Child maltreatment and risk patterns among participants in a child abuse prevention program

The relationship between risk factors and Child Protective Services (CPS) outcomes in families who participate in home visiting programs to prevent abuse and neglect and who are reported to CPS is largely unknown. We examined the relationship between parental risk factors and the substantiation status and number of CPS reports in families in a statewide prevention program. We reviewed CPS reports from 2006 to 2008 for families in Connecticut's child abuse prevention program. Six risk factors (histories of CPS, domestic violence [DV], mental health, sexual abuse, substance abuse, and criminal involvement) and the number of caregivers were abstracted to create risk scores for each family member. Maltreatment type, substantiation, and number of reports were recorded. Odds ratios were calculated. Of 1,125 families, 171 (15.6%) had at least one CPS report, and reports of 131 families were available for review. Families with a substantiated (25.2%) versus unsubstantiated (74.8%) first report had a high number of paternal risk factors (OR = 6.13, 95% CI [1.89, 20.00]) and were more likely to have a history of maternal DV (OR = 8.47, 95% CI [2.96, 24.39]), paternal DV (OR = 11.23, 95% CI [3.33, 38.46]), and maternal criminal history (OR = 4.55; 95% CI [1.32, 15.60]). Families with >1 report (34.4%) versus 1 report (65.6%) were more likely to have >3 caregivers, but this was not statistically significant (OR = 2.53, 95% CI [0.98, 6.54]). In a prevention program for first-time families, DV, paternal risk, maternal criminal history, and an increased number of caregivers were associated with maltreatment outcomes. Targeting parental violence may impact child abuse prevention.     

Association of adverse childhood experiences with shaking and smothering behaviors among Japanese caregivers

Shaking and smothering in response to infant crying are life-threatening child abuse. Parental childhood abuse history is known to be one of the most robust risk factors for abusing their offspring. In addition to childhood abuse history, other adverse childhood exposures (ACEs) need to be considered due to co-occurrence. However, few studies have investigated the impact of ACEs on caregivers shaking and smothering their infant. This study aims to investigate the association of ACEs with shaking and smothering among caregivers of infants in Japan. A questionnaire was administered to caregivers participating in a four-month health checkup between September 2013 and August 2014 in Chiba City, Japan, to assess their ACEs (parental death, parental divorce, mentally ill parents, witness of intimate partner violence, physical abuse, neglect, psychological abuse and economic hardship), and shaking and smothering toward their infants (N = 4297). Logistic regression analysis was used to examine the cumulative and individual impacts of ACEs on shaking and smothering. Analyses were conducted in 2015. A total of 28.3% reported having experienced at least one ACE during their childhood. We found that only witness of IPV had a significant association with shaking of infant (OR = 1.93, 95% CI: 1.03–3.61). The total number of ACEs was not associated with either shaking or smothering. Our findings suggest that shaking and smothering in response to crying can occur regardless of ACEs. Population-based strategies that target all caregivers to prevent shaking and smothering of infants are needed.     

Relationship between child abuse exposure and reported contact with child protection organizations: Results from the Canadian Community Health Survey

Much of what is known about child abuse in Canada has come from reported cases of child abuse and at-risk samples, which likely represent the most severe cases of child abuse in the country. The objective of the current study is to examine the prevalence of a broad range of child abuse experiences (physical abuse, sexual abuse, and exposure to IPV) and investigate how such experiences and sociodemographic variables are related to contact with child protection organizations in Canada using a representative general population sample. Data were drawn from the 2012 Canadian Community Health Survey: Mental Health collected from the 10 provinces using a multistage stratified cluster design (n = 23,395; household response rate = 79.8%; aged 18 years and older). Physical abuse only (16.8%) was the most prevalent child abuse experience reported with the exposure to specific combinations of two or more types of child abuse ranging from 0.4% to 3.7%. Only 7.6% of the adult population with a history of child abuse reported having had contact with child protection organizations. Experiencing all three types of child abuse was associated with the greatest odds of contact with child protection organizations (AOR = 15.8; 95% CI = 10.1 to 24.6). Physical abuse only was associated with one of the lowest odds of contact with child protection organizations. Preventing child abuse is widely acknowledged as an important, but challenging public health goal. Strategies to increase reporting of child abuse may help to protect children and to connect families with necessary services. One obvious priority would be physical abuse.     

Empowering and protecting children by enhancing knowledge,skills and well-being: A randomized trial of Learn to BE SAFE with Emmy™

Australia needs effective programs to protect children and prevent abuse, but there is little information available for policymakers or families. Using a randomized controlled trial, Learn to BE SAFE with Emmy™, a school-based protection program for young children designed by Act for Kids, was evaluated to determine its effectiveness for promoting young children's knowledge and skills. Grade one children (n = 245) from 15 classrooms across 5 primary schools completed assessment measures. A subset of these children received the program (n = 131) or acted as a comparison group (n = 114). Parents (n = 72) completed questionnaires about their child's participation in the program. When compared with children who had not received the program, children who completed Learn to BE SAFE with Emmy™ demonstrated increased knowledge of interpersonal safety and were more likely to choose a safe response option to hypothetical unsafe scenarios 6 months after participation than at both pre- and post-intervention. Parents reported their children who participated used more safety strategies immediately and 6 months after participation compared to pre-intervention. Outcomes can assist in guiding future policies around the prevention of child abuse and protect the well-being of Australian children.     

Domestic violence and immigration status among Latina mothers in the child welfare system: Findings from the National Survey of Child and Adolescent Well-being II (NSCAW II)

Many children involved with the child welfare system witness parental domestic violence. The association between children's domestic violence exposure and child welfare involvement may be influenced by certain socio-cultural factors; however, minimal research has examined this relationship. The current study compares domestic violence experiences and case outcomes among Latinas who are legal immigrants (n = 39), unauthorized immigrants (n = 77), naturalized citizens (n = 30), and US-born citizen mothers (n = 383) reported for child maltreatment. This analysis used data from the second round of the National Survey of Child and Adolescent Well-being. Mothers were asked about whether they experienced domestic violence during the past year. In addition, data were collected to assess if (a) domestic violence was the primary abuse type reported and, if so, (b) the maltreatment allegation was substantiated. Results show that naturalized citizens, legal residents, and unauthorized immigrants did not differ from US-born citizens in self-reports of domestic violence; approximately 33% of mothers reported experiences of domestic violence within the past year. Yet, unauthorized immigrants were 3.76 times more likely than US-born citizens to have cases with allegations of domestic violence as the primary abuse type. Despite higher rates of alleged domestic violence, unauthorized citizens were not more likely than US-born citizens to have these cases substantiated for domestic violence (F(2.26, 153.99) = 0.709, p = .510). Findings highlight that domestic violence is not accurately accounted for in families with unauthorized immigrant mothers. We recommend child welfare workers are trained to properly assess and fulfill the needs of immigrant families, particularly as it relates to domestic violence.     

Child welfare outcomes for youth in care as a result of parental death or parental incarceration

Every day, in the United States, children are removed from their homes and placed into state supervised out-of-home care because of concerns around their safety. These children enter care as a result of child abuse, child neglect, abandonment or some other reasons. Lost in most discussions of out-of-home care is the role that parental incarceration and parental death have on the trajectory of children through the child welfare system. In order to address this gap in the literature, the present study aims to compare youth in foster care as a result of parental death or youth in foster care as a result of parental incarceration with youth in care because of child maltreatment in terms of the length of time to achieve permanency. Holding all other variables constant, entering care as a result of parental death more than doubled the average time to exit (HR = 2.32, SE = 0.22), and these youth were significantly less likely to exit to permanency when compared to children entering care for other maltreatment reasons (OR = 0.35, SE = 0.24). Entering care as a result of parental incarceration led to a 24% longer time to exit (HR = 1.24, SE = 0.09) compared to children entering care for other maltreatment reasons. Findings suggest that a one-size-fits-all approach to policy and practice may not be useful to identifying permanent placements for children entering care as a result of parental death or incarceration.     

Maternal and paternal physical abuse: Unique and joint associations with child behavioral problems

Although there is a substantial amount of literature documenting the relationship between child abuse and behavioral problems in China, there is, on the other hand, a limited number of studies on the joint and unique associations of maternal and paternal physical abuse with child behaviors within the Chinese context. The present study, using the family systems theory as the theoretical framework, aims to examine these joint and the unique associations of maternal and paternal physical abuse with externalizing and internalizing behaviors among a community sample of Chinese children. A total of 296 children (54.7% boys, mean age 12.31 ± 0.56 years) from two-parent families participated in the study, and they reported their physical abuse experience by their mother and father in the previous year using the Chinese version of the Parent-Child Conflict Tactics Scale. Participants, using the Youth Self Report, reported personal externalizing and internalizing behaviors, and, similarly, their mothers, using the Child Behavior Checklist, assessed children’s externalizing and internalizing behaviors. Linear mixed effect models with random intercept and slope were used to examine the joint and unique associations of maternal and paternal physical abuse with child externalizing and internalizing behaviors. Results revealed that physically abused children were more likely to be simultaneously abused by both mothers and fathers. Furthermore, when compared with their non-abused counterparts, children with physical abuse that was carried out solely by mothers (externalizing behaviors: β = 6.71, 95% CI = 2.45–10.98, p < 0.01; internalizing behaviors: β = 4.52, 95% CI = 0.37–8.66, p < 0.05) or by both mothers and fathers (externalizing behaviors: β = 4.52, 95% CI = 1.80–7.24, p < 0.001; internalizing behaviors: β = 2.98, 95% CI = 0.34–5.61, p < 0.05) reported more externalizing and internalizing behaviors. Externalizing and internalizing behaviors of children who were physically abused solely by fathers did not significantly differ from those of their non-abused counterparts, which may result from the small sample size. The present findings suggest that maternal physical abuse may have a dominant and unique association with child behaviors, regardless of whether paternal physical abuse occurs within the family. Implications for future research and practice within the Chinese context regarding the subject of child behaviors and parental abuse are discussed.     

Adverse childhood experiences and suicide attempts among those with mental and substance use disorders

Using the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions data, we examined the associations of ten types of adverse childhood experiences (ACEs) with (1) lifetime suicide attempts and (2) number and age of attempts among U.S. adults aged 18+. In a case-control design, suicide attempters (5.14% of the full sample) were matched with never attempters (matched sample N = 3912) on nine mental and substance use disorders. ACE rates were higher among attempters (3.30 [SE = 0.07]) than their matched controls (2.19 [SE = 0.06]). Results from multivariable logistic regression analyses showed that sexual abuse and parental/other family member’s mental illness were associated with increased odds of having attempted suicide among both genders, and emotional neglect was also a factor for men. Population attributable risk fractions for sexual abuse were 25.75% for women and 8.56% for men. Sexual abuse and a higher number of ACEs were also related to repeated suicide attempts. A higher number of ACEs was associated with a younger first attempt age. Gay/bisexual orientation in men and the lack of college education in both genders were significant covariates. In conclusion, this study underscores that ACEs are significantly associated with lifetime suicide attempts even when mental and substance use disorders are controlled.     

The relationship between child abuse,parental divorce,and lifetime mental disorders and suicidality in a nationally representative adult sample

ObjectivesTo determine how the experiences of child abuse and parental divorce are related to long-term mental health outcomes using a nationally representative adult sample after adjusting for sociodemographic variables and parental psychopathology.MethodsData were drawn from the National Comorbidity Survey (NCS, n = 5,877; age 15–54 years; response rate 82.4%). Logistic regression models were used to determine the odds of experiencing lifetime psychiatric disorders and suicidal ideation and attempts.ResultsParental divorce alone was associated with some psychiatric disorders after adjusting for sociodemographic variables (AOR ranging from 1.30 to 2.37), while child abuse alone was associated with psychiatric disorders (AOR ranging from 1.39 to 6.07) and suicidal ideation (AOR = 2.08; 95% CI = 1.57–2.77) and attempts (AOR = 1.54; 95% CI = 1.02–2.31) after adjusting for sociodemographic variables. However, having experienced both parental divorce and child abuse together resulted in significantly increased odds for lifetime PTSD (AOR = 9.87; 95% CI = 6.69–14.55), conduct disorder (AOR = 4.01; 95% CI = 2.92–5.51) and suicide attempts (AOR = 2.74; 95% CI = 1.84–4.08) compared to having experienced either parental divorce or child abuse alone. These results were attenuated when further adjusting for parental psychopathology.ConclusionsWhen the experience of parental divorce is accompanied with child abuse, the associations with some poor mental health outcomes are significantly greater compared to the impact of either parental divorce or child abuse on its own. Therefore, parental divorce is an additional childhood adversity that significantly contributes to poor mental health outcomes especially when in combination with child abuse. Parental psychopathology attenuated these relationships suggesting that it may be one possible mechanism to explain the relationships between child abuse, parental divorce, and psychiatric disorders and suicide attempts.     

Childhood adversity and adult depression: The protective role of psychological resilience

Adverse childhood experiences (ACEs), such as childhood abuse, neglect, and household dysfunction, have been identified as salient risk factors for adult depression. However, not all individuals who experience ACEs go on to develop depression. The extent to which resilience- or the ability to demonstrate stable levels of functioning despite adversity- may act as a buffer against depression among individuals with a history of ACEs has not been adequately examined. To address the associations between ACEs, depression, and resilience, 4006 adult participants were recruited from primary care clinics. Participants completed self-report questionnaires including: the Adverse Childhood Experiences Questionnaire, a retrospective measure of childhood adversity; the Patient Health Questionnaire-9, a measure of the presence and severity of the major symptoms of depression; and the Connor Davidson Resilience Scale, a measure of psychological resilience. Results from regression analyses indicated that, while controlling for a range of demographic variables, both ACEs and resilience independently predicted symptoms of depression, F(9, 3040) = 184.81, R² = 0.354. Further, resilience moderated the association between ACEs and depression, F(10, 3039) = 174.36, p < 0.001, R² = 0.365. Specifically, the association between ACEs and depression was stronger among individuals with low resilience relative to those with high resilience. This research provides important information regarding the relationships among ACEs, resilience, and depression. Results have the potential to inform the development of treatments aimed to reduce symptoms of depression among primary care patients with a history of childhood adversity.     

Child care for children with and without disabilities: The provider,observer, and parent perspectives

This three-phase study, part of a larger study conducted by the Midwest Child Care Research Consortium (MCCRC), investigated the characteristics of child care providers in inclusive and non-inclusive center-based classrooms and family child care homes, the observed quality of care in a subset of these programs, and families’ perceptions of quality and satisfaction with child care services. A telephone survey of 2022 randomly selected Midwestern providers, 36% of whom provided inclusive services, revealed that inclusive providers rated themselves higher on most quality-related indicators. Inclusion status was related to observed quality in family childcare homes (n = 132), with non-inclusive homes higher, while trends in the opposite direction were observed in preschool center-based classrooms (n = 112) but not in infant/toddler center-based classrooms (n = 105). Six percent of the 1325 parents surveyed reported parenting a child with a disability. These parents indicated less income, and more frequent changes in child care settings than other families, and reported the quality of their children's child care as good, particularly if center-based. Improved access to inclusive child care services and enhanced training opportunities related to serving children with disabilities and inclusion, especially for family child care providers, is recommended.     

Identifying child abuse and neglect risk among postpartum women in Japan using the Japanese version of the Kempe Family Stress Checklist

The aims of this study were to determine the rate of women who are high-risk for child abuse and neglect in a perinatal unit in Japan, and to identify the factors associated with risk level. To assess the potential risk for child abuse and neglect the Japanese version of the Kempe Family Stress Checklist (FSC-J) was used to guide interviews with postpartum women. FSC-J uses a three-point scale to score 10 categories, categorizing responses as “no risk = 0”, “risk = 5”, and “high risk = 10”. The range of FSC-J is 0–100. Using an established cutoff point of 25, subjects were divided into high and low risk groups. For both groups, relationships between factors were analyzed. Of the 174 subjects who agreed to participate, 12 (6.9%) scored high-risk, and 162 (93.1%) scored low-risk. Adjusted odds ratio identified three associated factors as important for predicting risk level: past mental illness (OR = 341.1), previous experience of intimate partner violence (OR = 68.0), and having a partner who was unemployed (OR = 14.5). Although this study was on a small sample of women in one hospital in Japan and a larger population would make this study much stronger, these results suggest that some 6.9% of postpartum women in Japan may be at high-risk for child abuse and neglect. It is critical, therefore, to develop a system for screening, intervention, and referral for such women and their children.     

Prevalence of different forms of child maltreatment among Taiwanese adolescents: A population-based study

Reported cases of child maltreatment are increasing in Taiwan. Yet, comprehensive epidemiological characteristics of adolescents’ exposure over the wide spectrum of violence are still lacking. The purpose of this study was to estimate the prevalence and magnitude of child maltreatment among Taiwanese adolescents. A population-based study was conducted with 5,276 adolescents aged 12–18 from 35 schools in 17 cities and townships to determine the prevalence of five forms of child maltreatment in Taiwan. A total of 5,236 adolescents completed anonymous, self-report, structured questionnaires. Most adolescents (91%, n = 4,788) experienced at least one form of maltreatment with 83% (n = 4,347) exposed during the previous year. Violence exposure was the most common type of child maltreatment experienced, followed by psychological abuse, physical abuse, neglect, and sexual abuse. Adolescents reported an average of 7.4 (SD = 5.87) victimizations over their lifetime and 4.8 (SD = 4.82) victimizations during the past year. Females reported a higher rate of neglect, while males reported a higher rate of sexual abuse. Most of the sexual abuse perpetrators were known by their victims. Adolescents’ victimization and polyvictimization from child maltreatment in Taiwan deserves a review and modification of national control and prevention policies.     

Child maltreatment as a function of cumulative family risk: Findings from the intensive family preservation program

This study examined child maltreatment as a function of cumulative family risk in a sample of at-risk families (N = 837) who were referred to an intensive family preservation program because of child behavior problems or suspected child abuse and neglect. The goal of this intensive family preservation program is to improve parenting skills and reduce immediate family stressors that may lead to an increased risk of child abuse and neglect. The findings indicate that the most prominent family risks comprising the cumulative risk scale in our sample were socio-economic disadvantage (e.g., income, unemployment, housing instability) and parental characteristics (e.g., mental/physical health, parental use of alcohol, domestic violence). Further, the results demonstrated a strong quadratic trend in the relationship between cumulative family risk and child maltreatment, and identified a risk threshold effect at three cumulative family risks after which the child risk for maltreatment increased exponentially. These findings are interpreted in the light of the current research on differentiative interventions, supporting differentiated services to the families with low vs. higher risk for child maltreatment.     

Exposing the culture of silence: Inhibiting factors in the prevention,treatment, and mitigation of sexual abuse in the Eastern Caribbean

This article features a study that explored the presence of adverse childhood experiences (ACEs), including childhood sexual abuse and neglect, among women associated with Partnership for Peace (PfP), the first and only culturally adapted domestic violence diversion program for men in the Eastern Caribbean. Within a multiyear evaluative study that assessed the impact of the PfP intervention in reducing domestic violence in Grenada in the West Indies, life-history interviews were collected from a subsample of women (N = 9) associated with men enrolled in the PfP program between 2009 and 2011. We found that the exposure to sexual abuse and neglect during childhood was evident in the histories of the women. Most perpetrators were trusted family or community members who suffered from a common set of behavioral patterns, most prominently alcohol use. Our findings reflect an evidence-based connection, as one causative factor, of a culture of silence that is related to child sexual abuse and its management. The apparent lasting effects of these traumatic childhood exposures reflect cycles of abuse in the life histories collected during the domestic violence evaluation study. Our study identified three key structural deficiencies (insufficient research, ineffective policy, and lack of public-health interventions) and one embedded cultural norm (the culture of silence) that together “inhibit current attempts to address ACEs as a means of curbing domestic violence in the Caribbean.”     

Intervention effects on negative affect of CPS-referred children: Results of a randomized clinical trial

Exposure to early adversity places young children at risk for behavioral, physiological, and emotional dysregulation, predisposing them to a range of long-term problematic outcomes. Attachment and Biobehavioral Catch-up (ABC) is a 10-session intervention designed to enhance children's self-regulatory capabilities by helping parents to behave in nurturing, synchronous, and non-frightening ways. The effectiveness of the intervention was assessed in a randomized clinical trial, with parents who had been referred to Child Protective Services (CPS) for allegations of maltreatment. Parent–child dyads received either the ABC intervention or a control intervention. Following the intervention, children from the ABC intervention (n = 56) expressed lower levels of negative affect during a challenging task compared to children from the control intervention (n = 61).     

Emotion regulation as a mediator of the relation between sexual abuse and behavior problems in preschoolers

Maltreated children show poor emotion regulation competencies compared to non-maltreated children. Emotion regulation has been found to mediate the association between maltreatment and behavior problems in children. The aim of the present study was to examine the relationships among child sexual abuse (CSA), emotion regulation (ER), and internalized and externalized behavior problems in preschoolers using conditional process analyses. ER competencies were assessed in 127 children aged 41–79 months (62 abused, 65 non-abused) by their parents (N = 124) and early childhood educators (N = 88) using the Emotion Regulation Checklist (Shields and Cicchetti, 1995, Shields and Cicchetti, 1997). Behavior problems were evaluated by parents using the Child Behavior Checklist (Achenbach and Rescorla, 2000, Achenbach and Rescorla, 2001). ER was found to completely mediate the relation between CSA and internalized behavior problems and partially mediate the relation between CSA and externalized behavior problems. Parents’ and educators’ evaluations of ER were also found to differ as a function of child gender. The discussion focuses on the relationships among CSA, ER, behavior problems, and child gender. The clinical implications of these findings are also examined. Promoting the optimal development of ER could prevent the emergence and exacerbation of behavior problems in these at-risk children and, in turn, foster resilience.     

Children neglected: Where cumulative risk theory fails

Neglected children, by far the majority of children maltreated, experience an environment most deficient in cognitive stimulation and language exchange. When physical abuse co-occurs with neglect, there is more stimulation through negative parent–child interaction, which may lead to better cognitive outcomes, contrary to Cumulative Risk Theory. The purpose of the current study was to assess whether children only neglected perform worse on cognitive tasks than children neglected and physically abused. Utilizing LONGSCAN archived data, 271 children only neglected and 101 children neglected and physically abused in the first four years of life were compared. The two groups were assessed at age 6 on the WPPSI-R vocabulary and block design subtests, correlates of cognitive intelligence. Regression analyses were performed, controlling for additional predictors of poor cognitive outcome, including socioeconomic variables and caregiver depression. Children only neglected scored significantly worse than children neglected and abused on the WPPSI-R vocabulary subtest (p = 0.03). The groups did not differ on the block design subtest (p = 0.4). This study shows that for neglected children, additional abuse may not additively accumulate risk when considering intelligence outcomes. Children experiencing only neglect may need to be referred for services that address cognitive development, with emphasis on the linguistic environment, in order to best support the developmental challenges of neglected children     

Sexual abuse history among adult sex offenders and non-sex offenders: A meta-analysis

ObjectiveThe sexually abused–sexual abuser hypothesis states there is a specific relationship between sexual abuse history and sexual offending, such that individuals who experience sexual abuse are significantly more likely to later engage in sexual offenses. Therefore, samples of adult sex offenders should contain a disproportionate number of individuals who have experienced sexual abuse, but not necessarily other types of abuse, compared with samples of other types of offenders.MethodsWe compared rates of sexual and other forms of abuse reported in 17 studies, involving 1,037 sex offenders and 1,762 non-sex offenders. We also examined the prevalence of different forms of abuse in 15 studies that compared adult sex offenders against adults (n = 962) and against children (n = 1,334), to determine if the sexually abused–sexual abuser association is even more specific to individuals who sexually offend against children.ResultsWe observed a higher prevalence of sexual abuse history among adult sex offenders than among non-sex offenders (Odds Ratio = 3.36, 95% confidence intervals of 2.23–4.82). The two groups did not significantly differ with regard to physical abuse history (OR = 1.50, 95% CI = 0.88–2.56). There was a significantly lower prevalence of sexual abuse history among sex offenders against adults compared to sex offenders against children (OR = 0.51, 95% CI = 0.35–0.74), whereas the opposite was found for physical abuse (OR = 1.43, 95% CI = 1.02–2.02).ConclusionThere is support for the sexually abused–sexual abuser hypothesis, in that sex offenders are more likely to have been sexually abused than non-sex offenders, but not more likely to have been physically abused. We discuss potential mechanisms for the relationship between sexual abuse history and sexual offending, including the possibility that a third factor might account for the relationship.Practice implicationsThe most obvious implications of these findings is that the prevention of sexual abuse of children, either through prevention programs directly targeting children or through treatment programs targeting individuals who are likely to sexually offend against children (e.g., known sex offenders against extra-familial boys), may eventually reduce the number of sex offenders. This implication is dependent, however, on a causal role of childhood sexual abuse, and on the effectiveness of prevention and treatment practices.     

Early intervention with children of dyslexic parents: Effects of computer-based reading instruction at home on literacy acquisition

The hereditary basis of dyslexia makes it possible to identify children at risk early on. Pre-reading children genetically at risk received during 14 weeks a home- and computer-based training in phonemic awareness and letter–sound relationships in the context of reading instruction. At posttest training effects were found for both phonemic awareness and letter knowledge. Trained at-risk children (n = 31) made more progress than untrained at-risk controls (n = 26) and kept up with untrained not-at-risk controls (n = 16). However, the headstart of the trained group did not affect beneficially first and second grade reading and spelling proficiency. Following the start of phonics-based instruction at school, the trained at-risk children could not be discriminated from the untrained at-risk controls, and they were delayed relative to the not-at-risk controls. In order to promote long-term benefits and prevent undoing the advantage of early intervention, delivery should be both home- and school-based and more effort needs to be put in throughout first grade.