The report presents a composite description of maltreated children and their families and discusses changes in the Federal response to child abuse and neglect. The report notes that, despite the emphasis on protecting children, hundreds of thousands of children are starved, abandoned, burned, severely beaten, raped, sodomized, berated, and belittled each year. An estimated 2.5 million cases of suspected child abuse and neglect are reported yearly, and direct and indirect costs of such maltreatment are enormous. The U.S. Advisory Board on Child Abuse and Neglect recommends that the child protection system be enhanced at all levels, including law enforcement, education, public health, mental health, courts, and private nonprofit agencies and organizations. Further, the Federal role in child protection should be comprehensive yet flexible. Six broad recommendations for change are offered: (1) develop and implement a national child protection policy; (2) prevent and reduce child maltreatment by strengthening neighborhoods and families; (3) provide a new focus on child abuse and neglect that strengthens families; (4) enhance Federal efforts related to generating, applying, and disseminating knowledge about child protection; (5) improve coordination among Federal, State, tribal, and private sector child protection efforts; and (6) implement a new Federal initiative aimed at preventing child maltreatment that pilots universal, voluntary neonatal home visitation. The Federal Government's performance in child protection is assessed, and the legislative history of the Child Abuse Prevention and Treatment Act (CAPTA) is reviewed. Additional information on recommendations of the U.S. Advisory Board on Child Abuse and Neglect and the text of the CAPTA are appended. Footnotes