THE 'BATTERED CHILD SYNDROME' AS INTRODUCED BY KEMPE IN 1962 IS DEFINED. AFTER DEVELOPMENT OF AN ORGANIZATION TO MANAGE THE PROBLEM AT PRESTON, ENGLAND, IN 1970, THE INCREASED NUMBER OF DISCOVERED CASES INDICATED THAT THERE MIGHT BE APPROXIMATELY 11,000 CHILD ABUSE CASES IN ENGLAND AS A WHOLE. DIAGNOSTICIANS ARE OFFERED MANY SUGGESTIONS FOR DETECTING CHILD ABUSE: SPECIFIC PHRASES USED BY PARENTS TO EXPLAIN A CHILD'S INJURIES, THE USE OF X-RAYS AND PHOTOGRAPHS, SPECIFIC RESPONSES OF THE CHILD WHEN APPROACHED FOR EXAMINATION, THE PLACEMENT AND PATTERN OF MARKS, AND SPECIAL CHARACTERISTICS OF HEAD BRUISES. INVESTIGATION BY THE DOCTOR ON THE FIRST MEDICAL VISIT IS ADVISED, AND FOR FURTHER INVESTIGATION, REFERRAL TO A HOSPITAL IS SUGGESTED. STRICT MEDICAL CONFIDENTIALITY APPLIES EVEN TO CHILD ABUSE IN ENGLAND, BUT THIS DIFFICULTY IN RELATION TO THE MEDICAL CODE OF ETHICS IS BEING CONSIDERED BY THE BRITISH MEDICAL ASSOCIATION. LEGALLY THE ABUSED CHILD IS AT A DISADVANTAGE SINCE HEARSAY EVIDENCE CANNOT BE ACCEPTED IN COURT; THE DOCTOR CAN GIVE ONLY FIRSTHAND KNOWLEDGE, AND THE PARENT WHO ORIGINALLY GAVE THE INFORMATION MAY REFUSE TO GIVE EVIDENCE. THE COURT THUS MAY HAVE NO LEGAL POWER TO DECLARE A CARE ORDER FOR THE CHILD'S PROTECTION, MAKING IT NECESSARY TO RETURN THE CHILD TO THE HOME. IN THE MEDICOSOCIAL FIELD, MORE RESEARCH SHOULD BE DONE ON CHILD ABUSE WITH RECOGNITION THAT NOT ONLY DOCTORS CAN BE OF HELP BUT ALSO HEALTH VISTORS, DISTRICT NURSES, AND MIDWIVES. REFERENCES ARE INCLUDED. (FCW)