The Future of Children, Princeton - Brookings: Providing research and analysis to promote effective policies and programs for children.

Several reviews of research on the effects of domestic violence on children have been published in the past decade. Four are described here. Three of these reviews, published in 1989, 1996, and 1998, included studies that compared children exposed to domestic violence with children from nonviolent homes with respect to one or more aspects of child functioning, including: (1) externalizing behaviors (such as aggressive behavior and conduct problems); (2) internalizing behaviors (such as depression, anxiety, and low self-esteem); (3) intellectual and academic functioning; (4) social development (social competencies with peers and adults, for example); and (5) physical health and development. ^23,24,25 The 1998 review also included research on the co-occurrence of child maltreatment and exposure to domestic violence, as well as studies that examined factors that mediate or modify child outcomes. The fourth review, completed in 1998, applies a developmental-epidemiological perspective in its analysis of the research, and sets forth important principles to guide future empirical work in the field.²⁶ To date, research on the effects of child exposure to domestic violence indicates that this exposure has an adverse impact across a range of child functioning, produces different effects at different ages, increases the risk for child abuse, and is associated with other risk factors such as poverty and parental substance abuse. This research does not, as yet, reveal reliable information about the impact of particular types or frequencies of domestic violence on children, or how children with specific characteristics are affected across time.

The 1989 and 1996 literature reviews indicated that children exposed to domestic violence demonstrated more externalizing and more internalizing behaviors than did children from nonviolent homes.^23,24 Specifically, the studies that examined differences across groups in these behaviors revealed that children exposed to domestic violence tended to be more aggressive and to exhibit behavior problems in their schools and communities ranging from temper tantrums to fights. Internalizing behavior problems included depression, suicidal behaviors, anxiety, fears, phobias, insomnia, tics, bed-wetting, and low self-esteem. The few studies that assessed problems related to cognitive and academic functioning found differences between children from violent, versus nonviolent, homes. Children exposed to domestic violence demonstrated impaired ability to concentrate, difficulty in their schoolwork, and significantly lower scores on measures of verbal, motor, and cognitive skills.

By contrast, the findings were somewhat less clear with respect to social development. The 1989 review noted that all of the studies that examined social development found that both boys and girls from violent homes evidenced significantly lower levels of social competence, such as poorer problem-solving skills and lower levels of empathy, than did the comparison group children.²³ Yet, the 1996 review pointed out that 5 of 11 studies that assessed social functioning did not find a significant relationship between child exposure to violence and lower levels of social competence. The 1996 review also reported that the studies that assessed differences in physical health found no clear evidence of a causal link between exposure to domestic violence and health problems.²⁴

The 1998 review confirmed the conclusions of the previous reviews. In addition, studies in this review indicated that between 45% and 70% of children exposed to domestic violence are also victims of physical abuse, and that as many as 40% of child victims of physical abuse are also exposed to domestic violence.²⁷ Children in households with domestic violence were also found to be at higher risk for sexual abuse than were children in nonviolent households. In addition, studies in this review suggested that negative outcomes were more likely for children who experienced both domestic violence and child maltreatment than for children who had experienced only one form of violence or no violence. This review concluded, in fact, that the coexistence of multiple risk factors was more important in predicting problems than was the presence of any single factor alone.

Studies that examined age as a factor in mediating outcomes indicated that exposure to domestic violence produced different developmental problems at different ages. The literature was inconclusive with respect to whether the child's gender in any way mediated the effects of exposure to domestic violence. Some studies found that gender made no difference, while others found that boys were more severely and negatively affected than girls. Only a few studies had investigated the effects of race or ethnicity; one found that being an African-American male predicted externalizing behavior, and another revealed that Hispanic children exposed to domestic violence had higher levels of anxiety and phobias than similar children in other ethnic groups.²⁸

The final review included in this article used a developmental-epidemiological framework to critique 21 empirical studies that examined the effects of exposure to domestic violence on children.²⁶ This framework combines the research methods and scientific principles from both epidemiology and developmental psychopathology. The goal of epidemiological research is to predict and prevent public health problems by using rigorous definitions for the problems and accurate assessments of their prevalence. The developmental perspective seeks to identify changes in children's functioning as they grow, and examines how children's life experiences influence child outcomes. Using the developmental approach, the impact of child exposure to domestic violence can be assessed by measuring a child's performance of age-appropriate physiological, cognitive, emotional, and social tasks.²⁹ The developmental-epidemiological framework examines children's functioning as they grow while analyzing how environmental influences affect child outcomes. Many of the studies reviewed did not use the research methods needed to accomplish the goals of this approach. Limitations in methodology included the use of study samples that were not representative of children exposed to domestic violence, unclear definitional standards, and a lack of longitudinal designs to track child functioning across time.

Population-Based Research Issues

Most of the reviewed studies used, as study participants, children residing in domestic violence shelters.²⁶ This population of children may not be representative of the entire population of children exposed to domestic violence. In fact, there is evidence that children who reside in shelters demonstrate different characteristics and significantly higher levels of psychological distress than those exposed to domestic violence who are not in shelters.^30,31 The psychological adjustment problems of children in shelters may be associated with factors particular to the shelter setting. These children have been uprooted from their homes, have been separated from other family members, and have experienced their mothers under conditions of great stress. For these reasons, conclusions about the information learned from shelter samples should not be presumed to characterize all children exposed to domestic violence.

Definitional Issues

The current body of knowledge regarding child exposure to domestic violence does not satisfy the standards for definition and substantiation required for epidemiological research.²⁶ Many studies do not clearly define domestic violence or child exposure, nor do they typically obtain independent corroboration that the violent incident occurred. Only five studies provided definitions of child exposure to domestic violence, and they characterized it as being within auditory or visual range of physical fighting between the parents. These studies used unsubstantiated reports by the child and the mother to indicate that the child had witnessed the violence. Most of the studies used the Conflict Tactics Scale as their only independent measure of the violence. Only two studies offered official substantiation of the violence in the family; the substantiation was based on reports from child protective services. The absence of clear, consistently used definitions of child exposure, and of independent substantiation of exposure, makes it difficult to compare findings across studies, or to rely with assurance on the validity of reported results.

Child-Centered Research Issues

A majority of the studies reviewed did not demonstrate recognition of important developmental issues, including: (1) an appreciation for the whole child across multiple aspects of functioning, (2) sensitivity to the developmental stage of the child and skills appropriate for that stage, and (3) acknowledgment of the importance of tracking functioning across time. Most of the studies did not consider age as a variable in their research design; about half of the studies included only school-age children in their samples. Only three of the five studies examining multiple developmental stages looked at the differences in child outcomes as a function of age. There were no studies that used a longitudinal research design to study the impact of exposure to domestic violence across time.²⁶

Other Research Issues

Most of the studies reviewed did not make any reference to a theoretical basis for the study, even though sound theoretical frameworks are essential to determining which variables are important to examine.³² All of the studies comparing children exposed to domestic violence with children from nonviolent homes used research designs that require that both groups of children share common characteristics. Although most studies controlled for child age and gender, as well as socioeconomic status of the family, fewer than half controlled for other family variables such as marital status, family size, and age of the mother. Even fewer studies controlled for ethnicity, child health, or family stress. In addition, only about half of the studies had sufficient numbers of participants to detect significant differences between the study and control groups.³³ And, at present, research tools designed specifically to assess children exposed to domestic violence do not exist,²⁹ so studies use general psychological checklists, which may be culturally biased and unrepresentative of low-income children from highly stressed families.^34,35 Clearly, the field must develop standardization measures for assessing child functioning in the context of domestic violence.