Up to 60% of children across the country are exposed to violence
and other forms of trauma. 1 in 4 girls and 1 in 6 boys are
molested before 18. 10% of adolescents are beaten by a
caregiver each year. 16 million children end up in emergency rooms
annually because of injury.
The mental health consequences of child sexual
abuse can be severe and insidious. More than 60% of abuse
victim-survivors report symptoms of PTSD. They also suffer
from depression, anger, and acting out/aggression. Child
sexual abuse is one of the best predictors of suicidal gestures and
other risky behaviors. In adulthood, child abuse survivors
have occupational and relationship problems. Physical illness also
is much more common in child trauma survivors, including
cardiovascular problems and cancer. A year’s worth of child
maltreatment costs $124 billion over the lives of the
Keeping Every Youth Safe (KEYS) is a program
designed to prevent child injury, excessive discipline, and sexual
abuse. KEYSuses evidence-informed techniques to empower
parents/caregivers, educators, and others to protect children.
Trained facilitators presents KEYS in one 90-minute session which
includes child sexual abuse prevention, effective parenting
strategies (to counter excessive corporal punishment), and CPR and
first aid. The inclusion of CPR and first aid in a program for
child abuse prevention makes it easier for the hesitant caregiver
to attend. Lecture, discussion, and role-plays engage attendees in
the material and challenge them to overcome the barriers to
discussing difficult topics. The interaction among participants
creates a sense of community and shared responsibility, which make
the learning process most effective.KEYS targets audiences from
multicultural backgrounds and adaptations are made for cultural
KEYS is suitable for all caregivers of
children. One potential model is to target kindergarten
parents/caregivers—a group that is highly motivated and interested.
After 6 years in a given school, an entire community would be
trained. This model also creates a school-parent partnership, known
to be associated with better child outcomes. For greatest access to
the program, we propose a train-the-trainer model, in which
community or school leaders in each district learn to become
facilitators. The train-the-trainer model provides an opportunity
to educate and empower an entire community.
KEYS has embedded evaluation in its design,
which informs program development and ensures return-on-investment.
KEYS participants complete measures of satisfaction, knowledge, and
protective behaviors before and after the training. Participants
have shown significant increases in both knowledge about abuse and
injury, and protective behaviors. Satisfaction with the program has
been at the highest levels.
KEYS was developed in 2011 by Dr. Elissa
Brown, one of the nation’s top experts in childhood trauma and
mental health, and Lois Beekman Oliveira, a nationally known
advocate on issues related to family violence and partner in one of
the nation’s first child safety training programs.
To date, KEYS has been piloted with several
groups of caregivers from various comuunities. These groups have
provided feedback on the content and process of KEYS delivery and
evaluation. We are ready to conduct the next empirical step, an
open (pre/post) test of KEYS with a larger, diverse sample.