From battered children to family violence: what lessons should we learn?

Child abuse is an ancient problem but one that has grown alarmingly in the United States in the last few decades. Once the problem of child abuse was recognized in the 1960s, mandatory reporting was instituted to develop public health mechanisms for intervention. But the approaches taken then were inadequate, and as sexual abuse of children was acknowledged, social service agencies gradually devolved from providing help to simply investigating, a trend that has contributed to the present emergency situation. Proper knowledge of how best to treat and prevent child abuse is scarce; this makes it harder to base an educational program in family violence on sound evidence. Also, public awareness of child abuse is far ahead of efforts to intervene and prevent it. Neither federal nor state laws have clear policies about what child protection strategies should be, which inhibits professionals who are attempting to deal with the problem. National guidelines and resources are needed, although efforts to solve the problem are best approached on a local level. Any teaching program on child abuse should discuss the policy alternatives, and any group that is helping children and their families must agree on a policy to guide its work. The author maintains that the child protection system should be run not by county or state governments but by the private and public health care system because this system has greater financial resources, has a tradition of scientific inquiry, and is still perceived as a "helping" system.(ABSTRACT TRUNCATED AT 250 WORDS)