We are now into the last week of April, National Child Abuse Prevention Month. Many of us have recently paid our taxes; all of us are feeling the impact of economic crises throughout the world. There’s a lot of bipartisan rhetoric about how to treat foreign nationals’ access to healthcare, problems embedded in our healthcare delivery system in general, and on tonight’s news, the issue of insufficient availability of dental care for low income families was highlighted through reporting the tragic death of a child from a dental infection that spread into his brain. It seems to me that now, while we wrestle with these issues, it’s important to also gain a perspective on the costs of child abuse and neglect, and to take note of effective prevention and intervention programs that are proving to make a difference.

The Center for Disease Control and Prevention (CDC) reported in February that results of a study looking at confirmed cases of child maltreatment over a one year period, (www.cdc.gov/media/releases/2012/p0201_child_abuse.html) estimated that the total lifetime financial costs for each victim who lived was $210,012. This, the CDC tells us, is comparable to other costly health conditions such as stroke, with a lifetime cost per person estimated at $159, 846 or type 2 diabetes, which is estimated between $181, 000 and $253, 000. Likewise, negative effects of maltreatment over a survivor’s lifetime generate costs which directly impact our national health care, families, education, criminal justice and welfare systems.

The estimated average lifetime cost per surviving victim includes:

• $32,648 in childhood healthcare costs

• $10,530 in adult medical costs

• $144,360 in productivity losses

• $7,728 in child welfare costs

• $6,747 in criminal justice costs

• $7,999 in special education costs

Child abuse and neglect is also linked to too many emotional, behavioral, and physical health problems like aggression, conduct disorder, delinquency, antisocial behavior, substance abuse, intimate partner violence, teenage pregnancy, anxiety, depression, sex addiction, and suicide. It is a complicated issue, and so the solutions aren’t simple. Everyone who interfaces with a child, from his or her mother or father to his or her athletic coach, is influenced by many forces: how they were raised, parenting skills, stress, living conditions, extended family, community, religious beliefs, and culture. It’s easy to become overwhelmed by these lists; by the interdependencies, which contribute to a sense that the problems are insurmountable. But I am grateful to be able to report that many people have been passionately committed to creating safety for our children; they have invested their time, money, and talents, and they are making a difference.

The CDC report mentioned above noted several programs that have been found to reduce the number of incidents of child maltreatment:

• Nurse – Family Partnership, an evidence–based community health program (http://www.nursefamilypartnership.org/), this program partners a registered nurse with a first-time mother during pregnancy and continues through the child’s second birthday.

• Early Start (http://www.dds.ca.gov/earlystart/) provides coordinated, family-centered system of services/ California’s response to federal legislation providing early intervention services to infant and toddlers with disabilities and their families.

• Triple P, a multilevel parenting and family support system which aims to prevent severe emotional and behavioral disturbances in children by promoting positive and nurturing relationships between parent and child. (http://www.triplep-americ.com/)

Two others that I know of and that particularly appeal to me also include parental education and are quite personal. The first one was developed by the American Academy of Pediatrics (AAP) when in 2008 they developed a subspecialty of Child Abuse Pediatricians who are trained to detect and intervene in cases where there’s child abuse and neglect. (http://healthland.time.com/2012/04/04/child-abuse-pediatricians-recommen...) The second one is one of the best early intervention programs I’ve heard of -  the Bringing Baby Home Program. Bringing Baby Home (www.bbhonline.org) was developed by Drs. John and Julie Gottman at the Relationship Research Institute in Seattle. This is a research-based, research-proven 12-hr. workshop for expectant parents which teaches couples how to enrich their relationship during the transition to parenthood, while also teaching them about the psychological development of their infant. Dr. Gottman has trained Bringing Baby Home Certified Educators around the country; a registry can be found at the website.

I’m sure that there are many other programs around the country as well, and I invite you to share the good news. Please tell us what you know about them in the comments section.

In closing, I urge you to take a personal interest in child abuse and neglect. Don’t let disturbing statistics psych you out; instead, let them challenge you to get involved. “We stop child abuse one house at a time, one child at a time,” said New York Times bestselling author Regina Brett at a Child Abuse Prevention Month kickoff event in Pennsylvania last month. “We have to do more to protect our children – and they are all our children.” Hold that thought, and let it move you.

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If you suspect a child is being abused or neglected call the Childhelp National Child Abuse Hotline at 1.800.4.A.CHILD(1.800.422.4453)

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