In October 2020, as the leaves began to change colors, University Park was a shadow of its usual fall self. The campus was quiet and mostly empty; few were around to notice the families with young children entering Henderson Building and making their way to the softly lit suite that houses Penn State’s Child Maltreatment Solutions Network (CMSN).

The children are participants in the CMSN’s flagship Child Health Study, a large-scale research project launched in 2017 with a five-year, $7.8 million grant from the National Institutes of Health. The goal of the study is to understand how life experiences can affect children’s health and well-being in both the near and long term. The study is specifically concerned with how children who have experienced abuse are able to cope with trauma, including how the stress of this type of early adversity might manifest in biological changes tied to health and development outcomes. Until the COVID-19 pandemic hit, more than 400 children—many of whom had been involved with Pennsylvania’s child protective  services after experiencing some level of abuse or neglect—had already taken part in the study, which resumed in October after a seven-month pause. The children entering Henderson, with extensive COVID-19 protocols in place, would, like their pre-pandemic predecessors, spend an entire day in the CMSN suite while a team of trained research professionals conducted a broad array of psychological, physical, cognitive, neuroimaging, behavioral, emotional, and relational assessments. After participating in these assessments and completing science and art projects, the children would leave their handprint on one of the suite’s walls. They’d return home at the end of a long day with a Penn State T-shirt imprinted with a picture of their brain as it looked in their MRI, taken on a machine located in Chandlee Lab.

The Child Health Study exemplifies the CMSN’s mission: using research to improve outcomes for children by gathering evidence that will facilitate the design of intervention programs that states, communities, school districts, and families can implement, and by influencing policy reform at the local, state, and federal levels. Ultimately, the goal is to use hard data from a broad range of studies to better prevent children from experiencing neglect and abuse, and to promote safe, happy, and healthy childhoods for children at risk.

“Our central mission embodies how science can change lives,” says Jennie Noll, director of the CMSN. “We work with child welfare administrators and providers to identify pressing questions and address those questions empirically, such that we then have the traction to change the way child welfare works for children and families. Our work involves asking the right questions, applying state-of-the-art methods that are unassailable, and then translating that research into messages that resonate with policy and practice.”

It’s a tall order, and a particularly meaningful one given the institution that’s hosting it: The CMSN was set up immediately after, and in direct response to, the Jerry Sandusky scandal, which rocked the university community and tarnished its reputation when it emerged in 2011. People demanded answers—and, ultimately, tangible solutions, something concrete to address systems that were intended to protect children, and that had so clearly and tragically failed.

In that context, Noll says, the CMSN’s first mandate was to begin to figure out ways to stop such egregious acts from happening again. Penn State’s notoriety in the aftermath of the tragedy lit a fire under state legislators: Pennsylvania asked Noll and CMSN research faculty member Katelyn Guastaferro to conduct an in-depth sexual abuse prevention study, which led to the launch in 2018 of a unique state-university partnership that established a universal child sexual abuse prevention effort in five large Pennsylvania counties. This effort, the Safe and Healthy Communities Initiative, combines and coordinates several evidence-based sexual abuse prevention components, including: “Stewards of Children,” which teaches community members about spotting signs of sexual abuse and how to respond if they suspect it; “Safe Touches,” which educates second graders on the difference between safe and nonsafe touches and makes them understand that abuse is not a child’s fault; and “Smart Parents—Safe and Healthy Kids,” which teaches parents about sexual abuse, its impact on development, and ways they can recognize signs of abuse and protect their children from potential perpetrators.

photo Jennie Noll
classroom environment
Healthy Outcomes
Jennie Noll (above) leads the Child Maltreatment Solutions Network, which conducts a broad range of studies related to child health, with the goal of using data to improve the well-being of at-risk children in Pennsylvania and beyond.

These programs, says Noll, have been proven to change mindsets and attitudes on sexual abuse. Through them, she explains, “our goal is to enlist schools, parents, and adults within the community in a collective action to keep kids safe, ultimately decreasing rates of child sexual abuse at the state level. So far, we have trained over 14,000 kids and over 15,000 adults.”

Child sexual abuse awareness and prevention remain primary goals for CMSN researchers, and Noll herself heads a series of large studies, including one examining the social media behavior of 460 sexually abused teens between 12 and 15 to better understand how digital activity—including social media use, pornography consumption, and gaming—can impact child development, to inform internet safety campaigns for teens.

But child maltreatment, she says, is a huge and broad arena. Sexual abuse is the most sensationalized form, but children also suffer different forms of physical abuse, neglect, and emotional abuse. The CMSN’s research efforts are geared toward understanding the scope and gravity of child maltreatment, and the consequences different forms of maltreatment have on development.

To that end, a broad swath of research—efforts that have been backed by more than $40 million in federal funding since 2013—falls under the CMSN’s umbrella: One current study is investigating how childhood stress can impact gene expression, which can promote disease and accelerate cellular aging. Others are focused on the development of children adopted from the foster care system; the impact of interventions on how youth in foster care transition to adulthood; the effectiveness of child welfare interventions on child development; and how the stress processes of early abuse can impact the immune system.

“Very often, things that happen in childhood do not manifest until the adult years,” says Sandee Kyler ’99 Edu, the network’s assistant director. “We’re trying to assess whether there are interventions that could be put in place before the mental and physical problems become more serious and before they affect people in their adult years, so that we can turn that trajectory into a more positive outcome.”

Unfortunately, the arc of science is slow to bend. It can take months, sometimes years, for any significant study to conclude. Science is where “the rubber meets the road,” says Max Crowley, associate professor of human development and family studies, and director of the Evidence-to-Impact Collaborative, a research center that works with the CMSN to distill science for lawmakers. “Since 2017, we have received hundreds of requests from policymakers about our science that we have been able to address,” Crowley says. “That highlights how much Penn State’s child maltreatment research has been elevated over this decade, so that we are now not just the place where Sandusky happened, but a leader in the scientific response to child maltreatment. We are the country’s leader in understanding how science can be an instrument in change for the better.”

 

sign on door

 

When they learned, nearly a decade ago, that children had been abused on the Penn State campus, faculty members such as Susan McHale were shocked, saddened, and humbled.

“Our faculty has long been recognized for its work on behalf of children and their families,” says McHale, Distinguished Professor of Human Development and Family Studies and director of the university’s Social Science Research Institute. “My own field is child development, and I’ve been at Penn State my entire career—so mounting evidence of this predator’s crimes, and our understanding of the devastation they brought, motivated a deep and widespread desire among our faculty to launch an academic response to this tragedy.”

That response—and McHale played an integral role in it—would lead to a 30-member interdisciplinary Presidential Task Force and result in a proposal to leverage Penn State’s expertise in teaching, research, and clinical practice to combat child abuse through designing novel approaches to prevention, detection, and treatment, disseminating research-based knowledge through education and outreach, and applying that knowledge to develop effective child welfare policies. It laid the foundation for the Child Maltreatment Solutions Network, which officially came into existence through a 2012 grant from the provost’s office that enabled a cluster hire of 12 faculty from five different Penn State colleges and brought Noll to Penn State in 2013 from Cincinnati Children’s Hospital, where she served as director of research in the division of behavioral medicine. She liaised across the university to create interdisciplinary research partnerships, and her efforts also gave rise, in 2015, to the establishment of an undergraduate minor in child maltreatment and advocacy studies that includes a field placement capstone experience.  In 2017, the CMSN received national recognition through funding from the NIH to establish Penn State as a national capstone center for child maltreatment research and training, named the Center for Healthy Children. The first of its kind in a university setting, the Center for Healthy Children established Penn State’s CMSN as a national resource for cutting-edge research, training scientists and advocates, and promoting evidence-informed policy through studies including the flagship Child Health Study.

Since 2017, the University of Rochester and Washington University in St. Louis have also received funding to set up capstone centers for child maltreatment research. But Crowley cites the CMSN’s research expenditures, its senior leadership in the field, an unprecedented training mission, and the more than 500 researchers it has trained across the country to serve as a rapid response network for policymakers, as evidence of Penn State’s commitment to this issue.

“We’ve got people at universities, at nonacademic research shops, career researchers with expertise, and early-career people working on new problems,” he says. “We’re now serving the whole country and providing research to many state legislatures, so whenever a member of Congress asks us a question, we can connect them to a researcher in their state.”

The success of that model rests partly on Noll’s experience working with policymakers and translating hard science into something they can understand and potentially act upon. She knows the power of appealing to legislators with stories of abuse survivors, then backing those accounts with hard data. The CMSN now has such a solid reputation at the state and national levels that lawmakers actually seek help in garnering research that will support child welfare policy reform.

“Pennsylvania child welfare administrators asked us to perform a time-use study of caseworkers, so we did a very sophisticated empirical study based on administrative data to quantify how much time it takes to work a case,” she says of a recent example. “Data from that study was used to change caseload sizes at the state level.”

Not every CMSN researcher has Noll’s comfort level speaking with lawmakers. That’s where Crowley comes in. He came to Penn State from Duke University, where he and Taylor Scott, an assistant professor at Penn State’s Prevention Research Center, developed a research-to-policy model that demystifies science for a broader audience. His team works closely with researchers to distill their data into a format that’s easy for lawmakers to digest and coaches researchers on how to speak to legislative groups. “There are logistical and cultural differences between scientists and policymakers, so we’re training researchers in that context on how to present to an informed but lay audience,” Crowley says. “We even teach them how to manage their body language.”

 

The pandemic has placed an inordinate amount of stress on families, and children often bear the brunt of their parents’ tensions—job insecurity, unemployment, illness, substance abuse, domestic violence. Child abuse rates have also been impacted: Because many children have been attending school remotely, far from educators and experts trained to recognize the signs of abuse, fewer cases are being reported, but those that are seem far more severe.

COVID-19 has also constrained budgets, and there are concerns that funding could be stripped from child welfare programs. Such circumstances make the CMSN’s work more important than ever and reinforce an even greater need to keep research going and put data in front of lawmakers.

“The fact that 12.5% of kids in the country will experience some form of abuse by the time they turn 18 . . . we’re talking about a prevalent and very costly problem that should be recognized as a public health issue,” Noll says. “The consequences—substance abuse, obesity, teen pregnancy, mental health issues, intergenerational transmission, and so on—can be avoided if we prevent maltreatment to begin with.”

Noll hopes that the Child Health Study will enroll 1,200 children across Pennsylvania by 2022 and then will follow them as they grow, with reassessments every two years. “Our assessments can reveal abnormalities in terms of things like physical and mental health, educational milestones, brain development, problems with parents or within the family, and even instances of re-abuse. If we find anything, we ensure that the families get hooked up with the appropriate services,” Noll says. “If they don’t have a primary care provider, for example, we’ll try to get them one. We also have a large focus on kids who are developing well even in the face of pretty severe adversity. This type of information will help us advance novel treatments that promote resilience.”

Being part of an effort to protect a greater number of children and give them a shot at a better adult life is an important and noble goal. Susan McHale calls it the highlight of her career. Nothing can erase the suffering endured by survivors of Sandusky’s crimes, but the scope and success of the efforts they inspired is their legacy. “Penn State,” says Noll, “is now part of the solution.”