In 2009, approximately 3.3 million child abuse reports and allegations were made involving an estimated 6 million children. More than five children die every day as a result of child abuse and approximately 80% of those children that die from abuse are under the age of 4 (Source: http://www.childhelp.org/pages/statistics/).
April is National Child Abuse Prevention Month. The Blue Ribbon Campaign and Prevent Child Abuse America (PCAA)’s Pinwheels for Prevention® campaign have shifted to positive messages of supporting families and strengthening communities to prevent child abuse and neglect. But while blue ribbons and pinwheels may raise awareness, there is little evidence to suggest that health promotion alone can change behavior! As a QI Advisor, I facilitated pediatric primary care teams in implementing Practicing Safety, a child abuse and neglect prevention intervention (http://www2.aap.org/qualityimprovement/quiin/PracticingSafety.html ). We identified key strategies to help pediatricians intervene with families at risk of abuse and neglect. This work was supported by a grant from the Doris Duke Foundation to the American Academy of Pediatrics and our research identified strategies that practice teams could successfully implement. The practices we worked with as a result of Practicing Safety would:
- Discuss crying with all new parents, not just those with expressed concerns. Help parents be aware of their baby’s temperament. Teach new parents how to swaddle their infant.
- Screen all new moms for post-partum depression using a standardized screening tool, such as the Edinburgh, and conduct follow-up for moms found to be at risk.
- Encourage parents to read to their baby. Practice enrollment in the Read Out And Read (ROAR) program provides free books in multiple languages and appropriate age levels that can be given to families.
- Talk about child development at each well-child visit, starting at 6 months, to help parents understand each stage of their child’s development. This can help parents keep their perspective as their child goes through developmental changes. Discuss establishing routines, modeling behaviors and that discipline equals teaching, not punishment.
- Provide stickers and potty charts for parents who are toilet-training their toddlers, making it a more positive and rewarding experience. Personal Note: My adult daughter was toilet trained that way and she still uses a chart and star stickers to achieve a personal goal!
Ruth Gubernick is a JSPH doctoral student.