“We must give the public balanced views of the [child abuse] problem and its solution. Yes, we need to hear about the horrible cases of violent and deadly abuse. But we also need to know about the subtler, but equally devastating, cases of neglect and emotional abuse.” —Donna E. Shalala, former Secretary of Health and Human Services

In 1995, six-year-old Elisa Izquierdo died at the hands of her mother in New York City. In the sixteen months before Elisa’s death, on at least ten occasions, a teacher, a doctor, or a social worker saw physical injuries or “bizarre” behaviors indicative of maltreatment that were either not reported to the state child abuse hotline or were rejected as abuse when a call was made. The wide media attention given Elisa’s death resulted in the clarification of New York laws requiring that...