U.S. Department of Justice

Office of Justice Programs

Office of Juvenile Justice and Delinquency Prevention

John J. Wilson, Acting Administrator November 2000

The NurturingParenting Programs

Stephen J. Bavolek, Ph.D.

The Office of Juvenile Justice and Delin-quency Prevention (OJJDP) is dedicated topreventing and reversing trends of increaseddelinquency and violence among adoles-cents. These trends have alarmed the publicduring the past decade and challenged thejuvenile justice system. It is widely acceptedthat increases in delinquency and violenceover the past decade are rooted in a num-ber of interrelated social problems—childabuse and neglect, alcohol and drug abuse,youth conflict and aggression, and earlysexual involvement—that may originatewithin the family structure. The focus ofOJJDP’s Family Strengthening Series is toprovide assistance to ongoing efforts acrossthe country to strengthen the family unit bydiscussing the effectiveness of family inter-vention programs and providing resourcesto families and communities.

Child abuse and neglect are tragic reali-ties within millions of families world-wide. Each day children are abandoned,neglected, beaten, tortured, mutilated,sexually molested, starved, and terror-ized. Sadly, violence toward childrenis not a new phenomenon; it is deeplyrooted in cultural and religious values.Reasons offered throughout the centu-ries to justify child maltreatment in-clude eliminating children with disabil-ities, expelling evil spirits, pleasingcertain gods, maintaining discipline at

home, and transmitting educational con-cepts (Radbill, 1974). Although the firstthree practices may still occur in re-mote regions of the world, contempo-rary social scientists agree that the con-tinued maltreatment of children todayis primarily the result of poorly trainedadults who, in their roles as parents andcaretakers, attempt to instill disciplineand educate children within the contextof the violence they themselves experi-enced as children. Thus, professionalparent educators consider the genera-tional cycle of violence to be the leadingcause of child abuse and neglect.

The Need for EffectiveInterventionIn 1979, the National Institute of MentalHealth funded a 2-year national project todevelop and research a family-centeredparenting program to help curb the seri-ous and growing problems of child abuseand neglect. The result was a group- andhome-based intervention effort called theNurturing Parenting Programs.

The need to create such an interventionwas based on the following facts:

◆ Reported cases of child abuse andneglect have been increasing steadilynationwide since the inception of man-datory reporting statutes in the late

From the Administrator

Since laws requiring mandatoryreporting of child abuse were enactedin the late 1960’s and early 1970’s,the number of reported cases hasincreased. According to the NationalClearinghouse on Child Abuse andNeglect Information, State childprotective services agencies reportedthat just over 900,000 children wereidentified as victims of substantiatedor indicated abuse and neglect in1998. More than four-fifths (87 per-cent) of all victims were maltreated byone or both parents, with neglect by afemale parent with no other perpetra-tors identified as the most commonmaltreatment pattern (45 percent).

Although many factors contribute tochild abuse and neglect, many socialscientists believe that the leadingcause is the generational cycle ofviolence in which parents rear childrenwithin the context of the violence theyexperienced as children. In 1979, theNational Institute of Mental Healthfunded a 2-year research project thatresulted in the development of theNurturing Parenting Programs, afamily-centered parenting initiativedesigned to address this cycle ofviolence.

This Bulletin describes how parentingpatterns are learned and how theNurturing Parenting Programs help tostop the generational cycle of abuseand neglect by building nurturingparenting skills.

John J. WilsonActing Administrator

Fam

ilyStrengthening Series

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1960’s and early 1970’s. In 1996, theU.S. Department of Health and HumanServices estimated that the number ofchild abuse and neglect reports nearlydoubled between 1986 and 1993, rising98 percent from 1.42 million to 2.81million. In addition, the number ofseriously injured children nearly quad-rupled, increasing from 141,700 in 1986to 565,000 in 1993.

◆ An average of three children die ofchild abuse and neglect each day inthe United States. The number of chil-dren who will die of these causes with-in the average lifespan of the typicalAmerican, 72.5 years, will approximate80,000, the size of many small townsacross the country (National Clearing-house on Child Abuse and Neglect In-formation, 1998).

◆ Abused children exhibit high degreesof antisocial and delinquent behaviorin adolescence and criminal behaviorin adulthood (Bavolek, Kline, andMcLaughlin, 1979). Child abuse hasclearly been shown to be one of theleading causes in the development ofjuvenile delinquency and criminal be-havior in adults (Straus, 1991).

◆ Coupled with the relationship betweenchild abuse and increased delinquencyand criminal behavior are the escalat-ing costs of treatment and incarcera-tion and the overcrowded conditionsof detention centers and jails. Facilitiesto house lawbreakers are in short sup-ply, while the need for such facilitieskeeps increasing.

How ParentingPatterns Are LearnedIt is widely accepted by parent educatorstoday that parenting patterns are learned inchildhood and replicated later in life whenchildren become parents. The experienceschildren have during the process of grow-ing up have a significant impact on the atti-tudes, skills, and childrearing practicesthey will use with their own children. Al-though the concept of intergenerationalreplication of parenting is easy to accept,understanding the issues that affect theexperiences children have while growingup is more complex. Professionals in thehelping fields commonly discuss two typesof childhood experiences:

◆ Positive experiences that build strongcharacter and a sense of self-worth andthat model a nurturing parenting style.

◆ Negative experiences that engulfchildren in parenting models of abuse,neglect, exploitation, and victimization.

Although neither the positive, nurturingexperiences nor the negative, abusive ex-periences are isolated from one another,dominance of one over the other doesmake a difference. That is, the more chil-dren are exposed to a particular parent-ing style and quality of experience, themore they internalize that style and mani-fest it in their subsequent parenting atti-tudes and practices.

Process and ProductIf the primary goal of the helping profes-sions is to help families replace unwantedabusive patterns of behavior with moreacceptable nurturing patterns, then a clearunderstanding of how people change isnecessary. Parenting is both a process anda product. A process is something thathappens, a direct or indirect action takento achieve a goal or an end product. Aproduct is the end result of a direct orindirect action. Examples are:

◆ Sexual intercourse (process) leads topregnancy (product).

◆ Parenting (process) leads to parentingstyle of the child (product).

◆ Intervention (process) leads to change(product).

Any process has two opposite qualities:good/desirable and bad/undesirable. Themost significant process that humans ex-perience after birth is being parented. Par-ents create an environment that producesexperiences that affect the growth of theindividual child. In parenting, processesare either nurturing or abusive. Nurturingparenting processes employ nurturingtouch, empathy, empowerment, and un-conditional love to promote the overallhealth of the child. Conversely, abusiveparenting processes such as hitting, belit-tling, neglecting basic needs, and otheractions that lower an individual’s sense ofself-worth have a negative impact on thehealth of the child.

Abusive and NurturingParenting ContinuumClearly, individuals can parent in only oneof two ways—nurturing or abusive—atany given moment. The frequency andseverity of each type of interaction makea significant difference in whether thechild will learn nurturing parenting styles,abusive parenting styles, or some of both.Figure 1 details the relationship. Thehigher the degree of parental nurturing,the lower the degree of abuse becausethe behaviors are mutually exclusive.That is, hugging exists on the nurturingcontinuum, and hitting exists on the

Figure 1: Inverse Relationship of Nurturing Versus Abusive Parenting

Note: On the “nurturing parenting” axis, “10” represents the absence of abuse; on the“abusive parenting” axis, “10” represents the absence of nurturing.

Nur

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aren

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5

10

105Abusive Parenting

Behavior defined as “nonabusive parenting” in mostinvestigations of child abuse.

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abusive continuum. Praising a child is anurturing parenting practice, and beratinga child is an abusive parenting practice.At each end of the continuum, the com-plete presence of one behavior is thecomplete absence of the other. The goalof child abuse prevention is the completeabsence of abuse in any form, at any time,and to any degree. As shown in figure 1,lesser degrees of physical injury aresometimes not considered reportableabuse because of the minor nature of theinjury. As the severity of the physical inju-ries increases, so does the likelihood thata mandated reporter will view the injuryas child abuse and report the case. Redmarks on the wrist as a result of havinghands taped together (perhaps a 5 on thescale shown in the figure) might get re-ported, whereas second-degree burnson the hands (a 7 or 8 on the scale) wouldsurely elicit a response to report theinjury. As the severity of the abuse in-creases, the level of nurturing decreases.Accepting more severe injuries to chil-dren as normal is one danger of living ina society with escalating rates of violence.

Role of ExperiencesNurturing and abusive parenting patternsare learned through experience. Experi-ences have either a positive or a negativeeffect on the development of the self(see figure 2).

Furthermore, human learning occurs ontwo levels: cognitive (information, facts,and knowledge) and affective (feelings).Experiences not only provide informationand knowledge, but they also provoke feel-ings and influence attitudes (see figure 3).

When experiences are positive or pleas-ant, so is the impact on the self. One isleft with desirable information, percep-tions, and memories of the experienceand with desirable feelings of comfort andpleasure. The experiences contribute tothe overall health and personal develop-ment of the individual. A lifetime of posi-tive experiences clearly can have a lastingpositive effect on an individual’s thoughtsand feelings.

The same theory and outcome holds truewith undesirable experiences. The detri-mental impact of such experiences can alsolast a lifetime. Whether positive or negative,the quality of a person’s experiences can beobserved in his or her behavior. As figure 4illustrates, what one experiences gives riseto how one behaves, which in turn givesrise to new experiences. If abuse is domi-nant in the life experiences of a developingchild, the elements of abusive parenting canbecome entrenched in the child’s personal-ity, thoughts, perceptions, memories, feel-ings, and behaviors.

Behavior and Self-ImageIn general, self-image consists ofthoughts about oneself (self-concept)and feelings about oneself (self-esteem).How one is treated during the processof growing up (experiences) has a stronginfluence on one’s overall self-image.

The experience of nurturing has beenshown to exert a positive influence onself-image and self-worth. The experience

of child abuse has been shown to have adetrimental impact on self-image, whichin turn gives rise to a feeling of low self-worth. An individual’s sense of self-worthhas been shown to be the best predictorof how he or she will treat others. Thosewho value themselves and treat them-selves with respect predictably displaysimilar behavior toward others. The rela-tionship between self-worth and theworth of others is a critical concept in thetreatment and prevention of child abuseand neglect (Cohn, 1979).

Abusive Parenting andChildrearing PracticesThe prevention of child abuse and neglectis a primary goal in the helping servicefields. Theories and hypotheses havebeen tested, examined, and reexamined inattempts to identify the most efficient andvalid ways for preventing injuries to chil-dren by their parents. Of all primary pre-vention strategies tested, parenting edu-cation for adults and adolescents beforethey become parents is often identified asthe strategy most likely to prevent initialinjuries to children. This belief is basedon the theory that children learn abusiveparenting practices from observing theirparents and experiencing abuse duringthe process of growing up. Learned pat-terns of abusive parenting are transmittedfrom parent to child and are replicated bythe child when he or she becomes a par-ent. Steele and Pollock (1968) and Martin(1976) observed the perpetuation theoryof child abuse and neglect at work in theirclinical cases. Steele, Pollock, and Martinrequired parents charged with child mal-treatment to participate in psychiatricprograms to remediate their “abusive”personality traits. Clinicians found that

Figure 2: Impact of Experienceon the Self

Figure 3: Effects of Experienceon Cognitive andAffective Development

Figure 4: Relationship of Experience to Behavior

+ +Experience Self

– –

+Cognitive

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+Experience Self

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+Affective

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+Experience

–

+Cognitive

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Self+

Behavior–

+Affective

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abusive parents commonly referred totheir own histories of childhood abuse.Similar clinical findings reported subse-quently by other professionals across thecountry have added increased support tothe perpetuation theory of abuse.

Until the mid-1970’s, however, the per-petuation theory of abuse lacked support-ing empirical data. From an empiricalperspective, the question still remained:What percentage of abused children be-come abusive parents as a result of theirearly childhood maltreatment?

A major stumbling block in compiling em-pirical data to support the theory was thelack of a specific behavioral definition ofparental abuse and neglect. Put in behav-ioral terms: What do abusive parents dothat nonabusive parents do not do? Theanswer to this question is critical to devel-oping effective programs and strategiesto assess, treat, and prevent abusiveparenting practices. To identify and catego-rize the known behaviors of abusive par-ents, Bavolek and colleagues (1979) re-viewed articles, books, and media programsand interviewed professionals known fortheir expertise in treating child abuse andneglect. The analysis of the information gar-nered from these sources distinguishedfour patterns (constructs) of abusive andnegligent parenting. These constructs arediscussed in the following sections.

Inappropriate ParentalExpectations of the ChildMany abusive parents have unrealisticexpectations of their children’s develop-mental skill level. Steele and Pollock(1968) found that parents in their studygroup expected and demanded their in-fants and children to behave in a mannerthat was developmentally inappropriatefor their ages. Such parents expect morefrom their children than is reasonable fortheir developmental states. For example,they might expect an infant to be toilettrained by age 6 to 12 months, a toddlerto be able to talk before the age of 2, andyoung children to help with houseworkand food preparation or to care for them-selves or younger siblings in the absenceof adult supervision.

Inappropriate expectations stem fromabusive parents’ own inadequate percep-tions of self and from a lack of knowledgeabout the capabilities and needs of chil-dren at each developmental stage. Theeffect of inappropriate parental expecta-tions on children can best be character-ized as a stressful environment that

negatively impacts the children’s self-worth (Greven, 1990). Martin (1976) sug-gests that when children are unable tomeet these expectations, biologically orcognitively, they perceive themselves asfailures who are worthless, unacceptable,and disappointing to adults. Perry (1997)notes that a lack of critical emotional ex-periences and persisting traumatic stressleads to a dramatic alteration in thebrain’s modulation and regulation capac-ity. This change is characterized by anoverdevelopment of brain stem and mid-brain neurophysiology and functions (i.e.,anxiety, impulsivity, poor affect regula-tion, and motor hyperactivity) and an un-derdevelopment of limbic and corticalneurophysiology and functions (i.e., em-pathy and problem-solving skills).

Lack of Empathy TowardChildren’s NeedsA second common trait of abusive par-ents is the inability to be empathicallyaware of their children’s needs and to re-spond to those needs in an appropriatefashion (Steele, 1975). According toGoleman (1995), empathy builds on self-awareness; the more open individuals areto their own emotions, the more skilledthey will be in reading feelings.

Empathic awareness of a child’s needsentails a parent’s ability to understandthe condition or state of mind of the childwithout actually being able to experiencethe child’s feelings. To empathize as aparent is to participate in the child’sfeelings and ideas (Rowen, 1975). Stern(1987) refers to the process of recogniz-ing, accepting, and reciprocating a child’semotions as “attunement,” which he con-tends is critical for a healthy, nonabusiveparent-child bond. Abusive parents oftenignore their children because they do notwant to “spoil” them, with the result thatthe child’s basic needs are left unatten-ded (Steele, 1975). They place a high pre-mium on the child being “good,” acting“right,” and learning to be obedient. How-ever, what constitutes good and rightbehavior is seldom clarified. At the ex-treme end of the scale, these parents areviolent, cruel, and physically or psycho-logically abusive under the guise of teach-ing, helping, and controlling.

The effect of inadequate empathic paren-tal care during the early years of life isprofound and enduring (Steele, 1975).Children who are ignored and whose ba-sic needs are neglected often fail to de-velop a basic sense of trust in themselves

and in others (Martin, 1976). Childrenwho live in a world of parental neglect,where they are not permitted to makedemands on the parents who place highvalue on obedience and acting right, havelittle or no basis for learning respect forrules and for distinguishing right fromwrong. When children are taught to obeyorders, they do what they are told to dobecause they are told to do it rather thanbecause the behavior has intrinsic value.Such children often fail to develop confi-dence in themselves and in their basicabilities. Acting their age often meanscomplying with the demands of the par-ents rather than testing reality (exploringtheir environment, challenging bound-aries, saying no).

Parental Value of PhysicalPunishmentThe third behavior common among abu-sive parents is a strong belief in the valueof physical punishment. Abusive parentsoften believe babies should not be “givenin to” or allowed to “get away with any-thing.” They believe that their childrenmust periodically be shown “who is boss”and made to respect authority so theywill not become disobedient (Steele,1975). Abusive parents not only considerphysical punishment a proper disciplin-ary measure but also strongly defendtheir right to use physical force.

Physical attacks by abusive parents arenot often haphazard, uncontrolled, impul-sive discharges of aggression toward theirchildren. To the contrary, studies appearto indicate that abusive parents usephysical punishment as a unit of behaviordesigned to punish and correct specificbad conduct or perceived inadequacies.Much of what abusive parents find wrongwith their children reflects the behaviorsfor which they were criticized and pun-ished as children; hence, the punishmentcarries the approval of traditional familyauthority and an aura of righteousness.

The effects of physical abuse on childrenare often demonstrated in their subse-quent behavior. Straus (1991) found thatthe use of corporal punishment led to theprobability of deviance, including delin-quency in adolescence and violent crimeinside and outside the family in adult-hood. In examining the effects of abuseand neglect on the optimal developmentof the critical areas of the brain in youngchildren, Perry (1997) found that abusedand neglected children tend to have 20 to30 percent smaller limbic and cortical

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areas of the brain. These regions of thebrain regulate emotional response andattachment, which in turn lead to the ex-pression of empathy towards others.

In addition, children who see and experi-ence recurrent episodes of serious vio-lence in their own families learn and be-lieve violence is a useful way to solveproblems. On becoming parents, thesechildren tend to punish their own chil-dren more severely. Thus, abused chil-dren often become abusive parents(Straus, 1991).

Parental Role ReversalThe fourth common attribute of abusiveparents is a need to reverse parent-childroles; that is, the children are expected tobe sensitive to the parents’ needs and re-sponsible for much of their happiness(Martin, 1976). Steele (1975) describesthis role reversal as the parent behavingas a helpless, needy child who looks tohis or her own children as though theywere adults who could provide parentalcare and comfort.

Ackley (1977) states that potential abus-ers both seek and shun intimate relation-ships. They may seek intimacy to obtainwhat is missing in their relationship withtheir parents, which leads them to definea close relationship as one in which, simi-lar to a child, they can obtain emotionalsupport and warmth without giving muchin return; and depend on their partners tosolve the problems of living that adultsare called on to solve. Alternately, theymay shun intimacy because their earliestchildhood attempts at intimacy with theirparents were seen as failures. The earlyfailures at achieving intimacy may suggestthat close relationships are dangerous,doomed to produce disappointment, anda threat to self-esteem because peoplecannot be trusted.

According to Ackley, the behavioral out-come of this complex set of feelings isthat potential abusers replicate their ear-lier childhood experiences and marry in-dividuals who are less able than most toprovide emotional support and then ex-pect their children to give them the lovethey have been missing all their lives.They soon learn that the early stages ofparenting involve giving, not taking, and,as a result, experience only more disap-pointment. These parents attempt to ma-nipulate and structure the family interac-tions in an effort to meet their own needs.

They see their children as “inadequate”and, in their frustration, beat, chastise,belittle, or ignore the children.

Although the phenomenon of role reversalis often associated with an inability to beempathically aware of children’s needs,the two behaviors are markedly different.When abusive parents fail to show em-pathic awareness of their children’s needs,the children are often left to care for them-selves. Carried to the extreme, the chil-dren are emotionally or physically ne-glected or abused. They are not, however,expected to assume the role of the “nurtur-ing parent.” In a role-reversal situation,children are an integral part of the familyfunctions, often becoming a source of au-thority, control, and decisionmaking.

The effect of role reversal on abused chil-dren is destructive. Children who assumethe role of responsible parent fail to nego-tiate the age-specific developmentaltasks—forming close relationships withloved ones, developing a sense of trust,developing a separate sense of self—thatmust be mastered if they are to achievenormal development. A child’s failure toperform any one developmental task notonly hampers development in succeedingstages but further reinforces feelings ofinadequacy. Children in a role-reversalsituation exhibit little sense of self andperceive themselves as existing only tomeet the needs of their parents.

Theoretical Assumptionsof the NurturingParenting ProgramsThe foundation of the Nurturing ParentingPrograms is that parenting is learned. Theprograms are based on six assumptions,several of which follow naturally from thefour patterns of abusive behavior de-scribed above.

◆ The family is a system. Involvement ofall members is essential to change thesystem. Parents and children in theNurturing Parenting Programs partici-pate together in group- or home-basedinterventions.

◆ Empathy is the single most desirablequality in nurturing parenting. Empathyis the ability to be aware of the needs ofothers and to value those needs. Whenempathy is high among family members,abuse is low—the two are essentially in-compatible. The Nurturing Parenting Pro-grams seek to develop empathy in allfamily members.

◆ Parenting exists on a continuum. Tosome degree, all families experiencehealthy and unhealthy interactions.Building positive, healthy interactionsbetween family members is an impor-tant key to reducing family violence.

◆ Learning is both cognitive and affec-tive. To be effective, education or

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intervention must engage the learneron both the cognitive (knowledge)level and the affective (feeling) level.

◆ Children who feel good about them-selves are more likely to become nur-turing parents. Children who feel goodabout themselves are more capablethan children with low self-worth ofbeing nurturing sons and daughtersand of becoming nurturing parents. Amajor goal of the Nurturing ParentingPrograms is to help both parents andchildren increase their self-esteem anddevelop positive self-concepts.

◆ No one truly prefers abusive inter-actions. Given a choice, all familieswould rather engage in happy, healthyinteractions than abusive, problematicones such as belittling, hitting, andshaming.

Program ObjectivesThe ultimate objectives of the programsare to:

◆ Stop the intergenerational cycle ofchild abuse in families by building nur-turing parenting skills.

◆ Reduce the rate of recidivism in fami-lies receiving social services.

◆ Reduce the rate of juvenile delin-quency among high-risk youth.

◆ Reduce the rate of alcohol abuse inhigh-risk families.

◆ Lower the rate of multiple pregnanciesamong teenage girls.

To compete with the negative impact ofinappropriate parenting, the followingintermediate objectives form the basis ofthe programs’ activities:

◆ Develop positive self-concept and self-esteem in all family members.

◆ Build an empathic awareness of theneeds of others.

◆ Teach alternatives to hitting andyelling.

◆ Increase family members’ awarenessof their own and each other’s needs,strengths, and weaknesses.

◆ Increase family members’ awarenessof the developmental needs of otherfamily members.

◆ Increase communication and expres-siveness within the family.

◆ Help parents substitute nurturingbehaviors for abusive ones.

◆ Teach family members to promotehealthy physical and emotional devel-opment for themselves and others.

◆ Build family support and cohesion.

◆ Help family members learn to have funtogether.

Program ContentTarget PopulationsThe Nurturing Parenting Programs havebeen field tested with families at risk forabuse and neglect, families identified bylocal social services as abusive or ne-glectful, families in recovery for alcoholand other drug abuse, families at risk fordelinquency, parents incarcerated forcrimes against society, and adults seekingto become adoptive or foster parents. Assuch, a primary use of the NurturingParenting Programs is to treat child andadolescent maltreatment, prevent its re-currence, and build nurturing parentingskills in at-risk populations.

There are 13 separate Nurturing ParentingPrograms currently being implementedacross the United States, Canada, Mexico,Europe, South America, and Israel:

◆ Prenatal Families.

◆ Parents and Children, Birth to 5 Years.

◆ Parents and Children, 5 to 11 Years.

◆ Parents and Adolescents.

◆ Teenage Parents and Their Families.

◆ Foster and Adoptive Parents and TheirChildren.

◆ Parents With Special Learning Needsand Their Children.

◆ Families in Substance Abuse Treatmentand Recovery.

◆ Hmong Parents and Their Adolescents.

◆ African American Families.

◆ Crianza con Cariño Programa ParaPadres y Niños (Hispanic Parents andChildren, Birth to 5 Years).

◆ Crianza con Cariño Programa ParaPadres e Hijos (Hispanic Parents andChildren, 4 to 12 Years).

◆ The ABC’s Parenting Program forParents and Children.

Adaptations for SpecialPopulationsHmong families. The Nurturing ParentingProgram for Hmong Parents and TheirAdolescents was designed in cooperationwith the staff at the Department of SocialServices in Fresno, CA—location of thelargest population of Hmong refugees inthe United States—where delinquencyrates have escalated more than 3,000 per-cent during the past 8 years. BecauseHmong refugee families have had little tono formal support in acculturating fromLaos to the United States and becausemany traditional Southeast Asianparenting practices are inappropriate forAmerican society, frustrated Hmong par-ents have had little control over theirteenage children. Rates of gang member-ship, delinquency, school dropouts, anddrug use continue to increase amongHmong youth (H. Himes, Fresno County,CA, Social Services Department, personalcommunication, 1995). The program usesan instructional parenting video and ahandbook for parents in the Hmong lan-guage, and the program activities taketraditional Hmong values and modifythem to fit Hmong life in American soci-ety. The program is active in Hmong com-munities throughout the United States.

Hispanic families. The Crianza conCariño Nurturing Parenting Programs forHispanic Parents and Children, Birth to 5Years, and Hispanic Parents and Children,4 to 12 Years, were developed and evalu-ated for Spanish-speaking families inArizona, Colorado, Texas, Wisconsin,Mexico, and Venezuela. Agencies servingHispanic families of Mexican, Central andSouth American, and Puerto Rican de-scent participated in the field testing.Program concepts and language werecarefully edited and reviewed by Hispanichuman services professionals to ensurethat the nurturing parenting concepts areculturally sensitive and appropriate andaccurately presented. These programsare now implemented nationwide andthroughout Mexico and Central and SouthAmerica.

African American families. The Nur-turing Parenting Program for AfricanAmerican Families is designed to teachnurturing parenting within the contextof African American history, traditions,practices, and beliefs. The program’s in-formation and activities provide helping

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organizations with a grounded perspec-tive for teaching nurturing parenting skillsto African American parents and children.

Families in treatment and recovery. TheNurturing Parenting Program for Familiesin Substance Abuse Treatment and Recov-ery is a new psychoeducational group-based program that assists parents instrengthening their own recovery, facil-itating recovery within their families, andbuilding a nurturing family lifestyle. Acore goal of this program is to nurtureparents, thereby enhancing their abilityto nurture their children. To enhance therichness of the experiences of nurturingand recovery, the program focuses onparenting as a relationship characterizedby mutuality (building attachments withtheir children), authenticity (being wor-thy of their children’s trust), and empa-thy. Parents develop self-awareness andbuild nurturing skills by using a varietyof techniques and activities that accom-modate different learning styles. Parentsexplore their childhood experiences,their fears and their strengths, and theeffects of substance abuse on them andon their families. They build skills thatstrengthen their recovery, explore theirown development as adults in recovery,and examine similarities and differencesin the development of their children.This program is also useful for partnersof parenting adults in treatment andrecovery and for extended family mem-bers who may be parenting children ofsubstance-abusing adults.

Program FormatsThe frequency and length of NurturingParenting Program sessions vary accord-ing to the type of program. Generally,group-based sessions run from 21/2 to 3hours once a week. Home-based sessionsrun 11/2 hours once a week. The number ofgroup-based sessions varies from 12 (Par-ents and Adolescents) to 23 (Parents andChildren, Birth to 5 Years). Home-basedsessions for Birth to 5 Years programstotal no more than 45. In addition:

◆ Group sessions are held in sites rang-ing from church basements to prisonclassrooms, but conference rooms atState, county, or private nonprofitagencies are the most common sites.

◆ Parents and children meet in separategroups that run concurrently.

◆ A total of 12 to 15 adults attend thegroup programs (single parents or in-tact couples).

◆ Two professionals or paraprofessionalsfacilitate the parent group; at least twostaff (more when necessary) facilitatethe children’s program.

◆ For many families, attending a NurturingParenting Program has been either man-dated by the court or required by socialservices as a stipulation of the family’streatment plan to learn new, nonabusiveparenting skills. Normal (nonabusive)families who are not involved in abuseor neglect but who want to attend Nur-turing Parenting Programs may registervoluntarily. The programs are promotedthrough the media and fliers.

Home-based programs. For the first hourof a 11/2-hour session, the NurturingParenting Program home visitor meetsone-on-one with the parents. Noninfantchildren who do not require close super-vision are free to be present as they wish,but the focus is primarily on the parentsand the home visitor. Each home sessionfollows a consistent format:

◆ Icebreaker and Home PracticeCheck-In (10 minutes). This is a timefor parents to increase their self-awareness, for the home visitor to in-troduce the concept for the session,and for parents to review their suc-cess in completing their home prac-tice exercise.

◆ Parenting Skills and Self-NurturingActivities (45 minutes). Parents and

the home visitor engage in role-playing, discuss new ideas, view vid-eos, and express themselves throughart activities using paints, markers,and clay. The focus of home sessionsalternates between nurturing parentingskills and nurturing self skills.

◆ Home Practice Exercise (5 minutes).Parental activities conclude with the as-signment of a home practice exercise forparents to complete for the next session.

◆ Family Nurturing Time (25 minutes).Parents and children learn new skillsand ways to have fun.

❖ Infant Activities (birth to 15months). These include tellingstories using fingers (“Mr. PointerFinger says ‘Good morning’”), sys-tematic use of infant massage as adaily parent-child interaction, andinteractive play.

❖ Toddler Activities (15 months to3 years). These include finger plays,hand-eye motor coordination skills,large muscle movement, sensorydiscovery, language development,and child massage.

❖ Preschooler Activities (3 to 5years). These include Hello Time,a chance for everyone to talk, sing,and have fun; Big Motor Time, ac-tivities to promote movement andlarge muscle exercise; Circle Time,a time for family members to talkabout a topic (puppets and gamesare used to facilitate learning); andArt Time, a time for family members

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to work together and individuallyon creative projects.

◆ Family Hug (5 minutes). At the end ofeach home visit, the home visitor, par-ents, and children engage in a group hug.

Group-based programs—parent format.Each session follows a consistent format:

◆ Icebreaker and Home Practice Check-In (20 minutes). Parents share theirthoughts and feelings, and the groupfacilitator introduces the concept forthe session. Home practice check-inallows parents the opportunity toshare their successes in trying out newconcepts and skills.

◆ Parenting Skills Activities (40 min-utes). Parenting skills, nurturing rou-tines, and behavior encouragementtechniques are presented throughvideos, discussion, art activities, androle-playing.

◆ Family Nurturing Time (30 minutes).Parents, children, and group facilita-tors engage in activities, includinggames, songs, and infant massage, andenjoy snacks and beverages. Facilita-tors model and teach new skills andsupervise parents in practicing them.

◆ Self-Nurturing Activities (50 min-utes). Parents increase their self-awareness and self-growth and learnways to nurture themselves throughgroup discussion, videos, role-playing,and art activities.

◆ Home Practice Exercise (5 minutes).Parents are given a brief exercise re-lated to the session concept to prac-tice at home before the next session.

◆ Group Hug (5 minutes). Sessions con-clude with a group hug. The intent ofthe hug is to increase group cohesion,offer praise, and experience positivetouch.

Group-based programs—child format.Children participate in Family NurturingTime with their parents and engage inage-appropriate activities for the remain-der of the session.

◆ Infant Activities (2 hours). Duringthe times the parents are in theirgroups, facilitators engage infants inage-appropriate activities, includinginfant stimulation, reading stories,holding, smiling, and talking to theinfants.

◆ Toddler Activities (2 hours). Childrenparticipate in songs, games, and large-muscle motor activities.

◆ Preschooler Activities (2 hours). Chil-dren ages 3 to 5 participate in sched-uled activities that include Hello Time,Big Motor Time, Circle Time, Art Time,and closing Group Hug.

StaffProfessionals in parent education, socialwork, psychology, education, publichealth, and the general helping fields(medicine, mental health, parent aide pro-grams, and home visitor programs) andparaprofessionals in helping fields facili-tate the parent, adolescent, and children’sprograms. Generally, two staff are re-quired to facilitate the parent groups, andtwo or more staff are required to facilitatethe children’s and adolescents’ groups.Professionals who have previously facili-tated groups and taught parenting educa-tion and who subscribe to teaching non-violent, nurturing parenting values andpractices can successfully facilitate theNurturing Parenting Programs.

Session ContentThe Nurturing Parenting Programs teachage-specific parenting skills. The programalso addresses the need to nurture oneself.These two elements are considered equallyimportant. Each program session is dividedinto parenting instruction and self-improve-ment instruction.

Parenting instruction. Program topicsrelated to parenting skills include:

◆ Discipline—philosophy of discipline,alternatives to spanking, rewards andpunishment, family rules, timeout, lossof privilege, restitution, being grounded.

◆ Nurturing—needs and self-esteem; de-veloping empathy; ways to nurtureothers; praise; nurturing routines atmealtime, bath time, bedtime, dressingtime; communicating with your childthrough touch.

◆ Communication—redirecting, ignoring,communicating age-appropriate expec-tations, recognizing and understandingfeelings, “I” statements.

◆ Spoiling children.

◆ Toilet training.

◆ Baby-proofing a home.

◆ Establishing morals, values, and rules.

◆ Relationship between anger, alcohol,and abuse.

Self-nurturing instruction. Programtopics related to self-nurturing includeindividual needs; self-esteem and self-

concept; handling stress and anger; com-municating needs and wants; personalpower; personal space; pregnancy pre-vention; using alcohol and drugs; dating,love, and rejection; sex and sexuallytransmitted diseases; choices and conse-quences; and ways to care for oneself.

All concepts taught in the programare discussed in the context of theparticipant’s personal history (e.g., whatexperience the person has with a conceptsuch as timeout, being hit, or feeling loved).Establishing a personal connection with theconcept reinforces the likelihood that theindividual will integrate it into his or herbehavior, because understanding personalhistory plays an important role in changingold, unwanted, abusive parenting patterns.

Teaching aids. The program uses the fol-lowing teaching aids to engage parentsand children on both cognitive and affec-tive levels:

◆ Training manuals (activities manuals)for parents, children, and adolescents.These manuals are program specificand constitute the curriculum for eachof the 13 Nurturing Parenting Programs.

◆ Parenting handbooks for parents andadolescents. These handbooks arewritten at a fifth-grade reading level.

◆ Implementation manual that describesthe how-to’s of implementing the pro-grams, facilitating groups, gatheringpretest and posttest data, recruitingfamilies, and working with children.

◆ Instructional videos in which actorsdemonstrate examples of abusiveparenting with inappropriate behav-iors such as hitting and yelling. Parents

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discuss the interactions dramatized inthe video and alternatives to the abu-sive behavior.

◆ Games for parents and children thathelp build their nurturing skills andprovide an opportunity for them tointeract and have fun together. Thegames reinforce the concepts that arebeing presented.

◆ Instructional aids that include cardgames, pictures, and questionnaires.

Facilitator Qualificationsand TrainingProfessionals and paraprofessionals withtraining in teaching parents nurturingskills or a professional background in par-ent education are candidates to facilitateNurturing Parenting Program classes.Empathy, positive self-worth, dependabil-ity, and sharing are desirable facilitatorcharacteristics.

Instructor training workshops last from 2to 4 days, depending on the group’s levelof sophistication. Costs also vary, de-pending on whether the workshops aresponsored by the agency (such as achurch, YMCA/YWCA, or Boys & GirlsClub) seeking to implement the Nurtur-ing Parenting Program or whether thetraining is sponsored by the communityand participants register individually. Inthe latter case, registration fees gener-ally average $125 per workshop.

EvaluationMethodsThe initial Nurturing Parenting Programfor Parents and Children 4 to 12 Years andeach subsequent program were exten-sively field tested. The initial study fundedby the National Institute of Mental Healthincluded 121 abusive adults and 150abused children. The average age was 30years for adults and 6 years for children.The program was field tested in five States:Indiana, Minnesota, Ohio, Pennsylvania,and Wisconsin. Ninety-two percent of theparents and 90 percent of the childrenwere Caucasian. The remaining parentsand children were African American (6 per-cent), American Indian (2 percent), andHispanic (1 percent). The initial field trialand all subsequent studies used the bat-tery of inventories and forms describedbelow. Each inventory was administeredbefore the program began (pretest), at theend of the program (posttest), and 12 to 18months after completion of the program.

◆ The Adult Adolescent Parenting In-ventory (AAPI): A norm-referenced,standardized inventory designed toassess the parenting and childrearingattitudes of adults and adolescents.Responses generated from the inven-tory measure the expectations parentshave of their children, empathy towardchildren’s needs, belief in the use ofcorporal punishment, and parent-childrole clarification.

◆ The Children’s Personality Inventory(CPI): An informal parenting inventoryfor young children designed to assessthe same parenting attitudes as de-scribed in the AAPI. The children re-spond to parenting examples with “Iagree,” “I’m not sure,” or “I disagree.”

◆ The 16 Personality Factor (PF): A stan-dardized, norm-referenced personalityinventory measuring the polarities of16 primary personality factors and 4secondary personality factors.

◆ The Children’s Personality Question-naire (CPQ) and the Early School Per -sonality Questionnaire (ESPQ): Inven-tories based on the same 16 primarypersonality factors and 4 secondarypersonality factors measured by the16 PF.

◆ The Family Environment Scale (FES):Inventory designed to assess 10 charac-teristics of family interaction patterns.

◆ The Nurturing Quiz: An informal,criterion-referenced inventory designedto measure knowledge of appropriatebehavior management strategies.

◆ The Family Social History Question-naire: An inventory designed to gatherdemographic data (age, gender, levelof education) and perceptions of child-hood experience. (Questions include:Do you feel you were abused as achild? If yes, what kind of abuse didyou experience?)

◆ Observational Data Collection Forms:Forms used to collect data during lon-gitudinal in-home observations of fam-ily interactions.

◆ Program Evaluation Forms: Forms thatparents complete at the end of eachweekly session, after the completion ofthe entire 15-week treatment program,and 1 year after completion of the pro-gram. Parents are asked to rate thequality of the instruction (1 = low to5 = high), the usefulness of the informa-tion taught, and the likelihood that theywould use the new information.

ResultsProgram participants.1 Of the 121 adultswho participated in the initial study, 95(79 percent) completed the program. Ofthe 150 children who participated, 125 (83percent) completed the program. Train-ers rated 88 (93 percent) of the adultswho completed the program as havingsuccessfully modified their abusive parent-child interactions. Seven adults (7 percent)who committed new acts of child abuse ordid not achieve program goals were ratedas having failed the program.

Parents’ attitudes about parenting prac-tices. Pretest and posttest data gatheredfrom administration of the AAPI indicatedthat significant (p<0.05) positive changesoccurred in the parenting and child-rearing attitudes of the parents. Thesechanges included expectations moreappropriate to the development of theirchildren, an increased empathic aware-ness of children’s needs, a decrease in theuse of corporal punishment, and a de-crease in parent-child role reversal.

Data gathered from parents 1 year afterthey completed the program indicated aretention of empathic attitudes towardchildren’s needs and a clear differentia-tion of appropriate parent-child roles.Approval of alternatives to the use of cor-poral punishment increased, as did theappropriateness of the parents’ expecta-tions of their children relative to theirdevelopmental level, which showed asignificant (p<0.01) increase.

Children’s attitudes about parenting prac-tices. Data generated from the administra-tion of CPI indicated that prior to their in-volvement in the treatment program,abused children supported the use of cor-poral punishment by parents, showed littleempathic awareness of the needs of others,and tended to support parent-child rolereversals. Responses concerning develop-mental expectations tended to show a lowlevel of self-awareness.

Posttest data indicated significant (p<0.05)increases in self-awareness and under-standing of appropriate parent-childroles. The followup scores of abused chil-dren 1 year after their participation in theprogram indicated a significant (p<0.01)increase in self-awareness and a concomi-tant decrease (p<0.01) in their support ofcorporal punishment.

1 All families participated on a voluntary basis (nonewere court-ordered to participate).

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Personality characteristics of parents.The 16 PF was used to develop a personal-ity profile of the parents who participatedin the study. Prior to participation in theprogram, they received high scores in in-telligence (abstract thinking), aggression,anxiety, independence, and radicalism(e.g., experimenting and free thinking).Their scores further indicated a highly un-disciplined self-concept and disregard forrules. Posttest results showed significantincreases in intelligence (p<0.01), enthusi-asm (p<0.01), social boldness (p<0.01), andself-assuredness (p<0.05) and significantdecreases in radicalism (p<0.05), anxiety(p<0.02), and tough demeanor (p<0.05).

When the personality characteristicsof parents who completed the programwere compared with those of parents whodropped out, the dropouts were found ingeneral to be less intelligent and more sus-picious, apprehensive, radical, frustrated,anxious, and tough minded. The data alsoindicate that the dropouts were moreaffected by feelings and more detached(aloof), careless of social rules, indepen-dent, and tougher in demeanor. In com-parison with parents who successfullycompleted the program, those identified as“failures” (i.e., who completed the programbut did not achieve program goals) tendedto be more detached (aloof), threat sensi-tive, tough minded, practical, apprehen-sive, careless of social rules, frustrated,and anxious but less tough in demeanor.

Personality characteristics of children.The CPQ and ESPQ were used to developa personality profile of the abused chil-dren who participated in the study. Theirpretest responses showed personalitytraits that fell within the normal rangefor their age group, with two exceptions:they tended to be more concrete in theirthinking and undemonstrative in nature.Posttest results indicated a significantincrease in assertiveness (p<0.05), enthu-siasm (p<0.01), and tough demeanor(p<0.03).

Family interaction patterns. The FESwas used to develop an interaction pro-file of the families who participated inthe study. Pretest responses indicatedthat abusive families tended to demon-strate low family cohesion, low expres-siveness, low independence, and lowachievement but a high degree of familyconflict. The responses also indicated alow orientation toward intellectual, cul-tural, and recreational activities amongabusive families.

Posttest results showed significant in-creases in family cohesion (p<0.03), fam-ily expressiveness (p<0.03), and familyindependence (p<0.01) and a concurrentsignificant decrease in family conflict(p<0.001). When posttest responses werecompared with responses gathered 1 yearafter completion of the program, furthersignificant increases were seen in familycohesion (p<0.05), family expressiveness(p<0.04), family organization (p<0.02),and moral-religious emphasis (p<0.02);a significant decrease was seen in familyconflict (p<0.05).

When responses of parents who suc-cessfully completed the program werecompared with those of parents whodropped out, the dropout parents werefound in general to have lower scoresfor family cohesion, expressiveness, in-dependence, organization, and control.Dropout families also tended to scorelower for moral-religious emphasis andorientation toward intellectual, cultural,and recreational activities. In compari-son with families who successfully com-pleted the program, families who wereidentified as “failures” (i.e., who com-pleted the program but did not achieveprogram goals) tended to demonstrateless family independence and organiza-tion and greater orientation toward fam-ily achievement and control.

Nurturing Quiz. Posttest data generatedfrom administration of the Nurturing Quizindicated a significant (p<0.05) increase inacquired knowledge related to behaviormanagement concepts and techniques.No significant changes in test scores werefound when the Nurturing Quiz was ad-ministered 1 year after completion of theprogram.

Followup in-home observations. Trainedprogram observers conducted in-homeobservations of 52 families who completedthe program. Each family was visitedtwice, and each observation lasted 2hours. The observer engaged the familyin structured interactions using an ethno-graphic recording strategy in which theobserver wrote down what was heard andseen without subjective interpretation.The written observations were then cat-egorized into family interaction patterns.

Data generated from the in-home observa-tions were divided into two categories:empathy and behavior management. Themost frequently observed empathic be-haviors are presented in rank order intable 1. A review of the table shows thattwo behaviors, recognition and accep-tance of feelings/needs, accounted for 54percent of observed behaviors amongfamily members. Dominance (demandingobedience)/submissiveness, disinterest/coldness (not paying attention to thechild’s needs/wants), inappropriateexpectations of children, and anger ac-counted for 15 percent of observed familyinteractions.

Behavior management concepts canbe applied appropriately and inappropri-ately. The behavior management tech-niques observed are presented in table 2.The appropriate use of praise was themost frequently observed behavior man-agement technique, while ignoring wasthe most widely misused. The parentstended to ignore behavior that warrantedeither intervention or punishment.

Involvement with helping professionals.Fifty-eight percent of the families in theinitial study were required to attendparenting classes or seek counseling with

Table 1: Observed Behaviors

Percentage of FamiliesBehaviors Exhibiting Observed Behaviors

Recognition of feelings/needs 28%Acceptance of feelings/needs 26Interest/warmth 19Expression of feelings/needs 12Dominance/submissiveness 9Disinterest/coldness 4Inappropriate expectations of children 1Anger 1

Total 100

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departments of social services for childabuse prior to their participation in theprogram. One year after completing theprogram, only 16 percent of the familieswere still receiving such services, a de-cline of 42 percent. Of the families whocompleted the treatment program, 7 per-cent were charged with additional countsof child abuse.

Fifty-five percent of the families were in-volved in Parents Anonymous prior totheir participation in the program. Oneyear after completing the program, only30 percent of the families were attendingParents Anonymous groups, a declineof 25 percent. Forty-seven percent of thefamilies were receiving additional ser-vices while participating in the program.These included marital and individualcounseling, family therapy, and alcoholand chemical dependency counseling.On a scale from 0 to 10 (0 = unsuccessful,5 = successful, and 10 = very successful),program facilitators rated the overall suc-cess of the program in modifying abusiveparenting behavior at 6.93.

Parent evaluation of program. Parentswere asked to complete a program evalua-tion questionnaire immediately after theycompleted the program and again 1 yearlater. Parents were asked to use a four-

point scale (1 = strongly agree, 2 = agree,3 = disagree, and 4 = strongly disagree) toindicate whether the program helpedthem increase their knowledge of age-appropriate developmental expectationsand behavior management techniquesand their degree of self-awareness andempathy. The results of the questionnaireare presented in table 3.

Additional research. Evaluationsof subsequently developed NurturingParenting Programs have yielded similarresults. Program participants showedsignificant pretest and posttest changesin parenting attitudes and childrearingpractices.2

The Nurturing Parenting Programs arefamily-centered programs proven tohelp parents and children learn to carefor themselves and each other and toreplace old, unwanted abusive interac-tions with newer, more nurturing ones.

Continued revisions and updates of theprograms will ensure that families canachieve success in developing theirnurturing parenting skills and that gen-erations of abuse can finally come toan end.

For Further InformationThe cost of implementing the NurturingParenting Programs ranges from $1,000 to$2,000, depending on the program pur-chased. Additional costs include stafftime, snacks, and expendables such as artsupplies.

For more information about the Nur-turing Parenting Programs, contact:

Stephen J. Bavolek, Ph.D.Family Development Resources, Inc.27 Dunnwoody CourtArden, NC 28704828–681–8120; 800–688–5822Fax: 828–681–8620E-mail: fdr@familydev.com

ReferencesAckley, D. 1977. A brief overview of childabuse. Social Casework 58(January):21–24.

Bavolek, S.J., Kline, D.F., and McLaughlin,J.A. 1979. Primary prevention of childabuse: Identification of high risk adoles-cents. Child Abuse and Neglect: The Inter-national Journal 3(3):1071–1080.

Cohn, A.H. 1979. Essential elements ofsuccessful child abuse and neglect treat-ment. Child Abuse and Neglect: The Inter-national Journal 3(2):491–496.

Goleman, D. 1995. Emotional Intelligence.New York, NY: Bantam Books, pp. 96–104.

Greven, R.P. 1990. Spare the Child. NewYork, NY: Knopf, pp. 122–135.

Martin, H. 1976. The environment of theabused child. In The Abused Child: A Multi-disciplinary Approach to DevelopmentalIssues and Treatment, edited by H. Martin.Cambridge, MA: Ballinger, pp. 11–25.

National Clearinghouse on Child Abuseand Neglect Information. 1998. Child Mal-treatment 1996: Reports From the States tothe National Child Abuse and Neglect DataSystem. Washington, DC: U.S. GovernmentPrinting Office.

Perry, B. 1997. Incubated in terror: Neuro-developmental factors in the cycle ofviolence. In Children, Youth and Violence:Searching for Solutions, edited by Joy D.Osofsky. New York, NY: The Guilford Press.

Table 2: Observed Behavior Management Techniques

Percentage of Observed BehaviorManagement Techniques

Technique Appropriate Use Inappropriate Use

Praise 35% 2%Ignoring 21 16Choices and consequences 20 4Timeout 2 0

Total 78 22

Table 3: Nurturing Program Evaluation

Parents’ Evaluation of Program*

At Program 1 Year AfterCompletion Completion

Developmental expectations 1.8 2.0Behavior management 1.4 1.5Self-awareness 1.8 1.6Empathy 1.5 1.9

*Parents were asked to rate the effectiveness of the program according to the following scale:1 = strongly agree, 2 = agree, 3 = disagree, 4 = strongly disagree.

2 The evaluation report on continued research on theNurturing Parenting Programs is available from theJuvenile Justice Clearinghouse (JJC). To request acopy, contact JJC at 800–638–8736 or 410–792–4358(fax) or through www.ncjrs.org/puborder. An onlineabstract of the evaluation report is available from theNational Criminal Justice Reference Service AbstractsData Base: www.ncjrs.org/database.htm.

PRESORTED STANDARDPOSTAGE & FEES PAID

DOJ/OJJDPPERMIT NO. G–91

NCJ 172848Bulletin

U.S. Department of Justice

Office of Justice Programs

Office of Juvenile Justice and Delinquency Prevention

Washington, DC 20531

Official BusinessPenalty for Private Use $300

Points of view or opinions expressed in thisdocument are those of the author and do notnecessarily represent the official position orpolicies of OJJDP or the U.S. Department ofJustice.

Acknowledgments

Stephen J. Bavolek, Ph.D., is the founder and President of Family DevelopmentResources, Inc., and Executive Director of the Family Nurturing Center. He hasconducted extensive research in the fields of parent education and child abuseand neglect prevention and has developed the Adult-Adolescent ParentingInventory and the Nurturing Parenting Programs.

All photographs in this Bulletin were provided by Dr. Bavolek.

The Office of Juvenile Justice and Delin-quency Prevention is a component of the Of-fice of Justice Programs, which also includesthe Bureau of Justice Assistance, the Bureauof Justice Statistics, the National Institute ofJustice, and the Office for Victims of Crime.

Radbill, L.S.X. 1974. A history of childabuse and infanticide. In The BatteredChild, 2d ed., edited by C.H. Kempe andR.E. Helfer. Chicago, IL: The University ofChicago Press.

Rowen, B. 1975. Tuning in to Your Child:Awareness Training for Parents. Atlanta,GA: Humanics Press.

Steele, B.F. 1975. Working With AbusiveParents From a Psychiatric Point of View.Bulletin. DHEW Publication No. (OHD)76–30070. Washington, DC: U.S. Govern-ment Printing Office.

Steele, B.F., and Pollock, C.D. 1968. A psy-chiatric study of parents who abuse in-fants and small children. In The BatteredChild, edited by C.H. Kempe and R.E.Helfer. Chicago, IL: The University ofChicago Press.

Stern, D. 1987. The Interpersonal World ofthe Infant. New York, NY: Basic Books, p. 30.

Straus, M.A. 1991. Discipline and devi-ance: Physical punishment of childrenand violence and other crime in adult-hood. Social Problems 38(20):131–154.