No agreement exists regarding the definition of maltreatment. However, it is clear that our cultural support for domestic violence and inadequate child care, the concepts of family autonomy and parental ownership of children, and the stresses of daily social and economic life all combine to produce psychosocially impoverished families and physically damaged children. Factors contributing to child maltreatment include economic and social stress, particular ethnic and cultural values, poor general coping skills and parenting skills, a history of maltreatment in the parent's background, and other characteristics. Appropriate responses include therapeutic services or permanent removal of the child, intensive casework, interdisciplinary teams, and preventive education and support. Child maltreatment is a source of developmental harm, and many handicaps may be the result of earlier maltreatment. Many handicapped children also experience heightened risk of abuse and neglect. However, handicapped children with highly motivated and competent parents may be at lower risk than usual.