There is no escape from violence in America, even for children. Public health leaders have identified violence as a problem of epidemic proportions. Family violence has been described as endemic; its existence is a constant feature of many American families, with the home as its major setting. Family violence accounts for at least 21,000 hospitalizations, 99,800 hospital days,28,700 emergency department (ED)visits, and 39,000 physician visits each year. The United States Department of Justice estimates that from 1987 to 1990, the aggregate cost of domestic violence amounted to$67 billion per year. Losses due to violence against children exceed$164 billion annually.

In 1962, Dr Henry Kempe raised the consciousness of the nation and pediatricians to the problem of child abuse with the publication of his paper “The Battered Child Syndrome.” Over the subsequent decades, pediatricians have become well educated and familiar with the problems of child abuse, sexual assault, and neglect. Yet,overwhelming...

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