Healing, Justice & Trust

A National Report on Outcomes for Children's Advocacy Centers 2019 - Download Report (PDF)

What is the National Children's Alliance?

NCA is the national association and accrediting body for the largest network of care centers for child victims of abuse in the United States - more than 880 Children's Advocacy Centers (CACs). We provide support, advocacy, quality assurance, and national leadership for CACs, all to help support the important work they do in communities: CACs provide a coordinated, evidence-based response to children who have been abused.


What are CACs and how do they help kids?

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. CACs change all that.

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 multi-disciplinary team (MDT) that includes medical professionals, law enforcements, mental health, prosecution, child protective services, victim advocacy, and other professionals makes decisions together about how to help the child. Finally, CACs offer a wide range of services like therapy, medical exams, courtroom preparation, victim advocacy, case management, and more.


CACs provide healing, justice, and trust for child victims of abuse

This past year, CACs demonstrated that their module works through the results of more than 73,000 surveys from caregivers and MDT members collected through our Outcome Measurement System (OMS). Here are some highlights that show our families and partners believe in the healing, justice, and trust we provide.



The CAC movement is growing and improving.

With 881 member CACs serving 367,797 children in 2018, NCA represents a growing movement providing more and better services to children and families nationwide. In the last 10 years, the number of NCA members serving kids has grown 29%. Compared to 2008, in 2018 our member provided...


  • 43% more children with mental health services
  • 69% more children with onsite forensic interviews
  • 22% more children with medical exams/treatment
  • 306% more children and family members with case management services
  • 92% more children, family members, and community members with prevention education

And served...

  • 90% more child victims of physical abuse
  • 86% more child victims of neglect
  • 155% more child witnesses to violence
  • 66% more children endangered by drugs

There's no one-size-fits-all CAC. They may be independent nonprofits, hospital based or part of the government; rural or urban; have large budgets or small; and serve clients from diverse backgrounds. What doesn't vary is quality. In 2018, NCA partnered with research consultants to compare feedback from OMS and found consistently high caregiver and team member satisfaction. No matter how they're structured, CACs help children heal.


The need remains

Despite the success of the CAC model in helping children who have been victimized by abuse, there's still an outstanding need for more CAC coverage and more support. Stats in red below have a lower proportion of counties covered by CACs while states in blue have a higher proportion of CAC-served counties or have full coverage.


Funding and legislative support helps ensure children across the country have access to a CAC when they need it, and helps expand capacity and geographic coverage to reach more children and families with the services they need. Thank you for your support for this crucial resource for children and families in communities across the country.

This project was supported by Grant #2018-CI-FC-K003 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication are those of the authors and do not necessarily reflect those of the Department of Justice.