Empirical risk factors for delinquency and best treatments: where do we go from here?

Youth development and prevention of violence are two sides of the same public policy issue. A great deal of theoretical and empirical effort has focused on identification of risk factors for delinquency and development of interventions for general risks. Recent calls for changes in public policy are evaluated here--and challenged--in light of new comprehensive, longitudinal empirical data on urban violent delinquency. Treatments such as prenatal care, home visitation, prevention of bullying, prevention of alcohol and/or drug abuse, promotion of alternative thinking, mentoring, life skills training, rewards for graduation and employment, functional family therapy, and multidimensional foster care are effective because they prevent or ameliorate risks for delinquency occurring during development. At present, the best treatments yield 10 to 40% reductions in delinquent recidivism. Better controlled application of developmentally appropriate treatments in higher doses, with narrow targeting of the highest-risk youth based on actuarial testing--rather than less accurate clinical judgment--should result in higher effectiveness. Such a focused approach in a geographical area with high homicide rates should be cost-effective. A prediction of cost-benefit outcomes for a carefully constructed example of a large-scale program is presented.