Prevention of Child Abuse and Neglect (Primary) Programs

Nurse-Family Partnership® (NFP) is an intensive, strengths-based, trauma- and violence-informed community health program whose goals are to improve the health and lives of first-time moms and their children living in poverty. Specially trained registered nurses regularly visit first-time moms-to-be (adolescents and adults), starting early in pregnancy and continuing through children's second birthday. NFP nurses aim to leverage their clinical expertise in applying behavior change and human ecology theories to deliver this client-centered program. Ideally, NFP participants develop close relationships with their nurse. It is hoped that the nurse becomes a trusted resource for advice on everything from safely caring for their child to taking steps to provide a stable, secure future for their family. In addition to living in poverty, NFP moms also often are experiencing, or at risk of experiencing, homelessness; addiction or substance misuse; involvement with child welfare or juvenile or criminal justice systems; intimate partner violence; severe developmental disabilities; behavioral or mental health needs; or a high-risk pregnancy.

SEEK utilizes pediatric primary care as an opportunity to help address social determinants of health and to prevent child maltreatment in families who may have risk factors for child maltreatment. Most children receive this care and there are frequent visits in the first 5 years. Also, the generally good relationship between health professionals and parents offers an opportunity to identify and help address prevalent psychosocial problems. By addressing these problems, SEEK aims to also help strengthen families, support parents and parenting, and promote children's health, development, and safety.

SEEK begins with training professionals to play this role. Online videos and other materials are available on the SEEK website. Continuing Medical Education (CME) credit is offered as well as Maintenance of Certification (MOC) Categories 2 and 4 and Performance Improvement (PI) credits (through the American Board of Pediatrics and the American Board of Family Medicine). The revised SEEK Parent Questionnaire-R (PQ-R) is a tool to screen for the targeted problems: parental depression, substance abuse, major stress, intimate partner violence, food insecurity, and harsh punishment. It is completed in advance and given to the professional at the start of a regular checkup.

The trained professional then briefly assesses and initially addresses identified risk factors and makes necessary referrals to community resources, ideally with the help of a behavioral health professional. Principles of Motivational Interviewing have been incorporated into SEEK. SEEK Parent Handouts are available as adjuncts to advice offered in the visit.

Childhelp® Speak Up Be Safe is a school-based curriculum that helps children in grades Pre-K to 12 learn skills to prevent or interrupt cycles of neglect, bullying, and child abuse—physical, emotional, and sexual—through developmentally appropriate lessons. The program uses an ecological approach, providing materials to engage parents and caregivers, teachers, school administrators, and community stakeholders. It increases children's ability to recognize unsafe situations or abusive behaviors and helps them build resistance skills and a responsive safety network with peers and safe adults. Program facilitators receive training and tools to deliver the lessons with fidelity.

Dads Matter^HV (HV = Home Visitation) is a father inclusion enhancement designed to strengthen evidence-informed early home visitation services in ways that fully consider and include fathers’ roles, aiming to augment the preventive impact of home visitation on physical child abuse and neglect risk from either/both parents. The intervention is manualized and modular in nature, and designed to be flexibly delivered in conjunction with a standard home visiting program within the first 4 to 6 months of services. The intervention can be delivered flexibly in a variety of ways: during individual home visits with fathers and mothers, separately or conjointly, with service delivery occurring virtually, over the telephone, or in person. The intervention modules enhance and do not supplant standard home visiting services, guiding home visitors to assess fathers’ roles, engage, and intervene with biological fathers, working to reduce barriers to father engagement and build positive home visitor-father working relationships, improve the quality of father-mother co-parenting relationship, and directly support fathers in their roles as parents of young children.

The Kinship Navigator (CHN-KN) Children’s Home Network provides supportive services to any relative or nonrelative raising a child on a full-time basis when a parent is unable or unwilling to provide care. Nonrelative refers to someone unrelated who has a significant or family-like relationship to the child. This program provides services to families regardless of their status with the child welfare system, therefore serving informal and formal families. CHN-KN provides a centralized intake line, comprehensive assessments, family conferencing, and navigation services that include securing concrete needs, enrollment in public assistance, linkage to key community resources, development of informal and formal supports, service and crisis planning, support groups, and follow-up contacts at 3-month intervals postcompletion of the program.

The Second Step Child Protection Unit program for PreK and Elementary school children is a universal, classroom-based program designed to develop students' knowledge and skills for protecting themselves from unsafe and abusive situations, both in and out of the classroom.

The Second Step Child Protection Unit program aims to provide developmentally appropriate explicit skills instruction, offering content and media that is designed to be age-appropriate and engage students in learning how to recognize, refuse, and report unsafe situations and inappropriate touching.

The overall Triple P program is a multi-tiered system of 5 levels of education and support for parents and caregivers of children and adolescents. Although Triple P can be used in parts (e.g., using only one level of the five or a group version versus standard), this entry on the CEBC reviews System Triple P as a whole (i.e., using all 5 levels) in its standard version and only reviewed research evidence that evaluated the whole system. The CEBC also evaluated Triple P Level 4 as a separate program and it is rated a "1 - Well-Supported Research Evidence" on the Scientific Rating Scale in the areas of Parent Training Programs That Address Behavior Problems in Children and Adolescents and Disruptive Behavior Treatment (Child & Adolescent).

As a prevention program, System Triple P helps parents learn strategies that promote social competence and self-regulation in children. Parents become better equipped to handle the stress of everyday child rearing and children become better able to respond positively to their individual developmental challenges. As an early intervention, System Triple P can assist families in greater distress by working with parents of children who are experiencing moderate to severe behavior problems. Throughout the program, parents are encouraged to develop a parenting plan that makes use of a variety of System Triple P strategies and tools. System Triple P practitioners are trained, therefore, to work with parents' strengths and to provide a supportive, non-judgmental environment where a parent can continually improve their parenting skills.

ACT Raising Safe Kids Program is a universal parenting program designed to promote positive parenting and prevent child maltreatment by fostering knowledge and skills that change or improve parenting practices. The program is delivered by trained and certified ACT Facilitators in 9 sessions of 2-hour each on average. The ACT program has a universal public health approach and aims to reach to all parents of young children in a given community. The ACT program addresses parents' use of effective, nonviolent discipline and nurturing behaviors. It addresses parental knowledge of child development, discipline methods, and media literacy. It also addresses parents' anger management, social problem solving skills and their ability to teach/model these skills to children. By promoting effective parenting practices, the program also addresses children's aggression and behavior problems. ACT also provides a supportive community of parents who help and support each other during and after the program: it builds community.

The Body Safety Training (BST) Workbook is a behaviorally based and developmentally appropriate curriculum for parents and teachers to instruct young children about personal safety. There are two versions of the BST Workbook; one for parents to use at home and one for teachers to use in a classroom setting. The two versions can be used separately or in combination. The BST Workbook contains ten lessons; the first half of the workbook covers general safety (e.g., fire, gun, pedestrian, poison) and the second half covers body safety (e.g., teaching children the body-safety skills of recognizing, resisting, and reporting inappropriate touching).

MBF Child Safety Matters® is designed to be a comprehensive, primary prevention education program based on polyvictimization research. It was developed by the Monique Burr Foundation for Children (MBF). The program is available to elementary schools and organizations partnering with elementary schools to educate and empower students, school personnel, and parents with information and universal Safety Rules and strategies to prevent many types of victimization. The curriculum is designed to be practical and easy for schools to implement.

MBF Child Safety Matters covers bullying, cyberbullying, four types of child abuse (physical, sexual, emotional and neglect), digital abuse, and other digital dangers in two classroom lessons ranging from 35-55 minutes (or in 4 shorter lessons). The program also provides reinforcement materials and activities for students, parents, and schools.

The CEBC has also reviewed MBF Teen Safety Matters® and it can be accessed here.

Parents Anonymous® is designed to be both a prevention and treatment program that strengthens families that are at risk of becoming (or already are) involved in the child welfare system, have behavioral health challenges, substance use disorders or face other family issues. It is open to any parent or caregiver in a parenting role who is seeking emotional support, personal growth and change, and to improve parent, child and youth well-being regardless of the age or special challenges of their children or youth including severe emotional concerns. Services include weekly support groups, peer parent partner services (such as advocacy, kinship navigator services, in-home parenting, and supportive services including linkages to community resources), and helpline services. The Parents Anonymous® program aims to mitigate the impact of Adverse Childhood Experiences (ACEs) for parents/caregivers and prevent the occurrence of ACEs for their children and teens. The program also aims to build on the strengths of all family members and enhance family well-being by increasing protective factors through trauma-informed practices and decreasing risks, substance abuse, and domestic violence.

Parents as Teachers™ is a home visiting model that promotes the optimal early development, learning, and health of children by supporting and engaging their parents and caregivers. The home visiting model can be offered prenatally through kindergarten and can be replicated by various types of organizations including health departments, nonprofit organizations, hospitals, and school districts.

The Parents as Teachers model offers a cohesive package of services for families with young children and is framed around four dynamic components: Personal Visits, Group Connections, Child Screenings, and Resource Network. These components are guided by explicit fidelity and quality standards that guide program service delivery and replication of the program.

Parents as Teachers home visiting professionals meet families where they are comfortable; each personal visit includes a focus on parent-child interaction, development-centered parenting, and family well-being.

The Period of PURPLE Crying program is the name given to the Shaken Baby Syndrome/Abusive Head Trauma (SBS/AHT) prevention program developed by National Center on Shaken Baby Syndrome. The program educates parents and caretakers on normal infant crying, the most common trigger for shaking an infant. It was designed to be used primarily in universal, primary prevention settings, but is applicable to secondary prevention as well.

The letters in PURPLE stand for the common properties of crying, including unsoothable crying, in infants during the first few months:

• Peak pattern (crying peaks around 2 months, then decreases)
• Unpredictable (crying for long periods can come and go for no reason)
• Resistant to soothing (the baby may keep crying for long periods)
• Pain-like look on face
• Long bouts of crying (crying can go on for hours)
• Evening crying (baby cries more in the afternoon and evening)

The other important word in the name is "period," letting parents and caregivers know there is a beginning and ending to the infant crying phase. The program includes a full color 10-page booklet, parent reminder card, a 16-minute PURPLE Crying video and a 17-minute Crying, Soothing, Coping: Doing What Comes Naturally video intended to be given to parents of new infants. The program materials are available in an App+Booklet package which grants them access to a web and/or mobile application. The program materials are available in two formats: DVD with booklet package or web and mobile application with booklet package. The program also contains a public media component aimed at changing cultural attitudes about crying, especially inconsolable crying.

Play it Safe!® Child Abuse Prevention Program – 3rd-5th Grade is a child abuse prevention program designed to be presented to one classroom at a time. There are separate curricula for 3rd, 4th, and 5th grade.

Note: Play it Safe! has grade-level curriculum for Pre-K through 2nd grade students and 6th grade through high school students, but the CEBC has not reviewed and rated the curriculum for those grades.

Safe Touches - A Child Sexual Abuse Prevention Program for Children is designed for children in kindergarten through third grade (K-3). Specially trained facilitators use puppets to talk about body safety concepts and help children learn and practice key safety skills. The workshop is classroom-based (approximately 25-30 children per workshop) and lasts 45-50 minutes, including a question-and-answer session at the end. After the workshop, children are given an age-appropriate activity booklet on body safety to complete at home with their caregivers and encourage continued conversations about sexual abuse prevention. Teachers are also provided with a link to a video of a recorded puppet skit with follow-up questions. They are encouraged to play the video for the children one week after the workshop to reemphasize the safety skills taught in the workshop.

The Stewards of Children program is a 2-hour training that teaches adults how to prevent, recognize, and react responsibly to child sexual abuse. It integrates commentary from sexual abuse survivors, experts in the field, and other concerned adults, all providing practical guidance for preventing and responding to child sexual abuse. It is available in both a facilitator-led and online model.

The Safe Child Prevention of Child Abuse Program is a free comprehensive curriculum that teaches prevention of sexual, emotional, and physical abuse for children ages 3-11 utilizing a broad base of life skills and specific role-play-based applications. Believing that it is never a good idea to reinvent the wheel, these grade-level programs are provided as a starting point. Each country should adopt the programs to reflect cultural norms and language. Link to Contents here: https://safechild.org/prevention-of-child-abuse-program/

The "Who Do You Tell?"™ child sexual abuse education program is designed for children from kindergarten to grade 6, with three different versions tailored to reflect the developmental level of the children being taught. It is delivered to Kindergarteners and those in grades 3-6 in two 45-minute sessions, those in grade 1 have nine sessions and those in grade 2 have eight on separate days in order to enhance retention by the students. Typically, "Who Do You Tell?"™ is taught in a classroom setting, but can easily be adapted to other child-oriented settings (e.g., community centers, boys and girls clubs, etc.).

A one-hour session with teachers outlining what will be taught, how to recognize sexual abuse in children, and how to respond to disclosures is an additional part of the program. A parent night which prepares parents for their children's participation in the program and provides them with information about child sexual abuse and responding to disclosures is also included.