For most pediatricians, the mention of treating an abused child calls to mind the broken bones or patterned bruises of a physical assault or a disclosure of sexual abuse. It is important to remember, however, that some of our most crucial interventions with abused and neglected children can happen long after the injuries have healed.

It is with this in mind that the AAP Committee on Child Abuse and Neglect, along with the AAP Section on Adoption and Foster Care, has released the clinical report, “Understanding the Emotional and Behavioral Consequences of Early Maltreatment” (

Pediatrics
2008
;
122
:
667
-673
).

Recent epidemiologic research shows a disturbingly robust, lifelong correlation between early misfortune and a host of adult diseases ranging from obesity to drug and alcohol addiction. Neurodevelopmental researchers have confirmed that the constant threat state experienced by an abused child leads to measurable changes in the brain’s...

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