The Spectrum of Intent in Fatal Child Abuse

To the Editor. —We want to correct the reference to our estimate of the magnitude of fatal child abuse and neglect made in the Special Communication entitled "Origins and Clinical Relevance of Child Death Review Teams." 1 A report on our complete work, a joint effort of the Centers for Disease Control and the University of Missouri School of Medicine, will soon be published in Pediatrics . Using cause-of-death data, Federal Bureau of Investigation data, the Missouri Child Fatality Study, and the results from other research, we estimated that, from 1979 to 1988, the annual number of child abuse and neglect fatalities averaged between 949 and 2022. The Special Communication attributes the following to us: "Over 1000 American children die each year of intentional [our emphasis] injuries at the hands of a caretaker." It was not our wish to suggest that these fatalities are either intentional or unintentional. We believe that