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 CHILD MALTREATMENT
RESEARCH, POLICY, AND PRACTICE
FOR THE NEXT DECADE
WORKSHOP SUMMARY

Steve Olson and Clare Stroud, Rapporteurs

Board on Children, Youth, and Families

Copyright © 2012. National Academies Press. All rights reserved.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 THE NATIONAL ACADEMIES PRESS • 500 Fifth Street, NW • Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing
Board of the National Research Council, whose members are drawn from the councils of
the National Academy of Sciences, the National Academy of Engineering, and the
Institute of Medicine.

This study was supported by Contract No. HHSP23320110010YC between the National
Academy of Sciences and the U.S. Department of Health and Human Services. The views
presented in this publication do not necessarily reflect the view of the organizations or
agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-25442-7

International Standard Book Number-10: 0-309-25442-6

Additional copies of this report are available from the National Academies Press, 500
Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313;
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For more information about the Institute of Medicine, visit the IOM home page at:
www.iom.edu.

Copyright 2012 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all
cultures and religions since the beginning of recorded history. The serpent adopted as a
logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by
the Staatliche Museen in Berlin.

Suggested citation: IOM (Institute of Medicine) and NRC (National Research Council).
Copyright © 2012. National Academies Press. All rights reserved.

2012. Child maltreatment research, policy, and practice for the next decade: Workshop
summary. Washington, DC: The National Academies Press.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 The National Academy of Sciences is a private, nonprofit, self-perpetuating society of
distinguished scholars engaged in scientific and engineering research, dedicated to the
furtherance of science and technology and to their use for the general welfare. Upon the
authority of the charter granted to it by the Congress in 1863, the Academy has a mandate
that requires it to advise the federal government on scientific and technical matters. Dr.
Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the
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The National Academy of Engineering also sponsors engineering programs aimed at
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achievements of engineers. Dr. Charles M. Vest is president of the National Academy of
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The Institute of Medicine was established in 1970 by the National Academy of Sciences
to secure the services of eminent members of appropriate professions in the examination
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be an adviser to the federal government and, upon its own initiative, to identify issues of
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of Medicine.

The National Research Council was organized by the National Academy of Sciences in
1916 to associate the broad community of science and technology with the Academy’s
Copyright © 2012. National Academies Press. All rights reserved.

purposes of furthering knowledge and advising the federal government. Functioning in

accordance with general policies determined by the Academy, the Council has become
the principal operating agency of both the National Academy of Sciences and the
National Academy of Engineering in providing services to the government, the public,
and the scientific and engineering communities. The Council is administered jointly by
both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M.
Vest are chair and vice chair, respectively, of the National Research Council.

www.national-academies.org

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Copyright © 2012. National Academies Press. All rights reserved.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 PLANNING COMMITTEE ON CHILD MALTREATMENT
RESEARCH, POLICY, AND PRACTICE FOR THE NEXT
GENERATION1

ANNE C. PETERSEN (Chair), Research Professor at Center for

Human Growth and Development, University of Michigan, and
Founder and President of Global Philanthropy Alliance
RICHARD P. BARTH, Dean, School of Social Work, University of
Maryland, Baltimore
LUCY BERLINER, Director of Harborview Center for Sexual Assault
and Traumatic Stress, Clinical Professor at School of Social Work
and Department of Psychiatry and Behavioral Sciences, University
of Washington, Seattle
LINDA M. BURTON, James B. Duke Professor of Sociology, Duke
University, Durham, North Carolina
MARK J. CHAFFIN, Professor of Pediatrics, Clinical Professor of
Psychiatry and Behavioral Sciences, University of Oklahoma Health
Sciences Center, Oklahoma City
MARY DOZIER, Amy E. du Pont Chair of Child Development,
Professor of Psychology, University of Delaware, Newark
PHILIP A. FISHER, Professor of Psychology, University of Oregon,
Eugene
JOHN M. LEVENTHAL, Professor of Pediatrics, Yale University
School of Medicine, New Haven, Connecticut
JOY D. OSOFSKY, Barbara Lemann Professor of Pediatrics and
Psychiatry, Louisiana State University Health Sciences Center, New
Orleans
Copyright © 2012. National Academies Press. All rights reserved.

Project Staff
MELISSA WELCH-ROSS, Project Director (through January 2012)
CLARE STROUD, Project Director (from February 2012)
ROSEMARY CHALK, Consultant
YEONWOO LEBOVITZ, Research Associate
CHRISTINA FEDAK, Senior Program Assistant

1
Institute of Medicine and National Research Council planning committees are solely
responsible for organizing the workshop, identifying topics, and choosing speakers. The
responsibility for the published workshop summary rests with the workshop rapporteurs
and the institution.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 Board on Children, Youth, and Families Staff

KIMBER BOGARD, Director, Board on Children, Youth, and Families

PATRICK BURKE, Financial Associate
WENDY KEENAN, Program Associate
Copyright © 2012. National Academies Press. All rights reserved.

vi

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 Reviewers

This report has been reviewed in draft form by individuals chosen for
their diverse perspectives and technical expertise, in accordance with
procedures approved by the National Research Council’s Report Review
Committee. The purpose of this independent review is to provide candid
and critical comments that will assist the institution in making its
published report as sound as possible and to ensure that the report meets
institutional standards for objectivity, evidence, and responsiveness to
the study charge. The review comments and draft manuscript remain
confidential to protect the integrity of the process. We wish to thank the
following individuals for their review of this report:

Lucy Berliner, University of Washington

Mark Chaffin, University of Oklahoma Health Science Center
Rob Geen, The Annie E. Casey Foundation
Sarah (Sally) M. Horwitz, Stanford University
Frank Putnam, Cincinnati Children’s Hospital Medical Center
David Sanders, Casey Family Programs
Charles H. Zeanah, Jr., Tulane University
Copyright © 2012. National Academies Press. All rights reserved.

Although the reviewers listed above have provided many

constructive comments and suggestions, they did not see the final draft of
the report before its release. The review of this report was overseen by
Elena O. Nightingale, Institute of Medicine. Appointed by the Institute
of Medicine, she was responsible for making certain that an independent
examination of this report was carried out in accordance with
institutional procedures and that all review comments were carefully
considered. Responsibility for the final content of this report rests
entirely with the rapporteurs and the institution.

vii

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
Copyright © 2012. National Academies Press. All rights reserved.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 Contents

ACRONYMS xiii

1 INTRODUCTION AND OVERVIEW 1

Research, Policy, and Practice for the Next Decade, 2
A Vision for the Future, 3
About This Summary, 4

2 REFLECTIONS ON THE 1993 NRC REPORT

UNDERSTANDING CHILD ABUSE AND NEGLECT 7
Expansion of Research, 7
Nature and Scope of Child Maltreatment, 8
Definitions of Child Abuse and Neglect, 9
Consequences of Child Maltreatment, 10
Ethical Issues, 12
Copyright © 2012. National Academies Press. All rights reserved.

Science Policy for Child Maltreatment Research, 12

From Analysis to Action, 13

3 RECOGNIZING AND ASSESSING CHILD

MALTREATMENT 15
Medical and Psychosocial Assessment and Diagnosis of
Child Abuse and Neglect, 15
Assessment for Mental Health Services Planning, 20

4 SOCIAL TRENDS AND CHILD MALTREATMENT

TRENDS 25
Social Trends and Their Implications for Understanding
Rates of Child Maltreatment, 26
Data Sources for Understanding Child Maltreatment, 29

ix

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 x CONTENTS

Child Maltreatment Reporting Practices and Patterns, 38

5 CAUSES AND CONSEQUENCES OF CHILD

MALTREATMENT 43
Influence of Neighborhood on Child Maltreatment Behaviors
and Reports, 44
Neurobiology of Neglect, 48
Neurobiology of Trauma and Stress Associated with Adverse
Early Experience, 50
6 PREVENTING CHILD MALTREATMENT 55
Universal Preventive Interventions, 56
Secondary Preventive Interventions with High-Risk
Populations, 60
Prevention of Recurrences and Adverse Outcomes, 63

7 DESIGN AND DELIVERY OF SERVICES 69

Parent-Focused Interventions, 70
Child-Focused Interventions, 72
Families Dealing with Multiple Problems, 75
Implementation of Evidence-Based Practice, 78
8 SYSTEMS-LEVEL ISSUES 81
A Cross-National View of Child Protective Systems, 81
Alternative Child Welfare Services Approaches, 84
Role of Class-Action Suits in Building Evidence-Based Child
Welfare Systems, 87
Copyright © 2012. National Academies Press. All rights reserved.

Leadership and Management in Child Welfare Agencies, 91

9 CLOSING REMARKS AND RESEARCH

OPPORTUNITIES 95
Closing Remarks, 95
Future Research and Other Opportunities Suggested by Individual
Participants, 96

APPENDIXES

A REFERENCES 103
B WORKSHOP AGENDA 109
C REGISTERED WORKSHOP ATTENDEES 115

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 CONTENTS xi

D BACKGROUND PAPER: MAJOR RESEARCH

ADVANCES SINCE THE PUBLICATION OF THE 1993
NRC REPORT UNDERSTANDING CHILD ABUSE AND
NEGLECT: HIGHLIGHTS FROM THE LITERATURE 119
Copyright © 2012. National Academies Press. All rights reserved.

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Copyright © 2012. National Academies Press. All rights reserved.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 Acronyms

ACF Administration for Children and Families

ACYF Administration on Children, Youth and Families
ADHD attention-deficit/hyperactivity disorder
AFCARS Adoption and Foster Care Analysis and Reporting System
ARC Availability, Responsiveness, and Continuity

CAC Child Advocacy Center

CAPTA Child Abuse Prevention and Treatment Act
CEBC California Evidence-Based Clearinghouse for Child
Welfare
CFSR Child and Family Service Review
CPS Child Protective Services

DBT dialectical behavioral therapy

DJJ Department of Juvenile Justice
Copyright © 2012. National Academies Press. All rights reserved.

DSS Department of Social Services

GAL guardian ad litem

HHS U.S. Department of Health and Human Services

HPA hypothalamus-pituitary-adrenal

ICD International Classification of Diseases

IEP individualized education program
IH-CBT In-Home Cognitive Behavioral Therapy
IOM Institute of Medicine
IRB institutional review board

xiii

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 xiv ACRONYMS

MDT multidisciplinary team

MST multisystemic therapy
MTFC-P Multidimensional Treatment Foster Care for Preschoolers

NCANDS National Child Abuse and Neglect Data System

NCS National Children’s Study
NIH National Institutes of Health
NIS National Incidence Studies
NPM New Public Management
NRC National Research Council
NSCAW National Survey of Child and Adolescent Well-Being

PTS posttraumatic stress

PTSD posttraumatic stress disorder

QSR quality service review

SACWIS Statewide Automated Child Welfare Information System

UNICEF United Nations Children’s Fund

Copyright © 2012. National Academies Press. All rights reserved.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 1

Introduction and Overview1

In 1993 the National Research Council (NRC) released its landmark

report Understanding Child Abuse and Neglect (NRC, 1993). That report
identified child maltreatment as a devastating social problem in Ameri-
can society. It observed that social service agencies received case reports
involving over 2 million children in the year 1990 alone. From 1979
through 1988, about 2,000 child deaths (ages 0-17) resulting from abuse
and neglect were recorded annually. As the report noted, the services
required for children who have been abused or neglected, including med-
ical care, family counseling, foster care, and specialized education, cost
many hundreds of millions of dollars annually.
At that time, according to the report, research in the field of child
maltreatment studies was relatively undeveloped when compared with
related fields such as child development, social welfare, and criminal
violence. To reduce the physical and emotional tolls of child maltreat-
ment, the report called for a wide-ranging research program with four
Copyright © 2012. National Academies Press. All rights reserved.

separate objectives:
1. The Nature and Scope of Child Maltreatment. Clarify the nature
and scope of child maltreatment, guided by well-developed re-
search definitions and instrumentation.
2. The Origins and Consequences of Child Maltreatment. Provide
an understanding of the origins and consequences of child mal-
treatment in order to better inform theories regarding its etiology

1
This report has been prepared by the workshop rapporteurs as a factual summary of
what occurred at the workshop. The planning committee’s role was limited to planning
and convening the workshop. The views contained in the report are those of individual
workshop participants and do not necessarily represent the views of all workshop partici-
pants, the planning committee, or the National Research Council and Institute of
Medicine.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 2 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

and to establish a foundation for improving the quality of future

policy and program efforts to address the problem.
3. Treatment and Prevention of Child Maltreatment. Determine the
strengths and limitations of existing approaches and interven-
tions in preventing and treating child maltreatment to guide the
development of new and more effective interventions.
4. A Science Policy for Research on Child Maltreatment. Develop a
science policy for child maltreatment research that recognizes
the importance of developing national leadership, human re-
sources, instrumentation, financial resources, and appropriate in-
stitutional arrangements for child maltreatment research.
By pursuing this agenda, the report argued, researchers could “develop
knowledge that can improve understanding of, and response to, child
maltreatment.”

RESEARCH, POLICY, AND PRACTICE FOR THE

NEXT DECADE

Nearly 20 years later, on January 30-31, 2012, the Board on Chil-

dren, Youth, and Families at the Institute of Medicine (IOM) and the
NRC held a workshop to review the accomplishments of the past two
decades of research related to child maltreatment and the remaining gaps.
“There have been many exciting research discoveries since the ’93 re-
port,” said Anne Petersen, research professor at the Center for Human
Growth and Development at the University of Michigan. She was chair
Copyright © 2012. National Academies Press. All rights reserved.

of the panel that produced the report and also chaired the planning com-
mittee for the workshop. “But we also want people to be thinking about
what is missing.”
The workshop brought together many leading U.S. child maltreat-
ment researchers for a day and a half of presentations and discussions.
Presenters were asked to review research accomplishments, identify gaps
that remain in knowledge, and consider potential research priorities. A
background paper highlighting major research advances since the publi-
cation of the 1993 NRC report was prepared by an independent consult-
ant to inform the workshop discussions; this paper is included in
Appendix D. In the past two decades, there has also been significant pro-
gress in research on child development more generally, but it was beyond
the scope of the workshop to consider this broader topic (see Box 1).

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 INTRODUCTION AND OVERVIEW 3

BOX 1
Research on Child Development
As presenters noted throughout the workshop, the past two decades
have seen an outpouring of original research and syntheses of research
on child maltreatment. There has also been much effort to improve our
general understanding of child development and the ways in which the
social and physical environments of children interact with their health and
development. For example, the National Research Council and Institute
of Medicine report From Neurons to Neighborhoods: The Science of Ear-
ly Childhood Development (NRC and IOM, 2000) reviewed studies of
early childhood development and their implications for policies and pro-
grams that affect the lives of young children. This report noted that “an
explosion of research in the neurobiological, behavioral, and social sci-
ences has led to major advances in understanding the conditions that
influence whether children get off to a promising or a worrisome start in
life” (p. 1). Much additional research has been undertaken in the 12
years since the report was published, but it was beyond the scope of this
workshop to review the broad literature on child development.

A VISION FOR THE FUTURE

The workshop was sponsored by the Office on Child Abuse and Ne-
glect, which is situated in the Children’s Bureau of the Administration on
Children, Youth and Families (ACYF). ACYF is part of the U.S. De-
Copyright © 2012. National Academies Press. All rights reserved.

partment of Health and Human Services’ (HHS’s) Administration for

Children and Families (ACF). The Children’s Bureau was founded in
1912 to improve the lives of children and families. The centennial of the
bureau “provides a wonderful opportunity . . . to step back and reflect on
what we know and have learned and to make sure that we are clear about
the foundation that has been laid and where we ought to be going in the
future,” said Bryan Samuels, Commissioner of the ACYF, in his opening
remarks at the workshop. “The timing couldn’t be better.”
Samuels noted that there continue to be questions about the fundamen-
tal goals and purposes of the field of child maltreatment and the provision
of services for children and families. For example, he said, child welfare
systems emphasize safety and permanency, but they place less emphasis
on the well-being of children. The workshop “is an opportunity to look,
in the context of maltreatment, at how we build and improve a system to

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 4 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

address the healing and recovery for children who have been exposed to
it, as well as to, in some respects, learn how we do a better job of pre-
venting maltreatment.”
Research is a critical contributor to policy and practice, said Samuels.
When he was director of the Illinois Department of Children and Family
Services, he relied heavily on the research literature to produce a better
child welfare system even as the system got smaller. Research results on
the prevention of child maltreatment informed policies to reduce the in-
cidence of maltreatment, while understanding the consequences of mal-
treatment informed responses. Drawing on this knowledge, Samuels said,
he was able to make “significant changes in the system.”
The objective of the workshop, he said, should be not just to under-
stand the current system, but to provide a vision for the future of re-
search, policy, and practice.

ABOUT THIS SUMMARY

This document is intended to summarize the presentations and dis-

cussions at the IOM/NRC workshop Child Maltreatment Research, Poli-
cy, and Practice for the Next Generation. The summary also highlights
participant suggestions for future research priorities, policy actions, and
practices that would enhance understanding of child maltreatment and
efforts to reduce and respond to it. The workshop speakers and presenta-
tion topics were selected to cover a range of important issues in child
maltreatment research, policy, and practice. However, it was impossible
Copyright © 2012. National Academies Press. All rights reserved.

to include all potential topics during the course of a day-and-a-half work-

shop and, in their presentations, speakers could not exhaustively cover all
relevant findings and issues for each topic. Consequently, some relevant
topics could not be included in the workshop and, by extension, are not
included in this workshop summary.
Whenever possible, ideas presented at the workshop are attributed to
the individual who expressed them. Any opinions, conclusions, or rec-
ommendations discussed in this workshop summary are solely those of
the individual participants and should not be construed as reflecting con-
sensus or endorsement by the workshop, the Board on Children, Youth,
and Families, or the National Academies. The workshop agenda is in
Appendix B and a list of registered participants is in Appendix C.
The 21 presentations at the workshop are divided into eight chapters
following this introductory chapter. (For clarity, the presentations have

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 INTRODUCTION AND OVERVIEW 5

been somewhat reorganized from the agenda.) Chapter 2 summarizes the

keynote address at the workshop, which looked back to the research done
in the 20 years since Understanding Child Abuse and Neglect and for-
ward to the research that still needs to be done. Chapter 3 examines the
medical and psychosocial assessment of child abuse and neglect as the
instigating event in the provision and planning of services. Chapter 4
considers social trends and child maltreatment trends, largely on a na-
tional level, and probes the relationships among those trends. Chapter 5
considers the causes and consequences of child maltreatment, with a par-
ticular emphasis on the neurobiological effects of abuse and neglect.
Chapter 6 looks at research on primary, secondary, and tertiary preven-
tions and the impact of this research on policy and practice. Chapter 7
discusses the design and delivery of services, including implementation
research. Chapter 8 looks at system-level issues in responding to child
maltreatment, including responses in different countries, alternative child
welfare services, and legal action to build evidence-based systems. Chap-
ter 9 provides Petersen’s final observations on themes that arose during
the workshop and lists selected suggestions for future research priorities
proposed by presenters during the workshop.
At the time of the workshop, an IOM/NRC consensus study on child
maltreatment research was being planned. The workshop presentations
and discussions, as summarized here, could serve as a source of infor-
mation for the committee that will be convened to conduct the consensus
study.
There continues to be discussion about the definition of types of
child abuse and neglect. Individual states set their own definitions of
Copyright © 2012. National Academies Press. All rights reserved.

child abuse and neglect while meeting minimum federal standards. Fur-
thermore, workshop participants noted the research challenges stemming
from a lack of consensus on definitions of child abuse and neglect; this is
discussed in Chapter 2, Chapter 4, Appendix D, and various other places
throughout the workshop discussions. For the purposes of initial illustra-
tion only, therefore, Box 2 presents example definitions of the major
types of child abuse and neglect from a Children’s Bureau publication
(HHS, 2008).

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 6 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

BOX 2
Defining Major Types of Child Abuse and Neglect
The Federal Child Abuse Prevention and Treatment Act (CAPTA, 42
U.S.C.A. § 5106g) sets a minimum set of acts or behaviors that define
child abuse. States provide their own definitions on child abuse and ne-
glect that meet these minimum standards. Furthermore, there is little
consensus on definitions used in research. The following definitions are
provided in a Children’s Bureau publication as examples; actual defini-
tions vary by state (HHS, 2008).
“Physical abuse is nonaccidental physical injury (ranging from minor
bruises to severe fractures and/or death) as a result of punching, beat-
ing, kicking, biting, shaking, throwing, stabbing, choking, hitting (with a
hand, stick, strap, or other object), burning, or otherwise harming a child,
that is inflicted by a parent, caregiver, or other person who has responsi-
bility for the child….
Neglect is the failure of a parent, guardian, or other caregiver to provide
for a child’s basic needs….
Sexual abuse includes activities by a parent or caregiver such as fon-
dling a child’s genitals, penetration, incest, rape, sodomy, indecent expo-
sure, and exploitation through prostitution or the production of
pornographic materials….
Emotional abuse (or psychological abuse) is a pattern of behavior that
impairs a child’s emotional development or sense of self-worth, This may
include constant criticism, threats, or rejection, as well as withholding
Copyright © 2012. National Academies Press. All rights reserved.

love, support, or guidance.”

SOURCE: HHS, 2008.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 2

Reflections on the 1993 NRC Report

Understanding Child Abuse and Neglect

Key Points Raised by the Speaker

 Despite increased levels of research over the past two decades, the
incidence of different kinds of abuse and neglect remains unclear.
 Differing definitions of child abuse and neglect continue to hinder
research, prevention, and treatment.
 Though the consequences of child maltreatment are better under-
stood today than they were two decades ago, the contextual factors
that influence maltreatment need more study.
 Child maltreatment research needs to move from the fringe to the
mainstream, with increased funding and better use of research results
to shape policy and practice.

Looking back provides an opportunity to look forward as well, said

Copyright © 2012. National Academies Press. All rights reserved.

Cathy Spatz Widom, in her keynote address at the workshop. She is a

distinguished professor in the psychology department at John Jay Col-
lege, a faculty member at the Graduate Center of the City University of
New York, and a member of the panel that produced the 1993 NRC re-
port. Any such review has the temptation of painting a picture of great
progress. “Alas, I think the story is more complicated,” she said.

EXPANSION OF RESEARCH

The research literature on child abuse and neglect has undergone a

substantial increase since 1993 (Figure 1). During the 1980s, approxi-
mately 8,000 medical and psychological articles were published in the

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 8 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

areas of child abuse and neglect. By the first decade of the 21st century,
that number had risen to nearly 25,000.
However, the approximate parity between the increases in medical
and psychological articles obscures an important trend. In the areas of
physical and sexual abuse, publications from medicine and from psy-
chology are increasing at about the same rate. In the area of neglect,
however, medical publications are increasing at a significantly faster rate
than psychological publications. “I would suggest that we have neglect
of neglect by psychologists,” said Widom.

NATURE AND SCOPE OF CHILD MALTREATMENT

More data are available today on the incidence and prevalence of

child maltreatment than were available in 1993. (Chapter 4 of this
summary addresses major data sources and trends over time.) However,
fundamental questions remain, Widom noted. According to data from the
National Incidence Studies (NISs), the incidence of child maltreatment
declined 19 percent in the 12 years between NIS-3 and NIS-4. Most
of the decline appears to be related to significant decreases in physical and

14000

12000
Number of Publications

MEDICAL
10000
PSYCHOLOGICAL
Copyright © 2012. National Academies Press. All rights reserved.

8000

6000

4000

2000

0
1950- 1960- 1970- 1980- 1990- 2000-
1959 1969 1979 1989 1999 2009
Decade

FIGURE 1 Published articles on child abuse and neglect: 1950-2009.

SOURCE: Widom, 2012.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 REFLECTIONS ON THE 1993 NRC REPORT 9

sexual abuse, whereas the level of child neglect has remained about the
same. Other studies—for example, of hospital admissions—do not show
such dramatic changes. This discrepancy needs further study, said
Widom.
Widom suggested that a more accurate picture of the nature and
scope of maltreatment is needed. In particular, the picture needs to in-
clude the types of child maltreatment currently excluded from existing
official statistics. She recommended a series of large population-based
epidemiological surveys that would include the types of maltreatment
missed today. Ideally, these surveys would become part of a series ena-
bling comparison of rates over time.

DEFINITIONS OF CHILD ABUSE AND NEGLECT

Less progress has been made than Widom might hope on definitions
of child abuse and neglect. No gold standard exists to determine whether
child abuse and neglect have occurred, she observed. For example, a pe-
diatrician might have a low threshold for considering a situation to be
abuse or neglect; a child protective services worker, guided by state laws
and limited agency resources, might have a higher threshold; and a pros-
ecutor might have the highest threshold in pursuing only the most serious
cases.
For researchers, knowledge gaps in the definition, identification, and
assessment of child abuse mean that maltreated and control populations
might not be comparable. Unless studies use the same or similar defini-
Copyright © 2012. National Academies Press. All rights reserved.

tions, Widom remarked, findings will not converge.

A related issue is that the amount of time a researcher spends as-
sessing child maltreatment can also generate tensions. Survey instru-
ments have notable advantages such as relative ease of administration
and scoring, but some surveys include only a few items to assess mal-
treatment, and these assessments may be vague or ambiguous. Also,
child maltreatment is sometimes bundled with other life adversities,
which runs counter to a recommendation from the 1993 NRC report to
clarify the common and divergent pathways in the etiologies of different
forms of maltreatment.
Reliable and valid clinical diagnostic research instruments for child
maltreatment are essential needs, said Widom. A consensus on research
definitions should be established for each type of child maltreatment.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 10 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

These definitions should be tested for relevance and usefulness in eco-

nomically and culturally diverse populations.

CONSEQUENCES OF CHILD MALTREATMENT

The medical, cognitive, behavioral, and psychological conditions as-

sociated with child maltreatment are better understood today than they
were 20 years ago (Table 1). But, Widom said, contextual factors need
much more study, including genes, poverty, parenting styles, beliefs re-
garding discipline, cultural differences, and community resources. Fur-
thermore, these contextual factors need to be studied in combination to
understand both the causes and consequences of maltreatment. Research-
ers need to design studies to test and analyze theoretical models using
more sophisticated statistical techniques.
The almost exclusive reliance on cross-sectional studies has limited
progress in understanding the origins and causes of child abuse and ne-
glect, Widom stated. This situation could be remedied by including child
maltreatment in the National Children’s Study (NCS). Authorized by the
National Children’s Health Act of 2000, the NCS plans to recruit and
follow a nationally representative sample of 100,000 children from be-
fore birth until age 21 to examine the effects of physical, chemical, and
social environments on their growth, development, and health.
Child maltreatment is not now included in the National Children’s
Study. However, a planning workshop for the study indicated that inves-
tigation of the causes and consequences of child maltreatment was an
Copyright © 2012. National Academies Press. All rights reserved.

appropriate scientific hypothesis to test. Inclusion of this topic in the

study could help identify early markers of problematic parent–child in-
teractions and factors that contribute to the likelihood of child maltreat-
ment. This could provide valuable information about the delivery of cost-
effective interventions to prevent and address the consequences of child
maltreatment. “I would urge anyone who is involved in a sentinel site or
in a leadership position or on the advisory board of the NCS to lobby to
have child maltreatment included as one of the focal topics,” said
Widom.
By contrast, Widom pointed to neurobiology as an example of an ar-
ea where major progress has been made in understanding the conse-
quences of early stress and maltreatment. Recent studies have shown that
maltreatment is associated with critical changes in the central nervous
system. (Chapter 5 describes some of these changes in more detail.) Sim-

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 REFLECTIONS ON THE 1993 NRC REPORT 11

ilarly, study of how interactions between genes and the environment af-
fect the immune system has brought attention to child maltreatment re-
search. Researchers studying the origins of many adult diseases have
begun to recognize the importance of early experiences in shaping the
neurological and hormonal pathways through which individuals handle
stress and physical and emotional threats. Animal models also provide
opportunities to understand transgenerational processes. “We have made
great progress,” she said.

TABLE 1 Outcomes Frequently Associated with Child Maltreatment

Neurological/ Cognitive/ Social/ Psychological/
Medical Intellectual Behavioral Emotional
 Brain damage  Lowered IQ  Aggression  Anxiety
 Neurobiologi-  Inattention  Truancy  Depression
cal effects  Learning  Running away  Dysthymia
 Mental disorders  Delinquency  Low
retardation  Poor reading  Prostitution self-esteem
 Speech  Poor school  Teenage  Poor coping
defects performance pregnancy skills
 Physical  School  Problem  Hostility
handicaps drop-out drinking  Suicide and
 Physical  Drug use Attempts
health  Crime and  Posttraumatic
problems violence stress disorder
 Death  Partner  Dissociation
 Increased violence  Borderline
Copyright © 2012. National Academies Press. All rights reserved.

health care  Child abuse personality

use  Unemploy- disorder
ment  Antisocial
personality
disorder
NOTE: This table shows outcomes often associated with child maltreat-
ment, but the evidence linking child maltreatment to these outcomes var-
ies in quality, quantity, and consistency.
SOURCE: Widom, 2012.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 12 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

ETHICAL ISSUES

Ethical issues, such as legal reporting requirements, continue to pose

difficulties, said Widom. Conducting research with maltreated children is
challenging due to difficulties in recruiting samples, in navigating ethical
and legal reporting requirements, and in collecting information from
families where abuse has occurred. In particular, mandatory child abuse
reporting laws make researchers fearful of losing participants because of
the impact of reporting. This was an issue with the National Children’s
Study, where the advisory board was concerned about the need to report,
although communicable or life-threatening diseases also would need to
be reported, said Widom.
Early career investigators and institutional review boards (IRBs)
need education in how to deal with these issues. Empirical evidence from
several longitudinal studies reveals that these challenges are not insur-
mountable. “The potential knowledge to be gained is critical to further
our understanding of child abuse and neglect,” said Widom.

SCIENCE POLICY FOR CHILD

MALTREATMENT RESEARCH

Finally, Widom addressed several issues involving science policy

that were discussed in the 1993 NRC report. That report recommended
that federal agencies concerned with child maltreatment research formu-
late a national research plan. The creation of the Child Abuse and Ne-
Copyright © 2012. National Academies Press. All rights reserved.

glect Working Group, which includes representatives of the National

Institutes of Health (NIH) and other federal agencies, represents progress
on this recommendation, she said, but more is needed. “We need to fig-
ure out a way to raise the profile and importance of child abuse and ne-
glect research,” she said. In particular, research on child maltreatment
should be recognized as critical for the federal government’s children’s
research agenda.
Neurobiological studies provide an opportunity to integrate research
on child maltreatment into the broader stress and trauma literatures. An-
other such opportunity is the PhenX toolkit project developed by the
NIH, in which groups of experts have developed phenotypic and expo-
sure measures for use in genome-wide association studies (RTI Interna-
tional, 2012). This toolkit includes a measure of exposure to violence and
child abuse, which can provide genetics researchers and others with lim-

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 REFLECTIONS ON THE 1993 NRC REPORT 13

ited expertise in measurement of these constructs in a way to integrate

them into multidisciplinary studies.
Administrative and grant review processes need to ensure that re-
viewers have adequate expertise with child maltreatment so that mal-
treatment research proposals are evaluated on the basis of the quality of
work proposed. In addition, special efforts are needed to find new funds
for research on child maltreatment, Widom said. In 1992, research ex-
penditures in the field were about $15 million. In 1997 they were $33.7
million, and the estimated budget for 2012 is $32 million. In comparison,
$55 million goes for suicide and suicide prevention research, which is
associated with child maltreatment (NIH, 2012).
Also, the capabilities of the researchers who can contribute to child
maltreatment research need to be sustained and improved. Relatively few
postdoctoral fellowship awards from the NIH are devoted to this subject.
A conference grant supports annual meetings of a child neglect consorti-
um that brings together scholars in this area, and a data archive at Cornell
holds summer training sessions.
The interdisciplinary nature of child maltreatment research requires
both specialized disciplinary expertise and opportunities for collaborative
research. However, categorical funding for federal research programs
creates significant barriers to collaborative or innovative efforts among
researchers concerned with maltreatment. In many cases children and
families reported for maltreatment experience multiple other problems,
such as substance abuse, intimate partner violence, mental health disor-
ders, poverty, inadequate housing, poor schools, and violent neighbor-
hoods. Researchers working in these separate areas need systems to
Copyright © 2012. National Academies Press. All rights reserved.

communicate with one another, Widom said. In addition, child and de-
velopmental psychologists need to recognize child maltreatment as an
important contributor to a wide range of social problems and family pa-
thologies.
A funding mechanism is needed that can reflect the interdisciplinary
nature of child maltreatment research and extend to graduate and post-
graduate training. Perhaps the new NIH initiative in translational re-
search can provide a needed infusion of funding, Widom suggested.

FROM ANALYSIS TO ACTION

Finally, Widom examined how to translate research findings for

practitioners and policy makers. Researchers in the field of child abuse

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 14 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

and neglect are continually pressed to translate their findings into clinical
applications as well as recommendations for policy and practice. With
some exceptions, however, the infrastructure to support the dissemina-
tion and translation of basic research findings into policy and practice is
limited. Organizational changes need to improve the process by which
child maltreatment research findings are converted into action.
Progress in understanding child maltreatment has been slowed by
many factors, including ethical and legal challenges, a lack of consensus
in research definitions, and a lack of trained investigators. But perhaps
the most important factor has been the perception that child maltreatment
is a fringe issue, Widom concluded. It is not. “Child maltreatment re-
mains a public health and a social welfare problem. It compromises the
health of our children. It threatens their long-term physical and mental
health as adults. It impacts their parenting practices. And it negatively
affects their economic productivity as wage earners.” The high burden
and long-lasting consequences of child maltreatment warrant increased
investment in preventive and therapeutic strategies from early childhood,
Widom added. “We need to bring child maltreatment research out of the
fringe and into the mainstream.”
Copyright © 2012. National Academies Press. All rights reserved.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 3

Recognizing and Assessing Child

Maltreatment

Key Points Raised by Individual Speakers

 The diagnosis of child maltreatment, which is based on a combina-
tion of clinical features rather than a single diagnostic test, is often
difficult for pediatricians to make, yet it can have major consequences
for children and families.
 Many maltreated children have not only physical symptoms, but sig-
nificant mental health problems, which also need to be assessed if
they are to be addressed.
 Evaluations have become more collaborative and multidisciplinary.
 Effective evaluation tools have been developed and are available for
use, but a lack of workforce skills can hinder their use.
 Assessments are of little value unless they are used to guide interven-
tion plans.
Copyright © 2012. National Academies Press. All rights reserved.

The first step in treating and preventing child maltreatment is to rec-

ognize children who have been maltreated and to evaluate their condi-
tion. Two speakers at the workshop discussed the progress that has been
made in recognizing and assessing child maltreatment from both a physi-
cal and a mental health standpoint.

MEDICAL AND PSYCHOSOCIAL ASSESSMENT AND

DIAGNOSIS OF CHILD ABUSE AND NEGLECT

The first epidemiological study of child maltreatment appeared in an

article titled “The Battered-Child Syndrome” (Kempe et al., 1962). The
article summarized observations of about 750 children, most of whom

15

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 16 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

had been seriously injured or who had died because of abuse. The article
described some of the key clinical features of child maltreatment, includ-
ing the discrepancy between clinical findings and the historical data,
some of the physical and radiographic findings of abuse, and why physi-
cians would have difficulty believing parents can hurt their children. The
publication of the article was a “landmark” for the field of child abuse
and neglect, said John Leventhal, professor of pediatrics at Yale Univer-
sity School of Medicine and an attending pediatrician at Yale-New Ha-
ven Children’s Hospital. Many problems it described are still problems
today.

Challenges in the Assessment of Maltreatment

One such problem involves the diagnosis of maltreatment, noted
Leventhal. Diagnoses of maltreatment are based on a combination of
clinical features rather than a single diagnostic test. Furthermore, these
diagnoses have major implications for children and families related to
safety, placement, and possible termination of parental rights. Pediatri-
cians continue to struggle with this diagnosis, said Leventhal. “Many of
us know physicians who have made the wrong diagnosis and have sent
abused children home, and sometimes those children come back with
more serious injuries due to abuse or even die from an abusive injury.
We take these problems very seriously.”
An additional problem cited by Leventhal is that some so-called ex-
perts in court continue to deny that abuse has occurred and propose spe-
cious theories of causation, such as vitamin deficiencies or reactions to
Copyright © 2012. National Academies Press. All rights reserved.

vaccines.
In contrast to the 750 children described in the 1962 article,
Leventhal and his colleagues have estimated that in the United States
about 4,500 children annually enter the hospital with serious injuries due
to abuse (Leventhal et al., 2012). The majority of these children are
younger than age 3, and most of those are less than a year old. The
mortality rate for these children is very high, at around 6 percent in the
hospital.

Changes in the Assessment of Maltreatment

Partly in response to the problems he identified, the assessment of
maltreatment has undergone major changes over the past two decades,
Leventhal observed.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 RECOGNIZING AND ASSESSING CHILD MALTREATMENT 17

First, evaluations have become more collaborative and multidiscipli-

nary. Once done largely in a hospital setting or by child protective ser-
vices (CPS) or the police, assessments are increasingly done in child
advocacy centers (CACs) or by multidisciplinary teams (MDTs). In
Connecticut, for example, MDTs can include prosecutors, CPS workers,
physicians, forensic interviewers, social workers, mental health treatment
staff, and school social workers. In Florida, pediatricians are closely in-
volved in CPS work and provide advice to agencies about the kinds of
investigations, medical workups, or other assessments needed.
Second, hospitals have emphasized child protection teams, with sup-
port from the National Association for Children’s Hospitals and Related
Institutions, which recently published standards of excellence for such
teams (NACHRI, 2011).
A new focus on sentinel injuries has directed attention to less serious
injuries that often occur before serious injuries. In Connecticut, for ex-
ample, every child reported to CPS who is less than a year old and has a
physical injury triggers a consultation with a pediatrician to decide
whether that child needs a more substantial investigation.
Finally, in 2009, 191 pediatricians were certified in the new specialty
of child abuse pediatrics, which has changed perspectives in departments
of pediatrics, according to Leventhal.

Research Advances Relevant to the Assessment of

Child Maltreatment
Leventhal described several research advances that have furthered
Copyright © 2012. National Academies Press. All rights reserved.

the assessment of child maltreatment. For example, much research has

focused on defining the disease (and nondisease) and generating strong
evidence about the range and specificity of clinical findings due to phys-
ical abuse. Some research has examined the process of evaluation, such
as the use of skeletal surveys as a diagnostic test or the evaluation of the
siblings of abused children. However, little research has examined deci-
sion making by clinicians, such as their biases and reporting patterns.
As an example, Leventhal described research on bruises as an indica-
tor of abuse in young children. Children can be bruised when they start
“cruising,” or pulling themselves upright and walking from object to ob-
ject, at about the age of 9 months. “These studies have suggested that
children who cruise can bruise, but children who are not cruising are less
likely to have bruises as part of normal activities,” said Leventhal. Chil-
dren with unexplained bruises at less than 9 months of age need careful
evaluations to determine whether abuse has occurred to the child. Other

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 18 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

studies have examined children less than age 48 months and have found
different distributions of bruising in the abuse group versus the accident
group. This research has led to a mnemonic called TEN-4, where “TEN”
stands for the location of bruises that are worrisome for abuse—torso,
ears, and neck, and “4” stands for children who are less than 4 years of
age or any bruise in a child less than 4 months old (Pierce et al., 2010).
“TEN-4 is a great way to teach about this problem,” Leventhal said.
He also described a study of 434 primary care clinicians who collect-
ed data on more than 15,000 child injury visits in two national practice-
based research networks (Jones et al., 2008). More than 1,600 of these
children had a “suspicious” injury, but only 95, or 6 percent, were re-
ported to CPS, and 27 percent of “likely” or “very likely” abuse cases
were not reported to CPS. Reasons given for not reporting the children
included familiarity with the family (“if we like them we don’t report
them”), aspects of the case history (“I kind of believe what the mother
said”), the use of available resources (“I’ll handle that on my own”), and
negative views of CPS, which is an attitude that Leventhal has heard
from primary care colleagues.
Leventhal briefly described research on the evaluation of suspected
child sexual abuse. For example, the interview protocol developed by
Lamb (the National Institute of Child Health and Human Development
Interview Protocol) provides helpful ways of interviewing children and
has been studied extensively, as have the various influences on children’s
memories (Lamb et al., 2007). Again, decision making by physicians,
CPS workers, and police has received less attention, and little research
has been done on the value of the multidisciplinary approaches despite
Copyright © 2012. National Academies Press. All rights reserved.

the proliferation of CACs, MDTs, and other collaborative efforts.

Finally, individual family variables have received a moderate amount
of research. These variables include domestic violence, substance abuse,
and the mental health of parents. One variable that has not received
enough research, said Leventhal, is the abuse inflicted by males. “A lot
of the serious abuse that we see in hospitalized patients comes from
men—either fathers, stepfathers, or boyfriends. How to reach that part of
the society to prevent some of these serious injuries is an important chal-
lenge.” In addition, less is known about combinations of factors, how
individual parents respond to a child’s behaviors such as crying, and how
to ameliorate the risk of maltreatment if it is elevated.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 RECOGNIZING AND ASSESSING CHILD MALTREATMENT 19

Future Research on Assessment and Diagnosis

Leventhal concluded by listing several suggestions for future re-
search. Systems of evaluation and care need additional study, including
the linkages between child abuse pediatricians and CPS. The role of
CACs and MDTs also needs more study, especially because these evalu-
ation systems are so tightly linked to treatment.
Leventhal mentioned the need to fund fellowships in child abuse pe-
diatrics. “We need to figure out ways to train these physicians and en-
hance their research expertise.”
Finally, research should examine how to improve the decision mak-
ing of primary care clinicians, emergency room physicians, and child
abuse pediatricians, Leventhal said. How can physicians be trained not to
overreport or underreport injuries that are reasonably suspicious? The
process of evaluation also should be a subject of research. Which chil-
dren need which diagnostic tests? This question should be studied in
multiple sites to yield widely applicable findings, Leventhal said. Later
in the workshop, Charles Sabel, the Maurice T. Moore Professor of Law
and Social Science at Columbia Law School, discussed the importance of
decision making by other frontline workers such as case workers, teach-
ers, and police officers. He said that more research is needed to study
innovative systems-level changes that may address challenges associated
with decision making by frontline workers in the current system. His
presentation is summarized in Chapter 8.

Discussion
Copyright © 2012. National Academies Press. All rights reserved.

During the discussion session, Frank Putnam from Cincinnati Chil-

dren’s Hospital Medical Center and the University of North Carolina
School of Medicine observed that hundreds of thousands or possibly mil-
lions of videotaped interviews done for maltreatment assessments exist,
but there are no guidelines on how those interviews can be used. They
could be a valuable research resource, but they are sensitive tapes that
need to remain confidential. “How long do we maintain them? Who has
access to them?”
Also, Joy Osofsky of the Louisiana State University Health Sciences
Center recommended doing research in cooperation with CACs, which
Leventhal labeled an excellent idea. For one thing, he noted, such re-
search could make IRBs more accepting of CAC procedures.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 20 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

ASSESSMENT FOR MENTAL HEALTH

SERVICES PLANNING

A substantial portion of children in the child welfare system have

significant mental health problems, observed Benjamin Saunders, a pro-
fessor in the Department of Psychiatry and Behavioral Sciences at the
Medical University of South Carolina. Given this observation, the child
welfare system has a responsibility to provide proper interventions for
those problems. Providing interventions requires that children undergo
screening for mental health needs, and this screening requires appropriate
training, tools, and systems. The important point, said Saunders, “is that
the system has agreed that doing this type of assessment is appropriate. . . .
We need to find good ways of making it happen.”

The Nature of Assessments

One of the first questions that needs to be answered, said Saunders,
involves the type of assessment. Should it be shorter, easier, and free,
which would be easier for the existing child welfare workforce to han-
dle? Or should it be more comprehensive to obtain all of the information
that might be needed? Such assessments would require professional
skills “that are probably far beyond the child welfare system workforce
and therefore would require substantial coordination with community
resources,” said Saunders. This is a question that applies not just in as-
sessments, but throughout human services, he added.
A fair number of evaluation tools have been developed and tested.
Copyright © 2012. National Academies Press. All rights reserved.

For example, Johnson et al. (2008) reviewed 85 instruments covering

patterns of social interaction, parenting practices, parent or caregiver his-
tories, and problems accessing basic necessities, and found 21 to be
sound. “Automated” assessment, interpretation, and service planning
frameworks have been developed, along with multidisciplinary ap-
proaches. “We have a lot of psychometrically sound, useful measures of
the common problems exhibited by children in the child welfare system,”
Saunders said. “Doing mental health types of assessments for the pur-
poses of service planning is a well-accepted operation within the child
welfare system.”
Assessment frameworks point to multiple sources of information, in-
cluding the child, siblings, parents, other caregivers, teachers, family
members, and peers. The “gatherers” of information include departments
of social services, guardians ad litem, forensic interviewers, medical pro-
viders, mental health providers, victim advocates, law enforcement, and

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 RECOGNIZING AND ASSESSING CHILD MALTREATMENT 21

school personnel. Methods for gathering information include open inter-

views, structure interviews, standardized assessment instruments, obser-
vations, and other forms of interaction. Targets for information gathering
include family and social history, abuse history, other trauma history,
anxiety, depression, behavior problems, delinquency, substance abuse,
academic performance, social functioning and support, and family func-
tioning and support.

Outcomes of Assessments
Despite the attention devoted to assessments, not much research has
examined whether they improve outcomes for children, particularly men-
tal health outcomes. For example, few studies have assessed whether
purported best practices are being followed and, if they are, whether they
lead to better outcomes. “We can ask administrators and mental health
systems how many people their centers saw in the past year, and they can
tell you with extraordinary precision how many new patients they had,”
said Saunders. “They can tell you with precision how many units of ser-
vice they delivered. They can tell you how much they can bill. [But] very
few people can tell you how many people actually got better.”
The research that has been done points to the difficulty of implemen-
tation, Saunders said. “We know a lot,” he said. “We have some tools to
do some very good work. However, actually translating that into the dai-
ly behavior of the typical child welfare worker turns out to be extraordi-
narily difficult.”
Standardized systems that are highly dependent on worker compli-
Copyright © 2012. National Academies Press. All rights reserved.

ance have been criticized as taking away from worker judgment. “Of
course, that is exactly what they are intended to do,” said Saunders, but
this outcome is a two-edged sword. “The computer does not always
make great decisions.” On the contrary, research on the input to stand-
ardized systems suggests that they still require judgment and information
input by the worker, though this input can vary from person to person
based on experience.
Research also demonstrates that many assessment findings are not
followed. People may do an assessment, but pay little or no attention to
the results in a service plan. The child welfare workforce needs certain
levels of knowledge and skill to use assessments effectively, but the
question is whether the child welfare system can establish such prerequi-
sites for the workforce. “Our history has not been all that great in this,”
Saunders said.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 22 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

Many stakeholders are involved in making a decision in the child

welfare system. Some are doing assessments; others are doing service
planning and delivery. Many times a judge is at the center of conflicting
inputs. “When it is not coordinated, the judge hears about different
treatment plans, some of which are completely contradictory, which then
extends the life of the case and makes it more difficult for people to actu-
ally get treatment,” Saunders said (Figure 2). A community-based ap-
proach may be one way to provide greater coordination for these inputs.

Future Research on Assessment

Saunders concluded by listing a number of critical research ques-
tions, many of which involve implementation:
 Within the context of frontline child welfare practice, how well
do current (and proposed) assessment tools and procedures identi-
fy children with particular problems who likely need mental
health services?
Copyright © 2012. National Academies Press. All rights reserved.

FIGURE 2 Competing treatment plans in child maltreatment cases.

NOTE: DJJ = Department of Juvenile Justice; DSS = Department of So-
cial Services; GAL = guardian ad litem; IEP = individualized education
program.
SOURCE: Saunders, 2012.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 RECOGNIZING AND ASSESSING CHILD MALTREATMENT 23

 What are the major sources of error in child welfare assessment

approaches?
 How should assessment approaches be adjusted due to factors
such as culture, ethnicity, race, and gender to reduce disparities?
 What is the influence of worker background and experience on
the implementation of assessment systems?
 What are the most cost-effective and efficient approaches (in
terms of financial cost, worker and family time, training, super-
vision, and compliance effort) to effective assessment?
 What levels of assessment can be reasonably performed by typi-
cal child welfare workers, and what levels require additional
community professional resources?
 What are the minimal knowledge and skills needed in the child
welfare workforce to do the levels of assessment necessary for
good practice?
 What sorts of initial and ongoing training, supervision, and mon-
itoring of practice are needed to achieve and maintain effective
assessment activity?
 To what degree can technology be used to make the assessment
process (and application of assessment results) more efficient
and more effective without negating appropriate child welfare
worker judgment?
 Does greater coordination of assessment tasks with community
resources and the family result in better assessment?
Copyright © 2012. National Academies Press. All rights reserved.

Discussion
During the discussion session, Clare Anderson from the ACYF
pointed to research showing that increased mental health assessment can
lead to the increased use of psychotropic medications among children in
foster care. An important research question, she said, is whether the scaling-
up of evidence-based practices would affect the use of psychotropic med-
ications in this population.
In responding to a comment about procedures for doing mental
health assessments, Saunders argued for a combination of standardized
tools and professional judgment. Such a balance would accommodate a
realistic view of how well the workforce ever will be trained, he said.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
Copyright © 2012. National Academies Press. All rights reserved.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 4

Social Trends and Child

Maltreatment Trends

Key Points Raised by Individual Speakers

 American families have been undergoing major changes in demo-
graphic structure, economic status, and health care coverage, all of
which can influence child maltreatment.
 Many sources of data point to a substantial reduction in the incidence
of child physical and sexual abuse, but not neglect, over the past two
decades.
 The causal factors behind changes in child maltreatment rates are
difficult to untangle, but an increased emphasis on prevention may
be responsible for the reduction in physical and sexual abuse.
 Despite some positive trends, pockets of severe unmet need continue
to exist throughout the United States.
Copyright © 2012. National Academies Press. All rights reserved.

Multiple sources of data on child maltreatment are available, each

with strengths and weaknesses. Four speakers at the workshop explored
these various sources of data, thereby providing a valuable context for
the other workshop presentations. Data on child maltreatment also can be
compared with data on broad social trends to probe the causes and con-
sequences of child abuse and neglect. This chapter examines the broad
relationships between social trends and child maltreatment trends, while
the next chapter looks at more specific causes and consequences.

25

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 26 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

SOCIAL TRENDS AND THEIR IMPLICATIONS

FOR UNDERSTANDING RATES OF CHILD
MALTREATMENT

Broad social and economic factors can influence trends in child mal-
treatment. The connection between the two is difficult to ascertain be-
cause of the uncertainties in the data and the complex causal relationship
factors that contribute to maltreatment. Nevertheless, it is important to
monitor and probe social trends to explore their possible effects on child
maltreatment, said Christina Paxson, dean of the Woodrow Wilson
School of International and Public Affairs and the Hughes Rogers Pro-
fessor of Economics and Public Affairs at Princeton University. Under-
standing these trends can indicate what might happen in the future as
social and economic influences continue to change and can shape the
research agenda to anticipate these changes.

Demographic Structure of American Families

American families look much different today than they have in the
past. In the 1950s, only about 5 percent of U.S. births were to unmarried
women. After a steady increase over the past five decades, that number is
today approximately 40 percent (Ventura, 2009). This does not mean that
children are living in households without men, said Paxson. Slightly
more than 50 percent of children who are born to unmarried women live
with parents who are cohabiting, and these relationships are often stable.
Nevertheless, the increase in unmarried births has focused the attention
Copyright © 2012. National Academies Press. All rights reserved.

of researchers on what happens in these families. For example, children

who are born to unmarried women, whether cohabiting or not, experi-
ence a greater frequency of transitions in living arrangements within their
households. They are more likely to live with nonbiological fathers, and
they are more likely to have step-siblings in a household. “How do these
different family structures influence children?” asked Paxson.
Longitudinal data are needed to understand how family structure is
related to maltreatment, said Paxson. Such data can reveal the family
transitions that have happened over time, how such transitions affect the
attachment of parents to children, and the types of risks to which children
are exposed. “This is an important area for research and one that is ne-
cessitated by the continuing trends that we see in the structure of Ameri-
can families,” Paxson said.
Another notable change has been in the birth rate for teenagers in the
United States, which has dropped by approximately 50 percent for all

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 SOCIAL TRENDS AND CHILD MALTREATMENT TRENDS 27

U.S. women ages 15-19 since 1970, reducing such births from a high of
about 600,000 in 1970 to about 400,000 today (Ventura and Hamilton,
2011). Research has suggested that children born to teenage parents are
at higher risk of maltreatment, and in that respect the decline in teen
births is a “good news story,” said Paxson. The reasons for this drop are
contentious because they involve such issues as the provision of birth
control and sex education for teens. But the drop provides an opportunity
for research to examine how changes in U.S. fertility patterns may have
influenced rates of child maltreatment.

Economic Status of American Families

The poverty rate among children is higher than for any other age
group in the United States. This rate has varied between about 25 and 15
percent over the past half-century, with a movement upward over the
past few years to about 22 percent in 2010 (DeNavas-Walt et al., 2011).
The percentage of children with unemployed parents has also gone up in
recent years, to about 9 percent in 2011. Increases in caseloads under the
Supplemental Nutrition Assistance Program grew from 9 percent of
Americans in 2007 to 14 percent in 2011, though growth of caseloads
under the Temporary Assistance for Needy Families program has been
slower (Isaacs, 2011).
Poverty is an important factor in child maltreatment, said Paxson,
and poverty has been worsening. One way to learn more about the effects
of poverty on child maltreatment would be to look at the uneven effects
of the recession on different parts of the United States. “This will be a
Copyright © 2012. National Academies Press. All rights reserved.

good opportunity to look at how economic factors influence maltreatment.”

Health and Health Care

The fraction of poor children without health insurance has been
dropping in recent years—from 23 percent of children below 200 percent
of the poverty line in 1997 to 12 percent in 2009—even as the percentage
of children without health insurance above this income level has re-
mained fairly stable (at about 5 percent) (HHS, 2011). This decrease,
made possible largely through Medicaid and state children’s health in-
surance programs, has been another success story, said Paxson.
The Affordable Care Act will further change access to health care by
providing more adults with health insurance. This change may provide
an opportunity to deal with some of the physical and mental health prob-
lems among adults that can contribute to child maltreatment, though

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 28 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

many of these adults will be covered by state Medicaid programs that

may have limited resources to deal with such issues as substance abuse
and mental health.
In particular, substance abuse is an important factor in child mal-
treatment. Recent trends have seen a slight increase in marijuana use,
while cocaine use is down slightly (SAMHSA, 2011). “A continuing fo-
cus on substance abuse in adults who are parents or could become par-
ents is important,” said Paxson.

Fiscal Capacity of Governments

Projections of the fiscal capacity of governments to support children
and families point to “a really difficult time,” according to Paxson. Over
the past 20 years, funding to support at-risk families has shifted from
state and local budgets to federal budgets (CBO, 2011). This may pro-
vide insulation from the budgetary ups and down of state and local budg-
ets, but over the next few decades, federal expenditures could be severely
constrained. Support for children and families, as well as for research on
children and families, is very likely to be squeezed.
A major factor in the fiscal constraints at the federal level is the pro-
jected increase in healthcare spending. This is ironic, said Paxson, be-
cause in essence the federal government will be putting more resources
into health care and less into programs to support the health and well-
being of American families. Paxson suggested thinking hard about how
to use Medicaid as a vehicle for the prevention and treatment of child
maltreatment. The constrained fiscal outlook also calls for the develop-
Copyright © 2012. National Academies Press. All rights reserved.

ment of cost-effective primary prevention models, sophisticated tools to

assess the risk for secondary maltreatment (maltreatment in addition to
another kind of trauma identified as the primary descriptor for the situa-
tion, e.g., domestic violence), and better methods for tracking and moni-
toring high-risk families.
Child maltreatment imposes large costs on society in terms of pre-
vention, treatment, legal fees, foster care, and other expenditures, Paxson
stated, in addition to the costs to children. “Adding in these other costs is
important because it helps make the case that this is an issue that we need
to pay attention to.”

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 SOCIAL TRENDS AND CHILD MALTREATMENT TRENDS 29

DATA SOURCES FOR UNDERSTANDING CHILD

MALTREATMENT

Andrea Sedlak, a vice president of Westat, described the major data

sources used to assess national levels of child maltreatment and trends
over time.

National Child Abuse and Neglect Data System

The National Child Abuse and Neglect Data System (NCANDS) is a
data system created in response to the requirements of the Child Abuse
Prevention and Treatment Act (CAPTA). NCANDS centralizes the an-
nual collection, tracking, and analysis of child maltreatment information
as reported to CPS agencies in each of the 50 states, the District of Co-
lumbia, and the Commonwealth of Puerto Rico. In the early 1990s, states
submitted NCANDS data as aggregated counts. Since the mid- to late
1990s, NCANDS has been converting to a case-level data submission
system, which now encompasses 51 of the 52 jurisdictions.
NCANDS seeks to obtain a full census annually. States use their own
definitions and codes to classify cases and then map their state codes into
the NCANDS codes by agreed-upon rules. The original codings come
from workers in local agencies who use their state’s system, and these
codings are eventually reflected in the NCANDS data.
NCANDS data provide rich information, Sedlak observed. They
provide the numbers of screened-in versus screened-out referrals, report
dispositions, the sources of reports to CPS agencies, response times, and
Copyright © 2012. National Academies Press. All rights reserved.

CPS workforce and caseload levels. They classify child victims by mal-
treatment type, sex, age, race, ethnicity, disability status of the child,
caregiver domestic violence, and caregiver alcohol or drug abuse. They
report on fatalities, perpetrators of maltreatment, and services the cases
have received.
NCANDS classifies maltreatment into six categories: physical abuse,
sexual abuse, neglect, medical neglect, psychological maltreatment, and
other. NCANDS also provides indicators of compliance with federal
mandates on the absence of maltreatment recurrence, the absence of mal-
treatment in foster care, and first-time victims.

National Incidence Study

The NIS, which is also mandated by CAPTA, is conducted approxi-
mately once every decade under a contract from the Administration for

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 30 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

Children and Families. It seeks to estimate broadly the national incidence

of maltreatment through both investigated and noninvestigated cases of
child abuse and neglect. The NIS collects and categorizes data according
to standardized definitions for types of child maltreatment, the severity
of maltreatment, and key demographic characteristics of maltreated chil-
dren and their families.
The NIS began with definitions for the Harm Standard in 1979-1980
and modified definitions for the Endangerment Standard in NIS-2 in
1986. The Harm Standard definitions are stringent in requiring that a
child already have experienced demonstrable harm from abuse or neglect
before they could be counted in NIS estimates. The Endangerment
Standard includes children who were endangered by the events of abuse
or neglect that they experienced.
Unlike NCANDS, which is a census-based approach, the NIS uses a
representative sampling of counties. The latest cycle (NIS-4) collected
data from a nationally representative sample of 122 counties in 2005 and
2006. Information gathered in each county includes CPS data, but it also
includes cases seen by individual sentinels, or community representa-
tives, in public schools, public health departments, public housing, juve-
nile probation, law enforcement, hospitals, day care centers, shelters, and
other institutions.
Also unlike NCANDS, which relies on the states’ definitions of
abuse and neglect, the NIS applies standardized definitions to case de-
tails. Its reports include the numbers and rates of maltreated children by
maltreatment type; child victims by sex, age, race/ethnicity, disability,
and school enrollment; family characteristics by employment, socioeco-
Copyright © 2012. National Academies Press. All rights reserved.

nomic status, family structure and living arrangement, grandparent care-

givers, family size, and metropolitan status of residence area; perpe-
trators’ characteristics; and maltreated children by the sources recogniz-
ing their maltreatment.
“We obtain narrative descriptions of what happened to this child,”
Sedlak explained. “Who did it? What have you seen in terms of injuries?
What were the actions or omissions going on? What else was going on?”
These reports are then evaluated in the terms of the standardized defini-
tions that the NIS applies to classify maltreatment events, injuries, and
circumstances.
The maltreatment classification has eight overarching categories:
physical abuse, sexual abuse, emotional abuse, physical neglect, educa-
tional neglect, emotional neglect, other maltreatment, and maltreatment

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 SOCIAL TRENDS AND CHILD MALTREATMENT TRENDS 31

that is not countable in the NIS. These eight categories encompass 60

separate codes that describe the nature of the maltreatment.
In addition, the NIS provides detailed information about CPS inves-
tigation rates by maltreatment type and recognition source, CPS agency
structure and practices related to investigation rates, CPS screening poli-
cies related to uninvestigated children, and sentinel training and reporting
of maltreatment.

Other Data Sources

The Adoption and Foster Care Analysis and Reporting System
(AFCARS) is a database of all case-level information on foster children
under the care of state child welfare agencies, including information on
foster and adoptive parents. States are required to submit AFCARS data
on a semi-annual basis to the ACF, which uses the data to inform a varie-
ty of initiatives.
AFCARS does not focus on abuse or neglect, but it includes the rea-
son for a child’s removal into foster care, such as physical abuse, sexual
abuse, neglect, and other potential reasons. Many states can now link
their NCANDS case-level data with AFCARS data to provide indicators
of maltreatment recidivism in foster care. Unfortunately, said Sedlak, this
system does not support tracking individual children across years.
Finally, Statewide Automated Child Welfare Information Systems
(SACWISs) are in place in 36 states, with 3 in development and the other
states using non-SACWIS models. SACWISs are comprehensive auto-
mated case management tools. States use their SACWIS data to provide
Copyright © 2012. National Academies Press. All rights reserved.

NCANDS and AFCARS reports.

From Data to Knowledge

Both the NIS and NCANDS reveal national trends. NCANDS pro-
vides annual trends, including trends in report sources, dispositions, re-
sponse times, and overall victimization rates. The NIS shows long-range
trends over 7- to 12-year periods in overall maltreatment and in major
maltreatment categories. It also provides significant changes in victimi-
zation rates (overall and by category) for subgroups (by child and family
characteristics).
However, NCANDS does not provide trends by maltreatment type,
although this information can be extracted from the raw data. Sedlak
urged that these important trends be part of the national analysis and dis-
tribution of the data, rather than having individual researchers extract the

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 32 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

trends from the data. The NIS does not report trends in specific subforms
of maltreatment, though again more information can be extracted from
the data.
In NCANDS, states’ varied definitions of maltreatment can affect
trend statistics. By contrast, the NIS directly codes case-level descrip-
tions of maltreatment through notes and narratives. NCANDS loses some
maltreatment event information, whereas uninvestigated maltreatment is
filtered through sentinels’ observations in the NIS. Changes in sentinels’
processes can affect trend statistics, so NIS-4 established baselines to
calibrate these changes. An analysis done by Sedlak and her colleagues
showed the NIS found more multiple-maltreated children than NCANDS
sees from its CPS sources. “When you are using something for case
management, you suffice in terms of your coding,” she said. “But we are
losing stuff because of that, or we are not seeing it. It is buried.”

Future Opportunities to Enhance Use of Data Sources

Important uncertainties surround the meaning of findings from
NCANDS and NIS, said Sedlak. NCANDS makes little effort to under-
stand the findings in relation to agency policy or administrative practice.
Administrative changes in a few states that drive an overall trend are bur-
ied in appendixes or brief summary notes, with no analysis of trends. In
contrast, NIS has improved on this. The NIS-4 had included supplemen-
tary studies of CPS agencies’ organization, practices, and policies and
analyses to relate those results to the overall NIS results on investigation
rates and uninvestigated children. For example, analyses have found
Copyright © 2012. National Academies Press. All rights reserved.

lower rates of investigation in places that relied on referrals being filtered

through hotlines. “Things like that that are important to know about how
your practice [and] your policy may be affecting what you are seeing . . .
and how successful you are in reaching maltreated children,” said
Sedlak.
A major problem is that the findings from these data sources are not
being well disseminated, Sedlak stated. States hardly use, publicize, or
even know about their own NCANDS data trends. Many states do not
use or know how to use their SACWIS data to examine patterns in case-
loads, to compare to other systems’ data, to make sense of policy chang-
es, or to make other improvements. Federal clearance processes
introduce extensive delays in releasing reports on important findings, not
just in HHS, but in other departments as well.
National systems provide data on maltreated children, but they do
not regularly collect data on representative samples of both maltreated

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 SOCIAL TRENDS AND CHILD MALTREATMENT TRENDS 33

and nonmaltreated children to see how the risk of maltreatment varies

across settings and time periods. Nor are maltreatment data in other sys-
tems being used or improved. For example, the National Crime Victimi-
zation Survey interviews individuals ages 12 and older about their
criminal victimization experiences every 6 months, repeating these inter-
views for 3 years. Adding proxy interviews on victimization of younger
children could provide victimization data for all ages. Surveys with chil-
dren as young as 9 have been comprehensive, and tools exist for measur-
ing self-reports of neglect in very young children using picture
methodologies on computer-assisted systems.
Another missed opportunity is the National Incident-Based Report-
ing System, which provides detailed information about crimes known to
police, including injuries, offenders, and victims. Codes that show
whether law enforcement referred to CPS or vice versa and designating
offenders as caretakers or noncaretakers when victims are children would
provide a rich database on maltreatment.
Finally, Sedlak observed, no one knows how many children in the
United States are sexually abused or assaulted. Law enforcement data
cannot now be compared with NCANDS, NIS, or other data sources to
arrive at this number. “Given that this is such an important policy issue,
it is alarming to realize that we don’t know and we have no plans for get-
ting” this information. In addition, the other victimization experiences
children undergo, such as abduction by family and nonfamily members,
peer victimization, and dating violence, are largely undetected. Many
children are traumatized in multiple ways that do not come under the
jurisdiction of CPS agencies. “Without understanding that, we really
Copyright © 2012. National Academies Press. All rights reserved.

can’t understand what we need to do to intervene,” Sedlak concluded.

Discussion
During the discussion session, Bernard Guyer from Johns Hopkins
University raised several issues about the underlying theory of measure-
ment in the field of child maltreatment. Distinguishing incidence and
prevalence could make a big difference in looking at trends. Similarly, is
maltreatment an acute disease or a chronic disease? Once children have
been maltreated, are they maltreated for life? How are children seen in
multiple places for maltreatment tallied? Finally, he asked whether
changes in birth cohorts could account for the decline in abuse seen in
national data.
Sedlak responded that the NIS gives just period prevalence rates,
while NCANDS also gives the period rate and numbers for the children

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 34 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

investigated over the course of the year. She also said that NCANDS and
NIS make efforts to deduplicate cases through data matching and model-
ing, and that considerable work has been devoted to improving the relia-
bility of individual data sources.
Richard Barth, University of Maryland, pointed to the use of vital
statistics such as birth records as a source of population information. By
linking birth records with other administrative data, important infor-
mation could be uncovered more quickly than in planned longitudinal
studies.

CHANGES IN RATES OF REPORTED CHILD

ABUSE AND NEGLECT

Lisa Jones, a research associate professor of psychology at the Uni-

versity of New Hampshire’s Crimes Against Children Research Center,
described one of the more notable—and contentious—data points dis-
cussed at the workshop.

Evidence for a Decline in Physical and Sexual Abuse

NCANDS data indicate a steady decline in physical abuse and sexual
abuse over the past two decades (Figure 3). According to these data, sex-
ual abuse has declined by 62 percent since 1990, while physical abuse
has declined by 56 percent. Neglect also has declined, but by much
less—just 10 percent since 1992. These data embody “one of the most
interesting and important events that have occurred in the epidemiology
Copyright © 2012. National Academies Press. All rights reserved.

of child maltreatment,” said Jones.

NCANDS data come from CPS agencies across the country and rep-
resent substantiated cases of maltreatment. Jones noted that the declines
are seen across the entire country, not just in a few states.
Some have expressed concerns that state and local finances or work-
er caseloads might be affecting CPS agencies in such a way that fewer
child maltreatment reports are being indicated or substantiated. However,
Harvard School of Public Health researchers explored this possibility and
found no evidence to support this (Almeida et al., 2008). Instead, they
found evidence that supports “a true decline in incidence of substantiated
child sexual abuse cases during the latter part of the 1990s” (p. 373). Fur-
thermore, research by Jones and colleagues (2001) found no evidence
that less severe abuse and neglect dropped more than severe types of mal-
treatment, which would be expected if CPS agencies were triaging cases.

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 SOCIAL TRENDS AND CHILD MALTREATMENT TRENDS 35

95
Rate per 10,000 Population <18 Years

85
Neglect: 10% decline

75

65

55
Physical Abuse (x2): 56% decline

45

35
Sexual Abuse (x3): 62% decline

25

Year

FIGURE 3 Substantiated cases of maltreatment compiled by NCANDS,

1990-2010.
SOURCE: Jones, 2012.

Other data sources such as the NIS support the trends seen in
Copyright © 2012. National Academies Press. All rights reserved.

NCANDS data. Between NIS-3 in 1993 and NIS-4 in 2005, sexual abuse
was down 44 percent and physical abuse was down 23 percent, even
though the sentinel data in the NIS come from a different source than the
NCANDS data.
Self-reported data from a school survey in Minnesota with 6th-, 9th-,
and 12th-graders show a decline of 28 percent in children reporting sex-
ual abuse and 20 percent in children reporting physical abuse from 1992
to 2010. Similarly, the National Crime Victimization Survey shows de-
clines in juvenile sex victimization of 52 percent between 1993 and
2005.
Many correlates of child maltreatment show remarkably similar
trends. Teen birth rates underwent a 48 percent decline from 1994 to
2009, youth runaways rates were down 66 percent from 1994 to 2009,
teen suicide declined 43 percent from 1994 to 2007, teen drug use was

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
 36 CHILD MALTREATMENT RESEARCH, POLICY, AND PRACTICE

down 27 percent between 1997 and 2007, and domestic violence fell 60
percent from 1993 to 2005. “What is remarkable and convincing about
these trends is that we are not talking about just one data source, but ex-
tremely similar trend patterns coming from many different studies and
sources,” said Jones.

Possible Explanations for the Decline

Jones suggested several possible explanations for the declines. One
possible source could be economic fluctuations. The greatest declines
occurred in the 1990s, when the United States was going through a rela-
tively positive economic phase, with a slower decline in the past decade.
However, throughout the past decade, and even in the recent recession,
rates of physical abuse, sexual abuse, and neglect have continued to fall.
“This suggests that we need to look for other explanations,” Jones said.
An “optimistic possibility” is that the tremendous amount of work
done in the past several decades to prevent child maltreatment is having
an effect. An observation supporting this idea is that sexual abuse de-
clined first and then physical abuse. Sexual abuse received a lot of atten-
tion during the 1980s and early 1990s through, for example, prevention
programs in schools and increased protection efforts in youth programs
like the Boy Scouts. There is a possibility, said Jones, that these efforts
had an effect on maltreatment.
Also starting in the late 1980s and increasing in the 1990s, the crimi-
nal justice system became more involved in child abuse and domestic
violence. Consistent with the trend patterns, this involvement centered
Copyright © 2012. National Academies Press. All rights reserved.

more on sexual abuse and physical abuse and less on neglect. “It may be
that the increased incarceration and prosecution of offenders is having a
direct effect,” Jones said. “It may also be having a preventive effect as it
conveys the idea that these are serious crimes and that it is something
that officials take seriously.”
Better mental health and trauma treatment may have reduced child
maltreatment by reducing intergenerational transmission. In addition,
access to psychopharmacological medication to treat depression and anx-
iety may have had an effect.
Finally, Jones pointed to something less measurable: cultural norms
around caring for and protecting children. These may have improved as
researchers learned more about what children need. “On a national level,
some of that information [may have] gotten through to families in a way
that decreases the amount of maltreatment that we have been seeing.”

National, Research Council, et al. Child Maltreatment Research, Policy, and Practice for the Next Decade : Workshop Summary, edited by
Another random document with
no related content on Scribd:
OLD HOUSES WITH CARVED DOORPOSTS, NORWAY.
 CHAPTER XXVI.
THE SIGURD SAGA.

While the first part of the Elder Edda consists of a collection of

alliterative poems describing the creation of the world, the
adventures of the gods, their eventual downfall, and gives a
complete exposition of the Northern code of ethics, the second part
comprises a series of heroic lays describing the life and adventures
of the Volsung family, and especially of their chief representative,
Sigurd, the great Northern warrior.
These lays form the basis of the great Scandinavian epic, the
The Volsunga Volsunga Saga, and have supplied not only the
Saga. materials for the Nibelungenlied, the German epic,
and for countless folk tales, but also for Wagner’s
celebrated operas, “The Rhinegold,” “Valkyr,” “Siegfried,” and “The
Dusk of the Gods.” They have also been rewritten by William Morris,
the English poet, who has given them the form which they will
probably retain in our literature, and it is from his work that almost
all the quotations in this chapter are taken in preference to extracts
from the Edda.
Sigi, Odin’s son, was a powerful man, and generally respected
Sigi. until he killed a man out of jealousy because the latter
had slain the most game when they were out hunting
together. In consequence of this crime, Sigi was driven from his own
land and declared an outlaw. But, although he was a criminal, he
had not entirely forfeited Odin’s favor, for the god now gave him a
well-equipped vessel, provided him with a number of brave
followers, and promised that victory should ever attend him.
 Thanks to Odin’s protection, Sigi soon won the glorious empire
of the Huns and became a powerful monarch. But when he had
attained extreme old age his fortune changed, Odin suddenly
forsook him, his wife’s kindred fell upon him, and after a short
encounter he was treacherously slain.
His death was soon avenged, however, for his son Rerir,
Rerir. returning from a journey, put all the murderers to
death and claimed the throne. But, in spite of all
outward prosperity, Rerir’s dearest wish, a son to succeed him,
remained unfulfilled for many a year. Finally, however, Frigga decided
to grant his constant prayer, and to vouchsafe the heir he longed for.
Her swift messenger Gna, or Liod, was dispatched to carry him a
miraculous apple, which she dropped into his lap as he was sitting
alone on the hillside. Glancing upward, Rerir recognized the emissary
of the goddess, and joyfully hastened home to partake of the apple
with his wife. The child thus born in answer to their prayers was a
handsome little lad called Volsung, who, losing both parents in early
infancy, became ruler of all the land.
Every year Volsung’s wealth and power increased, and, as he
Volsung. was the boldest leader, many brave warriors rallied
around him, and drank his mead sitting beneath the
Branstock, a mighty oak, which, rising in the middle of his dwelling,
pierced the roof and overshadowed the whole house.

“And as in all other matters ’twas all earthly houses’ crown,

And the least of its wall-hung shields was a battle-world’s renown,
So therein withal was a marvel and a glorious thing to see,
For amidst of its midmost hall-floor sprang up a mighty tree,
That reared its blessings roofward and wreathed the roof-tree dear
With the glory of the summer and the garland of the year.”

Volsung did not long remain childless, for ten stalwart sons and
one lovely daughter, Signy, came to brighten his home. As soon as
 this maiden reached marriageable years, many suitors asked for her
hand, which was finally pledged to Siggeir, King of the Goths, whom,
however, she had never seen.
The wedding day came, and when the bride first beheld her
The wedding
destined groom she shrank back in dismay, for his
of Signy. puny form and lowering glances contrasted oddly with
her brothers’ strong frames and frank faces. But it was
too late to withdraw,—the family honor was at stake,—and Signy so
successfully concealed her dislike that none except her twin brother
Sigmund suspected how reluctantly she became Siggeir’s wife.
The wedding feast was held as usual, and when the
The sword in merrymakings had reached their height the guests
the were startled by the sudden entrance of a tall, one-
Branstock.
eyed man, closely enveloped in a mantle of cloudy
blue. Without vouchsafing word or glance to any in the assembly,
the stranger strode up to the Branstock and thrust a glittering sword
up to the hilt in its great bole. Then, turning slowly around, he faced
the awe-struck assembly, and in the midst of the general silence
declared that the weapon would belong to the warrior who could pull
it out, and that it would assure him victory in every battle. These
words ended, he passed out and disappeared, leaving an intimate
conviction in the minds of all the guests that Odin, king of the gods,
had been in their midst.

“So sweet his speaking sounded, so wise his words did seem,
That moveless all men sat there, as in a happy dream
We stir not lest we waken; but there his speech had end,
And slowly down the hall-floor and outward did he wend;
And none would cast him a question or follow on his ways,
For they knew that the gift was Odin’s, a sword for the world to
praise.”
 Volsung was the first to recover the power of speech, and,
waiving his own right to try to secure the divine weapon, he invited
Siggeir to make the first attempt to draw it out of the tree-trunk.
The bridegroom anxiously tugged and strained, but the sword
remained firmly embedded in the oak. He resumed his seat, with an
air of chagrin, and then Volsung also tried and failed. But the
weapon was evidently not intended for either of them, and the
young Volsung princes were next invited to try their strength.

“Sons I have gotten and cherished, now stand ye forth and try;
Lest Odin tell in God-home how from the way he strayed,
And how to the man he would not he gave away his blade.”

The nine eldest sons were equally unsuccessful; but when

Sigmund.
Sigmund, the tenth and youngest, laid his firm young
hand upon the hilt, it easily yielded to his touch, and
he triumphantly drew the sword out without making the least
exertion.

“At last by the side of the Branstock Sigmund the Volsung stood,
And with right hand wise in battle the precious sword-hilt caught,
Yet in a careless fashion, as he deemed it all for naught;
When, lo, from floor to rafter went up a shattering shout,
For aloft in the hand of Sigmund the naked blade showed out
As high o’er his head he shook it: for the sword had come away
From the grip of the heart of the Branstock, as though all loose it
lay.”

All present seemed overjoyed at his success; but Siggeir’s heart

was filled with envy, for he coveted the possession of the weapon,
which he now tried to purchase from his young brother-in-law.
Sigmund, however, refused to part with it at any price, declaring that
the weapon had evidently been intended for him only. This refusal so
offended Siggeir that he secretly resolved to bide his time, to
exterminate the proud race of the Volsungs, and thus secure the
divine sword.
Concealing his chagrin therefore, he turned to Volsung and
cordially invited him to visit his court a month later, bringing all his
sons and kinsmen with him. The invitation so spontaneously given
was immediately accepted, and although Signy, suspecting evil,
secretly sought her father while her husband slept, and implored him
to retract his promise and stay at home, he would not consent to
appear afraid.
A few weeks after the return of the bridal couple Volsung’s well-
Siggeir’s manned vessels came within sight of Siggeir’s shores,
treachery. and Signy perceiving them hastened down to the
beach to implore her kinsmen not to land, warning
them that her husband had treacherously planned an ambush,
whence they could never escape alive. But Volsung and his sons,
whom no peril could daunt, calmly bade her return to her husband’s
palace, and donning their arms they boldly set foot ashore.
THE BRANSTOCK.—Hoffmann.
“Then sweetly Volsung kissed her: ‘Woe am I for thy sake,
But Earth the word hath hearkened, that yet unborn I spake;
How I ne’er would turn me backward from the sword or fire of bale;
—
—I have held that word till to-day, and to-day shall I change the
tale?
And look on these thy brethren, how goodly and great are they,
Wouldst thou have the maidens mock them, when this pain hath
passed away
And they sit at the feast hereafter, that they feared the deadly
stroke?
Let us do our day’s work deftly for the praise and the glory of folk;
And if the Norns will have it that the Volsung kin shall fail,
Yet I know of the deed that dies not, and the name that shall ever
avail.’”

Marching towards the palace, the brave little troop soon fell into
Siggeir’s ambuscade, and, although they fought with heroic courage,
they were so overpowered by the superior number of their foes that
Volsung was soon slain and all his sons made captive. Led bound
into the presence of Siggeir, who had taken no part in the fight (for
he was an arrant coward), Sigmund was forced to relinquish his
precious sword, and he and his brothers were all condemned to die.
Signy, hearing this cruel sentence, vainly interceded for them,
but all she could obtain by her prayers and entreaties was that her
kinsmen should be chained to a fallen oak in the forest, there to
perish of hunger and thirst if the wild beasts spared them. Then,
fearing lest his wife should visit and succor her brothers, Siggeir
confined her in the palace, where she was closely guarded night and
day.
Early every morning Siggeir himself sent a messenger into the
forest to see whether the Volsungs were still living, and every
morning the man returned saying a monster had come during the
night and had devoured one of the princes, leaving nothing but his
bones. When none but Sigmund remained alive, Signy finally
prevailed upon one of her servants to carry some honey into the
forest and smear it over her brother’s face and mouth.
That very night the wild beast, attracted by the smell of the
honey, licked Sigmund’s face, and even thrust its tongue into his
mouth. Clinching his teeth upon it, Sigmund, weak and wounded as
he was, struggled until his bonds broke and he could slay the nightly
visitor who had caused the death of all his brothers. Then he
vanished into the forest, where he remained concealed until the
daily messenger had come and gone, and until Signy, released from
captivity, came speeding to the forest to weep over her kinsmen’s
remains.
Seeing her evident grief, and knowing she had no part in
Siggeir’s cruelty, Sigmund stole out of his place of concealment,
comforted her as best he could, helped her to bury the whitening
bones, and registered a solemn oath in her presence to avenge his
family’s wrongs. This vow was fully approved by Signy, who,
however, bade her brother abide a favorable time, promising to send
him a helper. Then the brother and sister sadly parted, she to return
to her distasteful palace home, and he to seek the most remote part
of the forest, where he built a tiny hut and plied the trade of a
smith.

“And men say that Signy wept

When she left that last of her kindred; yet wept she never more
Amid the earls of Siggeir, and as lovely as before
Was her face to all men’s deeming: nor aught it changed for ruth,
Nor for fear nor any longing; and no man said for sooth
That she ever laughed thereafter till the day of her death was
come.”

Years passed by. Siggeir, having taken possession of the Volsung

Signy’s sons.
kingdom, proudly watched the growth of his eldest
son, whom Signy secretly sent to her brother as soon as he was ten
years of age, bidding Sigmund train the child up to help him, if he
were worthy of such a task. Sigmund reluctantly accepted the
charge; but as soon as he had tested the boy and found him
deficient in physical courage, he either sent him back to his mother,
or, as some versions relate, slew him.
Some time after this Sigmund tested Signy’s second son, who
had been sent to him for the same purpose, and found him wanting
also. Evidently none but a pure-blooded Volsung could help him in
his work of revenge, and Signy, realizing this, resolved to commit a
crime.

“And once in the dark she murmured: ‘Where then was the ancient
song
That the Gods were but twin-born once, and deemed it nothing
wrong
To mingle for the world’s sake, whence had the Æsir birth,
And the Vanir, and the Dwarf-kind, and all the folk of earth?’”

This resolution taken, she summoned a beautiful young witch,

exchanged forms with her, and, running into the forest, sought
shelter in Sigmund’s hut. Deeming her nothing but the gypsy she
seemed, and won by her coquetry, he soon made her his wife. Three
days later she vanished from his hut, returned to the palace,
resumed her own form, and when she gave birth to a little son, she
rejoiced to see his bold glance and strong frame.
When this child, Sinfiotli, was ten years of age, she herself made
Sinfiotli. a preliminary test of his courage by sewing his
garment to his skin. Then she suddenly snatched it off
with shreds of flesh hanging to it, and as the child did not even
wince, but laughed aloud, she confidently sent him to Sigmund. He,
too, found the boy quite fearless, and upon leaving the hut one day
he bade him take meal from a certain sack, and knead and bake the
bread. On returning home Sigmund asked Sinfiotli whether his
orders had been carried out. The lad replied by showing the bread,
and when closely questioned he artlessly confessed that he had
been obliged to knead into the loaf a great adder which was hidden
in the meal. Pleased to see that the child, for whom he felt a strange
affection, had successfully stood the test which had daunted his
predecessors, Sigmund bade him refrain from eating of that loaf, as
he alone could taste poison unharmed, and patiently began to teach
him all a Northern warrior need know.

“For here the tale of the elders doth men a marvel to wit,
That such was the shaping of Sigmund among all earthly kings,
That unhurt he handled adders and other deadly things,
And might drink unscathed of venom: but Sinfiotli was so wrought
That no sting of creeping creatures would harm his body aught.”

Sigmund and Sinfiotli soon became inseparable companions, and

The
while ranging the forest together they once came to a
werewolves. hut, where they found two men sound asleep. Wolf
skins hanging near them immediately made them
conclude that the strangers were werewolves (men whom a cruel
spell forced to assume the habits and guise of ravenous wolves, and
who could only resume their natural form for a short space at a
time). Prompted by curiosity, Sigmund donned one of the wolf skins,
Sinfiotli the other, and they were soon metamorphosed into wolves
and rushed through the forest, slaying and devouring all they saw.
Such were their wolfish passions that they soon attacked each
other, and after a fierce struggle Sinfiotli, the younger and weaker,
fell down dead. This sudden catastrophe brought Sigmund to his
senses. While he hung over his murdered companion in sudden
despair, he saw two weasels come out of the forest and fight until
one lay dead. The live weasel then sprang back into the thicket, and
soon returned with a leaf, which it laid upon its companion’s breast.
At the contact of the magic herb the dead beast came back to life. A
moment later a raven flying overhead dropped a similar leaf at
Sigmund’s feet, and he, understanding that the gods wished to help
him, laid it upon Sinfiotli, who was restored to life.
Afraid lest they might work each other further mischief while in
this altered guise, Sigmund and Sinfiotli now crept home and
patiently waited until the time of release had come. On the ninth
night the skins dropped off and they hastily flung them into the fire,
where they were entirely consumed, and the spell was broken
forever.
It was now that Sigmund confided the story of his wrongs to
Sinfiotli, who swore that, although Siggeir was his father (for neither
he nor Sigmund knew the secret of his birth), he would help him to
take his revenge. At nightfall, therefore, he accompanied Sigmund to
the palace; they entered unseen, and concealed themselves in the
cellar, behind the huge beer vats. Here they were discovered by
Signy’s two youngest children, who were playing with golden rings,
which rolled into the cellar, and who thus suddenly came upon the
men in ambush.
They loudly proclaimed the discovery they had just made to their
father and his guests, but, before Siggeir and his men could don
their arms, Signy caught both children by the hand, and dragging
them into the cellar bade her brother slay the little traitors. This
Sigmund utterly refused to do, but Sinfiotli struck off their heads ere
he turned to fight against the assailants, who were rapidly closing
around him.
In spite of all efforts Sigmund and his brave young companion
soon fell into the hands of the Goths, whose king, Siggeir, sentenced
them to be buried alive in the same mound, a stone partition being
erected between them so they could neither see nor touch each
other. The prisoners were already confined in their living graves, and
the men were about to place the last stones on the roof, when Signy
drew near, bearing a bundle of straw, which they allowed her to
throw at Sinfiotli’s feet, for they fancied that it contained only a few
 provisions which would prolong his agony a little without helping him
to escape.
When the workmen had departed and all was still, Sinfiotli undid
the sheaf and shouted for joy when he found instead of bread the
sword which Odin had given to Sigmund. Knowing that nothing
could dull or break the keen edge of this fine weapon, Sinfiotli thrust
it through the stone partition, and, aided by Sigmund, sawed an
opening, and both soon effected an escape through the roof.

“Then in the grave-mound’s darkness did Sigmund the king upstand,

And unto that saw of battle he set his naked hand;
And hard the gift of Odin home to their breasts they drew;
Sawed Sigmund, sawed Sinfiotli, till the stone was cleft atwo,
And they met and kissed together: then they hewed and heaved full
hard
Till, lo, through the bursten rafters the winter heavens bestarred!
And they leap out merry-hearted; nor is there need to say
A many words between them of whither was the way.”

Sigmund and Sinfiotli, free once more, noiselessly sought the

Sigmund’s
palace, piled combustible materials around it, and
vengeance. setting fire to it placed themselves on either side the
door, declaring that none but the women should be
allowed to pass through. Then they loudly called to Signy to escape
ere it was too late, but she had no desire to live, and after kissing
them both and revealing the secret of Sinfiotli’s birth she sprang
back into the flames, where she perished.

“And then King Siggeir’s roof-tree upheaved for its utmost fall,
And its huge walls clashed together, and its mean and lowly things
The fire of death confounded with the tokens of the kings.”
 The long-planned vengeance had finally been
Helgi.
carried out, Volsung’s death had been avenged, and
Sigmund, feeling that nothing now detained him in Gothland, set sail
with Sinfiotli and returned to Hunaland, where he was warmly
welcomed and again sat under the shade of his ancestral tree, the
mighty Branstock. His authority fully established, Sigmund married
Borghild, a beautiful princess, who bore him two sons, Hamond and
Helgi, the latter of whom was visited by the Norns when he lay in his
cradle, and promised sumptuous entertainment in Valhalla when his
earthly career should be ended.

“And the woman was fair and lovely, and bore him sons of fame;
Men called them Hamond and Helgi, and when Helgi first saw light
There came the Norns to his cradle and gave him life full bright,
And called him Sunlit Hill, Sharp Sword, and Land of Rings,
And bade him be lovely and great, and a joy in the tale of kings.”

This young Volsung prince was fostered by Hagal, for Northern

kings generally entrusted their sons’ education to a stranger, thinking
they would be treated with less indulgence than at home. Under this
tuition Helgi became so fearless that at the age of fifteen he
ventured alone into the palace of Hunding, with whose whole race
his family was at feud. Passing all through the palace unmolested
and unrecognized, he left an insolent message, which so angered
Hunding that he immediately set out in pursuit of the bold young
prince. Hunding entered Hagal’s house, and would have made Helgi
a prisoner had the youth not disguised himself as a servant maid,
and begun to grind corn as if it were his wonted occupation. The
invaders marveled somewhat at the maid’s tall stature and brawny
arms, but departed without suspecting that they had been so near
the hero whom they sought.
Having thus cleverly escaped, Helgi joined Sinfiotli; they
collected an army, and marched openly against the Hundings, with
whom they fought a great battle, during which the Valkyrs hovered
overhead, waiting to convey the slain to Valhalla. Gudrun, one of the
battle maidens, was so charmed by the courage which Helgi
displayed, that she openly sought him and promised to be his wife.
Only one of the Hunding race, Dag, remained alive, and he was
allowed to go free after promising never to try to avenge his
kinsmen’s death. This promise was not kept, however, for Dag,
having borrowed Odin’s spear Gungnir, treacherously made use of it
to slay Helgi. Gudrun, now his wife, wept many tears at his death,
and solemnly cursed his murderer; then, hearing from one of her
maids that her slain husband kept calling for her in the depths of his
tomb, she fearlessly entered the mound at night and tenderly
inquired why he called and why his wounds kept on bleeding even
after death. Helgi answered that he could not rest happy because of
her grief, and declared that for every tear she shed a drop of his
blood must flow.

“Thou weepest, gold-adorned!

Cruel tears,
Sun-bright daughter of the south!
Ere to sleep thou goest;
Each one falls bloody
On the prince’s breast,
Wet, cold, and piercing,
With sorrow big.”
Sæmund’s Edda (Thorpe’s tr.).

To still her beloved husband’s sufferings, Gudrun then ceased to

weep, but her spirit soon joined his, which had ridden over Bifröst
and entered Valhalla, where Odin made him leader of the Einheriar.
Here Gudrun, a Valkyr once more, continued to wait upon him,
darting down to earth at Odin’s command to seek new recruits for
the army which her lord was to lead into battle when Ragnarok, the
twilight of the gods, should come.
 Death of Sinfiotli, Sigmund’s eldest son, also came to an
Sinfiotli. early death; for, having quarreled with and slain
Borghild’s brother, she determined to poison him. Twice Sinfiotli
detected the attempt and told his father there was poison in his cup.
Twice Sigmund, whom no venom could injure, drained the bowl; but
when Borghild made a third and last attempt, he bade Sinfiotli let
the wine flow through his beard. Mistaking the meaning of his
father’s words, Sinfiotli immediately drained the cup and fell to the
ground lifeless, for the poison was of the most deadly kind.

“He drank as he spake the words, and forthwith the venom ran
In a chill flood over his heart, and down fell the mighty man
With never an uttered death-word and never a death-changed look,
And the floor of the hall of the Volsungs beneath his falling shook.
Then up rose the elder of days with a great and bitter cry,
And lifted the head of the fallen; and none durst come anigh
To hearken the words of his sorrow, if any words he said
But such as the Father of all men might speak over Balder dead.
And again, as before the death-stroke, waxed the hall of the
Volsungs dim,
And once more he seemed in the forest, where he spake with
naught but him.”

Speechless with grief, Sigmund tenderly raised his son’s body in

his arms, and strode out of the hall and down to the shore, where
he deposited his precious burden in the skiff of an old one-eyed
boatman who came at his call. But when he would fain have stepped
aboard also, the boatman pushed off and was soon lost to sight. The
bereaved father then slowly wended his way home again, knowing
that Odin himself had come to claim the young hero and had rowed
away with him “out into the west.”
Sigmund repudiated Borghild in punishment for this crime, and
Hiordis. when he was very old indeed he sued for the hand of
Hiordis, a fair young princess, daughter of Eglimi, King
of the Islands. Although this young maiden had many suitors,
among others King Lygni of Hunding’s race, she gladly accepted
Sigmund and became his wife. Lygni, the discarded suitor, was so
angry at this decision, that he immediately collected an army and
marched against his successful rival, who, overpowered by superior
numbers, fought with the courage of despair.
Hidden in a neighboring thicket, Hiordis and her maid anxiously
watched the battle, saw Sigmund pile the dead around him and
triumph over every foe, until at last a tall, one-eyed warrior suddenly
appeared, broke his matchless sword, and vanished, leaving him
defenseless amid the foe, who soon cut him down.

“But, lo! through the hedge of the war-shafts, a mighty man there
came,
One-eyed and seeming ancient, but his visage shone like flame:
Gleaming gray was his kirtle, and his hood was cloudy blue;
And he bore a mighty twi-bill, as he waded the fight-sheaves
through,
And stood face to face with Sigmund, and upheaved the bill to
smite.
Once more round the head of the Volsung fierce glittered the
Branstock’s light,
The sword that came from Odin: and Sigmund’s cry once more
Rang out to the very heavens above the din of war.
Then clashed the meeting edges with Sigmund’s latest stroke,
And in shivering shards fell earthward that fear of worldly folk.
But changed were the eyes of Sigmund, the war-wrath left his face;
For that gray-clad, mighty Helper was gone, and in his place
Drave on the unbroken spear-wood ’gainst the Volsung’s empty
hands:
And there they smote down Sigmund, the wonder of all lands,
On the foemen, on the death-heap his deeds had piled that day.”
 All the Volsung race and army had already succumbed, so Lygni
immediately left the battlefield to hasten on and take possession of
the kingdom and palace, where he fully expected to find the fair
Hiordis and force her to become his wife. As soon as he had gone,
however, the beautiful young queen crept out of her hiding place in
the thicket, ran to the dying Sigmund, caught him to her breast in a
last passionate embrace, and tearfully listened to his dying words.
He then bade her gather up the fragments of his sword, carefully
treasure them, and give them to the son whom he foretold would
soon be born, and who was destined to avenge his death and be far
greater than he.

“‘I have wrought for the Volsungs truly, and yet have I known full well
That a better one than I am shall bear the tale to tell:
And for him shall these shards be smithied; and he shall be my son,
To remember what I have forgotten and to do what I left undone.’”

While Hiordis was mourning over Sigmund’s lifeless body, her

Elf, the
watching handmaiden warned her of the approach of
viking. a party of vikings. Retreating into the thicket once
more, Hiordis exchanged garments with her; then,
bidding her walk first and personate the queen, they went to meet
the viking Elf (Helfrat or Helferich), and so excited his admiration for
Sigmund that he buried him with all pomp, and promised them a
safe asylum in his house.
As he had doubted their relative positions from the very first
moment, he soon resorted to a seemingly idle question to ascertain
their real rank. The pretended queen, when asked how she knew the
hour had come for rising when the winter days were short and there
was no light to announce the coming of morn, replied that, as she
was in the habit of drinking milk ere she fed the cows, she always
awoke thirsty. But when the same question was put to the real
Hiordis, she answered that she knew it was morning because the
golden ring her father had given her grew cold on her hand.
 Elf, having thus discovered the true state of affairs, offered
Sigurd.
marriage to the pretended handmaiden, Hiordis,
promising to foster her child by Sigmund—a promise
which he nobly kept. The child was sprinkled with water by his hand
—a ceremony which our pagan ancestors scrupulously performed—
received from him the name of Sigurd, and grew up in the palace.
There he was treated as the king’s own son, receiving his education
from Regin, the wisest of men, who knew all things and was even
aware of his own fate, which was to fall by a youth’s hand.

“Again in the house of the Helper there dwelt a certain man,

Beardless and low of stature, of visage pinched and wan:
So exceeding old was Regin, that no son of man could tell
In what year of the days passed over he came to that land to dwell:
But the youth of king Elf had he fostered, and the Helper’s youth
thereto,
Yea, and his father’s father’s: the lore of all men he knew,
And was deft in every cunning, save the dealings of the sword:
So sweet was his tongue-speech fashioned, that men trowed his
every word;
His hand with the harp-strings blended was the mingler of delight
With the latter days of sorrow; all tales he told aright;
The Master of the Masters in the smithying craft was he;
And he dealt with the wind and the weather and the stilling of the
sea;
Nor might any learn him leech-craft, for before that race was made,
And that man-folk’s generation, all their life-days had he weighed.”

Under this tutor young Sigurd grew up to great wisdom. He

mastered the smith craft, and the art of carving all manner of runes,
learned languages, music, and eloquence, and, last but not least,
became a doughty warrior whom none could subdue. By Regin’s
advice, Sigurd, having reached manhood, asked the king for a war
horse—a request which was immediately granted, for he was bidden
hasten to Gripir, the stud-keeper, and choose from his flock the steed
he liked best.
On his way to the meadow where the horses were at pasture,
Sigurd encountered a one-eyed stranger, clad in gray and blue, who
bade him drive the horses into the river and select the one which
could breast the foaming tide most successfully.
Sigurd, acting according to this advice, noticed that one horse,
after crossing, raced around the meadow on the opposite side; then,
plunging back into the river, he returned to his former pasture
without showing any signs of fatigue. The young hero selected this
horse, therefore, calling him Grane or Greyfell. This steed was a
descendant of Odin’s eight-footed horse Sleipnir, and, besides being
unusually strong and indefatigable, was as fearless as his master. A
short time after this, while Regin and his pupil were sitting over the
fire, the former struck his harp, and, after the manner of the
Northern scalds, sang or recited the following tale, which was the
story of his life:
Hreidmar, king of the dwarf folk, was the father of three sons.
The treasure Fafnir, the eldest, was gifted with a fearless soul and a
of the dwarf powerful hand; Otter, the second, with snare and net,
king.
and the power of changing form at will; and Regin,
the third, could, as we have already seen, command all knowledge
and skillfully ply the trade of a smith. To please the avaricious old
Hreidmar, this youngest son fashioned for him a house which was all
lined with glittering gold and flashing gems, and guarded by Fafnir,
whose fierce glances and Ægis helmet none dared encounter.
Now it came to pass that Odin, Hoenir, and Loki once came
down upon earth in human guise for one of their wonted expeditions
to test the hearts of men, and soon reached the land where
Hreidmar dwelt.
“And the three were the heart-wise Odin, the Father of the Slain,
And Loki, the World’s Begrudger, who maketh all labor vain,
And Hönir, the Utter-Blameless, who wrought the hope of man,
And his heart and inmost yearnings, when first the work began;—
The God that was aforetime, and hereafter yet shall be
When the new light yet undreamed of shall shine o’er earth and
sea.”

These gods had not wandered very far before Loki perceived an
otter basking in the sun. Animated by his usual spirit of destruction,
he slew the unoffending beast—which, as it happened, was the
dwarf king’s second son, Otter—and flung its lifeless body over his
shoulders, thinking it would furnish a good dish when meal time
came.
Following his companions, Loki came at last to Hreidmar’s house,
entered with them, and flung his burden down upon the floor. The
moment the dwarf king’s glance fell upon it he flew into a towering
rage, and before the gods could help themselves they were bound
by his order, and heard him declare that they should never recover
their liberty unless they could satisfy his thirst for gold by giving him
enough of that precious substance to cover the otterskin inside and
out.

“‘Now hearken the doom I shall speak! Ye stranger-folk shall be free

When ye give me the Flame of the Waters, the gathered Gold of the
Sea,
That Andvari hideth rejoicing in the wan realm pale as the grave;
And the Master of Sleight shall fetch it, and the hand that never
gave,
And the heart that begrudgeth forever, shall gather and give and
rue.
Lo, this is the doom of the wise, and no doom shall be spoken
anew.’”
 As this otterskin had the property of stretching itself out to a
fabulous size, no ordinary treasure could suffice to cover it. The gods
therefore bade Loki, who was liberated to procure the ransom,
hasten off to the waterfall where the dwarf Andvari dwelt, and
secure the treasure he had amassed by magical means.

“There is a desert of dread in the uttermost part of the world,

Where over a wall of mountains is a mighty water hurled,
Whose hidden head none knoweth, nor where it meeteth the sea;
And that force is the Force of Andvari, and an Elf of the dark is he.
In the cloud and the desert he dwelleth amid that land alone;
And his work is the storing of treasure within his house of stone.”

In spite of diligent search, however, Loki could not find the

dwarf; but perceiving a salmon sporting in the foaming waters, he
shrewdly concluded the dwarf must have assumed this shape, and
borrowing Ran’s net he soon had the fish in his power. As he had
suspected, it was Andvari, who, in exchange for liberty, reluctantly
brought forth his mighty treasure and surrendered it all, including
the Helmet of Dread and a hauberk of gold, reserving only the ring
he wore, which was gifted with miraculous powers, and, like a
magnet, helped him to collect the precious ore. But the greedy Loki,
catching sight of it, wrenched it away from him and departed
laughing, while the dwarf hurled angry curses after him, declaring
that the ring would ever prove its possessor’s bane and would cause
the death of many.
 “That gold
Which the dwarf possessed
Shall to two brothers
Be cause of death,
And to eight princes,
Of dissension.
From my wealth no one
Shall good derive.”
Sæmund’s Edda (Thorpe’s tr.).

On arriving at Hreidmar’s hut, Loki found the mighty treasure

none too great, for the skin widened and spread, and he was even
forced to give the ring Andvaranaut (Andvari’s loom) to purchase his
and his companions’ release. The gold thus obtained soon became a
curse, as Andvari had predicted, for Fafnir and Regin both coveted a
share. As for Hreidmar, he gloated over his treasure night and day,
and Fafnir the invincible, seeing that he could not obtain it
otherwise, slew his own father, donned the Helmet of Dread and the
hauberk of gold, grasped the sword Hrotti, and when Regin came to
claim a part drove him scornfully out into the world, where he bade
him earn his own living.
Thus exiled, Regin took refuge among men, to whom he taught
the arts of sowing and reaping. He showed them how to work
metals, sail the seas, tame horses, yoke beasts of burden, build
houses, spin, weave, and sew—in short, all the industries of civilized
life, which had hitherto been unknown. Years elapsed, and Regin
patiently bided his time, hoping that some day he would find a hero
strong enough to avenge his wrongs upon Fafnir, whom years of
gloating over his treasure had changed into a horrible dragon, the
terror of Gnîtaheid (Glittering Heath), where he had taken up his
abode.
His story finished, Regin suddenly turned to the attentive Sigurd,
told him he knew that he could slay the dragon if he wished, and
 inquired whether he were ready to help his old tutor avenge his
wrongs.

“And he spake: ‘Hast thou hearkened, Sigurd? Wilt thou help a man
that is old
To avenge him for his father? Wilt thou win that treasure of gold
And be more than the kings of the earth? Wilt thou rid the earth of a
wrong
And heal the woe and the sorrow my heart hath endured o’er long?’”

Sigurd immediately assented, declaring, however, that the curse

Sigurd’s
must be assumed by Regin, for he would have none
sword. of it; and, in order to be well prepared for the coming
fight, he asked his master to forge him a sword which
no blow could break. Twice Regin fashioned a marvelous weapon,
but twice Sigurd broke it to pieces on the anvil. Then, declaring that
he must have a sword which would not fail him in time of need, he
begged the broken fragments of Sigmund’s weapon from his mother
Hiordis, and either forged himself or made Regin forge a matchless
blade, whose temper was such that it neatly severed some wool
floating gently down the stream, and divided the great anvil in two
without being even dinted.
After paying a farewell visit to Gripir, who, knowing the future,
foretold every event in his coming career, Sigurd took leave of his
mother, and accompanied by Regin set sail from his native land,
promising to slay the dragon as soon as he had fulfilled his first duty,
which was to avenge his father Sigmund’s death.
 “‘First wilt thou, prince,
Avenge thy father,
And for the wrongs of Eglymi
Wilt retaliate.
Thou wilt the cruel,
The sons of Hunding,
Boldly lay low:
Thou wilt have victory.’”
Lay of Sigurd Fafnicide (Thorpe’s tr.).

On his way to the Volsung land Sigurd saw a man walking on the
waters, and took him on board, little suspecting that this individual,
who said his name was Feng or Fiöllnir, was Odin or Hnikar, the wave
stiller. He therefore conversed freely with the stranger, who promised
him favorable winds, and learned from him how to distinguish
auspicious from unauspicious omens.
After slaying Lygni and cutting the bloody eagle on his foes,
The fight Sigurd left his reconquered kingdom and went with
with the Regin to slay Fafnir. A long ride through the
dragon.
mountains, which rose higher and higher before him,
brought him at last to his goal, where a one-eyed stranger bade him
dig trenches in the middle of the track along which the dragon daily
rolled his slimy length to go down to the river and quench his thirst.
He then bade Sigurd cower in one of those holes, and there wait
until the monster passed over him, when he could drive his trusty
weapon straight into its heart.
 SIGURD AND THE DRAGON.—K. Dielitz.

Sigurd gratefully followed this advice, and as the monster’s

loathsome, slimy folds rolled overhead he thrust his sword under its
left breast, and, deluged with blood, sprang out of the trench as the
dragon rolled aside in the throes of death.

“Then all sank into silence, and the son of Sigmund stood
On the torn and furrowed desert by the pool of Fafnir’s blood,
And the serpent lay before him, dead, chilly, dull, and gray;
And over the Glittering Heath fair shone the sun and the day,
And a light wind followed the sun and breathed o’er the fateful
place,
As fresh as it furrows the sea plain, or bows the acres’ face.”

Regin, who had prudently remained at a distance until all danger

was over, seeing his foe was slain, now came up to Sigurd; and
fearing lest the strong young conqueror should glory in his deed and
claim a reward, he began to accuse him of having murdered his kin,
and declared that instead of requiring life for life, as was his right
according to Northern law, he would consider it sufficient atonement
if Sigurd would cut out the monster’s heart and roast it for him on a
spit.

“Then Regin spake to Sigurd: ‘Of this slaying wilt thou be free?
Then gather thou fire together and roast the heart for me,
That I may eat it and live, and be thy master and more;
For therein was might and wisdom, and the grudged and hoarded
lore:—
Or else depart on thy ways afraid from the Glittering Heath.’”
 Sigurd, knowing that a true warrior never refused satisfaction of
some kind to the kindred of the slain, immediately prepared to act as
cook, while Regin dozed until the meat was ready. Feeling of the
heart to ascertain whether it were tender, Sigurd burned his fingers
so severely that he instinctively thrust them into his mouth to allay
the smart. No sooner had Fafnir’s blood touched his lips than he
discovered, to his utter surprise, that he could understand the songs
of the birds, which were already gathering around the carrion.
Listening to them attentively, he found they were advising him to
slay Regin, appropriate the gold, eat the heart and drink the blood of
the dragon; and as this advice entirely coincided with his own
wishes, he lost no time in executing it. A small portion of Fafnir’s
heart was reserved for future consumption, ere he wandered off in
search of the mighty hoard. Then, after donning the Helmet of
Dread, the hauberk of gold, and the ring Andvaranaut, and loading
Greyfell with as much ruddy gold as he could carry, Sigurd sprang on
his horse, listening eagerly to the birds’ songs to know what he had
best undertake next.
Soon he heard them sing of a warrior maiden fast asleep on a
The sleeping mountain and all surrounded by a glittering barrier of
warrior flames; through which only the bravest of men could
maiden.
pass in order to arouse her.

“On the fell I know

A warrior maid to sleep;
Over her waves
The linden’s bane:
Ygg whilom stuck
A sleep-thorn in the robe
Of the maid who
Would heroes choose.”
Lay of Fafnir (Thorpe’s tr.).
 After riding for a long while through trackless regions, Sigurd at
last came to the Hindarfiall in Frankland, a tall mountain whose
cloud-wreathed summit seemed circled by fiery flames.

“Long Sigurd rideth the waste, when, lo! on a morning of day,

From out of the tangled crag walls, amidst the cloudland gray,
Comes up a mighty mountain, and it is as though there burns
A torch amidst of its cloud wreath; so thither Sigurd turns,
For he deems indeed from its topmost to look on the best of the
earth;
And Greyfell neigheth beneath him, and his heart is full of mirth.”

Riding straight up this mountain, he saw the light grow more

and more vivid, and soon a barrier of lurid flames stood before him;
but although the fire crackled and roared, it could not daunt our
hero, who plunged bravely into its very midst.
“Now Sigurd turns in his saddle, and the hilt of the Wrath he shifts,
And draws a girth the tighter; then the gathered reins he lifts,
And crieth aloud to Greyfell, and rides at the wildfire’s heart;
But the white wall wavers before him and the flame-flood rusheth
apart,
And high o’er his head it riseth, and wide and wild its roar
As it beareth the mighty tidings to the very heavenly floor:
But he rideth through its roaring as the warrior rides the rye,
When it bows with the wind of the summer and the hid spears draw
anigh;
The white flame licks his raiment and sweeps through Greyfell’s
mane,
And bathes both hands of Sigurd and the hilt of Fafnir’s bane,
And winds about his war-helm and mingles with his hair,
But naught his raiment dusketh or dims his glittering gear;
Then it fails and fades and darkens till all seems left behind,
And dawn and the blaze is swallowed in mid-mirk stark and blind.”

No sooner had Sigurd thus fearlessly sprung into the very heart
of the flames than the fire flickered and died out, leaving nothing
but a broad circle of white ashes, through which he rode until he
came to a great castle, with shield-hung walls, in which he
penetrated unchallenged, for the gates were wide open and no
warders or men at arms were to be seen. Proceeding cautiously, for
he feared some snare, Sigurd at last came to the center of the
inclosure, where he saw a recumbent form all cased in armor. To
remove the helmet was but a moment’s work, but Sigurd started
back in surprise when he beheld, instead of a warrior, the sleeping
face of a most beautiful woman.
All his efforts to awaken her were quite vain, however, until he
had cut the armor off her body, and she lay before him in pure-white
linen garments, her long golden hair rippling and waving around her.
As the last fastening of her armor gave way, she opened wide her
beautiful eyes, gazed in rapture upon the rising sun, and after