title: Epidemiologic features of the physical and sexual maltreatment of children in the Carolinas.
abstract: BACKGROUND
  Child maltreatment remains a significant public health and social problem in the United States. Incidence data rely on substantiated reports of maltreatment known to official social service agencies.
  
  
  OBJECTIVE
  The objective of this study was to describe the epidemiologic features of child physical and sexual abuse, on the basis of maternal self-reports.
  
  
  METHODS
  Computer-assisted, anonymous, cross-sectional, telephone surveys (N = 1435) were conducted with mothers of children 0 to 17 years of age in North and South Carolina. Mothers were asked about potentially abusive behaviors used by either themselves or their husbands or partners in the context of other disciplinary practices. They were also asked about their knowledge of any sexual victimization their children might have experienced.
  
  
  METHODS
  The incidence of physical and sexual maltreatment determined through maternal reports.
  
  
  RESULTS
  Use of harsh physical discipline, equivalent to physical abuse, occurred with an incidence of 4.3%. Shaking of very young children as a means of discipline occurred among 2.6% of children <2 years of age. Mothers reported more frequent physical discipline of their children, including shaking, for themselves than for fathers or father figures. Nearly 11 of 1000 children were reported by their mothers as having been sexually victimized within the past year. The incidence of physical abuse determined with maternal self-reports was 40 times greater than that of official child physical abuse reports, and the sexual abuse incidence was 15 times greater. For every 1 child who sustains a serious injury as a result of shaking, an estimated 150 children may be shaken and go undetected. There was no statistically significant difference in the overall rates of physical or sexual maltreatment between the 2 states.
  
  
  CONCLUSIONS
  Official statistics underestimate the burden of child maltreatment. Supplemental data obtained with alternative strategies can assist policymakers and planners in addressing needs and services within communities and states. These data support the need for continued interventions to prevent maltreatment.
authors.affiliation: Department of Pediatrics, University of North Carolina, CB 7220, 5th Floor, Bioinformatics Building, Chapel Hill, NC 27599, USA. adrea_theodore@med.unc.edu
authors.forename: Adrea D
authors.initials: AD
authors.lastname: Theodore
authors.forename: Jen Jen
authors.initials: JJ
authors.lastname: Chang
authors.forename: Desmond K
authors.initials: DK
authors.lastname: Runyan
authors.forename: Wanda M
authors.initials: WM
authors.lastname: Hunter
authors.forename: Shrikant I
authors.initials: SI
authors.lastname: Bangdiwala
authors.forename: Robert
authors.initials: R
authors.lastname: Agans
mesh_terms: D000293:Adolescent; D002648:Child; D002649:Child Abuse / Q000706:statistics & numerical data*; D002650:Child Abuse, Sexual / Q000706:statistics & numerical data; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D016487:Parenting; D011678:Punishment; D038642:Shaken Baby Syndrome / Q000453:epidemiology; D013022:South Carolina / Q000453:epidemiology