Toward Expanding Interventions for Child and Adolescent Adversity/Maltreatment: Research, Policy and Practice

Children and adolescents who have experienced child maltreatment and adversity are at increased risk for multiple negative behavioral health outcomes including internalizing and externalizing problems, academic failure, substance use, and juvenile delinquency. Although interventions have been developed to address traumatic stress experiences, it is not clear whether there are sustained impacts, for whom they work, and under what circumstances they work best. For those who do not respond to established interventions, can research advances examining social, behavioral, neurobiological, and genetic factors be used to develop targeted and improved interventions to influence pathways to substance use risk and related behavioral health problems, also taking into account developmental and contextual factors? What can be done to mitigate risk now, through improving the uptake of evidence-based interventions, for example, for youth in the child welfare system? The purpose of this Research Roundtable is to bring together experts working across the spectrum of pre-intervention research, intervention research, services/practice research, and policy, to discuss progress and gaps, and to provide recommendations for the next stages of research to improve outcomes for children and adolescents who have experienced early adversity. Discussants provide a range of expertise: neurobiological and behavioral consequences of early life adversity and their implications for prevention; longitudinal research on children and adolescents who experienced abuse and neglect that informs risk and protective factors for the development of substance use/abuse, and related behavioral health problems; intervention research for youth in the child welfare system; testing implementation models to facilitate the uptake and adoption of evidence-based prevention in child welfare systems; and programs and policies to address child and adolescent traumatic stress/maltreatment, such as use of the child welfare waiver demonstration program to support evidence-based prevention. Discussants will consider the issues raised above, in the context of current research progress, and provide recommendations for the next steps in research to develop, refine and implement interventions to address child and adolescent maltreatment and early adversity.