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(Pediatrics in Review. 1981;2:197-207.)
© 1981 American Academy of Pediatrics
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Pediatric Understanding of Child Abuse and Neglect

Stephen Bittner MD1
Eli H. Newberger MD2
 1 Assistant in Pediatrics, Department of Medicine, Children's Hospital Medical Center, Boston; Instructor in Pediatrics, Harvard Medical School, Boston
2 Director, Family Development Study, Children's Hospital Medical Center, Boston; Assistant Professor of Pediatrics, Harvard Medical School, Boston

When C. Henry Kempe and his colleagues coined the term "battered child syndrome" in 1961, the attention of the American medical community was focused on one of the most dramatic manifestations of family violence. Since then family violence has been perceived as a major social problem, and the eyes of pediatricians have been opened to familial causes of morbidity and mortality.

In this paper the term "child abuse" is used to encompass all the symptom indicators of maltreatment of children, including physical injury, physical neglect, sexual abuse, and some ingestions of harmful substances. We address these problems not as discrete illness entities or syndromes, but as symptoms of different issues and risks for particular children in individual families.

Kempe noted that notwithstanding a long history of concern with child welfare, the pediatric community ignored the implications of injury and neglect of children because of a "process of denial that was unequal to anything ... previously seen in pediatrics." This denial continues today in spite of an increasing and visible literature on child abuse.

The task of this paper is to summarize current knowledge about the causes, differential diagnoses, and management of child abuse in a fashion accessible to pediatricians and members of the colleague disciplines.




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Copyright © 1981 by the American Academy of Pediatrics.