Preventive involvement in child abuse and neglect by general pediatrician in a military community

Thirty-three cases among nineteen troubled families of U.S. Coast Guard personnel with problems of child abuse and neglect in Hawaii were managed by joint U.S. Public Health Service, U.S. Coast Guard, U.S. Army, State and County child protection, social and health staff, and local and area-wide lay volunteers. These cases ranged from inaccurate accusations in an emergency room to abdominal gunshot wounds. The preventive role of primary pediatric involvement in community health areas such as pre-school, day care, prenatal infant care education, parent discussion groups, and lay therapists is stressed. The early intervention therapy of pediatric advocacy for social and psychological services to families in stress is emphasized. Continued pediatric leadership for prevention and early intervention is essential in our times of pervasive family breakdown.