Fourth National Incidence Study of Child Abuse and Neglect (NIS–4)

interpreted as less serious than moderate injury, because the types of maltreatment thatgenerally warrant inferred harm (e.g., incest, abandonment) could actually have adevastating impact on a child.Changes since the NIS–3 and NIS–2 in the severity of outcomes fromHarm Standard maltreatment. Tests of differences between the NIS–4 estimates for2005–2006 and the corresponding NIS–3 findings for 1993 reveal a significant declineonly in the incidence of children with inferred harm from their maltreatment. The numberof children for whom injury could be inferred declined by 57% from 165,300 to 71,500while the rate of children with inferred harm declined by 60% from 2.5 to 1.0 child per1,000. Differences between the NIS–4 and the NIS–3 in the incidence of fatal, serious,and moderate injuries are not statistically significant.The NIS–3 identified a significant increase since 1986 in the incidence ofchildren with serious maltreatment injuries and a statistically marginal increase in theincidence of children for whom injury could be inferred. The NIS–4 results show that theincidence of children with serious harm remains significantly higher than the 1986 levels,but that the decrease since 1993 in the incidence of children with inferred harm actuallybrought that rate significantly below its 1986 level as well. Specifically, the estimatednumber of seriously injured children increased by 244% between the NIS–2 and the NIS–4, from 141,700 to 487,900. In terms of incidence rates, this increase means that the riskof a child being seriously harmed by Harm Standard abuse or neglect was 187% higher in2005–2006 than in 1986. At the same time, there was a substantial and significantdecrease in the number of children for whom injury could be inferred. This totaldeclined by 32% between the NIS–2 and the NIS–4, from 105,500 to 71,500. Theincidence rate declined by 42%, meaning that the risk of a child qualifying for inferredharm from Harm Standard maltreatment was 42% lower in 2005–2006 than in 1986.The NIS–4 also revealed a statistically marginal increase in the rate of fatalinjury compared to the NIS–2 rate. The estimated number of children who were fatallyinjured under the Harm Standard increased by 118% since 1986, reflecting a rise of 50%in the incidence rate per 1,000 children in the United States.The incidence of children with moderate harm as a result of Harm Standardmaltreatment has not measurably changed since the NIS–2.3–13