DISRUPTION PAPER WINNERS
We held a competition for professionals in our field to share their most disruptive ideas on how to end child abuse and neglect in our lifetime. Below are the winners.
We received over 50 applications for ideas. 27 applications were accepted, and 22 papers were submitted. These papers were blindly reviewed by 18 qualified peers. 3 winners were selected, and were presented at our first National Summit in March 2019, which was focused on collaboration and a united voice to end child abuse and neglect.
CATEGORY TO DISRUPT: CLINICAL
WINNER: Babcock, Patricia
What if Child Maltreatment was Childhood Leukemia?: Lessons from the Halls of the Hospital
This paper aims to examine the aspects of childhood acute lymphoblastic leukemia (ALL) prevention, research, training, and clinical treatment that can be applied to child welfare. Since the 1960s, childhood cancer researchers have been able to reach a 98% remission rate and 90% five-year survival rate with limited research, training, and treatment dollars. In contrast, child welfare fatalities and maltreatment incidences have continued to increase. Although childhood leukemia is not readily associated with child welfare and child maltreatment, there are approaches, protocol and lessons from the cancer arena that can and will disrupt the status quo of how we address child welfare. This paper focuses on utilizing childhood cancer research and treatment as the catalyst for disrupting or re-creating a child welfare system that is preventative in nature and better equipped to treat the multitude of family and community issues that contribute to maltreatment.
CATEGORY TO DISRUPT: PREVENTION
WINNERS: Risser, Heather; Svevo-Cianci, Kimberly; Karim, Elba Jung; Morford, Alexandra
Achieving Comprehensive Prevention of Child Abuse & Neglect
The U.S. has a comprehensive array of child abuse and neglect (CAN) prevention resources, has allocated funding to provide these resources, and professionals are committed to preventing CAN. Yet, the current paradigm to prevent CAN is inadequate for three reasons. First, access to CAN prevention resources is not ubiquitous. Second, stigma prevents parents from seeking support and accessing services. Third, the average individual does not have a clear role in preventing CAN in their everyday lives. We need to shift the paradigm so that everyone feels entitled to advocate for CAN prevention and everyone knows how to engage in CAN prevention. We will use the handwashing paradigm as an example. Handwashing protocols are ubiquitous across all settings. Clear instructions for handwashing are posted in most restrooms, regardless of the setting. Every person believes they are entitled to have access to clean water and soap in every restroom, to request that others wash hands, and know how to model the behavior. Our aim is to create a shared mindset where people feel entitled to resources to build and maintain a web of healthy social relationships, displacing the current paradigm in which parents fear child welfare involvement and the stigma associated with asking for support; and non-parents question their role in preventing CAN. To achieve ubiquitous access and promote feelings/beliefs of entitlement to CAN prevention we propose one option for implementation by leveraging existing infrastructure, increasing system collaboration and engaging experts in a population-based public health campaign to inoculate society against CAN.
CATEGORY TO DISRUPT: RESEARCH
WINNERS: Bullinger, Lindsey; Feely, Megan; Raissian, Kerri; Schneider, William
Heed Neglect, Disrupt Child Maltreatment: A Call to Action for Researchers
Given that child neglect remains the most common type of child maltreatment and neglect is present in 80% of the child fatalities attributed to maltreatment, the disruption of child maltreatment must prioritize neglect prevention. Moreover, a new approach of focusing on macro-level factors, such as economies, labor markets, and governmental affairs should be investigated. These macro factors play a key, yet underexplored, role in family circumstances, and they strongly influence parents’ ability to consistently provide safe and sufficient environments for their children. Existing research, policies, and programs have successfully improved the health and safety of children in many areas including reducing physical and sexual abuse and reducing child deaths from disease and car accidents. Yet, these strategies have not been implemented in the area of child neglect, partially because the research community does not fully understand the causes of neglect. To inform new directions for child protection, we propose shifting the focus of research away from individual and family-level factors of indicated populations. Instead, we suggest focusing on macro-level factors that, while receiving far less attention from researchers, show initial promise for understanding the causal pathways of neglect and identifying policies for universal prevention. Additionally, financial support is needed for this vein of research and to encourage the research, policy and practice partnerships that are essential for implementing effective solutions.
*THERE WERE NO WINNERS IN THE TRAINING CATEGORY*
The following papers received honorable mention:
CATEGORY TO DISRUPT: CLINICAL
The application of a social justice theory to the well-being of substance-exposed infants
In utero exposure to drugs and alcohol threatens the well-being of infants. Federal law has established child well being as one of the three main goals of the child welfare system, and recent changes to federal law require state child welfare programs to assess the needs of substance-exposed infants and plan for their safe care. CPS workers are often the first point of contact these infants have with the public child welfare system; yet, CPS workers have no framework for assessing the well-being of substance-exposed infants. In this paper, the author applies the Theory of Justice as Well-being to substance-exposed infants as a way to assess the deficits to well-being these infants experience. Furthermore, Justice as Well-being is applied to substance-exposed infants and their families to serve as a conceptual framework for an interprofessional approach to planning for the treatment and safe care needs of this highly vulnerable child welfare population.
CATEGORY TO DISRUPT: PREVENTION
Roygardner, Debangshu; Palusci, Vince; Hughes, Kelli
Advancing Prevention Zones: Implementing Community-Based Strategies to Prevent Child Maltreatment and Promote Healthy Families
If we were to create a broadly defined system to protect children, it would be necessary to begin our work with families, using professionals from multiple disciplines and members of the community, as early as the prenatal period. Families raise children within communities, and that is where child maltreatment prevention begins. While reporting, investigations and services would all still exist, they would be placed into a model nested within a community that meets basic human needs. Addressing food insecurity, inadequate housing, and problematic child care at the community-level would address all forms of child maltreatment through early identification, treatment, and prevention. Imagine a world where children were conceived, born, and grew up in communities with dedicated professionals and supports that promoted family strengths and individual resiliency as well as identified early manifestations of risk for future maltreatment. Within our lifetime, we can instill the expectation among professionals that child maltreatment occurs across social strata, race, and ethnicity, and that prevention is the norm rather than the exception. While it has been more than 25 years since the U.S. Advisory Board heralded community-based Prevention Zones, we believe the time is right again to propose this “disruptive” concept of strengthening community resources, placing investigation and investigators within a community context, and fully integrating home-visitation programs, primary medical care systems and parental support into a community-based prevention network.
CATEGORY TO DISRUPT: RESEARCH
Christ, Sharon L.; Schwab Reese, Laura M.
Shedding the Constraints of Formal Systems in Research on Child Maltreatment through High Quality Measurement and Broad Population Surveys
Effective prevention and intervention of child maltreatment requires that we understand what exposures harm children in the natural environments in which they live and develop. Determining which exposures cause harm requires appropriately defining and measuring the exposures as well as determining the relevant developmental outcomes used as indicators of harm. Research establishing these harms should not depend on definitions used by the formal regulatory systems responsible for child welfare, i.e., Child Protective Services (CPS) and the associated legal infrastructure. In addition, child maltreatment research requires engagement with populations outside of formal child welfare regulatory systems and across social, cultural, political, or institutional boundaries. In this paper, we appeal for more “systems-free” research with the goal of new discoveries in both defining and recognizing childhood maltreatment and the varied social pathways of prevention. We specifically propose rigorous measurement and modeling approaches, diverse samples, and rich data collection to meet these goals. These methods would provide new insights into multifaceted approaches to prevention and intervention, many of which may not involve existing child welfare systems. Though the proposed methods are ambitious and may be costly, the resulting improvements to prevention and intervention efforts could substantially reduce the mental and physical health, social, and economic costs of child maltreatment.
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