We reviewed the empirical evidence on whether early childhood primary prevention programs can reduce rates of child abuse and neglect. Fifteen studies of 14 programs for children ages birth to 5 years were completed from 1990 to 2007 and assessed impacts with methodological rigor. All but one of the programs intervened from birth to age 3 through home visits, parent education classes, or the provision of health services. The weighted average effect size of program participation was a 2.9 percentage-point reduction in maltreatment (6.6% vs. 9.5%), which is equivalent to a 31% reduction in the rate of maltreatment and a fifth of a standard deviation. Of the five programs showing significant reductions in substantiated rates of child maltreatment, three provide strong evidence of preventive effects. Only the Child-Parent Centers (CPCs) and the Nurse-Family Partnership (NFP) assessed longer term preventive effects. Common elements of these effective programs included implementation by professional staff, relatively high dosage and intensity, and comprehensiveness of scope. The major conclusion is that the evidence base for programs in early childhood to prevent child maltreatment remains relatively weak. To advance the field, more longer term studies of a variety of intervention models are needed.
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