EMERGENCY CARE FOR INJURED CHILDREN AND THEIR PARENTS MUST BE KEPT SIMPLE AND STRAIGHTFORWARD. EMERGENCY ROOM PHYSICIANS SHOULD CONSIDER THE DIAGNOSIS OF CHILD ABUSE IN ALL CASES INVOLVING TRAUMATIC INJURY TO SMALL CHILDREN. ALL PRESCHOOL CHILDREN AND MOST OLDER CHILDREN FOR WHOM CHILD ABUSE IS SUSPECTED MUST BE ADMITTED TO THE HOSPITAL SO THAT THE CHILD AND FAMILY MAY BE EVALUATED. PARENTS RARELY, IF EVER, SHOULD BE ACCUSED OR CONFRONTED BY THE EMERGENCY ROOM PHYSICIAN WHEN ABUSE IS SUSPECTED. THE EMERGENCY ROOM OR ADMITTING PHYSICIAN SHOULD CONSULT A PEDIATRICIAN AND/OR A SOCIAL WORKER EXPERIENCED IN CHILD ABUSE. PHYSICIANS SHOULD BE FAMILIAR WITH SIGNS AND SYMPTOMS IN PARENTS AND CHILDREN WHICH INDICATE THAT A DIAGNOSIS OF ABUSE SHOULD BE CONSIDERED. EARLY RECOGNITION OF ABUSE IS CRITICAL. GENERAL PRACTITIONERS, OBSTETRICIANS, AND THEIR NURSES AND RECEPTIONISTS SHOULD BE AWARE OF INDICATORS THAT MOTHERS-TO-BE OR NEW MOTHERS ARE LIKELY TO HAVE DIFFICULTIES WITH THEIR BABIES. FOR EXAMPLE, A NEW MOTHER WHO EXPECTS HER BABY TO SOLVE HER OWN EMOTIONAL PROBLEMS MAY INTERPRET THE CHILD'S CRYING AND ORDINARY INFANT PROBLEMS AS THE BABY'S REJECTION OF HER. SUCH MOTHERS TEND TO DESCRIBE THEIR BABIES IN NEGATIVE TERMS, AND A MOTHER'S DESCRIPTION THAT DOES NOT SEEM WARRANTED BY A BABY'S CONDITION OR BEHAVIOR IS AN IMPORTANT WARNING SIGN FOR THE PHYSICIAN. TRUE ACCIDENTS IN INFANCY ARE RARE, AND ANY INJURY TO A SMALL BABY MUST BE CONSIDERED HIGHLY SUSPECT. INITIATION OF TREATMENT WHEN AN INFANT SHOWS SIGNS OF MILD BATTERING (E.G., MOUTH ABRASIONS, USUALLY CAUSED BY FORCED FEEDING OR SLAPPING OF A CRYING CHILD) CAN PREVENT FURTHER INJURY THAT MAY BE MORE SEVERE OR EVEN FATAL. MEDICAL PERSONNEL AND SOCIAL WORKERS MUST DEVELOP RAPPORT WITH PARENTS SO THAT ADEQUATE FOLLOWUP AND PROTECTION FOR AN INJURED CHILD IS ASSURED. WHEN THE COURT PLACES A CHILD UNDER THE TEMPORARY CARE OF A CHILD WELFARE AGENCY, THE REFERRING PHYSICIAN SHOULD CONTACT THE AGENCY AND COURT TO MAKE CERTAIN THAT THE CHILD WILL NOT BE RETURNED HOME WITHOUT THE PHYSICIAN'S KNOWLEDGE. A LIST OF SIGNS AND SYMPTOMS OF ABUSE AND GUIDELINES FOR DETERMINING WHETHER A HOME IS SAFE FOR A CHILD ARE INCLUDED. (LKM)