SEEK was developed to take advantage of primary health care to help prevent child maltreatment. Considerable progress had been made identifying abused and neglected children, but much room remained (and remains) for preventing maltreatment – before it occurs. A review of the research literature revealed certain risk factors to be commonly associated with child abuse and neglect: parental depression, major stress, substance use, intimate partner violence, harsh punishment and food insecurity. This list is clearly not inclusive, but it prioritizes problems for which some services are often available. It was thought that if we could help with these problems, we should see fewer maltreated children. Importantly, we should also see stronger families, healthier parents and parenting, and children’s improved health, development and safety. This is the cascade SEEK hoped (and hopes) to set in motion.

Two large, federally-funded studies of SEEK were conducted, one in a high risk urban population, the other in a relatively low risk suburban population. The findings were very encouraging, showing lower rates of child maltreatment in families exposed to the SEEK approach.

Steadily, increasing numbers of practices have been adopting the SEEK approach, and their experience has been very positive. Parents too appear grateful for the interest shown in the whole family. This experience has helped further develop SEEK. For example, the Parent Questionnaire was revised in 2017 based on feedback from the field.

SEEK project staff have been working with two software companies to help implement the approach electronically. This seems important as healthcare is rapidly incorporating software to facilitate practice and documentation.

Inevitably, a project such as SEEK is a work in progress. A grant from the NICHD is enabling us to examine what facilitates and impedes adoption and implementation of the SEEK approach. We are particularly interested in comparing two training modalities: independent learning and the Maintenance of Certification level 4 SEEK Activity, approved by the American Board of Pediatrics. We are also studying the cost of implementing SEEK as well as its effectiveness in preventing child maltreatment.