Update on child maltreatment.

PURPOSE OF REVIEW: Recent literature regarding assessment, management and prevention of child maltreatment will be considered. Unexplained infant and child death will also be reviewed. RECENT
FINDINGS: Controversies in the evaluation of unexpected infant death and inflicted traumatic brain injury are ongoing. Evidence continues to accumulate describing the serious long-term sequelae of child maltreatment. Studies have examined the earliest beginnings of these adverse outcomes commencing in childhood. Despite sustained efforts to develop a variety of training and intervention programs, the deployment of these efforts has been hampered by the lack of evidence that they make any difference in improving recognition of child abuse or in preventing recurrent maltreatment. There is a great need in the child abuse field for more formal, rigorous assessment of all manner of intervention programs.
SUMMARY: Efforts to improve the recognition of and management of child abuse need to be sustained. As our understanding of child maltreatment continues to grow, evidence-based interventions will likely improve outcomes for abused children and their families. General pediatricians are often the first to notice signs and symptoms of possible child maltreatment; collaboration with hospital-based Child Protection Teams is critical when considering the possibility of abuse or neglect.