Not enough evidence to support interventions to prevent child abuse in kids without any signs of abuse - report in JAMA. Maybe they should look into the parents' beliefs in satanism or MK Ultra programming.

https://www.medpagetoday.com/pediatrics/domesticviolence/76546?xid=nl_mpt_DHE_2018-11-28&eun=g1185334d0r&pos=1&utm_source=Sailthru&utm_medium=email&utm_campaign=DailyHeadlines_112818&utm_term=NL_Daily_DHE

USPSTF: Jury Still Out on Interventions to Prevent Child Maltreatment

—Still insufficient evidence to assess balance of benefits and harms

by Elizabeth Hlavinka, Staff Writer, MedPage Today

November 27, 2018

Evidence was "limited" and "insufficient" to determine benefits and harms of primary care interventions to prevent child maltreatment in children with no signs of abuse or neglect, according to the U.S. Preventive Services Task Force (USPSTF).

There was not sufficient evidence to determine the efficacy of these interventions, including parental education and home visits, psychotherapy, or referral to community resources, reported Susan J. Curry, PhD, of the USPSTF, and colleagues.

The recommendation was made for children age ≤18 who do not show signs of maltreatment such as unexplained injuries or being excessively withdrawn and fearful, according to the Task Force.

This final recommendation statement ("I" statement) was published in JAMA and simultaneously on the USPSTF website, and reaffirms the USPSTF 2013 recommendation.

Task Force member Alex Kemper, MD, MPH, of Nationwide Children's Hospital in Columbus, Ohio, emphasized that primary care clinicians, pediatricians, and other healthcare professionals should still report any concerns that a child is being maltreated to Child Protective Services (CPS), and that this recommendation is in regards to preventing child maltreatment in the first place, in children who do not demonstrate signs of abuse.

"Obviously child maltreatment is tragic, and as pediatricians and primary care clinicians, we want to do everything that we can do to prevent maltreatment," Kemper told MedPage Today. "Unfortunately, what the Task Force found was there was insufficient evidence to know whether or not interventions to prevent maltreatment before it occurs were effective."

Most of the research included in the USPSTF's evidence review was collected from studies of home visitation programs, in which a peer educator or community health worker provided periodic counseling and services within the child's home. However, the Task Force reported that there was "significant heterogeneity" in study design and outcome measurements across the 22 randomized clinical trials included, and that without developing standardized measurements and collecting data from diverse populations including children known to be at high risk, it will remain difficult to interpret whether interventions are effective and to what magnitude certain methods are successful.

"The studies looked at a wide variety of outcomes and we know from other research that home visiting programs can be very important to support new families, but in looking specifically at whether or not it prevented child maltreatment, the evidence just wasn't there," Kemper said.

In 10 studies involving CPS reports and action interventions, the Task Force found no significant difference between intervention and control groups (pooled OR 0.94, 95% CI 0.72-1.23), and in 4 trials that tested the efficacy of removing a child from their home, no significant difference was found between study groups (OR 1.09, 95% CI 0.16-7.28).

In an accompanying editorial, Desmond Runyan, MD, of the University of Colorado School of Medicine in Aurora, said that this statement, which is supported by research involving more than 11,000 children, may disappoint advocates working towards preventing child maltreatment. But he noted that the number of children experiencing this issue was likely underestimated, and that actual rates for some types of abuse may be 10 to 40 times higher.

[Moar at website]

Full text of the JAMA (Journal of the American Medical Association) medical paper at:

https://jamanetwork.com/journals/jama/fullarticle/2716570