A child is likely to be at risk for abuse or neglect when a caretaker is experiencing chronic, situational, or precipitating stress. Stressors include poverty, a crisis situation, and unrealistic expectations of the child. In addition, investigators should ask the parent or caretaker to describe their own childhood experiences with discipline to understand and diagnose intergenerational abuse. Parent and family characteristics that place a child at high risk for abuse include transference, chemical dependency, social isolation, and personality disturbances. The child's temperament may also contribute to the onset of abuse, as indicated by cases involving an easygoing child, a difficult child, and a child who is slow to respond to adults. Investigators should also consider the role of cultural and religious doctrines, including the use of biblical doctrines. After assessing these factors, the investigator should determine whether the diagnosis of abuse can be affirmed. The four behaviors that should be present for affirming such a diagnosis include tangible behavior intentionally inflicted on the child, proven injury, a causal link between the intentional behavior and the harm to the child, and sufficient abuse to demand intervention. Figure and 55 references