title: Update on child maltreatment: toward refining the evidence base.
abstract: OBJECTIVE
  This review is designed to aid general pediatricians as they assess cases of possible child maltreatment. The authors have selected salient articles that inform the daily practice of any professional involved in assessing child abuse.
  
  
  RESULTS
  The incidence of child abuse continues to decline in the United States, although a large number of children still suffer from abuse and neglect, and many are subject to more than one type of maltreatment. Clinicians are encouraged to be vigilant about the subtle indicators of physical abuse, with many authors adding to our understanding about how children present after inflicted abdominal or skeletal trauma. Clinicians are also cautioned to watch for signs of Munchausen syndrome by proxy, which may be elusive and difficult to discern.
  
  
  CONCLUSIONS
  The field of child abuse pediatrics is still young, with the first board certification in 2009. The volume of research in the field is exploding and there is a greater level of awareness and data collection occurring throughout the world. Pediatric clinicians are encouraged to play a role in preventing abuse and neglect, as well as addressing intimate partner violence, and to maintain vigilance about child maltreatment and its subtle clinical presentations.
authors.affiliation: Department of Pediatrics, Harvard Medical School, Child Protection Program, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Denton
authors.forename: Alice W
authors.initials: AW
authors.lastname: Newton
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Vandeven
mesh_terms: D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000706:statistics & numerical data / Q000628:therapy; D002650:Child Abuse, Sexual / Q000175:diagnosis / Q000628:therapy; D002669:Child Welfare; D006259:Craniocerebral Trauma / Q000209:etiology; D006801:Humans; D016735:Munchausen Syndrome by Proxy / Q000175:diagnosis