Update on child maltreatment with a special focus on shaken baby syndrome.
OBJECTIVE
The many forms of child maltreatment exact an unacceptably heavy toll on our children. Recent work exploring the risk factors for child abuse and neglect, long-term consequences of child maltreatment, and potential for primary prevention will be reviewed. In the past year there have been many notable contributions in the field of shaken baby syndrome that have deepened our understanding of this devastating form of child abuse.


RESULTS
Evidence of the long-term sequelae of child abuse and neglect continues to accumulate, but with increased understanding of the clinical manifestations of child maltreatment has come greater ability to intervene early and perhaps improve long-term outcomes. Although the effectiveness of some home visiting programs to prevent child maltreatment is coming into question, rigorous review of program components is helping to improve quality. There remain controversies in the diagnosis of shaken baby syndrome but several carefully done case-series are clarifying our knowledge of the myriad presentations of this form of non-accidental head trauma.


CONCLUSIONS
Pediatricians have an important role to play in the prevention and recognition of child maltreatment.
Newton
Alice W
AW
Department of Pediatrics, Harvard Medical School, and the Child Protection Program, Children's Hospital Boston, Boston, Massachusetts 02115, USA. alice.newton@childrens.harvard.edu
Vandeven
Andrea M
AM
D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000517:prevention & control*; D006801:Humans; D010371:Pediatric Nursing / Q000592:standards; D010819:Physician's Role; D038642:Shaken Baby Syndrome / Q000175:diagnosis / Q000517:prevention & control*