ABSTRACT
The victimization of children through abuseand neglect remains an all too common occurrence2. In 2002, 12.3 per 1,000 children in the United States were victimized, and young children and infants had the highest rates3. While there are trends suggesting decreasing incidence, the United States child abuse and neglect reporting system continues to document over 900,000 substantiated victims of child maltreatment annually, with over 1,400 deaths4-6. Overall, injuries place a heavy burden on children, and inflicted injuries affect far too many7,8. Health care costs for inflicted injures are difficult to estimate, but estimates place the total costs associated with abuse at over $9 billion annually in the United States6. Maltreated children suffer from a variety of behavior problems and mental disorders, in addition to physical injuries9-11. The Adverse Childhood Experiences study has noted the powerful relationship between adverse childhood experiences and several conditions of adulthood, including risk of suicide, alcoholism, depression, illicit drug use, and other lifestyle changes12. While the exact pathways are still being explored, childhood abuse is thought to affect adult health by putting people at risk for depression and post-traumatic stress disorders, difficulties in relationships, and negative beliefs and attitudes towards others13,14.
