Data came from 167 children and adolescents followed from ages 7 to 18 in British Columbia and Alberta. The analysis focused on physical abuse, physical neglect, verbal abuse, emotional neglect, and sexual abuse. Results revealed that less than 5 percent of these mistreatments occurred in isolation. Because the vast majority of abused children experience more than one kind of abuse or neglect, it was important to determine which combinations have the greatest effect. The analysis indicated that a combination of physical neglect, physical abuse, and verbal abuse had the greatest impact on children, affecting such things as their enjoyment of living and their hopes for the future. In addition, an early age of onset for verbal abuse and emotional neglect was significantly associated with greater severity and frequency of abuse. Neglect also appeared to be a precursor to abuse in many cases. Tables and 22 references (Author abstract modified)