Child maltreatment has a profound impact on healthy child and family development and is associated with numerous detrimental outcomes that persist across the lifespan. Infants and toddlers enrolled in Early Head Start are at increased risk for child maltreatment due to the presence of numerous risk factors across a developmental-ecological framework, such as poverty, parental mental health problems and developmental disability. It is critically important to identify and ameliorate these risk factors prior to the occurrence of maltreatment.

Within Early Head Start, home visitors are in a unique position to identify the families most likely to experience abuse and neglect, given their access to at-risk families in their homes. However, research has demonstrated that home visitors are often ill equipped to identify and address risk factors that are highly associated with maltreatment, such as parental mental health concerns, substance abuse and domestic violence. Further, little is known about whether home visitors recognize the association between those risk factors and maltreatment. There is a critical need to understand how home visitors identify the behaviors that constitute maltreatment and the factors that place families at increased risk for experiencing maltreatment. 

The primary objectives of our proposed study are to: 

1. Identify how Early Head Start home visitors understand maltreatment, determine risk for maltreatment and refer at-risk families to relevant Early Head Start and community-based services.
2. Identify the association between the presence of risk factors and court-substantiated child maltreatment in order to develop the model that best predicts maltreatment occurrence. 

Data sources for this study include:

1. Qualitative interviews with Early Head Start home visitors and supervisors, exploring identification and determination of risk for maltreatment. 
2. Archival data on approximately 600 Early Head Start families. Archival records include Early Head Start services received, mental health services received and juvenile court records of substantiated instances of maltreatment.

Analysis will utilize mixed methodology in a sequential design to identify the presence of risk factors and predict occurrence of maltreatment. While the goals of Early Head Start broadly aim to promote healthy family functioning, prevention of maltreatment is not measured as a primary program outcome; thus, there is limited knowledge on how Early Head Start and its home visitors identify and prevent risk for maltreatment.

This research will provide information to Early Head Start researchers, practitioners and policymakers on how to better serve families through increased ability to identify and target risk factors within the context of an ongoing intervention. Further, findings will provide crucial information about the role that home visitors play in this process. Identification of gaps in home visitors’ knowledge will allow for effective training of staff in order to successfully assist and engage families in services. Results will provide further direction in how to engage families and deliver program and community-based services in a manner that reduces risk for, and prevents, maltreatment.