The findings note a marked increase of approximately 10 percent in reported child abuse and neglect cases in 1989. While wide variation exists in reporting trends across the States, more States realized an increase in reports in that year. One of the main explanations for the increase in reports is the concomitant increase in substance abuse. Other social problems contributing to increases in severe maltreatment include poverty, lack of medical and child care, homelessness, domestic violence, and economic stress. In rural areas, inaccessibility to prevention services is another contributing factor. The expansion of child assault prevention education in schools, as well as general public awareness and media coverage, have probably led to an increased disclosure of prior or ongoing abuse. A final factor is the systemic or definitional changes taking place in some jurisdictions. The survey results indicate a need for expansions of child welfare budgets; child abuse hotlines; educational and support services to pregnant women and new parents; the current foster care system; comprehensive prevention services through existing medical, mental health, and educational systems; and coordination of services. 4 tables, 18 references.