Detecting child abuse by studying the parents.

Children have been abused by their parents and other adults from time immemorial. When children were considered chattel, the problem of child abuse was largely dormant. As the concept of child-as-person evolved during the nineteeneth and twentieth centuries, the groundwork was laid for increased public interest and concern. • The therapeutic optimism of the 1950s and the thrusts toward social programs and the rights of individuals in the 1 960s provided an ideal atmosphere for change. Thus, when Kempe et al. 3 described the "battered child syndrome" in 1962, the U.S. Children's Bureau drew up model legislation for reporting child abuse and, within four years, aroused legislators in every state had passed child abuse reporting laws. So great was the flurry of activity on the national, state, and local levels that by 1979, more than 1.1 million cases of child abuse were being reported annually-an eight-fold increase in reported cases in just 20 years. 5 Child abuse is not only prevalent; it offends our sensibilities. Children are both physically and emotionally defenseless and the long-lasting effects of the physical and emotional trauma can be crippling. When such abuse is reasonably suspected, child protection agencies and, often, the courts launch an investigation. This investigation has two phases. First, the facts must be established. Did the abuse actually occur? If so, in many cases it is important to identify the abuser, seldom for criminal prosecution but to determine whether the abuser should have help and/or continued contact with the child. This is the adjudication phase. Second, if it has been determined that the abuse did occur, the investigating agency must evaluate the various options for handling the situation for the best possible outcome for the child. This is the disposition phase. In my opinion, unless the investigating agency or court has established actual abuse (or neglect), it should back off and not procede to the second phase; this would be unwarranted government intrusiveness. Professionals and legislators have a variety of definitions of child abuse; they range from actual physical abuse to vague concepts of emotional abuse without any physical trauma whatsoever. In this article, I shall confine the term to nonaccidental physical injury of a child or sexual contact between