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Abuse of children and adolescents is part of the spectrum of family dysfunction and results in injury and death to millions of children each year in the United States. Abuse causes physical, sexual and/or emotional trauma or may occur in the form of neglect when caregivers fail to provide basic physical, emotional or medical needs. Medical professionals are required by law in all 50 states to identify abuse and to report it to child protective services. Students must understand the varying presentations of abuse, must recognize the physical, emotional and social factors that put a child at risk for abuse, must know when to consider abuse in the differential diagnosis and must understand their ethical and legal obligations.