About National Children's Alliance & CACs
NATIONAL CHILDREN'S ALLIANCE (NCA) is the national association and accrediting body for a network of 854 Children’s Advocacy Centers—CACs. We provide support, advocacy, quality assurance, and national leadership for CACs, all to help support the important work that CACs do in communities across the country. CACs provide a coordinated, evidence-based response to child victims of abuse.
Our mission is to promote and support communities in providing a coordinated investigation and comprehensive response to child victims of abuse through child advocacy centers and multidisciplinary teams.
Why do children need Children's Advocacy Centers?
An estimated 1,564 children died from abuse and neglect in the United States in 20141, the most recent year for which there is national data. But child abuse fatalities are not the only consequences of abused children suffer. Sexual abuse, physical abuse, an neglect are forms of Adverse Childhood Experiences (ACEs) that researchers have linked to mental health problems, such as mood disorders, anxiety, substance abuse, and impulse control disorders.2 Child abuse often co-occurs with other ACEs, like witness to domestic or community violence, traumatic loss or separation, or sexual assault. Adults with multiple ACES have even been shown to be more likely to endure poor health outcomes like diabetes, STDs, heart disease, and early death.
In short, without intervention, child abuse causes lifelong problems.
But Children’s Advocacy Centers help kids by providing them with justice and healing from their abuse in a child-friendly setting they can trust. In addition to helping collect forensic evidence to help law enforcement and CPS protect children from abusers, CACs coordinate a complete response to the needs of a child after abuse. Last year, CACs around the country served more than 311,000 child victims of abuse, providing forensic interviews, evidence-based mental health treatments that are proven to reduce symptoms, case management, victim advocacy services, and more.
What is a CAC?
CACs are how communities mount a coordinated response to allegations of child abuse. To understand what a CAC is, you must understand what children face without one. Without a CAC, the child may end up having to tell the worst story of his or her life over and over again, to doctors, police, lawyers, therapists, investigators, judges, and others. They may not get the help they need to heal once the investigation is over, either.
When police or child protective services believe a child is being abused, the child is brought to the CAC—a safe, child-focused environment—by a caregiver or other “safe” adult. At the CAC, the child tells their story once to a trained interviewer who knows the right questions to ask. Then, based on the interview, a multidisciplinary team (MDT) that includes medical professionals, law enforcement, mental health providers, prosecution, child protective services, victim advocates, and other professionals make decisions together about how to help the child. Finally, they offer a wide range of services like therapy, medical exams, courtroom preparation, victim advocacy, case management, and more.
How do we know it works?
We know the services CACs provide work because the evidence shows it does.
Evidence from studies of mental health treatments
In a collaborative partnership among NCA, The Duke Endowment, Yale University, Children’s Advocacy Centers of North Carolina, and the South Carolina Network of Children’s Advocacy Centers, we launched an initiative to bring a promising, evidence-based treatment to children in the Carolinas who needed it. The Child & Family Traumatic Stress Intervention (CFTSI) has already demonstrated significant results. NCA will expand this important work in the coming years.
In this ongoing project, many children came in presenting high levels of Post-Traumatic Stress Disorder (PTSD) symptoms. Caregivers also reported that their children had high levels of PTSD symptoms, as well as other problems like nightmares, feeling scared, feeling worried, or having trouble concentrating in school, feeling lonely, not wanting to play, and having intrusive thoughts.
In the chart above3, the Child PTSD Symptom Scale (or CPSS, a common PTSD assessment for kids), shows the average child- and caregiver-reported symptom score before and after receiving the CFTSI therapy. Researchers and clinicians agree that scores of 11 or higher reflect significant distress, and indicate that a child may eventually qualify for a diagnosis PTSD upon further assessment. Children with scores of 15 or higher are almost certain to meet the full criteria for PTSD.
Children treated through this program whose symptoms were assessed before receiving CFTSI reported an average score of 20.86. On average, children reported high levels of trauma symptoms at the time they were first seen at the CAC. Following the brief mental health treatment, children and their caregivers both reported much lower levels of symptoms. Children reported with an average score of 8.96, which is below clinically significant levels.
Responses from caregivers
Children are usually brought to CACs by caregivers, who will support them in the months and years ahead as they recover from the abuse. NCA provides a standardized tool called the Outcome Measurement System (OMS) to CACs to collect feedback from caregivers and team partners to ensure CACs are doing the best possible job to support children and their families. 580 CACs participate in this program to ensure they are providing the highest quality care to caregivers.
Caregivers and kids feel safe
95% of caregivers agree their children feel safe at CACs.4
Caregivers feel informed
By the end of the first visit, 93% of caregivers report they know what to expect with the situation facing them and their children. Weeks later, 92% of caregivers still agree that, as a result of their contact with the CAC, they knew what to expect in the days and weeks after their visit.4 93% of caregivers agree they received information that helped them understand how to best keep their children safe in the future.4
Caregivers and kids leave feeling better
96% of caregivers agree, if they knew anyone else who was dealing like a situation the one their family faced, they would tell that person about the CAC.4
Types of NCA Members/NCA Structure
Children's Advocacy Centers (CACs) are child-focused, facility-based programs in which representatives from many disciplines work together to conduct interviews and make team decisions on cases of child abuse. CAC models for child abuse intervention are proven and effective, bringing together trained professionals to investigate and provide medical and mental health care as well as support to child victims of abuse, while holding offenders accountable through the court system. CAC locations are child-focused and designed to create a sense of safety and security for child victims.
CACs associated with NCA undergo an accreditation process that follows a regularly updated set of 10 standards established by the NCA board of directors that ensure effective, efficient and consistent delivery of services. Once accredited, CACs then localize the standards to meet the unique needs of individual communities. The accreditation process ensures that CAC programs adhere to rigorous standards of quality service provision known to be effective in helping children heal from the effects of abuse. Click here for a downloadable PDF of the NCA Fact Sheet. CACs are located across the country with services that generally include:
- Forensic Interviewing Services
- Forensic Medical Evaluations
- Victim Advocacy and Support
- Specialized Mental Health Services
- Community Education and Outreach
State Chapters are member organizations comprised of CACs within a given state, similar in structure to NCA. And, like the CACs they serve, no two Chapters are alike. State Chapters exist primarily to support their member CACs, assisting with the development, continuation and enhancement of the CAC model as promoted by NCA Standards for Accreditation. State Chapters also serve as a resource for their member CACs, facilitating a network within the state to support their members and the agencies involved in the investigation, treatment and prosecution of allegations involving child abuse. State Chapters are eligible to apply for accreditation with NCA, in a process that follows a separate set of standards from those for individual CACs.
Regional Children's Advocacy Centers (RCACs) were established by the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention. RCACs are funded separately from NCA, local CACs and State Chapters, but work in tandem with NCA to offer a full range of training, technical assistance, consultation and information to established and developing CACs. RCACs are also instrumental in assisting individual communities in developing a comprehensive and multi-disciplinary approach to child abuse intervention, increasing community understanding of child abuse and assisting in the accreditation application process for local CACs by clarifying membership standards and conducting site visits. There are four RCACs located within accredited CACs throughout the country:
- Northeast Regional (Serving Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont)
- Midwest Regional (Serving Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin)
- Southern Regional (Serving Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia)
- Western Regional (Serving Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington and Wyoming)
In 1988, representatives from children's advocacy centers around the country joined forces to establish the National Network of Children's Advocacy Centers. A decade later, in an effort to reflect the Network's national composition and focus, the National Network became known as the National Children's Alliance (NCA). In line with original intent, NCA continues to provide accreditation opportunities, financial assistance, training, technical assistance, research and education to communities, child abuse professionals and the more than 800 children's advocacy centers throughout the United States in support of child abuse intervention, advocacy and prevention.
1 U.S. Department of Health and Human Services: Administration for Children & Families. Child Maltreatment 2014. http://www.acf.hhs.gov/cb/resource/child-maltreatment-2014
2 Centers for Disease Control, 1998. https://www.cdc.gov/violenceprevention/acestudy/about.html
3 Ongoing National Children’s Alliance/Yale University/Duke Endowment study, Change in Trauma Symptoms in CFTSI Cases Completed at North Carolina and South Carolina Sites 3/1/15-1/31/16. N=97
4 National Children’s Alliance, Healing, Justice, & Trust: A National Report on Outcomes for Children’s Advocacy Centers, 2016.