This synthesis was made possible by the Children's Bureau, Administration for Children, Youth and Families, Administration for Children and Families, U.S. Department of Health and Human Services. The conclusions discussed here are solely the responsibility of the authors and do not represent the official views or policies of the funding agency. Publication does not in any way constitute an endorsement by the Department of Health and Human Services. Suggested citation: U.S. Department of Health and Human Services, Administration for Children and Families, Children's Bureau (2003). School-Based Child Maltreatment Programs: Synthesis of Lessons Learned. Washington, DC.

1. General Service Approaches and Outcomes
2. Lessons Learned
3. Conclusion
Appendix A
Appendix B

Schools provide a unique environment for identifying child maltreatment and providing prevention and intervention services. Due to their sustained contact with children, teachers and other school personnel have extensive opportunities to observe children's behaviors, socio-emotional functioning, academic achievement, and cognitive development. Schools also have access to parents through activities such as parent-teacher conferences, Parent-Teacher Association meetings, and other events that encourage parent involvement in their children's schools. In addition, schools are often a focal point for community activities and concerns.

In Fiscal Year 1997, the Office on Child Abuse and Neglect (OCAN), Children's Bureau, Administration for Children and Families, Department of Health and Human Services, provided 3-year grants to develop and implement demonstration projects that address child maltreatment identification, prevention, and treatment in collaboration with preschool, elementary, and secondary school systems. This synthesis, based on an evaluation of the final reports of 11 grantees¹, describes the demonstration projects and some of the key lessons learned about how child maltreatment prevention and intervention efforts can be enhanced through the involvement of a school or school system. The projects identified strategies that improved outcomes for children by:

• Facilitating collaboration with schools.
• Enhancing teacher, parent, and child knowledge and skills pertaining to child maltreatment.
• Enlisting school staff in efforts to prevent child maltreatment and intervene when children are at risk for, or are victims of, maltreatment.

Children's Bureau demonstration projects test new, distinctive approaches for service delivery, or whether a service that has proven successful in one setting can work in a different context. A demonstration project must:

• Develop and implement an evidence-based model; or replicate a successfully evaluated program model.
• Use multiple measures to evaluate the effectiveness of the model.
• Produce detailed procedures and materials that may be used to guide replication or testing of strategies, practices, and programs in other settings.

As such, the evaluations of these programs provide information that can help guide organizations wishing to implement evidence-based child maltreatment identification, prevention, and intervention services in collaboration with schools. Detailed information about each demonstration project is available in Appendix A. Contact information for each grantee is listed in Appendix B. The grantees' final reports are available from the National Clearinghouse on Child Abuse and Neglect Information (1-800-FYI-3366 or nccanch@caliber.com).

1. GENERAL SERVICE APPROACHES AND OUTCOMES

Services provided by the demonstration projects fit three general categories: child maltreatment identification-related services, primary prevention services and activities, and intervention-related services. Grantees typically focused on one or two of these service types.

1.1 Child Maltreatment Identification-related Services

Grantees trained or assisted teachers and other professionals in identifying the signs of child maltreatment and in making appropriate referrals to services and reports to child protective services agencies. Activities included:

• Training on identifying and reporting child maltreatment. The primary goals of these trainings were to increase participants' knowledge of the signs of child abuse or neglect, how to meet mandated reporting requirements if child maltreatment is suspected, and how to make appropriate referrals to services if necessary.

• Assisting teachers in identifying the signs of child maltreatment. Grantees developed risk assessment protocols for teachers to use in identifying children who may be at risk for child maltreatment, trained teachers in the correct use of the protocols, and provided individual technical assistance in identifying signs of child maltreatment and making referrals to community services.

Outcomes. Participants demonstrated an increased understanding of the roles and procedures associated with child abuse and neglect investigations. Teachers who attended trainings also indicated a greater willingness to report suspected cases of child abuse or neglect than those who had not attended.

1.2 Primary Prevention Services/Activities

Services classified as primary prevention are designed to increase the knowledge and skills of teachers, parents, and children regarding appropriate discipline and parenting practices, positive adult-child and peer interactions, and nonviolent responses to stress or conflict. These services were offered to the general population, rather than to populations identified as at risk for child maltreatment. They included:

• Parenting education for the general population. Parenting education for the general population took place both in structured settings such as workshops and training sessions and in unstructured settings such as support groups.

• Teacher education. The objectives of these services were to create nurturing and violence-free classrooms and to support teachers in serving as positive role models for children in responding to stressful events.

• Special activities/presentations for children and youth. These included activities for children such as self-esteem groups, teen mom programs, and mentoring programs; presentations of skills-based curricula for children such as Kids on the Block and Talking About Touch; and training for teachers on implementing a particular classroom curriculum.

• Special activities/presentations for families and parents. These activities were designed to present child maltreatment-related information through events such as community fairs, walk-a-thons, and school fairs.

• Public awareness campaigns. Activities included distributing promotional items, offering health screenings, and printing newsletters to increase public knowledge regarding child maltreatment, available services, and trainings.

Outcomes. Teachers who participated in prevention services demonstrated an increased understanding of the principles of nonviolence, appropriate discipline, and nurturing behaviors. They also integrated what they learned into their classroom behavior and lesson plans. Children who attended prevention presentations showed an increased awareness of safety issues and demonstrated greater knowledge of child abuse and neglect. In some cases, this led to disclosures about their own experiences of maltreatment. The community at large benefited from public awareness campaigns by becoming more knowledgeable about child maltreatment issues and the community services available to support families.

1.3 Intervention-related Services

This category includes services delivered to children and families identified as at risk for child maltreatment or children who were suspected victims of child maltreatment.

• Direct services to at-risk families. Direct services included home visits, case management, counseling, therapy, mentoring, and food and clothing.

• Direct services to at-risk children. These services included support groups, social events, tutoring, counseling, and therapy.

• Technical assistance and training in responding to suspected or disclosed child maltreatment. Some projects provided individual technical assistance and guidance to teachers in responding to children's disclosure of child maltreatment. Others included the topic of responding to suspected or disclosed child maltreatment as part of their training for teachers and professionals.

• Parenting education for at-risk families. Parenting education efforts for families identified as at risk generally involved presenting an established curriculum in a series of sessions.

• Developing resource directories and/or service guidelines. Some projects developed resource directories or service guidelines designed to be used by schools or other agencies in making child abuse and neglect reports and referring families for appropriate services.

Outcomes. Children who received intervention services generally experienced improved school performance, increased attendance, and fewer behavior problems. Participating parents demonstrated significant gains in their knowledge of how the child maltreatment reporting system works, knowledge about stress and violence, and increased awareness of the implications of children as a source of parental stress. For at least one grantee, intervention-related services proved cost effective. The annual cost for an at-risk family to participate in the grantee's program was far less than the annual cost for the Department of Human Services to assist a family referred for services.

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2. LESSONS LEARNED

The grantees discussed in this report overcame many challenges to meet their objectives of collaborating with schools to provide child maltreatment identification, prevention, and intervention services. As a result, they were able to offer recommendations that may be of use to organizations implementing similar projects.

2.1 General Recommendations

Several of the grantees' recommendations apply to the implementation of any comprehensive child maltreatment identification, prevention, and intervention project.

• Be flexible to accommodate the schedules of all participants, including school personnel, parents, teenagers, and children.
• Be sensitive to differences in language and culture in developing outreach and prevention education efforts.
• Be willing to eliminate a planned service or change an existing service in response to new information about participant needs and interests.
• Be realistic about participation levels. Most projects expected they would be serving more teachers, parents, and children than were actually served.

2.2 Collaboration with Schools

Challenges associated with collaboration with schools included lack of support from school administrators, scheduling conflicts with other school activities, and inappropriate referrals or requests resulting from misperceptions about the project's goals. Grantees cited the following lessons learned:

• Full commitment from the school system leadership or school principal is necessary to ensure effective collaboration. Consider including a school principal on the program advisory board.
• Schedule project activities involving teachers in advance and with the full support of school principals or administrators.
• Develop a shared understanding of the project's model, methods, and desired outcomes among school and project staff.
• Help school personnel see how the project contributes to the school's mission. This will result in more (and more appropriate) referrals to the project.
• Work to develop constant communication between project and school staff, and strive for visibility of project staff at the schools.
• Be persistent. Schools are under pressure to fulfill many agendas.
• Be aware of the challenges teachers encounter working in schools where the problems experienced by children and families often outnumber available supports and services.
• Seek to establish collaborative relationships with other agencies in the community (primarily, but not exclusively, social service agencies). A school-based prevention program works best when it engages all sectors of the community.

2.3 Project Staffing

Frequent staff turnover and difficulty recruiting qualified staff were common challenges reported by grantees. Recommendations included:

• Seek project directors with experience implementing Federal grants.
• Stress the importance of commitment and continuity when hiring staff.
• Offer project staff full-time positions and salaries commensurate with those of teachers and public health workers.
• Project staff must have extensive knowledge of and experience with the network of local providers in order to make appropriate service referrals.
• Project staff should include someone who is a member of the community being served, or should work to develop and maintain support from members of the community to establish trust between the community and the project.

2.4 Teacher Training

Demonstration projects reported scheduling conflicts and low participation to be common challenges associated with teacher training. They made the following recommendations:

• Schedule training as far in advance as possible; take the school calendar into account.
• Provide training that does not require an extensive time commitment from participants.
• Provide continuing education credits.
• Offer training off site; provide a stipend and lunch.

2.5 Direct Services

In implementing direct services for children and families, demonstration projects noted difficulties with ensuring project staff safety during home visits and with recruiting and retaining participants. Grantees cited the following lessons learned:

• Families may be more willing to participate if the program is perceived as being focused on family strengthening or support, rather than on child maltreatment prevention or intervention.
• Make direct services available to children and families outside of school hours.
• Consider providing one-on-one case management to families in their own homes.
• Develop procedures to keep program staff safe when making home visits.

2.6 Parent Engagement and Retention in Parenting Education

The key challenge associated with parent education was low attendance. For some participants, protecting confidentiality was a concern. Recommendations included:

• Be aware of other programs for parents being offered at the same time.
• Recruit volunteers to provide child care and transportation.
• Provide food or other incentives (such as gift certificates) at each session.
• Offer parenting education on a one-to-one basis if confidentiality is an issue.
• Work with schools to obtain commitments from parents to attend the program.
• Some attrition is to be expected. Recruit more participants (at least 30 percent more) than you need for the program.

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3. CONCLUSION

The projects included a variety of approaches to child abuse prevention and intervention, many of which proved effective. Direct services provided to at-risk families and children appear to have improved family functioning and child behaviors. Training on recognizing the signs of maltreatment and on reporting maltreatment appears to have enhanced school personnel's knowledge, skills, and comfort with the reporting process. Teacher training on nurturing and on the principles of nonviolence appears to have been integrated into the classroom environment. Classroom presentations to young children were found to enhance their understanding of child maltreatment issues and, in some instances, to help them disclose their own experiences of maltreatment.

Organizations wishing to implement school-based programs for identification, prevention, and intervention of child maltreatment can use the lessons learned from these demonstration projects to build more successful programs in the future.

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¹ Synthesis Report of the School-Based Child Maltreatment Prevention, Identification and Treatment Services Demonstration Projects, final report for Children's Bureau contract #GS-10F-0204K, "Technical Assistance on Evaluation," prepared for James Bell Associates by Jacqueline Smollar, Ph.D. back