FOR UNICEW -Research Essay

A research essay on how exsposure to domestic violence in the home shapeS our attitudes toward domestic violence. Discuss the cycle of violence of domestic violence and how children witnessing domestic violence can turn to abusing others. ( THE ARTICLE ON CHILDREN EXPOSED TO VIOLENCE .A HAND BOOK FOR POLICIES TRAINING TO INCREASE UNDERSTANDING…HAS LOTS INFORMATION ON shortern and long terms effects )

USE THE 5 ARTICLES ATTATCHED -THIS IS AN EXPLOSITORY ESSAY

MUST BE IN APA STYLE

MUST HAVE A WORK CITED PAGE

MUST HAVE A BRIEF ARTICLE REVIEW

MUST BE 6 PAGES LONG

Resilience Among Children Exposed to Domestic Violence: The Role of Risk

and

Protective Factors

Cecilia Martinez-Torteya, G. Anne Bogat, Alexander von Eye, and Alytia A. Levendosky
Michigan State University

Individual and family characteristics that predict resilience among children exposed to domestic violence
(DV) were examined. Mother–child dyads (n = 190) were assessed when the children were 2, 3, and 4 years
of age. DV-exposed children were 3.7 times more likely than nonexposed children to develop internalizing or
externalizing problems. However, 54% of DV-exposed children maintained positive adaptation and were
characterized by easy temperament (odds ratio [OR] = .39, d = .52) and nondepressed mothers (OR = 1.14,
d = .07), as compared to their nonresilient counterparts. Chronic DV was associated with maternal depression,
difficult child temperament, and internalizing or externalizing symptoms. Results underscore heterogeneous
outcomes among DV-exposed children and the influence of individual and family characteristics on children’s
adaptation.

Using a person-oriented approach, this longitudinal
study examined the individual and family factors
that predict resilience among young children (from
ages 2 to 4) exposed to domestic violence (DV;
defined as male aggression toward a female
partner). Research has consistently documented the
negative effects of DV exposure on children’s
adaptation (e.g., Kitzmann, Gaylord, Holt, &
Kenny, 2003), but very few studies have explored
what characteristics typify DV-exposed children
who maintain positive adaptation (Grych, Jouriles,
Swank, McDonald, & Norwood, 2000; Hughes &
Luke, 1998). Longitudinal studies with high-risk
samples (not DV exposed) have previously
identified a variety of individual and family factors
that predict and hinder resilience (e.g., Tiet et al.,
1998; Wyman et al., 1999), but the role of these
factors has not been delineated in the context of

exposure.

DV and Its Negative Effects on Children

DV-exposed children are approximately 2 times
more likely than nonexposed children to exhibit
internalizing and externalizing problems (Stern-

berg, Baradaran, Abbott, Lamb, & Guterman, 2006).
Among young children, the trauma of exposure is
likely to disrupt the development of basic compe-
tencies, threatening the child’s ability to process
and manage emotions effectively and increasing
internalizing and externalizing behaviors (Cole,
Zahn-Waxler, Fox, Usher, & Welsh, 1996). For
example, young DV-exposed children experience
more distress in response to interadult conflict than
their nonexposed peers (DeJonghe, Bogat, Levendo-
sky, von Eye, & Davidson, 2005), and trauma
symptoms have been reported in children as young
as age 1 (Bogat, DeJonghe, Levendosky, Davidson,
& von Eye, 2006).

Overall, children exposed to DV are at risk to
develop both internalizing and externalizing prob-
lems (e.g., Sternberg et al., 2006). However, chil-
dren’s outcomes vary widely, and many children
have adequate behavioral and emotional function-
ing despite witnessing DV. Research has reported
resilience rates from 31% to 65% (Grych et al., 2000;
Hughes & Luke, 1998) among school-age children.
These studies suggest that positive adaptation is
associated with less partner-to-mother physical
aggression, shorter duration of DV exposure, per-
ception of the conflict as less threatening, less self-
blame, and absence of maternal depression (Grych
et al., 2000; Hughes & Luke, 1998). However, the
scope of these studies was limited, and many
individual and family characteristics that have been

This research was supported by a grant from the National
Institute of Justice (8-7958-MI-IJ) and Centers for Disease Control
(R49 ⁄ CCR ⁄ 518519-03-1) to the second, third, and fourth authors.
Portions of this paper were presented at the Society for Research
in Child Development biennial meeting in Boston, Massachu-
setts, in March 2006.

Correspondence concerning this article should be addressed to
Cecilia Martinez-Torteya, Clinical Psychology, Michigan State
University, Psychology Building, East Lansing, MI. Electronic
mail may be sent to marti933@msu.edu.

Child Development, March/April 2009, Volume 80, Number 2, Pages 562–577

� 2009, Copyright the Author(s)
Journal Compilation � 2009, Society for Research in Child Development, Inc.
All rights reserved. 0009-3920/2009/8002-0019

identified as protective factors among other
high-risk samples (e.g., positive parenting, easy
temperament) were not assessed. In addition, these
studies were cross-sectional, and early develop-
mental trajectories associated with resilience or
recovery were not investigated.

The present research explored a number of fac-
tors relevant to young children’s adaptation identi-
fied by previous research with high-risk children:
child’s easy temperament, child’s cognitive ability,
positive parenting, maternal depression, stressful
life events, low income, and minority status. Indi-
vidual- and family-level factors are consistent with
the guidelines for research on resilience recom-
mended by Luthar, Sawyer, and Brown (2006)
including (a) saliency to life context (young chil-
dren’s reliance on their caregivers, high prevalence
of maternal depression and stressful life events in
DV households), (b) enduring characteristics (rela-
tive stability of temperament and cognitive ability),
and (c) contribution to the development of other
assets (impact on children’s self-regulation and cop-
ing skills).

Defining Resilience

Resilience has been defined as the maintenance of
healthy ⁄ successful functioning or adaptation within
the context of a significant adversity or threat
(Garmezy, 1993; Luthar, Cicchetti, & Becker, 2000;
Masten & Obradovic, 2006). Thus, two elements
must co-occur for resilience to be present: a circum-
stance that has the potential to disrupt children’s
development and reasonably successful

adaptation

(Luthar et al., 2000; Masten, 2001). Multiple defini-
tions have been used to measure risk or adversity;
an individual risk model explores the contribution of
one risk factor to the development of negative
outcomes (e.g., child maltreatment), whereas a
cumulative risk model asserts that accumulation of
adversity results in maladaptation (Rutter, 1979).
Despite the widespread use of both models in the
study of resilience, cumulative risk models provide
limited insight into unique characteristics that
provide protection in the context of a particular risk
(i.e., DV); thus, individual risk models might be
better suited to identify predictors of resilience in
the children exposed to DV.

Likewise, positive adaptation has been defined
in several ways, including absence of psychopathol-
ogy (Tiet et al., 1998), behavioral and cognitive
competence (Kim-Cohen, Moffitt, Caspi, & Taylor,
2004), and mastery of appropriate developmental
tasks (Masten, 2001). Masten and Obradovic (2006)

emphasize the importance of both external adapta-
tion to the environment and internal sense of well-
being as part of a comprehensive assessment of
resilience. Moreover, resilience is better character-
ized as a dynamic process, because individuals can
be resilient to specific environmental hazards or
resilient at one time period but not another (Rutter,
2006).

Consistent with an individual risk model, the
present study used DV exposure as the index of
adversity; other risk factors (maternal depression,
stressful life events, minority status, and low
income) that might heighten the negative effects of
DV or individually contribute to disruptions in chil-
dren’s adaptation were also explored. To incorpo-
rate indices of both external and internal
functioning, positive adaptation is defined as the
maintenance of nonclinical levels of both internaliz-
ing and externalizing behaviors over time.

Risk and Protective Factors

Broadly defined, protective or promotive factors
refer to the characteristics that enhance adaptation,
whereas the terms vulnerability and risk are used for
the factors that increase the likelihood of maladap-
tation. However, there are some inconsistencies
associated with the use of these terms (Luthar
et al., 2000). Some authors have used an internal
versus external classification, in which vulnerability
refers to the individual’s biologically based traits,
whereas risk concerns environmental threats to
adaptation (e.g., Shannon, Beauchaine, Brenner,
Neuhaus, & Gatzke-Kopp, 2007). Other authors
propose a classification based on an interaction
with adversity, such that risk and compensatory fac-
tors have a similar effect on the whole population
(individuals who are and are not exposed to adver-
sity), whereas vulnerability and protective factors
influence outcomes only under high-risk conditions
(e.g., Steinhausen & Metzke, 2001).

Despite conceptual inconsistencies, research has
reliably reported a number of characteristics associ-
ated with resilience, including a positive and sup-
portive caregiver–child relationship, competent
(structured and warm) parenting, positive caregiver
mental health, child easy ⁄ engaging temperament,
and child’s higher cognitive ability (Masten et al.,
1999; Tiet et al., 1998; Wyman et al., 1999). Research
has also found that positive adaptation is associated
with lower levels of risk, including less parental
psychopathology, life stress, and poverty, as well as
being a member of a majority ethnic group (Bradley
& Corwyn, 2002; Leech, Larkby, Day, & Day, 2006).

Child Resilience to Domestic Violence 563

Interestingly, the profiles of resilient children
resemble those of competent children who are not
exposed to adversity or high risk (Masten et al.,
1999).

The present study focuses on characteristics at
the family level (positive parenting, maternal
depression, stressful life events, and low income)
and individual level (easy temperament, high cog-
nitive ability, race) that might influence children’s
adaptation. The term risk is used to describe envi-
ronmental characteristics that have been commonly
associated with increases in child behavioral ⁄ emo-
tional problems (maternal depression, stressful life
events, minority status, and low income), whereas
protective factor will be used for the environmental
and individual characteristics that are associated
with an increase in positive adaptation (including
promoting effects, child easy temperament, positive
parenting, child high cognitive ability).

Protective Factors: Positive Parenting, Child Easy
Temperament, and

Cognitive Ability

Positive Parenting

Parental warmth, positive expectations, support,
and low derogation predict children’s behavioral
and emotional adaptation under a wide variety of
adverse circumstances (Katz & Gottman, 1997;
Kim-Cohen et al., 2004). Among DV-exposed chil-
dren, high maternal authority or control is associ-
ated with more positive and less antisocial
behaviors (Levendosky & Graham-Bermann, 2000),
and effective parenting is associated with decreased
externalizing behaviors (Levendosky, Huth-Bocks,
Shapiro, & Semel, 2003). Thus, children whose
mothers are available and supportive will be better
able to develop self-regulation abilities within the
context of effective mother–child interactions
(Wyman et al., 1999).

Child Temperament

At-risk children with easy temperaments (regu-
larity, approachability, high adaptability, positive
mood, low reactivity; Thomas & Chess, 1985) show
fewer behavior problems than children with diffi-
cult temperaments (Kim-Cohen et al., 2004; Smith
& Prior, 1995; Tschann, Kaiser, Chesney, Alkon, &
Boyce, 1996). Children with easy temperaments are
less reactive to stressors and more likely to utilize
active and flexible coping strategies to deal with
stress (Compas, Connor-Smith, & Jaser, 2004); they
are also better able to regulate their feelings of sad-

ness and anger (Olson, Bates, Sandy, & Schilling,
2002). Research examining the moderating effect of
child’s temperament on DV-exposed children’s
adaptation is sparse. For example, DeJonghe et al.
(2005) found that temperament predicted infants’
observed distress to verbal conflict among children
not exposed to DV but not among exposed chil-
dren. However, no studies to date have examined
the link between temperament and internalizing
and externalizing problems in the context of DV.

Cognitive Ability

High intelligence has also been associated with
positive adaptation in the face of adversity (Jaffee,
Caspi, Moffitt, Polo-Tomas, & Taylor, 2007; Tiet
et al., 1998) and is predictive of lower levels of psy-
chiatric disorders, lower rates of conduct problems,
and higher levels of overall functioning (Malcarne,
Hamilton, Ingram, & Taylor, 2000). Similar studies
with DV-exposed samples are sparse but suggest
that IQ is negatively associated with behavioral
problems (Kolbo, 1996). Well-developed verbal cog-
nitive abilities may facilitate verbal mediation of
conflict and therefore lead to more appropriate
behavioral choices and a wider range of coping
strategies (Buckner, Mezzacappa, & Beardslee,
2003).

Risk Factors: Maternal Depression, Stressful

Negative

Life Events, Income, and Race

Maternal Depression

Maternal depression has been associated with
negative child adjustment among high-risk chil-
dren (Tiet et al., 1998) as well as DV-exposed chil-
dren (e.g., Levendosky, Leahy, Bogat, Davidson, &
von Eye, 2006). Levendosky et al. (2006) found
that maternal functioning (posttraumatic stress
disorder, depression, anxiety, and self-esteem)
mediated the relation between DV exposure and
preschoolers’ externalizing problems. A depressed
mother’s unavailability may lead her child to
expect rejection and feel helpless. Depressed
mothers might also model maladaptive emotion
regulation strategies; for example, Kliewer et al.
(2004) found that mothers who are unable to man-
age effectively their own feelings of sadness have
children with more internalizing problems. Alter-
natively, the depressed mother’s predisposition to
psychopathology may be inherited by her child
and activated by the stress of exposure to marital
violence (Jaffee, 2005).

564 Martinez-Torteya, Bogat, von Eye, and Levendosky

Stressful Life Events

The accumulation of stressful life events is also
associated with children’s emotional and behavioral
problems (Smith & Prior, 1995). Among children
exposed to DV, mothers’ reports of stressful life
events are a significant predictor of children’s
increased behavior problems and decreased social
competence (Levendosky et al., 2003). The experi-
ence of stressful life events increases the environ-
mental demands on the mother–child dyad, such
that the mother’s parenting can be negatively
affected and the child might become sensitized to
stressful situations (Davies, Winter, & Cicchetti,
2006).

Race and Low Income

Research on the effects of racial background on
the development of internalizing and externalizing
problems has shown mixed results. For example,
Leech et al. (2006) found that being African Ameri-
can was a predictor of higher levels of depression
and anxiety. On the other hand, a higher incidence
of depression and behavioral problems among
White children, as compared to minority children,
has also been reported (Gerard & Buehler, 2004).
Additionally, children in poor families are more
likely to develop behavioral and emotional prob-
lems than children in middle and upper income
families (Bradley & Corwyn, 2002), and low income
is associated with a relatively high prevalence of
other risk factors, such as maternal psychiatric
symptoms, life stress, and ineffective parenting
(e.g., McLoyd, 1998).

Person Orientation

Current research primarily uses a variable-
oriented approach to study the effects of DV on chil-
dren’s development (Levendosky, Bogat, & von Eye,
2007). However, aggregating all participants in a
single group (e.g., children exposed to DV) may mis-
represent the individuals within the group in many
important aspects. Alternatively, the person-ori-
ented approach assumes that individuals are unique
and behavior can be understood through the pre-
dictable patterns that occur across the dependent
and independent variables (Bogat, Levendosky, &
von Eye, 2005). Person-oriented research ascertains
the complex and multifaceted nature of child devel-
opment by examining the patterns that result from
the interassociations among variables at various eco-
logical levels (Bergman & Magnusson, 1997).

Person-focused approaches to resilience allow
the researcher to explore specific patterns and local
associations that exist within groups, identifying
individuals with positive versus negative function-
ing (Masten, 2001). Complex designs include four
groups of children that differ in their levels of
adversity and adaptation. However, the profiles of
risk and protection have not been investigated in
the context of DV exposure. For the present
research, the four-group model proposed by
Masten was used, and groups were defined as
follows: Resilient children are exposed to DV and
are positively adapted, nonresilient children are
exposed to DV and are negatively adapted, compe-
tent children are not exposed to DV and are posi-
tively adapted, and vulnerable children are not
exposed to DV and are negatively adapted.

Hypotheses

Consistent with previous research, we expected
to find a group of young children who showed
resilience to DV. However, DV-exposed children
were hypothesized to be more likely to develop
emotional and behavioral problems than were non-
exposed children, and longer duration and higher
frequency of DV exposure were expected to pre-
dict internalizing and externalizing symptoms.
Family and individual characteristics that were
hypothesized to predict resilience included posi-
tive parenting, child’s easy temperament, and
child’s high cognitive ability. Nonresilience was
expected to be characterized by maternal depres-
sion, more stressful negative life events, low
income, and ethnic minority status. Resilient chil-
dren were predicted to display characteristics simi-
lar to competent nonexposed children.
Additionally, specific configurations of adversity
(e.g., early vs. late DV exposure), risk, and protec-
tive factors were hypothesized to be associated
with positive and negative adaptation.

Method

Participants

The present research is part of a larger, longitudi-
nal study that explores the effects of DV on women
and their children (Bogat, Levendosky, & Davidson,
1999; Levendosky, Bogat, Davidson, & von Eye,
2000). Participants of the original study were 206
pregnant women recruited from urban, suburban,
and rural areas in a Midwestern state. The study
oversampled for DV in order to obtain two

Child Resilience to Domestic Violence 565

relatively equal numbered groups: women who expe-
rienced violence during pregnancy and nonexposed
women with similar demographic characteristics.
Sixteen mother–child dyads from the original
sample were excluded because of mother’s death
(n = 2), child’s death (n = 2), loss of custody (n = 6),
mother’s imprisonment (n = 1), or withdrawal from
the study before the child’s first birthday (n = 5).
The excluded participants did not differ from the
current study sample on demographic characteris-
tics, such as maternal age, maternal race, child’s race
or child’s gender. Excluded women reported lower
family income as well as higher levels of DV and
depression at the first assessment period (third
trimester of pregnancy).

Participants for the current study were 190 chil-
dren (95 boys) and their mothers who were
assessed yearly when the children were ages 2, 3,
and 4. Forty-seven percent of the children were
Caucasian, 25% African American, 23% multiracial,
2% Hispanic, 2% Native American, and 1% Asian
American. The median monthly family income
when children were 2 years old was $2,54

(SD = $2,187), and the average age of mothers was
27.38 (SD = 4.99).

Measures

Screening Instrument: DV

A subset of items from the 14-item Verbal and
Physical Aggression scales of the Conflict Tactics
Scales (CTS; Straus, 1979) were used to classify
women’s DV experiences prior to the interview
(Items 6 to 14; e.g., ‘‘Threatened you with a gun or
knife’’). Straus, Hamby, Boney-McCoy, and Sugar-
man (1996) reported an internal consistency of
a = .58 for the verbal and physical aggression scale.
For the present study, internal consistency was
good (a = .88).

Grouping Variables

DV. The 46-item Severity of Violence Against
Women Scales (SVAWS; Marshall, 1992) assessed
violent behaviors and threats that the woman had
experienced from her partner during the last year
on a 4-point frequency scale. A total score is
obtained by adding all items (0 to 138); higher
scores represent more frequent abuse. High internal
consistency (a = .97) has been previously reported
(Huth-Bocks, Levendosky, & Semel, 2001). For the
present study scores ranged from 0 to 94 and

internal consistency was excellent (a = .95 at age 2,
a = .94 at age 3, a = .94 at age 4). Children were
assigned to the DV group if their mothers endorsed
any DV item at any of the three time periods. A DV
dichotomous score (present or absent) was also
created for each time period. A duration of DV
score (0–3) was computed by adding the number
of time periods in which the woman reported
experiencing DV.

Child’s behavioral adaptation. Developmentally
appropriate versions of the Child Behavior
Checklist (99-item CBCL 2–3, Achenbach, 1992;
113-item CBCL 4–18, Achenbach, 1991) assessed
children’s behavioral and emotional functioning at
each time period. Mothers rated each item on a
3-point scale. There are two broadband subscales:
Internalizing and Externalizing. T scores (30–100)
were used with higher scores reflecting more
frequent ⁄ severe symptoms. Excellent internal
consistency (as = .90–.96) has been reported for
the broadband scales (Achenbach, 1991, 1992). In
this study, scores ranged from 30 to 72 for Inter-
nalizing (a = .81 at age 2, a = .77 at age 3, a = .69
at age 4) and 30 to 77 for Externalizing (a = .89 at
age 2, a = .90 at age 3, a = .85 at age 4). Children
were classified as positively adapted if their CBCL
scores were lower than 60 for both scales at all
time periods. Children with scores equal to or
higher than 60 (i.e., clinical cutoff; Achenbach,
1992) on either scale at one or more time periods
were classified as negatively adapted.

Protective Factors

Maternal positive parenting. The nurturing (20
items; e.g., ‘‘I read to my child at bedtime’’) and
discipline (30 items; e.g., ‘‘I send my child to bed
as a punishment’’) subscales of the Parent Behav-
ior Checklist (PBC; Fox, 1994) were used to assess
maternal parenting. Responses are scored on a
4-point scale. For the present study, the discipline
(reverse coded; higher scores reflect less harsh
discipline) and nurturing scores were summed to
create a composite positive parenting variable
(50–200); higher scores indicate more consistent
discipline, less punishment, and more nurturing
parenting. High internal consistency has been
reported for the Nurturing (a = .82) and Disci-
pline (a = .91) scales (Fox, 1994). For the present
study, positive parenting scores ranged from
142 to 199 and showed good internal consistency
(a = .79 at age 2, a = .77 at age 3, a = .74 at
age 4).

566 Martinez-Torteya, Bogat, von Eye, and Levendosky

Child temperament. Temperament characteristics
were assessed using the Carey Temperament Scales
(97-item Toddler Temperament Scale at age 2,
Fullard, McDevitt, & Carey, 1984; 100-item
Behavioral Style Questionnaire at ages 3 and 4,
McDevitt & Carey, 1978). Mothers rated their
child’s attitudes and behavior on a 6-point scale.
For this study, the rhythmicity, adaptability,
approach, intensity, and mood scales were added
to create an easy temperament variable (5–30;
Saylor, Boyce, & Price, 2003). Adequate internal
consistency has been reported for this composite
(a = .87; Bogat et al., 2006). For the present study,
scores ranged from 15 to 24 and showed good
internal consistency (a = .85 at age 2, a = .85 at age
3, a = .81 at age 4). A dichotomous variable was
also created based on the median score (19):
Children whose score was greater than the median
were classified as having easy temperament; those
with scores lower than or equal to the median were
classified as difficult.

Child cognitive ability. This was the only measure
given at just one time point (age 4). Children’s cog-
nitive ability was measured using the Peabody Pic-
ture Vocabulary Test–Third Edition (PPVT–III;
Dunn & Dunn, 1997). The PPVT–III is a 204-item
measure of verbal ability for children ages 2.5 and
up. Children are asked to select which of four
black-and-white illustrations best represents a word
read aloud by the interviewer. Age-normed scores
(40–160) have a mean of 100 (SD = 10), and higher
scores reflect better cognitive functioning. Good
internal consistency (as = .93–.98.) and test–retest
reliability (rs = .89–.97) have been reported (Dunn
& Dunn, 1997). For the present sample, scores
ranged from 55 to 132.

Risk Factors

Maternal depression. Mother’s symptoms of
depression were assessed using the 21-item self-
report Beck Depression Inventory (BDI; Beck, Men-
delson, Mock, & Erbaugh, 1961). Participants select
the best self-description from four evaluative state-
ments with values from 0 to 3. A total score (0–63) is
obtained; higher scores reflect more severe symp-
toms. Good internal consistency (a = .86; Beck, Steer,
& Garbin, 1988) has been reported. For the present
study, scores ranged from 0 to 27 (a = .87 at age 2,
a = .90 at age 3, a = .90 at age 4). A dichotomous
score was used (Beck et al., 1988); scores greater than
or equal to 10 reflect mild to severe depression,
whereas scores less than 10 indicate no depression.

Stressful negative life events. Maternal stress asso-
ciated with negative life changes was assessed
using the 49-item Life Experiences Survey (LES;
Sarason, Johnson, & Siegel, 1978). Respondents
rated the occurrence and impact of 46 specific
events (e.g., ‘‘Death of a close family member’’)
during the last year on a 7-point scale, ranging
from extremely negative ()3) to extremely positive (3).
For the present study all the negative item ratings
were summed ()1 to )3). Scores ranged from 0 to
)147; lower scores indicate a greater degree of
stress. Good test–retest reliability has been reported
(r = .88; Sarason et al., 1978). For the present study,
scores ranged from 0 to )25 (a = .60 at age 2,
a = .68 at age 3, a = .71 at age 4).

Income and race. Participants reported their mean
monthly family income at each time period, and
the three scores were averaged into a total income
score, ranging from $400 to $11,333. Mothers
identified their child’s race (White ⁄ Caucasian,
Black ⁄ African American, biracial ⁄ mixed, Native
American, Asian American ⁄ Pacific Islander, and
Latino ⁄ Hispanic ⁄ Chicano). Because of the small
number of children in the last three groups as well
as the large number of children in the biracial
group, the racial grouping White or non-White was
used in the analyses.

Procedures

Participants were recruited from a Midwestern
state through flyers distributed to organizations
serving women as well as flyers posted in the
community. Interested pregnant women contacted
the project office and were screened by a research
assistant to determine eligibility: (a) 18 to 40 years
old, (b) able to understand English well enough to
complete interviews and questionnaires, and (c)
involved in a romantic relationship for at least
6 weeks during pregnancy. Items 6 to 14 of the
Conflict Tactics Scale (CTS; Straus, 1979) were
administered during the telephone interview, after
approximately half of the original sample had been
recruited and interviewed (n = 96), in order to
ensure that about 50% of the final sample
experienced DV during pregnancy. Women were
categorized as experiencing DV if they indicated that
any of the CTS events occurred during pregnancy.
One hundred and sixty-one women were excluded
because they did not meet age, relationship status,
or DV criteria; there were no demographic
differences between these excluded women and
participants. The final participants were

Child Resilience to Domestic Violence 567

demographically representative of the area where
they were recruited.

All women were first interviewed for the larger
study during their last trimester of pregnancy. For
the present research, interviews occurred at the
child’s second, third, and fourth birthdays. Mother
and child were interviewed at the project offices
and mothers completed all measures, except the
child’s cognitive ability test. Interviews were con-
ducted by graduate student project staff members
and trained undergraduate research assistants. The
DV questionnaires were administered last, to
ensure that interviewers were blind to the woman’s
abuse status for as long as possible. Interviews took
about 2 to 3 hr to complete. Women were paid
for their participation, and children received an
age-appropriate gift.

Results

Missing Data and Data Reduction

Missing data were imputed using the Hot Deck
method (LISREL; Jöreskog & Sörbom, 1996). One
case could not be imputed through this procedure
and was imputed using the expectation-maximiza-
tion algorithm (EM algorithm; SYSTAT 11, 2004).
Overall, only 8% of all data points were imputed.
Missing data estimates for all the variables
were based on total DV, maternal depression,
and income at pregnancy, as well as child’s
temperament at 2 months old. All transformations,
composites, and dichotomizations of continuous
scores were conducted after imputation.

Correlations between missingness dichotomous
variables (missing data = 1, complete data = 0) and
the original variables were either nonsignificant or
small (r < .30), indicating a nonsystematic pattern of attrition. Additionally, when participants were classified into complete data versus missing data groups, there were no significant differences in total DV exposure, maternal depression, or income at pregnancy. Therefore, the imputed data set was used in all analyses.

Most predictor variables (except for race and
cognitive ability) were measured at ages 2, 3, and
4, and all showed relative stability over time
(rs = .29–.66). To attain more parsimonious models
and avoid multicollinearity, average scores for all
variables were used in analyses. The averaged
predictors showed small- to medium-size associa-
tions among themselves (rs = .10–.54) and with
children’s internalizing and externalizing behav-
iors (rs = .08–.57).

Hypothesis Testing

DV Exposure and the Odds of Resilience

To address the first hypothesis, DV and adapta-
tion were cross-classified to obtain four groups of
children: (a) resilient: exposed to DV and displayed
positive adaptation (n = 62), (b) nonresilient:
exposed to DV and displayed negative adaptation
(n = 51), (c) competent: not exposed to DV and dis-
played positive adaptation (n = 63), and (d) vulnera-
ble: never exposed to DV and displayed negative
adaptation (n = 14; see Table 1). Fifty-four percent
of DV-exposed children displayed resilience,
whereas 82% of nonexposed children showed
positive adaptation. Odds ratio (OR) analysis of the
four group frequencies showed a strong main effect
for DV exposure, indicating that DV-exposed chil-
dren were 3.7 times (95% confidence interval
[CI] = 1.86, 7.36, d = .72) more likely to develop
behavioral or emotional problems.

Adaptation and DV duration (zero to three time
periods of exposure) were cross-classified to deter-
mine the link between prolonged exposure and the
likelihood of positive adaptation. Eight groups of
children were obtained (see Table 1): four with
positive adaptation (not exposed to DV, n = 63;
exposed at one time period, n = 30; exposed at two
time periods, n = 16; and exposed at three time
periods, n = 16); and four with negative adaptation
(not exposed to DV, n = 14; exposed at one time
period, n = 18; exposed at two time periods, n = 14;
and exposed at three time periods, n = 19).

Positive

adapation was achieved by 62% of children
exposed during one time period, 55% exposed dur-
ing two time periods, and 45% exposed during
three time periods. OR analysis showed that
children in all the DV-exposed groups were
significantly more likely to show externalizing or

Table 1

Group Frequencies: Cross Classification of Adaptation by Domestic

Violence (DV) Exposure and DV Duration

Positive
adaptation
Negative
adaptation

No DV exposure 63 14

DV exposure 62 51

DV duration (No.

of time periods)

DV duration (No.
of time periods)

1 2 3 1 2

30 16 16 18 14 19

568 Martinez-Torteya, Bogat, von Eye, and Levendosky

internalizing problems, with effect sizes ranging
from medium to large (one time exposure,
OR = 2.7, 95% CI = 1.19, 6.15, d = .55; two times,
OR = 3.94, 95% CI = 1.57, 9.90, d = .76; and three
times, OR = 5.34, 95% CI = 2.12, 12.91, d = .93).
However, among DV-exposed children, longer
duration of DV exposure did not significantly
increase the likelihood of negative adaptation (one
vs. two times, OR = 1.46, 95% CI = .58, 3.68;
two vs. three times, OR = 1.36, 95% CI = .51, 3.61;
and one vs. three times, OR = 1.98, 95% CI = .82,
4.79).

The cross-classification of Adaptation · DV
Duration suggested that the number of positively
adapted children diminished with prolonged DV
exposure, whereas the number of children with
internalizing or externalizing problems remained
fairly constant (see Table 2). Log-linear modeling
was used to elucidate this trajectory. First, a main
effects model (DV Duration · Adaptation) was esti-
mated. The model showed significant lack of fit, LR
v2(3, N = 190) = 16.98, p = .00, and indicated that a
linear trajectory does not provide an accurate repre-
sentation of the groups’ observed frequencies.
Alternatively, a nonstandard model (Mair & von
Eye, 2007) including three variables (the main effect
of adaptation and independent DV duration main
effects for positively adapted and negatively
adapted children) was estimated, with high power
(.93) to detect medium-sized effects (Gpower;
Erdfelder, Faul, & Buchner, 1996).

The model showed adequate fit, LR v2(4, N = 190)
= 3.64, p = .46, and Pearson v2(4, N = 190) = 3.69,

p = .45, and revealed significant main effects of DV
duration for positively adapted children (z = )5.91,
p = .00), but not for negatively adapted children
(z = 0.61, p = .53). Thus, the number of positively
adapted children significantly decreased and the
number of negatively adapted children remained
constant as the number of exposure periods
increased.

Protective and Risk Factors

Multinomial logistic regression (Hosmer & Lem-
eshow, 1989) was conducted (SPSS 14.0) to examine
the second research hypothesis. Group status (resil-
ient, nonresilient, competent, or vulnerable) was
predicted using a main effects model with the pro-
tective (i.e., positive parenting, easy temperament,
and cognitive ability) and risk factors (i.e., maternal
depression, stressful life events, low income, and
race) entered in the first step, using the resilient
group as the comparison group. Power for detect-
ing medium-sized effects in this analysis was high
(.95). The model was also estimated using family
size as a covariate, to control for its influence on
socioeconomic status (SES), and results remained
unchanged.

The main effects model showed significantly
better fit than the null model, LR v2(21,
N = 190) = 131.24, p = .00, and the overall model fit
was excellent, LR v2(546, N = 190) = 353.89,
p = 1.00, and Pearson v2(546, N = 190) = 559.27,
p = .34. Taken together, the main effects of all pre-
dictors explained a large amount of variance in

Table 2

Descriptive Statistics by Group

Resilient

(n = 62)

Non resilient

(n = 51)

Competent

(n = 63)

Vulnerable

(n = 14)

Mean (SD) Mean (SD) Mean (SD) Mean (SD)

Race 47% White

53% non-White

35% White

65% non-White

60% White

40% non-White

36% White

64% non-White

Income 2281.10 (1130.49) 1862.71 (1193.22) 3266.18 (2328.31) 2891.27(2650.82)

Maternal Depression 5.68 (4.73) 9.90 (6.03) 3.16 (2.79) 10.40 (8.73)

Negative Life Events )6.21 (4.35) )7.83 (4.83) )3.08 (3.22) )5.31 (3.60)
Positive Parenting 172.22 (10.50) 168.18 (11.95) 180.03 (11.67) 174.86 (13.99)

Easy Temperament 19.43 (1.43) 17.86 (1.32) 20.00 (1.51) 18.10 (1.41)

Cognitive Ability 93.35 (18.25) 90.94 (19.63) 101.32 (18.21) 95.14 (16.34)

DV Frequency 7.05 (11.04) 5.88 (6.18)

DV Duration 1.78 (0.83) 2.02 (0.86)

Internalizing 41.76 (5.36) 50.62 (5.35) 39.98 (4.81) 50.19 (5.46)

Externalizing 45.12 (5.50) 55.58 (5.68) 42.40 (5.03) 54.69 (6.15)

Note. Domestic violence (DV) Frequency and DV duration were not calculated for the non-exposed groups.

Child Resilience to Domestic Violence 569

group membership (Nagelkerke R2 = .54); how-
ever, only negative life events, LR v2(3,
N = 190) = 368.03, p = .00; maternal depression, LR
v2(3, N = 190) = 377.69, p = .00; and child’s easy
temperament LR v2(3, N = 190) = 394.33, p < .00, emerged as significant predictors (see Table 3). Pre- dictors showed small- to medium-sized effects. Children who exhibited higher levels of easy tem- perament (OR = .39, 95% CI = .26, .58, d = .52) and whose mothers reported less depression (OR = 1.14, 95% CI = 1.03, 1.25, d = .07) were more likely to be classified resilient than nonresilient. Additionally, resilient children experienced more stressful life events (OR = 1.22, 95% CI = 1.07, 1.40, d = .11) than competent nonexposed children. The three predictors also significantly discriminated resilient children from their vulnerable peers: Chil- dren in the vulnerable group experienced fewer stressful life events (OR = 1.26, 95% CI = 1.03, 1.55, d = .13), had more difficult temperaments (OR = .37, 95% CI = .21, .65, d = .55), and had mothers with higher levels of depression (OR = 1.26, 95% CI = 1.10, 1.44, d = .13). Impor- tantly, this group of children was not exposed to DV, but did encounter other environmental risks or vulnerabilities, such as more depressed mothers and more difficult temperaments.

DV duration and frequency could not be
incorporated in the previous model because the
nonexposed groups had zero variance. Therefore,
binomial logistic regression was conducted only
with DV-exposed children (n = 113). Race,
income, positive parenting, easy temperament,
cognitive ability, maternal depression, stressful
life events, DV frequency, and DV duration were
entered simultaneously in the first step of the
model. Power for detecting medium-sized effects
was adequate (.86). The main effects model

showed significantly better fit than the null
model, LR v2(9, n = 113) = 47.22, p = .00, and
had overall good fit, Hosmer–Lemeshow v2(8,
n = 113) = 12.93, p = .11, explaining a large
percentage of the variance (Nagelkerke R2 = .46).
Maternal depression (OR = 1.14, 95% CI = 1.02,
1.28, d = .07) and easy temperament (OR = 0.46,
95% CI = 0.31, 0.68, d = .43) emerged again as
significant predictors of resilience, with small
to medium effect sizes. Income, race, DV
duration, or average frequency of DV did not
(see Table 4).

Configurations of DV Exposure, Protective, and Risk
Factors

To test the association between specific
trajectories of DV exposure (e.g., early vs. late
exposure, chronic vs. intermittent exposure) and
resilience, prediction configural frequency analysis

Table 3

Multinomial (Four Groups) Logistic Regression Predicting Resilience

Nonresilient Competent Vulnerable

B OR (CI) B OR (CI) B OR (CI)

Race .60 1.83 (0.69–4.84) ).11 .90 (0.38–2.13) 1.12 3.07 (.65–14.52)
Income .00 1.00 (0.99–1.00) .00 1.00 (1.00–1.00) .00 1.00 (1.00–1.00)

Maternal depression .13* 1.14 (1.03–1.25) ).02 .98 (0.86–1.11) .23* 1.26 (1.10–1.44)
Negative life events .02 1.02 (0.92–1.13) .20* 1.22 (1.07–1.40) .23* 1.26 (1.03–1.55)

Positive parenting .01 1.01 (0.97–1.06) .03 1.03 (0.99–1.08) .04 1.04 (0.98–1.11)

Easy temperament ).94* .39 (0.26–0.58) .07 1.07 (0.81–1.42) )1.00* .37 (0.21–0.65)
Cognitive ability .02 1.02 (0.99–1.05) .01 1.01 (0.99–1.03) .02 1.02 (0.98–1.07)

Note. LR v2(546, N = 190) = 353.89, p = 1.00; Pearson v2(546, N = 190) = 559.27, p = .34; Nagelkerke R2 = .54; reference group: resilient.
*p < .05.

Table 4

Binary (Two Group) Logistic Regression Predicting Resilience

Wald p OR CI

Race 2.05 .15 0.47 0.17–1.32

Income 2.57 .11 1.00 0.99–1.00

Depression 5.48 .02 1.14* 1.02–1.28

Negative life events 0.20 .66 1.03 0.92–1.15

Positive parenting 0.12 .73 1.01 0.96–1.06

Easy temperament 15.57 .00 0.46* 0.31–.68

Cognitive ability 1.10 .29 1.02 0.99–1.01

DV frequency 2.92 .09 0.94 0.88–1.01

DV duration 1.37 .24 1.46 0.77–2.74

Note. LR v2(9, n = 113) = 12.93, p = .11; Negelkerke R2 = .46;
reference group: resilient. OR = odds ratio; CI = confidence
interval; DV = domestic violence.
*p < .05.

570 Martinez-Torteya, Bogat, von Eye, and Levendosky

(PCFA; von Eye, 2002) was used. PCFA is a cate-
gorical data analysis technique that identifies types
and antitypes, which indicate a relation between a
specific configuration of predictors and the criterion
(von Eye & Bogat, 2005). Types are those configura-
tions that occur more often than expected by
chance; antitypes are those that occur less often
than expected by chance. The base model for PCFA
is saturated both within the predictors and the
criterion variables; thus, the first- and second-order
autocorrelations between repeated measures (e.g.,
DV at ages 2, 3, and 4) are accounted for in the
analysis.

DV status at ages 2, 3, and 4 was used to
create predictor configurations (1 = no exposure,
2 = DV exposure); total adaptation was used as
the criterion (1 = positive across all of the time peri-
ods, 2 = negative at any time period). A 2 (DV at
age 2) · 2 (DV at age 3) · 2 (DV at age 4) · 2
(adaptation) cross-classification yielded 16 differ-
ent configurations; for example, the configuration
2221 describes a child who was exposed to DV
during all three time periods and maintained
positive adaptation. The Lehmacher Test with
Bonferroni correction was used, which is
appropriate for product-multinomial sampling.
Deviations from the model (types or antitypes)
were significant if p < .003. Power to detect medium effect sizes was adequate (.88).

The base model was not a good fit for the pat-
tern of cell frequencies, LR v2(7, N = 190) = 23.23,
p = .00; that is, the results cannot be accurately
explained by the main effects or associations
among the predictors; thus, types and ⁄ or antitypes
are expected to emerge. Results indicated two
types (1111 and 2222) and two antitypes (1112 and
2221; see Table 5). The first type, 1111, fo = 63,
fe = 50.66, p = .00, represents children who were
not exposed to violence at any time period and
who exhibit positive adaptation. Its reciprocal anti-
type, 1112, fo = 14, fe = 26.34, p = .00, portrays chil-
dren who were never exposed to violence and
developed negative adaptation. The second type,
2222, fo = 19, fe = 11.97, p = .00, represents children
who were exposed to DV at all time periods and
display negative adaptation, and its reciprocal an-
titype, 2221, fo = 16, fe = 23.03, p = .00, describes
children who were continuously exposed to DV
and maintained resilience. Taken together, these
configurations indicate that chronic DV exposure
predicts the development of internalizing or exter-
nalizing problems. As expected, children who
were never exposed to DV are more likely to dis-
play positive behavioral outcomes. However, no

other specific patterns of DV exposure (e.g., early
exposure) showed specific associations with posi-
tive or negative behavioral and emotional out-
comes.

To identify characteristic configurations of pro-
tective factors, risk factors, and DV exposure that
are associated with resilience, a main effects confi-
gural frequency analysis (CFA) model was tested
among the DV-exposed participants (n = 113). CFA
also identifies types and antitypes among variables,
but the variables are not specified as predictors and
criteria as in PCFA (von Eye, 2002). A first-order
CFA base model assumes that the variables are not
associated among themselves, and it accounts only
for their individual main effects. Significant devia-
tions from the model (types or antitypes) are
obtained based on the comparison of observed and
estimated frequencies and indicate second-order
interactions among the variables.

Only the predictors that achieved significance in
previous models were included in this analysis.
Four categorical variables were included: maternal
depression (1 = absent, 2 = present), easy tempera-
ment (1 = low, 2 = high), DV duration (one to three
time periods), and adaptation (1 = positive, 2 = neg-
ative). These variables were cross-classified to
obtain 24 patterns that represented children’s
profile of risk ⁄ protective factors, duration of DV

Table 5

Prediction CFA: DV at Ages 2, 3, and 4, Predicting Adaptation

Predictors Criteria Prediction CFA

DV
2
DV
3
DV

4 Adaptation foijkl feijkl zijkl pijkl

N N N + 63 50.66 3.83 T .000

N N N ) 14 26.34 )3.83 A .000
N N Y + 13 10.53 1.36 .087

N N Y ) 3 5.47 )1.36 .087
N Y N + 6 5.92 0.06 .477

N Y N ) 3 3.08 )0.06 .477
N Y Y + 3 3.95 )0.83 .204
N Y Y ) 3 2.05 0.83 .204
Y N N + 11 15.13 )1.93 .027
Y N N ) 12 7.87 1.93 .027
Y N Y + 9 9.87 )0.49 .312
Y N Y ) 6 5.13 0.49 .312
Y Y N + 4 5.92 )1.38 .084
Y Y N ) 5 3.08 1.38 .084
Y Y Y + 16 23.03 )2.76 A .003
Y Y Y ) 19 11.97 2.76 T .003

Note. LR v2(7, N = 190) = 23.226, p = .002; Lehmacher test with
Bonferroni-adjusted p = .003; fo = observed frequency; fe =
expected frequency; T = Type; A = Antitype.

Child Resilience to Domestic Violence 571

exposure, and adaptation. For example, the pattern
1111 represents children whose mothers are not
depressed, who show low levels of easy tempera-
ment, who experienced DV at one time period,
and who exhibit positive adaptation. The Lehm-
acher test with Bonferroni correction was used to
protect from Type I errors (p < .002). Because of the large number of configurations, this analysis’ power estimate (.43) was lower than desirable; thus, results can be considered a conservative estimate of the possible associations between the variables. Accordingly, types and antitypes that constitute smaller deviations from the main effects model might not have been identified as significant.

The main effects model was not a good fit for the
pattern of cell frequencies, LR v2(18, n = 113) =
57.55, p = .00, which indicates local associations
among the variables. Three types emerged: 1211,
1221, and 2132 (Table 6). The first configuration
1211, fo = 15, fe = 7.44, p = .00, describes a group of
resilient children whose mothers are not depressed,
who have easy temperaments, and who were

exposed to DV only during one time period. The
second configuration, 1221, fo = 10, fe = 4.65,
p = .00, describes a similar group of children who
experienced DV at two time periods. Taken
together, these two types indicate that absence of
maternal depression and presence of child easy
temperament are associated with resilience, but
only among children with one or two time periods
of DV exposure. The last configuration, 2132, fo = 9,
fe = 2.65, p = .00, describes the group of nonresilient
children whose mothers report high levels of
depression, display difficult temperaments, and
were exposed to DV during three time periods. This
pattern suggests that chronic DV in the household
is associated with maternal depression, more diffi-
cult child temperament, and negative adaptation.

Discussion

The present study explored resilience among
DV-exposed young children. The study identified a
group of DV-exposed children who maintained

Table 6

CFA With DV-Exposed-Only Children: Depression, Temperament, DV Duration, and Adaptation

Cell index CFA

Depression Temperament Duration Adaptation foijkl feijkl zijkl pijkl

N ) 1 + 13 11.67 .52 .303
N ) 1 ) 7 9.60 1.07 .142
N ) 2 + 5 7.29 1.06 .145
N ) 2 ) 6 6.00 .00 .500
N ) 3 + 3 8.51 2.40 .008
N ) 3 ) 10 7.00 1.39 .082
N + 1 + 15 7.44 3.40 T .000

N + 1 ) 4 6.12 1.02 .154
N + 2 + 10 4.65 2.89 T .002

N + 2 ) 3 3.83 .48 .315
N + 3 + 6 5.43 .29 .385

N + 3 ) 0 4.46 2.44 .007
Y ) 1 + 2 4.41 1.33 .093
Y ) 1 ) 6 3.63 1.41 .080
Y ) 2 + 0 2.76 1.84 .033
Y ) 2 ) 3 2.27 .53 .300
Y ) 3 + 5 3.22 1.12 .132
Y ) 3 ) 9 2.65 4.31 T .000
Y + 1 + 0 2.81 1.85 .032

Y + 1 ) 1 2.31 .94 .173
Y + 2 + 1 1.76 .62 .269

Y + 2 ) 2 1.45 .50 .312
Y + 3 + 2 2.05 .04 .485

Y + 3 ) 0 1.69 1.40 .082

Note. LR v2(18, n = 113) = 57.554, p = .000; Lehmacher test with Bonferroni-adjusted p = .002. CFA = confirmatory factor analysis;
DV = domestic violence; fo = observed frequency; fe = expected frequency; T = type.

572 Martinez-Torteya, Bogat, von Eye, and Levendosky

positive adaptation throughout ages 2–4. Fifty-four
percent of DV-exposed children in this community
sample were classified as resilient, which suggests
that positive adaptation in the face of adversity is
common and embedded in the processes of normal
development (Masten, 2001). Results are consistent
with previous studies with DV-exposed shelter-
residing children (Grych et al., 2000; Hughes &
Luke, 1998). However, DV exposure confers
an almost fourfold increase (OR = 3.7) in the
likelihood of internalizing or externalizing prob-
lems. Similar results have been reported in previ-
ous studies (e.g., Sternberg et al., 2006).

Examination of duration, frequency, and trajecto-
ries of DV exposure as predictors of children’s
behavioral ⁄ emotional outcomes provided mixed
results. One-unit increases in DV duration were not
associated with higher likelihood of internalizing
and externalizing symptoms, as indicated by the
odds-ratio analysis and the binary logistic regres-
sion results. Similarly, frequency of DV exposure
did not predict resilience, indicating that the main-
tenance of positive adaptation is not a direct result
of exposure to lower levels of adversity. However,
log-linear modeling techniques and person-
centered analyses (CFA) suggest a complex relation
between DV duration and resilience: Prolonged
exposure prevented the development of positive
adaptation rather than directly increasing the likeli-
hood of negative outcomes. That is, the number of
positively adapted children decreased as the num-
ber of time periods of exposure increased, but
increases in DV duration were not associated with
greater numbers of negatively adapted children.
Findings underscore the heterogeneity of outcomes
displayed by DV-exposed children and the impor-
tance of using person oriented methods; a main
effects model, which aggregates all DV-exposed
children in the same group, did not provide an
accurate explanation of the relation between
duration of exposure and children’s adaptation.

Additionally, exploration of DV trajectories as
predictors of resilience revealed that constant expo-
sure to DV predicted the development of internaliz-
ing or externalizing problems, whereas no specific
configuration of exposure (e.g., single exposure,
early exposure) was associated with resilience.
Findings suggest that the experience of those chil-
dren who are continuously under stress is qualita-
tively different from that of children exposed to
intermittent DV. Children who experience intermit-
tent DV exposure might benefit from periods of less
stress and of relatively higher quality family func-
tioning. As pointed out by previous research with

high-risk populations, when children face continu-
ous and severe environmental stressors, it is
unlikely that they will be able to sustain resilient
adaptation over time (Luthar & Zelazo, 2003).
Children were only assessed during the early
childhood period, and results should not be
generalized to middle childhood or adolescence.
Future research should compare the effects of
exposure at these different developmental periods
to determine whether there are potential
discontinuities in children’s adaptation.

Findings identified specific individual and fam-
ily factors that predicted children’s group status
(resilient, nonresilient, competent, or vulnerable).
The main effects model, which included income,
race, positive parenting, child easy temperament,
child cognitive ability, maternal depression, and
stressful life events, was a good predictor of chil-
dren’s group status. The combination of all predic-
tors provided a better fit for the data than models
that only included an isolated variable, underscor-
ing the multiply-determined nature of children’s
behavior. Overall, resilient children had more pro-
tective factors and lower levels of risk as compared
to their nonresilient peers; they differed from com-
petent nonexposed children only in their higher
levels of stressful life events. The similarity
between both groups of positively adapted children
is consistent with previous findings from longitudi-
nal, person-oriented research (e.g., Masten et al.,
1999). Interestingly, resilient children were exposed
to lower levels of maternal depression and had eas-
ier temperaments as compared to vulnerable chil-
dren, which suggests that the vulnerable children
were under considerable amounts of stress and had
few resources to manage their environments,
despite not being exposed to DV. Consistent with
previous research (e.g., Masten et al., 1999), only a
small percentage of nonexposed children were clas-
sified as vulnerable.

Maternal depression and child’s easy tempera-
ment emerged as significant predictors of resilience.
These findings are consistent with previous
research with other high-risk populations (e.g.,
Tschann et al., 1996), including DV-exposed chil-
dren (Hughes & Luke, 1998). Mothers with good
mental health are more likely to model appropriate
responses to stressful events and help their children
achieve healthy emotion regulation. On the other
hand, depressed mothers are more likely to provide
a role model of dysregulated responses to stress.
DV-exposed children with easy temperaments are
also more likely to display positive adaptation, as
their low reactivity, high adaptability, and positive

Child Resilience to Domestic Violence 573

mood might promote the development of self-
regulatory competence (Olson et al., 2002) and elicit
positive responses from their caregivers and other
adults (Rutter & Quinton, 1984).

Surprisingly, positive parenting, child cognitive
ability, stressful life events, income, and race did
not significantly predict children’s adaptation. Pre-
vious research has shown that parental warmth
and support predict positive adaptation (e.g., Katz
& Gottman, 1997). However, the effects of positive
parenting might have less impact in a chaotic envi-
ronment, such as that of DV households, which
may require stricter parenting to foster competence
(see Baldwin, Baldwin, & Cole, 1990; Levendosky &
Graham-Bermann, 2000). Measurement issues
might also account for some of the discrepancies
with previous studies. The present study used self-
report measures, and a social desirability bias
might have influenced maternal reports. Addition-
ally, cognitive ability was not significantly associ-
ated with resilience, which is inconsistent with
some previous findings (e.g., Tiet et al., 1998).
Inconsistencies with previous results might be asso-
ciated with measurement differences, as the current
research used the PPVT–III, which is strongly
dependent on verbal cognitive ability.

In this research, exposure to stressful life events
did not discriminate between resilient and nonresil-
ient children; however, DV-exposed children (both
resilient and nonresilient) had more stressful life
events than did nonexposed children (both compe-
tent and vulnerable). The association between DV
exposure and other stressful life events has been
previously reported (Eby, 2004), reflecting the dis-
organized environments faced by abused women
and their children. Additionally, the same pattern
(worse outcomes for DV-exposed children) was
also observed for positive parenting and cognitive
ability, although differences did not achieve statisti-
cal significance. This pattern is consistent with pre-
vious findings on abused women’s parenting (e.g.,
Levendosky & Graham-Bermann, 2000) and DV-
exposed children’s verbal cognitive ability (e.g.,
Huth-Bocks et al., 2001). Results suggest that these
resources might be reduced by DV exposure, even
within the group of children that achieve positive
behavioral adaptation.

Racial background was not a significant predictor
of resilience. However, in this research children
were classified as White or non-White, which might
have obscured the influence of belonging to a
particular racial group (i.e., Black, Latino, Asian
American, Native American, and biracial children
were all aggregated in the non-White group).

Moreover, although race showed nonsignificant
main effects in the present study, its moderating
effects on other protective and risk factors require
further exploration.

Consistent with contemporary conceptualizations
of development and resilience (Masten, 2001),
results suggest that resilience is associated with
specific configurations of adversity (DV exposure),
protective, and risk factors. Among DV-exposed
children, the combination of child easy tempera-
ment and absence of maternal depression was asso-
ciated with positive outcomes after one or two time
periods of exposure. The association between easy
temperament and absence of maternal depression
reflects a competent mother–child dyad in which
the young child effectively obtains what she or he
needs from a responsive mother and is protected
against the effects of intermittent DV. Conversely, a
distinguishable group exposed to cumulative
adversity was identified. More children than
expected by chance exhibited co-occurring maternal
depression, negative temperament, chronic DV, and
negative behavioral adaptation. This configuration
suggests that chronic DV is associated with other
risk factors at the individual and family levels, and
the interaction of chronic adversity and impover-
ished resources disrupts the patterns of normal
adaptation.

There are some limitations to this study. First, all
predictors were assessed through maternal reports,
except for child’s cognitive ability. Although there
is some evidence that depressed mothers do not
consistently overreport their children’s behavioral
problems (Richters, 1992), results should be inter-
preted with caution because maternal reports might
have been influenced by maternal characteristics or
social desirability biases. Unfortunately, because of
the young age of the child participants, it would
have been difficult and unreliable to obtain
their own reports of DV exposure, environmental
characteristics, or behavior ⁄ well-being. Future
research would benefit from a multi-informant,
multimethod approach.

Additionally, despite the high retention rate of
this research, excluded participants had signifi-
cantly higher levels of depression, more frequent
DV exposure, and lower family income during
pregnancy. Therefore, results might not generalize
to women who are experiencing frequent violence
and high levels of adversity.

The definition of resilience for the present study
was based on behavioral and emotional outcomes.
Measures of positive adaptation (e.g., achieve-
ment of developmental milestones, quality of peer

574 Martinez-Torteya, Bogat, von Eye, and Levendosky

relations, school achievement) would provide a
comprehensive assessment of resilience. Moreover,
all predictors were measured as continuous vari-
ables, such that high levels of a given predictor
might be considered protective (e.g., positive par-
enting), whereas low levels of the same predictor
reflect risk (e.g., harsh parenting). This approach
does not allow for identification of purely protec-
tive mechanisms and might not accurately repre-
sent the effects of variables that only exert influence
at one end of the continuum or that have nonlinear
associations with adaptation (Luthar et al., 2006).

Lastly, the sample size placed a constraint on the
statistical analyses. For example, it was not possible
to test for differences associated with the develop-
mental period in which the protection ⁄ risk
occurred or the different patterns (increasing vs.
decreasing) of exposure or resources. Similarly,
testing for interactions between risk ⁄ protection and
specific racial backgrounds was not possible within
the current sample. Additionally, this research was
not able to examine trajectories of behavioral out-
comes and the effects of protective factors on
changes (e.g., continuity or discontinuity) in adap-
tation. Growth curve modeling techniques or
group-based semiparametric models are especially
suited to address these important questions. Longi-
tudinal studies with large samples of DV-exposed
children are needed.

In summary, the present article contributes to
the current understanding of the effects of DV
exposure on children’s development as well as the
characteristics of young children who maintain
resilience in the context of intimate partner violence
directed toward their mothers. Findings indicate
that resilience in the face of DV exposure does
occur and is associated with a configuration of co-
occurring protection and lower risk, particularly
when DV exposure is limited. Future research
should address the stability of DV-exposed chil-
dren’s positive adaptation as well as the role of
these individual and family characteristics as pro-
tective or risk factors at different developmental
stages.

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Clinical Child and Family Psychology Review, Vol. 6, No. 3, September 2003 ( C© 200

The Effects of Children’s Exposure to Domestic Violence:
A Meta-Analysis and Critiqu

David A. Wolfe,1,2,4 Claire V. Crooks,1 Vivien Lee,1

Alexandra McIntyre-Smith,1 and Peter G. Jaffe3

A wide range of children’s developmental outcomes are compromised by exposure to domestic
violence, including social, emotional, behavioral, cognitive, and general health functioning.
However, there are relatively few empirical studies with adequate control of confounding
variables and a sound theoretical basis. We identified 41 studies that provided relevant and
adequate data for inclusion in a meta-analysis. Forty of these studies indicated that children’

exposure to domestic violence was related to emotional and behavioral problems, translating to
a small overall effect (Zr = .28). Age, sex, and type of outcome were not significant moderators,
most likely due to considerable heterogeneity within each of these groups. Co-occurrence of
child abuse increased the level of emotional and behavioral problems above and beyond
exposure alone, based on 4 available studies. Future research needs are identified, including
the need for large-scale longitudinal data and theoretically guided approaches that take into
account relevant contextual factors.

KEY WORDS: domestic violence; child witnesses; marital aggression; meta-analysis; child behavior prob-
lems; family violence; child abuse.

Describing the effects of exposure to domestic vi-
olence on children and adolescents has been the sub-
ject of intense research efforts since early studies o

this topic emerged in the mid-1980s. Several scholarly
reviews have been conducted of this literature, result-
ing in a general consensus that exposure to domes-
tic violence has a significant and measurable negative
effect on children’s functioning, relative to children
from nonviolent families (Edleson, 1999; Fantuzzo &
Lindquist, 1989; Fantuzzo & Mohr, 1999; Margolin
& Gordis, 2000; Wolak & Finkelhor, 1998). These

1Centre for Research on Violence Against Women and Children,
The University of Western Ontario, London, Ontario, Canada.

2Centre for Addiction and Mental Health, The University of
Toronto, Toronto, Canada.

3Centre for Children and Families in the Justice System of the
London Family Court Clinic, London, Ontario, Canada.

4Address all correspondence to David A. Wolfe, Centre fo

Research on Violence Against Women and Children, The Uni-
versity of Western Ontario, 1137 Western Road, Room 1118, Fac-
ulty of Education Building, London, Ontario, Canada N6G 1G7;
e-mail: dawolfe@uwo.ca.

negative effects pertain to emotional and behavioral
functioning, social competence, school achievement,
cognitive functioning, psychopathology, and general
health. Although some of these effects have been
replicated across studies and generally fit with theo-
retical and clinical expectations, there are a number of
methodological issues that cloud their interpretation.

Researchers acknowledge that exposure to do-
mestic violence is a nonspecific risk factor for devel-
opmental harm, typifying the process of multifinality
of development (Sameroff, 2000). That is, such expo-
sure is part of a group of harm-producing contextual
factors (such as child abuse, harsh parenting practices,
and other forms of trauma and violence) that interfere
with normal development and lead to unpredictable,
but generally negative, outcomes in the short- and
long-term. Embedded in the literature is the further
assumption that exposure to domestic violence cre-
ates a negative impact on children’s emotional and
behavioral adjustment over and above other coexist-
ing factors (i.e., it is not merely a confound or a cor-
relate). Saunders (2003) underscores this latter poin

171

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172 Wolfe, Crooks, Lee, McIntyre-Smith, and Jaffe

by reporting how different types of violence often co-
occur in children’s lives and, coupled with the comor-
bidity of problem outcomes, investigations of any sin-
gle type of violence face considerable challenges.

Although recognizing that exposure to domestic
violence is often harmful, researchers have caution

that the heterogeneity of the population, variability
in findings across studies, and many other method-
ological limitations pose considerable obstacles to
implying a cause and effect relationship (Edleson,
1999; Fantuzzo & Lindquist, 1989). Given the num-
ber of methodological concerns that have been noted
in these reviews, it is important to examine the overall
empirical findings (including possible moderators of
the impact of domestic violence on children) with a
cautious lens. Significant remaining barriers include,
for example, sampling concerns (i.e., generalization
from shelter samples), reliance on mother-only rat-
ings of children’s behavior, defining exposure to vio-
lence, and separating the impact of child abuse fro

indirect exposure to domestic violence. As well, the
literature suffers from a lack of theoretical clarity and
guidance, which seems especially warranted given the
complexity of the issues involve

A DEVELOPMENTAL PSYCHOPATHOLOGY
FRAMEWORK

Developmental psychopathology provides a use-
ful framework for organizing the study of children’s
exposure to domestic violence. This framework em-
phasizes the role of developmental processes, the im-
portance of context, and the influence of multiple and
interacting events in shaping adaptive as well as mal-
adaptive development (Rutter & Sroufe, 2000). More-
over, the importance and complexity of family, social,
and cultural factors are acknowledged in predicting
and understanding developmental changes and ab-
normal outcomes, and single-variable causes are held
to greater scrutiny. This framework, therefore, con-
siders how children adapt to harsh events in their
daily surroundings, such as direct and indirect forms
of violence, at the expense of important regulatory
processes, which compromises their ongoing devel-
opment. For example, episodes of violence and abuse
between family members may prompt efforts on the
part of the child to accommodate to such events and
form a hypervigilant, insecure approach to relation-
ships, often marked by strong emotions (e.g., frustra-
tion, disappointment, hostility, fear). From this per-
spective, children’s varied emotional and behavioral

problems associated with exposure to domestic vio-
lence are understandable in that they represent efforts
to adapt to a maladaptive situation.

Developmental psychopathology further rais

the importance of a multidimensional, interactive ap-
proach to the study of children’s development, in
contrast to static comparisons of one-to-one relation-
ships. This view, shared by other perspectives as well,
argues that there is rarely a direct causal pathway
leading to a particular outcome; instead, there are
ongoing interactions between protective and vulner-
ability factors within the child, between the child and
his or her surroundings, and among particular risk
factors. These factors are processes rather than ab-
solutes, since the same event or condition can func-
tion as either a protective or a vulnerability factor
depending on the overall context in which it occurs.
Acute, stressful situations as well as chronic adver-
sity put children’s successful development at risk, yet
these critical variables have rarely been controlled or
examined in relation to domestic violence exposure.
Finally, this perspective highlights the need to exam-
ine children’s normal and abnormal development in
relation to meaningful moderators such as sex, age,
and type of outcome.

Whereas studies of children’s exposure to do-
mestic violence have acknowledged the importan

of potential moderators that may affect developmen-
tal pathways, there has been only limited success

understanding their significance or roles. Shelter res-
idence of the sample, reliance on maternal report of
children’s behavior, and efforts to control for direct
and indirect exposure to violence are commonly men-
tioned as potential confounds or critical independent
variables. For example, because children exposed to
violence may present with similar difficulties to those
who are direct victims of abuse, it is difficult to de-
termine the degree to which behavioral outcomes are
attributable to one or the other (Saunders, 2003). Sec-
ond, there may be important differences in the char-
acteristics of the families and the symptoms of chil-
dren in these two groups (i.e., spouse-abusive versus
spouse- and child-abusive), which get obscured when
children exposed to domestic violence are grouped
together regardless of child abuse status (Shipman,
Rossman, & West, 1999). As a final consideration,
the presence of child abuse raises the issue of mul-
tiple risk factors or stressors, and is an important re-
minder of contextually valid research (see Margolin
& Gordis, 2000). Children’s age and sex are also noted
as being especially relevant in interpreting the effects
of exposure to domestic violence although, like the

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Children Exposed to Domestic Violence 173

contextual factors noted above, practical limitations
in sample selection often preclude any separate anal-
yses of these variables.

In summary, there is a wide degree of method
variance in the research conducted on children ex-
posed to domestic violence. These differences make it
difficult to compare across studies due to different def-
initions, samples, and methodology, and to draw firm
conclusions. Nonetheless, it is important to look for
common elements in these findings and examine theo-
retically relevant variables. Therefore, the main objec-
tive of this meta-analysis was to summarize the empir-
ical findings of research evaluating consequences of
domestic violence exposure on children. In addition,
attempts were made to identify moderators that might
lend more precision to the wide range of methodolo-
gies used in the area. The limits of the current lit-
erature are identified, in addition to suggestions for
advancing research in this area. We approached the
task of meta-analysis with these limitations and needs
firmly in mind, and therefore chose to use a conser-
vative approach to examining overall effect sizes and
potential moderators. Thus, the current meta-analysis
analyzes a smaller set of studies that more accurately
assess exposure to domestic violence, while keep-
ing in mind the potential methodological limitations
described above.

METHOD

Meta-analytic techniques facilitate the synthesis
of a large number of studies by distilling the empiri-
cal results to interpretable averages, thus potentially
identifying emerging themes across studies. One ap-
proach is to include every study that has been con-
ducted in an area, with the assumption that underly-
ing “truths” will be identified, and that the advantages
gained by a larger sample size outweigh the disadvan-
tages of potentially faulty design or logic in any one
study. This approach, used in a recent meta-analysis
on exposure to domestic violence, facilitates the inclu-
sion of a large number of studies (Kitzmann, Gaylord,
Holt, & Kenny, 2003). A competing model is the one
espoused by the Campbell Collaboration (n.d.),

international nonprofit organization that aims to help
researchers make well-informed decisions about the
effects of interventions in the social, behavioral, and
educational arenas. The goal of this collaboration is
to stimulate the empirical methodological research
required to improve the validity, relevance, and preci-
sion of systematic reviews and the randomized trials

and nonrandomized trials on which they are based.
Rather than including all available studies in a meta-
analysis or review, this approach advocates a theoret-
ically driven approach that relies on drawing conclu-
sion from studies that meet more stringent criteria.

The starting point for any meta-analysis is to con-
ceptually define the parameters of study with respect
to independent and dependent variables. Studies of
the effects of children’s exposure to domestic violence
have used wide-ranging parameters and various pop-
ulations, including parental conflict and divorce, ret-
rospective studies of exposure experienced by adults
as children, simulated conflict studies, and studies of
children exposed to domestic violence in their homes.
In contrast to Kitzmann et al. (2003), the current anal-
ysis incorporated only those studies that pertained to
children exposed to domestic violence. This decision
was based on the knowledge that there are so many
existing sources of error and variability in these stud-
ies (shelter status, clinical versus nonclinical samples,
etc.) that a more narrowly defined independent vari-
able increases the interpretability of the results.

PsycInfo and the National Clearinghouse on
Child Abuse and Neglect databases were searched
using the terms: [(domestic or interparental or mari-
tal) AND (exposure or witness*) AND (violence or
conflict or abuse or battered) AND (child or children
or youth)]. A manual search of the references of re-
view articles was also conducted to supplement the
electronic searches. Approximately 400 journal arti-
cles were initially found and evaluated with respect
to the inclusion criteria (below), and of those 40 met
our criteria and were included in the present analyses.
These 40 articles actually represent 41 studies as one
article had two separate studies (Jouriles, Norwood,
McDonald, Vincent, & Mahoney, 1996). The final 41
studies had been published in peer-reviewed journals
and included behavioral and/or emotional outcome
measures of children’s adjustment. See Table I for de-
scriptive information.

Inclusion and Exclusion Criteria

To calculate effect sizes, only studies that pub-
lished means and standard deviations for at least two
groups (i.e., a group of children exposed to domestic
violence and an appropriate nonexposed comparison
group) or correlations within a target group were an-
alyzed. A small number of methodologically sound
studies were excluded because they provided statis-
tics that were not applicable with meta-analysis (e.g.,
multiple regression coefficients).

P1: GMX
Clinical Child and Family Psychology Review (CCFP) pp923-ccfp-469658 July 18, 2003 12:22 Style file version Nov. 07, 2000

Ta
bl

e
I.

D
es

cr
ip

ti
on

s
of

St
ud

ie
s

U
se

d
in

M
et

a-
A

na
ly

si
s

P
ar

ti
ci

pa
nt

gr
ou

ps
(r

el
ev

an
tt

o
m

et
a-

an
al

ys
is

)
O

ut
co

m
es

m
ea

su
re

d
To

ta
l

B
oy

s
G

ir
ls

A
ge

ra
ng

e
Ta

g
et

Ta
rg

et
C

m
pa

ri
so

n
C

it
at

io
n

(N
)

(N
)
(N
)

(y
ea

rs
)

E
th

ni
ci

ti
es

G
ro

up
1

G
ro

up
2

G
ro

up
A

bu
se

d/
W

it
ne

ss
Sh

el
te

r
R

at
er

sa
In

t.
E

xt
.

P
T

SD
O

th
er

C
hr

is
to

po
ul

s
et

al
.

(1
98

7)
b

67
—

—
5–

13
79

%
C

au
ca

si
an

;
21

%
A

fr
ic

an
A

m
er

ic
an

Sh
el

te
r

(

n
=

37
)

C
om

m
un

it
y

C
on

tr
ol

(n
=

30
)

Y
es

O
ne

P
er

ce
iv

d
co

m
pe

te
nc

C
oy

ne
,B

r
re

tt
,&

D
uf

fy
(2

18
18

0
7–

11
N

ot
sp

ec
ifi

ed
W

it
ne

ss
es

(n
=

10
)

C
om
m
un
it
y

co
nt

ro
l(

n
=

8)
N

o
O

e
×

×
C

P
IC

th
re

at
;

B
la

m
e

D
uR

an
t,

C
ad

en
he

ad
,

P
en

de
rg

ra
st

,
Sl

av
en

s,
&

L
in

de
r

(1
99

22
5

99
12

6
11

–1
9

10
0%

A
fr

ic
an

A
m

er
ic

an
C

om
m

un
it

y
(i

nn
er

-c
it

;
n
=

N
o

O
ne

×
A

do
le

sc
en

tu
se

of
vi

ol
en

E
l-

Sh
ei

kh
&

H
ar

ge
r

(2
00

1)
86

46
43

8–
11

81
%

C
au

a
si

an
;8

%
A
fr
ic
an
A
m
er
ic
an

;2
%

H
is

pa
ni

c;
2%

A
si

an
;7

%
ot

he
r

C
om
m
un
it
y
(n
=

86
)

N
o

M
ul

ti
pl

e
×
×
C
P
IC
th
re
at
;
B
la
m
e

Fa
nt

uz
zo

et
al

.(
19

91
)

77
41

36
3–

6
59

%
C
au
ca
si
an

;5
%

A
fr
ic
an
A
m
er
ic

an
;2

%
H

is
pa

ni
c;

4%
A

bo
ri

gi
na

l;
4%

A
si
an
;2

%
m

ix
ed

Sh
el
te
r

(V
er

ba
l/P

hy
si

ca
l;

n
=

23
)

H
om

e
(V

er
–

ba
l/P
hy
si
ca
l;
n
=

27
)

C
on
tr
ol
(n
=
27
)
P
ar

ti
al

gr
ou

ps
O

ne
×

×
C

B
C

L
so

ci
al

co
m

G
ra

ha
m

-B
er

m
an

n
(1

99
6)

12
1

59
62

7–
12

40
%

C
au
ca
si

an
;

60
%

un
sp

ec
ifi

ed
(m

aj
or

it
y
A
fr
ic
an
A
m
er
ic

an
)

Sh
el
te
r
(n
=

60
)

C
om
m
un
it
y
co
nt

ro
l

(n
=

61
)

Y
es
O
ne

×
×

G
ry

ch
,F

in
ch

am
,

Jo
ur

ile
s,

&
M

cD
on

al
d

(2
00
0)

46
4

23
5

22
9

10
–1

4
W

it
ne

ss
gr

ou
p:

33
%

C
au
ca
si

an
;3

2%
A

fr
ic
an
A
m
er
ic
an

;3
2%

H
is
pa
ni

c;
1%

ot
he

r
Sh
el
te
r
(n
=

14
5)

C
om
m
un
it
y
co
nt
ro
l
(n
=

Y
es
O
ne

c
×

C
P

IC
Se

lf
-b

la
m

e;
T

hr
ea

H
er

sh
or

n
&

R
os

en
ba

um
(1

98
5)

32
32

0
N

ot
sp
ec
ifi

ed
(M

1
=

8.
5;

M
2
=

9.
6)

N
ot

sp
ec

ifi
ed

W
it

ne
ss

(n
=

15
)

C
om
m
un
it
y
co
nt
ro
l
(n
=

18
)

N
o
O
ne
×
×

H
ol

de
n

&
R

it
ch

ie
(1

99
1)

74
35

39
1–

8
N

ot
sp
ec
ifi
ed
(m
aj
or
it
y
C
au
ca
si
an
)
Sh
el
te
r
(n
=
37
)
C
om
m
un
it
y
co
nt
ro
l
(n
=
37
)
Y
es
O
ne
×
×

e
m

pe
ra

m
en

H
ug

he
s

(1
98

8)
18

0
86

94
3–

12
N

ot
sp
ec
ifi

ed
Sh

el
te

r
(n
=

40
)

C
om
m
un
it
y
co
nt
ro
l
(n
=

83
)

A
bu

se
d/

W
it
ne
ss
(n
=

55
)

Y
es
M
ul
ti
pl
e
×
×
H
ug

he
s,

P
ar

ki
ns

on
,&

V
ar

go
(1

98
9)

15
0

ns
ns

4–
12

N
ot
sp
ec
ifi
ed
Sh
el
te
r
(n
=

44
)

C
om
m
un
it
y
co
nt
ro
l
(n
=

66
)

A
bu
se
d/
W
it
ne
ss
(n
=
40
)
Y
es
M
ul
ti
pl
e
×
×
C
B
C
L
so
ci
al
co
m
p.

In
go

ld
sb

y,
Sh

aw
,

O
w

ns
,&

W
ils

lo
w

(1
99
9)

12
9

0
T

2:
3.

5
ye

ar
s;

T
3:

5
ye

ar
s

77
%

C
au
ca
si
an
;

20
%

A
fr
ic
an
A
m
er
ic
an
;3
%
ot
he
r
C
om
m
un
it
y

lo
ng

it
ud

in
al

(n
=

12
9)

N
o
M
ul
ti
pl
e
×
×

Ja
ff

e,
W

ol
fe

,W
ils

on
,&

Z
ak

(1
98

6)
d

47
47

0
4–

16
N

ot
sp
ec
ifi
ed
Sh
el
te
r
(n
=

32
)

C
om
m
un
it
y
co
nt
ro
l
(n
=
15
)
Y
es
O
ne
×
×

C
B

C
L

so
ci

al
co

m
p.

Jo
ur
ile
s,

B
ar

lin
g,

&
O

’L
ea

y
(1

98
7)

45
22

23
5–

13
N

ot
sp
ec
ifi
ed
W
it
ne

ss
(n
=

45
)

N
o
M
ul
ti
pl
e
×

×
B

P
C

m
ot

or
ex

ce
ss

;
P

y
ch

ot
ic

Jo
ur
ile
s,

M
ur

ph
y,

O
’L

ea
ry

(1
98

9)
87

41
46

5–
12

N
ot
sp
ec
ifi
ed

C
lin

ic
al

m
ar

it
al

(n
=

87
)

N
o
M
ul
ti
pl
e
×
×
B
P
C

in
ad

eq
ua

Jo
ur
ile
s,
et
al

.
(1

99
6a

)e
,f

55
23

32
5–

12
95

%
C
au
ca
si
an
;5
%
un
sp
ec
ifi

ed
C

lin
ic

al
m

ar
it

al
(n
=

55
)
N
o
M
ul
ti
pl
e
×
×

174

P1: GMX
Clinical Child and Family Psychology Review (CCFP) pp923-ccfp-469658 July 18, 2003 12:22 Style file version Nov. 07, 2000
Jo
ur

ile
s

et
al
.(
19

96
b)

f
19

9
10

6
93

5–
12

39
%

C
au
ca
si
an
;

37
%

H
is
pa
ni

c;
24

%
A
fr
ic
an
A
m
er
ic
an
Sh
el
te
r
(n
=

19
9)

Y
es
O
ne
×
×

Se
lf

–

e
st

ee
m

Jo
ur
ile
s,

Sp
ill

er
,

St
ep

he
ns

,
M

cD
on

al
d,

&
Sw

an
k

(2
00
0)

15
4

83
71

8–
12

40
%
C
au
ca
si
an
;

32
%

A
fr
ic
an
A
m
er
ic
an
;2

7%
H

is
pa
ni
c;

1%
ot

he
r
Sh
el
te
r
(n
=

15
4)

Y
es
M
ul
ti
pl
e
×
×
C
P
IC
th
re
at

K
em

pt
on

,
M

cC
om

bs
-T

ho
m

as
,

&
Fo

re
ha

nd
(1

98
9)

48
29

19
11

–1
5

N
ot
sp
ec
ifi
ed
C
om
m
un
it
y
(n
=

48
)

N
o
M
ul
ti
pl
e
×

×
Te

ac
he

r-
ra

te
d

co
m

pe
te

nc
e

K
er

ig
(1

99
8)

17
4

88
86

7–
11

85
%

C
au
ca
si
an
;

10
%

A
si

an
;1

%
ea

ch
A

fr
ic
an
A
m
er
ic
an

,
H

is
pa

ni
c,

&
A

bo
ri
gi
na

l;
2%

ot
he
r
C
om
m
un
it
y
(n
=

17
4)

N
o
M
ul
ti
pl
e
×
×
C
P
IC
th
re
at
;
Se
lf

-b
la

m
e

K
ilp

at
ri

ck
et

al
.(

19
97

)
35

18
17

6–
12

N
ot
sp
ec
ifi
ed
W
it
ne
ss
(n
=

20
)

C
om
m
un
it
y
co
nt
ro
l
(n
=
15
)
N
o
M
ul
ti
pl
e
×

K
ol

bo
(1

99
6)

60
30

30
8–

11
73

%
C
au
ca
si
an

;7
%

A
fr
ic
an
A
m
er
ic

an
;5

%
H
is
pa
ni
c;

3%
A

bo
ri
gi
na

l;
12

%
ot
he
r
W
it
ne
ss
(n
=
60
)
N
o
O
ne
×
×

L
ev

en
do

sk
y,

H
ut

h-
B

oc
ks

,S
em

el
,

&
Sh

ap
ir

o
(2

00
2)

62
25

37
3–

5
42

%
A
fr
ic
an
A
m
er
ic
an

;2
4%

C
au
ca
si
an
;1

9%
m

ix
ed

;1
5%

ot
he
r
C
om
m
un
it
y
(n
=

62
)

N
o
O
ne
×

L
it

ro
w

ni
k

et
al

.(
20

03
)

68
2

34
1

6
ye

ar
ol

ds
on

ly
52

%
A
fr
ic
an
A
m
er
ic
an

;3
6%

C
au
ca
si
an
;1

2%
ot

he
r
C
om
m
un
it
y
lo
ng
it
ud
in
al
(n
=

68
2)

N
o
O
ne
×
×

M
ar

ti
n

&
C

le
m

en
ts

(2
00

2)
48

21
27

4
ye

ar
ol
ds
on

ly
96

%
C
au
ca
si
an

%
un

sp
ec
ifi
ed
C
om
m
un
it
y
(n
=
48
)
N
o
M
ul
ti
pl
e
×
×

M
at

hi
as

,M
er

ti
n,

&
M

ur
ra

y
(1

99
5)

g
44

—
—

6–
12
N
ot
sp
ec
ifi
ed
Sh
el
te
r
(n
=

22
)

C
om
m
un
it
y
co
nt
ro
l
(n
=
22
)
Y
es

(r
ec

en
t)

M
ul
ti
pl
e
×
×
A

da
pt

iv
e

be
ha

vi
or

M
cC

lo
sk

ey
,

So
ut

hw
ic

k,
Fe

rn
an

de
z-

E
sq

ue
r,

&
L

oc
ke

(1
99
5)

48
25

23
5–

12
10

0%
H

is
pa

ni
c

(M
ex

ic
an
A
m
er
ic
an
)
W
it
ne
ss
(n
=

24
)

C
om
m
un
it
y
co
nt
ro
l
(n
=
24
)
N
o
M
ul
ti
pl
e
×
×
×

M
cD

on
al

d,
Jo

ur
ile

s,
N

or
w

oo
d,

W
ar

e,
&

E
ze

ll
(2

00
0)

0
70

20
4–

7
79

%
C
au
ca
si
an

;
10

%
A
fr
ic
an
A
m
er
ic
an

;1
0%

H
is
pa
ni
c;
1%
ot
he
r
C
lin
ic
al

ch
ild

(n
=

43
)

C
lin
ic
al
co
nt
ro
l
(n
=

47
)

N
o
M
ul
ti
pl
e
×
×

M
cG

ee
,W

ol
fe

,&
W

ils
on

(1
99

7)
16

0
70

90
11

–1
7

96
%

C
au
ca
si

an
;4

%
un
sp
ec
ifi
ed

(

A
bo

ri
gi

na
l&

A
fr
ic
an

C
an

ad
ia

C
P

S
ag

en
cy

(n
=

16
0)

N
o
M
ul
ti
pl
e
×
×

175

P1: GMX
Clinical Child and Family Psychology Review (CCFP) pp923-ccfp-469658 July 18, 2003 12:22 Style file version Nov. 07, 2000
Ta
bl
e
I.
C
on

ti
nu

ed
P
ar
ti
ci
pa
nt
gr
ou
ps
(r
el
ev
an
tt
o
m
et
a-
an
al
ys
is
)
O
ut
co
m
es
m
ea
su
re
d
To
ta
l
B
oy
s
G
ir
ls
A
ge
ra
ng
e
Ta
rg
et
Ta
rg
et
C
om
pa
ri
so
n
C
it
at
io
n
(N
)
(N
)
(N
)
(y
ea
rs
)
E
th
ni
ci
ti
es
G
ro
up
1
G
ro
up
2
G
ro
up
A
bu
se
d/
W
it
ne
ss
Sh
el
te
r
R
at
er

s
In

t.
E
xt
.
P
T
SD
O
th
er
M
ul

le
r

et
al
.(
20

00
)

65
25

0
13

–1
7

63
%

C
au
ca
si
an
;

22
%

A
fr
ic
an
A
m
er
ic
an
;1

5%
H

is
pa
ni
c
C
lin
ic
al
ch
ild
(n
=

65
)

N
o
O
ne
×
×
×

O
’B

ri
en

et
al
.(
19

97
)

43
23

20
8–

12
60

%
C
au
ca
si
an

;
14

%
A
fr
ic
an
A
m
er
ic
an

;1
2%

H
is
pa
ni

c;
7%

A
si
an
;7
%
ot
he
r
C
om
m
un
it
y

sa
m

pl
e

(n
=
43
)
N
o
M
ul
ti
pl
e
×

×
Se

lf
-w

r
th

O
’K

ee
fe

(1
99

5)
18

4
93

91
7–

13
42

%
C
au
ca
si
an

;
37

%
H
is
pa
ni
c;

21
%

A
fr
ic
an
A
m
er
ic
an
Sh
el
te
r
(n
=

12
0)

A
bu
se
d/
W
it
ne
ss
(n
=

64
)

Y
es
O
ne
×
×

O
so

fs
ky

,W
ew

er
s,

H
an

n,
&

Fi
ck

(1
99
3)

53
ns

ns
9–

12
10

0%
A

fr
ic
an
A
m
er
ic
an
C
om
m
un
it
y
(n
=

53
)

N
o
O
ne
×
×

Po
rt

r
&

O
’L
ea
ry
(1
98

0)
64

37
27

5–
16

N
ot
sp
ec
ifi
ed
C
lin
ic
al
ch
ild
(n
=
64
)
N
o
O
ne
×
×

R
og

er
s

&
H

ol
m

be
ck

(1
99

7)
80

28
52

11
–1

5
36

%
C
au
ca
si
an

;
25

%
A
fr
ic
an
A
m
er
ic
an

;2
3%

H
is
pa
ni

c;
3%

A
si
an
;8

%
E

as
t

In
di

an
;5
%
m
ix
ed
C
om
m
un
it
y

(s
ch

oo
l;

n
=

80
)

N
o
O
ne
×
×

Sp
ac

ca
re

lli
,S

an
dl

er
,&

R
oo

sa
(1

99
4)

29
1

14
4

14
7

9–
12

50
%

C
au
ca
si
an
;

24
%

H
is
pa
ni

c;
14

%
A
fr
ic
an
A
m
er
ic
an

;4
%

A
bo
ri
gi

na
l;

8%
ot

he
r
C
om
m
un
it
y

(i
nn

er
-c

it
y;

n
=

29
1)

N
o
M
ul
ti
pl
e
×
×
Se

lf
-e

st
ee

St
er

nb
er

g
et
al
.(

19
93

)
77

43
34

8–
12
10
0%
C
au
ca
si

an
(I

sr
ae

l)
W

it
ne
ss
(n
=

16
)

C
om
m
un
it
y
co
nt
ro
l
(n
=

31
)

A
bu
se
d/
W
it
ne
ss
(n
=
30
)
N
o
M
ul
ti
pl
e
×
×

Ta
ng

(1
99

7)
39

17
22

6–
13

10
0%
A
si

an
(C

hi
ne

se
)

Sh
el
te
r
(n
=

21
)

C
om
m
un
it
y
co
nt
ro
l
(n
=
18
)
Y
es
M
ul
ti
pl
e
×
×

Ta
nn

en
ba

um
et

al
.
(1
99

2)
27

0
13

5
13

5
11

–1
5
10
0%
C
au
ca
si
an
C
om
m
un
it

y
(n
=

27
0)

N
o
O
ne
×
×

W
ol

fe
,J

af
fe

,W
ils
on
,&
Z
ak
(1
98

5)
19

8
98

10
2

4–
16

N
ot
sp
ec
ifi
ed
Sh
el
te
r
(n
=

10
2)

C
om
m
un
it
y
co
nt
ro
l
(n
=

96
)

Y
es
O
ne
×
×
W
ol

fe
,Z

ak
,W

ils
on

,&
Ja

ff
e

(1
98

6)
63

35
28

4–
13

N
ot
sp
ec
ifi
ed
Sh
el
te
r

(c
ur

re
nt

;
n
=

17
)

Sh
el
te
r

(f
or

m
er
;
n
=
23
)
C
om
m
un
it
y
co
nt
ro
l
(n
=
23
)
P
ar
ti
al
gr
ou
ps
O
ne
×
×

To
ta

l
50

88
24

97
h

22
82

h
39

37
4

M
ea

n
6.

6–
12

.0
ye

ar
s

59
%

C
au
ca
si
an
;

25
%

A
fr
ic
an
A
m
er
ic
an
;1

9%
H

is
pa
ni
c;

11
%

A
si
an
;7
%
ot
he
r

a
N

o.
of

ra
te

s
fo

r
ch

ild
ou

tc
om

e
m

a
su

re
s

in
cl

ud
ed

in
th

e
m
et
a-
an
al
ys
is

.
b

M
ea

ns
fr

om
na

rr
ow

ed
sa

m
pl

e
(i

n
w

hi
ch

s
w

it
ho

ut
D

V
w

er
e

ta
ke

n
ou

to
ft

he
D

V
gr

ou
p,

an
d

th
os

e
Ss

w
it

h
D

V
w
er
e
ta
ke
n
ou
to
ft

he
co

m
pa
ri
so

n
gr

ou
p)

.
c O

ut
co
m
e
m
ea
su
re
s
w
er
e

ob
ta

in
ed

fr
om

m
ul

ti
pl

e
so

ur
ce

s,
bu

to
nl

y
ch

ild
re

po
rt

s
ha

d
in

fo
rm

at
io

n
fo

r
bo

th
th

e
w

it
ne

s
an

d
co
m
pa
ri
so
n
gr

ou
ps

.
d

A
ls

o
ha

s
an

“a
bu

se
on

ly
”

gr
ou

p
no

ti
nc

lu
de

d
in

th
e

an
al
ys
is

.
e O

ve
rl

ap
pi

ng
Ss

.
f
Jo

ur
ile
s
an
d
co

lle
ag

ue
s

19
96

a
an

d
19

96
b

re
pr

es
en

td
if

fe
re

nt
st

ud
ie

s
(a

nd
sa

m
pl

es
)

w
it

hi
n

a
si

ng
le

pa
pe

r.
g

O
nl

y
P

ha
se

II
of

M
at
hi
as
et
al
.(
19

95
)

w
as

in
cl
ud
ed
in
th
e
m
et
a-
an
al
ys
is

.T
he

P
ha

e
II

sa
m
pl
e
in
cl

ud
es

a
su

bs
et

of
pa

rt
ic

ip
an

ts
fr

om
P

ha
se

I;
ho

w
ev

er
,d

em
og

ra
ph

ic
in

fo
rm
at
io
n
w

as
on

ly
pr

ov
id

ed
fo

r
th

e
la

rg
er

P
ha

se
I

sa
m

pl
e.

h
E

st
im

at
es

du
e

to
m

is
si

ng
in

fo
rm
at
io

n
on

se
x.

176

P1: GMX
Clinical Child and Family Psychology Review (CCFP) pp923-ccfp-469658 July 18, 2003 12:22 Style file version Nov. 07, 2000

Children Exposed to Domestic Violence 177

Studies that only involved comparison groups of
abused children, abused/witnesses, or witnesses of a
lesser severity of domestic violence were excluded be-
cause they overlap with the target group (i.e., both
groups of children had been exposed to some form or
degree of interparental violence; Jouriles et al., 1998).
Multiple articles that relied on the same sample of
children were not entered; in these cases, the article
with the most comprehensive results that met the in-
clusion criteria was used. In addition, studies were
excluded that reported two groups but used a stan-
dardized norm group as their comparison (e.g., studies
that reported the results from the CBCL standardiza-
tion group as their control group). Studies focusing
primarily on interparental conflict (but not violence)
were excluded, as were studies that used children’s
reactions to a simulated conflict paradigm.

Effect sizes were calculated in the present study
for behavioral (e.g., externalizing, conduct problems),
emotional (e.g., internalizing, depression, anxiety),
and Posttraumatic Stress Disorder (PTSD) outcome
measures. An overall effect size was calculated for
each study by taking the average of the behav-
ioral, emotional, PTSD, and social problem effects
(weighted by sample size, where relevant). Studies
that examined other constructs (e.g., cognitive attri-
butions, emotional encoding, perceptions, reactions
to conflict vignettes, self-esteem) and did not include
measures of the aforementioned outcomes were ex-
cluded. Retrospective studies with adult participants
recalling childhood experiences were also excluded.
A recent twin study was excluded because the sam-
ple size (N = 1, 103 twin pairs) was so much larger
than any of the other studies (Jaffee, Moffitt, Caspi,
Taylor, & Arsenault, 2002). Because a meta-analysis
approach weights the effect sizes by relative sample
size, this study would have been disproportionately
responsible for the overall outcome. The effect size
for this study was .17 for the total sample of twin pairs
(N = 2, 206).

Definitions of Confounding Variables

Despite the narrower focus of this meta-analysis,
considerable variability remained with respect to the
determination of key variables. One construct that
defies precise definition and measurement is the na-
ture and extent of exposure to domestic violence. Al-
though a wide range of variation is recognized in the
types, severity, and chronicity of violence experienced
by women in intimate relationships (Holtzworth-

Munroe & Stuart, 1994), the heterogeneity of these
experiences tends to be overlooked when the focus
shifts to the children of these women (see Jouriles
et al., 1996, 1998 for notable exceptions). The defi-
nitions of interparental violence in the present anal-
yses varied greatly, with a common definition being
the endorsement of at least one physical incident in
the past year (in contrast with a chronic history of se-
vere battering). Previous research suggests that adults
tend to vastly underestimate the extent to which their
children are exposed (Jaffe, Wolfe, & Wilson, 1990;
O’Brien, John, Margolin, & Erel, 1997). As well, there
is a whole continuum of involvement for children,
ranging from seeing the sequelae of violence or being
passive observers, to attempts by children to physi-
cally intervene or seek help. A recent telephone sur-
vey of 114 battered women revealed that almost 25%
of their children were reported to have been phys-
ically involved in a battering incident, and over half
verbally intervened while in the same room (Edleson,
Mbilinyi, Beeman, & Hagemeister, 2003). To date, the
literature on children exposed to domestic violence
has overlooked this continuum of involvement, and
tends to assume that exposure is a uniform experience.
Source of information used to determine the presence
of child abuse is likewise variably determined.

Table II summarizes how investigators of the
studies included in this meta-analysis determined the
key inclusion criteria of interparental violence, child
exposure, and child abuse. To define the interparental
violence group, 19 studies used maternal report only
(which was often based on responses or direct ques-
tioning from the Conflict Tactics scale; Straus, 1979);
15 studies relied on information obtained from multi-
ple informants (which typically consisted of both par-
ents, or mother and child in some cases); 3 assumed
parental violence on the basis of shelter residence,
and 4 on child report alone. Similarly, the majority of
studies (13) assumed the presence of child exposure
from maternal report or through direct questioning of
the mother (16). Fewer studies (12) asked the children
themselves about their exposure.

Very few studies controlled for the possible con-
founding factor of child abuse, and many did not
address the issue at all. Some studies assessed child
abuse, yet did not utilize that information. Others
controlled for child abuse in later analyses (e.g., hi-
erarchical regression) using statistics that could not
be incorporated into the meta-analysis (13). Rela-
tively few studies (4) separated the domestic violence
groups (i.e., witness versus abused/witness) or used
child abuse as an exclusionary factor (3). For those

P1: GMX
Clinical Child and Family Psychology Review (CCFP) pp923-ccfp-469658 July 18, 2003 12:22 Style file version Nov. 07, 2000
Ta
bl
e
II

.
C

ri
te

ri
a

fo
r

D
et

r
m

in
in

g
In

te
rp

ar
en

ta
lV

io
le

nc
e,

C
hi

ld
E

xp
os

ur
e

to
V

io
le
nc
e,
an
d
C
hi

ld
A

bu
se

In
te

rp
ar

en
ta

lv
io

le
nc

e
C

hi
ld

ex
po

su
re
C
hi

ld
ab

us
e

M
ot

he
r

on
ly

M
ul

ti
in

fo
rm

an
t

P
ar
en
ta

l
M

at
er

na
ld

ir
ec

t
E

xa
m

in
ed

(n
o

gr
ou

p
So

ur
ce

of
ch

ild
Sh

el
te

r
(e

.g
.,

C
T

S,
(e

.g
.,
C
T

S,
C

hi
ld
C
T

S/
D

V
re

po
rt

(e
.g

.,
m

od
ifi

ed
C
hi
ld

Se
pa

ra
te

di
ff

er
en

ce
s;

no
tu

se
d;

N
ot

m
al

tr
ea

tm
en

t
as

su
m

ed
a

in
te

rv
ie

w
)

in
te
rv
ie
w
)
on
ly

as
su

m
ed

C
T

S,
in

te
rv

ie
w

)
re

po
rt
gr
ou

ps
E

xc
lu

de
d

un
us

ab
le

st
at

s
fo
r
m

et
a)

ad
dr

es
se

d
in
fo
rm
at
io
n
C
hr
is
to
po
ul
os
et
al
.
(1
98

)
×

×
×

C
oy

e
et

al
.(

20
00

)
×
×
×
In
te
rv
ie

w
w

it
h

m
ot
he
r
D
uR

an
te

ta
l.

(1
99

4)
×

×
×

N
/A

E
l-
Sh
ei
kh
&
H
ar
ge
r
(2
00

1)
×

×
×
N
/A
Fa
nt
uz
zo
et
al
.
(1
99
1)
×
×
×
C

P
S

re
co

rd
s

G
ra
ha
m
-B
er
m
an
n
(1
99
6)
×
×

×
N

/A
G
ry

ch
et

al
.(
20
00
)
×
×
×
N
/A
H
er
sh
or
n
&
R
os
en
ba
um
(1
98
5)

×b
×

×
N
/A
H
ol
de
n
&
R
it
ch
ie
(1
99
1)
×
×

×
P

C
-C

T
S

(m
ot

he
r)

H
ug
he
s
(1
98

8)
×

×
×
M
ot
he
r

&
sh

el
te

r
st

af
fr

ep
or

ts
H

ug
he

s
et
al
.(

19
89

)
×
×
×
M
ot
he
r
&
sh
el
te
r
st
af
fr
ep
or

ts
In

go
ld

sb
y

et
al
.
(1

99
9)

×
×c

×
N
/A
Ja
ff
e
et
al
.(

19
86

)
×
×
×
C
P

S
re

co
rd

s
Jo

ur
ile
s
et
al
.(

19
87

)
×
×
×
P
C

-C
T

S
(m

ot
he
r
re
po
rt

s
bo

th
pa

re
nt

s)
Jo

ur
ile
s
et
al
.(
19
89
)
×
×
×
N
/A
Jo
ur
ile
s
et
al
.
(1
99
6a
)
×
×
×
N
/A
Jo
ur
ile
s
et
al
.
(1

99
6b

)
×
×
×
N
/A
Jo
ur
ile
s
et
al
.(
20
00
)
×
×
×
P
C
-C
T
S
(m
ot
he
r

&
ch

ild
re
po
rt

s)
K

em
pt

on
et

al
.
(1
98

9)
×d

×
×
N
/A
K
er
ig
(1
99
8)
×
×
×
N

/A
K

ilp
at

ri
ck

et
al
.
(1

99
7)

×
×

×
M

ot
he
r
&
ch
ild

qu
es

ti
on

na
ir

178

P1: GMX
Clinical Child and Family Psychology Review (CCFP) pp923-ccfp-469658 July 18, 2003 12:22 Style file version Nov. 07, 2000
K
ol
bo
(1
99
6)
×
×
×
P
C
-C
T
S

(c
ar

eg
iv

er
—

m
aj

or
it

y
m

ot
he

r)
L

ev
en

do
sk

y
et

al
.
(2
00

2)
×

×
×
C
hi

ld
in

te
rv
ie
w
L
it
ro
w
ni
k
et
al

.
(2

00
3)

×
×
×
P
C
-C
T
S
(m
ot
he
r)
M
ar
ti
n
&
C
le
m
en
ts
(2
00
2)
×
×
×
N
/A
M
at
hi
as
et
al
.(
19
95
)
×
×

×
In

te
rv
ie
w
w
it

h
m

ot
he

r
M

cC
lo

sk
ey

et
al
.
(1
99
5)
×
×
×
N
/A
M
cD
on
al

d
et

al
.
(2
00

0)
×

×
×
P
C
-C
T
S
(m
ot
he
r
&

fa
th

er
)

M
cG

ee
et

al
.(
19
97
)
×
×
×

A
ll

Ss
fr

om
C

P
S

ag
en

cy
/C

hi
ld

re
po

rt
(R

P
L

E
)

M
ul
le
r
et
al
.(
20
00
)
×
×
×
C
hi
ld
m
ea
su
re

(M
yE

T
V

)
O

’B
ri

en
et

al
.(
19
97
)
×
×
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179

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180 Wolfe, Crooks, Lee, McIntyre-Smith, and Jaffe

studies that did assess for child abuse (21), the major-
ity used only one informant (14), and only five queried
the children themselves about abuse. One third of
abuse assessments were conducted with the Parent–
Child Conflict Tactics Scale (PC-CTS; Straus, 1979).
Clearly, there is much heterogeneity between studies
in terms of how domestic violence, exposure to such
violence, and coexisting child abuse are addressed.

Data Coding and Analytical Approach

Means and standard deviations (for witnessing
and comparison groups) and correlational data (for
relating domestic violence to outcomes within witness
groups) were used to generate effect sizes for each
of the relevant outcomes. Effects were also coded
for shelter sample, number of raters, and separate
direct and indirect exposure to violence, to facilitate
moderator analyses. Coding was independently veri-
fied by a second (and in some cases third) rater. Dis-
agreements or ambiguity regarding coding were re-
solved through discussion among authors.

A total of 41 average effect sizes were included
in this analysis (generated by combining measures of
internalizing and externalizing difficulties, PTSD, and
social problems for each study). The meta-analysis
was conducted using methods outlined by Rosenthal
(1995) and Wolf (1986). Effect sizes expressed as a
standard difference score (d) were transformed to
r scores to facilitate comparison of studies that re-
ported either type of statistic. Next, a Fisher’s r to Z
transformation was performed to standardize all of
the effect sizes. Results are reported for a random
effects analysis, which is appropriate because of the
recognized variability within the sampling of studies
(Borenstein & Rothstein, 1999).

Moderator Analysis

Studies that provided results separately for girls
and boys, or those that included only males or females,
were used to evaluate the sex of the child as a mod-
erator. There were 10 studies that provided results
for boys and girls separately, and another 4 that in-
cluded boys only. To examine outcomes by develop-
mental stage, age categories were chosen to represent
preschool (3–6 years), school age (5–12 years), and
adolescence (11 years +). Although these categories
are somewhat arbitrary, they overlap to accommodate
the inclusion of more studies in this moderator analy-

sis. Studies that had samples completely within one of
those three categories were coded for developmental
stage. Approximately 2/3 of the studies were coded
(as shown in Table III), with the remaining ones not
coded by age due to their large age span.

The various outcomes measured in the studies
were divided into internalizing and externalizing cate-
gories to examine outcome type as a moderator. Only
studies that reported both types of measures were in-
cluded, because using two effects (i.e., externalizing
and internalizing) from some studies and only one
effect (i.e., externalizing or internalizing) from other
studies would result in overrepresentation of samples
of children from studies that provided both types of
outcome compared to those that did not. As a re-
sult, none of the studies that measured PTSD was
included,5 as they did not also include a measure of
externalizing behavior. The measures used to deter-
mine the externalizing and internalizing variables are
provided in Table IV. If the Child Behavior Checklist
(CBCL) Internalizing or Externalizing scores were
available, subscales were not used. If the CBCL In-
ternalizing score and an internalizing score from an-
other measure (e.g., the Children’s Depression Inven-
tory) were available, the average of these was used
(weighted by subsample size, if relevant).

Although a developmental psychopathology
framework should permit the evaluation of multiple
dimensions in combination, too few studies provided
results that would permit such analyses. As seen in
Table III, only 7 of the studies that provided informa-
tion by developmental stage also provide sex-specific
results, and 12 provided information about both in-
ternalizing and externalizing outcomes. Only four of
the studies provided results that analyzed data with
respect to three of these dimensions.

RESULTS

Results are presented in three sections: descrip-
tive statistics of the characteristics of the studies; an
overall meta-analysis across all outcomes; and mod-
erator analyses.

5The average effect size for the three studies that measured PTSD
symptomatology was r = .51(SD = .39). This large effect size
should not be overinterpreted as the effects ranged from r = .16
(Muller et al., 2000) to r = .94 (Kilpatrick et al., 1997). Further-
more, the total sample size of the three studies combined was only
162 participants. Clearly, the link between exposure to domestic
violence and PTSD requires further study.

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Children Exposed to Domestic Violence 181

Table III. Studies Providing Sex and Outcome Results for a Particular

Developmental Stage

Outcomes measured

Stage Citation N Overall effect Outcomes by sex Internalizing Externalizing PTSD

Preschool (3–6) Fantuzzo et al. (1991) 77 .51 × ×
Ingoldsby et al. (1999) 129 .25 × ×
Levendosky et al. (2002) 63 .42 ×
Litrownik et al. (2003) 583 .13 × ×
Martin & Clements (2002) 48 .33 × ×

Total (Preschool) 5 studies 900 0 4 4 1

School Age (5–12) Coyne et al. (2000) 18 .73 × ×
El-Sheikh & Harger (2001) 86 .11 × ×
Graham-Bermann (1996) 121 .14 × ×
Grych et al. (2000) 464 .12 × ×
Jouriles et al. (1996a) 55 .23 × × ×
Jouriles et al. (1996b) 199 .18 × ×
Jouriles et al. (2000) 154 .24 × ×
Kerig (1998) 174 .30 × × ×
Kilpatrick et al. (1997) 35 .94
Kolbo (1996)a 60 .26 ×
McCloskey et al. (1995)a 48 .33 ×
O’Brien et al. (1997) 43 .22 × ×
O’Keefe (1995) 185 .15 × ×
Osofsky et al. (1993) 53 .67 × ×
Spaccarelli et al. (1994) 131 .10 × × ×
Sternberg et al. (1993) 47 .54 × ×

Total (School) 16 studies 1,873 5 13 12 2

Adolescent (11–19) DuRant et al. (1994) 225 .29 ×
Kempton et al. (1989) 48 .21 × ×
McGee et al. (1997) 160 .07 × × ×
Muller et al. (2000) 65 .21 × × ×
Rogers & Holmbeck (1997) 80 .40 × ×
Tannenbaum et al. (1992) 224 −.20 × × ×

Total (Adolescent) 6 studies 802 2 6 5 1
aOverall CBCL problem score only (internalizing and externalizing not reported).

Table IV. Measures Grouped Into Internalizing and Externalizing
Categories of Outcomes

Internalizing Externalizing

CBCL: Internalizing CBCL: Externalizing
CBCL: Anxious/Depressed CBCL: Aggressive
CBCL: Somatic CBCL: Attention
Children’s Depression Inventory CBCL: Delinquent
Revised Children’s Manifest BPC: Anxiety

Anxiety Scale
(R)BPC: Personality (R)BPC: Conduct Problems
BPC: Anxiety BPC: Aggression
YSR: Internalizing ECBI: Intensity

ECBI: Frequency
YSR: Externalizing
Conners: Conduct
Conners: Hyperactivity

Note. CBCL= Child Behavior Checklist; (R)BPC= (Revised) Be-
havior Problem Checklist; YSR = Youth Self-Report; ECBI = Ey-
berg Child Behavior Inventory.

Description of Samples

The summary of studies provided in Table I
shows wide variability in participant characteristics
across studies. Sample sizes reported for each study
are minimum samples; that is, the reported N rep-
resents the number of participants for which all of
the relevant data were available. Age is reported as a
range where available, as ranges were reported more
often than means. In terms of shelter residence, 32%
of the studies used shelter-only samples for their wit-
ness group, 63% used nonshelter samples, and 5%
used both (with separate groups). Of the 26 nonshel-
ter samples, 50% were community samples, in which
the number of families with interparental violence
may have been relatively low, but scores on domes-
tic violence measures were correlated with outcome
measures. The proportion of studies with single versus
multiple raters of child outcomes were similar: 51%

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182 Wolfe, Crooks, Lee, McIntyre-Smith, and Jaffe

Table V. Shelter Residence, Number of Raters, Sex and Type of Child Outcome as Moderating
Variables of Child Adjustment

Moderator n Zr SD 95% CI z-values z-score (diff)

Gender (10 studies)
Boys 746 .11 .19 .04–.19 3.08 ns
Girls 734 .09 .19 .02–.16 2.38

Type of outcome (31 studies)
Internalizing 5148a .19 .12 .16–.21 13.59 ns
Externalizing 5148 .21 .12 .18–.23 15.05

aSame samples, but different measures.

single (e.g., mother only, child only), and 49% multi-
ple (e.g., mother and child, mother and teacher). Most
studies had measures of child externalizing and inter-
nalizing difficulties, except for those involving PTSD
(which tended to exclude externalizing symptoms).
Although the sex ratio was approximately equivalent
overall, 10% of the studies included only boys. The
majority of participants was Caucasian, although a
fair number of other ethnicities was represented (see
Table I).

Consequences of Exposure to Domestic Violence

Forty of the 41 effects indicated that exposure to
domestic violence has a negative effect on children.
Further support for an overall relationship between
exposure to violence and negative outcomes was pro-
vided by an aggregate weighted mean correlation of
Zr = .28 (SD = .17; 95% CI = .21–.32), which is sig-
nificant (Zc = 8.86, p < .001). A Zr = .28 effect cor- responds to a small effect size (Cohen, 1977). The one study that reported a reverse effect from what would be expected provided somewhat ambiguous results (Tannenbaum, Neighbors, & Forehand, 1992). In that study the overall correlation between exposure to vi- olence and problematic child outcomes was negative, but the unique contribution of exposure to violence in predicting poor outcomes (when other confounds were controlled) was positive. Thus, the unexpected result likely represents a complicated pattern of rela- tionships among domestic violence and other dynam- ics, and underscores the need for contextually relevant research.

Moderator Analyses

An analysis of heterogeneity was conducted to
determine whether there was adequate dispersion
of individual outcomes vis a vis the overall effect

to explore for possible moderators (Borenstein &
Rothstein, 1999). Given evidence of significant het-
erogeneity (χ2 = 188.49, df = 40, p < .001), a small number of variables was explored, with the results summarized in Table V. Results of a fixed effects anal- ysis are reported for the moderators as per convention (Borenstein & Rothstein, 1999).

Developmental Stage

When all 27 studies that had samples within a
particular developmental stage were compared, the
school aged children demonstrated the largest av-
erage effect size (Zr = .23), followed by preschool-
ers (Zr = .22) and adolescents (Zr = .11). The dif-
ference across developmental stages was significant
(Z= 8.76, p < .05). However, this analysis exempli- fies one of the problems that arises in using meta- analysis techniques with a small number of studies that have wide variability in methodology. The aver- age effect size for school aged children was strongly affected by one study (Kilpatrick, Litt, & Williams, 1997), in which the outcome of interest was PTSD. However, rather than using rates of diagnosis, results were reported with respect to a PTSD scale, and there was considerable dispersion in mean scores between the groups (with a corresponding effect size of Zr = .94). This outcome, therefore, may have been an arte- fact of the scale rather than the difference suggested by such an extreme effect size; alternatively, this may suggest that comparing mean scores for a syndrome such as PTSD may be misleading. Similarly, the effect size for adolescents may be artificially suppressed by the Tannenbaum et al.’s study (Tannenbaum et al., 1992), which generated a negative effect size.

When the developmental stage moderator anal-
ysis was conducted without these two studies, signif-
icant differences among developmental stages disap-
peared. Adolescent (Zr = .23), preschool (Zr = .21),
and school age samples (Zr = .21) showed similar

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Children Exposed to Domestic Violence 183

effect sizes. Rather than providing a basis for draw-
ing conclusions about the effects of domestic violence
at different stages of development, this example il-
lustrates the lack of a clear result with respect to
developmental stage, and underscores the variability
across studies with respect to methodology. Because
of the lack of stability for a solution concerning de-
velopmental stage, this moderator is not presented in
Table V.

Sex

Initially, studies that reported results for both
sexes as well as those that only involved boys were in-
cluded in the analysis, generating average effect sizes
of Zr = .17 for boys and Zr = .09 for girls. When the
four studies that only included boys were removed,
this gap between boys and girls disappeared (Zr = .11
and .09, respectively). The substantial convergence
between boys and girls achieved by removing the
“boys only” studies suggests that the high effect sizes
for those samples might be related to sample charac-
teristics other than sex. The latter analysis is reported
in Table V as the more conservative estimate of the
two with respect to sex differences in the effects of
exposure to domestic violence.

Type of Outcome

On the basis of the 31 studies that provided in-
formation about both internalizing and externalizing
adjustment problems, the moderator analysis with re-
spect to type of outcome was not significant (Zr = .21
for externalizing, Zr = .19 for internalizing).

Comparison of Witnesses and Combined
Witness/Victims

Although the intention at the outset of this pa-
per was to examine the presence of direct victim-
ization as a moderator of exposure to domestic vi-
olence, meta-analysis was curtailed because of the
availability of only four studies. The individual results
of these studies are presented in Table VI for descrip-
tive purposes only. Because there was significant vari-
ability, internalizing and externalizing outcomes are
presented separately for each study. Effect sizes are
presented such that a positive effect corresponds to
a finding that children who are both witnesses and

victims are functioning more poorly than those who
only witness. The findings across these four studies
suggest a small effect size for the difference between
children who are combined witness/victims and those
who are witnesses only. There is preliminary evidence
that this difference is greater for externalizing behav-
iors, although more studies are required to determine
whether or not this trend is significant. Although the
difference in outcomes between these two groups of
children may be statistically nonsignificant, there is an
issue of restricted range that is important to consider.
That is, the comparison group in this case is children
exposed to violence (and the target group has been
exposed to direct and indirect violence). Thus, the ex-
perience of direct victimization may add a small effect
size in addition to the medium effect already present
with respect to exposure to domestic violence.

DISCUSSION

The purpose of this article was to synthesize the
collective literature on children exposed to domes-
tic violence, with respect to negative emotional and
behavioral outcomes. The answer to whether or not
children exposed to violence experience more diffi-
culties than their peers emerged as an unequivocal
yes. When evaluated across all of the samples and
outcomes, a small effect size was evident for expo-
sure to domestic violence. In terms of translating an
effect size of r = .28 into a more concrete concept, in
the treatment literature an effect size of r = .30 would
mean an increase in successful treatment rate from 35
to 65% (Wolf, 1986). Conversely, the variance equiv-
alent to an effect of r = .30 could be interpreted as in-
creasing the number of children exhibiting difficulties
from 35 to 65%. Clearly, the statistical significance of
exposure to domestic violence is matched by clinical
significance. Furthermore, child abuse experiences (in
addition to exposure) added a small increment in ef-
fect size above and beyond exposure alone, although
this finding is preliminary due to the limited number
of studies.

The fundamental building blocks of developmen-
tal theory (developmental stage, sex, and type of out-
come) were examined as moderators. The lack of sig-
nificant findings with these moderators, as well as
the degree to which the results changed with minor
alterations to the analyses, underscores the lack of sta-
bility in the underlying data set. Another way of fram-
ing these findings is to note that the disparity in sam-
pling (i.e., shelter versus clinical versus community),

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184 Wolfe, Crooks, Lee, McIntyre-Smith, and Jaffe

Table VI. Preliminary Effect Sizes Comparing Children Who Are Both Witnesses
and Victims with Witnesses only

Internalizing Externalizing

Study N Zr Effect size Zr Effect size

Hughes (1988) 24 −.17 Smalla .22 Small
Hughes et al. (1989) 56 .22 Small .28 Medium
O’Keefe (1995) 185 .12 Small .18 Small
Sternberg et al. (1993) 46 .22 Small .12 Small
aEffect in reverse direction.

wide range in outcomes among these children, the
wide method variance in measuring outcomes, and
lack of a contextually sensitive approach produced
greater variability across studies than that found be-
tween sexes or across developmental stages. In other
words, methodological variability and other unspeci-
fied factors produced larger differences in effect sizes
than did the selected moderators of age, sex, and type
of outcome.

The current state of the literature on children
exposed to domestic violence provides a solid foun-
dation from which to move forward with more com-
plicated hypotheses and analyses. In comparison to
the literature on other forms of child maltreatment,
the state of this literature is less developed. For exam-
ple, early analyses of child sexual abuse sequelae have
been followed by more detailed analyses that indicate
that the impact of sexual abuse may vary according to
many factors, such as severity of the abuse, age of
onset, nature of perpetrator, patterns of disclosure,
and support systems in place for the child (Oddone-
Paolucci, Genuis, & Violato, 2001). The impact of ex-
posure to violence is likewise a complex phenomenon
that may be determined by a host of factors within the
child’s environment, family, and individual character-
istics. This experience is different from many other
single traumatic events and requires complex, mul-
tivariate models that examine the interplay between
trauma and development.

Several reviews have pointed to the challenges
that face abused women and their children in escaping
from batterers. These challenges may include the dis-
tress of repeated separations, ongoing violence dur-
ing visitation, and prolonged child custody battles in
court (Jaffe, Lemon, & Poisson, 2003; Jaffe, Poisson, &
Cunningham, 2001). The field will require multisite
studies that can capture these complexities with large
enough data samples to examine all the variables of
interest including changes at different stages of de-
velopment. Furthermore, questions remain about the
long-term effects in adult relationships that may not

be visible from traditional measures of child adjust-
ment. There may be some specific effect on children’s
knowledge and attitudes about violence in relation-
ships and their sense of personal responsibility for
domestic violence that is not captured by current
measures.

The question of long-term adjustment versus
short-term adaptation to crisis will only be answered
with the use of longitudinal data. Furthermore, given
the variability within the population of children ex-
posed to domestic violence, large samples are re-
quired to capture the full picture. There is also a
pressing need to investigate a wider range of nega-
tive outcomes. Although the initial intention was to
include educational and cognitive outcomes in this
meta-analysis, there were not enough studies to facil-
itate this inclusion. There are sound theoretical rea-
sons to expect exposure to violence to have an impact
on cognition and learning and to further explore these
links; however, it is misleading to present this as a
well-documented finding at this time. Similarly, there
is emerging evidence for the link between exposure
to domestic violence and PTSD in children; however,
the dearth of studies in this area makes it premature
to offer anything other than tentative conclusions.
Our preliminary analyses show that PTSD symp-
toms appear to be one negative outcome, particularly
for younger children. Lehmann’s study (Lehmann,
1997) of child witnesses also found significant PTSD
symptomatology in over half of the sample, raising
the possibility of an interaction between trauma and
the developmental stage of the child at the time of
exposure.

Future Research Directions/Promising Approaches

Although the concept of ecologically valid mod-
els has become de rigeur in the developmental lit-
erature, research on children exposed to domestic
violence has tended to focus on these children in a

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Children Exposed to Domestic Violence 185

vacuum. The need to evaluate the contribution of
exposure to domestic violence in tandem with other
risk factors is paramount. Some research efforts have
begun to look at the exposure to domestic violence
within the context of exposure to community violence,
(e.g., Muller, Goebel-Fabbri, Diamond, & Dinklage,
2000), which highlights the unique and shared char-
acteristics of these related forms of trauma.

Recent studies have begun to address some of
the fundamental methodological flaws in this liter-
ature by employing longitudinal designs with large
samples, multiple raters of child outcomes, and sophis-
ticated multivariate techniques. One multisite, lon-
gitudinal study, (LONGSCAN) reported the effects
of exposure to violence at 3 years of age on exter-
nalizing and internalizing behavior at age 6, and is
continuing to follow these children (Litrownik, New-
ton, Hunter, English, & Everson, 2003). Other lon-
gitudinal studies (Ware et al., 2001) have compared
maternal ratings of child outcomes during and fol-
lowing shelter residence to examine whether moth-
ers’ more negative ratings of their child’s behavior
(compared to rating by teachers and shelter staff,
diagnostic interviews by researchers, etc.) are a re-
sult of their level of distress during shelter residence.
Studies that have examined this issue of maternal rat-
ings with a cross-sectional design (Morrel, Dubowitz,
Kerr, & Black, 2003), have compared child outcomes
across raters, and controlled for maternal victimiza-
tion and depression in addition to maternal distress.
Finally, multivariate techniques are being utilized to
identify developmental profiles that children may ex-
hibit following exposure to domestic violence. To il-
lustrate, a recent cluster analysis of 228 children from
shelters identified five clusters based on internalizing
and externalizing outcomes, which could be distin-
guished with respect to frequency of the children’s
exposure to interparental violence, and child abuse
(Grych, Jouriles, Swank, McDonald, & Norwood,
2000).

In sum, in contrast to many meta-analyses that
summarize a large set of studies and provide con-
clusive findings, results of the current meta-analysis
should be considered as a preliminary springboard to
further research on this topic. Important progress has
been made in terms of isolating possible moderators
of the impact of exposure to violence on children,
but unanswered questions still remain. The field is
beginning to move away from epidemiological studies
emphasizing prevalence and extent of clinically signif-
icant problems, towards a more refined developmen-
tal focus on the interaction of risk and protective fac-

tors that mediate the impact of exposure to domestic
violence.

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Certified Batterer Intervention Programs:

History

, Philosophies, Techniques, Collaborations, Innovations and Challenges

David Adams, Ed.D.

(Adapted and updated from article that first appeared in Clinics in Family Practice,

Vol. 5(1), May 2003)

While treatment programs for batterers have proliferated in the United States over the
past 20 years, little is known about these programs by other human service providers, and much
less by the general public. This article reviews the historical development of such programs,
overviews their goals and methodology, and concludes with a discussion of emerging issues.

At this writing, at least 1,500 batterer intervention programs exist in the United States and
the number continues to grow. Part of the general public’s unfamiliarity about batterer
intervention programs stems from the fact that domestic violence is itself only beginning to be
widely viewed both as a social problem and as criminal behavior. While defining domestic
violence as criminal behavior has served to elevate battering as a serious issue, it has also tended
to reinforce popular stereotypes of batterers as a social subset of the population; those who get
arrested. This obscures the reality that batterers come from all walks of life and that batterer
intervention programs are not intended only for the worst offenders of domestic violence, or
those who successfully prosecuted.

History

Most batterer intervention programs have been established since the mid 1990’s. While a

few programs provide groups for women who abuse their male partners, and even fewer serve
lesbians and gay men, the vast majority of programs are geared for heterosexual men who abuse
their female partners. Men attending these programs are overwhelmingly court-referred, though
the exact proportion isn’t known and varies from program to program. The original programs,
including Emerge in Boston, RAVEN in St. Louis, AMEND in Denver, Manalive in Marin
County California, the Domestic Assault Program in Tacoma Washington, and Men Stopping
Violence in Atlanta were established in the late 70’s, before significant numbers of batterers
were arrested and mandated into such programs. The nation’s first program, Emerge, was
established in Boston in 1977 by a group of ten men at the behest of women who were working
in Boston-area battered women’s programs. [1] Staff at RESPOND, Transition House and Casa
Myrna Vazquez, charged with helping battered women, had been also been fielding calls on their
hotline from abusive men who were often desperate for help. Some were seeking counseling in
hopes of reconciling with their partners while others were hoping to avert a separation. Other
early programs like RAVEN, AMEND and the Oakland Men’s Project were similarly founded
by men who had backgrounds in social services or experience in social causes such as the anti-
war movement of the Vietnam era, and the civil rights movement. Most had also been allies of
women involved in the woman’s rights movement. [2]

By the mid to late 1980’s, a second generation of batterer intervention programs began to
Emerge. By then, most states began to enact pro-arrest and prosecution policies regarding
perpetrators of domestic violence. In some cases, these new policies were prompted by new laws
that expanded police powers of arrest for domestic violence and even created liability for police
who failed to protect victims. [3] In other cases, states merely began to more consistently enforce
existing laws. Some states and jurisdictions developed new guidelines relating to police and
court responses to domestic violence. While these protocols vary from state to state, they have in
common the dual goals of protecting victims and increasing accountability for perpetrators.
Police in many states are now required to advise victims of their rights, offer them assistance and
referrals, and arrest the alleged perpetrator when there was probable cause to believe that
domestic violence had occurred. Many states and counties have also adopted ‘victimless
prosecution’ policies in which prosecution of the offender does not depend upon the testimony of
the victim, thereby reducing the likelihood of retaliation to victims who testify against their
abusers. These new protocols have been accompanied by ongoing trainings of police and
prosecutors that are intended to increase sensitivity to victims, and identify more effective
investigatory strategies. [4] As a result of these new laws and policies, there has been a dramatic
increase in the numbers of batterers who were arrested and prosecuted over the past 15 years.

This increase in the arrest and prosecution of batterers spurred an increased demand for
treatment and rehabilitation programs for batterers, and in response, many states enacted
legislation that specified batterer intervention programs as a sentencing option for the courts.
This in turn led to an almost overnight proliferation of such programs in many states. In many
cases, new programs were offered by community mental health or family service agencies,
substance abuse centers, or health clinics that had little experience or expertise in serving
perpetrators of abuse. As a result, the approaches and services offered were sometimes modeled
after the services offered to other populations that the agency already served such as mental
health clients, couples with communication problems, or substance abusers, without adequate
regard to the special needs and challenges posed by batterers. For those who advocated for the
rights of victims, this raised concerns about victim safety and batterer accountability. One key
issue was whether batterers should be granted the same level of confidentiality as given patients
of clients of mental health or substance abuse programs, even if they were re-offending. Another
issue was whether victims should be required or even asked to participate in their partner’s
treatment, such as is common for treatment of substance abuse, mental illness, or marital discord.

Responding to concerns about quality control and victim safety, many states have
developed certification standards for batterer intervention programs. By 2008, 45 states had
developed such standards. [5] In some states, these are legally binding standards, while in others
they are offered as guidelines to be voluntarily followed, with little oversight. In some states,
certification is tied in with state or county funding of the programs. In Massachusetts, funding
from the Department of Public Health is available to the fifteen certified batterer intervention
programs. The certified programs may apply for this funding in order to better serve indigent
clients or clients referred by the child welfare agency. Funding is also available to extend
services to non-English speaking men, batterers in same-sex relationships, and teen boys. In most
states with standards, programs are certified and overseen by the Department of Probation or the
Department of Corrections (which typically includes community probation and parole). In other
states, the state coalition of battered women’s programs certifies and oversees the batterer
intervention programs. [5,6]

Characteristics of Certified Programs

The following overview of programs is based primarily on known practices of state-

certified programs as well as published accounts of programs that serve as national training
centers or are widely recognized program models with active training programs. In order to
capture a wider spectrum of practices, the descriptions of some practices is based upon
unpublished accounts, such as websites, program manuals, and personal communication.
Judging from the volume of training they provide to other batterer intervention programs as well
as to statewide networks of programs, the most widely emulated program models are Domestic
Abuse Intervention Project (DAIP) in Duluth, MN and Emerge in Cambridge, MA. Though each
program model has been widely replicated by other programs, often the replicators have often
made substantial adaptations, combining elements of DAIP and/or Emerge with those from other
models including their own pre-existing practices. As a result, the vast majority of programs
could best be described as eclectic in their orientation. One major challenge in overviewing
batterer intervention programs is that they are ever evolving, including the original models.
Programs have evolved not only in response to their own experience, including program
evaluations, but also to the changing demographics of the communities they serve. Further
adaptations have been prompted by the many changes in local, state and federal laws and policies
that address domestic violence, including the advent of coordinated community responses.

Program Duration

Certified batterer intervention programs have a fairly wide range of minimum program

durations, ranging from 12 sessions in Utah, to 52 in California, New Hampshire, and
Washington. [5] The average duration is 24-26 sessions, usually offered on a weekly basis. [6]
Most of the batterer intervention programs that serve as national training centers offer longer
intervention models. Men Stopping Violence and DAIP are 24-26 sessions long respectively,
while Emerge and AMEND each have a minimum duration of 40 sessions. [7,8,9,10] It should
be noted that programs that replicate these models may be shorter or longer, depending upon the
minimum program duration requirements in their particular state.

Definition of Abuse

Most state standards for batterer intervention programs define battering more broadly than do

their laws pertaining to domestic assault. For instance, Chapter 209A of the Massachusetts
General Laws defines abuse as:

a) attempting to cause or causing injury
b) placing another in fear of imminent or serious physical harm
c) causing another to engage involuntarily in sexual relations by force, threat, or duress. [11]

By contrast, the Massachusetts State Standards for Certified Batterer Intervention Programs

defines abuse “as a pattern of coercive control directed to the victim” The standards further state
that abuse may consist of one, or a combination of the following:

a) physical assault
b) verbal of emotional forms of assault and control such as intimidation, coercion, threats,

isolation or degradation
c) economic forms of control such as withholding or denying access to money or other basic

resources, sabotaging employment, housing or educational opportunities
d) sexual assault or coercion
e) social isolation such as possessiveness, jealousy, denying communication with friends,

prohibiting access to transportation or the telephone
f) failure to comply with immigration requirements making the immigrant partner unable to

work and vulnerable to deportation or loss of child custody
g) stalking, harassing and on-going monitoring and pursuing of the victim. [12]

While many state standards do not specify abusive acts in as much detail as the above, most

conceptualize battering as “a pattern of coercive control” that typically includes physical, sexual,
psychological and economic forms. [6] This view of domestic abuse as a pattern of behavior
counters more traditional notions of battering as discrete or isolated episodes of physical
violence. Most batterer intervention programs seek to broaden their clients understanding of
abuse as more than violent or illegal behavior. The Duluth Model uses the “power and control
wheel” as a schema that represents eight categories of abuse, symbolized as spokes of a wheel
that has power and control as its hub. For each category of abuse represented on the wheel, 3-4
group sessions are devoted to identifying how this type of abuse is manifested in relationships
and how it affects the victim. [13]

Contact with Victims

Certified programs in most states make some form of contact with victims, though the

purpose and frequency of such contact varies considerably from state to state and program to
program. One survey of state and county standards in 1997, found that 86% allowed or required
certified batterer interventions to have contact with victims, minimally to warn them if they were
subject of threats by their abusers. [5,6] Many certified programs additionally contact victims to
inform her of the abuser’s program enrollment, and beyond that, to notify her of his program
completion or termination. State standards in Georgia, Washington and Wisconsin specify that
programs shall keep victims informed of the batterer’s progress, while those in Colorado and
Delaware provide guidelines for the programs to inquire about the victim’s safety or to help her
in developing a safety plan. [5,6] The standards in Massachusetts and in several other states
permit programs to ask victims about the abuser’s history of abusive behaviors in the relationship
and to do follow-up contacts to inquire if there have been any re-offenses. To prevent retaliation
from abusers, nearly all standards require that information received from victims shall be kept
confidential by the batterer intervention program. Some states discourage or ban batterer
intervention programs from having direct contact with victims, except to mail her an information
packet or to warn her of imminent danger. [6]

Community Linkages

Certified batterer intervention programs distinguish themselves from uncertified ones in

their linkages with systems of accountability such as state or county program oversight agencies,

referring courts, community-wide collaborations to address domestic violence, and battered
women’s programs. Most state standards require certified programs to submit to regular program
review by the monitoring agency. In Massachusetts, the Department of Public Health conducts
site visits of each certified program every two years. Programs must apply to renew their
certification every two year period by submitting, for instance, evidence that a) all new hires
have received the minimum 30 hours of training on batterer interventions, b) they have made
efforts to contact victims of abuse as specified by the Standards, furnished timely client progress
reports to the courts and other referral sources, c) made services accessible to indigent clients,
and d) contracted with a battered woman’s program for observation of its perpetrator groups.[12]
Certification standards in Ohio require programs to have formal linkages with their local battered
women’ s programs. In some states, including Virginia and West Virginia, the overseeing
agencies are the state coalitions for battered women’s programs. [14,15] In some cases, batterer
intervention programs have been incorporated within existing programs for victims of abuse.

Many certified programs participate in coordinated community responses to domestic
violence that are intended to bring agencies and individuals together to devise community-wide
responses to domestic violence that promote victim safety as well as abuser accountability.
Development of coordinated community responses to domestic violence was pioneered in
Duluth. The batterer intervention program in Duluth is an integral part of a carefully crafted
community intervention that includes a wide array of integrated services and advocacy for
victims, a 911 policy that gives priority status to all domestic violence calls, jail holding of all
offenders until the next weekday morning, aggressive prosecuting of offenders, pre-sentence
investigations for all domestic violence cases including assessment of dangerousness, mandating
of nearly all offenders in batterer intervention programs, probation monitoring of offenders’
compliance with programs, and prompt revocation of probation status for re-offences. [10] DAIP
notes that there has been a dramatic drop of domestic violence homicide and felony cases since
the advent of these policies in 1986. [13] All the programs cited in this report actively participate
in community, county and statewide collaborations with battered women’s programs, child
welfare agencies, criminal justice agencies, clergy, health care providers, and other service
providers. AMEND is a member of the Denver Domestic Violence Fatality Review Board that is
charged with reviewing all domestic violence deaths in Denver. [16]

Many certified battered intervention programs have actively collaborated with victim-
based programs prevention strategies aimed at young people. For instance, Emerge and
Transition House co-founded the Dating Violence Intervention Project (DVIP) in 1987. DVIP
offers a three-session curriculum addressing teen dating violence at many high schools and
middle schools, trainings of educators and peer leaders, separate groups for young victims and
perpetrators of abuse, and parent awareness programs. [17] Men Stopping Violence in Atlanta
has participated in a wide variety of collaborations with battered women’s programs as well as
other organizations that reach out to boys and men. According to Dick Bathrick, “Strategies for
ending violence against women are unlimited when we allow ourselves to think beyond
batterer’s intervention programs. We are part of a growing network of men….. relentlessly
moving those boundaries.” [18] Caminar Latino, another agency in Atlanta that provides batterer
interventions, similarly sees itself as part of a larger community. Caminar Latino is a member of
TAPESRI (The Refugee and Immigrant Coalition Against Domestic Violence) which provides
domestic violence services as well as prevention programs for families from the international
community in Georgia. [19]

Program Philosophy

The majority of certified batterer intervention programs subscribe to the so-called “power

and control” model of battering, which is primarily informed by sociological and feminist
theories. According to this model, battering does not arise from mental illness, anger,
dysfunctional upbringings, or substance abuse. Rather, battering is viewed as learned behavior
that is primarily motivated by a desire, whether conscious or unconscious, by the abuser to
control the victim. According to this viewpoint, battering is purposeful rather than irrational
behavior, though many batterers may present to mental health providers as impulsive, angry, or
otherwise unable to control their emotions.[9,20,21] Research by Dobash & Dobash found that
many of abusive men’s outbursts toward their wives appeared to be attempts to enforce male
prerogatives regarding housework, childcare, sex, or emotional caretaking.[22] Despite its
outward appearance as irrational and spontaneous outbursts, the battering behavior has an
underlying logic. [23] Practitioners have pointed out the many batterers manage to refrain from
‘losing their tempers’ toward other people in their lives who disappoint them or otherwise fail to
fulfill their expectations. [9,21,22,24]

Many batterer intervention programs integrate the power and control philosophy with social
learning theory, which essentially posits domestic violence as learned, and often socially
reinforced, behavior. Research about domestic violence seems to confirm its intergenerational
transmission. Several studies have found that boys exposed to domestic violence in their
upbringings are more likely to become abusers in their adult relationships. [25,26,27]
The idea that battering is learned behavior contrasts with rival theories that it is essentially a
result of mental illness. [28,29,30,31] While studies of domestic violence offenders have found
that some, though not the majority, have diagnosable mental health conditions, many batterer
intervention programs see the mental health problem as a separate issue, rather than a
contributing factor to domestic violence. [9,23] In fact, most state standards of batterer
intervention programs prohibit psychotherapeutic approaches that view battering as a
psychopathology, or which devote primary emphasis on helping individual batterers to
understand how unresolved issues stemming from their childhoods may have contributed to their
violence as adults. Most state standards do, however, require certified batterer intervention
programs to provide mental health treatment referrals for individuals who have mental health
problems or who have experienced untreated childhood trauma, much as they also require those
with alcohol and drug problems to do so. [6,9,12,14] In many cases, mental health treatment is
concurrent with participation in the batterer intervention program. Some programs have found
that early detection of and referral for mental health problems has helped to reduce batterer
program attrition. [9,32] Besides making referrals to mental health programs, some batterer
intervention programs, like AMEND, have licensed mental health staff who provide concurrent
individual sessions for clients with problems like depression, suicidality, and thought disorders
which impact on their group participation as well as their overall progress. [12]

Program Goals and Techniques

Batterer intervention programs utilize a wide variety of techniques to confront abusive

behavior and teach alternatives. These include, but are not limited to didactic education, group
participatory exercises, structured feedback, self-evaluation, role-plays, skills training and

practice, homework assignments, positive reinforcement, and cognitive behavioral techniques.
The following summary briefly details learning goals and techniques that are typically used to
meet these goals. These teaching methods and techniques are thought to work best in a group
modality. That such education is offered in groups is for pragmatic as well as philosophical
reasons. The group format not only facilitates an educational framework but also serves to
counter the common perception among batterers that their violence is a private matter that should
be of no concern to others. Group interventions are also thought to promote social accountability
of battering men by requiring them to disclose their abusive behavior to others, as well as
providing opportunities for social reinforcement and peer support of nonviolence.

Overcoming Denial

Since abusers typically minimize or deny their abusive behavior, many batterer

intervention programs seek to broaden the abuser’s understanding of what constitutes violence
and abuse. Most programs therefore include didactic or educational exercises in which abusive
men are taught to identify the various forms of abuse. The Emerge curriculum includes an
exercise in which men are asked to list, in brainstorm fashion, examples of physical,
psychological, economic and sexual abuse. [7] Later in the program, clients are expected to
identify, and to discuss in more detail, the abusive behaviors they have most frequently used. The
DAIP program utilizes videotaped portrayals of various kinds of abusive behavior as a tool for
identifying and analyzing such behaviors committed by others. After identifying the actor’s
abusive behavior, group members are encouraged to recognize their own versions of that
behavior. [10] The Alternatives to Domestic Aggression program (ADA) utilizes an exercise
called “Do I have a reason to be in this program?” in which group members are asked to list
reasons that they should not attend, as well as reasons that they should. [33] Though not
specifically identified as a motivational interviewing technique, the group leaders see it as a
means to enhance the individual abuser’s motivation to confront his violence. Similarly, many
other practitioners recognize that countering client denial involves more than simply educating or
confronting individuals about abusive behavior. It also involves helping abusers to develop their
own motivations for change. More will be said about use of motivational interviewing and other
motivational enhancement techniques in a later section.

Taking Responsibility for Abuse

Beyond identifying abusive behavior, many batterer intervention programs have a goal of

promoting responsibility for abusive behavior. AMEND uses education and group feedback to
help each client break down his denial and to recognize his own rationalizations for abuse.
Abusers are taught to recognize that abusive behavior is not ‘provoked’ by one’s partner but is
always behavior that is chosen by the abuser. [9] DAIP uses videotaped depictions of various
kinds of abusive behavior to engage group members in a guided de-construction of the portrayed
incidents. Clients are asked not only to identify the abuser’s controlling actions but also the
expectations that motivated the behavior. Lastly, clients are asked to identify the effects of the
abusive behavior on the victim. [13]

The Alternatives to Aggression Program has operationalized accountability and
developed a set of procedures for promoting it. First, accountability is generally defined as an
obligation and willingness to accept responsibility for one’s abusive actions, and more

specifically defined as ‘actions involving others that reflect the integrity of the person that you
want to be’. Second, various domains of accountability are presented, and these include
accountability toward one’s intimate partner, children, family and extended family, community,
and self. Third, various stages of accountability are presented in the form of a baseball metaphor,
with first base symbolizing acknowledgement of one’s past abuse, second base meaning change
of one’s behavior and/or repair of one’s situation, third base involving the commitment to take
further steps, and home plate symbolizing the integration of these changes into one’s lifestyle.
Finally, program participants receive guidance and feedback about their roadblocks and progress
in making these changes. [33]

The Cultural Context Model in Somerset New Jersey uses an exercise in which abusers
are asked to write a “letter of accountability” to their partners. Such letters, which include
admissions of abuse as well as acknowledgement of responsibility for abuse, are read in the
group and used to spur discussion about the impact of abuse on victims. [34] Letters of
accountability are also used in the AMEND Program. [9] Some programs see recognizing of
effects as the first step toward developing empathy for partners. Empathy training is an explicit
goal of some programs. This includes teaching skills such as active listening, paraphrasing their
partner’s comments during arguments, or simply being asked in group to state their partner’s
perspective during incidents that have resulted in abusive behavior.

Refraining from Abuse

For clients attending many certified batterer intervention programs, refraining from

violence is both a learning goal as well as a requirement for program completion. Approximately
half of the states with certification standards for batterer intervention programs specify that
program participants must refrain from violent or threatening behavior as a condition for
program completion, though some of these states do not specify how the programs are to
determine whether clients have complied with this requirement. [6] Many certified programs
require clients to be in compliance with any protective orders pertaining to contact with their
partners, ex-partners, and children. Many states require programs to inform the courts of any new
acts of abuse that are reported by their clients. Clients entering such programs are required to
sign a waiver of confidentiality concerning new acts of abuse, as well as program attendance and
participation. Because programs are required to report new acts of violence that are reported by
their clients, it must therefore be said that court sanctions are one technique used by certified
batterer intervention programs to promote nonviolence. In fact, some studies concerning the
outcomes of batterer intervention programs have concluded that the legal sanctions and court
monitoring may play as much a role in the perpetrator’s refraining from abuse as the educational
content of the batterer intervention program. These researchers have said that it is the
combination of the batterer education and consistent court monitoring that seems to result in the
most consistent positive results. [35,36,37,38,39]

Almost all certified batterer intervention programs teach techniques for refraining from
abuse. Many teach abusers to become more aware of their somatic and cognitive cues to violence
so that they can take steps to refrain and redirect themselves. The Men’s Group Program in
Racine Wisconsin teaches ‘arousal management skills’ which entail becoming more aware of
anger arousing thoughts and teaching them skills, such as relaxation, and thought switching, to
reduce arousal and to better cope with aversive situations . Some BIPs teach abusers to take a
‘time out’ when they believe that they might otherwise imminently commit a new act of

violence. Given that some abusers may misuse timeouts to psychologically punish their partners,
those programs that teach this technique generally promote it only as a temporary measure in the
earlier stages of intervention, and also provide guidelines for how to take timeouts in a
responsible way. [7]

Learning Alternatives to Abuse

Certified batterer intervention programs employ a variety of techniques for helping their
clients to avoid violence and learn nonabusive behavior. One of the most common techniques is
teaching, or otherwise promoting, alternatives to abuse such as listening, supporting and
validating to one’s partner, recognizing other people’s perspectives, compromising, and
practicing self-reflection and self-care.

Some programs teach alternatives to violence by providing opportunities for participants
to identify possible nonabusive responses to situations in which they have been abusive in the
past. As mentioned previously, DAIP requires batterers to analyze video portrayals of abusive
behavior and to identify how the abusive person could have responded in a noncontrolling
manner to his partner. Some programs using the DAIP curriculum require clients to keep ‘control
logs’ in which they reflect on situations in which they have used controlling and noncontrolling
behavior in response to situations they faced during the past week, and to dissect the underlying
intentions and beliefs that supported that behavior. [13] Many programs, such as Men Stopping
Violence, simply require their clients to give weekly reports in group that include descriptions of
situations in which they have used controlling behavior or avoided using controlling behavior.
(Bathrick D, personal communication, 2002) Programs using the Emerge curriculum require
clients to give weekly updates on their progress in pursuing their individual goals while attending
the program. Each man is required to establish specific goals that are based on his history of
abusive behavior toward women, as well as his behavior toward his children. Program
participants are then assigned regular ‘turns’ in the group during which they receive feedback
from fellow group members and group leaders about their progress in meeting their established
goals. To promote a higher level of group accountability, group leaders teach group members
how to give constructive feedback to one another, and accompany this with regular feedback to
each group member about the quality of his feedback to others in the group. [23]

Some batterer intervention programs integrate cognitive behavioral techniques as a means
for helping men to avert abusive behavior. These typically include exercises that promote
identification and critical re-examination of the thoughts, beliefs and expectations that give rise
to battering behavior. In the Aggression Cycle Exercise used by the Manalive Program in Marin
County California, men are required to reconstruct acts of abuse in order to identify particular
cognitive elements. This ‘script analysis’ teaches men how to deconstruct each other’s past
incidents of abusive behavior by breaking it down into six ‘stations’. In the first five of these
stations, abusers are taught to identify habitual decisions they are wittingly or unwittingly
making. These include the decision not to listen to one’s partner, to expect authority based on
male prerogatives, to perceive that services from his partner have been denied him, and to assert
control. [40] Emerge teaches men to identify their ‘negative self-talk’, or internal dialogue, that
typically precedes physical or verbal violence. Examples of negative self-talk include jealous
thoughts, habitual negative beliefs about one’s partner (such as ‘she never gives me credit’, or
‘she’s so stupid’), jumping to conclusions (such as ‘there she goes again), or blaming thoughts
(such as ‘she makes me so angry’). Clients are further taught to interrupt these habitual thoughts

and to replace them with positive self-talk, or more constructive ways of thinking. [23] This is
similar to the thought-switching technique used by the Men’s Group Program. During this
exercise, men are taught to identify self-defeating thoughts in response to interactions with their
partners. According to program originators, these typically include dehumanizing thoughts such
as “she’s nothing but a bitch”, ‘all or nothing’ thoughts such as “I can’t stand it when she does
that”, rigid expectations such as “she should do things the way I want her to”, threat-oriented
thoughts such as “I’m under attack”, profanity or abusive self-instructions such as “I’ll kick her
ass for that”, and sexist beliefs such as “All women are like that”. [41] This analysis is followed
by cognitive re-structuring assignments in which men are taught to self-monitor for negative
thoughts and to replace these with more responsible thoughts.

Batterer intervention programs vary in whether they teach communication skills, and if
so, which skills are taught. Beyond teaching relaxation skills as a way for men to cope with
anger arousal and avoid violence, the Men’s Group Program also provides responsible
assertiveness training to help them avoid, passive, or passive-aggressive behavior. [41] Skill-
building exercises are used to give participants practice, with feedback, about such behaviors as
active listening, showing empathy, expressing feelings, receiving negative feedback, and giving
and receiving positive feedback. The Manalive Program teaches intimacy skills as part of its
Assertion Cycle Exercise. [40] Intimacy is explained as process that includes listening, noticing
one’s partner, recognizing feelings, acknowledging oneself and others. Emerge utilizes several
exercises to help men recognize the differences between abusive and respectful ways of
communicating with partners, including non-verbal forms of communication. This material is
accompanied by regular feedback to each man about how he his applying or misapplying this
information in his interactions with his partner. This feedback piece is considered critical
because of the tendency for abusive men to misappropriate information about negative forms of
communication and to use it as ammunition against their partners. [7]

Some programs teach, or otherwise promote, empathy for victims as a strategy for
promoting gender equality to abusive men. As one method for this, many programs teach
program participants to identify the effects of abuse on partners, as well as on children who are
exposed to this abuse. Emerge uses a separate small group brainstorming exercises to identify
how partners, as and children of specific ages, are affected by abuse. In another exercise, men are
asked to describe their most recent or most serious act of abuse from the perspective of their
partners or children. [7]

Supporting Gender Equality

For many batterer intervention programs, another strategy for stopping violence is

promoting gender equality in relationships. DAIP utilizes an Equality Wheel that includes eight
categories of behavior that contribute to equality. These include respect for one’s partner,
nonthreatening behavior, negotiation and fairness, economic partnership, shared responsibility
for housework and decision-making, responsible parenting, honesty and accountability and trust
and support. Group leaders devote 3-4 sessions for discussion, reflection and exercises
concerning each of these eight elements of equality. [10] The Cultural Context Model employs a
socio-educational process to help “raise critical consciousness about issues of gender, race,
culture and sexual orientation”. The program makes use of videos, readings, and music lyrics, to
stimulate discussion among men about how they have been socialized and how this socialization

has shaped their decision-making and behavior with women, children, as well as with people of
other backgrounds. [34]

Another approach to promoting gender equality, as well as other forms of positive male
role modeling, has been pioneered by the Manalive Program, which expects their clients to
become “community advocates” following completion of their first year in the batterer
intervention program. Community advocates are told that they must give something back to their
communities, such as by becoming involved in neighborhood violence prevention efforts. [40]

Program and System Innovations

Many batterer intervention programs are still in their infancy and continue to refine their

approaches as well as working to enhance the effectiveness of the coordinated community
responses in which the participate. Program changes are occurring at such a rapid pace that it is
difficult to characterize the emerging trends in the field or to identify those that will have the
most lasting impact. Despite this several broad trends are noteworthy.

Reducing Attrition and Enhancing Program Compliance

Client attrition rates in batterer intervention programs range from 25-65% according to

various studies and surveys. [36,42,43,44] The rate of attrition varies both according to program
length, with shorter programs having higher completion rates. Program attrition is significant
because it appears to be related to recidivism. Most outcome studies have found that program
dropouts are more likely to re-offend than program completers. One study of 840 batterers
participating in 4 different batterer intervention programs found that at the 30-month follow-up
period, program dropouts had re-offended at 1.5 times the rate as program completers. [36] A
study in Seattle found that program completers had re-arrest rates of 8% compared to 23% for
noncompleters, and 62% of a control group of offenders who did not receive treatment. [45] A
smaller study in Pittsburgh found that program drop outs were four times more likely to be
arrested than those who had completed their batterer intervention program. [46] While it could
be argued that men who drop out of their programs are demographically different from those
who complete programs, at least two studies have found program effects to persist even after
statistically controlling for these differences. [36,45] In his analysis of program effect, one
researcher estimates that completing a batterer intervention program reduces the likelihood of
recidivism by 44-64%. [36]

One factor that is believed to contribute to higher program attrition rates is inconsistent
court responses to clients who drop out or who fail to enroll in programs. An outcome study in
Seattle concluded that the high rate of program drops-outs (40%) seemed related to a lax
response on the part of the courts in sanctioning noncompliant clients. In reviewing this and
similar findings, the authors conclude, “not sanctioning men for noncompliance implicitly
excuses domestic violence and colludes with batterers in minimizing the seriousness of the
crime”. [47] Both practitioners and researchers have argued that the effectiveness of batterer
intervention programs depends upon consistent court and community sanctions that serve to
reinforce the goals of the intervention programs. [34,36]

Coordinated community responses have been shown to lower rates of recidivism among
offenders. [36,37,38] In reviewing these findings, one researcher states, “each part of the
community network of interventions contributes something to the reduction of violence…… and

that coordination of activities enhances the efficacy of the separate parts”. [48] Given this,
batterer intervention programs have increasingly sought to articulate how other elements of the
system can best reinforce the goals of their programs. The Dorchester Roundtable on Domestic
Violence in Boston included a batterer intervention subcommittee that sought both to promote
batterer accountability and also to make batterer intervention program more accessible. One
significant innovation was the development of court sessions that are dedicated to domestic
violence cases. Under this system, offenders referred to batterer intervention programs go before
a judge every 30 days to review their progress in the program. Probation officers schedule
weekly visits with offenders, including home visits for offenders who are considered to pose the
highest risk for re-offenses. Outreach workers have were hired to advise recipients of protective
orders about the law, and to direct them to batterer intervention programs as well as other
services. [49] Both DAIP and AMEND provide outreach staff at the county jails so that
offenders can have immediate access to information about their programs. [9,10]

Some batterer intervention programs have pioneered ways of promoting social
accountability that extends beyond the courts and depends more on community peers. The
Cultural Context Program has devised a sponsorship program for its program participants.
Sponsors are male volunteers who receive intensive training that includes attending the batterer
intervention program. Following this, sponsors are paired with program participants for one-year
periods to serve as their advisors and role models for nonviolence. [34] Men Stopping Violence
requires each group members to select two people from the community (usually a friend or
relative) to participate in his evaluation process in the group. [8]

Increasingly, certified batterer intervention programs have incorporated concepts of
Motivational Interviewing as well as Stages of Change as parts of strategies for enhancing client
motivation. Developed initially as a response to substance abuse, Motivational Interviewing (MI)
is a broad approach to overcoming client resistance and promoting self-motivation. The basic
elements include eliciting the client’s own reasons for resisting change rather than directly
confronting resistance, using a nonjudgmental empathetic therapeutic style, evoking the client’s
own motivations for change such as by facilitating the development self-directed goals, drawing
upon the client’s own strengths to develop and implement these goals, and emphasizing the
client’s responsibility for change versus past problems. Compared to more didactic or directive
treatment approaches, MI has been found to be effective in promoting change among substance
abusers. [50]

Many programs that use MI techniques have similarly integrated those that are informed
by Stages of Change (SOC) theory, also originally developed in response to substance abuse.
Stages of Change theory is a central element of the Transtheoretical Model of Change developed
by Prochaska and DiClemente. SOC posits that clients engaged in anti-social behavior have
differing levels of motivation to change, ranging from ‘pre-contemplation’ (characterized by
minimization and denial) to ‘action’ which entails taking active steps to make changes, and
ultimately to ‘maintenance’ which means actively monitoring oneself in order to maintain
changes and to avoid relapse. In between ‘pre-contemplation’ and ‘action’, are the important
stages of ‘contemplation’ (having a dawning awareness of one’s problem behavior) to
‘preparation’ (entailing one’s first intentions to change). [51] Proponents of SOC for batterer
intervention programs argue that treatment intervention strategies must match the particular level
of motivation to change exhibited by the client. [52,53] In the substance abuse intervention field,
Motivational Interviewing has been augmented by the SOC notion that treatment providers not

only should explore the individual client’s reasons for resistance, but also assess his/her level of
readiness for change. [54]

While a number of BIPs have integrated aspects of SOC and MI to enhance client
motivation and to promote active participation, it should be noted that SOC and MI were not
devised as educational curricula but rather as broad approaches to change. Proponents of SOC
argue that BIPs should be better attuned to the level of motivation of their clients. Further, they
state that a confrontational approach is not appropriate for clients who are still in the pre-
contemplation or contemplation stages. [54]. To date, there has little outcome evaluation of BIPs
that have integrated elements of SOC or MI. One outcome evaluation that directly compared a
BIP that included SOC and MI in its educational curriculum with a more traditional one based on
a cognitive behavioral techniques, found no difference in overall program completion rates
among the program participants, though the completion rate were actually higher for the
Spanish-speaking men who were assigned to the more traditional treatment option. While there
were no significant differences in self-reported reports of violence recidivism among the men
assigned to the SOC and the traditional treatment options, the researchers did find significant
fewer victim-reported assaults by those attending the SOC groups, particularly for the English-
speaking men. Overall, those men who were self-referred to the BIP responded less favorably to
the SOC treatment condition than to the traditional approach, as did the Spanish-speaking men.
Despite this, both English and Spanish-speaking group leaders in the SOC groups rated higher
levels of client ‘working alliance’ among their clients. [55]

Though not explicitly using MI, other BIPs have experimented with client motivational
enhancement strategies that are analogous. One such strategy is the more active engagement of
clients in establishing their own goals. The Batterer Education Program for Incarcerated African
American Men, developed by Oliver Williams, asks program participants to establish two goals
for ‘self-transformation’. While the first of these goals must be to end violence, the second is left
to them. Typical examples include staying out of jail, entering a drug/alcohol treatment program,
making a religious commitment and taking steps to become a better father. In this way, ending
violence is included within a broader context of bettering or transforming oneself. [56] Emerge
asks clients to self-identify six goals: two having to do with the man’s treatment of his partner,
two with his treatment of his children, and two with his treatment of himself. While each
individual group member constructs his own goals, and then presents these to the group, fellow
group members are invited to give feedback and to suggest additional goals, so that the
individual goal-setter has the opportunity to consider other goals or to refine those he has already
chosen. [23] One team of researchers who conducted a preliminary outcome evaluation of the
efficacy of self-determined goals in BIPs, found improved program completion rates and reduced
recidivism, particularly for those participants whose self-determined goals were ‘specific’ and
congruent with the overall goals of the program. [57]

Most outcome evaluation studies have found that program attrition is particularly likely
in the earliest stages of BIPs. [36,42,48] Program drop out rates are particularly high for abusive
men who are not mandated into treatment by the courts. [36] In response, some BIPs have taken
greater measures to enhance the motivation of new clients, and in some cases, potential clients.
One such protocol is the Men’s Domestic Abuse Check-Up (MDACU) being piloted by
researchers at the Schools of Social Work at the Universities of Washington and Minnesota. [58]
Adapted from the Drinker’s Check Up in the substance abuse field, MDACU is a protocol geared
to substance abusing abusive men who are resistant to participation in a batterer intervention
program. Its goal is to motivate these men to self-refer into domestic violence and/or substance

abuse treatment. Utilizing a MI approach, targeted men receive a telephone call that invites them
to participate in two informational sessions. During these meetings, men are given information
about domestic violence which increases their awareness of its scope, typical consequences, and
risk factors. They are then asked to discuss their own behavior concerning abuse of an intimate
partner and use of alcohol and drugs. After this, men are given ‘normative feedback’ which
enables them to compare their own behavior with the extent to which it exists in the general
public. This is important since it’s been found that people tend to overestimate the frequency of
problems like intimate partner violence and substance abuse, and this is even more so for those
have these problems. Their over-estimation of these problems may lead them to ignore the
problem because they believe that they are in such ‘good company’. [59] Normative feedback
has been found to motivate some people to seek help because they learn that their behavior is
more atypical than they originally believed. This normative feedback is followed by feedback
about the consequences and risk factors pertaining to intimate partner violence and substance
abuse. [58] It is hoped that this kind of early intervention, will prove to be as successful in
engaging voluntary clients into treatment as it has been found to be for substance abusers.
Though it does not utilize this protocol, Emerge has increased the proportion of self-referred
abusive men from 10%-28% over the past 10 years. Emerge attributes this to the following
factors:

• replacing the term ‘batterer intervention program’ in program brochures with ‘a
program for abusive and controlling behaviors in intimate relationships’.

• active participation in men’s outreach campaigns.
• providing free parenting education groups that are geared for men with histories

of domestic violence.
• intensive outreach to faith communities through the Safe Havens Interfaith

Partnership Against Domestic Violence, and to employers through Employers
Against Domestic Violence.

• intensive outreach to substance abuse and other social service agencies. [60]

Becoming Culturally Relevant

Another trend in batterer interventions is to make programs more accessible and relevant

to underserved populations of abusers. These include, but are not limited to rural men, African
American men, Latinos, Asian-American men, Native American men, and abusers in same-sex
relationships. Proponents for culturally relevant programs have noted that the original batterer
intervention programs were developed primarily for Caucasian men and that the resulting models
do not reflect the perspective of men from other cultural traditions. [61,62] For instance, African
American men and other men of color may be less trusting of batterer intervention programs that
are mandated by courts and therefore less willing to believe it is in their interest to disclose
abusive behavior in such a program. Abusers in same-sex relationships are likely to feel that an
educational curriculum that is heavily geared toward discussion of male-female relationships is
not relevant to their problems.

Responding to these problems, some batterer intervention programs have developed
culturally specific programs while others have used the diversity of their groups to connect
gender inequality to other forms of inequality and domination. Pioneering examples of the first
approach are Centro de Capacitiacion para Erradicar la Violencia Intrafamiliar Masculina

(Training Center to Eradicate Masculine Intrafamily Violence), otherwise known as CECEVIM
for Latino men in San Francisco, the Batterer Education Program for Incarcerated African
American Men (BEPIAAM) in Atlanta, the DAIP program for Native American men in Duluth,
the African American Program at Men Stopping Violence, the Latino the Vietnamese Programs
at Emerge, and the program for abusive gay men at Men Overcoming Violence (MOVE) in San
Francisco. Pioneers of the second approach include the Cultural Context Model and the
EVOLVE curriculum that is currently being used at various locations in Connecticut. [63] The
culture and language specific groups have many of the same goals and methodologies as other
batterer intervention programs but have made adaptations to make them more relevant to the
experience of the population that they are serving. For instance, CECEVIM borrows curriculum
and techniques from the Manalive Program but has evolved unique features to suit Latino men.
CECEVIM uses an ecological framework to help clients to ‘deconstruct’ their male and
individual identities in terms of the physical, intellectual, emotional, cultural and social ‘spaces’
in which they live. Groups are facilitated in a democratic manner in order to promote maximum
motivation for men to self-reflect and to help one another. [64]

Culturally specific groups not only afford greater opportunities for abusive men to trust
their group leaders but also for programs to make use of cultural norms and strengths that
promote nonviolence. Both the African American Program at Men Stopping Violence and
BEPIAAM use African American men’s experience and understanding of racial oppression as a
strength for understanding gender inequality. BEPIAAM devotes one session to social learning
in which men are asked to reflect on how they learned about violence in their families, peer
groups, and communities. [56] Compared to other programs, culturally specific batterer
intervention programs appear to devote more attention to issues of self-care, balancing this with
attention to how men treat others. The Vietnamese and Latino Programs at Emerge encourage
men to address unmet problems related to physical or mental health, legal immigration status,
education and employment training. Attention is also devoted to insuring that clients understand
this countries laws pertaining to domestic violence and child abuse. [65]

Assessment of Dangerousness, Substance Abuse and Mental Health Problems

Some outcome findings of batterer intervention programs have shown that battering men
who abuse substances are more likely to re-offend. [36,39] Other predictors of re-assaults are
men with prior histories of serious assaults, lengthy criminal record, and severe mental disorder.
[36] These findings have spurred some programs to develop methods for earlier detection of
dangerousness, substance abuse and mental disorders. One of most comprehensive set of
assessment protocols is provided by The Men’s Group Program. Evaluators of this protocol have
found that information derived from psychometric and substance abuser screening tools that are
administered at intake has been useful customizing and enhancing treatment. [66] Besides
developing better assessment tools, programs have also established more consistent criteria for
requiring clients to seek outside evaluation for substance abuse or mental illness as well as
concurrent treatment for these problems when it is warranted. Some have also sought stronger
linkages or collaborations with substance abuse and mental health providers so that these
services can be better integrated with batterer interventions. While Gondolf found only weak
support for the efficacy of one such protocol, he concluded that this was primarily due to poor
implementation rather than on the protocol itself. The impediments included failure to make or to

follow through with mental health referrals, inadequate supervision, and poor collaboration
between the BIP and the mental health programs. [67]

Methods for risk assessment vary a great deal among programs. The better programs
routinely seek to assess for risk factors such as suicidality and depression, past threats to kill,
stalking behavior, past use of weapons, sexual violence, and past criminal behavior. AMEND
provides one of the more rigorous risk assessments with the use of the Violence Risk Inventory
(VRI), a 22-item list of psychosocial and violence history factors to be filled out by the
interviewer upon client intake. [68] This is accompanied by separate tool in which the
interviewer indicates the presence of various situational factors, such as ‘recent loss of job’, as
well as potential triggering factors such as ‘intrusive or obsessive thoughts about the victim’. As
new information becomes available about the client, it is added to the VRI, enabling AMEND
staff to update their assessment of dangerousness, and to conduct long-term risk management
with clients. [9] Programs like DAIP, AMEND and Emerge routinely gather police reports as
well as criminal records regarding each court-mandated client from the referring probation
departments. These and a growing number of BIPs also actively participate in community-based
high risk assessment teams that review and pool information about particular high risk cases for
the purposes of enhancing victim safety as well as monitoring of the offender. [69,70]

Providing Parenting Education

Numerous studies have shown significant overlaps between partner and child abuse.

[25,26,27,71] Even when they are not directly abusing their children, abusive men often expose
their children to the verbal and physical abuse of their mothers. [25,27] Exposure to abuse is
known to have many short and long term negative effects on children. [25,27,72,73] Recognizing
this, some batterer intervention programs provide education to their clients about the effects of
domestic violence on children. Several also provide ongoing feedback to their clients about their
parenting behavior. AMEND, Emerge and the Domestic Abuse Project (DAP) in Minneapolis
have developed separate parenting classes that are available to all clients who are parents or step-
parents. The Responsible Fatherhood Program at Emerge is based on the Caring Dads curriculum
developed by the Changing Ways abuser education program in London Ontario. Changing Ways
developed this curriculum in collaboration with researchers when it became apparent that a
second generation of abusers – the sons of men who had attended past groups – where beginning
to attend their abuser education program. By providing more specific education about parenting,
Caring Dads sought to help abusive men to become better and more cooperative co-parents, and
in so doing, set a more positive example for their own children. Additionally, according to Tim
Kelly, “We found that in our current system of intervention, fathers were not being held
accountable for their abusive actions. Instead, women and children were being left to pick up the
pieces.” [74] Similarly, the Restorative Fatherhood Program at DAP believes, “It is important for
the men in the program to understand that the violence in the home has redefined how the
children see them as fathers. Restorative Parenting helps these men better understand their
children’s perspectives, increase empathy for their children, and improve the quality of their
connection with their children.” [75]

Besides, or lieu of, offering their own dedicated parenting education groups, some BIPs
have integrated parenting education into their abuser education curriculum. Some programs have
used the Parenting After Violence (FAV) curriculum developed by the Family Violence

Prevention Fund. One rationale for providing such education for abusers is that surveys of
battered women have found that many want their partners or ex-partners to remain apart of their
children’s lives, so long as these fathers end their violence and take responsibility for their past
abusive actions. [76] The Fathering After Violence curriculum includes one lesson, called the
Empathy Exercise, in which abusers view pictures that children have drawn of their abusive
fathers in order to sensitize them to how violence affects childrens’ perceptions of their fathers.
The men are then asked to draw pictures of themselves to reflect how their children might
perceive them following an incident of abuse. Another lesson provides guidelines for abusive
men about how to responsibly make reparations for their children for having exposed them to
abuse of their mothers. Beyond ending their abusive behavior, important steps of reparation
include stopping the minimization, denial or justification of past abusive behavior,
acknowledging the damage done to children and their mother, accepting consequences for past
violence, including any limits placed on their contact with children, modeling constructive
behavior, validating and supporting children’s feelings, and supporting and respecting the
mother’s parenting. In taking these steps, abusers are admonished not to ‘rush the process’, or to
pressure their children into reconciliation. It is emphasized that the reparation framework with
children needs to be seen as a long term process, and it is one that is not necessarily appropriate
for all fathers. [76]

Preliminary outcome evaluations of parenting education within the context of batterer
intervention programs have found positive benefits in terms abusive men’s understanding of their
children, reductions in anger toward children, and improvements in their parenting skills. [77,78]
One additional benefit, according to BIPs that have provided this kind of curricula, is that this
attention to how children are impacted by domestic violence appears to enhance fathers’
motivations to confront their domestic violence. There appears to be two reasons for this. First,
information from outside experts about how children are adversely affected by violence often
bolsters the credibility of the abusive man’s partner who has often attempted to call attention to
these effects. Secondly, attention to children often stimulates men to self-reflect to their own
experiences as children, and in so doing, better identify how abusive behavior might have been
modeled by their own fathers or mothers. [79] It is hoped that this self-reflection might
strengthen abusive men’s resolve to set a better example for their own children.

Conclusion

Certified batterer intervention programs distinguish themselves from uncertified
programs and more generic forms of treatment in their emphasis on abuser accountability as well
as victim safety. Certified programs are themselves accountable to larger community and
statewide responses to domestic violence. Beyond this, batterer intervention programs also
appear to help significant numbers of abusers to change their behavior, and to have more positive
relationships with their partners and children. [36,77] Despite this, batterer intervention programs
are still underutilized, particularly by the larger human service and medical communities, who
tend to view these programs as mere extensions of the criminal justice system. However, batterer
intervention programs are continuing to evolve by refining their methodology as well as their
message.

A major challenge for batterer intervention programs is to make themselves more familiar
to the general public as well as to other human service providers, including health care

professionals as potential sources of referral. One survey that was commissioned by the Florida
Department of Corrections found that only 41% of the general public was aware of the existence
of batterer intervention programs while 8% knew of someone who attended such a program.
Despite this, 92% of the respondents believed it should be a requirement for those charged with
domestic violence crimes to attend a batterer intervention program. [80] Some BIPs have
responded to this challenge by mounting community education campaigns that help men and
women recognize abusive or controlling behavior that falls short of criminal behavior. Emerge
has utilized posters, billboards, as well as radio and television ads to help men and women self-
identify the need to confront any behaviors that are alienating to intimate relationships.
Similarly, Men Stopping Violence has sought to create a climate of ‘community accountability’
in which all men are asked to become allies in motivating abusive men to seek help. [81] Other
batterer intervention programs have targeted outreach to faith communities. An increasingly
utilized model for community accountability is Restorative Justice, which is a broad category of
informal, dialogue-based practices that seek to address harms caused by crime. [82] Applied to
intimate partner violence, restorative justice has sought to counteract the messages that it is a
‘private matter’ on the one hand, or strictly a criminal justice matter on the other. But rather than
replacing the criminal justice response, restorative justice seeks to augment it by increasing
social accountability for abusers by ‘widening the circle’ of support for victims. [83,84]. This is
similar to other community organizing efforts which seek to broaden the base of those who are
informed about domestic violence, and once informed, better able to serve as social agents for
change. Examples of this are the Neighbors, Friends and Family campaign in London Ontario
Close to Home in Boston, and Bringing In the Bystander at several college campuses. [85,86,87]
An important side benefit of community education is that it may well serve to prevent domestic
violence by helping people recognize abusive behavior in its earliest stages.

BIP participation in community education and violence prevention efforts reflects the
philosophy of most of the pioneer programs that efforts to eliminate intimate partner violence
must proceed on both the community and the individual levels. DAIP stresses that the Duluth
Model is more than a batterer intervention program but rather a coordinated community response
system that seeks to create justice for accountability for abusers as well as justice for victims.
[13] Yet this broader purpose of BIPs has been rarely included in outcome studies that have
tended to narrowly focus on their role in changing individual batterers in isolation from other
factors. [48,88] Certified Batterer Intervention Programs are but one part, though an integral one,
to the overall community response to domestic violence. To be effective, these efforts must be
coordinated and transparent. When well integrated within social this broader social response,
BIPs represent an opportunity for individual abusers to change within a context of community
accountability.

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The idea that battering is learned behavior contrasts with rival theories that it is essentially a result of mental illness. [28,29,30,31] While studies of domestic violence offenders have found that some, though not the majority, have diagnosable men…

Program Goals and Techniques
Overcoming Denial
Taking Responsibility for Abuse
Refraining from Abuse
Learning Alternatives to Abuse
Supporting Gender Equality
Program and System Innovations
Becoming Culturally Relevant
Assessment of Dangerousness, Substance Abuse and Mental Health Problems
References

Children Exposed to Violence
A Handbook for Police Trainers to

ncrease Understanding and Improve
Community Responses

Sponsored by:
The David and Lucile Packard Foundation

Linda L. Baker
Peter G. Jaffe

Steven J. Berkowitz
Miriam Berkman

The support of The David and Lucile Packard Foundation is gratefully
acknowledged.

The views expressed herein are those of the Centre for Children and Families
in the Justice System of the London Family Court Clinic, Inc. and the
National Center for Children Exposed to Violence and do not necessarily
reflect those of The David and Lucile Packard Foundation.

002, Centre for Children and Families in the Justice System
of the London Family Court Clinic, Inc., London, Ontario, Canada

ISBN #

-895953-14-6

The content of this book cannot be reproduced for publication without the
written permission of the Centre for Children and Families in the Justice
System.

Authors:

Linda L. Baker
Peter G. Jaffe

Steven J. Berkowitz
Miriam Berkman

Graphic Design:

Jeanie MacWilliam

This handbook can be printed from the Centre f

Children and Families in the Justice System website:
www.lfcc.on.ca/pubs.html

the National Center for Children Exposed to Violence
website: www.nccev.org/us

Order a published copy by writing to: Centre for Children and
Families in the Justice System (see address above)

or by calling: (519)679-7250 ext 206

or by emailing: pubs@lfcc.on.ca

National Center for Children Exposed to
Violence, Child Study Center, Yale
University School of Medicine,
230 South Frontage Road, P.O Box
207900, New Haven, CT 06520-7900

Centre for Children and Families in the
Justice System, 254 Pall Mall St., Suite
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Table of contentsTable of contents
INTRODUCTION

This handbook

Definition of terms used in this handbook

MODULE 1 – DOMESTIC VIOLENCE: WHAT IS IT?

I) Description

) Core Characteristics

Table 1: Power & Control Wheel
Domestic violence calls: Police officers’ experiences
Factors influencing victims’ decisions about their
relationships with abusive partners

MODULE 2 – UNDERSTANDING THE NEEDS OF CHILDREN
& ADOLESCENTS EXPOSED TO DOMESTIC VIOLENC

I) How are Children and Adolescents Affected?

Increased risk for child maltreatment
Increased risk for problems
Adjustment and resilience
Table 2: Short term effects: Potential problems
associated with exposure to domestic violence in
childhood
Traumatic stress reaction
Do children living with violence learn to be violent?
Long term effects: Potential adult problems associated
with exposure to violence in childhood
Module 2, Section I Summary

II) Potential Impacts at Different Developmental Stages
and Case Illustrations
Infants & toddlers: Potential impacts of exposure to
domestic violence
Case Examples – Infants & Toddlers
Preschoolers: Potential impacts of exposure to domestic
violence
Case Examples – Preschoolers
Children ages six to eleven: Potential impact of
exposure to domestic violence
Case Examples – Children Ages Six to Eleven

…………………………………………………….1
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……………..5

………..7
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……………………………………..9
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….11

…………………….13

..15
……16

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….21

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…………………………………..24

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…………………………………………………………30
……………………………31

……………………………34
……….35

Adolescents: Potential impact of exposure to domestic
violence
Case Examples – Adolescents

III

) Interventions

Needs-based intervention goals for children &
adolescents
Module 2, Section III Summary

MODULE 3 – SPECIAL CONSIDERATIONS FOR POLICE
OFFICERS

I) Domestic Violence is Distinguished by the Intimate
Context in which Crimes Occur
Childrens’ relationship to the victim and perpetrator
Module 3, Section I Summary

II) The Presence of Children in Domestic Violence
Situations is Significant
Considerations when children are present
Tips for Talking with Children
My Safe Place (illustration)
Interviewing children
Key factors in interviewing children
Module 3, Section II Summary

III) Risks to Children in Domestic Violence Situations
Need to be Assessed
Legislation, policy and procedures
When reporting to Child Protection Services is
not legally mandated nor automatically required by
policy & procedures
Module 3, Section III Summary

IV) Risk Assessment, Risk Reduction and Safety
Planning for Victims of Domestic Violence Differ
in Important Ways from those Carried Out for Other
Victims

Components of risk assessment and safety planning
Brief risk assessment and safety planning
Table 3: Main components in domestic violence risk
assessments
Table 4: Main components in domestic violence safety
plans
Domestic violence and risk
Module 3, Section IV Summary

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&
……………………………………………………44

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…49

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…64
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III

V) Issues Related to Dual Arrests in Domestic Violence
Cases
Dual arrests in domestic violence cases: Problems and
impacts on children
Module 3, Section V Summary

VI) Collaborations and Coordinated Community
Responses Benefit Children and their Families
What are the benefits of collaboration and coordination?
Who should take part in community collaboration to
intervene and prevent domestic violence?
Strategies to facilitate collaborations
Examples of collaboration
Module 3, Section VI Summary

VII) Specialized Training and Cross Training Initiatives
in the Area of Domestic Violence Promote Effective
Law Enforcement Interventions and Enhance
Collaborations with Community Partners
Recommended topics for training
Training considerations
Module 3, Section VII Summary

MODULE 4 – FREQUENTLY ASKED QUESTIONS

APPENDIX A – RESOURCES

APPENDIX B – REFERENCES

………………………………………………………..69

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…73
…74

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I V

iolence in the US has been described as a public health
epidemic.1 Millions of children are affected each year.
Children are exposed to violence in their families, schools,
neighborhoods, and through the media.

Young children are particularly vulnerable. They often have
little or no contact with individuals or systems (e.g., education)
outside of the family that can identify harmful situations.

INTRINTRODUCTIONODUCTION

V
• Estimates based on data from 44 states

indicate that in 1997, approximately 984,000
children were victims of maltreatment
nationwide and approximately 1,100 children
die annually as a result of child abuse or
neglect.2

• Households where domestic violence
occurs are more than twice as likely to have
children.3

• Before a child turns 18, she or he is estimated
to have witnessed more than 200,000 acts of
violence on television, including 16,000
murders.4

• Children under age four accounted for 76%
of child abuse and neglect fatalities in 1997.2

• Young children are disproportionately
exposed to domestic violence relative to
children in older age groups.3

The David & Lucile Packard Foundation 1

While many children living with violence demonstrate
remarkable resilience, the development and emotional well-
being of a substantial number of children are significantly
compromised.

• Long-term consequences of childhood
victimization can include mental health
problems, educational difficulties, alcohol and
drug abuse, and employment problems.5, 6

• Being abused or neglected as a child increases
the likelihood of arrest as a juvenile by 53%
and of arrest for a violent crime as an adult
by 38%.6

• Exposure to domestic violence in childhood
is associated with a significant increase in
self-reported violent behaviours during
adolescence.7, 8

The magnitude and potential consequences of this threat to
children require that communities take action. Police officers

From the perspective of police officers, one of the most
observable and distressing consequences of children’s exposure
to violence is the increased likelihood that young people will
become involved in violence, either as a victim or as an
aggressor. In cases of domestic violence, police are well
acquainted with seeing a child first as a witness to his or her
parents’ fights and later arresting the same child for adolescent
delinquency. Both arrestees and victims in domestic violence
cases frequently report histories of repeatedly witnessing similar
abuse between their own parents or caregivers. While the cause
of delinquency is best described as a constellation of risk factors,
research is consistent with police observation and experience.

2 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

play an important role in increasing the safety and security of
children through law enforcement, community service and
crime prevention.

The capacity of police officers to carry out their role is enhanced
when they understand the impact of violence on children, and
the ways in which crimes associated with such violence may
differ from other police matters.

This handbook is for domestic violence specialists and trainers
in police departments. It is designed to increase the
understanding of children’s exposure to domestic violence
by officers responding to these situations.

While children are often exposed to multiple forms of violence
and all exposure is of concern, this handbook focuses on
children’s exposure to domestic violence and the related
considerations for law enforcement professionals. This
focus is significant because children in these situations have
been largely “invisible” to authorities and the public in the past.
An understanding of the short and long term impacts that may
be experienced by affected children has only developed in the
past couple of decades. Accordingly, information on children
living with violence and the implications for various professions
and services have not been fully incorporated into relevant
educational and training materials. The implications for law
enforcement professionals related to children’s exposure to
domestic violence generally apply to children’s exposure to other
forms of violence.

This handbookThis handbook

Introduction

The David & Lucile Packard Foundation 3

The significance of domestic violence in the lives of children is
highlighted by the following:

• Domestic violence is the most frequently
occurring violence children experience. Police
encounter as many as half a million children
during domestic violence arrests in the US
each year.5

• Exposure to domestic violence increases a
child’s risk of maltreatment (e.g., physical
victimization).9

• Children exposed to domestic violence may
experience many of the same symptoms and
lasting effects as children who are direct
victims of violence.10

4 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Definitions of the termsDefinitions of the terms
used in this handbookused in this handbook

refers to children seeing, hearing or being aware of violence
against one parent figure that is perpetrated by another
parent figure. This term is often used interchangeably with
child witnesses to domestic violence in other resources. The
latter term is not used in this handbook to avoid suggesting
that children are only impacted when they see the violence
occurring, and to avoid confusing children’s exposure to
domestic violence with children appearing as court
witnesses in legal matters. Children exposed to domestic
violence is used interchangeably with children living with
violence and children affected by violence.

refers to the abuse and/or assault of adolescents or
adults by their intimate partners. It is used
interchangeably with intimate partner abuse and inter-
parental violence. Battering is also used to refer to the
typical pattern of domestic violence which occurs most
frequently.

Domestic violence:

Perpetrator:
refers to individuals who are violent towards their
intimate partners. It is used interchangeably with
offenders, offending parents, batterers, abusive partners,
and abusive parent figures.

Victim:
refers to individuals who are abused by their intimate
partners. It is used interchangeably with survivor, non-
offending parent, abused partner, and battered partner.
Many domestic violence advocates prefer the term
survivors as this reflects the reality that most abused
individuals cope and move on with personal strength
and resourcefulness.

Children exposed to domestic violence:

Introduction

The David & Lucile Packard Foundation 5

6 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

MODULEMODULE

DOMESTIC VIOLENCE:DOMESTIC VIOLENCE:
WHAWHAT IS IT?T IS IT?

omestic violence is any use of physical or sexual force,
actual or threatened, in an intimate relationship.

Although both women and men can be victims of domestic
violence, the overwhelming majority of this violence involves
men abusing women.

These crimes are often committed in a context where there is a
pattern of assaultive and controlling behavior. This violence may
include physical assault, and emotional, psychological and
sexual abuse. It can include threats to harm children, other
family members, pets, and property. The violence is used to
intimidate, humiliate or frighten victims, or to make them
powerless. Domestic violence may include a single act of abuse.
It may also include a number of acts which may appear minor
or trivial when viewed in isolation, but collectively form a pattern
that amounts to abuse.

Intimate relationships include those between opposite-sex and
same-sex partners. These relationships vary in duration and
legal formality, and include current and former dating, common-
law and married couples. Criminal code offences resulting
from intimate violence include, but are not limited to, homicide,
assault, sexual assault, threatening death or bodily harm,
forcible confinement, harassment/stalking, abduction,
breaches of court orders and property-related offences. 11

I) DESCRIPTIONI) DESCRIPTION

A history of property-related offences may be associated
with domestic violence (e.g., breaking into ex-partner’s
home, destroying partner’s possessions).11

1.3 million women and 835,000 men experience violence
by a current or former partner annually.12

Over a lifetime, 22.1% of women and 7.4% of men
experience violence by a current or former partner.12

64% of women and 16% of men report being raped,
physically assaulted or stalked since age 18 by a current
or former partner.12

In 1999, 424 men and 1218 women were killed by intimate
partners. 12

8 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Module I: Domestic Violence: What is it?

II) COREII) CORE
CHARACHARACTERISTICSCTERISTICS

Domestic violence . . .Domestic violence . . .
occurs in all age, racial, socio-economic, educational
occupational, and religious groups;

occurs within an intimate relationship;

is learned behavior;

typically involves repetitive behavior encompassing
different types of abuse (e.g., physical assault and sexual,
psychological, emotional and economical abuse, use of
children – see Table 1: Power and Control Wheel);

is used to intimidate, humiliate or frighten victims as a
systematic way of maintaining power and control over
them;

is caused by the perpetrator, not by the victim or the
relationship;

differentially affects men and women. Women
experience more violence over a life time, more severe
forms of violence, and more serious injuries than do male
victims of domestic violence;12,13

is likely to present increased risk to the victim and children
at the time of separation from the abuser;

evokes victim behavior that is often about ensuring survival
(e.g., minimizing or denying the violence, taking
responsibility for the violence, protecting the perpetrator,
using alcohol or drugs, self defense, seeking help,
remaining in the abusive relationship).

The David & Lucile Packard Foundation 9

Power and Control WheelPower and Control Wheel
Table 1:Table 1:

Developed by Domestic Abuse Intervention Project, 202 E. Superior St., Duluth MN 55802
For more information contact: info@praxisinternational.org or fax: (218)722-1053

10 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Domestic violence calls:Domestic violence calls:
Police officers’ experiencesPolice officers’ experiences
It is often frustrating and confusing for police officers to deal
with cases of domestic violence. For a variety of reasons, some
of which are described in the next section, victims may resist
the officer’s efforts. Some victims may not provide the
information required for making an arrest. Others may appear
to minimize the extent of the violence perpetrated against them,
limiting the officer’s ability to substantiate serious charges.
While wanting their aggressive partner to be held criminally
responsible, victims may be overwhelmed by the impact of the
current offense and/or accumulated abuse incidents. In these
situations, victims may have difficulty providing the information
needed for arresting the perpetrator on charges that reflect the
seriousness of the incident. Officers may also encounter
situations where victims actively co-operate with the criminal
investigation, and then, at a later time, bail the defendant out
of jail or appear in court requesting that charges be dropped.

Criminal justice remedies tend to be limited. Most calls for
police service in domestic violence cases concern misdemeanor
offenses, such as breach of peace, threatening and simple
assault. These offenses do not carry significant penalties and
usually do not justify lengthy pre-trial detention. It is not
unusual for defendants to be released within days, if not hours,
with court orders of protection that may be worth little more
than the paper they are written on. In this context, officers
frequently find themselves responding repeatedly to the same
addresses, with little expectation that their attempts to
intervene will result in any real change. Not surprisingly, many
victims find their efforts to seek protection through criminal
law disappointing and frustrating. Police, who are the most
visible representatives of the criminal justice system, may then
find themselves on the receiving end of the disappointed
complainant’s rage at her partner’s violence and the inadequacy
of the system to provide the protection she requires.

Module I: Domestic Violence: What is it?

The David & Lucile Packard Foundation 11

Domestic violence calls present police with highly charged
emotional situations, which can be dangerous to everyone
involved. Across the United States, a significant proportion of
officers are injured while responding to domestic violence calls.
The personal and emotional nature of the calls can also arouse
strong feelings in the responding officers, particularly if they
remind officers of similar circumstances in their own family or
friendship network. It is not easy to remain neutral and
professional in the face of such physical and emotional triggers,
and officers may overreact to one party or the other, and/or
quickly move on to the next call.

Many of the dangers and frustrations associated with police
response to domestic violence are inherent in the law
enforcement role. While it is not productive for officers to
bemoan the thankless nature of their role, it is important to be
aware of the many ways in which officers’ frustration can get
in the way of their effective exercise of authority. Greater
knowledge about the dynamics of violence in intimate
relationships may assist officers to respond in ways that feel
most useful and supportive to the victim. It may also help
officers to understand why their best attempts to intervene are
so often met with resistence, and to tolerate the reality that
repetitive police interventions may be necessary. The following
information is provided with those goals in mind.

12 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

The rate of homicide by husbands is 25 times higher
when women are separated from their husbands
than when they are married and cohabitating.14

Factors influencingFactors influencing
victims’ decisions aboutvictims’ decisions about
their relationships withtheir relationships with
abusive partnersabusive partners

It is a process, and often a long one,
because of factors such as:
• safety issues;
• the impact of the abuse on the

victim (e.g., loss of self-confidence);
• the complexity of the relationship

with the abuser;
• the challenge victims face when

arranging to provide for
themselves and their dependents.

Evidence suggests that for many women
with children, the risks associated with
leaving violent men include:

• surviving escalations in violence that
often follow separation;

• raising children alone in poverty;

• facing the potential loss of their
children to abusive partners in
custody battles.

• Victims make decisions about staying in or leaving their
abusive relationship within the context of survival:

• Leaving is often better understood as a process rather
than an event:

Module I: Domestic Violence: What is it?

The David & Lucile Packard Foundation 13

• Victims from diverse backgrounds may face additional
pressures. Many women must access and navigate
legal and support services in a language with which
they have limited familiarity, comfort and skills:

Indirect or direct experience may
cause victims to fear they and their
children will be discriminated against. In
some cases, abuse by authorities in other
countries may prevent victims from
trusting or seeking assistance from police
or others in their current communities.
Also, experienced or perceived
discrimination by authorities in their
current communities will affect their
willingness to request help.

The capacity of police officers to support victims in
their efforts to protect themselves and

their children

increases with an awareness of the risks they face
and the manner in which these risks necessarily
influence their decision making. An understanding
of the realities of domestic violence should also shift
our focus from “why does the victim stay?” to “why
is the abuser still being violent and what needs to
happen to hold the perpetrator accountable for
ending the violence?”.

14 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

MODULEMODULE

UNDERSTUNDERSTANDING ANDING THETHE
NEEDS OF CHILDRENNEEDS OF CHILDREN

& ADOLESCENTS & ADOLESCENTS
EXPOSED EXPOSED TTO

DOMESTIC VIOLENCEDOMESTIC VIOLENCE

I) HOI) HOW W AREARE
CHILDREN ANDCHILDREN AND
ADOLESCENTSADOLESCENTS
AFFECTED?AFFECTED?

hen children live with domestic violence, their
experience is likely to be different from that of most
children. Watching, hearing, or later learning of a parent being
harmed threatens the sense of stability and security typically
provided by family. Children often experience sadness, fear,
guilt, anger, shame and confusion. The impact of directly or
indirectly witnessing one’s parent being emotionally and
physically injured is intensified when another parent figure is
responsible for the violence. Children may experience strong
ambivalence toward their offending parent. Affection often
coexists with feelings of resentment and disappointment over
their parent’s violent behavior.15

Between violent incidents, the emotional climate of the home
may be very tense. Children may see their abused parent treated
with ongoing disrespect. They may be concerned about when
and how the violence will occur next. Some children describe
trying hard to please or attempting to be invisible to keep the
perpetrator calm. Others describe trying to influence the non-
offending parent’s behaviors in an effort to keep the abusive
adult from becoming violent.

16 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Increased risk for childIncreased risk for child
maltreatment*maltreatment*

The risk of being maltreated in childhood
significantly increases if you live in a family where
woman assault is occurring: approximately 30 to
60% of battered mothers’ children also experience
neglect, emotional abuse, or physical violence.16

While exposure to domestic violence is considered to be maltreatment in some jurisdictions,
here the term child maltreatment is being used to refer to neglect, emotional abuse (apart from
exposure), sexual abuse, and physical abuse.

Children living with domestic violence face increased risks for
direct victimization.16 First, they may be accidentally injured
because of their close proximity to their non-offending parent
during a violent incident. Young children who are physically
near parents and older children who intervene to stop the
violence may be particularly at risk.

Second, children living in a home where domestic violence is
occurring are also at greater risk of experiencing neglect,
emotional abuse, sexual abuse and physical abuse. In addition,
children may experience victimization if the perpetrator uses
them as part of the control tactics employed against the adult
victim. While this can involve physical assaults, it is more likely
to involve emotional abuse such as:17

• claiming the children’s bad behavior is the
reason for the assaults on the non-offending
parent;

• engaging the children in the abuse of the other
parent;

• threatening violence against the children and
their pets in front of the non-offending parent;

• holding the children hostage or abducting
them in an effort to punish the adult

victim

or to gain compliance;

• talking negatively to children about the
abused parent’s behavior.

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 17

Children exposed to domestic violence may experience increased
psychological, behavioral and social problems (see Table 2, page
20).18,21 These difficulties include reduced social skills, as well
as withdrawn, anxious and acting out behaviors. Some research
has shown an association between children’s exposure to
domestic violence and subsequent aggressive behavior.1 9
However, not all children and adolescents who display such
problems have been exposed to domestic violence. In fact,
some children and adolescents exposed to intimate partner
abuse do not appear to experience increased problems.
Accordingly, while children are at increased risk for a variety
of problems, their adjustment varies widely following exposure
to violence.

Increased risk for problemsIncreased risk for problems

Adjustment and resilienceAdjustment and resilience

While children are at increased risk for a variety of
problems, their adjustment varies widely following
exposure to violence.

Research has helped us begin to identify the factors that
influence how children adjust following exposure to domestic
violence. The factors are generally understood to be related to:

• the nature of the violence (e.g., intensity,
proximity, duration);

• the child (e.g., age, gender, temperament,
developmental stage);

• the child’s immediate and broader social
context (e.g., parent-child relationships,
social connections, financial resources).

18 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

• a strong caring relationship with an adult
(e.g., parent, relative, teacher);

• community safe havens (e.g., community
centers, churches, schools);

• a child’s own internal resources (e.g.,
intelligence, interpersonal skills).

The way children make sense of their experience is strongly
related to their thinking abilities, as well as their social and
emotional maturity. Children’s developmental stages help us
understand how they might be affected by domestic violence.
Factors shown to help children to cope with exposure to violence
include:20

Children exposed to violence benefit from a caring
relationship with an adult, community safe havens,
and their own internal resources.

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 19

Short term effects: PotentialShort term effects: Potential
problems associated withproblems associated with
exposure to domestic violenceexposure to domestic violence
in childhoodin childhood18, 2118, 21

Examples for
Children & Adolescents

Table 2:Table 2:

Types of
Problems

less developed attention and
concentration abilities; poorer
understanding of social
situations

Less
developed

thinking skills

violence is okay to teach others
a lesson; ‘might is right’; violence
enhances one’s image and peer
status

Learned
attitudes

supporting
violence

fewer age-appropriate social
skills to initiate and sustain
relationships, to seek assistance
from others, and to satisfy
personal needs

Lower social
capabilities

increased stomachaches,
headaches, tiredness;

changes

in appetite

Increased
physical

complaints

Increased
internalized

behaviors

withdrawn, fearful, reluctant to try
new things, anxious

aggression toward others (e.g.,
bullying, fighting, dating
violence); property destruction;
antisocial behaviors (e.g., lying,
stealing)

Increased
externalized

behaviors

20 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Of the children who experience increased difficulties, some
experience traumatic stress reactions following exposure to
violence.22 This stress can be reflected in their emotions,
thoughts and actions. Features of traumatic stress reactions
include:

Traumatic stress reactionTraumatic stress reaction

• re-experiencing aspects of the violence (e.g.,
flashbacks, nightmares);

• avoidance of reminders of the violence (e.g.,
may avoid males who raise their voices; shy
away from conflict);

• numbing (e.g., may seem detached from
others);

• increased arousal (e.g., may show strong
startle-response to noise or startle easily in
general).

Children and adolescents learn from what they see modeled in
their environment. When intimate partner abuse occurs, they
may learn that hostile aggression can be used to control others.
Some research suggests boys are more likely to learn to be
aggressive, and girls may learn to accept violence from the
males in their lives. This learning can take place even though
children and adolescents want the violence in their homes to
end. Also, exposure to violence may desensitize children and
adolescents to aggressive behavior. When this occurs,
aggression becomes part of the “norm” and is less likely to
signal concern to the youth.

Do children living withDo children living with
violence learn to be violent?violence learn to be violent?

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 21

Exposure to domestic violence in childhood is
associated with increases in self-reported violent
behaviors during adolescence.7

Young men who grow up in violent homes have a
greater chance of becoming violent in their own
dating relationships.2 3

Recent exposure to domestic violence is a
significant factor in predicting a child’s violent
behavior.19

Long term effects:Long term effects:
Potential adult problemsPotential adult problems
associated with exposureassociated with exposure
to violence in childhoodto violence in childhood

poor social adjustment (e.g., relationship difficulties)

thinking distortions (e.g., underestimating self worth and
capabilities)

post-traumatic stress reactions (e.g., intrusive and
upsetting images)

emotional difficulties (e.g., depression, anxiety)

substance

abuse

aggressive behavior/criminality

22 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Impacts of exposure toImpacts of exposure to
domestic violence ondomestic violence on
children and adolescentschildren and adolescents
• Psychological, behavioral and social

problems may be experienced following
exposure to domestic violence in
childhood.

• Some children and adolescents who
experience difficulties display traumatic
stress reactions (e.g., nightmares,
hypervigilence).

• Not all children and adolescents who
display emotional and behavioral
p r o b l e m s h a v e b e e n e x p o s e d t o
domestic violence.

• Some children and adolescents exposed
to domestic violence do not appear to
experience increased problems.

Module 2, Section I SummaryModule 2, Section I Summary

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 23

ow young people relate and think about their experiences
changes dramatically as they mature. We can better

understand how they may interpret and be affected by exposure
to violence when we consider their stage of development.
Development encompasses cognitive (thinking), emotional and
social domains. Knowledge about child development should
guide our responses and interventions with children at different
ages. Case examples are presented to illustrate the relevance
of child development to law enforcement professionals.

II) POII) POTENTIALTENTIAL
IMPIMPAACTS CTS AAT

DIFFERENTDIFFERENT
DEVELDEVELOPMENTOPMENTALAL
STSTAAGES GES AND CASEAND CASE
ILLILLUSTRAUSTRATIONSTIONS

24 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Infants and toddlers:Infants and toddlers:
Potential impact of exposurePotential impact of exposure
to domestic violenceto domestic violence

Potential
Impact

Key Aspects of
Development

Take in information
from the world around

them through their
senses

Form secure
attachment

Become more active
explorers of their world
and learn through play

Learn about social
interaction and

relationships from
what they hear and

observe in
their families

loud noises, vivid visual
images associated with
violence can be distressing

parents may not be able to
consistently respond to
children’s needs

fear and instability may inhibit
exploration and play; imitation
in play may be related to
witnessed aggression

learn about aggression in
observed interactions

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 25

Case 1

Officers responded to a call regarding a domestic dispute.
Two young parents who did not live together were arguing
outside over who would take their 6 month old baby to
their parents for Thanksgiving. Yelling and screaming
escalated into pushing and shoving while the mother held
the baby in her arms. A neighbor heard the commotion
and called 911. When the officers arrived, the baby’s father
was punching the mother in the face as she struggled not
to drop the baby. The baby was clearly upset and crying.
Neither parent comforted the baby as they fought with each
other.

Questions

1) What steps should the police take in assessing proper care
of the infant?

The father will most likely be arrested for his assault on the
mother in the officers’ presence. It is important to find out who
actually cares for the infant (i.e., one of the grandparents, one of
the parents, or some combination), who will be available if
both parents are arrested, history of violence between the
parents, history of child abuse/neglect, and the capacity of the
Child Protection Services (CPS) to care for the infant. Continuity
and security of care for the infant should be a central factor in
the officers’ exercise of discretion.

2) Should the infant be seen in the emergency room?

One of the dilemmas is that parents may not accurately report
whether the infant was hit or injured during the altercation.
Accordingly, the safest course of action is to make sure the
infant is evaluated immediately.

In collaboration with CPS, the infant was placed with the maternal
grandmother, one of several primary caregivers for the baby.

Case Examples -Case Examples –
Infants & ToddlersInfants & Toddlers

26 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Case 2

Police received a call regarding a domestic assault in
progress. A woman had been sleeping in bed with her 4
month old baby. The baby’s father returned home
intoxicated late at night, and began to beat the mother.
Neighbors heard screams for help and called 911. When
officers arrived, they found a seriously bruised woman, the
injured baby and the father attempting to flee the
apartment. Officers interrupted and arrested the father.
Emergency medical services treated the mother at the
scene.

Questions

1) Can/should officers charge the father with risk of
injury to the baby?

What constitutes criminal risk of injury will depend on
local statutes, however, an argument could be made that
physical risk is only one factor among many to consider.
Another risk is the potential effects of the violence on the
infant’s psychological and central nervous system
development.

2) What additional assistance does the mother need to
be able to keep herself and the infant safe?

Issues to consider include shelter or alternate housing
for the mother, high bond to keep the father temporarily
incarcerated, other court orders likely to be issued,
any information regarding the father’s likelihood of
complying with orders, existing resources for battered
women, etc.

When the case was called for arraignment the next day, the
mother refused to speak with prosecutors or victim
advocates.

This is a common, frustrating experience for many officers.
There are likely many complex reasons for this woman’s

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 27

Case 3

Officers responded to the scene of a domestic dispute in
which a woman was stabbed by her boyfriend with a meat
cleaver and she retaliated by hitting him on the head with
a metal bar that was part of a baby swing. The violence
occurred in the presence of the couple’s two children, aged
two and eight. When officers arrived, they found the
children curled up on the couch, splattered with blood.
The mother was transported to the hospital by ambulance
and her boyfriend was arrested. The distressed children
were brought to the police station, where officers provided
food and looked after them while they waited for CPS to
respond. The two-year old, distraught and overwhelmed,
complained to officers that she “had blood on her” that
she feared would not come off.

decision not to pursue prosecution of her partner (e.g.,
fear, financial dependence, love). This mother, like many
people, may believe that these sorts of experiences have
little or no effect on very young children. While the
perpetrator is responsible for the violence, mothers
who learn about the potential effects of domestic violence
on their children’s development may be more likely to take
action to decrease the risk of their future exposure to
violence. Police officers and others can be helpful in
providing this information. Information about the effects
of domestic violence on young children will be most useful
when it is presented in a thoughtful and supportive way,
in co-ordination with other social services that can assist
the mother in developing a strategy for increasing her
safety. Information is least likely to be useful to battered
women when it is presented in a critical way and implies
that she is an inadequate mother.

28 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Questions

1) What can officers say or do to assist the two-year old?

It is human nature to want to say something to make
children feel better after these experiences. It is not
unusual for adults to tell children that everything is going
to be OK, or not to worry because the danger is over. But
this is far from the truth. It can be more helpful to a
young child for adults to acknowledge that something scary
has happened, and that the adults are going to do the
best they can to help them. One of the best things officers
can do is to find out what other adults the children are
close to, contact them, and bring them to the police station.
It will be easiest to regain a sense of safety and security,
especially for the two-year old, in the presence of a familiar,
nurturing adult.

For this two-year old, the concerns about blood spots may
reflect age-typical concerns about the body and cleanliness
that may occur in response to any kind of
mark on their clothing or body. The blood is also a powerful
reminder of the scary incident the child experienced. The
child’s distress about the blood may communicate her
fear of the memory of this event. A useful response is for
the officer to help the child to wash the spots wherever
possible and to find clean clothes if available. Although
this will not necessarily stop the memory from returning,
the child will not be visually confronted with the reminder.

While CPS workers and police worked closely together to
investigate the safety and appropriateness of relatives who
might care for the children, one of the officers held the two-
year old on his lap. The child asked the officer to sing, and
when he did, she fell asleep. The children were eventually
placed with their maternal grandmother.

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 29

Preschoolers:Preschoolers:
Potential impact of exposurePotential impact of exposure
to domestic violenceto domestic violence

Learn how to express
aggression and angry

feelings, as well as
other emotions, in
appropriate ways

Think in
egocentric ways

Form ideas about
gender roles basedon

social messages

Increased physical
independence

(dressing self, etc.)

learn unhealthy ways of
expressing anger and
aggression; possibly
confused by conflicting
messages (e.g., what I
see versus what I’m
told)

may attribute violence
to something they’ve
done

learn gender roles
associated with
violence & victimization

instability may inhibit
independence; may see
regressive behaviors

Potential
Impact
Key Aspects of
Development

30 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Case Examples -Case Examples –
PreschoolersPreschoolers
Case 4

A woman walked into the central police station with a 6
year old boy and asked to report an assault. She was taken
to the detective bureau, where she reported that her live-
in boyfriend (the father of her 3 year old daughter) had
kept her confined in their apartment for the past three
days and had repeatedly assaulted her both physically and
sexually. She had managed to leave the apartment by
telling the man she was going to the corner for cigarettes.
She took her 6 year old son with her, but left her 3 year old
daughter behind with her boyfriend. She explained that
she had left the girl behind because she did not think the
girl’s father would let her take their daughter. She made
sure to take the boy because she worried that her boyfriend,
who was not the child’s father, would hurt her son if he
was left. Police went immediately to the apartment to
check on the safety of the girl and to arrest the boyfriend.
The man heard officers approaching, grabbed the child and
ran to hide in the basement. Officers followed and
convinced him to come with them without a struggle.
Officers transported the man to jail and the 3 year old to
the police station, where she was reunited with her mother.
The girl surprised officers when she ignored her mother
and went to play with toys in the police station’s family
room. She also asked repeatedly where her father was and
complained that officers had taken him.

Questions

1) Why did the girl behave this way? What should officers
say or do?

There are several reasons why the 3 year old may have
ignored her mother and asked for her father. While the
information available to officers indicates that the father
is a dangerous figure, and his behavior during the previous
days put the family at serious risk, this is not necessarily
how the child sees her father.

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 31

In fact, we know almost nothing about the nature of the child’s
relationship with her father or his behavior towards her, as
distinguished from his treatment of her mother. For example,
it may be that the child plays with her father and/or that the
father has negatively influenced the child against the mother.
The experience of running and hiding with her father may
have been more playful than frightening to this young child.
Along with her father, the little girl seems to have seen the police
as intruders rather than as helpers. It is not uncommon for
children to be angry at the police for arresting their parent and
to worry that the arrested parent is hurt or in danger. In this
situation, it is most helpful for the officer to respect the child’s
attachment to her father and to explain that officers acted
because it was not safe for everyone at home. Officers can
reassure the child that her father is not hurt, that both of her
parents are in a safe place, and that her mother will take care of
her.

When children are chronically exposed to domestic violence,
they may feel that the world is an unsafe and unpredictable
place where adults cannot assure their safety. Excessive
clinginess or exaggerated independence may be indications of
disruptions in the child’s sense of security and attachment.
Officers may be helpful to this child and her mother by offering
a referral for clinical services, which can assist the mother in
understanding and responding to the child in relation to her
experience of this event.

2) Why would the 6 year old be especially at risk for being
hurt?

This case provides an opportunity to review information
about the co-occurrence of domestic violence and child
maltreatment. This child may be at heightened risk
because he is not the biological son of the aggressive man.
Because of the possibility that the boy has been maltreated
(recall the mother’s concern for the boy’s safety),
it would be wise for investigators from police and Child

32 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Protection Services to obtain the child’s medical records
and a complete skeletal x-ray series to check for previous
injuries.

3) What else does the mother need to protect herself and
her children?

Given that there has been a long and largely unreported
history of violence in this family, this incident provides
an opportunity for co-ordinated planning and support.
The mother’s decision to seek police intervention then
results in a real increase in safety for her and the children.
Considerations relating to physical safety include a high
bond to assure the defendant is temporarily incarcerated,
court orders of protection, and possible relocation of the
family if he is to be released. This mother also needs
substantial practical and emotional support to be able to
maintain her focus on safety. Officers can provide referrals
for advocacy and clinical services.

Detectives arranged for the highest possible bond by calling
a prosecutor at home in the evening. They then assured
the mother that she could safely return home with her
children for the night. They also called for immediate
assistance from an on-call mental health clinician familiar
with available services for domestic violence victims. The
clinician met with the mother at the police station, provided
her with the name and telephone number of the court-based
victim advocate, and explained the court procedure for the
following day. The advocate reported that the mother was
waiting for her at court when the doors opened, and that
this was the first time she had been successful in connecting
with this woman, though there had been previous cases
prosecuted in court against the same boyfriend. The clinician
also arranged for evaluations of both children and home-
based psychological support and case management for the
mother.

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 33

Children ages six to eleven:Children ages six to eleven:
Potential impact of exposurePotential impact of exposure
to domestic violenceto domestic violence

Competition assumes
new importance within

peer group

more aware of own reactions to
violence at home; more aware of
impact on others (e.g., mother’s
safety, concerned about father
being charged)

possibly more susceptible to
acquiring rationalizations heard to
justify violence (i.e., myths of
woman abuse)

accessibility for learning may be
decreased because of impact of
violence (e.g., distracted); may
miss positives, or selectively
attend to negatives, or evoke
more negative feedback

possibly more influenced by
messages that confirm attitudes
and behaviors associated with
intimate partner abuse

may learn gender roles
associated with intimate partner
abuse (e.g., males as
perpetrators — females as
victims)

may use hostile aggression to
compete; increased risk for
bullying and/or being bullied

Potential
Impact
Key Aspects of
Development

Increased emotional
awareness for self

and others

Increased complexity
in thinking about right
and wrong; emphasis
on fairness and intent

Academic & social
success at school has

primary impact on
self-concept

Increased influence
from school, peers,

community and media

Increased same sex
identification

34 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Case Examples -Case Examples –
Children Aged Six to ElevenChildren Aged Six to Eleven
Case 5

Police responded to a call about an ongoing fight between
a man and a woman. When officers arrived, a 6 year old
boy answered the door with a blank expression on his face.
A 4 year old boy was huddled on the couch with a badly
bruised woman. The 4 year old was crying. The woman
had deep scratches on her neck. Officers also heard an
infant crying in the next room. The female victim reported
that her boyfriend (infant’s father) returned home drunk
and accused her of having another boyfriend. When she
refused to talk about it, he began hitting her. She reported
this was the first time that he had hit her, but stated that
the father of the older children abused her regularly and
has been in jail for some time.

Questions

1) Are there any specific concerns about the children?

This case provides an opportunity to review effects of
exposure to domestic violence on children and the co-
occurrence of domestic violence and child maltreatment.*
In discussion, make the connection between exposure to
violence and potential difficulties including the
perpetration of violence in the future.

On follow-up by a domestic violence detective several days
later, the mother asked if the detective would talk to the 6
year old, who has been hitting her and his younger brother
since the events. She reported that the boy’s teacher has
been concerned about his aggressive behavior with other
children, but she had not noticed anything of concern to
her until the past few days.

*While exposure to domestic violence is considered to be maltreatment in some jurisdictions,
here the term child maltreatment is being used to refer to neglect, emotional abuse (apart from
exposure), sexual abuse, and physical abuse.
Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 35

2) How do you understand the 6 year old’s behavior?

Relatively new to school, children of this age are
experiencing separation and autonomy from their families.
Often they are very invested in feeling in charge of their
own experience and surroundings. Boys are likely to
identify with men and are becoming more independent.
The experience of being helpless at the time of the violent
events can be overwhelming for the child, particularly a
boy of this age who is concerned with issues of size and
power and wishes to be strong and competent. Aggressive
behavior after the event is one way for the child to turn
around or undo the experience of extreme vulnerability.
Aggressive acting out may also be a way for the child to
identify himself with the more powerful, aggressive figure
as opposed to the helpless victim. It is not unusual for
any child who feels helpless and overwhelmed to later
behave aggressively. The problem is when this response
becomes a lasting coping strategy.

3) What can the detective do to be helpful?

The mother is asking for the detective’s help because she
sees him as endowed with authority. Typically, people
think that officers authoritatively lecture a child into
‘getting straight’, but as we all know, this type of
intervention rarely works. The officer may be more
effective by discussing with the mother the relationship
between the child’s exposure, experience of confusing adult
relationships and his aggressive behavior. An offer to the
mother for on-going support and/or treatment from a
social service agency or mental health program to help
her and her children might be well received at this time.

36 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Case 6

Refer back to case #3, in which the mother was stabbed
and hospitalized and the two-year old was concerned about
the blood on her. The 8 year old girl was distraught and
crying in the police station. In an attempt to help the
child feel better, officers brought her and her sister
hamburgers, fries and drinks. Both girls greedily ate them.
One officer sat next to the 8 year old as she was eating and
she began to recount the details of the domestic incident.
One striking feature of her story was her stating several
times that she could have stopped them from fighting if
only she had gotten the baseball bat from the closet and
threatened to hit her stepfather. She also repeatedly asked
to know what was going to happen to her mother and
stepfather. She was very concerned that she would never
see them again.

Questions

1) How can you understand what the girl tells the officer
about her ability to stop the fight?

It is not uncommon for individuals, and especially children,
to feel helpless and without control in the face of these
experiences. To feel more powerful and in greater control,
they imagine that they could change the course of events,
though it is far beyond their capabilities. Feeling powerful
and psychologically in control feels better than being weak
and helpless. There is a cost, however. Taking responsibility
for changing the outcome almost invariably leads to guilt
and self-blame when things do not change. The officer,
by virtue of his/her authority and knowledge can simply
say: “I know you wish that things were different, but you
did the right thing by keeping yourself and your sister
safe.” Reminding the child that she was active in protecting
her sister gives her some sense of accomplishment and
efficacy.

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 37

2) What do you say to the girl about what is going to
happen to her mother and stepfather?

Most of us want to spare children from any unpleasant
information, but hiding the truth from them can be equally
disturbing and may lead to another traumatic experience
when the children discover that they are not returning
home. In addition, when information is kept from children
(and adults), they often imagine even more frightening and
upsetting outcomes than the factual details the officer can
provide. It is useful to tell the children that their parents
are being treated at the hospital. It may be useful and
important to get medical status reports from the hospital
staff and inform the children of their parents’ condition.
If it has been determined that the mother will remain in
the hospital, the children should be told of this decision
and be asked with whom they might stay. Whenever
possible, it is best to place children with people they know.

If a relative or family friend is going to care for the children,
it will be important to provide her or him with some
guidance about what reactions the children may have and
how to support them.

38 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Adolescents:Adolescents:
Potential impact of exposurePotential impact of exposure
to domestic violenceto domestic violence

Increased sense of
self and autonomy

from family

family skills for respectful
communication and negotiation
may be poorly developed due
to violence; transition of
adolescence may be more
difficult for youth and family

may try to physically stop
violence; may use increased
size to impose will with
physical intimidation or
aggression

possibly more embarrassed
by violence at home; may try
to escape violence by
increasing time away from
home; may use maladaptive
coping to avoid (e.g., drugs)

may have difficulty
establishing healthy
relationships; possibly at
greater risk to become
involved in dating violence
(e.g., boys as abusers & girls
as victims)

possibly more influenced by
negative media messages re:
violent behavior, gender role
stereotypes

Potential
Impact
Key Aspects of
Development

Physical changes
brought on by puberty

Increased peer group
influence and desire

for acceptance

Dating raises issues of
sexuality, intimacy,

relationship skills

Increased influence
by media

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 39

Questions

1) What do you do and say to the boy and his mother?

The issue of arrest of the boy, of course, is of primary
concern. Whether or not his arrest is mandatory will
depend on the individual jurisdiction. However, this boy
is at an age when he can perform in reality what younger
children could only imagine. He protected his mother
from a man that he views (perhaps rightly so) as cruel
and dangerous. The repeat calls for service confirm that
this boy has experienced innumerable episodes of domestic
violence and it is possible that he too has been maltreated.
He may have concluded, based on the repeated calls to
the police, that the justice system was unable or unwilling
to stop the violence against his mother. He likely felt
justified in taking matters into his own hands.

Case 7

Late on a Saturday night, mother’s boyfriend came home
intoxicated and began arguing and then beating his
girlfriend. The mother’s 12 year old son, who was having a
snack in the kitchen, picked up a steak knife and stabbed
the boyfriend in the back. The mother called 911 and asked
for an ambulance.

Officers arrived on the scene and both the mother and boy
told the story. The man was brought to the emergency
room by ambulance. The boy had no remorse, and stated
that he just could not take it anymore and that this happens
almost every weekend. Officers check police records and
see there have been 15 calls to the address in the last 6
months.

Case Examples -Case Examples –
AdolescentsAdolescents

40 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Although arrest may be necessary, this boy needs a
mental health evaluation and treatment. Punishment and
treatment are not mutually exclusive. Inform the mother
of the need for arrest and the recommendation that
will be made to the court for the need for a comprehensive
evaluation. In jurisdictions where the boy would be
released to his mother’s custody, the mother should be
informed of the concerns about the boy’s (and her)
psychological well-being, the need for treatment, and that
this recommendation will be made to the court. The
officers can assist the court by providing the details
about the domestic violence in their report.

Case 8

While on routine patrol, officers saw a girl who looked to
be about 14 years old sitting on her front steps. This was
the third mid-morning in a row that beat officers noticed
her there and the third school day she was truant. The
patrol officer stopped and asked her why she was not going
to school. She was reluctant to talk and what she said did
not make much sense. So, the officer took the girl up to
her apartment and knocked on the door. A woman (her
mother) answered and was wearing large sunglasses even
though the apartment was dark. She said that she thought
her daughter was going to school. She left at the right
time in the morning and returned at the normal afternoon
time.

The officer asked the mother if it was alright to come in
and talk with them. Obviously, he was suspicious about
the mother’s sunglasses and asked if there was somewhere
that he and the girl might talk alone. The mother left the
officer in the living room and went to her bedroom. The
officer asked, “What’s going on with your mom, why is she
wearing sunglasses?” With that the girl began to cry and
reported that her father (her parents are divorced) beat up
her mother over the weekend and threatened to kill her.

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 41

Questions

1) How do you understand the girl’s truancy?

This girl is not able to go to school because she is too
worried about her mother to leave her alone. The girl
does not stay inside for any number of reasons, including
concern that if her mother knew she was home, her mother
would insist she go to school. The girl may also feel that
she does not want to discuss her worries with her mother
because her mother is too vulnerable. Sitting on the steps
outside allows the girl to keep tabs on her mother, while
protecting her mother from knowing how worried she is
or that she is truant.

2) What can the officer do to help the girl and her mother?

The officer can inform the mother about the reasons for
the girl’s truancy, and begin to investigate and document
the assault on the mother. In addition to pursuing the
criminal investigation, the officer can provide the mother
with information and referrals to social service agencies
to assist her with safety planning and emotional support.

The case also raises the question about whether to refer
the girl to juvenile court or CPS for truancy. Although a
punitive response is not warranted, she is at serious risk,
and it is important to ensure she returns to school before
her truancy becomes chronic. There is reason to think
additional intervention will be required to return the girl
to school, especially if the mother is resistant to pursuing
a criminal complaint against her ex-husband.
A referral to the appropriate authoritative agency can
support the mother’s resolve to make sure the girl does
go to school, and can support the girl’s need to know her
mother is safe enough for her to leave home. CPS or
juvenile court can also facilitate mental health evaluation
and treatment for the girl.

42 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

III) INTERIII) INTERVENTIONSVENTIONS
ffective interventions for children and adolescents cannot
be separated from responses to domestic violence itself.

The welfare of children is strongly linked to their non-offending
parent’s safety and emotional well-being.

Responses to domestic violence should:

Within this framework, assessment and interventions must be
individualized to address the needs and strengths presented
by each family member and family. Some responses will
necessitate the involvement of Child Protection Services. Other
times this involvement will not be necessary. The different
combinations and range of resources that families require call
for meaningful collaboration and coordination between
community services. To be beneficial these services must be
accessible, respectful, flexible, and culturally relevant.

Children and adolescents benefit from informal (e.g., peers,
faith community) and formal supports (e.g., individual
counseling, children exposed to violence groups, non offending
parent-and-child interventions). Age-appropriate interventions
and those responsive to the youth’s individual circumstances
should be selected.

E
• provide safety;

• foster the emotional well-being of all victims;

• hold perpetrators accountable through legal
sanctions and re-education programs.

“Group was good. Before I went I thought this stuff
(violence) only happened in our family, like we were
weird or something. Lots of kids got stuff going on.
We helped each other.” (twelve-year-old female)

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 43

Needs-based interventionNeeds-based intervention
goals for children andgoals for children and
adolescentsadolescents

• breaking the silence about the abuse

• learning that they were not at fault

• learning that violence is not okay

• learning respectful ways of relating to others

• establishing safety plans in case the violence
recurs

44 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Effective responses toEffective responses to
domestic violencedomestic violence
• Children and adolescents living with

domestic violence require structure,
reassurance and support to help re-
establish stability and their sense of
security.

• Adult victims, children and adolescents
benefit from informal (e.g., relatives,
church groups) and formal supports (e.g.,
individual, group and family interventions).

• Perpetrators benefit from being held
accountable through legal sanctions and
re-education programs.

Module 2, Section III SummaryModule 2, Section III Summary

Module 2: Understanding the Needs of Children & Adolescents Exposed to Domestic Violence

The David & Lucile Packard Foundation 45

46 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

SPECIALSPECIAL
CONSIDERACONSIDERATIONS FORTIONS FOR

POLICE OFFICERSPOLICE OFFICERS

MODULEMODULE 3

I) DOMESTICI) DOMESTI

VIOLENCE ISVIOLENCE IS
DISTINGUISHED BYDISTINGUISHED BY
THE INTIMATHE INTIMATETE
CONTEXT IN WHICHCONTEXT IN WHICH
CRIMES OCCURCRIMES OCCUR

hile the act may behaviorally appear like types of
stranger-to-stranger violence (e.g., simple assault, sexual

assault, stalking), domestic violence significantly differs because
of the intimate relationship in which the crime occurs. The
relationship between the perpetrator and the victim gives the
perpetrator greater access to, and knowledge of, the victim.
This privileged position provides increased opportunities for
controlling and assaultive behaviors against the victim. There
is also evidence that the severity of assaults is greater within
intimate relationships12. The context of intimacy may intensify
the effects of the victim’s trauma. The perpetrator’s relationship
to the victim may also afford cultural or social, if not legal,
permission to abuse the victim.

Intimate relationships are complex. In addition to a sexual
relationship, partners may share or have complementary roles
and responsibilities related to finances, parenting, household
chores and social activities. While clearly wanting the violence
to stop, victims may not want their partners to be taken away
for a variety of reasons (e.g., loss of necessary income, love for
perpetrator, fear of reprisal violence in future). Thus, the
complex relationship within which the violence occurs may
create barriers to separation and lead victims to change their
minds about charges being laid against their abusive partners.

48 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Children exposed to domestic violence are also affected by its
context of intimacy. They have emotional ties to and
dependency on one or both of the adults involved. Because of
their relationship to the non-offending parent, children are often
used by the perpetrator to control the adult victim (e.g.,
engaging children in the abuse of the victim, holding children
hostage). While children want the violence to stop, they often
experience ambivalent and confusing feelings toward one or
both parental figures. Children’s attitudes and feelings are
influenced by a number of factors, including:

Children may also express ambivalence toward police
authorities: immense relief that they stopped the violence, but
anger that they took the offending parent away; or, anger that
they were taken away from their home after the police came.

Children’s relationship toChildren’s relationship to
the victim and perpetratorthe victim and perpetrator

“Why can’t they (police) stop it (violence) without taking
him (Father) away? He’s not a robber, like a bad guy or
something — he’s a Dad.” (ten- year-old boy)

“I love my Mom more than anything, but I was really
angry at her for not stopping him. I didn’t understand
back then that she was as terrified of him as I was.
She had no control over what happened. We were
both frozen.” (adolescent female client)

• their view of who is responsible for the violence
(e.g., the child blames self);

• their sense of security in relation to a number
of outcomes (e.g., How will we get money to
eat if they take my Dad away? Who will play
with me if they take me from my parents?
Who will look after my pet if we go to the
shelter?);

• the nature of their relationships with the
offending and non-offending parental figures.

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 49

Considerations whenConsiderations when
crime occurs in a contextcrime occurs in a context
of intimacyof intimacy
• The effects of the victim’s trauma may be increased.

• The perpetrator’s access to and knowledge of the
victim is increased and can be used to control and
abuse the victim in an ongoing way.

• The crime often occurs within a context of
ongoing psychological abuse that may not be
evident to police authorities.

• Victims’ multifaceted relationships with the
perpetrators may create barriers to separation
and lead victims to change their minds about
charges being laid against their partners.

• Children exposed to domestic violence have
significant relationships with and are dependent
on the victim and/or the perpetrator.

• Children may have confused and ambivalent
feelings toward the non-offending parent, the
perpetrator, and police officers.

Module 3, Section I SummaryModule 3, Section I Summary

50 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

olice may encounter as many as half a million children
during domestic violence arrests in the US each year.5
Households where domestic violence occurs are more than twice
as likely to have children, as US census data predicts.3 These
statistics highlight the presence of children in domestic violence
situations, as well as the importance of understanding the
implications of their presence for law enforcement professionals.
For example, children may be physically harmed or emotionally
distressed by the violence. Intervention by police authorities
may create immense relief and/or additional worries or distress
for the child (e.g., relief that the violence was stopped but
concern about the non-offending parent’s injuries and the
offending parent’s removal from the home). Either way, it is
important that police officers acquire skills for and comfort in
“talking” with children.

Considerations whenConsiderations when
children are presentchildren are present

II) THE PRESENCEII) THE PRESENCE
OF CHILDREN INOF CHILDREN IN
DOMESTIC VIOLENCEDOMESTIC VIOLENCE
SITUSITUAATIONS ISTIONS IS
SIGNIFICANTSIGNIFICANT

i) Ask about children:
Ask the non-offending parent where the
children are now, where they were when the
violence occurred, and if they are okay.

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 51

iv) Remember, children are affected by more than the
criminal act:

The majority of domestic violence crimes occur
within an ongoing pattern of psychological and
physical abuse. The abuse often involves using
children to control the adult victim. By the time
police arrive, children have often been exposed
to violence for a substantial length of time and
may be experiencing the accumulated
impacts of ongoing violence.

iii) Determine if children are harmed or hurt:

Ask to see the children. It is important for police
officers to find out if the children are physically
hurt or in extreme distress. Often parents are
unaware that children have heard or seen the
violence. Children may be hiding in another
part of the house. They may be sleeping or
pretending to be asleep. Children have likely
learned that what they are witnessing is a secret
that should not be discussed with others.
Threats may have been made to ensure their
silence on this occasion and/or in the past.
Many children learn that keeping quiet and out
of the way are good survival strategies.

ii) Reassure children:
Talking to them lets them know that someone
outside of the family knows and cares (e.g.,
“That must have been scary for you. Are you
okay?”).

52 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Tips for talking withTips for talking with
childrenchildren

Address the child at eye level.

Use simple, direct, age-appropriate language.

If the child does not understand your role, explain it in terms
that are easily understood.

Discuss confidentiality and its limits.

Honor a child’s loyalty to an abusive parent. Do not criticize
or demean the abusive parent.

Acknowledge a child’s right not to speak. Do not coerce a
child to talk if he/she is not comfortable doing so.

Don’t make promises you can’t keep.

Communicate your concern about safety of the child.

Developed by the Child Witness to Violence Project, Boston Medical Center,
One Boston Medical Center Place, Mat. 5, Boston, MA 02118-2393

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 53

Interviewing childrenInterviewing children
Interviews can be stressful and intimidating situations for
children. Children who witness a violent event or who are
victims of abuse may be frightened, upset and anxious. When
children feel reassured and comfortable, they are more likely
to be more confident and competent in their ability to
communicate. By developing your skills for interviewing
children of different ages, you can increase their comfort and
enhance the evidence gathered.

Ensure the child understands your question: Edith,
age 5, showed the police officer her dress when
asked for her address. The officer questioned her
competency to communicate. However, Edith knew
the answer to the question “where do you live?”.

MY SAFE PLAMY SAFE PLACECE

54 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

When possible, obtain information about the child’s family
situation, abilities, activities, and special needs.

Introduce yourself and describe your role in simple terms.

Explain the purpose of the interview.

Sit at the child’s physical level.

Use the child’s name.

Explain that you were not present and need help to understand
what happened.

Give the child permission to tell you when he/she does not
know the answer or does not understand a word or question.

Make no assumptions about a child’s knowledge base or
abilities.

Use simple words and short sentences.

Ask one question at a time.

Avoid double negatives.

Ensure the child understands your question (e.g., “I need to
make sure you understand my question. What do I want you
to tell me?”).

Continually clarify your understanding of the child’s responses
(e.g., “Do you mean _____?; Would you explain _____?; Tell
me more.”).

Avoid rushing the child. Wait for him/her to listen to your
question, to think about it, and to respond to it.

Ask open-ended questions (e.g., “Tell me about ______; What
happened when _____?; How did _____?”)

Avoid using “why” questions. “Why” questions may imply blame.

Observe a child’s non-verbal communication.

Limit the use of questions that require a yes/no answer.

Key factors in interviewingKey factors in interviewing
childrenchildren

Developed by the Child Witness Project, Centre for Children and Families in
the Justice System, 254 Pall Mall St., London, Ontario, CAN

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 55

Suggestions for dealingSuggestions for dealing
with the presence ofwith the presence of
childrenchildren
• Recognize the variety of ways children can

be present – directly and indirectly.

• Ask where the children were, where they
are now, and if they are hurt.

• Speak directly to the children to ensure
they are okay and to reassure them.

• Speak to them in language they can
understand.

• Sit or squat so you are physically at their
level.

• Recognize there is often a history of violent
incidents prior to your involvement. Children
may be responding both to the immediate
situation and from their own experience of
past incidents.

Module 3, Section II SummaryModule 3, Section II Summary

56 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

hildren living with domestic violence face increased risks.
First, some violence directed at the adult victim poses

threats to children’s physical safety. In such situations, children
may experience physical harm in a direct manner or by accident
due to their presence in the violent event. For example,
children’s presence in the middle of a violent event where
weapons are used creates a serious or compelling risk. Second,
children living in families where domestic violence occurs are
at increased risk of experiencing neglect, and emotional, sexual,
or physical abuse. Evidence shows that these experiences may
influence victims’ lives well into their teen and adult years.
Accordingly, officers should be aware that:

III) RISKS III) RISKS TTOO
CHILDREN INCHILDREN IN
DOMESTIC VIOLENCEDOMESTIC VIOLENCE
SITUSITUAATIONS NEEDTIONS NEED
TTO BE O BE ASSESSEDASSESSED

• a subset of domestic violence situations poses
serious and imminent risk to children;

• when there is concern that children are being
maltreated, the possibility of intimate partner
abuse should also be investigated;

• when intimate partner abuse is occurring, the
possibility that children are being maltreated
should be assessed.

30 – 60% of battered mothers’ children experience
maltreatment (e.g., physical abuse).1 6

Children who are exposed to domestic violence are
at increased risk of being murdered or physically
injured.9

The David & Lucile Packard Foundation 57

Police actions are governed by legislation and by the policies
and procedures set down in respective police services. The
legislation related to children exposed to domestic violence
differs across jurisdictions in the US. Police have little discretion
about possible actions in the few states where children’s
exposure to domestic violence is a crime, and/or where
automatic reporting to Child Protection Services (CPS) is legally
mandated or dictated by the policies and procedures within a
given police service.

Legislation, policy andLegislation, policy and
proceduresprocedures

When reporting to ChildWhen reporting to Child
Protective Services (CPS) isProtective Services (CPS) is
notnot legally mandated nor legally mandated nor
automatically required byautomatically required by
policy and procedurespolicy and procedures
In many jurisdictions and situations, police have increased
discretion over what action to take in regard to child protection.
The following points are presented for consideration in these
situations.
i) Assess for child maltreatment:

Many of the domestic violence calls you respond
to will not involve child maltreatment. In these
situations, children’s ongoing safety depends
primarily on the criminal justice system holding
perpetrators accountable and supporting non-
offending parents in looking after their children.
Police play an important, front-end role in their
decisions to remove the perpetrator, lay
charges, and make referrals (e.g., victim
services).

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Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Where available, the support of a police victim
crisis service should be offered. Police officers
should provide the non-offending parent with
the names and telephone numbers of services
that deal with violence against intimates and
with children’s mental health services within
the community.

It is important that non-offending parents are not
blamed for their partners’ abusive behavior, nor
for situations that they do not have control over.

ii) Consider the safety of victims and their children:

The welfare of children, on average, is strongly
linked to their non-offending parent’s safety and
emotional well-being.

iii) Refer and provide information:

iv) Report to CPS when the situation poses a serious
risk to children:

There is agreement across jurisdictions that
police officers have a duty to report to local child
protection agencies when children are at serious
risk due to domestic violence. These situations
must be recognized and responses taken to
ensure the safety of children and their non-
offending parents. For example, significant
substance abuse by adult victims and/or their
abusive partners may create situations of
extreme risk for children. In these situations,
officers may feel that non-offending parents are
unable to protect their children.

v) Do not blame the victim:

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 59

Approaching childApproaching child
protection issuesprotection issues
• Know the state legislation and the policy

in your department regarding reports to
Child Protection Services.

• On average, the safety and well-being of
children is dependent on supporting their
non-offending parents in looking after
them and in holding perpetrators
accountable through legal sanctions and
re-education programs.

• Police officers have a duty to report
extreme risk due to domestic violence to
Child Protection Services.

Module 3, Section III SummaryModule 3, Section III Summary

60 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

valuating risk is part of the ongoing work of police officers.
In domestic violence situations, children’s safety is

strongly linked to the safety and well being of the victimized
parent. The safety of both children and adult victims is
increased through effective risk assessment, risk reduction and
safety planning. Accordingly, risk assessment, risk reduction
and safety planning are of critical importance in domestic violence
situations and should be modified from evaluations carried out
in other areas of crime prevention. The following changes are
necessary for evaluating risk in domestic violence situations to:

IV) RISK IV) RISK ASSESSMENTASSESSMENT,,
RISK REDUCTION ANDRISK REDUCTION AND
SAFETY PLANNING FORSAFETY PLANNING FOR
VICTIMS OF DOMESTICVICTIMS OF DOMESTIC
VIOLENCE DIFFER INVIOLENCE DIFFER IN
IMPORIMPORTTANT ANT WAWAYYS FRS FROMOM
THOSE CARRIED OUTTHOSE CARRIED OUT
FOR OTHER VICTIMSFOR OTHER VICTIMS

The multifaceted and complex relationship
between the victim and perpetrator in domestic
violence is the host to a range of risks that do
not typically characterize stranger violence. The
perpetrator’s increased access to, knowledge of
and relationship with the victim enables
dimensions of their intimacy to be used to control
and harm the victim (e.g., sexual relationship,
children). As a result, assessment of risk must
“go beyond assaultive behavior to include
analysis of the complex package of physical,
legal, economic, familial, social and emotional
risks faced by the victim, and those the victim
feels bound to protect.”24

i) Broaden the concept of risk to include the complexity
of risks within the intimate relationship:24

E
Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 61

ii) Identify and use the context within which the violent
incident occurred to facilitate decision-making:25

The risk to adult victims and their children and
the strategies needed to reduce risk are
influenced by the general context in which the
act of domestic violence occurred. Accordingly,
the criminal justice system must go beyond the
incident and understand the general context
in which a given act occurs in the determination
of risk and intervention strategies. The context
for a given domestic violence act is determined
by the intent of the offender, the meaning of
the act to the victim, the effect of the violence
on the victim, as well as other relevant factors
(e.g., how much violence, coercion or intimidation
enwrapped the criminal act).

Frederick and Tilley 25 of the Battered Women’s
Justice Program in Minnesota identified general
contexts for domestic violence. Battering is
the most frequently occurring context, and is
described as a pattern of violence, intimidation
and control. Others include an isolated act,
a history of general violence – a fighter, and
mental impairment and incapacity. There
may be many complex, co-occurring problems
that require assistance from multiple agencies
(e.g., need for psychiatric intervention and
batterers’ program). Irrespective of the context
in which domestic violence occurs, there is always
a need to consider safety and accountability
issues.

The context for a given domestic violence act is
determined by the intent of the offender, the
meaning of the act to the victim, the effect of the
violence on the victim, as well as other relevant
factors (e.g., how much violence, coercion or
intimidation surrounded the criminal act).

62 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

iv) Give priority to the victim’s understanding of
past, present and future risks for self and children
in the analysis of the totality of risk:24

On average, victims engage in survival strategies
for some time before law enforcement
authorities are involved.27 They have lived with
the risk and are in a position to appreciate how
the current situation compares to previous
situations. They can also provide pertinent
information on less evident risks related to their
complex relationship with the perpetrator (e.g.,
economics, children). The trained, external view
provided by police officers is very important.
The safety of victims and children, however,
requires that this view be considered within the
context of the victim’s direct experience and
understanding of all risks.

iii) Carry out the assessment of risk, risk reduction and safety
planning in collaboration with the victim:26

However well intended and executed, criminal
justice interventions are limited in their ability
to keep victims and children safe. Victims
“ultimately carry the ‘every-moment’ burden of
attending to their safety and that of their
children.”24 Effective risk assessment, risk
reduction and safety planning must therefore
be a collaborative process to which the victim
is central.

v) Consider the possible strategies for risk reduction
in collaboration with the victim and evaluate for
the potentially serious risks or costs that may occur
in addition to expected benefits:24

The complexity of the relationship factors, and
the related dynamics of domestic violence,
necessitate that each risk reduction strategy and
safety plan be evaluated in a holistic manner
and that the evaluation include the victim’s
perception. Risk reduction that targets one
factor in an isolated way may not be effective.

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 63

Components of riskComponents of risk
assessment and safety plansassessment and safety plans
Police departments may have their own protocols for risk
assessment that may or may not include the use of specific
assessment tools. Assessment instruments assist officers to
identify and focus on critical elements of a particular case and
compare it to known cases that resulted in serious injury or
death. While these tools do not enable the behavior of a given
individual to be predicted, they are helpful in evaluating
comparative risk and guiding plans to safeguard victims and
children against identified dangers.

Victim advocates within the police service or community often
play important roles in risk assessment and safety planning.
The role of victim advocates is likely to depend on the
characteristics of the specific situation, and/or the policies and
procedures within a given police department. The areas covered
in brief risk assessment and safety planning are outlined below.
The elements contained in comprehensive domestic violence
risk assessments and safety planning are presented in Table 3
and Table 4 respectively.

Brief risk assessement andBrief risk assessement and
safety planningsafety planning

Ask a woman if she feels safe right now, and if there is
somewhere she can go or someone she can call in order
to feel safer.

Ask the victims of violence about risks to their safety,
including history of assaults/threats, recent escalation in
violence, and planned or recent separation.

Ask if her children know how to call for help and go to a
safe place in the house if they are afraid.

Discuss signs of danger that you may have noticed (e.g.,
locks broken, weapons present and accessible, etc.).

Provide contact information for the local shelter, counseling
services, etc.

64 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Assessing
threats

History of
violence/

use of force

The role of
weapons

Centrality

Stalking

Coercive
control

Significant
events/

changes

Substance
or alcohol

abuse

Table 3: Main components included inTable 3: Main components included in
domestic violence risk assessmentsdomestic violence risk assessments24, 2824, 28

• threats to harm/kill the victim or children
• victim fears serious injury or death for self or children

• victims’ perceptions about risks to their safety including
history of assaults/threats and recent escalation in
violence

• prior injuries to the victim/children
• any breach of court order by abuser

• access to firearms/weapons
• trained in use of weapons
• use of weapons in past violence

• extent to which abuser’s sense of self depends on the
relationship

• possessiveness of the victim
• material and emotional “overlaps” between abuser and

victim

• extent of monitoring and checking up on the victim
• engagement in stalking behaviors
• persistant efforts to communicate with the victim when

communication is unwanted

• degree and extent of control over the victim
• belief of entitlement to control by abuser
• level of verbal, psychological, financial control/abuse
• use of children to control the victim

• recent or anticipated separation
• recent changes in custody and access arrangements

or abuser’s time with children
• experiences of loss by abuser (e.g., loss of a job)
• flashpoints such as significant anniversaries,

holidays

• extent and pattern of usage
• recent escalation

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 65

How to leave safely (e.g., safe exits from the house for
self and children).

Where to go to be safe (e.g., shelter, alternative place).

Where to keep important papers and documents.

Which neighbors to tell about the violence so they can
call police if necessary.

Teach children how to call the police.

How to protect self and children in dangerous situations.

Local telephone numbers for shelter, crisis center, police,
child protection agency.

Importance of practicing and reviewing safety plan
regularly with children.

Possible safety measures at home (e.g., locks, lights,
rope ladders, smoke detectors and fire extinguishers,
code words for children to be picked up by another adult,
to call police or to get out of the house quickly).

Inform school of pick-up permission for children if necessary.

Inform employer and co-workers of risk.

Other friends, neighbors, family members who can look
after children, support non-offending parent when stress/
depression/anxiety levels are high.

Table 4: Main componentsTable 4: Main components
in domestic violencein domestic violence
safety planssafety plans

66 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

In 1999, 1218 women and 424 men were killed by
intimate partners.2 9

Physical abuse is the leading cause of injuries to
American women between the ages of 15 to 44 years
– more common than auto accidents, muggings, and
cancer deaths combined.3 0

Domestic violence may include a single act of abuse.
Typically it includes a number of acts, some of which
may appear minor or trivial when viewed in isolation,
but collectively form a pattern that amounts to
abuse.11

A history of property-related offences may be
associated with domestic violence (e.g., breaking
into ex-partner’s home, destroying partner’s
possessions).11

Domestic violence perpetrators may have good
qualities, in addition to their abusive and criminal
behavior. For example, a perpetrator of domestic
violence can be intelligent and socially skilled.
Moreover, the toll and nature of victimization within
an intimate relationship and the coping responses
the victim may use to survive the abuse, are such
that the perpetrator may be viewed as presenting in
a more credible way than the victim.17

“Each intervener in the criminal justice system must
ensure that the relevant information is obtained on
each person who uses violence in his/her relationship,
that the information is shared with other interveners
who need the information, and that the information is
incorporated into the decisions about how the case is
handled.” 24

Domestic violenceDomestic violence
and riskand risk

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 67

Considerations for riskConsiderations for risk
assessment and safetyassessment and safety
planningplanning
• Ensure that perpetrator is no longer a threat

in the current situation.

• Carry out brief risk assessment with the
victim to determine risk of the current
situation.

• Listen to the victim’s assessment of risk
and offer feedback based on your
observations.

• Discuss safety planning with non-offending
parent and older children/adolescents,
including what they can do to feel safe.

• Make referrals so that victim advocates
within the police department or community
can carry out a more comprehensive risk
assessment and safety planning as follow-
up to your intervention at the scene.

Module 3, Section IV SummaryModule 3, Section IV Summary

68 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

ver the past decade, police departments have begun to fine
tune their arrest policies to account for the fact that a significant

minority of the incidents to which they respond involve the use of
violence by both parties. Examination of these cases shows that the
use of violence by women can differ dramatically from that used by
men. For example, many women use violence against their abusers
in attempts to protect themselves from their attackers. Mutual arrests
are common in many jurisdictions and the results are problematic
for the following reasons:*

As a result of these unfortunate and dangerous developments, which
many characterize as unintended consequences of the use of the
criminal justice system to stop battering, police departments are
increasingly training their officers to investigate such cases for self

V) ISSUES RELAV) ISSUES RELATEDTED
TTO DUO DUAL AL ARRESTS INARRESTS IN
DOMESTIC VIOLENCEDOMESTIC VIOLENCE
CASESCASES

• Children of battered women are placed in foster
care even though their mothers have histories of
strong parenting and loving, supportive relationships
with their children. In these cases, separation from
the mother may heighten children’s sense of
insecurity and worry following the violent incident.

• Battered women refrain from seeking police
protection because they fear that they, themselves,
might end up being arrested and, where children
are present, being separated from them.

• Charges against the most violent and dangerous
abusers are routinely dropped because their victims
are also defendents. This outcome poses risk to
adult victims and may further expose children to
domestic violence.

* Personal communication (January 2002) to the authors from L. Frederick,
Battered Women’s Justice Project, Minneapolis, Minnesota.

Module 3: Special Considerations for Police Officers
O

The David & Lucile Packard Foundation 69

defense and to refrain from arresting the party whose use of violence
was legitimate in the eyes of the law. Furthermore, police are being
asked to investigate which party, if either, is the primary aggressor,
and to avoid arresting both parties where one is clearly more
dangerous, more controlling in the incident, and more in need of
government intervention. The goal is to reduce the risk of serious
harm to others in the family.

Some states’ statutes and many police departments’ policies now
require that police avoid arresting both parties where one acted in
legitimate self-defense or was the secondary and less dangerous of
the two parties.* There are other jurisdictions where policy continues
to dictate that dual or mutual arrests be made when violence has
been used by both parties in a domestic violence incident. In these
situations, officers may issue citations (promise to appear in court)
without custodial arrest to the less aggressive parent. This decision
may be made in consideration of children viewed to benefit from
remaining in the care of the parent receiving the citation. This
evolution of the role of law enforcement serves to re-orient police to
the primary purpose of police intervention in domestic violence cases.
It also serves to place the focus of intervention efforts where they are
most critically needed.

* Personal communication (January 2002) to the authors from L. Frederick,
Battered Women’s Justice Project, Minneapolis, Minnesota.

70 Centre for Children & Families in the Justice System of the London Family Court Clinic, Inc.

Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Dual arrests in domesticDual arrests in domestic
violence cases: Problemsviolence cases: Problems
and impacts on childrenand impacts on children

Charges against the
most violent and

dangerous abusers are
routinely dropped

because victims are
also defendents

separation from their mother may
heighten children’s sense of
insecurity and worry following the
violent incident

children and adult victims less
likely to access and benefit from
intervention by the police and the
justice system

increased probability that children
will continue to be exposed to
violence and the risks associated
with such exposure (e.g., direct
physical abuse, escalating
violence)

Potential
Impact

Problem

Children of battered
women with histories
of adequate or strong
parenting are placed

“in care”

Battered women
refrain from seeking
police protection for

fear they may be
arrested themselves
and separated from

their children
Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 71

Promising police practicePromising police practice
where violence is used bywhere violence is used by
both partiesboth parties
State statutes and police department policies
that direct police officers:

• to determine whether there is a primary
aggressor

• to avoid arresting both parties where

one acted in legitimate self-defense,

one was the secondary and less
dangerous of the two parties.

Module 3, Section V SummaryModule 3, Section V Summary

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Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

VI) COLLABORAVI) COLLABORATIONSTIONS
AND COORDINAND COORDINAATEDTED
COMMUNITYCOMMUNITY
RESPONSESRESPONSES
BENEFIT CHILDRENBENEFIT CHILDREN
AND THEIR FAMILIESAND THEIR FAMILIES

ollaboration is essential when it comes to responding to
domestic violence and the children living with it.3 1

Collaborative practice can be described as a range of joint
endeavors between individuals, organizations and agencies.
Examples include joint training, consultation, and various
approaches to coordinating activities among disciplines,
services and agencies.

Collaborative practice is promoted and reinforced by
collaborative leadership at multiple levels and in multiple
domains (e.g., intergovernmental bodies, interdisciplinary
bodies). At a general level, meaningful collaboration creates a
network of supports and protections for families in their
communities. Such a network facilitates access to and
navigation of services by a given individual, family or service
provider (e.g., police officer). Lack of effective community
collaboration places the burden of attempting to access and
coordinate services on victims and their families. This challenge
can be further complicated by the different philosophies and
lack of understanding between different disciplines and
services.

C
Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 73

i) Increasing early identification of, and intervention
with, vulnerable children and their non-offending
parents to reduce trauma and enhance healing:

What are the benefits ofWhat are the benefits of
collaboration andcollaboration and
coordination?coordination?

For example, collaborations between police and
mental health providers to obtain immediate
assistance and intervention for children
experiencing traumatic reactions from exposure
to violence.

Some of the benefits children and their families experience as
a result of collaborations and better coordination among
community partners include:10

ii) Reducing risks of re-traumatization of children and
families by systems:

For example, collaborations between criminal
justice professionals, victim services and mental
health professionals to reduce the number of
interviews a child undergoes, to minimize the
number of individuals involved in a case, and
to provide court preparation for child witnesses.

For example, collaborations between law
enforcement, prosecutors and child development
specialists to aid with forensic interviewing of
children.

iii) Enhancing the quality of discovered evidence:

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Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

For example, community coordinating bodies
made up of service partners working to end
domestic violence.

v) Reducing the risk that victims and their children, or
perpetrators, fall through the cracks within the
community service network:

For example, collaborations between various
partners within the criminal justice system to
increase training in the area of domestic
violence and to ensure monitoring of offenders
and enforcement of protection orders.

iv) Supporting intervention and prevention by holding
perpetrators accountable:

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Who should take part inWho should take part in
community collaborationcommunity collaboration
to intervene and preventto intervene and prevent
domestic violence?domestic violence?

Collaborations will differ according to the characteristics and
make-up of a given community. Generally, community
responses to domestic violence benefit from coordination
between key stakeholders: survivors and their families, law
enforcement authorities, child protection service professionals,
domestic violence advocates and service providers, mental
health and health care professionals.

There has been an increased awareness of the essential role of
survivors of different ages in working with community partners
to create services and support systems that meet the needs of
domestic violence victims and their children. This vital
dimension is relatively new. It is also important to expand the
network through training initiatives, consultation and resource
development, to include educators, early childhood care
providers, clergy, employers and others who play significant
roles in the lives of children and their families. These partners
are in positions to assist in the early identification of children
exposed to domestic violence and adult victims.

Continued efforts to develop a variety of approaches
and means of collaborating with survivors are
needed. These collaborations must be respectful
and responsive to survivors’ needs as well as helpful
in shaping services.

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Strategies to facilitateStrategies to facilitate
collaborationscollaborations

i) Make the benefits known:
Law enforcement professionals and other
community partners against domestic violence
are more likely to invest in collaborations when
they know the benefits experienced by affected
children and their families. Collaboration
becomes an easy sell if it makes some aspects
of one’s own job easier to carry out. In addition
to discovery through direct experience, benefits
can be identified from different perspectives
through joint training, as well as inter-
disciplinary or inter-agency meetings.

ii) Support community policing:
Community policing provides a foundation for
relationship building and problem-solving
partnerships between communities and law
enforcement. This strategy emphasizes crime
prevention and community service along with law
enforcement. For example, police officers are
more visible and known in the communities they
serve and play active roles in schools. This model
is highly compatible with and complementary to
collaborations and coordination to intervene in
and prevent domestic violence.

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The David & Lucile Packard Foundation 77

To facilitate collaboration and a co-ordinated
response at a community level, it is useful to
have inter-agency protocols in place. These
protocols can specify:

• when and how to make linkages and
referrals;

• how to share information following referral
when more than one agency is working
with a child or family;

• who to include in ongoing consultation re:
safety planning, discharge planning and
follow-up support;

• how to handle potential sources of conflict
or concern.

The following are examples of groups that might
be included in inter-agency protocols with police
departments: school boards, child protection
agencies, children’s and adults’ mental health
agencies, violence against women prevention
services, women’s shelters, violence against
intimate partner services, crisis telephone and
counseling services, health practitioners, family
service agencies, probation and parole services.

iii) Develop inter-agency protocols:

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Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Opportunities to participate in training with
other disciplines and services promote mutual
understanding, cross fertilization of ideas, and
better ways of working together. Police officers
are likely to benefit from domestic violence
training initiatives with mental health
professionals, domestic violence advocates,
child protection workers, victim services
professionals, and other groups within the
criminal justice sector. Training on establishing
and sustaining meaningful collaborations may
be of particular benefit.

iv) Provide opportunities for cross training:

Examples of collaborationExamples of collaboration
The following examples describe exciting collaborations between
law enforcement services and community partners such as
mental health professionals and domestic violence advocates.

Safe Start Initiative:10

Funded to expand community partnerships to prevent
and reduce the impact of violence by creating a
comprehensive service delivery system that will meet
the needs of children and their families at any point
of entry into the system. Partnerships between
service providers – including the fields of childhood
education and development, health and mental
health, family support and strengthening, domestic
violence and child welfare, substance abuse
prevention and treatment, crisis intervention, courts
and legal services and law enforcement – should
improve access to, and delivery and quality of,
services for young children at high risk of exposure
to violence, and for those who have been exposed to
violence. Safe Start is a multi-million dollar/5-year
initiative funded by the office of Juvenile Justice.

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An interagency effort in Southern Florida between local
shelters, the court system and police to identify victims
of domestic violence, expedite the provision of service
within the court system, and connect them and their
children with needed services. This service includes
a network of counseling agencies and treatment
providers for abusers, victims and children. In
addition, locations of all support services are provided
to victims each time they access the court system. Court
personnel educate the public about domestic violence
in cooperation with schools, the legal and medical
communities and private industry, as well as help
victims of violence understand the nature of cyclical
violence and the importance of safety planning. There
is also a partnership between the Junior League and
county government to provide long-term housing for
victims and their children. The service provides training
rotations for students in medicine, social work and
postdoctoral psychologists and psychiatrists at the
local university.

The Dade County Domestic Violence Division:32

A collaboration between the Yale Child Study Center
and the New Haven Department of Police Service
designed to provide on the job training for police
officers to recognize the needs of child witnesses at
the scene of violence and to provide appropriate
interventions. Police officers refer children for follow-
up mental health services or immediate therapeutic
attention. Clinicians are on call 24 hours a day. Police
supervisors can obtain Child Development Fellowships,
and clinicians can obtain Police Fellowships. A
seminar program is offered that focuses on how to
apply child development principles in the daily work
of clinicians and police. Police officers make referrals
and receive consultation immediately if necessary.
Police officers and clinicians meet weekly for case
consultation.

The Child Development-Community Policing Program:32

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Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Domestic violenceDomestic violence
interventions: Benefits ofinterventions: Benefits of
collaboration andcollaboration and
community coordinationcommunity coordination
• Increase early identification of, and

intervention with, vulnerable children and
their non-offending parents to reduce
trauma and enhance healing.

• Reduce risks of re-traumatization of
children and families by systems.

• Enhance the quality of evidence discovered.

• Support intervention and prevention by
holding perpetrators accountable through
the criminal justice system.

• Reduce the risk that victims and their
children, or perpetrators, fall through the
cracks within the community service
network.

Module 3, Section VI SummaryModule 3, Section VI Summary

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 81

VII) SPECIALIZED TRAINING ANDVII) SPECIALIZED TRAINING AND
CRCROSS OSS TRAINING INITIATRAINING INITIATIVES INTIVES IN
THE AREA OF DOMESTICTHE AREA OF DOMESTIC
VIOLENCE PRVIOLENCE PROMOOMOTE EFFECTIVETE EFFECTIVE
LALAW ENFORW ENFORCEMENTCEMENT
INTERINTERVENTIONS VENTIONS AND ENHANCEAND ENHANCE
COLLABORACOLLABORATIONS TIONS WITHWITH
COMMUNITY PARCOMMUNITY PARTNERSTNERS

raining is a means of imparting knowledge and skills to new
recruits, as well as providing refreshers and updates for experienced

staff. While recognizing the competing demands for limited training
hours, we strongly advocate that training in the area of domestic violence
and children’s exposure to violence be included in professional
development courses. Reasons for making this area a core component
of law enforcement training programs are:

• the volume of police calls related to
domestic disputes;

• the significant number of children
encountered by police at domestic violence
situations;

• the fact that these domestic violence crimes
differ from stranger violence and that
understanding the distinctions can assist
officers to carry out their roles;

• the serious consequences of domestic violence
on children and adult victims;

• the importance of participation by law
enforcement officers in cross training
initiatives to enhance coordinated community
interventions.

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Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

Training considerationsTraining considerations

The following topics are offered for consideration in training on
domestic violence and children’s exposure to violence:

Recommended topicsRecommended topics
for trainingfor training

• Domestic violence – how these crimes differ
from others

• Child development and impacts of exposure
to violence at different stages

• Assessing risk; risk reduction and safety
planning

• Forensic interviewing of children

• Identification of abuse-related injuries

• Legal issues related to child victims and
witnesses

• Establishing and maintaining effective
collaborations with community partners

Training is best situated within clear agency policy and practice.
It should increase knowledge and understanding, as well as
target particular needs. The following issues about training
are important to consider:

i) Provide ongoing training:
Training that is provided on an ongoing basis
(e.g., once a year) and over time helps to address
potential gaps (in knowledge and practice)
created by staff turnover.

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The David & Lucile Packard Foundation 83

iii) Use peer models:

Peer training models encourage investment in
the topic and the training.

iv) Integrate ethno-cultural issues:

Opportunities to promote awareness of and
sensitivity to ethno-cultural communities
should be integrated into all training courses.

v) Promote cross-training:
Cross-training – where members of different
disciplines and services attend training
initiatives – provides excellent opportunities for
promoting mutual understanding between
participating groups. Participants learn more
about the issues, mandates, practices and
strengths of each group. This inclusive
approach also enhances collaborative practice.

ii) Integrate theory into practice:

It is important to link theory and practice by
including practical implications and applications
during training.

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Recommended topics forRecommended topics for
training on domestictraining on domestic
violence and childrenviolence and children

• Domestic violence – how these crimes
differ from others

• Child development and the impact of
exposure to violence at different stages

• Assessing risk; risk reduction and safety
planning
• Forensic interviewing of children
• Identification of abuse-related injuries
• Legal issues related to child victims and
witnesses
• Establishing and maintaining effective
collaborations with community partners

Module 3, Section VII SummaryModule 3, Section VII Summary

Module 3: Special Considerations for Police Officers

The David & Lucile Packard Foundation 85

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Children Exposed to Violence: A handbook for police trainers to increase understanding and improve community responses

FREQFREQUENTLUENTLY Y ASKEDASKED
QUESTIONSQUESTIONS

MODULEMODULE 4

The magnitude and serious consequences of children’s
exposure to domestic violence makes it a priority. Law
enforcement practices can make a difference in the lives
of children. The promotion of these practices starts with
an understanding of the impacts of violence on children:

• Assessing for direct victimization

• Considering children in risk assessments, risk
reduction and safety planning involving mental
health or victim service professionals early to
address children’s needs and reduce negative
impacts

Understanding the vulnerability and the potential effects
of exposure to violence on children and adult victims
motivates all of us to invest in collaborative interventions
that protect children and victims and prevent violence.

2. Why do I need to know about the impact that exposure
to violence at home can have on children?

FREQFREQUENTLUENTLYY
ASKED QUESTIONSASKED QUESTIONS
1. What difference can I make?

First – you can save a life. Effective, coordinated
community interventions can reduce domestic homicides
which have been described as “America’s most
predictable murders.”33

Second – your intervention in a domestic violence
situation today is crime prevention for tomorrow. Law
enforcement and criminal justice responses that keep
children from being exposed to violence help prevent later
juvenile delinquency and a future generation of
perpetrators.

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The battering itself creates a climate of fear for children
and offers inappropriate role modeling for caring
relationships, conflict resolution and abusive power
through threats and violence. A batterer may have
positive qualities that are valuable as a parent. To
maximize these qualities, batterers have to acknowledge
responsibility for the violence against their partner and
take part in an intervention program with an ongoing
commitment to change.

3. Can a battering spouse be a good parent?

No! Leaving an abusive relationship is best understood
as a difficult process that takes time and can be life
threatening to victims and their children. The complexity
of their relationship with the perpetrator extends victims’
decision-making about leaving beyond the assaultive
behavior. When deciding about staying or leaving,
victims carefully weigh such things as:

• coping with escalations in violence that often occur
in relation to separation;

• the possibility of losing children to abusive partners
in custody battles;

• the numerous challenges faced when arranging to
provide for themselves and their children.

Evidence shows many victims do leave abusive
relationships and that the leaving process takes time.
Remember – victims want the violence to end, and
ultimately, victims carry the moment-to-moment
burden of attending to their safety and that of their
children. Police officers who express compassion,
hope, and the fact that the violence will not be
condoned, may be planting seeds for future decisions.

4. Can I force victims to get out of these unsafe
situations?

Module 4: Frequently Asked Questions

The David & Lucile Packard Foundation 89

Some youth learn from the modeling in their family that
violence is how you get want you want and how you
relate to others. They can be assaultive toward a parent,
siblings, girlfriend or others. Although less common, you
may also encounter situations where the youth’s
assaultive behavior results from an attempt to stop the
violence being perpetrated by the abuser.

Regardless of the context of the violence, the adolescent’s
assaultive behavior is not acceptable. In these situations,
it is important to provide complete information about
the circumstances in your report (e.g., long history of
exposure to domestic violence, assault occurred while
stopping a domestic violence incident). This information
can provide a context for the prosecutor that may be a
consideration in how the court deals with the matter
(e.g., sentencing, conditions of probation).

Many youth who have grown up watching one parent
victimize the other have difficulty dealing with the
seeming double standard when they are charged for their
violence in the family. The result is often intense anger
that may be directed at the victim and/or at the police
officer who intervenes.

5. What do I do when an adolescent who has grown up
with domestic violence begins to be assaultive toward
the adult victim or the perpetrator?

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The David & Lucile Packard Foundation 91

APPENDIX AAPPENDIX A

National Domestic Violence Hotline
Dial 1-800-799-SAFE or 1-800-799-3224 (TDD) Website: www.ndvh.org
• Trained counselors provide crisis intervention, referrals to local

service providers for victims of domestic violence and those
calling on their behalf, and information or support in many
languages

• Counselors answer every call in both English and Spanish
• Translators are available for 139 languages
• Crisis intervention and referrals to the deaf are available through the

TDD line

Local Service for Battered Women by Map of United
States (Victim Services, New York)
Website: www.dvsheltertour.org/helpusa.html
Email: contact@safehorizon.org
• Click on the state for a list of resources in that area or email Safe

Horizon requesting the resource(s) available in a specific community
and a response will be returned within 24 hours (a little longer on the
weekend)

Violence Against Women Office (VAWO)
810 7th Street, NW, Washington, DC 20531
Phone: (202)307-6026 Fax: (202)307-3911
Website: ww.ojp.usdoj.gov/vawo
• One of the Office of Justice Programs, United States Department of

Justice
• Works with victim advocates and law enforcement throughout the US

to develop grant programs supporting a wide range of services for
victims of domestic violence, sexual assault and stalking (e.g.,
emergency shelters, law enforcement and legal aid)

• Find a list of state hotlines, coalitions and advocacy groups by
going to the VAWO website and clicking on Help and Information
Near You

ResourcesResources
Contact the following organizations for additional information
on domestic violence, including impacts, getting assistance,
resources, prevention and training. The websites for these
organizations contain links to other valuable resources.

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Family Violence Department of the National Council of
Juvenile and Family Court Judges (NCJFCJ)
P.O. Box 8970, Reno, Nevada 89507
Phone: 1-800-52-PEACE or 1-800-527-3233
Website: www.dvlawsearch.com
• Improves the way courts, law enforcement, social service agencies

and the community respond to victims of domestic violence and their
families

• Provides information in a variety of areas, including new initiatives,
domestic violence laws, publications, training and conferences

National Coalition Against Domestic Violence (NCADV)
P.O. Box 18749, Denver, CO 80218-0749
Phone: (303)839-1852 Fax: (303)831-9251
Website: www.ncadv.org
• Grassroots, non-profit organization working to end violence in the

lives of women and children
• Provides a national network for state coalitions and local programs

serving battered women and their children
• Provides information and resources on domestic violence, including

assistance for getting help
• Find a domestic violence organization in any area by going to NCADV

website and clicking on Getting Help, and then clicking on State
Coalition List

Family Violence Prevention Fund (FVPF)
383 Rhode Island Street, Suite 304, San Francisco, CA 94103-5133
Phone: (415)252-8900 Fax: (415)252-8991
Website: http://endabuse.org Email: fund@fvpf.org
• A national non-profit organization
• Mobilizes concerned individuals, allied professionals, women’s rights,

civil rights, and other social justice organizations, and children’s
groups to join the campaign to end abuse

• Provides public education/prevention campaigns, public policy
reform, model training, advocacy programs and organizing

National Center for Children Exposed to Violence (NCCEV)
Child Study Center, Yale University School of Medicine,
230 South Frontage Road, P.O. Box 207900, New Haven, CT 06520-7900
Phone: 1-877-49-NCCEV or 1-877-496-2238
Website: www.nccev.org/us
• A national resource that increases awareness and provides

information about the effects of violence on children and the
initiatives developed to address this social problem

• Provides training, technical assistance and consultation to
initiatives throughout the US that responds to children and
families exposed to violence (e.g., Safe Start Intiative, Child
Development-Community Policing (CD-CP) Program replication sites)

The David & Lucile Packard Foundation 93

APPENDIX BAPPENDIX B
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2 Child Maltreatment 1997: Reports from the States to the National Child Abuse and Neglect

Data System. U.S. Department of Health and Human Services, Administration on
Children, Youth and Families,1997.

3 Fantuzzo, J., Boruxh, R., Berianna, A., Atkins, M., & Maracus, S. (1997). Domestic
violence and children: Prevalence and risk in five major U.S. cities. Journal of the
American Academy of Child and Adolescent Psychiatry, 36, 116-122.

4 Huston, A.C., Donnerstine, F., Fairchild, H., Feshbach, N.D., Katz, P.A., Murray, J. P.,
Rubinstein, E. A., Wilcox, B.L., & Zuckerman, D. (1992). Big World, Small Screen: The
Role of Television in American Society. Lincoln, NE: University of Nebraska Press.

5 Kilpatrick, D., & Saunders, B. (1997). Prevalence and Consequences of Child
Victimization: Results from the National Survey of Adolescents, Final Report. Research
in Brief. Washington, DC: U.S. Department of Justice, Office of Justice Programs,
National Institute of Justice. NCJ 181028.

6 Widom, C.S. (1996). The Cycle of Violence. Research in Brief. Office of Justice Programs,
National Institute of Justice. Washington, DC: U.S. Department of Justice. NCJ 136607.

7 Thornberry, T. (1994). Violent families and youth violence. Fact Sheet #21. Washington,
DC: Office of Juvenile Justice and Delinquency Prevention.

8 Hotaling, G., Straus, M., & Lincoln, A. (1989). Intra-family violence and crime and
violence outside the family. In L. Ohlin & M. Tonry (Eds.), Family Violence. Crime and
justice: A review of research (Vol. 11, pp. 315-375). Chicago: University of Chicago
Press.

9 Breaking the Cycle of Violence: Recommendations to Improve the Criminal Justice Response
to Child Victims and Witnesses, Monograph. U.S. Department of Justice, Office of Justice
Programs, Office for Victims of Crime, June 1999, NCJ 176983.

10 Safe from the Start: Taking Action on Children Exposed to Violence. Summary. (November
2000). U.S. Departments of Justice and Health and Human Services (p. 17).

11 Joint Committee on Domestic Violence. (1999). Working Toward A Seamless
Community and Justice Response to Domestic Violence: A Five Year Plan for Ontario.
A Report to the Attorney General of Ontario. TO, Ontario: Ministry of Attorney
General. (Adapted from definition on page 46). Available upon request from the
Ministry of the Attorney General.

12 Tjaden, P., & Thoennes, N. (November, 2000). Full report of Prevalence, Incidence and
Consequences of Violence Against Women. National Institute of Justice, Washington,
DC.

13 Cascardi, M., Langhinrichsen, J., & Vivian, D. (1992). Marital aggression: Impact, injury,
and health correlates for husbands and wives. Archives of Internal Medicine, 152, 1178-
84.

14 Bachmon, R., & Saltzman, L. E. (1995). National Crime Victimization Survey, Violence
Against Women: Estimates from the Redesigned Survey. U.S. Department of Justice
Statistics 1(4).

15 Peled, E. (1996). Supporting the Parenting of Battering Men: Issues and Dilemmas.
Manuscript submitted for publication.

16 National Research Council. (1993). Understanding Child Abuse and Neglect. Washington,
DC: National Academy Press.

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17 Schechter, S., & Ganley, A. L. (1995). Domestic Violence: A National Curriculum for
Family Preservation Practitioners (p.10). San Francisco, CA: Family Violence Prevention
Fund.

18 Edleson, J.L. (1999). Children’s Witnessing of Adult Domestic Violence. Journal of
Interpersonal Violence, 14(8).

19 Singer, M.I., Miller, D. B., Guo, S., Slovak, K., & Frierson, T. (1998). The mental health
consequences of children’s exposure to violence. Cleveland. OH: Cayahoga County
Community Mental Health Research Institute, Mandel School of Applied Social Sciences,
Case Western Reserve University.

20 Osofsky, J.D. (1999). The impact of violence on children. In the Future of Children:
Domestic Violence and Children, 9(3), California: The David and Lucile Packard
Foundation.

21 Rossman, R.B.B., Hughes, H.M., & Rosenberg, M.S. (2000). Children and Interparental
Violence: The Impact of Exposure. Philadelphia, PA: Brunner/Mazel.

22 Graham-Bermann, S. A., & Levendosky, A. A.. (1998). Traumatic stress symptoms in
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23 Sudermann, M., & Jaffe, P. (1993, August). Dating violence among a sample of 1,567
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24 Metropolitan Nashville Police Department. (2000). A Guide to Domestic Violence Risk
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Nashville Police Department.

25 Frederick, L. & Tilley, J. (2001). Effective Interventions in Domestic Violence Cases:
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Unpublished Manuscript.

26 National Judicial Institute on Domestic Violence. (2001). Enhancing Judicial Skills in
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Court Judges, the Family Violence Prevention Fund, and the Vera Institute of Justice.
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DC.

27 Jaffe, P., & Burris, C.A. (1981). The Response of the Criminal Justice System to Wife
Abuse. Solicitor General of Canada, Ottawa.

28 Hassler, R., Johnson, B., Town, M, & Websdale, N. (2000). Lethality Assessments as
Integral Parts of Providing Full Faith and Credit Guarantees. Violence Against Women
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29 Bureau of Justice Statics. (2001). Homicide Trends in the US: Intimate Violence. U.S.
Department of Justice, Washington, DC.

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the life of America (Prepared by the majority staff of the Senate Judiciary Committee).
Available from Hart Office Building, Room BO4,Washington, DC.

31 Hester, M., Pearson, C., & Harwin, N. (2000). Making an Impact: Children and Domestic
Violence. A Reader. Philadelphia, PA: Jessica Kingsley Publishers.

32 McHardy, L.W., & Hofford, M. (1998). Family Violence: Emerging Programs For Battered
Mothers and Their Children. Family Violence Department, National Council of Juvenile
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33 De Becker, G. (1997). The Gift of Fear: Survival Signals That Protect Us From Violence.
New York, NY: Little, Brown and Company.

The David & Lucile Packard Foundation 95

Child Abuse & Neglect 32 (2008) 797–810

Contents lists available at ScienceDirect

Child Abuse & Neglect

The impact of exposure to domestic violence on children and young
people: A review of the literature�

Stephanie Holta,∗, Helen Buckleyb, Sadhbh Whelana

a Children’s Research Centre, University of Dublin, Trinity College, Dublin 2, Ireland
b School of Social Work & Social Policy, University of Dublin, Trinity College, Dublin 2, Ireland

a r t i c l e i n f o

Article history:
Received 19 October 2006
Received in revised form 19 February 2008
Accepted 21 February 2008
Available online 26 August 2008

Keywords:
Domestic violence
Children
Young people
Impact
Outcomes

Resilience

a b s t r a c t

Objective: This article reviews the literature concerning the impact of exposure to domestic
violence on the health and developmental well-being of children and young people. Impact
is explored across four separate yet inter-related domains (domestic violence exposure and
child abuse; impact on parental capacity; impact on child and adolescent development; and
exposure to additional adversities), with potential outcomes and key messages concerning
best practice responses to children’s needs highlighted.
Method: A comprehensive search of identified databases was conducted within an 11-year
framework (1995–2006). This yielded a vast literature which was selectively organized and
analyzed according to the four domains identified above.
Results: This review finds that children and adolescents living with domestic violence
are at increased risk of experiencing emotional, physical and sexual abuse, of develop-
ing emotional and behavioral problems and of increased exposure to the presence of other
adversities in their lives. It also highlights a range of protective factors that can mitigate
against this impact, in particular a strong relationship with and attachment to a caring
adult, usually the mother.
Conclusion: Children and young people may be significantly affected by living with domes-
tic violence, and impact can endure even after measures have been taken to secure their
safety. It also concludes that there is rarely a direct causal pathway leading to a particular
outcome and that children are active in constructing their own social world. Implications
for interventions suggest that timely, appropriate and individually tailored responses need
to build on the resilient blocks in the child’s life.
Practice implications: This study illustrate the links between exposure to domestic vio-
lence, various forms of child abuse and other related adversities, concluding that such
exposure may have a differential yet potentially deleterious impact for children and young
people. From a resilient perspective this review also highlights range of protective factors
that influence the extent of the impact of exposure and the subsequent outcomes for the
child. This review advocates for a holistic and child-centered approach to service delivery,
derived from an informed assessment, designed to capture a picture of the individual child’s
experience, and responsive to their individual needs.

� We would also like to acknowledge the Health Research Board for funding Stephanie Holt’s research fellowship.
∗ Corresponding author.

http://www.sciencedirect.com/science/journal/01452134

dx.doi.org/10.1016/j.chiabu.2008.02.004

798 S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810

Introduction

The past three decades have witnessed unprecedented interest in the scope and consequences of children’s exposure to
domestic violence, resulting in a depth of empirical knowledge about its prevalence and impact on its youngest victims (Hague
& Mullender, 2006; Hazen, Connolly, Kelleher, Barth, & Landsverk, 2006). While the focus of this interest and understanding
has largely been achieved by eliciting the views of women, shelter workers and other professionals, more recent inquiry
has sought to explore directly children and young people’s experience of exposure to domestic violence (Buckley, Whelan,
& Holt, 2006; Hague & Mullender, 2006; McGee, 2000; Mullender et al., 2002). Influencing this shift has been a changing
perception and understanding of children’s position within this abusive context. Where previously children were thought
of as being tangential and disconnected to the violence between their parents, and commonly labeled “silent witnesses”
(McIntosh, 2003), more recent qualitative research has disputed this opinion, finding children dynamic in their efforts to
make sense of their experiences, while navigating their way around the complexity and terror intrinsic to domestic violence
(McIntosh, 2002; Mullender et al., 2002).

The term “domestic violence” broadly refers to the intimate context within which one partner is abused by another,
involving both men and women as victims and same sex partner violence. This term, while worn “smooth with use” (McIntosh,
2002) as the most frequently used and widely accepted term, is nonetheless criticised for, among other things, its gender-
neutrality, and the primary emphasis on physical assaults and exclusion of other abuse (Stark & Flitcraft, 1996). While some
research proposes equivalent prevalence rates of male and female perpetrated violence (Mirrlees-Black, 1999; Morse, 1995),
other research rejects the symmetry of men’s and women’s experience of intimate partner violence, for a number of reasons.
First, the numeric extent of violence against women exceeds that of violence against men (Tjaden & Thoennes, 2000; Walby
& Allen, 2004; Watson & Parsons, 2005). Second, the impact of the abuse is likely to be greater for women than men, both
emotionally and injuriously (Walby & Allen, 2004; Watson & Parsons, 2005; Women’s Aid & and the Child and Women Abuse
Studies Unit, London, 2001). Third, women are at far greater risk of serious and lethal abuse at the hands of their male partner
than men are at risk from their female partner (Campbell, Sharps, & Glass, 2001; Jaffe, Lemon, & Poisson, 2003; Walby &
Myhill, 2001; World Health Organization, 2002). Cognisant of these dilemmas regarding definition and terminology, the
term “domestic violence” is nonetheless used in this paper, primarily because it is in everyday and professional use and
would easily alert people to its content. The terms inter-parental violence and intimate partner violence will also be applied
interchangeably in this paper, which is concerned only with the intimate context within which women are abused by men.

Studies on the impact of children’s exposure to domestic violence have been beset with methodological concerns and
complications. First, exposure to domestic violence is not a “homogeneous uni-dimensional phenomenon” (Jouriles et al.,
1998, p. 178), whose impact can be neatly examined in isolation from the potential impact of other stressors or traumas
in a child’s life. With the co-occurrence of domestic violence and other forms of abuse and adversity clearly established in
the literature, failure to differentiate abused children who also witness violence from those who witness domestic violence
only, may inaccurately attribute a child’s difficulties to the impact of witnessing, without considering the impact that being
a direct victim of abuse may have on outcomes for the child (Connolly et al., 2006; Edleson, 1999). Similarly, comparing
children exposed to domestic violence with children who are not exposed, without regard for the variability in the level and
type of abuses those children are exposed to, both ignores and obscures the potential differential impact on child adjustment
from exposure to different types of spousal violence (Jouriles et al., 1998).

Second, while recent studies have been more inclusive of broader populations to reflect the perceptions and experiences
of multiple stakeholders in multiple settings (Levendosky & Graham-Bermann, 2001), prior research has been critisised for an
over-sampling of research participants from shelters (Kashani & Allan, 1998). While representing a unique and highly visible
sub-population of those exposed to domestic violence, shelter populations may constitute those most recently and severely
affected (Edleson, 1999; McIntosh, 2003) and who may be disproportionately representative of lower socio-economic popu-
lations (Kerig, 1998). In addition, shelter life may have a stressful and unique influence on children, which may be independent
of their experience of family violence and not necessarily an accurate representation of their mental health in the long term
(Edleson, 1999). Kerig (1998) also highlights concerns about research relying on children drawn from clinical populations,
as they may be over representative of boys and dominated by externalizing problems.

On a parallel vein, researchers comment on the paucity of reports of domestic violence from multiple family members
or professionals, citing evidence that when such reports are sought, agreement is surprisingly low (Holden, 2003), and
cautioning that studies which predominantly or solely reflects mothers’ reports of their children’s problems will by their
nature have limited accuracy as they lack the converging information necessary to ensure reliability and validity (Appel &
Holden, 1998; Edleson, 1999). Appel and Holden (1998) suggest that as mothers are the sole informants in the majority of
cases, the potential for both under and over-reporting needs to be considered. In partial agreement McIntosh (2003) warns
only of widespread underreporting of domestic abuse by women.

A third methodological issue is raised in Appel and Holden (1998) concerning the inconsistent use of a common criterion
for defining child abuse, finding upward of 15 different definitions applied to the 31 studies they reviewed. Holden’s later
(2003) reflections on terminology considered the range and dramatically different types of exposure mentioned in the
literature, with assessment of this exposure inclusive of both mothers’ reports about what their child saw or heard and
children’s own reports as witnesses.

Fourth, criticisms of the measures employed to gather data include what Edleson considers to be an over-reliance on
the child behavior checklist, on the grounds that it is a “rough gauge of general functioning,” and not developed to tap

S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810 799

the distinctive impacts of witnessing violence (1999, p. 860). Echoing this point, McIntosh (2003) highlights the limited
usefulness of measures across both cultural and socio-economically diverse populations, while Fantuzzo and Mohr (1999)
go so far as to say that checklists are biased against those diverse populations. Fantuzzo and Mohr (1999) also point out that
while the majority of research controls for the child’s age and gender and the family’s socio-economic status, less than half
of the studies they reviewed controlled for variables such as marital status, mother’s age and family size, with less again
controlling for family stress, child’s health or ethnicity (Fantuzzo & Mohr, 1999). Finally, Appel and Holden draw attention to
the inconsistent referent period applied, with some studies reviewing lifetime experiences, while others focus only on more
recent experiences (Appel & Holden, 1998).

Despite these methodological complexities, research has gone some way to indicate the prevalence of children’s
exposure to domestic violence, to establish the impact of this exposure for children and to distinguish between the unique
and universal impacts of this traumatic exposure to other forms of trauma in a child’s life. Remaining mindful of the
methodological criticisms outlined above and of the dearth of scientifically established estimates of the exact numbers
of children exposed to domestic violence, existing data drawn from a variety of sources does, however, suggest that large
numbers of children are involved. Fantuzzo and Mohr’s (1999) review of the existing databases in the US established that
children are present in households where intimate partner violence is occurring, at more than twice the rate they are present
in comparable homes in the general population. McDonald, Jouriles, Norwood, Shine Ware, and Ezell’s (2000) research with
children referred to a child mental health clinic for behavioral difficulties, found that domestic violence occurred in 48% of
clinic families, most commonly with 1–2 episodes of domestic violence per year.

A substantial accumulation of reliable empirical data regarding the short- and long-term developmental implications for
children who live with domestic violence has highlighted a differential yet potentially deleterious impact for children (Cleaver,
Unell, & Aldgate, 1999; Edleson, 1999; Hester, Pearson, & Harwin, 2000; McGee, 2000; Mullender et al., 2002; Saunders, 2003).
This article attempts to contribute to the understanding of this complex phenomenon, by exploring the impact from the child’s
perspective, in so far as that is possible. To this end, four separate yet inter-related domains of enquiry are identified, with
impact explored within and across these domains, as follows: (1) the co-occurrence of domestic violence and child abuse;
(2) the impact on parental capacity; (3) the impact on child development; and (4) exposure to additional adversities.

While there is undoubtedly a certain level of commonality in children’s experience of domestic violence, it would be
erroneous to assume that either impact or outcomes are predictably similar for all children. Masten and Coatsworth’s (1998)
work on resilient development identifies the different influences on children’s development, and that children are protected
“not only by the self-righting nature of development, but also by the actions of adults, by their own actions, by the nurturing
of their assets, by opportunities to succeed and by the experience of success” (p. 216). Holding this resilient focus, this paper
concludes with an overview of the potential outcomes for children exposed to domestic violence and a summary of the key
messages for professionals concerning best practice responses to children’s needs in the context of domestic violence.

Methods

A comprehensive search of identified databases (Arts & Humanities Citation Index; BMJ Journals Online; CINAHL; Inter-
nurse; ISI Web of Knowledge; JSTOR; Psychological and Behavioral Sciences Collection; PsycINFO; PubMed; Social Science
Citation Index) was conducted using the key words “domestic,” “intimate partner violence” “child,” “exposure,” “witness.”
This search was augmented with a review of the bibliographies of related articles. This yielded a vast literature of over 1000
articles in the initial search, from which online abstract and bibliographic information was used to identify selectively the
material that met the inclusion criteria of (1) those published within an 11-year framework (1995–2006), and (2) those
directly exploring impact according to one or more of the domains listed above. Key seminal texts meeting this criterion
were also included for review. The 11-year time frame was imposed for practical reasons, in that including all the available
material was neither possible nor practical, and because it is only within these more recent years that children and young
people have been directly invited to participate in research concerned with the impact of exposure to violence on them.

Findings

The findings of the data search will be presented according to the four domains outlined above, with a view to under-
standing both impact and outcomes for children and young people exposed to domestic violence.

Domestic violence as an abusive context for children

The literature reviewed has unequivocally established the interconnectedness between men’s abuse of women and child
abuse (Connolly et al., 2006; Cunningham & Baker, 2004; Edleson, 1999; Guille, 2004; Hester et al., 2000). At its most basic
level, living with the abuse of their mother can be considered a form of emotional abuse, with negative implications for
children’s emotional and mental health and future relationships (Brandon & Lewis, 1996).

Direct observation of violence can include witnessing both violent physical and sexual assaults on their mothers, the
nature of which appears to be consistent over time and across the studies reviewed. For example, McGee’s (2000) research
with 54 children and 48 mothers found 71% of children witnessed the physical assault of their mother and 10% witnessed the
rape of their mother. McCloskey, Figuerdo, and Koss’s (1995) earlier research with a substantially larger sample (365 women

800 S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810

and 365 children) reported similar findings, with two-thirds of the women interviewed reporting physical assault involving
choking, and just under half of the children reporting they witnessed such an assault.

Moreover, many authors agree that children can “witness” in ways that go beyond direct observation, such as overhearing
arguments or observing its aftermath, for example seeing bruises and cuts and broken furniture (Cunningham & Baker, 2004;
Mullender et al., 2002). Opinion diverges however on the effects of such witnessing on the child, with studies demonstrating
marked variability in the results (Edleson, 1999; Shipman, Rossman, & West, 1999), depending on the variables measured
and the risk and protective factors considered. Some authors highlight the importance of discerning whether the child has
been exposed by directly observing or hearing inter-parental violence, noting the absence of this distinction from many
earlier studies (Kaufman Kantor & Little, 2003). However, Jouriles et al.’s (1998) research with 155 exposed 8–12-year-olds
revealed that the severity of the violence, as reflected in the use of knives or guns influenced how traumatic this was for
children, regardless of whether they saw the assault or not. Dispute concerning the validity of the term “witnessing” has
resulted in the adoption of the more encompassing term “exposure” (Wolak & Finkelhor, 1998).

Domestic violence is also an important indicator of the risk of direct physical and sexual abuse of children (Farmer & Owen,
1995; Kellog & Menard, 2003; McGee, 2000; Osofsky, 2003), representing the extension of ongoing violence (Stark & Flitcraft,
1996). While rates of overlap between domestic violence and child physical abuse fluctuate between studies, as indicated
by a range of 45–70%, there is nonetheless agreement that the presence of domestic abuse is a risk factor for child physical
abuse, regardless of the methodology employed or the sample sourced. For example, Edleson’s (1999) review of 35 published
studies of the co-occurrence established that there was a high level of overlap ranging from 30–60% in most studies reviewed.
A slightly earlier review of 31 studies by Appel and Holden (1998) concluded that the abuse of the child co-occurred with the
abuse of their mother in 40% of cases. This figure was arrived at after the authors recalculated the rates of co-occurrence using
a definition of child abuse that was closest to the one used by social service agencies. Cross-referencing police records with
child protection referrals by Beeman, Hagenmeister, and Edleson (2001) identified over 64% of cases as dual violence families,
while Shepard and Raschick’s (1999) research with child welfare workers highlighted that 71% of the families in crisis had
reported issues relating to domestic violence. Osofsky (1999) concluded from her research that children who are exposed to
domestic violence are 15 times more likely to be physically abused and neglected than children without such exposure.

Although relatively little attention has been devoted to the overlap between domestic abuse and child sexual abuse, there
is evidence in the literature of a raised incidence of co-occurrence (Kellog & Menard, 2003; McCloskey et al., 1995). Again,
convergence on rates varies, primarily influenced by the sample and location the data are drawn from. For example, 4% of
Smith, Berthelsen, and O’Connor’s (1997) community sample of 54 abused mothers reported the sexual abuse of their child
by their ex-partners, while a higher rate of co-occurrence was recorded in a more recent follow-up study with 164 (7–19-
year-old) young people who had previously disclosed sexual abuse and attended a sexual abuse clinic (Kellog & Menard,
2003). While it would not be appropriate to compare the findings of these two studies because of the very different sample
populations, this later research nonetheless identified a concurrent rate of 77% when the sexual abuse offender was also the
perpetrator of the inter-parental abuse. McCloskey et al.’s earlier research (1995) with 365 women and 365 of their children
also established an overlap of abuses across relationships, with clear associations between the abuse of the mother and the
sexual abuse of the child, with men who were abusing their partners, more likely to abuse their children.

The ending of the relationship does not necessarily equate with an end to violence exposure, as reflected in the assertion
that “separation is not a vaccination against domestic violence” (Jaffe et al., 2003, p. 29). Violence has been found to continue
after separation and may actually increase in severity and lethality, across a broad range of research methodologies and
populations. These include national household surveys (Hotton, 2001), crime surveys (Walby & Allen, 2004), questionnaire
surveys of convenience samples of women (Radford, Sayer, & AMICA, 1999) and of domestic violence service providers
(Saunders & Barron, 2003), and mixed method research with young people (Mullender et al., 2002). Consequently, many
authors assert that post-separation contact is a potentially abusive experience for children who are exposed to the physical,
psychological and sexual abuse of their mother during contact visits (Radford et al., 1999; Mullender et al., 2002; Saunders
& Barron, 2003; Smith-Stover, Van Horn, Turner, Cooper, & Lieberman, 2003) and are also themselves at risk of physical and
sexual abuse and abduction (Radford et al., 1999). Additional abuse of the child involves their forced involvement in the
ongoing abuse of their mothers, where, for example, they convey threatening messages to their mother, or where there are
attempts made to indoctrinate children against their mother.

At its most extreme, violence against women may have lethal implications for both mother and child (Hester et al., 2000;
Jaffe & Juodis, 2006). Children may be abused as part of the abuse of their mother, and indeed vice versa (Hester & Radford,
1996; McGee, 2000), making it difficult at times to separate out discrete categories of child abuse and domestic violence,
because in some cases it is the abuser’s intention that the abuse of the child will have an abusive impact on the mother. Kelly
(1996) refers to this as a double level of intentionality. Supporting this assertion, McCloskey et al. (1995) found the father’s
relationship with his children to be secondary to his intermediary use of them to abuse their mother. The second domain
will explore this further.

Parenting ability and the experience of being parented in the context of domestic violence

The empirical evidence clearly states that the quality of parenting and ability of both parents to meet their child’s needs
are compromised in domestic violence households (Buchbinder, 2004; Levendosky & Graham-Bermann, 2001; McIntosh,
2002; Mullender et al., 2002). For women, continuing abuse affects their relationship with their children (Mullender et al.,

S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810 801

2002) and can impact negatively on their parenting capacity (Stephens, 1999) and on the quality of the attachment between
them (Cleaver et al., 1999; Levendosky, Huth-Bocks, Shapiro, & Semel, 2003). Holden (2003) suggested that maternal stress
and depression result at times in an emotionally distant, unavailable or even abusive mother, whose emotional energy and
time for her children are severely compromised. Holtzworth-Munroe, Smutzler, and Sandin’s (1997) review of the literature
estimated that one- to two-thirds of abused women experience post-traumatic stress disorder, low self-esteem, depression
and anxiety. This may compound the behavioral problems of the child and increase the impact of the violence for the child
(Levendosky & Graham-Bermann, 1998).

Research also indicates that domestic violence impacts negatively on the woman’s ability to develop authority and control
over her children, culminating in some cases in physical aggression by adolescents towards their parents (Jackson, 2003;
Ulman & Straus, 2003). This aggression increases with the child’s age and is 18 times more frequent in families in which the
mother is abused (McCloskey & Lichter, 2003). Levendosky, Lynch, and Graham-Bermann (2000) advise that this not only
has implications for parenting, but also serves to put children at risk of anti-social behavior.

While it may be considered erroneous to assume that all abused women show greater deficiencies in parenting than their
non-abused counterparts, the research highlights that as a result of living in constant fear, they may deny their children
normal developmental transitions and the sense of basic trust and security that is the foundation of healthy emotional
development (Levendosky et al., 2000; Levendosky & Graham-Bermann, 2001). The sequential perpetrator model (Coohey,
2004) proposes that battered women are more likely to hit their children as a reaction to being hit themselves. Under this
model, Holden, Stein, Richie, Harris, and Jouriles (1998) purport that children are not only directly at risk from the perpetrator
of the adult violence, but are also at the receiving end of either intentional or unintentional aggression from their victimized
mother, who may also be directed by the perpetrator to abuse the child. While Buchbinder’s (2004) small qualitative study
with 20 abused mothers study found them distressed after using physical punishment, Holden et al. (1998) concluded that
there was no evidence for diminished parenting in their sample of abused women, despite the extensive use of physical
punishment.

‘Failure to protect’ is a charge often leveled at women, either the failure to recognize the abuse of her child or the failure
to leave the violent relationship and thereby end its impact on the child (Farmer & Owen, 1995). Bell (2003) questions why
mothers often attract as much if not more anger and blame than the abuser himself, while both Mullender et al. (2002) and
Margolin, Gordis, Medina, & Oliver (2003) found evidence that women do make considerable efforts to protect their children,
and may in fact employ more authoritarian parenting tactics to ensure their children are well-behaved, to avoid aggravating
the abuser. Also reported by 19 of the 95 low-income women participating in Levendosky, Lynch, and Graham Berman’s
study (2000) are the positive direct effects on both parenting effectiveness and attachment. The participants in this study
were recruited with flyers distributed to shelters, community organizations and public places, and all had been in a violent
relationship in their children’s lifetime. As a result of the abuse they had or were still experiencing, they commented on their
increased sensitivity to their children and described the attempts they made to compensate for the violence and abusive
parenting of their children’s fathers. Stephens (1999) conducted qualitative research with 26 women victims of domestic
violence, six of whom were residing in a shelter and the remainder in their own communities at the time the research
was conducted. Stephens (1999) found that the abused women in her research had internalized a model of healthy and
appropriate parenting that predated their intimate abuse, and could locate their care-giving from this earlier experience.

Imposing a caveat on research that indicates a comparable quantity of corporal punishment by both parents both Appel
and Holden (1998) and Edleson (1999) caution that fathers nonetheless employ more severe levels than mothers, and that
as mothers are frequently the primary care-givers, they have enhanced opportunities to parent abusively. While the former
authors suggest that if the rate of co-occurrence across mothers and fathers was corrected for the amount of time spent
with the children, the rates would likely be quite different, Edleson (1999) hypothesizes that an over-reliance on measures
of the mother–child relationship relative to the father–child relationship, has also resulted in findings highlighting mothers’
problems, rather than the abusive dynamics that created them.

Guille’s (2004) comprehensive literature review highlights the lack of attention to the father–child relationship in domes-
tically violent families, revealing minimal investigation into the abuser’s perception of his violence or his relationship with
his children. What little information does exist suggests that when compared to their non-violent counterparts, these fathers
are less likely to have been involved with their children and more likely to have used negative child rearing practices, such
as slapping; are more controlling and authoritarian, and less consistent (Bancroft & Silverman, 2002); are more often angry
with their children (Holden et al., 1998); are less likely to allow freedom of expression, creativity and structure in their chil-
dren’s lives (Margolin et al., 2003); and are poor role models with regard to relationships and conflict resolution (Bancroft &
Silverman, 2002).

Fathers are characterized as individuals with low self-esteem and a poorly developed sense of identity that results in
neediness, dependency, a lack of trust in others, and an inability see the impact of their violence on their children (Mullender
et al., 2002), or to see violence towards women as child abuse and vice versa (Hearn, 1998). Peled (2000) also postulates
that the instrumental approach of abusive men’s post-separation parenting behavior results in a construction of fatherhood
in terms of rights to children, with little emphasis on nurturance. Some experts question if the risks for children outweigh
any possible benefits (Guille, 2004; Humphreys & Mullender, 2002; Jaffe, Crooks, & Bala, 2005; Jaffe & Geffner, 1998; Levin &
Mills, 2003; Lundy & Grossman, 2005; Saunders & Barron, 2003). Haddix’s (1996) comprehensive overview and commentary
on US statutory approaches to terminating parental rights (in cases where physical force is used by one parent against the
other), resulted in her presenting a model for the termination of these rights.

802 S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810

The empirical evidence highlights the complex relationships children who grow up with inter-parental violence have
with both of their parents (Edleson, 1999; Peled, 2000; Levendosky et al., 2003; Holden, 2003). Peled (2000) postulated
that children view their abusive fathers in two contradictory ways—as the “good, loved father” and as the “bad, abusive
father”—but seldom maintain both views simultaneously. Peled’s earlier research (1998) with 14 pre-adolescent children
found that they implemented strategies to both minimize the negative view of their fathers, and to find ways to see their
fathers in a positive light, with both of these strategies creating complex emotions when it came to making choices involving
their parents. Children and young people describe paternal experiences that are tainted with sadness, fear, confusion and
disappointment (Mullender et al., 2002) and ambivalent attitudes towards both their parents, including fear and empathy
towards their father, and compassion coupled with a sense of obligation to protect their mother (Goldblatt, 2003).

While acknowledging that parenting cannot prevent a child from ever experiencing conflict or stress, McIntosh (2002)
suggests that parenting is however about filtering those experiences in ways that can be thought about and integrated by
the child. McIntosh argues that the presence of domestic violence results in the failure or collapse of the parental functions
of protection and thought (2002). While the man has detached himself from the experiences of those around him, the
woman’s survival may require her to create a state of disassociation from aggression, that itself perpetuates a cycle of
fear and victimization (McIntosh, 2002). Both aspects of parental dissociation results in a lack of empathy with the child’s
experience, where the child is not helped to deal with and integrate the impact of family violence to recover from the
trauma they have experienced. This then has a differential impact across the developmental pathway, as the next domain
explores.

The impact of domestic violence on children: a developmental perspective

The empirical evidence suggests that growing up in an abusive home environment can critically jeopardize the devel-
opmental progress and personal ability of children (Martin, 2002; McIntosh, 2002), the cumulative effect of which may
be carried into adulthood and can contribute significantly to the cycle of adversity and violence (Cunningham & Baker,
2004; Levendosky & Graham-Bermann, 1998). Exposure to domestic violence may have a varied impact at different stages
(Cunningham & Baker, 2004), with early and prolonged exposure potentially creating more severe problems because it affects
the subsequent chain of development.

Infants and toddlers are totally dependent upon others for care and their lives are organized around the primary attach-
ment relationship to a care-giver, usually their mother. Distress may manifest itself behaviorally in excessive irritability,
regressed behavior around language and toilet-training (Osofsky, 1999); sleep disturbances, emotional distress and a fear of
being alone (Lundy & Grossman, 2005). Edleson’s (1999) review of the literature concluded that a toddler’s need for adults
to provide structure because of their developmental inability to understand and control their own emotions, may be difficult
to meet by depressed and overwhelmed mothers, thus impacting the child’s experience of emotional expression. Exploring
this further, Lundy and Grossman (2005) analyzed data collected between 1990 and 1995 from approximately 50 domestic
violence agencies in Illinois regarding the characteristics, difficulties and needs of 40,636 children aged 1–12 years, who used
one of these services with an adult client during this time period. Lundy and Grossman (2005) found that toddlers actually
seemed to exhibit emotionally distressed behavior less often than older children, a finding resonating in Bogat, DeJonghe,
Levendosky, Davidson, and Von Eye (2006) later, if considerably smaller study involving 48 mothers of infants. The women
were recruited during pregnancy from a wide range of sources including public settings, prenatal clinics and social services
programs. These women had experienced domestic violence during pregnancy and indicated that their infants had seen or
heard one or more abusive incidents. While Bogat et al. (2006) found that only 44% of infants exposed to domestic violence
had at least one trauma symptom, compared with the majority of pre-school and school-age children, Lundy and Grossman
(2005) found that more than any other age group, these youngest children appeared to have difficulty separating from
parents, perhaps reflecting problematic attachments.

Concurring with this, Martin’s (2002) review of the literature suggests that the dynamics of domestic violence undermine
the child’s developmental need for safety and security, potentially resulting in a difficulty developing a logical approach for
getting comfort, and in the development of disorganized attachments to their mothers, who is simultaneously a source
of comfort and fear for the child (McIntosh, 2002). If unabated, Martin (2002) concluded that such attachments result
in the infant being chronically overwhelmed, and if uninterrupted, this pattern could have devastating developmental
consequences for the child, underpinning much of the intergenerational cycle of domestic violence (Zeanah et al., 1999).

Both Rossman (1998) and Huth-Bocks, Levendosky, and Semel (2001) posit that pre-schoolers who witness violence have
more behavioral problems, social problems, post-traumatic stress symptoms, greater difficulty developing empathy, and
poorer self-esteem than non-witnesses. The effects of domestic violence are amplified for these young children, who are
completely dependent on parents for all aspects of their care and may therefore witness greater amounts of violence than
older children (Huth-Bocks et al., 2001). Not surprisingly, research with their mothers found this age group to exhibit more
problems, with care-giving more difficult than any other age group (Levendosky et al., 2003). Their developmentally limited
ability to verbalize the powerful emotions they are experiencing may manifest itself in temper tantrums and aggression,
crying and resisting comfort, or despondency and anxiety (Cunningham & Baker, 2004). While Lundy and Grossman’s study
(2005) found that aggressive behavior and possessiveness were particular problems for this age group, Martin (2002) sur-
mised that extreme fear may result in psychosomatic problems such as headaches, stomach aches and asthma, as well as
insomnia, nightmares, sleepwalking and enuresis. The ego-centrism of children of this age may be reflected in a preoccupa-

S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810 803

tion with fear for their own safety, and they may engage in mental and behavioral disengagements in an effort to cope with
this distress (Cunningham & Baker, 2004).

School-age children (6–12 years) are involved in developing a more sophisticated emotional awareness of themselves
and others, in particular of how the abuse is affecting their mothers (Daniel, Wassell, & Gilligan, 1999). They are also able
to think in more complex ways about the reasons for the violence, and may try to predict and prevent the abuse based on
this reasoning. Younger children in this developmental stage are still thinking ego-centrically and may blame themselves for
their mother’s abuse, absorbing guilt and self-blame. In working things out, they will try to rationalize their father’s behavior,
justifying it on the basis of alcohol, stress, or bad behavior on theirs or their mother’s behalf, helping them cope with the idea
that their father is bad or imperfect in any way. If inappropriate or inaccurate attitudes and beliefs are not addressed, the
child is potentially at risk of adopting anti-social rationales for their own abusive behavior, where this occurs (Cunningham
& Baker, 2004).

For school-age children, academic and social success at school has a primary impact on their self-concept. As children rely
increasingly more on influences outside the family as role models and as indicators of their own worth (Daniel et al., 1999),
most children will hide their “secret” from everyone, because if others found out, the shame would be devastating, further
compounding the imbuing sense of sadness and vulnerability (Alexander, Macdonald, & Paton, 2005). With the development
and preservation of friendships a fundamental part of this developmental stage, Lundy and Grossman (2005) believe that
social problems including poor social skills, may make this developmental task unachievable. They may either pick up on
and react to aggressive cues in their interactions with other children and consequently be at risk of bullying or tune out from
such cues and be at increased risk of being bullied (Bauer et al., 2006; Cunningham & Baker, 2004). One-third of Lundy and
Grossman’s (2005) sample of 4,636 children who were exposed to domestic violence were described as frequently aggressive,
and one-fifth had difficulties adhering to the rules of the school, with the acting out, peer difficulties, sadness and depression
of this peer group frequently bringing them to the attention of the teachers. The first US study to examine the relationship
between domestic violence exposure and bullying corroborated this finding that children exposed to violence engaged in
higher level of generalized aggression (Bauer et al., 2006). Furthermore, the child’s learning potential may be compromised
by poorly developed verbal skills (Moore & Pepler, 1998), competing demands for their energy, exhaustion or absenteeism.
Alternatively school is experienced as a respite and engaged in fully, both to maximise the respite and to avoid going home.

Adolescence may mark the point when the impact of domestic violence extends beyond the boundary of the family, with
difficulty forming healthy intimate relationships with peers due to the models they experienced in their family (Levendosky,
Huth-Bocks, & Semel, 2002). Research suggests exposed adolescents are less likely to have a secure attachment style and
more likely to have an avoidant attachment style, indicating perhaps that they no longer feel trust in intimate relationships
(Levendosky et al., 2002). Reflecting on the findings of their research, Levendosky and her colleagues (2002) speculated
that abusive patterns in intimate relationships initiated in adolescence, may well lead to violence on the part of men and
victimization on the part of women in their adult relationships.

Wekerle and Wolfe (1999) found exposure to violence in the home to be the best predictor of adolescent male abusive
behavior and a significant predictor of male and female experiences of victimization in intimate relationships. In contrast,
Levendosky et al.’s study (2002) with 111 exposed adolescents found they were more likely to be victimized, lending some
support to the intergenerational transmission of violence hypothesis. On a similar theme, the young people in Goldblatt’s
(2003) study doubted their competency to become non-violent partners and were ambivalent about their ability to control
themselves.

Coping strategies for this developmental stage include mental or emotional disengagement involving both tuning out by
listening to music or positioning themselves away from the violence, with more hazardous efforts involving experimentation
with alcohol and other mood altering substances (Cunningham & Baker, 2004; Mullender et al., 2002). As children get older,
they may become more active and focused in trying to prevent or intervene in the abuse, or in providing emotional or
practical support to their mother (Hester et al., 2000). Anger may be directed at the abuser for the violence or at the mother
for perceived failure to protect, inability to leave or returning to the abuser. Adolescents may adopt care-taking roles for
their mother and siblings, and although this can empower by providing a sense of control in an otherwise out of control
environment, Goldblatt (2003) cautions that the cost of over parentification is a lost childhood and the likelihood of severe
emotional distress.

Opening up the adversity package

Because domestic violence is not an isolated event but occurs within a family system, it is potentially something that dis-
rupts broader family functioning and the home environment (Huth-Bocks et al., 2001; Salcido Carter, Weithorn, & Behrman,
1999; Ullman, 2003). Rossman (2000, p. 45) adopted the term “adversity package” to describe the multiple stressors which
can accumulate in the lives of young people exposed to domestic violence, including child abuse, parental substance abuse
and mental health difficulties, unemployment, homelessness, social isolation and involvement in crime (Golding, 1999). The
presence of multiple stressors in a child’s life may both elevate the risk of negative outcomes and possibly render indistinct
the exact relationship between domestic violence and those negative outcomes (Jones, Gross, & Becker, 2002). This section
selectively reviews some of these adversities.

Although domestic violence cuts across the economic spectrum, the literature suggests that poor families are more likely
to be affected (Buckner, Bearslee, & Bassuk, 2004; Kruttschnitt et al., 2002). Current evidence suggests that the child’s

804 S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810

safety is related to the structure and socio-economic circumstances of the families (Berger, 2005). For example in Cox,
Kotch, and Everson’s (2003) longitudinal research with a purposive community sample of 184 low-income and high-risk (for
maltreatment) families, low socio-economic status is identified as a strong predictor of both domestic violence and child
maltreatment. A related correlation was highlighted by Levendosky and Graham-Bermann (1998) in their study with 60
shelter women and their children and a comparison group of 61 non-shelter women and their children who were living
in the same low-income community. This study found that domestic violence was reported by one-third of the families in
their low-income comparison group, suggesting that there may be a high incidence of domestic abuse in some low-income
communities.

Levendosky and her colleagues (2000) also found income to be a significant predictor of parenting behaviors, where
economically stressful situations result in parents needing to respond to external demands over and above their children’s
needs, with higher rates of physical and mental health difficulties for both parents and children when compared to the general
population (Ghate & Hazel, 2002). There is also a direct correlation between poverty and poor educational achievement, with
fewer resources and low-achieving classroom environments increasing children’s behavior problems (Keegan-Eamon, 2001).
This finding of a correlation between poverty and poor educational achievement is particularly significant for two reasons.
First, because family poverty in childhood and adolescence and low academic achievement are strong predictors of violence
in later life (World Health Organization, 2002), and second because resilience theory recognizes educational attainment as
a protective factor promoting positive outcomes for children living with adversity (Daniel & Wassell, 2002; Gilligan, 1999).
Unemployment, a closely related adversity to poverty, is found to be a common correlate in domestic assaults in Kruttschnitt
et al.’s (2002) review of the literature on female violence. This research concluded that the employment of women lowers
their risk of abuse when their partner is employed, but significantly increases their risk for abuse when their partner is
unemployed.

Research has also identified the potent presence and misuse of alcohol in the lives of women who are abused (Kashani &
Allan, 1998; Kruttschnitt et al., 2002). While alcohol is not understood or viewed as a causal factor in the abuse of women,
it has been established as a major contributor to female physical as well as sexual victimization (Lipsky, Caetano, Field, &
Larkin, 2004; Ullman, 2003). It is also more closely linked to murder, rape and assault than any other substance and found
to be a contributing factor in incest, child molestation, spousal abuse and other family violence, with the percentage of men
who assault their partners while under the influence of alcohol ranging from 48 to 87% (Lipsky et al., 2004).

Exploring this further, Ullman (2003) states that on the one hand heavy drinking in men is associated with lifetime
self-reported involvement in sexual aggression, with offender alcohol use potentially leading to disinhibition of violence,
contributing to more severe assault outcomes, for example rape and physical injury (Boles & Miotto, 2003). On the other
hand, victimization may contribute to subsequent drinking and development of drinking problems in order to cope with post-
traumatic stress symptoms that develop post-assault (Ullman, 2003). Similarly, Caetano, Field, and Nelson (2003) postulate
that early childhood abuse may contribute to increased drinking, which may lead to increased risk of adolescent sexual
assault and contribute to further problem drinking, as victims self-medicate in order to cope.

These adversities can together advance the web of social isolation and rejection that many families become entrapped
by (Anooshian, 2005; Kruttschnitt et al., 2002). Social isolation contributes to parenting difficulties and compromises the
opportunities children need for developing relationships with extended family and friends (Kruttschnitt et al., 2002). It is also
negatively connected with poverty, where poor environments and low-income families are both deficient in social support,
and where members of networks than can themselves be a source of obligation and stress (Ghate & Hazel, 2002). While
robust social support can protect women’s functioning, Levendosky and Graham-Bermann (2001) suggest that the absence
of such social support combined with traumatic experiences, negatively influence women’s psychological functioning. This is
a particularly important finding in that many women in battering relationships have few social supports due to the controlling
aspect of the battering relationship.

Factors influencing outcomes for children exposed to domestic violence

The previous sections have considered the deleterious impact that exposure to domestic violence can have for chil-
dren, reflected in high levels of cognitive, emotional, behavioral and social problems (Kitzmann, Gaylord, Holt, & Kenny,
2003; Kolbo, Blakely, & Engleman, 1996; McAlister-Groves, 1999; Peled, 2000). However, cognisant of the methodological
constraints discussed earlier in this paper, this section will respond to Kerig’s (1998) encouragement to “move beyond docu-
menting the negative effects,” in order to discover the processes underlying children’s responses to their mothers’ abuse (p.
346). Wolfe, Crooks, Lee, McIntyre-Smith, and Jaffe (2003) and Edleson (1999) also caution that the available research merely
demonstrates associations between exposure to domestic violence and other variables, such as an emotional or behavioral
difficulty. Wolfe et al. (2003) propose that these variables are “process rather than absolutes,” since the same experience
can operate as either a protective or a risk factor depending on the milieu within which it occurs (p. 172). Furthermore
each child is unique and their reaction will vary according to age, gender, personality, socio-economic status, role within the
family, the frequency, nature and length of exposure to violence, with the impact moderated or mitigated by a further set of
considerations, such as relationship with parents and siblings and available supports (Hester et al., 2000; Kashani & Allan,
1998; Salcido Carter et al., 1999).

At a very basic level, age has an influence on impact with regard to the child’s developmental ability to understand and
process their experience, and, as explored earlier, for the manner in which their distress is manifested. While Cunningham

S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810 805

and Baker (2004) argue that early and prolonged exposure can potentially create more severe problems because it affects the
subsequent chain of development, Kilpatrick and Williams (1998) relatively small quantitative study with 20 child witnesses
and 15 non-witnesses found that children are vulnerable to traumatization from exposure to violence, regardless of the
age of the child when they are first exposed. Kilpatrick and Williams (1998) concluded from this research that exposure to
domestic violence “has the potential to induce catastrophic and long-term trauma in the child witness” (p. 328). Goldblatt
(2003) however, found that adolescent freedom and autonomy allowed the 21 Israeli teenagers in his study to develop a
sense of control over their lives, enabling them to tolerate confusion and bewilderment.

An emergent pattern within the literature reviewed on gender suggests that boys and girls generally respond differently
to exposure to violence, with these differences reflected in both the nature and extent of the presenting problems. There
is evidence that boys exhibit externalized problems more frequently such as hostility and aggression, while girls exhibit
more internalized difficulties such as depression and somatic complaints (Buckner et al., 2004; Edleson, 1999; Martin,
2002). McIntosh (2003) explains that boys’ externalizing behaviors are linked to their experiencing a high level of threat
from violence exposure, while girls’ internalizing responses are reflective of them experiencing a higher level of self-blame.
Regarding the extent of these presenting problems, there is also some evidence that boys exhibit more frequent problems
than girls (Kerig, 1996).

Responding to Hester et al.’s (2000) caution against erroneous gender assumptions, a minority of research on exposed
children does not find significant gender differences for internalizing and externalizing symptoms (Cummings, Pepler, &
Moore, 1999; Kerig, 1996, 1998) or for the extent of difficulties across genders (Cummings et al., 1999; Lemmey et al., 2001).
Some characteristics of the samples sourced may go some way to explain these differences. For example, Cummings et al.’s
(1999) research with 114 girls and boys living in shelter accommodation and 82 boys and girls living in homeless hostel
accommodation, concluded that boys were not presenting with significantly higher rates of externalizing behaviors than
girls. Cummings et al. proposed that this finding may have been influenced by the age of their sample, suggesting 6–12-year-
old boys were too young and had not developed these behavior problems yet. This theory finds some resonance in other
qualitative research on children exposed to domestic violence (Buckley et al., 2006; Song, Singer, & McAnglin, 1998). As they
got older, girls in these samples exhibited more violent and aggressive behavior than boys. Similarly, McCloskey and Lichter’s
(2003) research determined that more girls than boys were perpetrating dating aggression.

Other findings worth noting include Cummings et al’.s (1999) finding that contrary to gender stereotypes, girls in their
shelter sample presented with higher rates of externalizing symptoms than boys who were also living in shelters. By way
of explanation, Cummings and colleagues (1999) suggest that these girls had been exposed to more verbal aggression from
their fathers than the boys in the shelter, and higher rates of father–daughter conflict in addition to the parental conflict.
Cummings et al. further suggest that these fathers may be identifying their daughters with their wives and that the daughters’
sensitivity and defense of their mothers may explain their conflictual relationship with their fathers.

Other factors influencing outcomes include the intensity, severity, co-occurring and different forms of violence to which
children are exposed. Jouriles et al.’s (1998) research found that domestic violence involving knives or guns placed children
at a greater risk of behavior problems than violence exposure where such weapons were not employed. On a related theme,
Lemmey et al. (2001) and Levendosky and Graham-Bermann (1998) found that an increase in physical violence against the
mother was correlated with enhanced internalizing behavioral problems in the child. Kitzmann et al.’s (2003) meta-analysis
of 118 studies highlighted that children experienced a greater impact when they witnessed physical violence between their
parents than when other abusive behaviors occurred (e.g., verbal aggression). Research on children’s exposure to the sexual
abuse of their mothers also highlights their distress and trauma arising from this experience (Weinhall, 1997, cited in Hester
et al., 2000). Contrary to these findings, Kilpatrick and Williams’s (1998) smaller study with 35 children and their mothers
found that neither intensity nor frequency was significant in predicting post-traumatic stress in children. These authors
concluded that domestic violence has the capacity to provoke trauma in the child, regardless of frequency or intensity.

Finally, a number of authors examined the impact on children exposed to both domestic violence and child abuse, estab-
lishing higher rates of internalizing behavior when children were exposed to both domestic violence and physical abuse
(Cummings et al., 1999; Kernic et al., 2003). In Kernic et al.’s (2003) research with 167 mothers experiencing domestic vio-
lence, 14.4% of their 167 children exposed to this domestic abuse were also recorded to be victims of maltreatment (physical
and sexual abuse and neglect). This research found significantly elevated rates of both internalizing and externalizing behav-
ior for the children who experienced both exposure to violence and child maltreatment. In contrast, Kitzmann et al.’s (2003)
meta-analysis found that children exposed to interpersonal violence in addition to physical abuse, did not demonstrate
significantly poorer outcomes than those exposed only to the violence between their parents.

The research provides ample support for the intergenerational transmission of violence theory, which holds that witness-
ing and experiencing violence as a child leads to a greater use or tolerance of violence as an adult (Markowitz, 2001; Smith
et al., 2000). Gelles and Cavanaugh (2005) suggest an estimated intergenerational transmission rate of 30% (±5%), which can
manifest itself in a number of ways. First, there is evidence that children from violent families go on to be violent or be abused
in their adult intimate relationships (Coohey, 2004; Guille, 2004; Margolin et al., 2003; Whitefield, Anda, Dube, & Felitti,
2003). Amato’s (2000) review of a 12-year longitudinal study found that young adults who had been exposed to parental
violence as children were 189% more likely than those not exposed, to experience violence in their own adult relationships.

Second, longitudinal studies on pathways to delinquency have shown that young offenders are more likely to have been
exposed to domestic violence, compared to their non-exposed counterparts (Steinberg, 2000), and to become involved in
anti-social behavior, violent crime, substance abuse, further delinquency and adult criminality (Edleson, 1999; Osofsky,

806 S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810

1999). Finally, there is an association between exposure to domestic violence and peer aggression and bullying (Baldry,
2003).

Drawing on an ecological perspective, Osofsky (2003) concludes that it is not just that children see aggression, but
rather that they learn how aggression is functional in intimate relationships, experiencing what Holden (2003) consid-
ered corruption or “mis-socialization.” Concurring with this hypothesis, Graham-Bermann, and Brescoll’s (2000) research
with 221 children (6–12-year-olds) and their mothers, found a direct relationship between the level of physical and emo-
tional abuse of mothers and children’s belief systems regarding the intrinsic dominance and privilege of men, and the
acceptable purpose of violence in family interactions. Reflecting on family systems theory, these authors surmise that
domestically abusive families methodically underline and internalize stereotyped gender beliefs through the acts of physical
abuse.

However, a final word of warning is expressed by Gelles and Cavanaugh (2005), that while a child’s experience of violence
is often correlated with later violent behavior, such experience is not the sole determining factor. Indeed despite all of
the above, there are some children and young people who remain resilient and emerge from their experiences relatively
unscathed, or with developed coping and survival strategies (Daniel & Wassell, 2002). Kitzmann et al.’s meta-analytic review
of the literature found that while approximately 67% of child witnesses were faring more poorly than the average child,
the remaining 37% presented with outcomes that were similar to or better than most of the non-witnesses (2003). These
results support Hughes and Luke’s (1998) earlier finding that not all children show maladjustment from exposure to domestic
violence. Acknowledging the caveat expressed by Kitzmann et al. (2003) and McIntosh (2003) that the absence of serious
adjustment problems does not necessarily mean that children are unaffected by the violence, a range of protective factors
have, nonetheless, been identified as influencing the extent of the impact of exposure to domestic violence on the child and
the subsequent outcomes for the child. The next section will detail these.

Resilience

A secure attachment to a non-violent parent or other significant carer has been cited consistently in the literature as an
important protective factor in mitigating trauma and distress (Graham-Bermann, DeVoe, Mattis, Lynch, & Thomas, 2006;
Mullender et al., 2002), with much of the research highlighting the considerable role that the maternal parenting role
plays in the overall adjustment of children, across their developmental stages (Levendosky & Graham-Bermann, 1998, 2001;
Mullender et al., 2002; Osofsky, 1999; Radford & Hester, 2006). Indeed Osofsky (1999) concluded from her review of the
literature that the relationship with a parent or another familiar and caring adult is the exposed child’s greatest protective
resource. This finding resonates in Mullender et al.’s (2002) research with 8–16-year-olds who cited mothers as “their most
important source of help than anyone else in their lives” (p. 210).

A related theme concerns the availability of someone for the child to turn to for emotional support, since the social support
system of exposed children and young people is considered crucial in determining the impact of the violence (Kashani &
Allan, 1998; Ullman, 2003). While this clearly overlaps with attachment issues, most accounts also emphasise the key role of
the wider social and community support structures and of supportive family relationships more generally. Cox et al.’s (2003)
longitudinal study with 219 families of 6–7-year-olds found that supportive adults such as grandparents could protect the
child by acting as agents of social control within the family, or by spending time with the child. Research conducted by
Levendosky and her colleagues (2002) with 111 adolescents and their mothers, also found that a supportive relationship
with an adult family member served as a protective factor in a high-risk environment. However, McCloskey et al. (1995)
argue that when the family is profoundly dysfunctional as to involve severe violence and sexual abuse, the supportive
qualities of family relationships fail to safeguard the children from negative effects, at least in the short-term.

Resilience is also associated with having positive peer and sibling relationships and friendships that can buffer the effects of
stress, prevent and mediate stress, provide support and nurturance and information as to how to deal with stress (Guille, 2004;
Mullender et al., 2002). However research conducted by Levendosky and her colleagues (2002) with 111 adolescents aged
14–16 years and their mothers, drawn from a community sample, highlights some interesting findings. These 111 adolescents
had varying levels of exposure to domestic violence and were described as belonging to the high or low domestic violence
group (DV group). Levendosky et al. (2002) found that while social support moderated the impact of domestic violence on
adolescent functioning, it had no influence on the impact of domestic violence on mental health functioning. This research
also found that social support served as a vulnerability factor for adolescents in the high DV group and as a protective factor
for those adolescents in the low DV group. Levendosky et al. (2002) speculated that this may be because adolescents in the
high DV group are in social networks of more violent adolescents, where violence is tolerated and encouraged.

Self-esteem, one of the building blocks of resilience (Daniel & Wassell, 2002; Martin, 2002), emerges as a critical ele-
ment underlying children’s ability to develop successful coping strategies, and as a significant distinguishing factor between
resilient and non-resilient adolescents (Kashani & Allan, 1998). Guille (2004) suggests that self-esteem and the locus of con-
trol contribute to the child’s ability to cope, because children who feel in control of their life circumstances and who have
better self-concepts may be less affected by the violence they witness. While the domestic violence literature reports that
self-esteem is often likely to be damaged as a result of living with the shame and the undermining attitudes of the abusive
man (McGee, 2000), it is also important to remember that children with high self-esteem in one area (for example school)
may focus on and build on that domain, which allows them more easily to escape their family’s violence.

S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810 807

Responding to the needs of children exposed to domestic violence

The past two decades have witnessed children occupying greater centrality and visibility within the literature and research
on domestic violence, with emergent awareness and understanding of the impact of exposure to domestic violence on the
growing child and of their needs within that context. Despite this burgeoning appreciation, the research systematically
highlights how the key health, social, legal and educational professionals have struggled to identify the signs, understand
the dynamics of children’s experiences and respond appropriately to their individual needs (Hester et al., 2000; Holt, 2003;
McGee, 2000; Mullender et al., 2002). This final section will reflect on these struggles and dilemmas and highlight what
constitutes best practice in responding to children exposed to domestic violence.

Frequently cited reasons for the lack of awareness and understanding of the dynamics of domestic violence and the inap-
propriate responses that follow, include a knowledge, training and skill base deficit (Holt, 2003; Kenny, 2004; Mullender,
1996; Shepard & Raschick, 1999), and the seemingly incompatible theoretical approaches and dichotomous agendas of
the child focused social services mandate and the woman focused ethos of shelter work (Rivett & Kelly, 2006). For
example, while Kelly (1996) asserts that the welfare of the child cannot be separated from that of their mother, Croke
(1999) argues against an automatic and simplistic assumption that the needs of the child and the woman are always
synonymous.

Focusing specifically on the child focused social services mandate, although exposure to domestic violence has increas-
ingly been viewed as a significant child protection concern, many authors nonetheless argue against defining and responding
to such exposure as a form of child abuse (Edleson, 1999; Kaufman Kantor & Little, 2003). Edleson (2004, p. 20) argues that
such a definition ignores the wide variability in children’s experiences, where some children “show no greater problems than
their peers who are not so exposed.” Reflecting on the North American experience of defining exposure to domestic violence
as a form of maltreatment under child care legislation, Edleson (1999) recalls how the child protection and welfare systems
became overloaded and punitively responsive to women, simultaneously holding them responsible for their children’s pro-
tection while ignoring their attempts to keep their children safe. As such, Edleson (2004) concludes that a child protection
response should only be invoked in the “minority of severe cases, advocating instead for a more generalized, welfare- and
community-based response in the majority of cases (p. 21).”

Experts have proposed that the differential impact on children of exposure to domestic violence requires a response that
can firstly assess and secondly respond more effectively on the basis of individual need (Cunningham & Baker, 2004; Rivett &
Kelly, 2006), something the child protection system is structurally unable to do. Indeed recent attempts to redress the dearth
of assessment frameworks appear to signal a greater recognition of the complexity of the needs of all those involved (Bell &
McGoren, 2003; Calder, Harold, & Horwath, 2004; Magen, Conroy, & Tufo, 2000). Echoed throughout the literature reviewed
is the need for a holistic assessment that takes account of the risk and protective factors in every family, before drawing
conclusions about the risks and harm to specific children and the interventions needed (Buckley, Horwath, & Whelan, 2006;
Cunningham & Baker, 2004; Edleson, 1999; Rossman, Rea, Graham-Bermann, & Butterfield, 2004). Implicit in such a child
centered assessment is the direct inclusion, where appropriate, of the child in this process, where research with children
highlights their need to be listened to and included in the decisions affecting their lives (Buckley, Whelan, et al., 2006;
Mullender et al., 2002).

Once these needs have been clearly identified and individually assessed, Mullender (2001) asserts that subsequent
responses can occur along a continuum of primary, secondary, or tertiary interventions. This can potentially involve both
challenging and supportive interventions that may be short or long-term, individual or group-based, formally organized or
occur more informally though the natural networks of the immediate and extended family and community (Mullender et
al., 2002). Influencing the nature of this support will include the child’s immediate needs, with resilient children possess-
ing a wide range of coping skills and supports that may not necessitate direct intervention for the child, but may instead
focus on supporting the non-abusing parent and on attachment relationships (McAlister-Groves, 1999). However, any inter-
vention strategy needs to be individualistically responsive to the child’s familial context, focused on stabilizing the home
environment and minimizing disruption (Hester et al., 2000), and one which recognizes and enhances informal supports
(Cunningham & Baker, 2004). The timing of intervention responses is crucial, with research suggesting that when a child
needs help, intervention should follow quickly and intensively (Osofsky, 2004).

Conclusion

This paper concludes that children may be significantly affected by the experience of domestic violence in their lives,
the impact of which may resonate intergenerationally with their own involvement in adult violence (Markowitz, 2001).
It also cautions however that there is rarely a direct causal pathway leading to a particular outcome (Wolfe et al., 2003)
and that children are not passive participants but are active in constructing their own social world. Given the potential
negative repercussions of children’s exposure to domestic violence, in particular the intergenerational transmission of such
violence (Ehrensaft, Cohen, & Brown, 2003), there exists a need for a wide range of programs that can intervene to improve
their potential for healthy adjustment (McAlister-Groves, 1999). The literature reviewed advocates for a holistic and child-
centered approach to service delivery, derived from an informed assessment of all of the issues outlined above and designed
to capture a picture of the individual child’s experience (Calder & Hackett, 2003; Hester et al., 2000; Kelly & Humphreys,
2001). Finally, interventions should be grounded in a clear philosophical and value base, beginning with an affirmation that

808 S. Holt et al. / Child Abuse & Neglect 32 (2008) 797–810

the child’s welfare is paramount and in many situations is intrinsically aligned to the protection and empowerment of their
mother (Hendry, 1998; Kelly, 1996).

Acknowledgements

The authors would like to acknowledge the valued support of Nicola Carr (Research Fellow, Children’s Research Centre,
Trinity College Dublin) and Matt Bowden (Part-time lecturer in Social Policy, School of Social Work & Social Policy, Trinity
College Dublin) for their feedback on earlier drafts.

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The impact of exposure to domestic violence on children and young people: A review of the literature

Introduction
Methods
Findings
Domestic violence as an abusive context for children
Parenting ability and the experience of being parented in the context of domestic violence
The impact of domestic violence on children: a developmental perspective
Opening up the adversity package
Factors influencing outcomes for children exposed to domestic violence
Resilience
Responding to the needs of children exposed to domestic violence
Conclusion
Acknowledgements
References

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