To estimate the cumulative prevalence of confirmed childhood maltreatment we used data from the National Child Abuse and Neglect Data System (NCANDS) Child File from 2004-2011,24-31 and estimates of the population of U.S. children by age, race/ethnicity, sex, and year from the Centers for Disease Control and Prevention.32 The NCANDS Child File is composed of case-level data for each report of maltreatment that was investigated by Child Protective Services (CPS) in the United States. CPS receives reports of alleged maltreatment from individuals who are required by law to report suspected abuse or neglect (such as physicians or teachers) as well as from other sources (such as neighbors). CPS typically screens reports and then investigates those that appear most likely to involve abuse or neglect. Following the CPS investigation, a case may or may not be confirmed as maltreatment. We defined confirmed maltreatment as a report that was substantiated or indicated, meaning there was sufficient evidence for CPS to conclude that abuse or neglect had occurred. (Most states use the term “substantiated” to imply sufficient proof to confirm maltreatment occurred, but
