NOTWITHSTANDING A CENTURY'S EXPERIENCE IN THE AMERICAN CHILD WELFARE MOVEMENT AND MORE RECENTLY CONTRIBUTIONS FROM NOTABLE EXPERTS, THE U.S. SERVICE SYSTEM IS STILL UNABLE TO PROMOTE THE SAFETY AND WELL-BEING OF MANY CHILDREN. BECAUSE OF A LACK OF SOLID THEORETICAL AND PRACTICAL UNDERSTANDING OF THE ORIGINS OF CHILD ABUSE, OUR CLINICAL WORK IS AT BEST INTUITIVE AND KIND, AT WORST REFLEXIVE AND MEAN. PART OF THE PROBLEM ARISES FROM THE LACK OF DEFINITION OF WHAT CONSTITUTES CHILD ABUSE. SUCH TERMS AS 'BATTERED CHILD SYNDROME' HAVE STRONG IMPLICATIONS WHICH NEGATIVELY AFFECT THE SERVICES PROVIDED ABUSIVE FAMILIES. REQUIRED QUESTIONING OF PARENTS TO FERRET OUT FACTS ARE CLINICALLY UNHELPFUL, ETHICALLY ABSURD, AND INTELLECTUALLY UNSOUND. SUCH DIAGNOSTIC PROCESSES RESULT IN FURTHER ALIENTATION OF ISOLATED, FRIGHTENED, AND CONFUSED ABUSIVE FAMILIES, THEREBY DESTROYING ANY CHANCE OF EFFECTIVE TREATMENT. A TWO PHASED STUDY OF 962 CHILDREN AT THE HOSPITAL FOUND A SIGNIFICANT OVERLAP IN PRIOR AND CURRENT STRESSES ACROSS SOCIAL CATEGORIES, SUGGESTING THAT THE CIRCUMSTANCES ASSOCIATED WITH CHILD ABUSE ARE WIDESPREAD AND GENERALLY IGNORED IN CLINICAL PRACTICE. THE STUDY SUPPORTS THE CONCEPT OF CHILD ABUSE AS A SYMPTOM OF FAMILY DISTRESS RATHER THAN AS THE ACTIONS OF SICK PARENTS. TREATMENT, AND ULTIMATELY, PREVENTION, OF THIS SYNDROME, THEREFORE, IS BEST CONCEIVED IN RELATION TO THE SOCIAL ECOLOGY OF FAMILY LIFE. (KCP).