viii Cite
Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
×

Page viii

extensive experience with earlier Academy reports as well as her wisdom about the process were essential to our steady progress and timely completion of this demanding task. Although the panel bears responsibility for any errors of inference, Rosemary deserves credit for much of the writing and for upholding high standards of evidence. Jessica Backer was the research assistant for the study, and she diligently identified and obtained hundreds of reference materials in addition to preparing background papers for the panel. Debbie MacGuffie, the project assistant, provided the panel with excellent support and guidance in organizing the panel meetings, preparing agenda materials, and guiding the report from the first drafts to the published volume.

Finally, the panel wishes to acknowledge the support and assistance of officials from the U.S. Department of Health and Human Services who were instrumental in the initiation and development of this study. Wade Horn, former Administrator of Children, Youth, and Families, was the key individual who sponsored this study. David Lloyd, director of the National Center for Child Abuse and Neglect, provided financial support, guidance, and information for the panel throughout the study. Marsha Liss, special assistant to the director of the National Center on Child Abuse and Neglect, served as the project monitor for this study and helped to negotiate administrative and information requests to keep the project moving smoothly through all phases of its operation.

In recognizing the contributions of these individuals, we want to affirm that the recommendations of this report are those of the panel members themselves. We have had a privileged opportunity to review, in an independent manner, the fruits of decades of research investments by governmental and private agencies. We hope that our report will stimulate those responsible for the development of this research to be encouraged by the progress that has been achieved, and to renew their sense of commitment to the tasks that must still be completed. Much remains to be done.

Anne C. Petersen, Chair
Panel on Research on
     Child Abuse and Neglect

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
×

Page ix

Contents

SUMMARY

1

1

INTRODUCTION

38

 

The Importance of Child Maltreatment Research

39

 

Research on Child Maltreatment is Currently Undervalued and Undeveloped

40

 

Dimensions of Child Abuse and Neglect

42

 

The Complexity of Child Maltreatment

43

 

Charge to the Panel

47

 

The Importance of a Child-Oriented Framework

49

 

An Ecological Developmental Perspective

50

 

Previous Reports

52

 

Report Overview

53

2

IDENTIFICATION AND DEFINITIONS

57

 

Review of Definitions

59

 

Principles Underlying Research Definitions

62

 

Specific Definitional Issues

63

 

Identification of Child Maltreatment

67

 

Research Recommendations

70

3

SCOPE OF THE PROBLEM

78

 

Current Estimates

79

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
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Page x

 

Methodological Issues

85

 

Conclusions

93

 

Research Recommendations

95

4

ETIOLOGY OF CHILD MALTREATMENT

106

 

Overview of Etiological Models

107

 

Individual Ontogenic Factors

111

 

Family Microsystem

126

 

The Exosystem

132

 

The Macrosystem

136

 

Summary of Etiological Factors

139

 

Research Recommendations

140

5

PREVENTION

161

 

Overview

161

 

The Family Microsystem

167

 

The Exosystem

178

 

The Macrosystem

188

 

Conclusions

190

 

Research Recommendations

191

6

CONSEQUENCES OF CHILD ABUSE AND NEGLECT

208

 

Childhood

210

 

Adolescence

217

 

Adulthood

223

 

Issues of Stigma, Bias, and Discrimination

226

 

Interaction of Risk and Protective Factors

226

 

Research Recommendations

232

7

INTERVENTIONS AND TREATMENT

253

 

Treatment Efforts at the Individual Level

256

 

Microsystem Approaches: Family-Oriented Interventions

261

 

Community Exosystem Interventions

266

 

Social/Macrosystem Interventions

274

 

Conclusions

274

 

Research Recommendations

275

8

HUMAN RESOURCES, INSTRUMENTATION, AND RESEARCH INFRASTRUCTURE

292

 

The Research Community

293

 

Training Issues

294

 

Instrumentation Issues

297

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
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Page xi

 

Information Services

299

 

Federal Funding for Research on Child Maltreatment

301

 

State Roles in Research on Child Maltreatment

312

 

Private Foundations

313

 

Conclusions

314

 

Research Recommendations

315

9

ETHICAL AND LEGAL ISSUES IN CHILD MALTREATMENT RESEARCH

324

 

Framework of Analysis

325

 

Issues in Research on Human Subjects

326

 

Ethical Issues in Child Maltreatment Research

329

 

Research on Children and Families

334

 

Research on Socially Sensitive Topics

336

 

Conclusions

338

 

Research Recommendations

338

10

PRIORITIES FOR CHILD MALTREATMENT RESEARCH

343

 

The Nature and Scope of Child Maltreatment

344

 

Understanding the Origins and Consequences of Child Maltreatment

346

 

Improving Treatment and Preventive Interventions

350

 

A Science Policy for Research on Child Maltreatment

355

APPENDICES

 

A

PANEL ACTIVITIES

365

B

SUPPLEMENTARY VIEWS

371

C

BIOGRAPHICAL SKETCHES

372

INDEX

379

Suggested Citation:"FRONT MATTER." National Research Council. 1993. Understanding Child Abuse and Neglect. Washington, DC: The National Academies Press. doi: 10.17226/2117.
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Understanding Child Abuse and Neglect Get This Book
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The tragedy of child abuse and neglect is in the forefront of public attention. Yet, without a conceptual framework, research in this area has been highly fragmented. Understanding the broad dimensions of this crisis has suffered as a result.

This new volume provides a comprehensive, integrated, child-oriented research agenda for the nation. The committee presents an overview of three major areas:

oDefinitions and scope--exploring standardized classifications, analysis of incidence and prevalence trends, and more.

oEtiology, consequences, treatment, and prevention--analyzing relationships between cause and effect, reviewing prevention research with a unique systems approach, looking at short- and long-term consequences of abuse, and evaluating interventions.

oInfrastructure and ethics--including a review of current research efforts, ways to strengthen human resources and research tools, and guidance on sensitive ethical and legal issues.

This volume will be useful to organizations involved in research, social service agencies, child advocacy groups, and researchers.

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