INTERVIEWS WERE COMPLETED WITH 1,696 PERSONS IN 1,760 ORGANIZATIONS, INCLUDING CHILD PROTECTIVE SERVICES, PUBLIC HEALTH NURSING AGENCIES, SCHOOL SYSTEMS, HOSPITALS, JUVENILE AND FAMILY COURTS, AND POLICE DEPARTMENTS. THE ORGANIZATIONS WERE SELECTED ON THE BASIS OF A PROBABILITY SAMPLE OF THE UNITED STATES POPULATION. IN ADDITION, INDEPTH INTERVIEWS WERE CONDUCTED IN A NUMBER OF COMMUNITIES WITH JUDGES, PHYSICIANS, POLICE OFFICERS, SOCIAL WORKERS, PUBLIC HEALTH NURSES, AND OTHERS IN ORGANIZATIONS ENCOUNTERING CHILD ABUSE AND NEGLECT. RESEARCHERS ALSO ATTENDED COURT SESSIONS AND TOURED PEDIATRIC WARDS AND OTHER FACILITIES. BASED ON THE RESULTS OF THESE EFFORTS, THE STUDY REPORT EXAMINES THE RIGHTS OF CHILDREN AND PARENTS, THE STATUS OF KNOWLEDGE AND TECHNOLOGY IN THE FIELD OF CHILD ABUSE, THE RELATIVE MERITS OF PUNITIVE AND THERAPEUTIC APPROACHES, AND THE DOMAINS OF ORGANIZATIONS AND PROFESSIONS INVOLVED IN COMBATING CHILD MALTREATMENT. VARIOUS ESTIMATES OF THE PREVALENCE OF CHILD ABUSE AND NEGLECT ARE COMPARED, AND AN ALTERNATIVE APPROACH IS SUGGESTED FOR OBTAINING CONFIRMABLE ESTIMATES WITHIN THE CONSTRAINTS OF EXISTING STATUTES AND ORGANIZATIONAL PRACTICES. ELEMENTS OF AN EPIDEMIOLOGICAL THEORY OF CHILD MALTREATMENT ARE OUTLINED. PROBLEMS ENCOUNTERED IN ATTEMPTING TO DEAL WITH CHILD MALTREATMENT (CASE IDENTIFICATION, RESPONSE TO REPORTS OF ABUSE AND NEGLECT, PROVISION OF SERVICES, CUSTODY AND PLACEMENT, PROGRAM COORDINATION AND IMPROVEMENT) ARE ANALYZED. AN OPTIMAL CHILD ABUSE-NEGLECT PROGRAM IS OUTLINED, AND THE STATUS OF EXISTING PROGRAMS IS ASSESSED. RECOMMENDATIONS FOR IMPROVING THE ORGANIZATIONAL RESPONSE TO CHILD MALTREATMENT TOUCH ON SPECIFIC PROGRAM COMPONENTS, COORDINATION AT THE COMMUNITY LEVEL, THE FUNDAMENTAL PROBLEMS BESETTING THE INSTITUTION OF THE FAMILY, AND THE FEDERAL ROLE. SUPPORTING DATA ARE INCLUDED. (AUTHOR ABSTRACT MODIFIED--LKM)