Abus, maltraitance et négligence: (2) prévention et principes de prise en charge

The first part of this article was devoted to the evaluation of the prevalence of different types of child maltreatment and their long-term consequences in children; here we conducted a literature review of studies evaluating the efficacy of medico-social interventions in these children. A better recognition of cases remains a major issue for improving the current system of reporting, the factors associated with delayed or no reporting was underlined in different reviews, and several proposals have been made to remedy, as professional training focus on warning signs. If psychological support can take different forms depending on the clinical context, encouraging verbalization of emotions in children and identification reliable person in the environment is well recognized, as well as the importance of extending follow-up for the most vulnerable children. Over the last twenty years, several studies have been dedicated to the evaluation of social interventions, as home or out-of-home care intervention. These studies highlight the reversibility of such disorders presented by children as well as positive effects on development and overall health in adulthood. In addition, research on risk factors for abuse have encouraged the development of targeted interventions with families with psychosocial risks to promote the quality of parent-child interaction and parenting skills. Such programs, for instance home-visiting program based on attachment theory in association with perinatal services, are currently under evaluation in France and showed encouraging results, although their direct effect on child abuse is not specifically assessed yet.