Sometimes bad news conceals good news. A few years ago, the journal Child Abuse & Neglect published a summary of evaluations of home visitation programs (programs that offer new or expectant parents educational and other supports from home visitors). And the news was bad – at least as far their effectiveness in the prevention of child maltreatment was concerned.

Only one of 12 rigorous evaluations found any improvement. One program actually appeared to put children at greater risk.

Do such disappointing findings mean that those seeking to reduce abuse and neglect should pull the plug on home visitation programs altogether? Not according to a more recent article in Child Abuse & Neglect. Although the evaluations suggest that home visitation is not for everyone, it might be quite effective for certain types of families.

Kimberly DuMont, a researcher for the state of New York and colleagues at the University of Albany in New York examined data collected from 1,173 families considered to be at risk for child abuse or neglect. Half were chosen by lottery to participate in Healthy Families New York, the other half were referred to other programs that did not involve home visits. The researchers followed all of the families’ progress over two years.

They found that the program was particularly helpful to teen mothers having their first children who entered the program when they were still pregnant (specifically no more than 30 weeks pregnant), and to women who tended to be depressed and to have “limited intellectual functioning”.

Overall, parents who received the home visits reported seriously abusing their children less frequently than those who did not receive visits. The effects of the program, however, appeared more pronounced for the teen parent subgroup. This group reported less frequent minor aggression and harsh parenting than their counterparts in the group that was not visited.

Because minor abuse likely precedes serious abuse, this finding could mean that the visits are helping teen parents to stay on the right path. It also appears to have been of particular help to psychologically vulnerable women who were less likely to seriously abuse or neglect their children when they received regular home visits.

DuMont and company urge policymakers to take a second look at home visiting programs. Rather than writing them off following disappointing evaluations, they suggest governments should consider offering this type of program to the families who are most likely to benefit from them.

As to the value of self-reporting, the researchers explain:

“Participants were interviewed in their homes shortly after the birth of their children, at the time of the target children's first and second birthdays, and, for a subsample, again at age three… At each follow-up we also extracted data from an automated database maintained by Office of Children and Family Services (OCFS) that tracks child abuse and neglect reports and determinations.

"Self-reports … have the benefit of capturing behaviors that may never come to the attention of CPS, but parents may under-report undesirable behaviors like abuse. On the other hand, although the incidents of child abuse and neglect that are substantiated by child protection services (CPS) are likely to have actually occurred, most … are never reported and only a small proportion of those are substantiated."

• Summary of “Healthy Families New York (HFNY) randomized trial: Effects on early child abuse and neglect” by Kimberly DuMont, Susan Mitchell-Herzfeld, Rose Greene, Eunju Lee, Ann Lowenfels, Monica Rodriguez, Vajeera Dorabawila in Child Abuse & Neglect, March 2008, Volume 32, Issue 3, pp 295-315.