Prevention of child abuse and neglect in the primary care setting.

The number of cases of child abuse and neglect has risen steadily since reporting began in the 1960s. Today, child abuse and neglect is a major cause of injury and death in those ages 0 to 5. Studies have identified certain factors that increase the risk of maltreatment. The primary care practitioner is in an ideal position to assess for the presence of risk factors and to provide primary prevention interventions. This article defines child abuse and neglect and reviews its epidemiology; the risk factors of child abuse and neglect are also summarized. The concept of attachment as a theoretical framework is discussed; its significance in the attainment of a positive adjustment to the maternal role should drive the clinician's thought process. Suggested interventions are aimed at strengthening the parent-child relationship, reducing stress, and providing support. A protocol is presented that may be a useful guide for the practitioner.