Children who have been abused are at high risk of recurrence and effective prevention strategies are urgently needed, state the authors of a randomised trial published online today (Thursday May 5, 2005) by The Lancet.
Recurrence of child maltreatment is a major problem. In a study involving 163 Canadian families with confirmed child physical abuse or neglect, Harriet MacMillan (McMaster University, Hamilton, Ontario, Canada) and colleagues tested whether regular home visits by public-health nurses prevented recurrence of abuse when compared with standard services from child protection agencies (CPA). Standard services include routine follow-up by CPA caseworkers to assess risk of recurrence and provide education about parenting. However, investigators found after 3-years follow-up recurrence of physical child abuse and neglect did not differ between the groups. About half the intervention families (47%) and control families (51%) had a recurrence of neglect and 33% of the intervention group and 43% of the control group had a recurrence of physical abuse.
The authors state that there is a high risk of abuse and neglect recurring when a child remains in the home and there is currently no intervention proven to reduce the risk.
Dr MacMillan concludes: “The high rates of recurrence in this study suggest that substantive efforts must be invested in prevention of child abuse or neglect before a pattern is established.”