Development and Psychopathology

Regular Articles

Nurse home visitation and the prevention of child maltreatment: Impact on the timing of official reports

David S. Zielinskia1 c1, John Eckenrodea2 and David L. Oldsa3

a1 Duke University

a2 Cornell University

a3 University of Colorado Health Sciences Center


This study examined the effects of the Nurse Family Partnership (NFP), a program of prenatal and infancy home visiting by nurses, on the timing of verified reports of child maltreatment. A sample of predominantly unmarried, low-income mothers and their first-born children were randomly assigned to receive either home visitation services by nurses beginning in pregnancy and lasting until the child was age 2, or comparison services. Previous studies have found that this program was effective in reducing the overall number of substantiated Child Protective Service reports by age 15. In the current study, survival analyses were used to assess temporal differences between nurse visited (n = 93) and comparison (n = 144) children's onset rates for maltreatment. The two groups' survival functions remained nearly identical until age 4, at which point the nurse-visited group's risk for onset began to significantly diminish. These results were more pronounced among the highest risk subgroup and among victims of neglect. The findings provide evidence that the NFP's success in reducing the number of maltreatment reports resulted in part from in its impact on the timing of the maltreatment process.


c1 Address correspondence and reprint requests to: David S. Zielinski, National Institute of Mental Health, Office of the Director, 6001 Executive Boulevard, Room 8206, Bethesda, MD 20892-9667; E-mail:


This research was supported by grants from the Prevention Research Branch of the National Institute of Mental Health (R01-MH49381); the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services (96ASPE278A); the Children's Bureau, US Department of Health and Human Services (90-CA-1631); a National Institute of Mental Health Senior Research Scientist Award (to D.L.O., 1-K05-MH01382-01); and the Smith–Richardson Foundation.

We thank John Shannon for his support of the program and data gathering; Alise Mahr, Darlene Batroney, Karen Hughes, Barbara Lee, Sherry Mandel, and Barbara Ganzel for tracing and interviewing the families; Renee Hallock and the New York State Office of Children and Family Services for assistance with coding the Child Protective Services records; Kim Sidora, Kathleen Buckwell, Sondra Thomas, Sharon Holmberg, and Elizabeth Anson for data coding and management. Special thanks to Judith Singer, Dennis Luckey, and Francoise Vermeylen for statistical consultation.