Guest Blogger: Sandra Alexander

My mother was a teacher during the time when teachers made regular home visits. Growing up, I remember going with her on some of these visits, wondering about the different kinds of homes, behavior, and environments of some of my school peers.

Some kids in school bullied other kids, others showed up at school with injuries, and some did not show up at all. My mother, in her calm, steady way, would explain to me that families had different kinds of struggles and that kids’ behaviors reflected the kind of environments, relationships, and challenges they have in their life.

In the early 70s, right out of college, I began my career as a child protective services, foster care, and adoption case worker. I received calls in the middle of the night about runaways, worked with children who were emotionally abused and neglected, and met the police in emergency departments where children were being treated for broken bones, multiple bruises, malnourishment, marks from hot irons, head injuries from shaking, or sexual abuse. Some children did not survive the abuse in their own homes. Those cases left me feeling that we sometimes had too little to offer, and often much too late.

The perception of child maltreatment and what we know about the importance of safe, stable, nurturing relationships for children has definitely changed since I first started in this field more than 40 years ago.  Today, there are more open conversations and coverage in local and national news, multidisciplinary teams to review child deaths and to make prevention recommendations, and more knowledge about risk and protective factors and effective prevention strategies. We know so much more about the association between child maltreatment and health and well-being later in life through the Adverse Childhood Experiences (ACE) Study and about early brain development.

Recognizing child maltreatment as a public health issue, the national leadership of the CDC  Injury Center, and a cadre of prevention partner organizations working together have been central to moving the prevention field forward.  And yet, thousands of children are still abused and neglected every year! That’s why I will keep doing what I do.

For the past seven years, I’ve had the opportunity to contribute to expanding a public health approach to prevention at the national level as an expert consultant on child maltreatment for the CDC Injury Center. The life-lessons that my mother taught me and the hard lessons I learned about inequities from the families I worked with continue to fuel my passion and vision for a world where all children grow up in safe, stable, and nurturing environments.