Children thrive under Hawaii's Healthy Start.

Saving a child before the first blow is ever struck--that's what the highly successful Healthy Start program has been able to do since it was established statewide by the Hawaii Legislature in 1989.

Healthy Start begins when a child is born into a family where the odds are high that he could be abused or neglected.

"We have a success rate of about 99.8 percent accuracy in identifying the potential for child abuse," says Gladys Wong, Healthy Start director.

National profiles show children are most at risk when born to poor, young (under 24), unmarried women who never finished high school. Other factors include mothers from an ethnic minority, histories of substance abuse by one or both parents, or histories of child abuse or neglect in the family.

If a social worker determines a child may be a potential victim, Healthy Start services are offered. If the mother chooses to enroll in the program, paraprofessionals will visit her home regularly until the child turns 5.

"I really believe all new parents benefit from a home visitor who can help explain parent-child interaction, child development and other things," Wong says.

Wong adds that one of the goals of the program is self-sufficiency. "If you don't have food, we help you get it. If you don't have insurance, we assist you. The home visitor helps families learn what needs to be done and how to go about it."

An estimated three children die every day in the United States from abuse or neglect. Hawaii has come a long way in breaking that horrible cycle. Analysis of child abuse and neglect data has shown that such cases were averted in 99.7 percent of the Healthy Start program participants. During the project demonstration period from 1985 to 1988, there were no confirmed cases of abuse and only four cases of neglect reported in the 176 families enrolled. A state study showed a 1 percent abuse rate among Hawaii's at-risk families compared to a national rate of 20 percent.

On the mainland, with its 147 percent increase in child abuse and neglect reports (the percentage translates to an estimated 2.4 million children over the past 10 years), interest is growing in the island program. Oregon has passed legislation to start a similar program. The National Center for the Prevention of Child Abuse and Neglect is offering training and start-up funding for a program, Healthy Families of America, based on the Hawaiian model. For more information on the Hawaii program, call the Maternal and Child Health Branch, Family Health Services Division, Honolulu, Hawaii; [phone] or [phone].