NOTING THAT ADVANCED CASES OF CHILD ABUSE ARE FREQUENTLY IRREVERSIBLE AND DIFFICULT TO REMEDY, EARLY IDENTIFICATION OF CHILD ABUSE AND SUBSEQUENT INTERVENTION ARE TARGETED AS HAVING HIGH PRIORITY IN A STRATEGY TO CURTAIL THE EFFECTS OF CHILD ABUSE. THE EMERGENCY ROOMS OF HOSPITALS ARE CONSIDERED THE MOST LIKELY PLACE WHERE CHILD ABUSE INJURIES WILL BE BROUGHT. IT IS ARGUED THAT CHILD ABUSE OFTEN PASSES UNNOTICED BECAUSE EMERGENCY ROOM PERSONNEL ARE NOT SCHOOLED IN RECOGNIZING THE SIGNS OF ABUSE AND IT IS RECOMMENDED THAT EMERGENCY ROOM STAFFS BE ACCLIMATED TO THE SPECTRUM OF COMMON CHILD ABUSE MANIFESTATIONS. A STUDY OF 156 CHILDREN SEEN IN THE EMERGENCY FACILITY OF THE UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE ATTEMPTED TO DISTINGUISH BETWEEN ACCIDENTS, REPEATED ACCIDENTS, AND CASES OF SUSPECTED ABUSE. IT WAS FOUND THAT 10 PERCENT OF THE SAMPLE HAD EXPERIENCED PHYSICAL ABUSE. THESE 17 CASES WERE NOT EQUALLY DISTRIBUTED AMONG THE TYPES OF INJURIES; HOWEVER, OVER HALF OF THE TOTAL SAMPLE HAD LACERATIONS OR WERE TREATED FOR INGESTION OF TOXIC SUBSTANCES, AND THIS GROUP WAS JUDGED A LOW RISK FOR CHILD ABUSE. ALL OTHER TYPES OF TRAUMA -- HEAD INJURIES, FRACTURES, BURNS, DISLOCATIONS, ABRASIONS, AND BRUISES -- WERE DEFINED AS A HIGH RISK GROUP. SIXTEEN OF THE SEVENTEEN ABUSE INCIDENTS FELL INTO THIS CATEGORY. THE IDENTIFICATION OF A HIGH RISK GROUP IS CONSIDERED IMPORTANT IN SCREENING CHILD INJURIES FOR EVIDENCE OF POSSIBLE ABUSE. IT IS BELIEVED THAT, WITH EARLY IDENTIFICATION, MANY ALTERNATIVES FOR FOLLOWUP SHOULD BE DEVELOPED. A COUNTYWIDE REGISTRY OF ALL CHILD INJURIES, FROM WHICH REPEATED INJURIES TO SPECIFIC CHILDREN COULD BE IDENTIFIED, IS ALSO RECOMMENDED AS A MEANS FOR THE EARLY DETECTION OF ABUSE. REFERENCES ARE PROVIDED. (RCB)