Prenatal screening for risk factors & early prevention of child maltreatment

Risk factors related to parents appear to be the strongest predictors of child maltreatment. Risk factors concerning both parents have even stronger effect. Strong parental risk factors are: domestic violence, perception of... [ view full abstract ]

Risk factors related to parents appear to be the strongest predictors of child maltreatment. Risk factors concerning both parents have even stronger effect. Strong parental risk factors are: domestic violence, perception of child as problem, psychopathology, low self-esteem, anger/hyper-reactivity, stress and anxiety (Stith et al, 2009; Mulder, underway). Because these risk factors are independent of the child they can be recognized during pregnancy, by midwives and obstetricians. How can this best be done? In this session we will present a Dutch working model for prenatal screening and early prevention of child maltreatment. In 2009 we introduced the ALPHA-NL, a translation of the Canadian ALPHA (Antenatal Psychosocial Health Assessment, Reid et al, 1998). Also training for midwives/obstetricians was developed and a protocol for follow-up care was agreed upon. When risk factors occur, the well-baby nurse (youth public health care) is notified, in dialogue with the parents-to-be. Home-visits with solution focused psychosocial support and referral if necessary are offered as soon as possible during pregnancy. In this way parents with risk factors for child maltreatment are given a head start once their baby is born. After birth the same well-baby nurse does the regular check-ups of the baby and stays involved. This collaboration between midwives/obstetricians and well-baby clinics is still not standard practice in our country -or worldwide. One of the reasons may be the differences in focus and culture between professions. The prenatal period however gives a great but underused window of opportunity for the early prevention of child maltreatment.