cial welfare, and criminal violence. Although no specific theory about the causes of child abuse and neglect has been substantially replicated across studies, significant progress has been gained in the past few decades in identifying the dimensions of complex phenomena that contribute to the origins of child maltreatment.
Efforts to improve the quality of research on any group of children are dependent on the value that society assigns to the potential inherent in young lives. Although more adults are available in American society today as service providers to care for children than was the case in 1960, a disturbing number of recent reports have concluded that American children are in trouble (Fuchs and Reklis, 1992; National Commission on Children, 1991; Children's Defense Fund, 1991).
Efforts to encourage greater investments in research on children will be futile unless broader structural and social issues can be addressed within our society. Research on general problems of violence, substance addiction, social inequality, unemployment, poor education, and the treatment of children in the social services system is incomplete without attention to child maltreatment issues. Research on child maltreatment can play a key role in informing major social policy decisions concerning the services that should be made available to children, especially children in families or neighborhoods that experience significant stress and violence.
As a nation, we already have developed laws and regulatory approaches to reduce and prevent childhood injuries and deaths through actions such as restricting hot water temperatures and requiring mandatory child restraints in automobiles. These important precedents suggest how research on risk factors can provide informed guidance for social efforts to protect all of America's children in both familial and other settings.
Not only has our society invested relatively little in research on children, but we also have invested even less in research on children whose families are characterized by multiple problems, such as poverty, substance abuse, violence, welfare dependency, and child maltreatment. In part, this slower development is influenced by the complexities of research on major social problems. But the state of research on this topic could be advanced more rapidly with increased investment of funds. In the competition for scarce research funds, the underinvestment in child maltreatment research needs to be understood in the context of bias, prejudice, and the lack of a clear political constituency for children in general and disadvantaged children in particular (Children's Defense Fund, 1991; National Commission on Children, 1991). Factors such as racism, ethnic discrimination, sexism, class bias, institutional and professional jealousies, and social inequities influence the development of our national research agenda (Bell, 1992, Huston, 1991).
The evolving research agenda has also struggled with limitations im-
A wide array of federal agencies have provided funding for child abuse and neglect research through various legislative initiatives. Major funding sources include but are not limited to the Child Abuse Prevention and Treatment Act (CAPTA); CDC; NIH; the Administration on Children, Youth and Families (ACYF) within HHS; the Agency for Healthcare Research and Quality (AHRQ); and the Title IV-E waiver demonstration program. As noted earlier, several private foundations also provide support for child abuse and neglect research.
Child Abuse Prevention and Treatment Act
CAPTA was originally enacted in 1974 and was most recently amended and authorized on December 20, 2010 (P.L. 111-320). The act provides funding to states to support prevention, assessment, investigation, prosecution, and treatment for child abuse. It also supports grants for demonstration programs and projects to public agencies, tribal organizations, and nonprofits.
CAPTA requires that every 2 years, the Children's Bureau within ACYF issue for public comment a set of priorities for research topics to be covered in grants and contracts. On February 3, 2006, the Children's Bureau published in the Federal Register “Children's Bureau Proposed Research Priorities for Fiscal Year 2006-2008.”5 Despite this extensive published research agenda, limited funding—no more than $27 million for the entire CAPTA discretionary grant program in 2008—has precluded a full examination of most of these topics through CAPTA or other Children's Bureau research funding streams (IASWR, 2008). Some field-initiated research is funded through CAPTA; however, the funding announcements are often prescriptive as to the use of these funds. In 2003, for example, the Children's Bureau requested applications for replication of an evidence-based program, Family Connections (developed by DePanfilis and colleagues at the University of Maryland); the funding was used to support dissertation and other research through quality improvement centers and implementation grants.
Centers for Disease Control and Prevention
CDC established the National Center for Injury Prevention and Control (NCIPC) 20 years ago. This center is the nation's authority for prevention of violence and injury. It provides funding and technical assistance to 20 state health departments to strengthen capacity in injury prevention. Child abuse and neglect is one of NCIPC's priority areas, although funding for child abuse and neglect activities has been limited—a total of 25 grant awards or cooperative agreements for research projects in child abuse prevention since 2002. In FY 2011, the latest year shown on the NCIPC website, no new awards were made in the area of child abuse. In addition, several CDC-funded injury prevention centers, such as the Center for Violence and Injury Prevention at Washington University's Brown School of Social Work, target child abuse and neglect.
In 2001, CDC convened 15 abuse and neglect experts to establish priorities related to surveillance (data collection, uniform definitions), etiological and risk factors, intervention and evaluation, and implementation and dissemination. The NCIPC research agenda was updated in 2009, with a plan to extend it through 2018. According to the updated agenda: “The mission of CDC's child maltreatment prevention program is to prevent maltreatment and its consequences through surveillance, research and development, capacity building, communication, and leadership. In pursuit of this mission, CDC's public health approach complements such other approaches as those of the criminal justice and mental health systems. In particular, CDC's approach emphasizes primary prevention of perpetration of child maltreatment or efforts that focus on preventing maltreatment before it occurs” (CDC, 2009, p. 75).
The foundation of CDC's child abuse and neglect prevention work is the promotion of safe, stable nurturing relationships (CDC, 2010). The agenda highlights the synergistic effects such relationships can have on health problems across the life span. These relationships also contribute to the development of skills that enhance the acquisition of healthy habits and lifestyles. CDC recognizes that to promote such relationships and reduce abuse and neglect, additional research is needed across the different social contexts in which children develop and interact, including the individual, the family, peers, the community, and society. The agenda draws on the Institute of Medicine (IOM) report Reducing the Burden of Injury, noting that “rigorous research is needed to assess the effectiveness of prevention programs and to determine which among them merit widespread use. To ensure the feasibility of widespread use of child abuse and neglect prevention programs, research is also needed to assess program cost-effectiveness and the cost of initiating or expanding effective programs” (CDC, 2009, p. 76).
CDC also has examined the economic costs of child abuse and neglect, finding that the costs for both victims and society are substantial (CDC, 2012a). According to Fang and colleagues (2012), the total lifetime estimated financial costs associated with just 1 year of confirmed cases of child physical abuse, sexual abuse, psychological abuse, and neglect is approximately $124 billion (see also the discussion of costs in Chapter 4).
National Institutes of Health
NIH pursues fundamental knowledge about the nature and behavior of living systems and the application of knowledge to enhance health, lengthen life, and reduce the burdens of illness and disability. It invests more than $30 billion annually in medical research; research in the area of child abuse and neglect generally accounts for about $30 million per year. Yet of the funding for child abuse and neglect research in FY 2011, just over one-half, or about $16 million, was awarded for grants whose abstract or title indicated that child abuse and neglect was either the major independent or dependent variable; the remainder of the grants were on a variety of other topics, such as treatment of suicide, delinquency, or drug treatment of mental disorders. Of the total NIH expenditures in the area of child abuse and neglect research in FY 2011, just over $4 million was spent on new, first-time R01 grants.
In 1997, the House of Representatives' Committee on Appropriations (House Report 104-659) directed that NIH “convene a working group of its component organizations currently supporting research on child abuse and neglect.” The NIH Child Abuse and Neglect Working Group was established in response to this mandate. Special funding announcements related to child abuse and neglect also were issued, encouraging new investigators across multiple disciplines to apply for funding. Special topics were targeted. In 2001, for example, a program announcement targeted research on child neglect.6 That announcement expanded support from several NIH institutes, the National Institute of Justice and Office of Juvenile Justice and Delinquency Prevention in the Office of Justice Programs at the Department of Justice, the Children's Bureau, and the Office of Special Education Programs in the Department of Education.
In 2007, a program announcement, “Research on Interventions for Child Abuse and Neglect,”7 was developed in response to the 2005 Surgeon General's workshop on this topic. The grant was supported by the National Institute of Mental Health (NIMH), National Institute on Alcohol Abuse and Alcoholism (NIAAA), National Institute of Child Health and Human Development (NICHD), National Institute on Drug Abuse (NIDA), and National Institute of Neurological Disorders and Stroke (NINDS); the NIH Office of Behavioral and Social Services Research; the NIH Fogarty International Center; CDC's NCIPC; and the Children's Bureau. After 2010, however, NIMH withdrew from participation.8
NICHD detailed to its council its commitment to research on child abuse and neglect and violence in general in January 2009, stating that within the Social and Affective Development/Child Maltreatment and Violence Program of NICHD's Child Development Behavior Branch, attention to child abuse and neglect includes active involvement in trans-NIH and transagency efforts to advance the science in the field of child abuse and neglect research; this involvement includes co-chairing the NIH Child Abuse and Neglect Working Group. The Child Development Behavior Branch also worked with the Children's Bureau, supporting supplemental studies, based on the NIS-4, aimed at understanding the various definitions of child abuse and neglect used by reporting agencies and their standards for reporting suspected abuse and neglect to child protective services or to the NIS-4.9
Administration on Children, Youth and Families, Children's Bureau
Created in 1912, the Children's Bureau within ACYF is focused on improving the lives of children and families. With an annual budget of about $8 billion, the agency funds services in all of the states and has a research program. The Children's Bureau funds an extensive training and technical assistance network; provides a series of child abuse prevention grants; and over the years has funded some field-initiated research grants and dissertation awards, as well as the NIS and annual reports on child abuse and neglect. The Children's Bureau also funds national quality improvement centers in several areas of child welfare that conduct evaluations. Currently there are three national quality improvement centers in the research domains of differential response in child protective services, early child experiences, and representation of children in the child welfare system (Children's Bureau, 2013). The goal for these centers is to assist child welfare professionals and agencies with service delivery by generating and disseminating research and lessons learned from the field. The Children's Bureau also funds the Child Welfare Information Gateway, an online clearinghouse for relevant information and statistics that archives data from federally supported and other research projects. In addition, the Office on Child Abuse and Neglect is now a unit within the Children's Bureau. The Children's Bureau does not currently provide support for investigator-initiated research and research grants responding to requests for applications.
Agency for Healthcare Research and Quality
AHRQ is the federal agency with responsibility for improving the quality, safety, efficiency, and effectiveness of health care, and it has a grant award program in these areas. The agency's total annual budget is about $400 million. Since 1993, AHRQ has awarded seven grants in the area of child abuse or neglect, including one career development award, two R01 awards, one conference grant, and three R03 awards.10
Title IV-E Waiver Demonstration Program
Title IV-E waivers, discussed in detail in Chapter 5, were first authorized in 1994 under P.L. 103-432 and were reauthorized under the Adoption and Safe Families Act. The creation of waivers is important for several reasons. First, they give successful state applicants the opportunity to use Title IV-B and IV-E funds more flexibly—for example, to focus more on prevention, in-home supportive services, or kinship care. Second, waivers require extensive evaluation, and several of the waiver demonstrations have used rigorous randomized designs. The authorizations for the waivers expired in 2006. However, a new round was supported under the Child and Family Services Innovation and Implementation Act of 2011 (P.L. 112-34), in part as a result of their success in states and localities as revealed by evaluation results.
A number of national, local, and regional foundations provide support for child abuse and neglect research initiatives. The following sections highlight the notable contributions of the Doris Duke Charitable Foundation, the Annie E. Casey Foundation, Casey Family Programs, the William T. Grant Foundation, and the Stuart Foundation, but generous support to this field of research has been provided by many others.
Doris Duke Charitable Foundation The Doris Duke Charitable Foundation has as part of its mission supporting work that advances the prevention of child abuse and neglect. The foundation supports research fellowships for doctoral students in child abuse prevention and a variety of specific prevention projects, including prevention of abusive head injury (formerly termed shaken baby syndrome).
Annie E. Casey Foundation Work supported by grants from the Annie E. Casey Foundation (AECF) aims to improve the futures of disadvantaged children in the United States through public policy, human-service reform, and community support. The AECF Child Welfare Strategy Group (CWSG) focuses on responsive systems and supportive communities to create lifelong family connections. With its use of an intensive, embedded consulting model, the CWSG collaborates with clients to strengthen agency management, operations, policy, and front-line practice in support of their efforts to improve outcomes for children and families. The AECF KIDS COUNT project is a national and state-by-state effort to track the well-being of children in the United States. The project develops and distributes reports on key areas of well-being, including the annual KIDS COUNT Data Book. Under the category Safety and Risky Behaviors, data are collected on the numbers of child abuse and neglect cases (both reported and substantiated).
Casey Family Programs Casey Family Programs (CFP) aims to improve foster care and the child welfare system in the United States. CFP research grants support studies that meet the needs of public child welfare jurisdictions and increase their capacity for data-driven decision making, evaluation, and performance monitoring. Specific areas of interest for research funding include preventing child abuse and neglect; accelerating permanency for children in foster care; improving the well-being of the children and families who encounter the child welfare system, including long-term outcomes such as employment, education, and mental health; and understanding the experiences of older youth who exit the child welfare system. From 2000 to 2011, CFP researchers published 60 peer-reviewed articles.
William T. Grant Foundation The William T. Grant Foundation funds research that enhances the lives of youth aged 8-25 through research grants and fellowship programs. Currently, the foundation funds research examining the formal and informal settings that youth inhabit and the use of research evidence about youth in policy and practice. Roughly 33 percent of the recent and ongoing research grants awarded before 2012 have entailed examining family life, and at least five studies have addressed issues related to youth experiences of violence, trauma, and neglect. The foundation also funds two fellowship programs: the William T. Grant Scholars Program supports scholars early in their careers; the William T. Grant Distinguished Scholars Program supports mid-career researchers seeking to work in policy or practice settings and mid-career policy makers and practitioners seeking to conduct research related to the well-being of youth.
Stuart Foundation The Stuart Foundation aims to support the ability of all children to realize their potential by improving the public education and child welfare systems in the states of California and Washington. While the aim is to improve the lives of all children and youth, the foundation strategically funds efforts to reach children in vulnerable environments, whose lives may be most impacted by improved programs and policies. The Stuart Foundation funds three main activities: the development and dissemination of effective, cutting-edge strategies for meeting the needs of children and youth; contributions to effective public policies related to children and youth; and direct delivery of support services for young people. Within the context of promoting data-informed policies and programs, the Stuart Foundation invests in projects that include efforts to gather, analyze, and use data to reveal how most effectively to serve children and youth, including children who have experienced abuse and neglect.
Despite the research support described above, funding for research on child abuse and neglect overall has been inconsistent and inadequate to support the type and extent of research necessary to sufficiently advance the field. In her keynote address for the IOM/NRC workshop “Child Abuse and Neglect Research, Policy, and Practice for the Next Decade: Reflections on the 1993 NRC Report,” Cathy Spatz Widom noted the large increase in medical and psychological articles on child abuse and neglect over the intervening period (IOM and NRC, 2012). She also observed that dedicated funding for child abuse and neglect research had remained constant since 1997, when it totaled $33.7 million; in 2012, it was projected to be $32 million. In an editorial in Pediatrics, “The Evolution of the Child Maltreatment Literature,” Christopher Greeley makes a similar observation about the enormous growth of knowledge “despite the absence of a coordinating national research body and being under resourced” (Greeley, 2012, p. 347). By this measure, child abuse and neglect researchers have been productive. Yet given the enormous social and monetary costs of child abuse and neglect, one might ask why so little funding is designated for research in the field.
Researchers in the field frequently point out that no major federal funder considers child abuse and neglect research central to its primary mission. Child abuse and neglect researchers have the impression that they are not as competitive in the NIH grant review process as researchers investigating childhood disorders with much lower prevalence. This impression is difficult to test, but methodological limitations inherent in child abuse and neglect research could in fact affect the competiveness of grant proposals in the field as compared with many childhood conditions. As discussed earlier, front-line child abuse and neglect research involving alleged or substantiated cases must be conducted in a crisis-driven atmosphere with unique legal, ethical, and organizational complexities. The high level of family dysfunction, frequent family moves or changes in the out-of-home placement of children, and quality problems with child welfare administrative data increase attrition among subjects and the amount of missing data compared with clinic-based research on middle-class families.
Child abuse and neglect research is methodologically messy (Socolar et al., 1995). Much of the investigation and child welfare process is beyond a researcher's control, and data helpful for statistical corrections generally are not readily available. Grant and journal reviewers steeped in laboratory or clinic-based research designs and methodologies that favor optimizing internal validity often fail to appreciate the severe limitations faced by the front-line child abuse and neglect researcher. The researcher's inability to control potentially critical variables and the heterogeneity of cases, together with the complexities of past histories and comorbidities, confound efforts to reduce threats to internal validity. This is especially true for multisite research that must deal with enormous variability in populations, processes, policies, and resources across agencies. External validity and its closely related construct ecological validity, however, can be enhanced under these conditions. Interventions that succeed across diverse sites are more likely to be generalizable to the field as a whole.
Yet another reason suggested for the relative paucity of designated funding for research on child abuse and neglect is that, in contrast with many serious childhood conditions, parental advocacy for such funding is sparse. A recent study looking at 53 diseases found that for every $1,000 spent on lobbying for a given disorder there was a $25,000 increase in NIH funding the following year (Best, 2012). The study also found that less research funding was allocated to disorders associated with social stigma, such as drug and alcohol abuse or smoking, than to nonstigmatized conditions on a per-death basis. Discomfort with the topic may contribute to the sparse designated funds available for child abuse and neglect research.
The considerable costs of child abuse and neglect are distributed across many sectors, including mental health, medicine, drug and alcohol programs, education, social services, unemployment, law enforcement, and the prison system. Because these costs are largely indirect, it is difficult to estimate the potential savings attributable to reducing the problem. Thus, service providers and institutions across many sectors may not fully appreciate the benefit that would accrue to them from reductions in child abuse and neglect, and therefore do not lobby separately or collectively for more effective prevention. On the other hand, a number of professional and social policy organizations and coalitions do actively lobby for child abuse and neglect prevention and changes in child welfare policy.
Training and Mentorship
To fulfill the training mission, a field must have a supply of funded investigators conducting ongoing studies in which trainees can participate and must have access to research training funds to support trainees and new investigators while they learn. Mentors must be competent, involved, and supportive, helping trainees develop new areas of investigation and novel approaches to persistent problems.
National Institutes of Health Career Development Awards
NIH's Child Abuse and Neglect Research announcement in 1999 encouraged researchers to seek K awards. Participating institutes included NIMH, NINDS, NICHD, NIDA, and NIAAA.
Centers for Disease Control and Prevention
In 1987, CDC funded five interdisciplinary Injury Control Research Centers at leading universities, providing core support and funding for specific projects. The program grew, and currently there are 11 funded centers. Another 8 universities have hosted an Injury Control or Prevention Center since the program began 25 years ago (CDC, 2012b). At least four current or past CDC-supported centers (North Carolina, Pittsburgh, University of Washington, and Washington University of St. Louis) have supported child abuse research as part of their work.
Child Welfare Researchers
Although several policy efforts have focused on enhancing the child abuse and neglect research enterprise, there still are no structured career development opportunities for child maltreatment/child welfare researchers (IASWR, 2008); the field lacks policy supporting a clear researcher development strategy or career trajectory within or across disciplines. Many university-based research centers undertaking child abuse and neglect research are populated by nontenured researchers with little job security. One important component of research capacity is a strong cadre of researchers committed to the field over the long term. To this end, certain key elements should be in place. First, career support at every level and across disciplines should target opportunities to create a sustainable child abuse and neglect research career and capitalize on early interest (in the field of social work, for example, there are doctoral students who have worked in child welfare and seek a doctoral education to build knowledge that will enhance practice and policy). Second, onsite and virtual mentorship and opportunities for networking and socialization are necessary to ensure quality professional development. Third, university/agency partnerships are needed to keep the research grounded in the complex environment of services and enable the research results to inform practice (see IASWR, 2008, regarding the development of partnerships and strategies for maintaining them11). Fourth, community-based participatory research is needed to ensure that the research is meaningful and useful. Finally, a multidisciplinary annual or biannual conference that brings child abuse and neglect researchers together is a good vehicle for sharing research findings (IASWR, 2008).
The Administration on Children, Youth and Families does regularly support both a Head Start research conference and a welfare research and evaluation conference,12 and the Children's Bureau supports a biannual child abuse and neglect conference and conferences for states and grantees. Although these conferences are not solely focused on dissemination of research, many of the sessions are opportunities for sharing findings from recent child maltreatment research.
Since 2009, the Children's Bureau has sponsored two National Child Welfare Evaluation Summits, providing funds for state and tribal staff to attend. These meetings have provided an opportunity to present and discuss research on child welfare/child abuse and neglect, but they have not been specific to child abuse and neglect research, nor have they focused especially on career development.
The 1993 NRC report notes that specialized research training in child abuse and neglect did not exist until the mid-1980s, when one such program became available (NRC, 1993). In the late 1980s, a number of efforts were made to develop interdisciplinary graduate programs in child abuse and neglect. Gallmeier and Bonner (1992) reviewed the 10 universities funded by NC Children and Nature Coalition (NCCAN) in 1987 for 3 years to establish interdisciplinary training programs in child abuse and neglect, finding that they trained more than 400 students, 61 percent of whom were involved in some area of child abuse and neglect. Despite recommendations that these pilot programs be continued and replicated at other institutions, no such follow-up was conducted.
Child abuse and neglect research overall lacks the educational infrastructure to create and capitalize on student interest in the field. The relatively few courses devoted exclusively to child abuse and neglect across multiple disciplines signal that it is not a mainstream subject in many areas of research (Champion et al., 2003). In the field of social work, there are large numbers of courses and concentrations geared toward practice, and although many students are interested in pursuing child welfare research, there are no funding streams to support this line of research. The extremely limited federal funding dedicated to child abuse and neglect research can be viewed as further evidence of this gap. The resulting shortage of well-funded mentors and sustainable research programs limits the availability of training for the next generation of child abuse and neglect researchers. While progress has been made since the 1993 report was issued, there remains a strong need to increase support for interdisciplinary research training in child abuse and neglect.
Finding: Child abuse and neglect research encompasses a wide range of disciplines and research problems. Each of these domains has unique research infrastructure needs, methodologies, and agendas.
Finding: Child abuse and neglect is increasingly recognized as a major public health problem. A public health approach to child abuse and neglect offers a cohesive strategy for this multifaceted problem. A high-quality national surveillance system is needed to collect and analyze data with which to detect and describe aspects of child abuse and neglect, along with attendant risk and protective factors, so as to systematically inform the planning and implementation of public health interventions.
Finding: Among the medical aspects of child abuse and neglect, adequate support is needed for rigorous research to further explore the process and outcomes of both screening and medical evaluation, to examine the validity of abusive head trauma diagnoses, to support the development of more uniform approaches to practice, and to arrive at a medical consensus regarding thresholds for reporting neglect.
Finding: Despite recent federal investments, such as Title IV-E and IV-B training funds, there has been no commensurate investment in child welfare research capacity. With few child welfare researchers being supported by major federal institutional funders, there are few mentors and reviewers in the field.
Finding: While a wide array of public and private funders have made notable contributions to child abuse and neglect research, high-level, national coordination for research in this field is lacking. Funding opportunities have been fragmented and generally insufficient to develop and sustain the capacity for a national child abuse and neglect research enterprise.
Finding: Given the increasing heterogeneity of families in the United States, there is an ongoing need to increase understanding of the role of race and ethnicity in the causes and consequences of child abuse and neglect. Culturally adapted prevention and intervention programs can be evaluated to determine cultural fit, reach, and efficacy.
Finding: Several vulnerable populations, including racial and ethnic minority children (e.g., African Americans, American Indians, Alaska Natives, Latinos), children with disabilities, children of immigrant families, and LGBT youth, are underrepresented in child abuse and neglect research. Information sharing among data systems, targeted research on vulnerable populations, and changes to population-based youth surveys (e.g., adding questions on sexual identity and behavior) could improve understanding and knowledge of the causes and consequences of child abuse and neglect among these populations.
Finding: Data from longitudinal studies are essential for identifying causal pathways between abuse- and neglect-related biological changes and later adult outcomes. Longitudinal analyses also are critical to track outcomes related to the implementation of programs and delivery of services so the planning of interventions can be improved.
Finding: Current national child abuse and neglect surveillance efforts rely heavily on data reported to child welfare agencies. The children encompassed by these reports may represent a minority of total abuse and neglect incidents and can vary based on jurisdictional reporting standards.
Finding: The infrastructure needed to support a high-quality national public health surveillance system for child abuse and neglect is currently lacking. The capacity to develop such a surveillance system will require the linking of data across multiple sources, improved standardization of definitions of child abuse and neglect, and the collection of additional information on risk and protective factors.
Finding: An opportunity to obtain more accurate information on circumstances surrounding child abuse and neglect lies in the recent growth in web technologies and applications, which has expanded the potential for linkage and analysis of survey and administrative data across multiple service sectors. Given the variety of sectors that come into contact with abused and neglected children, linkage of data across multiple sources is important for greater research, practice, and policy synthesis and for examination of risk factors, recurrence or recidivism, and prevention and intervention outcomes.
Finding: Evidence-based classification schemes have brought conceptual and practical coherence to the maturing and interdisciplinary field of prevention research and the implementation of sound prevention strategies. In the past decade, federal agencies have established a number of registries and clearinghouses with a focus on prevention of child abuse and neglect. Yet their varied institutional homes underscore the fragmentation of prevention research across federal agencies and the lack of a unified federal policy and research agenda. Universities and social science research organizations have attempted to unify the evidence base in child abuse and neglect and prevention research.