Policy and Practice | August 2022

identified as maltreatment victims, neglect is the most frequent allega tion (69 percent for children age 8 and younger). In all states, inadequate supervision, harm due to inadequate supervision, or failure to meet parent/ caretaker responsibilities is defined as maltreatment. Addressing condi tions that are linked to poverty, such as unaffordable or unavailable child care or housing, or other conditions related to extreme financial stress, can prevent neglect allegations. Opportunities for Coordination to Support Prevention of Maltreatment Our paper suggests several approaches for collaboration for prevention. n Connect primary prevention strat egies across systems. State child welfare systems are increasingly focusing on primary prevention— i.e., services designed to avoid any need for child welfare inter vention. For example, Thriving Families, Safer Children: A National Commitment to Well-Being 6 —a joint partnership between the federal Children’s Bureau, Casey Family Programs, the Annie E. Casey Foundation, and Prevent Child Abuse America—focuses on helping systems prevent the separa tion of families through foster care. Federal funding sources, including Title IV-B 7 and Community Based Child Abuse Prevention 8 can be used for prevention services such as Developmental Understanding and Legal Collaboration for Everyone, 9 which provides holistic services to families with infants. n Coordinate on prenatal sub stance abuse supports to help families access the services they need. The federal Child Abuse and Prevention Treatment Act 10 requires child welfare agencies to create and implement Plans of Safe Care that describe the process for supporting children born with prenatal drug or alcohol exposure and determining the need for child welfare interven tion. System leaders can coordinate on developing and implementing these plans and partner with

families to access services in a non punitive, strengths-based way. n Promote programs and policies that allow children to qualify for dyadic therapeutic services with their parents. States vary 11 in how they use Medicaid to cover dyadic treatment 12 (a type of therapy that supports the young child and parent together) and models that focus on parents/caregivers, and on the process by which parents/caregivers can access treatment (e.g., qualifica tion requirements and whether a referral is required). The National Center for Children in Poverty’s PRiSM Initiative 13 features policy strategies for connecting families to dyadic treatment in Arkansas, Colorado, Connecticut, Florida, New Mexico, and Oregon. n Coordinate with state efforts to implement the Family First Prevention Services Act Title IV-E Prevention Plans. The federal Family First Prevention Services Act 14 allows states to use federal child welfare dollars for qualifying evidence-based preven tion services, 15 including mental health, substance use, and in-home parent skill-building programs for children at imminent risk of entering foster care. Home visiting programs approved by the Title IV-E Prevention Services Clearinghouse 16 are eligible for federal funding, so some states—Hawai’i 17 is an example—include early childhood stakeholders on implementation teams. Early childhood leaders have important and relevant exper tise due to their administration of the Maternal, Infant, and Early Childhood Home Visiting Program, which has similar evidence-based requirements. n Join efforts to reduce the number of child fatalities. Over three-quar ters of the 1,750 children who died 18 from child abuse or neglect in 2020 (likely an undercount) 19 were ages 3 or younger. State child welfare agencies are required to create plans to reduce these fatalities, building on the work of a federal Commission to Eliminate Child Abuse and Neglect Fatalities 20 and state policies

Early Childhood Is a Critical Time to Focus on Prevention Compared to older children, the child welfare system is more likely to identify young children 2 —especially infants under age 1—as victims of abuse or neglect. Young children are also more likely to be placed in foster care than older children. In fact, in fiscal year 2020, nearly two out of three children who entered foster care were age 8 or younger. Early childhood trauma 3 is very harmful for young children, because it can cause long-term developmental and physical challenges. 4 To be most effec tive, strategies to reduce or prevent long-term consequences 5 of trauma and enhance resilience must be coor dinated across systems, anchored in evidence, begin as early as possible, and be grounded in early child devel opment best practices. Coordination Can Improve Access to Prevention Services for Young Children and Their Families Because the child welfare and early childhood systems often serve the same populations, coordination can streamline service access for families, broaden workforce awareness of family supports, and ensure families’ access to a cohesive set of needed services, ultimately reducing the need for child welfare involvement. Particularly important is coordination around connecting families to economic and concrete supports. Among children

Elizabeth Jordan is the Director of Policy Communications and Outreach for Child Trends.

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Policy&Practice August 2022