Chapter Four

FAMILY-BASED CRIME PREVENTION

by Lawrence W. Sherman

Family risk factors have a major effect on crime. Family based crime prevention can directly address those risk factors, with substantial success. The more risk factors they address, perhaps, the better. The earlier they start in life, it seems, the better. Programs for infants and young children may be most cost-effective in the long run, even if they are expensive in the short run. Combining home-visit parental support with preschool education reduces crime committed by children when they grow up. Rigorously evaluated pilot projects with tightly controlled prevention services are consistently effective. Family problems later in life are more difficult to address, especially family violence by adults. But it is still possible. The potential of early, adolescent and adult family-based crime prevention is held back only by our failure to invest in more research and development. The need for testing programs that can work on a large scale is particularly great.

Most of these conclusions have been reached independently by diverse scholars from diverse disciplines (Yoshikawa, 1994; Tremblay and Craig, 1995; Hawkins, Arthur and Catalano, 1995; Crowell and Burgess, 1996; Kumpfer, Molgaard and Spoth, 1996; Wasserman and Miller, forthcoming). Given the normal disagreements among social scientists, the level of consensus about these conclusions is striking. But of all these conclusions, the need for further careful evaluations is the strongest point of agreement. Evaluating the varieties of possible transitions from a small pilot test of a program to a large-scale operation is a step that is frequently left out, as it was in the case of Head Start (Lazar, 1992, and Zigler, 1992, both as cited in Yoshikawa, 1994). There is no government institution fully prepared to deliver family-based prevention of the kind found effective in the scientific literature. Making the most out of what we know already will require even more knowledge about how to go from pilot tests to full operations.

Much more is known about making families better at child-raising than about preventing family violence. A recent review of the effectiveness of criminal sanctions in combatting domestic abuse concludes that the evidence in favor of these programs is either weak or absent (Fagan, 1995). Batterer's counseling, mandatory arrest, special prosecution and victim advocacy programs all remain essentially unevaluated. While theoretical inferences support such programs as battered women's shelters to reduce danger during the high-risk aftermath of an incident reported to police, there is no assurance that any of these programs actually increase long-term victim safety. Court orders of protection and other legal steps advised by victims' advocates may even increase risk of serious injury to victims. Mandatory arrest for misdemeanor spouse assault without prosecutorial action or court treatment has been found to be either ineffective or criminogenic in repeated controlled trials, although it is effective in communities of strong social capital.

Perhaps least is known about the extent to which the same family-based programs can prevent both family violence and delinquent acts by children in the family. One home-visit program for infants, for example, reduced child abuse, which is both a crime of domestic violence and a risk factor for later delinquency of abused children. The potential for broadening the outcome measures and objectives of family-based crime prevention is important for public policy analysis. It has great potential, for example, in helping to design a program that might work on a much broader scale than the pilot tests to date, most of which are limited to a few hundred participants or less. It is also one more good reason to invest more heavily in research and development.

This chapter briefly reviews the variety of family-based crime prevention programs. It then considers a few of the major research issues in evaluating and designing family-based prevention. Five major areas of research are then examined in detail, each in relation to an ecological context where families seek or receive help affecting crime and risk factors: homes, pre-schools and schools, clinics, courts, and other contexts. The chapter concludes with a scientific summary of what works, what doesn't, and what's promising, with assessments of what is known about the effectiveness of federally funded programs and suggestions for improving effectiveness through better evaluations.

VARIETIES OF FAMILY-BASED CRIME PREVENTION

Family-based crime prevention is an unintended beneficiary of the vast research enterprise on human development. Much of what we know about it comes from evaluations of programs established for other purposes. Many of these human development programs are highly elaborated, each with its own terminology, literature, and professional community. As programs intended to improve parents' child-rearing skills, children's academic skills, or children's mental health, they have often resulted--almost coincidentally--in reduced crime. This fact underlines the importance of defining prevention not as intention, but as result. It also shows how basic to human experience the factors affecting the risk of crime can be.

Several analyses of risk factors for both serious and general delinquency conclude that family factors are important. While serious crime is geographically concentrated in a small number of high crime communities, it is individually concentrated in families with anti-social parents, rejecting parents, parents in conflict, parents imposing inconsistent punishment, and parents who supervise their children loosely (Tremblay and Craig, 1995: 158). Several analysts conclude that these risk factors are cumulative, and that the more of them a prevention program can address the better (Coie and Jacobs, 1993; Yoshikawa, 1994; Tremblay and Craig, 1995; Wasserman and Miller, forthcoming). This hypothesis is consistent with much of the literature, and not falsified by any direct test. Perhaps the best way to explore it is to evaluate rigorously prevention programs addressing different numbers and combinations of risk factors.

Risk Levels and Prevention Strategy

The basic structure of family-based prevention programs depends upon strategic choices with public safety, budgetary and political consequences. The basic choice is between universal and targeted programs (Institute of Medicine, 1994). Universal programs are offered to, or even imposed upon, all families. In several European countries, for example, all families with newborn children are required to admit trained nurses to their homes to visit the baby. This program applies to everyone without regard to any risk factors. Targeted programs are of two kinds. One kind is "selective," in which families (or individuals) identified as being at high risk are offered or mandated to receive a service intended to prevent the onset of harm. The other kind of targeted program is called "indicated." In the case of crime and delinquency, indicated programs are offered to prevent recurrence of crime by children already manifesting crime or crime risk factors. Because the term "targeted" in crime prevention policy is increasingly unacceptable to African-Americans as too resonant of racially discriminatory practices, this report will substitute the term "focused" to denote the same concept.

The choice between universal and focused programs is complex. Focused programs may make more efficient use of scarce resources, but universal programs may attract greater resource levels per family. It may not be necessary to allocate resources equally to all families within a program. But it may well be necessary to have the program itself be universal in order to make a very high cost investment politically palatable. The failure of Head Start to obtain full funding, for example, may be linked directly to the fact that it is seen as a program for poor children, rather than for all children.

Families with high levels of crime risk factors may also be more likely to accept universal programs than focused ones. This may be particularly important for more intrusive interventions into family life, such as frequent home visitation. Any possible stigma of such intrusion may be limited by the universal character of the program. To the extent that risk factors in some geographic areas are correlated with race, focused programs may be even more problematic. But programs applying to all children and all families avoid any implication of discrimination.

Even though this report generally concludes that crime prevention can be most effective when scarce resources are focused on concentrations of risk factors, family-based crime prevention provides an important exception. What makes sense across cities and even schools may not work at the level of family life. The state's relationship to the citizenry is most sensitive in the institutional setting of the family. Interpreting the policy implications of the scientific evidence reviewed in this chapter can be accomplished most usefully with the issue of universal versus focused programming in mind. The "elasticity" of demand for such programs may be such that the more expensive they become through universal access, the more likely they are to be fully funded.

Figure 4-1

Family-Based Crime Prevention by Ecological Context


Ecological Context           Program                      Prevention      Delivery       
                                                          Agent (s)                      

HOME                         Regular visits for           Nurses,         Universal or   
                             emotional, informational,    Teachers,       Selective      
                             instrumental and             Para-                          
                             educational support for      professionals,  Rarely         
                             parents of preschool (or     Preschool       indicated      
                             older) children              Teachers                       

                             Foster care outplacement     Family          Indicated      
                             for the prevention of        services,                      
                             physical, sexual abuse or    Social worker                  
                             neglect                                                     

                             Family preservation of       Private         Indicated      
                             families at risk of          Family,                        
                             outplacement of child        preservation                   
                                                          teams                          

                             Personal alarm for victims   Police          Indicated      
                             of serious domestic                                         
                             violence                                                    

                             In-home proactive            Police,         Indicated      
                             counseling for domestic      Social Workers                 
                             violence                                                    

PRESCHOOL                    Involvement of mothers in    Preschool       Universal or   
                             parent groups, job           teachers        selective      
                             training, parent training                                   

SCHOOL                       Parent training              Psychologists.  Indicated or   
                                                          Teachers        Selective;     
                                                                          some           
                                                                          universal      

                             Simultaneous Parent and      Psychologist,   Indicated or   
                             Child Training               Child Care      selective      
                                                              Workers,                   
                                                          Social Workers                 

CLINICS                      Family Therapy               Psychologists,  Indicated,     
                                                          Psychiatrists,  Selective      
                                                          Social Workers                 

                             Medication--psychostimulants Psychiatrists,  Indicated      
                                for treatment of          Psychologists,                 
                             hyperactivity and other      Pediatricians                  
                             childhood conduct disorders                                 

HOSPITALS                    Domestic Violence            Nurses,         Indicated      
                             Counseling                   Social Workers                 

                             Low-Birthweight Baby         Nurses,         Indicated      
                             Mothers' Counseling &        Social Workers                 
                             Support                                                     

COURTS                       Prosecution of Batterers     Police,         Indicated      
                                                          Prosecutors                    

                             Warrants for Unarrested      Police,         Indicated      
                             Batterers                    Prosecutors                    

                             Restraining Orders or        Police,         Indicated      
                             "Stay-Away" Orders of        Prosecutors,                   
                             Protection                   Judges,                        
                                                          Victims'                       
                                                          Advocates                      

                             Hotline Notification of      Probation,      Indicated      
                             victim about Release of      Victim                         
                             Incarcerated Domestic        Advocates                      
                             Batterer                                                    

BATTERED WOMEN'S SHELTERS    Safe Refuge during           Volunteers;     Indicated      
                             high-risk 2-7 days           staff                          
                             aftermath of domestic                                       
                             assault; counseling;                                        
                             hotlines                                                    



The Ecology of Family-Based Prevention

Despite the potentially greater appeal of universal programs, Figure 1 reveals a striking fact: almost all family-based crime prevention is currently offered on a focused basis. Absent an indicated reason to intervene in family life, American government generally leaves families alone. In contrast to many other western nations, the United States performs almost no universal monitoring of families in the home.1

This pattern creates a distinct ecology of prevention which treats families very differently in different places (Stinchcombe, 1963). The state imposes requirements on the disease-prevention vaccinations children must receive in hospitals and medical clinics, for example, but does not generally empower public health agents to invade the home to deliver vaccinations. The authority of the school teacher is great in a school building, but ambiguous when the teacher visits a private home by parental consent. The realm of the possible in family-based crime prevention programs is defined largely by the ecological context in which the programs might be delivered, and the authority vested in the government to intervene in family life associated with each of those contexts.

These contexts, as presented in Figure 1, include schools, preschools, hospitals, clinics, courts and battered women's shelters, as well as the home itself. All other contexts are in some sense merely windows on the home, opportunities for dialogue between the state and the family that can shape the results of family life for public safety. Hospitals and schools are places where crimes in the home are often detected and reported to police, who then have legal standing to investigate events in the home. They are also places where advice and instructions about reducing risk factors can be given. Absent the indication of existing problems or high risk, however, there are no universal crime prevention mechanisms comparable to medical vaccines.

This chapter is therefore a review of the effectiveness of programs within one strategic realm of family-based crime prevention: focused interventions. This represents an existing choice not to develop universal programs. It does not, of course, show whether focused programs are more or less effective than universal programs might be. In order to answer that question, it is necessary for a large-scale program of research and development to compare universal and targeted programs for their relative effectiveness. To the extent that universal programs might detect and prevent more problems than targeted programs, their value remains a major untested hypothesis in family-based crime prevention.

EVALUATING FAMILY-BASED CRIME PREVENTION

Scientific evaluations of family-based crime prevention programs face at least three distinctive problems, compared with other institutional settings. Perhaps foremost is the long time horizon often needed to measure the effectiveness of prevention programs. Also important is the possible variation in effectiveness by intensity or accumulation of risk factors. There are also unique problems in measuring crimes committed by family members against one another, in relation to both privacy and safety for research subjects and accuracy of measurement.

Long Time Horizon

A basic premise of developmental crime prevention is that what happens during infancy can affect the odds of crime two or three decades later. Giving this theory a fair test requires a very long time horizon. Sustaining the test over the time required creates problems of cost, management, and interpretation.

The problem of cost is not as great as it seems. Numerous birth cohort studies of delinquency have been funded intermittently over decades, keeping track of where to find the research subjects for repeated interviews and official record checks (Farrington, Ohlin and Wilson, 1987). The current OJP limitation of grant periods to two years poses more of a management problem than a cost problem, creating uncertainty about commitments to employ key staff and other planning issues. Relaxing that limitation for five- and ten-year projects would ease those difficulties, and help encourage more tests of developmental crime prevention strategies. The major problem this creates in interpreting available evidence is that there are so few long-term studies to examine.

The problem of management is perhaps more critical to interpretation of long-term findings. The two longest running tests of developmental crime prevention are both reputed to be very well managed programs (Berrueta-Clement et al, 1985; Lally, et al, 1987). Critics have raised the problem of generalizing from the results of small, well-managed programs to large, bureaucratically administered programs. The key question is how accurately we can predict that a long-term program serving tens of thousands of families will have the same effects as a short-term test program serving several hundred families for 3 to five years. In order to answer that question, we require research designs testing much larger scale programs over a longer period of time. That requires not only much greater cost, but a separate political process necessary to sustain the resources for the time horizon required. For example, ten years worth of birth cohorts might be needed to see if the long-term effects of a program operating during the enthusiasm (or confusion!) of an initial launch were the same as a program that was three, five, eight or ten years old.

Finally, the issue of interpretation is compounded by the speed with which our society is changing. By the time the results are in from a two-decade old test, the context of the program may have changed in important ways. Perhaps more qualified preschool teachers were available in the early 1960s than today, for example. Or perhaps the concentration of poverty in inner cities is so much worse in the 1990s than in the early 1960s (Wilson, 1996) that crime prevention benefits found in an earlier study would not stand up to today's more intense risk factors. Early feedback from measures of protective factors (like school conduct assessment) and child abuse might help solve this problem, providing both short- and long-term feedback. Conversely, short-term child abuse interventions such as Olds et al (1986) provide excellent opportunities for long-term followup of delinquency prevention, and even domestic violence prevention. Generating and funding such followup research should be a high priority for OJP. Similarly, short-term followups of drug abuse prevention programs merit much longer term followups, to see whether other factors cancel out early effects of interventions.

Cumulative Risk Factors and Contextual Data

This report's concern for the interdependency of crime prevention institutions is not widely shared in crime prevention research. Many clinic-based studies, for example, do not report precise data on the neighborhoods from which the research subjects are drawn. It is one thing to say that the children are from families on welfare or have teenage mothers. It is another thing altogether to report that 35% of the families in the sample reside in neighborhoods with adult unemployment rates in excess of 70%, and with 60% of households in the census tract below the poverty line (see Chapter two). Very few individual-level experiments report community-level data in the degree of specificity needed to begin to synthesize results and draw broader conclusions about program effectiveness.

Family-based prevention programs may work well in areas of high risk, but only up to a point. For example, clinic-based parent training for parents of aggressive elementary school children may work in all neighborhoods in Oregon, but not in many neighborhoods in Chicago. If there is a tipping point beyond which a parentally focused program may not work, it cannot be identified from the literature without more precise measurement. There is also a problem of consistency of the treatment itself across cities and treatment staff. That may interact, in turn, with the accumulation of risk factors. Some treatment staff or clinics may have greater capacity or experience to deal with concentrated risk factors than others.

Resolving the interaction of risk level with treatment effectiveness requires systematic attention and costly cross-site scientific designs. Planned variations in staff capacity, neighborhood social factors and family variables must be structured into the research design. Controlled experimentation with treatments across sites, as distinct from comparing naturally occurring variation in local treatment capacity, is required to bring a scientific methods score up to level 4 or 5. There is little precedent for this kind of research. But without it there will remain major limitations in generalizing from single-site experiments.

Measuring Crime in the Family

The issues of privacy and retaliation in measuring crimes within families pose a great challenge for research. Continuing disagreements about the interpretation of existing measures have afflicted even the strongest of research designs (Fagan, 1996). The central problems are low completion rates of personal interviews with victims of family crimes who have been treated, low or inconsistent reporting rates of subsequent crimes to police, and unwillingness to disclose crimes committed in the family during interviews in the home while other family members are present (NCVS study).

In several sites of the NIJ spouse assault replication project (SARP), for example, there are different results found from victim interviews and official reports to police. While victim interview data showed that arrested offenders had committed fewer repeat offenses than offenders randomly assigned to a warning, the official data showed the opposite (Dunford, et al, 1990; Berk et al, 1992). In other cities the victim data showed no effect of arrest while the official data showed some evidence of a backfiring effect (Hirschel, et al, 1990; Sherman, et al, 1991). But a major difference between these data was the completion level: official data covered 100% of the sample while the victim interview rates were as low as 23%, and averaged 41% in sites reporting a deterrent effect from victim interviews. Thus the effects of arrest may have interacted with victim willingness to be interviewed, biasing the sample towards victims who had enjoyed a protective effect from arrest.

The measurement theory challenging official data on family violence is that experimentally assigned criminal sanctions may encourage victims to call police more readily, whereas experimentally assigned warnings may discourage victims from calling police. Thus the higher rates of reported reoffending with the arrested subjects is arguably due to a measurement artifact. This theory does not explain why there are fewer repeat offenses reported about employed offenders randomly assigned to arrest compared to those assigned to a warning, and why the measurement artifact would only apply to unemployed offenders. A further theory could suggest that partners of employed males are less likely to call police than partners or unemployed males after an arrest has been made for fear of the employed batterer's losing his job. But none of these theories have been tested directly.

Possible solutions to these problems may lie in focusing scarce resources on prevention and measurement of injuries treated in hospital emergency rooms. Hospital cooperation with data collection on an anonymous basis could then provide more reliable measures of domestic violence (Sherman and Strang, 1996), although even then questions will remain.

PREVENTION AT HOME

Perhaps the most promising results in all areas of crime prevention are found in the evaluations of home visitation programs. While these programs are often combined with other institutional elements, such as preschool, there is a large and almost uniformly positive body of findings on this practice. Other prevention programs delivered in the home context, such as personal alarms for domestic violence victims and family preservation services, have been subject to far less research. These programs, however, generally operate on an indicated basis after crime problems have developed rather than on the selective basis of the home visitation programs. Combining these two findings may suggest even more reason for testing universal home-based prevention programs, to see if possible benefits of child-centered programs may be extended to family crimes involving adults.

Home Visitation Programs

Home visitation varies enormously in dosage levels, content, skill, and context. Yet there are common effects reported across all these variations. These common effects may be linked to a common core of treatment content, for which dosage levels may matter more than other dimensions. The common core of home visitation is a visitor who cares about child-raising sitting down in a home with a parent and a child. Visitors can be nurses, social workers, preschool teachers, psychologists or paraprofessionals. They can provide cognitive information, emotional support, or both. They can actively teach parents, with hands on the children. Or they can passively watch and listen, merely giving parents a good listening to. They can be trained in health (like nurses), human development (like psychologists and social workers), cognitive and social skills instruction (like preschool teachers) or some mixture of these subjects (like paraprofessionals). They can be experienced or novice, enthusiastic or burned out, assertive or hesitant. But no matter who they are or what they do, they provide a bridge between the parent, usually a mother, and the outside world.

Figure 2 summarizes the results of 18 different evaluations of programs that included a home visitation component. The Figure and this discussion draws primarily on the material in Yoshikawa's (1994) review, as well as Tremblay and Craig's (1995) and the draft OJJDP review prepared by Wasserman and Miller (forthcoming). Based on the limited information provided in the secondary reviews, the primary studies appear to merit level 4 to 5 scientific methods scores by the standards of this report, although some might drop to a 3 if they suffer large attrition problems. All of them show positive effects of home visits on either some measure of crime by children when they enter adolescence (N = 2 experiments), child abuse during or shortly after the period of home visits (N = 5 experiments), or risk factors for delinquency (N = 10 experiments, 1 meta analysis). While the meta-analysis of Head Start evaluations (McKey, et al, 1985) shows that the measured effects wear off, that analysis includes the lowest dosage of home visits of any of the experiments: as few as two per year. In contrast, the substantial reductions in later delinquency in the two long-term followup studies are associated with weekly home visits for periods up to five years.


Figure 4-2

Evaluations of Home Visitation Programs

(All studies ranked Level 4 or 5 on Scientific Methods Score)

(Secondary Review Sources: Yoshikawa, 1994 unless otherwise indicated; Tremblay & Craig, 1995; Wasserman & Miller, Forthcoming)

Primary Source     Effects           N of Visits,      Visitors,         Other    Age of    
(Secondary                          Time              Visited           Service  Child     
source if not                                                                              
Yoshikawa)                                                                                 

EFFECTS ON CRIME                                                                           

1)Berrueta-Clement Lower adult       Weekly, 2-3       Teachers,  High   Pre-     3-5 yrs   
et al 1984         arrests by age    years, 30 weeks   risk              school;            
High/Scope Perry   24 Exp=       7%  per yr            African-American  Parent             
Preschool          Control = 31%                       children & their   Groups            
                   ( N = 121)        (60 to 90         mothers                              
                                     visits)                                                

2) Lally, et al   Lower arrests by  Weekly, 5 years   Paraprofs, Low    Pre-scho 0-5       
1987              age 15                              income, mostly    ol;                
Syracuse          Exp =      6%                       African-American  pre-nata           
University        Control = 22%                       children & their  l                  
Family            (N = 119)         (260 visits)      mothers                              
Development                                                                                
Research Program                                                                           

3) Olds, et, al,  Lower Child       Bi-weekly over    Nurses, first     Doctor   0-2       
1986, 1988        Abuse by age 2    122 weeks from    born infants of   Visits             
University of     Exp =    19%      late pregnancy    high-risk low                        
Rochester         Control = 4%                        income white                         
Prenatal/Early    (N = 300)         (up to 60         mothers                              
Infancy Project                     visits)                                                

4) Barth,         Lower child       Bi-weekly over    Paraprof,         Taught   0-6 mos   
Hacking & Ash     abuse removals    26 weeks after    children of       Parent             
1988              from home of      birth             mothers at risk   Skills             
                  exps.                               for abusing them                     
                  (N = 50)          (12 visits)                                            

5) Gray, et al,   Fewer Injuries    Weekly over an    Nurses, children  Doctor   0-2.5     
1979              of Experimentals  average of 130    and high risk     visits   yrs       
                  (N = 50)          weeks             mothers                              
                                                                                           
                                    (130 visits)                                           

6) Infant Health  Less child abuse  ? 3 years         ? , High risk     pre-     0-3 yrs   
Program            & neglect                          children          school             
(Tremblay &       of experimentals                                                         
Craig)            (N = 985)                                                                

7) Larson 1980    Fewer Injuries    10 visits, most   BA Psychologist,  --       0- 15     
Montreal Home     of Experimentals  effect from 1 in  infants of                 mos.      
Visitation Study  (N = 95)          pregnancy, 9      Canadian mothers                     
(Wasserman &                        over 15 mos.      in Montreal                          
Miller)                                                                                    

EFFECTS ON CRIME  Effects           N of Visits,      Visitors,         Other    Age of    
RISK FACTORS                        Time              Visited           Service  Child     

8) Seitz, et al   Less anti-social  Mean = 28 visits  nurse, social     Doctor   0-2.5     
1982              behavior in       over 2.5 years    worker or         Visits   years     
Yale Child        school at age 10                    psychologist,                        
Welfare Project   by exp boys                         low ses                              
                  (N = 30)                            first-borns and                      
                                                      mothers                              

9) Johnson &      Less anti-social  25 visits first   Paraprofessional, Pre-     1-3 YRS   
Walker 1987       behavior in       year of life for                    school             
Houston           school at age 10  experimentals     Low ses only      and                
Parent-Child      by exp children                     children of       parent             
Development       (N = 113)                           Mexican-American                     
Center                                                families          classes            
                                                                        2d YR              

10) Wasik et al   Higher cognitive  Biweekly from     Teachers and      see      0-5 mos   
1990              scores up to 54   0-3; monthly 4-5  paraprofs,        column             
Project Care      mos. with Home    months of age     infants of low    2                  
                  visits +                            ses parents                          
                  cognitive day                                                            
                  care than with                                                           
                  only home visits                                                         
                                                                                           
                  (N = 62)                                                                 

11) Achenbach et  Experimental      11 home visits,   Reg. Nurse, Low   None     0-3 mos   
al 1990           children had      0-3 mos           Birth weight                         
Vermont           greater                             children                             
Intervention      cognitive skills                                                         
Project           by age 7                                                                 
                  (N = 56)                                                                 

12) McKey et al   Head Start        Varies, minimum   Preschool         Pre      3-4 yrs   
1985              Meta-analysis     2 visits per      teachers;         school             
                  shows effects     year              children of                          
                  wear off                            families in                          
                  (N= 26 studies)                     poverty                              

13) Gutelius et   Experimental      Yr  1=18+ visits  Nurses, first     None     pre-natal 
al 1977           children higher   Yr  2=12+ visits  children of                 to 3     
                  on cognitive      Yr  3= 8+ visits  unmarried                  years     
                  scores to 3 yrs.                    mothers                              
                  (N = 95)                                                                 

14) Barrera et    Experimental      Weekly 0-4 mos    Paraprof,         None     0-1 Yr    
al 1986           mothers more      Biweekly 5-9      Mothers of LBW                       
                  responsive to           mos         infants                              
                  age 1 LBW child   Monthly 10-12                                          
                  (N = 83)               mos                                               

15) Ross 1984     Mothers more      Biweekly 0-3      Nurses, low ses   None     0-1 Yr    
                  responsive,             mos         families with                        
                  children better   Monthly 4-12      LBW infants                          
                  cognition age 1         mos                                              
                  (N = 80)                                                                 

16) Jacobson &    Exp. Mothers and  Monthly in        Paraprof,         None     Pre-natal 
Frye 1991         Infants more             pregnancy  firstborn                   to       
                  attached at age   Weekly 0-2 mos    children of                1 Yr      
                  1                 Monthly 3-12      low-ses mothers                      
                  (N = 46)                mos                                              

17) Lieberman et  Exp. children     Weekly (52)       Social Worker     None     1-2       
al 1991           less anxious at                     (MA, MSW), low             years     
                  age 2                               ses anxious and                      
                  (N = 93)                            secure Hispanic                      
                                                      children                             

18) Lyons-Ruth    Exp. mothers and  Weekly from       Paraprof and MA   None     9-18 mos  
et al 1990        infants more      intake at 0-9     level; children                      
                  attached at 18    mos up to         of high risk                         
                  mos               completion at     mothers                              
                  (N = 76)          18 mos                                                 



While the two long-term experiments both included preschool programs (also called "day care" in some studies), positive effects were found in 11 of the experiments from home visitation without preschool. Some of the home visitations included doctor's office visits or some other contexts for instruction and observation outside the home, but most did not. None of the five experiments showing that home visitation reduced child abuse included involvement in preschool.

The consistent finding of beneficial effects of home visits without preschool is important for several reasons. One reason is theoretical: it shows that the visits are not simply a spurious correlate of the effects of preschool programs on both the children and their mothers, who in some studies are heavily involved in the preschool programs and who show beneficial effects themselves in reduced welfare support and longer time between pregnancies. The fact that one trial (Wasik, et al, 1990) found stronger effects from home visits with cognitively oriented day care than from home visits to comparison families (of which over half were in some other kind of day care) does not contradict the independent effects of home visits. Yoshikawa (1994) and others have concluded that home visits are likely to be more effective in combination with early education, but the empirical evidence may be still too preliminary to reach a conclusion either way.

Even if home visits were more effective in combination with other prevention efforts, the evidence of their independent effect has practical implications. The Hawaii state Healthy Start program, for example (U.S. Advisory Board, 1995: 129), which reaches over half of all Hawaiian newborns, operates on a $7 million annual budget as a home visit program only. The evidence reviewed in Figure 2 suggests that the Hawaiian program is likely to be effective at reducing child abuse, as would federal funding of home visit programs nationally. Whether they would be effective at preventing delinquency or serious crime in later life by the children visited cannot be determined without longer-term studies. Child abuse and neglect is a risk factor for delinquency, however, associated in one prospective study with a 50 percent increase in prevalence and a 100% increase in frequency of adolescent arrests (Widom, 1989). Thus if the results of the home visitation experiments can be generalized to other settings, they could clearly reduce a delinquency risk factor.

The effect sizes in these evaluations are particularly impressive. Both of the long-term delinquency prevention effects are on the magnitude of a relative reduction of three-quarters less prevalence of official criminal histories. Similarly, the Rochester University study found a 79% relative reduction (4% compared to 19%) in child abuse. It is unlikely that an effect of this magnitude could be replicated nationally across all child abuse cases because the same effect size is not observed in low-risk as in high risk families. Such large effects are also unlikely to persist beyond the first two years of life. But applying the effect size to the estimated 675,000 physical child abuse cases annually would reduce that number to 142,000, or prevent 533,000 serious crimes (Reiss and Roth, 1993: 228). If the 1 million neglect cases are included as well, then an additional 800,000 serious crimes might be prevented by home nurse visitation. Perhaps the most immediate question in advancing the capacity to generalize from controlled trials to national effects is the generalizability of the Rochester University results from a rural white upstate New York sample. A long-term trial of a similar approach among 1,100 African-American families in Memphis (National Research Council, 1993: 172) may soon report crucial results on this point.

Foster Care and Family Preservation

Families in which child abuse is proven pose a major dilemma between family preservation and prevention of recidivism. The many documented deaths and injuries of children after prior reports of abuse underline the seriousness of the dilemma. But the potential benefits of keeping thousands of families together must be weighed against the cost. The current state of the evaluation science of these two alternatives does not allow precise estimation of the costs and benefits. But a recent review of the evidence by a National Academy of Sciences panel finds that the larger problems is not the choice between family preservation and foster care. The problem is that in so many cases neither course is taken.

The review found a national survey showing that more than one-third of confirmed cases of child maltreatment received no therapeutic or support services (McCurdy and Daro, 1993, as cited in National Research Council, 1993: 268). This result occurs after 50 percent of the reported cases of maltreatment are found unsubstantiated, and the child protective services agency is required to decide whether children can remain safe in the home during treatment of the family. The officials making these decisions are often understaffed, with poor training and high turnover. In 1991 in New York City, for example, 77 percent of the workers investigating child abuse reports transferred to other agencies, resigned or were laid off (Dugger, 1992, as cited in National Research Council, 1993: 268).

When children are placed in foster care due to abuse, it is not clear what their risks of further abuse become. Few studies of abuse rates of the estimated 200,000 children placed in foster care each year distinguish between abuse of the estimated 50% of children who were maltreated before going into foster care and the other half who were not (Tatara, 1989, 1992, as cited in National Research Council, 1993: 271). Studies comparing rates of abuse in foster care to other settings are methodologically weak. One study almost two decades old did find that reported abuse by all foster parents is lower than that by the general population, and much lower than rates of re-abuse by abusive parents (Bolton, et al, 1981, as cited in National Research Council, 1993: 230). But even if foster care creates a protective factor against further abuse, many cities report major shortages in the availability of foster parents relative to the numbers of children judged to need it (Kammerman and Kahn, 1989, as cited in National Research Council, 1993: 271).

When children are left in their family homes after documented maltreatment, they may or may not be at higher risk of further abuse and later delinquency. A review of four major federally funded studies of the effectiveness of treatment across 3,253 families with abuse and neglect problems found that even early and costly services are "not very successful" (Cohn and Daro, 1987, as cited in National Research Council, 1993: 255). Yet the scientific literature in this area is characterized by many of the limitations of general concern in this report (National Research Council, 1993: 254):

The scientific methods used to evaluate family preservation programs have been stronger, but the results have been no more encouraging than for standard in-home treatment. Family preservation are often intense (20 to 30 hours per week), brief (often 6 weeks) programs designed to prevent foster care placement through a variety of strategies. These include strengthening family bonds, improving family skills, and providing stability in crisis situations. Rigorous experimental and quasi-experimental designs evaluating these programs show equivocal results, both on prevention of outplacement and longer-term outcome measures (National Research Council, 1993: 264-65). The studies have not yet disaggregated the problem by different kinds of family problems, which could produce different results. The National Research Council Panel on Child Abuse and Neglect concluded that these programs are of unknown effectiveness. But the strategy remains popular because of its significant costs savings, an estimated $27,000 in tax dollars for each outplacement prevented. No estimate of the risks of death and injury associated with that cost saving are available.

Domestic Violence Alarms and Visitation

Two home-based strategies for secondary prevention of domestic violence have shown increasing use over the past decade. Personal radio alarms are indicated for extremely serious cases, while home visitation has been employed as a followup strategy after police response to a domestic disturbance call.

The personal alarm is usually a small panic button worn as a necklace. Pressing the button directly activates a message at police headquarters to dispatch a police car on an urgent basis to the home of the wearer, who uses it to signal that a batterer is on the premises (Sherman, 1992: 242; Farrell, 1995: 518-19). While the system is expensive to maintain, it can be allocated rationally based upon known risk factors. Police serving the Liverpool, England area rotate the available alarms across the most recent and highest-risk victims of serious attacks, based on their finding that repeat attacks were most likely to occur within thirty days after the last attack. This finding of highest risk of repeat victimization in the first 24 hours and first 30 days after the last incident has been replicated in a sample of 40,000 cases in an around Melbourne, Australia (Strang and Sherman, 1996), and is an important basic research finding of indirect evidence in support of the use of personal alarms. Unfortunately, the many documented cases of domestic homicide of women who had been issued alarms shows that the system is not foolproof. While it seems unlikely to increase the risk of attack, there is no impact evaluation presently available to address the question of whether alarms are safe and effective.

The strategy of home visitation after a police contact for domestic violence or disturbances also focuses on the high-risk time period in the immediate aftermath of a police response to a domestic disturbance in the home. The strategy has been evaluated in three tests using strong scientific methods. An NIJ-funded Dade County (Florida) police experiment in the late 1980s randomly assigned four responses to misdemeanor assault cases in which there was legally sufficient evidence to make an arrest: arrest, warning, arrest with followup visitation, and warning with followup visitation. The design was thus two separate controlled tests of followup visitation by police, one test following an arrest and one test following a warning (Pate, et al, 1991). The home visits consisted of a police detective reviewing the family's history of domestic violence problems, their legal options, and social service agencies to which the detective could refer them for further assistance. The visit was a one-time treatment, with no attempt to provide a theoretically based psychological treatment. The very rigorous test of the strategy found no effects of home visits on several diverse measures of repeat domestic violence over a six-month followup period, including police offense reports, arrest reports, and victim interviews, analyzed by prevalence, frequency, and time to failure. The results were the same for visits after an arrest and visits after a warning.

A second controlled experiment included both arrest cases (21%) and non-arrest cases (79%) in the same sample randomly assigned to receive home visitation (or not) by two person police-social worker teams (Davis and Taylor, forthcoming). The home visits were observed by researchers as lasting from ten to thirty minutes, depending on the victim's receptiveness and whether the batterer was present. The team tried to educate the victim, and the batterer if present, about the seriousness of domestic violence and encourage the family to seek change through the courts or other services. Specific information was provided about how to go to court for restraining orders, and to social services including battered women's shelters, substance abuse treatment, relocation to another address, and home security. No difference in repeat violence between experimentals and controls were reported in victim interviews (response rate = 72%), but homes assigned to the experimental group generated twice as many domestic calls to police. The authors interpret this as evidence that visitation increases reporting but not violence; an alternative interpretation (untested in the analysis) is that visitation increased repeat calls, with the homes with no victim interviews accounting for a substantial portion of the total increase in the experimental group.

However the data are interpreted, there are now three strong tests of the police home visits strategy for preventing domestic violence. All three of the tests falsify the hypothesis that this strategy is effective.


Figure 4-3

Effects on Domestic Violence of Proactive Home Visitation after Reactive Police Contacts

Study                 Scientific  Home Visitation    Results                        
                                  Providers                                         
                      Methods                                                       
                      Score                                                         

Pate et al 1991            5      Police Detectives  Visits after a warning had no  
                                                     effect on repeat violence      
                      (N= 447)                       over a 6 month followup        
                                                     period as reported by victim   
                                                     interviews or documented in    
                                                     official records               

Pate et al 1991            5      Police Detectives  Visits after an arrest had no  
                                                     effect on repeat violence      
                      (N= 442)                       over a 6 month followup        
                                                     period as reported by victim   
                                                     interviews or documented in    
                                                     official records               

Davis and Taylor           5      Police-social      Visits in domestic violence    
forthcoming                       worker teams       public housing "hot spots"     
                                                     had no effect over a six       
                      (N= 436)                       month followup period on       
                                                     repeat violence reported by    
                                                     victims; calls to police       
                                                     about domestic incidents from  
                                                     experimental group almost      
                                                     twice as high as from control  
                                                     homes                          



PREVENTION LINKS BETWEEN PARENTS AND PRESCHOOL OR SCHOOL

Outside the home, the preschool and the school provide major opportunities for family-based crime prevention. Many of the prevention effects associated with early infancy home visits are impossible to separate from the simultaneous provision of a strong linkage between parents and preschool. As children age, the school takes over more of the child's day (see Chapter Five), but many schools continue to seek parental involvement in reducing a child's behavioral risk factors for delinquency. Without duplicating the coverage of school-based prevention in the next chapter, this section explores the evidence on family-based prevention delivered through school settings.

Developmentally, the family-school linkage can begin as early as infants are left in educationally enriched day care for even part of the day. For children whose parent or parents are employed, the availability of such care can be a crucial factor allowing the parents to work. For children who have at least one parent out of the labor force, the link to day care or preschool can be an important means of helping that parent find work. The daily structure of commuting to a child care center, and of spending part of each day or week there, can help establish patterns essential for participation in mainstream society. Effects of maternal participation in preschool in studies reviewed by Yoshikawa (1994) included increased employment, reduced welfare dependency, and increased time between giving birth. To the extent that these effects were also linked to home visitation, however, the greatest certainty about generalizing from these results lies in framing them as a combined preschool-home visitation effect.

School setting programs for parent training and family-based prevention with older children also combine several different treatments. The recent review by Tremblay and Craig shows generally positive effects of these programs on delinquency or, more often, risk factors for delinquency with indicated or selective samples. Many of the evaluations suffer from small samples, short (or no) followup periods, and other methodological weaknesses. But the consistency of the results suggests that school-family outreach to train parents of problem children could be an effective means of preventing delinquency in certain kinds of areas.

Children at Risk. Unfortunately, the results of the moderately strong evidence in Figure 4-4 were not confirmed by a very strong test of a very expensive program linking schools and families of very high-risk youth to a wide range of services in very high risk neighborhoods. The Urban Institute's four-year NIJ-funded evaluation of the Children at Risk program in Austin (TX),


Figure 4-4

Effects of Parent Training in School Settings

(Secondary Review Source: Tremblay and Craig, 1995; Scientific Methods Not Scored) 
Primary Source        Type         Sample       Treatments   Effects            

Tremblay et al 1994   Indicated    160 boys     2 Years of   6-Year Followup    
                                   aged 7       parent       showed lower       
                                   years at     training,    self-reported      
                                   outset       social       (ES= .25) and      
                                                skills       official (ES =     
                                                training     .07) delinquency,  
                                                             better school      
                                                             adjustment         

Hawkins et al 1992    Universal    1,659 boys   4 years of   5 month followup   
                                   and girls    training of  showed lower       
                                   aged 6 at    parents,     self-reported      
                                   outset       teachers,    delinquency (ES=   
                                                students     .16), better       
                                                             parenting,         
                                                             attachment to      
                                                             family & school    

Pepler et al 1991     Indicated    40 boys &    12 weeks of  3 month followup   
                                   girls aged   parent and   showed better      
                                   8 years      student      control over some  
                                                training     disruptive         
                                                             behaviors, not     
                                                             others             

Horn et al 1990       Indicated    42 boys &    12 weeks of  8 month followup   
                                   girls aged   parent       showed better      
                                   7 to 11      training     social control,    
                                   years        and child    less               
                                                self-control hyperactivity and  
                                                 therapy     conduct problems   

Kolvin et al 1981     Selective    574          3 to 15      20 to 32 month     
                                   Children     months of    followup showed    
                                   age 7 years  parent       less anti-social   
                                                counseling,  behavior and       
                                                group        neurotic problems  
                                                therapy                         



Bridgeport (Conn), Memphis, Savannah and Seattle was a randomized trial with 671 experimentals and controls, plus 203 youth in comparison neighborhoods (Harrell, 1996). Eligible subjects were referred to the program between ages 11 and 13 while attending 6th or 7th grade at the middle school in the study neighborhood in each city, where they were required to live. Referrals from school, police or courts were based on indicators of at least three school risk factors (such as truancy), one family risk factor (such as parental violence), or one personal risk indicator (such as prior arrests or gang membership). Service protocols were locally determined in each site, including some help from each of the following services: social work, family services, tutoring or educational services, recreational after-school and summer programs, mentoring, gifts and special events, community policing and juvenile courts. Half the sample was African-American and one third was Hispanic. Funding from private and DOJ sources for the program cost between $11 and 20 million.

The preliminary findings from the evaluation so far have shown that these intensive and expensive interventions combined had virtually no effect. The findings are based on self-reported behavior by the experimental and control adolescents, with a 75% response rate after four years from the original randomly assigned sample. No differences were detected in attrition patterns by treatment group, which gives the analysis a scientific methods score = 5. The interviews show no difference within the high-risk areas between experimentals and controls on self-reported delinquency, drug use in the past month or entire lifetime, or sexual activity. A small difference in weapon carrying favored the treatment group. Further analyses still to be reported include officially measured crime and delinquency from police and court records, which will cover 100% of the experimental sample and not just the survey respondents (Harrell, 1996). Thus the conclusions could change. Even with the best possible results from official data, however, further findings on the effectiveness of services costing about $35,000 per child will be unable to provide clear evidence of effective crime prevention.

The CAR findings from self-reported delinquency do not provide much guidance on how to prevent crime effectively in the places where prevention is needed the most. But the negative findings may not generalize to lower-risk families, adolescents, schools or neighborhoods. Figure 4-3 suggests that multi-treatment school outreach to parents might be effective with other samples. Similar results suggest the same about family therapy clinics working with families of children showing risk factors, either in the clinical setting or with the clinicians working with families in the home.

PREVENTION IN CLINICS

One key factor in the Children at Risk evaluation may have been the low parental involvement with the adolescent (Harrell, personal communication, 1996). Where parents can be successfully engaged in the question of how to raise their children more effectively, the results may be more encouraging. Figure 4-5 summarizes Tremblay and Craig's review of twelve evaluations of family therapy. Only one of these has a delinquency measure, but that one finds a prevention effect of moderate effect size. The other studies, while weaker, consistently report reductions in risk factors associated with family therapy by clinics.


Figure 4-5

Effects of Family Therapy Interventions By Clinical Staff

(Secondary Review Source: Tremblay and Craig, 1995; Scientific Methods Not Scored)

Primary Source        Type         Sample       Treatment    Effects            

Therapy Delivered in                                                            
Clinics                                                                         

Kazdin et al 1992     Indicated    97 boys &    6 to 8       1-Year Followup    
                                   girls        months of    showed lower       
                                   around 10    cognitive-be self-reported      
                                   years old    havioral     delinquency (ES=   
                                   at outset    parent       .25), anti-social  
                                                training     behavior and       
                                                             parental stress    

Dishion et al 1992    Selective    58 boys and  12 weeks of  During treatment   
                                   61 girls     parent       child's            
                                   aged 10 to   training,    Anti-social        
                                   14 at        self-regulat conduct and        
                                   outset       ion          parent's negative  
                                                             discipline         
                                                             declined; home     
                                                             conduct worse      

Yu et al 1986         Indicated    35 boys      20 weeks of  During treatment   
                                   aged 7 to    parent and   boys improved on   
                                   12 years     student      problem-solving,   
                                                training in  externalizing and  
                                                problem-solv social competence  
                                                ing                             

Horn et al 1990       Indicated    42 boys &    12 weeks of  8 month followup   
                                   girls aged   parent       showed better      
                                   7 to 11      training     social control,    
                                   years        and child    less               
                                                self-control hyperactivity and  
                                                 therapy     conduct problems   

Kolvin et al 1981     Selective    574          3 to 15      20 to 32 month     
                                   Children     months of    followup showed    
                                   age 7 years  parent       less anti-social   
                                                counseling,  behavior and       
                                                group        neurotic problems  
                                                therapy                         

                                                                                
Clinical Therapy                                                                
Delivered at Home                                                               

McNeil et al 1991     Indicated    30 children  14 weeks     less aggression &  
                                   X = 4.9      parent        opposition by     
                                   years old    training     children during    
                                                             treatment          

Packard et al 1983    Indicated    34           2 weeks of   11 week followup   
                                   mother-child parent       showed less        
                                    pairs,      training     problem behavior   
                                   child age                                    
                                   X = 4.3                                      

Shure & Spivak 1979   Indicated    10 boys, 10  3 months of  Less impulsivity,  
                                   girls age    Social       better             
                                   X = 4.3      problem-solv problem-solving    
                                                ing and      during treatment   
                                                parent                          
                                                training                        

Webster-Stratton et   Indicated    171 fathers  4 months of  3 year followup    
al 1988, 1990                      & mothers    parent       showed better      
                                   of children  training     parenting, less    
                                   aged                      child              
                                   X = 4.5                   hyperactivity      

Strain et al 1982     Indicated    40 boys &    17 weeks     3 to 9 year        
                                   girls aged   child &      followup showed    
                                   3 to 5       parent       less oppositional  
                                                training     behavior and more  
                                                             compliance         

Dadds et al 1987      Indicated    24 families  6 weeks of   6 month followup   
                                   with         parent       showed less        
                                   children     training,    oppositional,      
                                   aged         problem-solv more compliance    
                                   X = 4.2      ing          behaviors by       
                                                             children           

Strayhorn and         Selective    84 children  5 months     1 year followup    
Weidman 1991                       aged X =     parent       shows better       
                                   3.7 years    training     parenting, less    
                                                             hyperactivity, no  
                                                             effect on          
                                                             hostility          



A recent analysis by Kumpfer (forthcoming) also shows beneficial effects of parent training in "clinics" more broadly defined, including recreation rooms of public housing and other apartment complexes. Kumpfer's work attends to the practical issues of incentives and transportation in obtaining high parental attendance rates at training sessions focused on prevention of substance abuse by both parents and children; when such issues are properly addressed, she even finds high attendance rates in high-risk areas.

PREVENTION IN COURT

When prevention practices in all other settings fail, families often rely on the criminal justice system to stop the crime. This is especially true for problems of family violence. Compared to what is known about human development and developmental crime prevention, however, the science of domestic violence has little knowledge to offer for effective policymaking. But the opportunities for advancing evaluations of legal efforts at violence prevention are great, once the limitations of the current state of knowledge are fully understood.

The basic science of domestic violence and the law offers several well-known facts (Crowell and Burgess, 1996): domestic violence is widespread and highly under-reported to authorities. When police are called, they find no evidence of actual physical violence in over half of all "domestic" calls, and make no arrests in the majority of cases where such evidence is available. The vast majority of arrests that are made are for misdemeanor assaults with limited evidence of injury, for which prosecutors drop charges in the majority of the cases (Sherman, 1992). While the suspect is gone from the scene when police arrive in 40% of the cases in which police do have sufficient evidence to arrest, few courts or police agencies bother to issue arrest warrants unless the victim requests one by making a burdensome trip to court. Rising arrest rates for simple assault in the early 1990s has placed even more workload pressure on courts and prosecutors, for which there is some evidence that the odds of prosecution per arrest will decline. Odds of conviction per arrest for misdemeanor domestic assault are as low as 1 percent, with odds of incarceration per arrest as low as zero per 400 cases (Sherman, 1992: 337).

The prevention program often recommended in response to these facts of under-enforcement of the law is full, or fuller, enforcement. The premise of this policy is two-fold, both moral and empirical. The moral premise is that full enforcement is the proper response to all crimes, from drug possession to homicide, even though there is ample evidence that under-enforcement of the law by 50 percent or more cuts across both felonies and misdemeanors of almost all kinds (Reiss, 1971; Black, 1980; Smith and Visher, 1981). From this perspective, the crime prevention effects of fuller enforcement are not dispositive.

Fuller enforcement is also claimed, however, to have preventive effects. The empirical premise is that increasing certainty and severity of punishment will create either general or specific deterrence of domestic violence. "General" deterrence refers to prevention of crimes by people in the community generally regardless of whether they have been caught and punished for a crime. "Specific" deterrence denotes the preventive effects of punishment on people who have been caught. Both hypotheses are widely accepted as true by legislators, but hotly debated by evaluation scientists (Zimring and Hawkins, 1973; Blumstein, et al, 1978).

Rigorous scientific impact evaluation evidence is unavailable about most of the criminal law strategies for preventing domestic violence (Crowell and Burgess, 1996; Fagan, 1996). Police have been the component of the legal system most willing to engage in rigorous impact evaluations. Other agencies of the criminal justice system have repeatedly refused to allow careful testing of their effectiveness; prosecutors in Milwaukee and judges in Minneapolis are just two examples over the past decade. As a result, a great deal is known about the effects of one police decision, while little is known about most other criminal justice practices.

The National Institute of Justice has pioneered in supporting rigorous tests of domestic violence responses. This include the six offender-present and one offender-absent experiment in arrests for misdemeanor domestic assault (Scientific Methods Score = 5), reviewed in Chapter Eight. These studies find no consistent support for the specific deterrent hypothesis, in the general absence of any referrals, prosecutions or convictions after an arrest; they do find arrest is effective for employed offenders (Sherman, 1992) and absent offenders for whom police issue a warrant (Dunford, 1991). A frequent conclusion from these findings is that arrest must have followup actions in order to be effective. That hypothesis, however, remains untested. So does the general deterrence hypothesis that mandatory arrest in a city will prevent domestic violence city-wide. The hypothesis that allowing victims to decide whether or not an arrested batterer should be prosecuted will prevent violence, however, has also been tested by an NIJ-funded controlled experiment (Scientific Methods = 5). The Indianapolis Domestic Violence Prosecution Experiment (Ford, 1993) randomly assigned cases in the prosecutor's office to a policy of either "no-drop" or victim decision. The victim decision policy produced a lower repeat violence rate, also falsifying the hypothesis that full enforcement offers greater prevention.

The hypothesis that mandatory referral of arrested batterers to counseling or therapy will help prevent repeat violence has also been tested with NIJ support, although with weaker scientific methods than the evaluations described above. This test provides moderately strong evidence of a negative effect. Harrell (1991) found in a matched comparison of arrested batterers referred to court ordered treatment and those not referred to treatment that the treated group had higher repeat violence rates. Crowell and Burgess (1996: 122), however, cite several weaker studies that find the opposite conclusion. The strongest design appears to be Goldkamp's (1996) evaluation of the Dade County Domestic Violence Court program combining substance abuse treatment with domestic violence counseling, a randomized experiment not yet reported with significance tests or other statistics (SMS = 3); preliminary results suggest a reduction in same-victim domestic violence by offenders in the combined treatment, compared to offenders given only one or the other treatment approaches. The effects of court-ordered treatment seem likely to vary widely by the specific approach to treatment, the skills of the individual therapists, the background of the batterers, and other factors making it difficult to generalize from a few weak evaluation designs (Fagan and Browne, 1993).

Most domestic violence evaluations have been focused on noninjurious violence, and very little is known about the prediction or prevention of serious injury. One of the major practices to be evaluated is the effectiveness of court orders of protection. According to an NIJ-funded study by the National Center for State Courts (1996) in Wilmington, Denver and the District of Columbia, women who seek orders of protection suffer very high rates of serious injury prior to obtaining the order. According to a matched control evaluation of women granted orders in Denver and Boulder, the one-year recidivism rates are lower against women who obtain the orders (Harrell, et al, 1993), thus supporting the full enforcement deterrence hypothesis. In the absence of any other reported impact evaluations of restraining orders, this level three study makes the use of such orders at least "promising."

PREVENTION IN OTHER SETTINGS

The effects of practices in other settings on families and their crime risks may be quite substantial. Churches, employers, landlords and neighbors may all play roles that are not yet well understood. This section addresses only a few of the other settings affecting families: battered women's shelters, hospitals, and gun shops.

Battered Women's Shelters. The number of battered women's shelters in the US was recently estimated at 1,200 (Plichta, 1995, cited in Crowell and Burgess, 1996: 101). These shelters, and 600 other related programs, offer a wide array of services to families and women suffering intimate violence. The core of a shelter's service, however, is providing a safe haven during the high risk period in the immediate aftermath of a domestic violence incident (Farrell, 1995; Strang and Sherman, 1996). There is evidence that current levels of this service are insufficient to meet the demand; an estimated 300 women and children per week were turned away from New York City shelters in March of 1995 due to lack of space (O'Sullivan et al, 1995, as cited in Crowell and Burgess, 1996: 102).

Whether shelters actually reduce violence against women is an important question for evaluation. The logical basis for predicting that result is the reduction of risk after the passage of time with the offender unable to gain access to the victim. Berk et al (1986), however, found quasiexperimental (Scientific Methods Score = 4) evidence that unless the shelter clients took other steps to seek help beyond staying in the shelter, their rates of repeat violence after leaving the shelter were actually higher than a similar group who had not gone to a shelter. Among women who did take additional steps, however, the shelter stay had a measured protection effect against repeat violence lasting about 6 weeks. The relatively small sample size (N = 155) and Santa Barbara (CA) site for this analysis (N = 155) may limit the generalizability of the findings, but the results suggest the clear need for impact evaluations of all crime prevention programs.

Hospitals. Little is known about the identification and reporting of family violence in hospitals. A recent NIJ grant to the Illinois Criminal Justice Information Authority will examine the possible data collection opportunities in hospital emergency rooms, which could lead to operational indicators as well as research findings. A clear interpretation of the number domestic violence cases reported to police is impossible as long as increased reports might reflect growing confidence in the police, rather than more violence in the home (Davis and Taylor, forthcoming; Sherman and Strang, 1996). Hospital measures over time may provide a community with its most reliable indicator of progress or decline in the effectiveness of its efforts to deal with the problem.

Gun Shops also play a crucial role in family violence, and most of some 2,000 domestic homicides a year. The 1996 Lautenberg Act imposed a federal ban on gun ownership among persons convicted of domestic violence misdemeanors. We may estimate the likely effect of implementing this law by noting that an estimated 100,000 to 150,000 persons are convicted annually of domestic violence misdemeanors.2 Moreover, the risk of a domestic homicide is approximately eight times higher among people who have had police encounters for misdemeanor offenses than among people who have not in Milwaukee, and 18 times higher in Victoria (Melbourne), Australia (Strang and Sherman, 1996). While this risk is nonetheless a very low 1 in 33,000 person-years, it still amounts to 5 murders per year among people newly convicted of domestic violence. If the prior convictions were included for 20 years, that could amount to 100 murders per year committed by persons previously convicted of domestic violence misdemeanors. How many of those murders would be prevented by the Lautenberg law is impossible to predict. But the indirect evidence on risk factors suggests that the law does address a major risk factor for serious domestic injury and death.

CONCLUSIONS: WHAT WORKS, WHAT DOESN'T, WHAT'S PROMISING

This section discusses the following conclusions, and their research and policy implications:

What Works

o Long-term frequent home visitation combined with preschool prevents later delinquency

o Infant weekly home visitation reduces child abuse and injuries

o Family Therapy by clinical staff for delinquent and pre-delinquent youth

What Doesn't

o Home visits by police after domestic violence incidents fails to reduce repeat violence

What's Promising

o Battered women's shelters for women who take other steps to change their lives

o Orders of Protection for battered women

The Effectiveness of DOJ-Funded Local Prevention Programs

Over the last three decades, the Congress has left family-based crime prevention largely in the hands of other federal agencies besides the Department of Justice (DOJ). This began to change with the rising concern over domestic violence in the 1980s.3 The passage of the Violence Against Women Act (VAWA) as Title IV of the 1994 Crime Act was a major increase in the role of DOJ in the family (although the VAWA also addresses crimes committed by strangers). Most recently, the Office of Justice Programs has identified infant home visitation as an important strategy to include in comprehensive community prevention programs such as Weed and Seed and various OJJDP initiatives. The evidence suggests that DOJ's increasing responsibility for national crime rates logically draws it to the major risk factors for crime, which must clearly include the family.

In what may be a period of transition towards more explicit focus on family-based prevention, Congress has created a number of funding programs that offer opportunities to develop that role. These may be divided into developmental and family violence prevention. The developmental programs are funded primarily by OJJDP and the Executive Office of Weed and Seed with discretionary funds, while the family violence funding is concentrated in the Violence Against Women Grants Office.

Safe Kids, Safe Streets (OJJDP, with VAWGO and EOWS). This funding program will provide about $1.4 million per year for five years to each of six communities. Informed by much of the research reviewed in this chapter, the program is specifically aimed at prevention of child abuse and neglect and related risk factors for delinquency. The strategies supported by the program include family strengthening, mental health services and treatment. A national process evaluation is underway to determine exactly what strategies each site selects, and a national impact evaluation is planned for future years.4 To the extent that the local grantees elect to employ approaches to family based prevention reviewed in this chapter, there is evidence that the funding can be effective in preventing crime. To the extent that the local grantees focus on the highest risk pre-adolescents in the highest-risk neighborhoods, however, the preliminary results from the Children at Risk Program may indicate that the state of the prevention art is not yet up to such a sever challenge (Harrell, 1996).

Title V Incentive Grants for Local Delinquency Prevention (OJJDP). This program distributed $20 million in FY 1995 for local programs encouraged to adopt the Communities That Care model (Hawkins, et al, 1992). The program was initially developed and field tested by OJJDP in the early 1980s, and has established a substantial record of evaluation results. The CTC model recommends consideration of parent training as well as family therapy for high-risk adolescents and early childhood home-based and center-based strategies. This review finds all those approaches can be effective.5

Operation Weed and Seed (EOWS). This program is currently planning to conduct a field test of the Rochester University model of early infancy home nurse visitation. The location of such a test within Weed and Seed neighborhoods would provide an excellent replication of the original Elmira study. Results from the Memphis replication currently underway could also inform the Weed and Seed approach to this model, which has such strong evidence of reducing child abuse among high-risk rural white families.

Congressional Action on Universal Home Visitation. The evidence reviewed in this chapter suggests that substantial crime prevention effects could be obtained from greater federal investment in early infancy and pre-school home visitation. For reasons discussed in this chapter, a universal approach to such a program is more likely to succeed than a selective approach based upon risk factors. The latter approach is more cost-efficient but potentially stigmatizing. While further research is needed to compare the crime prevention benefits of early prevention to costly federal programs such as prison construction, such research could inform the Congress of where it can find the maximum crime prevention for each taxpayer dollar. While appropriations for Head Start have never been able to meet the demand for the program, that may reflect its use on a selective basis. A universal home visitation program that promises to reduce crime may be more feasible than fully funding Head Start. Controlled testing of visitation with and without Head Start, however, is required in order to determine whether visitation alone can create lasting benefits without reinforcement for both parent and child through the pre-school environment.

Universal home visitation for children may also have the benefit of helping to prevent or at least detect domestic violence. Visitation has been found ineffective in the immediate aftermath of a police response. But it may well be effective at reducing unreported cases, especially in families where police are never called. While this would not be a central goal of universal early infancy visitation, it could be a side benefit. That hypothesis also provides a linkage between DOJ efforts to prevent crime developmentally and among members of the family.

STOP (Services, Training, Officers, Prosecutors) Formula Grants (VAWGO). By far the largest OJP expenditure on issues affecting crime in families is the STOP Grant funding program, which distributed $23 million in fiscal 1995 and has been appropriated $145 million for FY 1997.6 This money, which addresses all violence against women and not just family violence, is appropriated on the basis of population. How the money is used is up to the states, within the broad initial guidelines of 25% allocations to each of three areas (Burt, 1996: vi): law enforcement, prosecution, and victim services. Much of it appears to go for training, model policies, equipment, and other support materials.

To the extent that this funding can be effective in reducing family violence, it could be more so if the funds were allocated on the basis of some crime risk indicator. Possible criteria include the number of women murdered by men in each state, or total women murdered (which would have less reporting bias than other crimes against women like rape). Like police patrol funding (see Chapter Eight), the population based formula may put the money equally in places that need it desperately and places that do not.

As the major source of federal funds that could be used to combat family violence, STOP might provide a vehicle for increasing prosecution and adjudication of domestic violence arrests. The full enforcement hypothesis remains an unanswered question, even though there is clear evidence that it is not supported with certain kinds of offenders. In order to test the effects of higher levels of prosecution and sentencing, the funding required for the extra courtroom work must be provided. A review of the FY 1995 grant awards made by the States, however, suggests that the funds are not being used to support increased volume of court case processing--unlike the competitive Grants to Encourage Arrest Policies. Most of the purposes are for support services such as training. The effects of training of police and prosecutors on crime prevention have not yet been evaluated. But the effects of increased prosecution are also unknown. The general absence of scientific tests of most local practices in domestic violence prevention provides very little guidance to Congress, DOJ and the states on how this funding can be spent most effectively to prevent domestic violence.

Grants to Encourage Arrest Policies (VAWGO). A review of grant award abstracts for the FY 1996 grants suggests that these grants are supporting diverse local programs. The most direct operational activity is increased capacity for prosecution, with DOJ funds used to hire prosecutors and bring charges in cases that would otherwise be dropped. Some jurisdictions even commit to 100% prosecution. Thus the program may provide a realistic possibility in many communities to link arrest to a high certainty of prosecution, a response that has never been evaluated but which could be very different from arrest alone. Until evaluations of that kind are conducted, the effectiveness of increased prosecution a crime prevention practice will remain unknown.

These grants also support training, data bases and other approaches designed to increase arrests made by police officers. Here again, the current state of evaluation science has little guidance to offer one way or another about any expenditures to encourage domestic violence arrests. The potential value for impact studies across a range of options for such programs would be to identify those which appear most cost-effective.

Rural Domestic Violence and Child Abuse Enforcement Assistance grants (VAWGO). The absence of scientific evidence on the effectiveness of local practices in rural areas, and with child abuse cases, also limits the assessment that can be made of this funding based on scientific evidence. The 1993 National Academy of Sciences Panel found the problem of child abuse to lack rudimentary science on many of these questions. To the extent that the Olds et al (1986) experiment prevented rural child abuse successfully, the Congress may wish to open the scope of acceptable funding for this program to include prevention as well as enforcement. Alternatively, the use of nurses legally obligated to report abuse might qualify as child abuse enforcement. If local programs funded by DOJ use their money in that fashion, it seems reasonably likely to be effective in rural white low-income communities or families.

National Stalker and Domestic Violence Reduction. This $6 million three-year program establishes a data base as part of the National Crime Information Center that will cover various offenses and offenders in domestic and family violence and stalking. In addition to the data base funding from the STOP Block grants, these funds will help create the capacity for implementing the 1996 Lautenberg Act extending the Brady Bill to misdemeanor domestic violence. While the latter Act prohibits persons convicted of such misdemeanors from owning a gun, there is currently no data base available in most states to identify such persons. This gap results from the absence of special statutes for "domestic" offenses, which are generally prosecuted under generic laws against assault. Whether a misdemeanor assault conviction reflects domestic violence is not a part of the court record, and can only be determined retrospectively by examining police records. The latter are often kept in paper files rather than computers, making the task very difficult in retrospect. But if new data bases can capture the data prospectively, it may be possible to implement the law with these funds by the 21st Century. It seems unlikely to happen without these DOJ funds.

No empirical test of the effect of a handgun ban for domestic violence misdemeanant has ever been conducted. Ongoing NIJ evaluations of the Brady bill may provide some idea. Other uses of the data bases created by VAWA funding could have even greater preventive effect, such as public access to a registry of convicted batterers. Such a registry could have a far greater deterrent effect than arrest alone, and could also help warn potential victims to avoid relationships with previously convicted batterers. Whether any of these hypothesized effects would occur, however, can only be determined by a program of rigorous research and development.

Office of Victims of Crime. This office, funded by fines collected by federal courts, provides grants in support of some of the local practices reviewed in this chapter. Support for battered women's shelters is a notable example. The potential value of these programs in preventing crime suggests that this Office might be included in the overall scope of DOJ crime prevention activity.

Improving Funding Effectiveness Through Better Evaluations

As the Congress recognized in its passage of the Violence Against Women Act of 1994, the research agenda for family-based crime prevention is substantial. A great many key questions about local practices remain unanswered, while tens of millions of cases are processed annually. This final section considers three high priority areas: home visitation, police arrest policies, and orders of protection.

Early Infancy Home Visitation. This Chapter's primary recommendation is the same as the 1993 Report of the National Research Council (1993) on Child Abuse and Neglect:

The theoretically powerful early infancy visitation model raises a host of unanswered questions about its effectiveness. Before formulating or proposing a national policy, DOJ needs to procure randomized experiments testing the basic model under different conditions: high and low crime neighborhoods, different training for the visitors, different frequency and length of visitation, and different combinations of other interventions such as preschool with parental involvement. The funding of visitation programs as part of existing DOJ programs creates an opportunity to implement this proposal. The absence of a randomized controlled trial, however, would gravely limit what can be learned from an impact evaluation. The feasibility of a rigorous experiment has been demonstrated in Elmira and Memphis, and DOJ can build upon that precedent.

Police Arrest Policies. Given the growing use of arrest for domestic violence and the continuing debate over the interpretation of the previous NIJ experiments, it would be very helpful to continue the program of research that produced them. Collaborative experiments with prosecutors and courts would seem to be the highest priority, to test the hypothesis that full enforcement by the criminal justice system is an effective prevention approach. Alternative sanctions, such as reintegrative shaming conferences (Braithwaite and Daly, 1993), also need to be tested against more customary measures like probation and fines. Even stigmatic shaming such as court-ordered display of bumper stickers or t-shirts proclaiming the offender to be a batterer (Kahan, 1997) could be tested against its theoretical competition in reintegrative shaming (Braithwaite, 1989). More sophisticated research designs can also now be employed to control for contextual effects of neighborhood labor force participation rates, rather than the less policy-relevant individual employment status.

Orders of Protection. Given the high risks of serious injury suffered by many domestic violence victims who receive orders of protection, the need for further research is great. The most theoretically promising strategy for further testing would be a randomized trial of the personal panic alarm in a big city jurisdiction. A large city would minimize the ethical problems with the creation of a control group, since there would be far too many victims for most jurisdictions to give them all a panic alarm. Randomized tests of women who volunteer for an evaluation of a randomized trial based upon informed consent may also lead to a strong test of orders of protection without any additional tools, which is by far the most common condition under which they are issued.


NOTES

1This discussion is limited to government, rather than a broader range of institutions, by the content of the available research. All of the available program evaluations examine the effects of government programs, broadly defined to include schools and publicly supported health care. Other institutions, such as churches and charities, no doubt provide crime prevention services (also broadly defined) to families. But in the current social structure of American life, it seems unrealistic to expect private resources to fund the level of intervention that research suggests is needed to appreciably reduce serious crime rates. While churches and other private groups may be ideal for administering such efforts under government contracts, the level of resources associated with the evaluated programs far exceeds those likely to be raised from solely non-public sources.

2This calculation employs the FBI count of 1.86 million arrests for all assaults in 1995, less 75% for non-domestic assaults, adjusted by the arrest probability of 22% for domestic and 13% for non-domestic assaults observed in the Indiana University police observation study (Oppenlander, 1982), and multiplied by a conviction probability estimate of 20% given a domestic arrest (Sherman, 1992).

3Attorney General's Task Force on Family Violence, Report. 1984.

4OJJDP Fact Sheet #38, June 1996.

5OJJDP, 1995 Report to the Congress: Title V Incentive Grants for Local Delinquency Prevention Programs.

6This program is not just focused on families, but aims to prevent all forms of violence against women including stranger violence. Since most violence against women is caused by relatives and intimates, however, much of these funds are appropriately focused on family violence.


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