Following a brief history of child abuse, guidelines for suspecting abuse are presented. Medical procedures required for filing an adequate report of suspected abuse are outlined. The requirements of mandatory child abuse reporting laws are provided, together with a discussion of civil, criminal, and professional liability associated with failures to report. A summary of reporting laws by State also is presented, and the issue of physician-patient relationships and confidentiality is discussed. Causes of abuse and neglect, such as parental stress or unrealistic expectations, are detailed; behavioral symptoms, indicative of possible abuse, that may be manifested by the child and the parent are presented. Also provided are protocols for nurses and physicians evaluating possible child abuse victims. Guidelines for the identification of various wounds are presented, including abrasions, contusions, lacerations, bone trauma and fractures, and burns. A checklist for medical diagnosis also is provided. Finally, physical and behavioral signs and symptoms of child sexual abuse are considered. An appendix includes a national resource directory, a glossary, photographs, and approximately 100 references.