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Prevention and Social Norms

(Originally published January 2019)

Discussions of prevention of child abuse and neglect among scholars and advocates usually focus on evidenced-based programs which, if taken to scale, could potentially reduce one or more types of child maltreatment by a large percentage. Prevention initiatives are viewed as

dependent on programs that involve outreach and service delivery to at risk populations, e.g., low income families and children, or to high risk groups such as substance abusers, mentally ill parents, victims of domestic violence or homeless families.

“Evidenced based” is a misused and overused term applied to programs that have been tested and found to be significantly more effective than business as usual or another widely used program in randomized controlled trials or quasi-experimental research studies. Many assertions that specific programs are evidenced based are overblown or questionable, but even when these claims have a solid basis, it is far from certain that a program which has achieved impressive results in one or more communities can be implemented statewide with the same results. Strong proponents of evidenced based practice recognize that poor implementation can undermine the efficacy of programs; as a result, implementation science has been emphasized by prevention advocates in recent years.

It is time to consider prevention strategies other than service delivery programs, and to combine services to at risk or high risk populations with these strategies. First and foremost, prevention of just about any unwanted social phenomenon depends on (usually) unwritten explicit and implicit social norms. Programs are far more likely to be effective when their practices and goals are congruent with strong social norms, and ineffective when social norms that support their goals are weak, or “loosely” enforced. For example, the “Me Too” movement reflects powerful social norms condemning sexual harassment, norms that have become much stronger in recent years. However, social norms regarding gun violence and possession of guns are much weaker and much disputed. In these circumstances, programs designed to reduce gun violence are likely to have a limited effect.

What are social norms?

Social norms are rules of acceptable conduct that members of a society, community or organization may not be able to clearly articulate, but which nevertheless influence social behavior. Every culture is replete with social norms which are second nature to members of the culture, but which may seem odd or puzzling to outsiders. Anyone who doubts the power of social norms might try the following experiments: (1) the next time you enter a coffee shop that has a long line, cut in front of others in the line instead of awaiting your turn or, (2) while talking to a stranger at a conference, step within a few inches of this person and make direct unwavering eye contact. In example #2, prepare for a quick end to the conversation, or for an assault or sexual overture.

Violations of social norms make people observing the behavior uncomfortable, and leads to social disapproval at the very least. In her book, Rule makers, Rule Breakers: How Tight and Loose Cultures Wire Our World (2018), Michele Gelfand contrasts “tight” cultures that strictly enforce social norms with “loose” cultures that often pay little attention to rule violations. Germany, she asserts, has a “tight” culture, i.e., little tolerance for deviance, while the U.S. has a relatively “loose” culture in which rule breaking is sometimes ignored, or even celebrated.

Societies, communities and organizations may enforce some social norms strictly, while tolerating violations of other norms. I have worked in organizations which expected employees to show up for work on time, or within a few minutes of when the office opened (or file a leave request), and others in which employees commonly showed up a half hour to two hours late, without comment or question by a supervisor. Public child welfare agencies in this country are far less tolerant of sexual abuse or recurrent physical abuse than of chronic neglect. For many years, I have offered a one day training on child neglect to child welfare staff in Washington State, and other states. During this training, I ask participants the question,”What is the most CPS reports you've ever seen on a family with an open case?” Answers usually begin at 30, 40, 50 or more reports, most of which contain allegations of neglect, often “low level” incidents of neglect. Many families with multiple CPS reports have also been reported for physical abuse or sexual abuse as well; but allegations of neglect are far more common in chronically referring families.

It is not just public child welfare agencies that frequently tolerate extreme cases of chronic neglect. Mandated reporters, courts and child advocates also tolerate chronic neglect and chronic maltreatment, i.e., combinations of neglect with physical and sexual abuse for the same reason, i.e., the inability to find a satisfactory answer to the question, “What would be the consequence of intolerance for chronic neglect?” If the answer is “a large increase in foster care,” the response is often to turn a blind eye to an extremely damaging type of child maltreatment that has a devastating cumulative effect on a child's health and development.

The development of social norms

Social 'norming' is a prevention strategy that has been utilized to discourage excessive use of alcohol among college students. The intervention makes use of information regarding the drinking behavior of peers, or the belief of peers regarding acceptable drinking behavior, to change the willingness of college students to drink to the point of inebriation. Research studies have shown mixed results with this approach to changing social norms around heavy drinking.

Imagine that newly initiated members of a fraternity are required to attend a session of social 'norming' related to alcohol consumption, and are also invited to a party which involves heavy drinking by older members of the fraternity and by co-eds. No amount of information regarding acceptable drinking behavior can overcome the modeling of drunkenness by high status members of the fraternity. An organizational culture cannot be changed by information or motivational talks when behavior that contradicts these verbal or written messages is the order of the day. Social norms are developed gradually through behavior that embodies or implies rules of conduct. Every instance of behavior that conforms to a social norm strengthens the norm; every instance of social behavior that violates a social norm without a negative consequence weakens the norm. Cultural norms develop incrementally through widespread responses to social behavior.

Neglect in its most egregious forms cannot be prevented if public child welfare agencies, mandated reporters and courts are willing to tolerate chronic neglect and chronic maltreatment much of the time. Social norms around neglect cannot crystallize in these circumstances. Programs, no matter how well funded or persistent, cannot be effective when social norms reflect toleration of parenting practices which no one would defend, but many are willing to ignore. I occasionally hear the assertion, “public agencies are not in the prevention business,” due to mission statements and inadequate funding. This widespread belief reflects zero understanding of how the day in day out decision making of child protection staff contributes to social 'norming'. CPS programs have a powerful influence on prevention initiatives through their implicit endorsement of unwritten social rules related to parenting behavior, even when they are unable to fund prevention services or programs.

Indicators of serious intent to prevent child maltreatment

When a society or community becomes serious about preventing some type of child maltreatment, there is widespread support for both initiatives and social norms that seek to eliminate the conditions which support the parenting behavior in question. A few decades ago, secrecy and shaming of victims surrounded child sexual abuse; as a result, child victims were often reluctant to acknowledge that they had been sexually abused. Currently, prevailing social norms regarding child sexual abuse prohibit any sexual contact of children below the age of consent with an adult, period, and communities are willing to prosecute priests and professionals who violate this norm. Substantiated cases of child sexual abuse declined by 65% between 1992 and 2013, according to David Finkelhor and Lisa Jones, two scholars who have written extensively about the decline in child maltreatment that occurred over two decades, arguably due (in part) to zero tolerance for sexual abuse of children.

Social norms regarding physical abuse of children are less clear cut because of the enmeshment of physical discipline of children permitted in state laws with physical abuse. A surprising percentage of parents admit in surveys to using physical discipline with babies and toddlers, a practice that can easily lead to injury of young children. Nevertheless, social attitudes no longer endorse or tolerate harsh physical punishment of children that results in bruises, lacerations, black eyes, etc., except in “outlier” religious groups which believe that parents have a duty to stop a child's oppositional behavior by any means necessary. Some European countries have banned physical discipline, though there has never been much support for such laws in this country. Professional groups such as pediatricians and child psychologists should mount public relation campaigns to discourage spanking, pinching, slapping or otherwise physically punishing babies and toddlers for any reason.

There has also been a surprisingly large decline (more than 50%) in substantiated physical abuse cases since the mid-1990's, though at least two studies during the 2008-09 recession found an increase in the number of children brought to hospital emergency rooms with minor or major inflicted injuries.

Social attitudes regarding child neglect are different than attitudes regarding child sexual abuse or physical abuse. Egregious cases of chronic neglect are often tolerated by public agencies and mandated reporters, and public outrage is muted unless a child dies or is seriously harmed by parental neglect. Concerned citizens who have limited knowledge of children with open CPS cases may be uncertain what the term “neglected child” even means. However, this excuse cannot justify the actions of child welfare caseworkers, supervisors and professionals who work with these children and their parents. Any experienced child welfare professional, therapist or educator has encountered neglected children with severe cognitive delays who are subject to “meltdowns” and have trouble calming down. Severe and chronic child neglect undermines a child's belief in their future, and sometimes their will to live (see Marilynne Robinson's novel, Lila). These children have been emotionally harmed in ways that are not easily reversed.

Any agency, community or society that is serious about preventing neglect must also be serious about eliminating the destitution of families, i.e., families with annual incomes less than half the federal poverty standard. There is no programmatic “work around” for destitution, no parenting program likely to impact parenting behavior in homeless families, or families on the verge of homelessness. The refusal to recognize the folly of funding parenting programs while turning a blind eye to family homelessness and youth homelessness is not due to lack of knowledge or understanding. Rather, it reflects a deep seated denial whose goal is to avoid confronting the consequences of severe poverty; one of those consequences is elevated rates of chronic neglect and chronic maltreatment. Until there is a widely accepted social norm in communities that refuses to accept child homelessness and youth homelessness, there will not be effective prevention programs for chronic neglect.

Between 1992 and 2013, substantiated cases of child neglect declined 13%, and much of this decline was probably due to implementation of differential response (DR) systems in almost half of states. Families assigned to the family assessment track in DR systems are not subject to “findings” of child maltreatment, and in most states that utilize DR a large majority of families assigned to the family assessment track have been reported for alleged child neglect.

Alternatives to foster care

The idea that a serious intent to stop child maltreatment requires coercive foster care placement has done great harm to child protection programs in the U.S. and other English speaking countries. CPS programs should be investing in day nurseries for infants and toddlers in chronically referring families, and in therapeutic child care programs for 3-5 year old children. Investments in residential drug treatment programs and in programs that utilize paraprofessional advocates such as Washington State's Parent Child Assistance Program (PCAP) should be increased. Foster families can sometimes serve as resource families to birth parents rather than alternative caregivers. Foster care may often be necessary when children are in danger due to parenting practices, but not as a routine response to chronic neglect, especially for school age behaviorally troubled children. These alternatives to foster care would be costly if used with large numbers of families, but I doubt that the cost per family would be greater than the average cost of foster care.

Social norms reflect social attitudes and beliefs

Social norms are the concrete practical application of widely held social values, attitudes and beliefs. Knowledge, or claims to knowledge, affects the development of social norms, but so do a society's values, cultural traditions and aspirations. Social norms develop gradually and may be highly resistant to change, especially when they support the deeply held values of a community or society. Nevertheless, well funded and persistent public information campaigns have the potential to change social norms around parenting, especially if these campaigns contain a consistent straightforward message from experts. However, no public information campaign can easily overcome the tolerance of child protection programs for some types of child maltreatment, or the denial of policymakers regarding conditions that foster child abuse and neglect. Advocates and scholars can only “chip away” at denial with research findings and stories regarding maltreated children, a frustrating process when children's lives are at stake.

References

Finkelhor, D. & Jones, L., “Have Sexual Abuse and Physical Abuse Declined Since the 1990's?”, Crimes Against Children Research Center, University of New Hampshire, November, 2012.

Gelfand, M., Rule Makers, Rule Breakers: How Tight and Loose Cultures Wire Our World, Scribner, 2018.

Robinson, M., I, Farrar, Straus & Giroux, 2014.

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