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The account of these patients documents the necessity for critical attention to the entire environment, including cultural factors believed to be especially important in the care and development of the injured child. It further documents the necessity for early intervention when abuse is suspected. Drastic management by removal from the home, the only method of intervention referred to in this paper, is indicated when the caretaker cannot respond to milder measures designed to improve his relations with the infant. Other methods such as home helps, intensive psychotherapy, or day care for the infant should be carefully tried if the child is considered safe from further assault. Of course, ongoing evaluation should be part of any attempt at intervention.
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