Changing spectrum of serious child abuse.

To determine whether the spectrum of serious child abuse has changed over the past decade, hospital and medical examiner records in the Seattle area were reviewed for the years 1971 to 1973 and 1981 to 1983. Although the incidence of hospitalized cases was similar in the two time periods (81 v 93), the proportion of severe injuries that occurred increased significantly (from 32% to 54%). The large number of cases in which the perpetrator was unknown makes generalization difficult. However, changes in the sex distribution for known perpetrators suggest that child abuse, especially serious and fatal cases, may be occurring more frequently at the hands of men.