When the Washington Post carried a story by Brigid Schulte about the new Institute of Medicine report New Directions In Child Abuse and Neglect Research, Ed Tronick, Ph.D., psychologist at the University of Massachusetts, wrote to her about his research and shared a link to the “Still Face” experiment video. In a recent blog post, Schulte’s reaction to the two-minute video was similar to Jane Stevens’ on this site just about a year ago: It is very hard to watch the infant’s distress build as her mother maintains a “still face” and there is a feeling of deep relief when the young mother returns to her normal expressive self.

While the video packs a wallop, it is still difficult to even begin to fathom the profound impact of child neglect (to say nothing of abuse), according to Schulte. A year ago the video had been viewed over 700,000 times and today that number has risen to well over a million.

Schulte reports that Ed Tronick and others have

continued their research since the findings from “still face” experiment were first published in the mid-1970s and are evaluating the physiological changes that occur to negative responses, utilizing still face and other stress paradigms. The research quantifies the devastating physical and emotional impact of neglect—sometimes the result of maternal depression—but also identifies the potential for successful interventions.

Schulte’s blog concludes by saying that the IOM report found that one of the biggest risk factors for child abuse and neglect is if the parent him or herself was abused or neglected. She sounds a note of optimism by saying the work of Tronick and others to train professionals, and educate and treat parents will help break the cycle and one hopes, “put an end to the wrenching effects of The Still Face.”

Major findings and recommendations found in the 400-plus-page IOM report include:

Findings

Emotional abuse has risen while physical and sexual abuse has declined over the 20 years since the original 1993 study Understanding Child Abuse and Neglect

Each year, child protective services received reports of child abuse and neglect involving 6 million children and many more go unreported.

The consequences of abuse and neglect are now known to encompass physical health, neurobiological development, relational skills and risk behaviors. The report reviews major studies, including ACEs research, that detail the consequences of abuse and neglect, especially on the brain and the “hypothalamic-pituitary-adrenal (HPA) ‘stress system.’”

The report identifies effective interventions and service delivery systems that have been developed and tested over the last twenty years: trauma-focused cognitive behavioral therapy, parent management training programs, and early home visiting. There are also gaps in knowledge such as understanding why some individuals and families fail to benefit from treatment and prevention, and knowing which strategies are most effective in building a collaborative culture among the institutions and agencies that constitute the child abuse and neglect response system.

Recommendations

The CDC, in partnership with an interagency work group, “should develop and sustain a national surveillance system for child abuse and neglect that links data across multiple systems and sources.”

Investments in research by federal agencies, in partnership with private foundations and academic institutions, need to increase and be part of national strategic research plan.

There is a significant need to develop and sustain a cadre of researchers who can examine issues of child abuse and neglect across multiple disciplines. This can be accomplished by addressing the reasons why scientists are discouraged from pursuing child abuse and neglect research as a sustainable career path: lack of adequate funding and “the scattered nature of funding opportunities.”

A two-page summary of the report and an excellent infographic are available on the Institute of Medicine website.