The role of home-visiting programs in preventing child abuse and neglect.

Kimberly Howard and Jeanne Brooks-Gunn examine home visiting, an increasingly popular method for delivering services for families, as a strategy for preventing child abuse and neglect. They focus on early interventions because infants are at greater risk for child abuse and neglect than are older children. In their article, Howard and Brooks-Gunn take a close look at evaluations of nine home-visiting programs: the Nurse-Family Partnership, Hawaii Healthy Start, Healthy Families America, the Comprehensive Child Development Program, Early Head Start, the Infant Health and Development Program, the Early Start Program in New Zealand, a demonstration program in Queensland, Australia, and a program for depressed mothers of infants in the Netherlands. They examine outcomes related to parenting and child well-being, including abuse and neglect. Howard and Brooks-Gunn conclude that, overall, researchers have found little evidence that home-visiting programs directly prevent child abuse and neglect. But home visits can impart positive benefits to families by way of influencing maternal parenting practices, the quality of the child's home environment, and children's development. And improved parenting skills, say the authors, would likely be associated with improved child well-being and corresponding decreases in maltreatment over time. Howard and Brooks-Gunn also report that the programs have their greatest benefits for low-income, first-time adolescent mothers. Theorists and policy makers alike believe strongly that home visiting can be a beneficial and cost-effective strategy for providing services to families and children. If home-visiting programs are to have their maximum impact, service providers must follow carefully the guidelines mandated by the respective programs, use professional staff whose credentials are consistent with program goals, intervene prenatally with at-risk populations, and carry out the programs with fidelity to their theoretical models.