Preventing Violence against Children and Youth

The headline, “Children Are No Safer One Year After School Shooting” in my local Sunday paper (Willey, 2024) prompted the thoughts I am sharing with you today. Last year, I had described the school shooting referenced by Willey in a previous editorial (Thomas, 2023). On a lovely spring day, a troubled individual in Nashville, Tennessee, had fired 152 rounds, murdering three 9-year-old children along with educators and a custodian at their school (Hassan & Cochrane, 2023). Despite community outrage, no substantive changes were made in gun laws of Tennessee, where more children die from gun deaths than any other cause (Willey, 2024).

The surviving children attend school in a church that offered its spaces after the shooting. My thoughts today are about these survivors and the psychological sequelae of the murders. We know from research that experiencing violence in childhood places children at risk for poor educational outcomes (Fry et al. 2018) and mental health issues, such as substance misuse, depression, and suicidal behavior, later in life (Fazel et al. 2024). These children and their grieving families need not only our strong support but also our activism to combat future violence against children.

Approximately 1 billion children across the globe are ­victims of violence every year, many of them experiencing more than one type of violence (CDC.gov/violenceprevention/childabuseandneglect/vacs/fastfact.html). Glancing through the pages of this journal during my years as editor, the outcomes of experiencing and witnessing violence during childhood are often portrayed, along with suggested therapeutic interventions. Back in 1996, Jones and Selder wrote about psychoeducational groups to promote effective coping in school-age children living in violent communities. Brandau and Rebello (2021) wrote about surviving cyberbullying. An article on services needed by children who witness violence was published in 2010 (Willis et al., 2010). Violence prevention has received less attention.

Violence prevention strategies have been promulgated by organizations such as the World Health Organization (WHO), which published INSPIRE: Seven Strategies for Ending Violence Against Children in 2016. The model interventions discussed in this report were based on evidence of effectiveness derived from high quality quasi-experimental or qualitative studies (WHO, 2016). The research demonstrated the effectiveness of measures such as enacting stricter gun licensing laws and banning corporal punishment of children. School psychoeducational programs decreased peer violence. The report is published in Arabic, Chinese, English, French, Russian, and Spanish, and can be downloaded free from WHO. A handbook is offered to guide implementation of the seven strategies.

Most violence interventions have not been properly tested, however. Implementing strategies that are not culturally appropriate may not only be unsuccessful, but also potentially harmful. That is why a new critical analysis of extant research is of great interest. Fazel et al. (2024) conducted an umbrella review of research on violence prevention interventions delivered to the general population, with findings that are particularly relevant to children and youth. This umbrella review included 16 meta-analyses published between 2010 and 2022, with a majority of articles focused on psychosocial interventions (e.g. child skills training, antibullying strategies), legislative and policy initiatives (e.g. gun laws), and gender-focused programs (e.g. sexual assault prevention). Outcome variables included aggression, bullying, sexual violence, and violent crime (including gun violence). Reviews in any language were considered.

The findings of this umbrella review (Fazel et al. 2024) are surprising in some aspects. While most psychosocial programs for children (such as child skills training) were effective, they had smaller effects than physical activity programs such as sports clubs. The strongest effects were for programs based on martial arts training. The specific type of martial arts training that was most effective was a traditional form emphasizing reflective and breathing techniques (see Hernandez & Anderson, 2015). Psychosocial anti-bullying training for school-aged children and youths was also consistently effective. Fazel et al. (2024) recommended further research on physical activity programs for youth, such as the sports clubs and martial arts training that were found effective in this umbrella review.

It should be noted that the Fazel et al. review of preventive interventions excluded studies focused on intervening with violent individuals or individuals deemed at high risk of perpetrating violent behavior, who would require more intensive and tailored interventions. The follow-up period in most studies was relatively short, indicating the need for studies with longitudinal designs. The researchers also acknowledged that most studies were done in higher income countries, limiting generalizability to low-and-middle income countries. For that reason, readers from lower income countries (where 80% of the world’s children live) may find the WHO (2016) document more useful; it contains examples of successful approaches in countries with fewer resources.

I welcome your manuscript submissions on any aspect of violence prevention against children and youth. Contributions from low-and-middle income countries would be especially welcome. The impact of violence on the world’s children is staggering, and it is time to intensify delivery of preventative initiatives and conduct longitudinal research on the outcomes.