The Clinical Management of Incest and Sexual Abuse of Children

SINCE the publication of "The Battered Child Syndrome" by Kempe et al in 1962,¹ physicians have been increasingly concerned with the problem of child abuse. Early thinking in the field focused on children who were seriously injured by their caretakers. As practice has evolved and experience has grown, it has become clear that battering of children is but the tip of an iceberg of childhood maltreatment. Professionals have started to be increasingly aware of the existence of sexual and emotional abuse, as well as of the gross neglect of children by their caretakers.

In the early 1960s, child abuse was seen as an attack by a malicious adult against an unsuspecting child in need of protection. As workers have become more familiar with abusing adults, they have realized that these people had themselves been the unfortunate victims of abusive situations in their past. A more compassionate attitude toward these