In most sectors, some well-intentioned interventions will succeed in making things better; some have little or no effect; and some may make things worse. Clearly children deserve better than adults to use the ‘strategy’ that we call “guess and hope”, so decisions relating to child protection should be made as carefully as possible – using the best available evidence. To misquote Sir Isaac Newton, the great scientist who discovered and described gravity (and much else), that will enable us to see further in terms of whether and when interventions are likely to work.
If I have seen further than others, it is by standing upon the shoulders of giants – Sir Isaac Newton
So what is the available evidence?
Specifically, we had two questions:
- What rigorous ‘what works’ studies exist about organisational responses to child abuse, i.e., what does the available evidence cover? And
- What do those studies say?
Porticus, an international philanthropic organisation with a strong programme in child protection, and Giving Evidence, a research and advisory organisation, collaborated to find out.
The goal was to inform Porticus’ own giving, as well as the activities of other funders, policy-makers and child-serving organisations.
Our findings are in two products, which respectively relate to those two questions above:
- An ‘evidence and gap map’: this shows all the relevant studies in a grid, coded by the intervention(s) and outcome(s) that they examine: the rows are interventions and the columns are outcomes. If a study looks at the effect of a prevention intervention on child mental health, it will be in the row for prevention (which is the top one), and in the column for mental health: it will be in that cell on the grid. It is also searchable by geography, type of participant etc., so that you can see easily just the studies from, say, Africa.
- A ‘Guidebook’. This says what the studies found. Inside each cell on the grid are plain-language summaries of the studies; and, where a cell has three or more studies, we also provide a synthesis of them, to spare users from reading loads of studies.
All this lives on a website – along with masses of guidance about using evidence, key findings, what all the terms mean, more detailed reports about the research. Below we talk through those findings.
What is included in this Evidence and Gap Map, and Guidebook:
| We included: | We didn’t include: |
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*’Organisations’ means schools, pre-schools, after-school clubs, sports and music clubs, holiday camps, residential care, hospitals, churches, etc.
The good news
All the interventions assessed succeed. None of them produces a harm.
Of course, that doesn’t guarantee that all of the studied interventions will always succeed: for example, it is perfectly possible to take an intervention which succeeded when it was studied, and run it badly and/or in an unsuitable context such that it creates a harm. But the fact that nothing was shown to be harmful is great news.
Further good news is that the amount of evidence is growing quite fast. This Evidence and Gap Map, and Guidebook are updates of previous versions that we made a few years ago. In 2019, we found just 58 completed primary studies; whereas in 2023, we found 108 of them: nearly double the number in just the last three years. {This needs caution because there can be giant delays in publishing the study. For example, one study published in 2021 examines an intervention which ran in 2013.} Also, there are eight ongoing studies on the map, whereas there were only three on our first EGM.
There are more studies now of treatments for survivors. In the first EGM, there were studies of only two interventions (though one had generated many papers), and both of those had started before 2000. Now there are studies of many more treatment interventions – though still only few.
The evidence is quite concentrated:
- Most studies are about prevention. Prevention was examined in 120 papers (some studies generate more than one paper).
- Sexual abuse is more studied than other types of abuse. Of the 108 completed primary studies, 75 look at sexual abuse, whereas 49 look at other types of abuse. (The numbers do not add up because some studies look at multiple types of abuse.)
- Most studies assess education-based prevention programmes, in early education and in school settings. Fully 60 of the 108 completed primary studies look at that.
- More than 70% (n=87) of the completed primary studies assess curriculum-based prevention programmes educating children about sexual abuse and teaching safety skills, e.g., how to handle ‘secrets’ and whom to tell in school settings.
- We found no studies on churches or other faith-based organisations. That is remarkable given all the clerical sexual abuse issues.
The outcomes studied:
- Few studies look at actual incidences of abuse (n=21).
- Most studies assess intermediate outcomes, such as children’s acquisition and retention of knowledge (n=84), but not actual disclosure of incidence.
- The outcomes were usually self-reported by children or young people, which are proxies for incidence. They may or may not be reliable proxies.
- Only one study looks at educational attainment.
- Only seven completed studies assessed interventions to stop adults from offending in organisations.
- Studies addressed only three of the seven INSPIRE strategies of the World Health Organization. Four of the INSPIRE strategies have no rigorous impact evaluations.
On geography:
- Most studies are from high-income countries. The USA dominates, with 40% of completed primary studies (n=44).
- There are very few studies from Africa (n=10), and they cover only four interventions, all in prevention. In other words, there are zero studies from Africa about encouraging disclosure, response or treatment.
What the studies found:
- Most effects are small! – that is true not just of child protection but of most social interventions: An effective programme may improve knowledge by 20-30 percent and reduce abuse by 10-20%. There is no vaccine for child abuse.
- School-based programmes have succeeded in raising children’s awareness about physical and sexual abuse, training them on what to do, and increasing disclosure. They don’t make children more anxious. These findings are consistent across over 60 studies in many countries.
- The effects of school-based interventions to prevent peer violence and gender-based violence are unclear: the studies are inconclusive. Further research is necessary to identify the most effective strategies and interventions to create safe and inclusive learning environments for all students.
- The Bucharest Early Intervention Project (BEIP) in Romania showed that moving orphaned children out of awful orphanages and into foster families significantly improved most developmental, physical, mental, emotional, and cognitive health outcomes. This was fairly early intervention: the children were moved before their third birthday.
In sum: the findings are positive – most things have been found to work, and more evidence is being produced – but there remains major holes, notably in studies from low-income countries, faith-based settings.
Written by Caroline Fiennes, Director, Giving Evidence
