Home-visit Program in Child Maltreatment Cases Strengthens Parent-child Interaction

NIH-funded study of videotape intervention program also reduced foster-care placements

parent-child interaction
Happy mother talking with baby boy on the floor

A home-visit program for parents previously investigated for child abuse, dramatically reduced the percentage of young children who were removed from their homes and placed in foster care, according to a study funded by the National Institutes of Health.  Central to the program are videotaped segments of parent-child play sessions.  A trained specialist then gives parents feedback on the interaction, encouraging parents to reflect on their children’s social or emotional needs.

I’m Dr. Valerie Maholmes, Chief of the Pediatric Trauma and Critical Illness Branch at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. Today, I’ll be speaking with study author Dr. Monica Oxford, Interim Director of the Barnard Center for Infant Mental Health and Development and research professor at the University of Washington Department of Family and Child Nursing.

According to the Administration on Children and Families, state child protective agencies received 3.6 million referrals of possiblechild maltreatment in 2014.  The youngest children are the most likely to be victims of abuse and neglect, with nearly a quarter of them three years of age or younger.  The study authors noted that child maltreatment may have lifelong effects, with victims experiencing poorer health and earlier death.  Removal from the abusive environment may also have negative effects, as the instability of foster care may be stressful and worsen behavioral problems.

Researchers studied a program called “Promoting First Relationships,” which seeks to help parents become more sensitive to their child’s emotional and social cues. In addition to enhancing emotional bonds between parents and children, researchers found that placement into foster care dropped significantly among the families that completed the program.

The study, conducted between 2011 and 2014, enrolled 247 families with children between the ages of 10 months and two years, all with cases under review by Child Protective Services. Families were randomly assigned to either the home-visit program, which included 1-hour visits over a 10-week period, or a telephone-based service that included three, 30-minute sessions, and packets of resource and referral information mailed to each family.

For the intervention, education specialists videotaped parents playing and interacting with their children.  The specialists then reviewed the footage with parents to reflect on how they recognized and responded to their children. Parents who received the video intervention scored higher on measures of engagement and sensitivity, compared to parents who received the telephone-based service.  Foster care placements also were lower by more than double among parents who received the home-based intervention.