The study sample consists of 53 children targeted by the local Indian Health Service Hospital Child Protection Team as being abused and/or neglected. In addition, information on the parents, grandparents and, in a number of cases, great-grandparents is examined. Results indicate that alcohol abuse was present in 85 percent of the neglect cases and in 63 percent of the abuse cases. In addition, child abuse and neglect occurred simultaneously in 65 percent of the sample. Child abuse and neglect are found to be part of a larger phenomenon of multiproblem families which raises the issue of intergenerational perpetuation of these problems. 5 tables, 40 references. (Author abstract modified)