AN ILLINOIS LAW PASSED IN 1965 REQUIRES MANDATORY REPORTING OF ALL DEFINITE OR SUSPECTED CASES OF CHILD ABUSE TO THE STATE DEPARTMENT OF CHILDREN AND FAMILY SERVICES. ALTHOUGH IT HAD BEEN HOPED THAT THE REPORTING OF ABUSE, TOGETHER WITH PUBLICITY AND EDUCATION, WOULD SERVE AS A DETERRENT, 6 YEARS LATER THE PROBLEM REMAINED. COOK COUNTY HOSPITAL, WHICH SERVES AN ECONOMICALLY DEPRESSED POPULATION, HOSPITALIZES AN AVERAGE OF 60 SEVERELY ABUSED CHILDREN EACH YEAR AND TREATS MANY OTHERS AS OUTPATIENTS. THESE CHILDREN ARE VICTIMS OF EVERY CONCEIVABLE TYPE OF TRAUMA AND OFTEN SUFFER MULTIPLE AND/OR REPEATED INJURIES. THEIR AGES RANGE FROM 2 WEEKS TO 14 YEARS. IN A GROUP OF 395 HOSPITALIZED ABUSED CHILDREN, 21.4 PERCENT WERE UNDER 1 YEAR OF AGE, AND 67 PERCENT WERE UNDER 3 YEARS OF AGE. THE DEATH RATE AMONG THESE CHILDREN WAS 10 PERCENT. MOST DEATHS RESULTED FROM SKULL FRACTURES, CEREBRAL CONCUSSIONS, SUBDURAL HEMATOMAS, SEVERE BURNS, INJURIES TO INTERNAL ORGANS, OR COMBINATIONS OF SUCH INJURIES. MANY VICTIMS WERE LEFT PHYSICALLY AND/OR MENTALLY HANDICAPPED, SOME WITH CONVULSIVE DISORDERS. FOR MOST, PERSONALITY CHANGES AND PSYCHOLOGICAL PROBLEMS COULD BE EXPECTED. MOTHERS ARE AMONG THE WORST OFFENDERS. OTHERS INCLUDE FATHERS, STEPFATHERS, BOYFRIENDS, SIBLINGS OR OTHER RELATIVES, BABYSITTERS, FOSTER PARENTS, AND GUESTS. ABUSERS COME FROM ALL STRATA OF SOCIETY AND USUALLY APPEAR QUITE NORMAL. MANY ABUSERS WERE THEMSELVES MISTREATED WHEN THEY WERE YOUNG. A DIAGNOSIS OF ABUSE SHOULD BE CONSIDERED FOR ANY CHILD WHO PRESENTS MULTIPLE INJURIES OR WHOSE INJURIES BELIE THE HISTORY GIVEN. X-RAYS ARE OF GREAT IMPORTANCE IN ESTABLISHING THE DIAGNOSIS OF ABUSE. ONCE THE DIAGNOSIS HAS BEEN MADE AND THE CHILD'S INJURIES TREATED, ATTENTION IS GIVEN TO THE FAMILY SITUATION. WHEN CASES ENTER THE LEGAL SYSTEM, A NUMBER OF PROBLEMS ARISE. PROSECUTORS FIND IT DIFFICULT TO PRODUCE PROOF OF ABUSE. JUDGES, WHO MUST ALSO PROTECT THE RIGHTS OF PARENTS SOMETIMES DENY PLEAS BY PEDIATRICIANS AND SOCIAL WORKERS FOR TEMPORARY REMOVAL OF A CHILD FROM A DANGEROUS SITUATION. ABUSING FAMILIES REQUIRE A MULTIDISCIPLINARY APPROACH TO REHABILITATION INVOLVING SOCIAL WORKERS, PEDIATRICIANS, PSYCHOLOGISTS, PSYCHIATRISTS, AND ATTORNEYS. ATTEMPTS ARE BEING MADE TO IDENTIFY AND ASSIST POTENTIAL CHILD ABUSERS. ANTICIPATED REFORMS OF ABORTION LAWS MAY MEAN FEWER UNWANTED BABIES, WHICH MAY IN TURN REDUCE THESE INCIDENCE OF CHILD ABUSE. A BIBLIOGRAPHY IS INCLUDED. (LKM)