Home visitation may help reduce
child abuse and neglect
Barlow J, Davis H, McIntosh E, Jarrett P, Mockford C, Stewart-Brown S
The Bottom Line:
This trial showed that home visiting has the potential to help improve the crucial parent-child relationship and increase identification of infants at risk of abuse and neglect. There may also be so far unknown positive effects in the future. More research is needed to determine how home visitation can be used to improve parenting skills and the home environments of infants. |
What problem is being addressed?
Children who are abused or neglected by their parents are at high risk of developing emotional or behavioural problems, failing at school, becoming delinquent during late childhood and adolescence, and having problems with relationships as adults. Parents who were abused or neglected as children, who suffer from mental problems or substance abuse, or who are economically or socially disadvantaged are at higher risk of abusing or neglecting their children. This study looks at one method of intervening with these high-risk parents to improve the health of their children.
What intervention is being tested?
This randomized controlled trial involved 131 pregnant women who were at risk of neglecting or abusing their infants. The mothers were randomly assigned to receive the usual care (not described) or weekly visits from a health visitor trained in the Family Partnership Model for a period of 18 months – 6 months before birth to 12 months after the birth of their child.
The study compared the impact of home visitation vs. usual care on the mother-child interaction, the mothers’ own mental health problems, her attitudes towards parenting and her ability to care for her child. Other outcomes included the level of the mothers’ social support, problems with her partner, self-esteem, and beliefs about her ability to cope with adult responsibilities. The home environment was also assessed, as were the infants’ social, emotional, and cognitive development. The mothers were also asked questions about their child’s well-being at 6 months (that is, feeding, disability, and immunization records). Health visitors reported on whether or not any of the participating children had been the subject of a protection order, had been removed from their home, or had died.
What is the real scientific evidence?
Mothers receiving home visitation showed slight improvement in their sensitivity to their child’s needs, and their infants were found to be more cooperative with their mother. No other positive effects were found by the end of the 12-month follow-up period. It is possible that there will be “sleeper effects,” that is, effects that don’t appear until years later. An example is a reduction in delinquent behavior in older children or adolescents, or a reduction in depression in adolescents.
The preceding is a summary of:
Barlow J, Davis H, McIntosh E, Jarrett P, Mockford C, Stewart-Brown S. Role of home visiting in improving parenting and health in families at risk of abuse and neglect: results of a multicentre randomised controlled trial and economic evaluation.2007 Archives of Disease in Childhood, 92: 229– 233.
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