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...