CAPSTONE Centers for Multidisciplinary Research in Child Abuse and Neglect

Program seeks Council approval to renew the initiative, “CAPSTONE Centers for Multidisciplinary Research in Child Abuse and Neglect.” 

Need for Stimulation of the Field:

Although NICHD has long supported research on child abuse and neglect, major gaps remain, particularly in the area of child sexual abuse (CSA). In 2022, more than 59,000 U.S. children had substantiated cases of CSA; however, these cases likely represent only a small fraction of the true prevalence and lifetime impact of CSA. CSA can result in immediate physical and psychological harm, including death, and its effects often persist into adulthood. Survivors are at increased risk for chronic gynecological, gastrointestinal, sexual health, and mental health conditions, including post-traumatic stress disorder, anxiety, depression, and suicidality. CSA may also interact synergistically with other forms of child maltreatment, such as physical or emotional abuse, producing substantially greater risk for adverse outcomes than any single exposure alone. A review of more than 20 potentially synergistic pairs of childhood adversities identified sexual abuse as the most synergistically reactive adverse childhood experience.

The Need for Renewal of the Initiative:

Prior iterations of this initiative focused on child abuse and neglect more broadly.  The renewed initiative will focus specifically on CSA as a preventable yet understudied public health issue with serious lifelong consequences. 

The goal of the proposed RFA will be to address critical gaps in CSA research while incorporating a required translation component to demonstrate measurable public health impact. As national resources for the field, the Centers will support innovative, high-quality research through: (1) studies evaluating the efficacy and effectiveness of CSA interventions, with an emphasis on primary prevention; (2) longitudinal studies examining CSA risk and protective factors and associated chronic disease outcomes; (3) research on biological embedding and related health implications; and (4) projects that strengthen CSA data collection infrastructure and address gaps in existing data sources.

Prior Results:

Four Centers have previously been funded, each focused on a specific area of child maltreatment research through scientific studies and outreach activities. Key advances include: (1) the Child Welfare DataSMART project, in which investigators partnered with six states to develop a common data structure across longitudinal datasets to improve child maltreatment risk prediction, screening, and research on understudied populations; (2) studies examining the long-term health effects of child abuse and neglect in a cohort followed into middle adulthood, including impacts on offspring and underlying biological mechanisms; (3) the longitudinal Child Health Study, which investigates psychosocial, behavioral, and resilience factors that may mitigate biological embedding mechanisms associated with adverse health and transition-to-adulthood outcomes among survivors of child abuse and neglect, as well as development of a clinical decision rule for pediatric intensive care units to identify abusive head trauma in critically injured children; and (4) the application of causal data science methods to identify etiologic factors underlying child maltreatment, inform intervention targets, and develop clinician decision-support tools and related interventions for pilot implementation.

The proposed concept aligns with the NICHD Strategic Theme 4: Improving Child and Adolescent Health and the Transition to Adulthood

This proposed concept aligns with the PTCIB Violence Affecting Children Program and the corresponding Child Maltreatment and Interpersonal Violence portfolios.

Program Contact

Leah Gilbert
Pediatric Trauma and Critical Illness Branch (PTCIB)