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This study is a comparison of data from the child welfare and the hospital files for each of 422 children identified from the Toronto Hospital for Sick Children's Child Abuse List. It shows significant differences between the families who abuse their children and those who neglect them, and it raises questions about children at risk for whom neither abuse or neglect can be proven to have occurred. Data relating to the difficulties in decision-making support the notion that interdisciplinary community teams might have much to offer in the development of more stringent guides for determining the nature of mistreatment and the probability of further risk to the child.

The course of referral, intervention, and outcome in Canadian child abuse cases was investigated by description of 422 Toronto cases who had been seen at the Hospital for Sick Children and known to the Children's Aid Society in the five-year period of 1973 to 1977. Through discriminant function analyses for the present study, variables that correctly predicted outcome were identified, but reasons were discussed for the importance of using caution in clinical applications of these predictors. Comparisons of the present study to the few previous Canadian ones are reported, and all were similar in two respects: bruises were the most common injury type, and abusers were rarely taken to criminal court. Differences in findings appeared to be due primarily to the ways the samples were selected and differences in available services and hospital or agency practices.