DUMORNAY, ET AL, AMERICAN JOURNAL OF PSYCHIATRY
Prevention is a hot topic in child welfare policy conversations, and for good reason. Preventing child maltreatment helps families thrive and reduces the frequency of tragic outcomes. The Family First Prevention Services Act of 2018 propelled prevention efforts forward and launched a national conversation about keeping children out of foster care except when absolutely necessary.
The State of Child Welfare
Child maltreatment rates have declined dramatically over the past 30 years. Between 1992 and 2019, physical abuse declined by 56% and sexual abuse declined by 62%. Public policy, awareness programs and decreased stigma associated with seeking help contributed to these changes.
By contrast, rates of child neglect remain high. Neglect is the most common type of child maltreatment in the U.S. Until recently, federal child welfare policies primarily responded to maltreatment without much attention to addressing risk factors. The outcome was to inadvertently punish struggling families more than help them.
More than 480,000 children were impacted by neglect in 2020, and it was a primary or contributing factor for 64% of children entering foster care the same year. By comparison, 13% of children entering foster care in 2020 were victims of physical abuse and 4% were victims of sexual abuse.
What Is Neglect?
Most experts agree child neglect occurs when the needs of a child are unmet by their primary caregivers. Inadequate clothing, food, shelter, medical and emotional care, along with unsafe environments, exposure to substance abuse and lack of supervision, are often included in definitions of neglect. Even with these definitions, pinpointing cases of neglect can be challenging. Policymakers and researchers are rethinking historical definitions, which often are intertwined with poverty. States have authority to define exactly what neglect means through legislation, and there is considerable variation.
Research shows the presence of one or more child maltreatment risk factors, such as poverty, can make a child more vulnerable to experiencing neglect. While risk factors do not cause maltreatment, buffering or reducing them is a promising prevention pathway.
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