CHILD ABUSE AND NEGLECT HAS EXISTED OVER THE CENTURIES IN VIRTUALLY ALL SOCIETIES. IT IS ONLY IN THE 1960'S THAT THE EXTENT OF CHILD ABUSE AND NEGLECT IN THE U.S. BECAME APPARENT AND THAT EFFORTS WERE EXPENDED TO COMBAT IT. CHILD ABUSE AND NEGLECT REFERS TO THE PHYSICAL OR MENTAL INJURY, SEXUAL ABUSE, NEGLIGENT TREATMENT, OR MALTREATMENT OF A CHILD UNDER 18 BY A CARETAKER. WHILE THE ACTUAL INCIDENCE OF ABUSE AND NEGLECT IS IMPOSSIBLE TO DETERMINE, THE BEST ESTIMATES ARE THAT 1.0 PERCENT OF CHILDREN UNDER 18 IS PHYSICALLY OR SEXUALLY ABUSED OR SEVERELY NEGLECTED. EARLY IDENTIFICATION AND TREATMENT IS IMPORTANT TO PREVENT RECURRENCE OF THE PROBLEM AND INCREASES IN MORBIDITY AND MORTALITY. THIS WILL REQUIRE THE COLLABORATIVE EFFORTS OF THE HELPING SERVICES AND AGENCIES, THE JUSTICE SYSTEM, THE COMMUNITY, AND OTHER COMMUNITY AGENCIES AND INSTITUTIONS. INDICATORS OF ABUSE IN THE CHILD MAY INCLUDE ANY INJURIES IN CHILDREN UNDER 12 MONTHS, GROSS OR MULTIPLE INJURIES IN ANY CHILD, INTRACRANIAL INJURIES, OR REPEATED INJURIES. WEIGHT LOSS, MALNUTRITION, OR DEHYDRATION ARE SIGNS OF NEGLECT. GENITAL TRAUMA OR VENERAL DISEASE MAY BE SIGNS OF SEXUAL ABUSE. LESS SERIOUS CASES REQUIRING ACTION MAY INVOLVE REPORTS OF EXCESSIVE CORPORAL PUNISHMENT, BRUISES, DIAPER RASH, OR SEXUAL EXPLOITATION OF OLDER CHILDREN. INDICATORS OF RISK FOR CHILD ABUSIVE BEHAVIORS IN CARETAKERS MAY INCLUDE INAPPROPRIATE AFFECT, INADEQUATE HISTORY OF INJURY OR FAILURE TO SEEK PROMPT MEDICAL CARE, INAPPROPRIATE EXPECTATIONS OF THE CHILD OR UNREASONABLE DISCIPLINE, ANGRY/IMPULSIVE BEHAVIORS, STRESS, ISOLATION, SUBSTANCE ABUSE, AND CHILDHOOD HISTORY OF ABUSE OR NEGLECT. IN CASES OF SUSPECTED ABUSE, DETAILED AND ACCURATE INTERVIEWING AND OBSERVATION ARE NECESSARY. IN MOST STATES PROVED AND SUSPECTED ABUSE/NEGLECT MUST BE REPORTED. TREATMENT SHOULD BE MULTIDISCIPLINARY, COMPREHENSIVE, AND INVOLVE THE ENTIRE FAMILY; FOLLOWUP IS CRUCIAL TO ULTIMATE CASE OUTCOME. SPECIAL PREVENTIVE EFFORTS SHOULD BE FOCUSED ON HIGH RISK CHILDREN AND PARENTS (I.E., HANDICAPPED CHILDREN, SOCIALLY ISOLATED PARENTS). INSERVICE EDUCATION OF PROFESSIONALS AND PARAPROFESSIONALS AND COMMUNITY EDUCATION ARE URGED. THE IMPORTANCE OF INTERAGENCY COORDINATION AND COLLABORATION IS STRESSED. PROGRAM EVALUATION IS ESSENTIAL TO EFFECTIVE SERVICE DELIVERY. CHILD ADVOCACY AND UTILIZATION OF VOLUNTEERS ARE BRIEFLY DISCUSSED. A LIST OF INFORMATION RESOURCES AND REFERENCES IS PROVIDED. THE CHILD ABUSE PREVENTION AND TREATMENT ACT IS APPENDED. (JAP)