Welcome to Best Practices in Prevention Oriented Child Death Review

Child Abuse

List of Potential Interventions




Child abuse takes many forms, including physical assault, neglect, sexual abuse and emotional injury. This review of interventions focuses on physical assaults. When assaults are committed against children by their caretakers it is known as physical abuse. Most physical abuse deaths of children are the result of injuries to the head due to violent shaking, slamming or striking. The second most common cause of child abuse fatalities is from punches or kicks to the abdomen leading to internal bleeding. Other likely causes include smothering, drowning, poisoning and immersion into hot water.

Although children who die from physical abuse have often been abused over time, a one-time event often causes a death. Caretakers who abuse their children usually cite crying, bedwetting, fussy eating and disobedience as the reason they lose "control" and harm their children. Young children are most vulnerable:  Children under 6 years of age account for four-fifths of all maltreatment deaths; infants account for roughly half of these deaths.

The National Child Abuse and Neglect Data System (NCANDS) reports that in the U.S. in the federal fiscal year (October 1 – September 30) 2007 of the 3,359,295 children who were subjects of a suspected child abuse investigation or assessment, an estimated 794,000 children were confirmed as victims of maltreatment.1 Almost 11 percent of those children were victims of physical abuse.1 NCANDS estimates there were 1,760 child fatalities in 2007.1 NCANDS defines "child fatality" as the death of a child caused by an injury resulting from abuse or neglect, or where abuse or neglect was a contributing factor. It is widely accepted that this number is at least three to ten times underestimated.

There are numerous interrelated risk factors for physical abuse fatalities, including poverty, domestic violence, substance abuse, caretakers under the age of 30, children left with male caregivers who lack emotional attachment to the child, children with emotional and health problems and parents and caregivers with unrealistic expectations of child development and behavior. Child abuse is linked to a number of poor health outcomes, and is a factor in many child deaths, including those occurring later in teens from homicide, suicide and unintentional injury. Some of the promising and recommended interventions to prevent child abuse and neglect have also shown positive effects in reducing later homicides and suicides among children whose families received the intervention.


  1. U.S. Department of Health and Human Services, Administration on Children, Youth and Families. ChildMaltreatment 2007