The causes of child abuse appear in both the parent and the child, and in the interaction of the two. Psychological characteristics observed in abusive parents include low self-esteem, a desire to have the child satisfy the parent’s needs, unrealistic expectations of the child’s abilities, inappropriate reactions to child injuries, and a lack of knowledge about child care (Boume, 1979). Pianta (1984), drawing from results of a longitudinal study of 267 women considered at risk for child abuse, and their children, found that abusing mothers were of lower intelligence than nonabusing mothers and had negative reactions, expectations, and self-images. A characteristic of the child that increases the possibility of child abuse is a premature birth (Friedrich & Boriskin, 1976), which may add to the stress the parent experiences in caring for an infant, thus setting the stage for later abuse. In addition, certain personality characteristics of the child may increase the likelihood of child abuse, although these characteristics have yet to be identified in a consistent manner (Friedrich & Boriskin, 1976). Hawkins and Duncan (1985) analyzed 923 cases of child abuse and found chronic illness, emotional disturbance, hyperactivity, mental retardation, and other physical handicaps to be more common in the abused than in the nonabused children. Kazdin, Moser, Colbus, and Bell (1985) looked at the characteristics of children who had been abused and found that physically abused children had lower self-esteem and greater depression and negative expectations toward their failures than did children who were not abused. It is certainly not the case that any of the above characteristics by themselves inevitably and necessarily lead to child abuse. Wolfe (1985), who reviewed 20 studies comparing abusive and nonabusive parents, views child abuse as an interactive process involving both parental competence and situational demands. Pianta (1984) found that social stressors associated with child abuse included unemployment, lack of social support, stressful life events, and high levels of confusion. Helfer (1975) suggests that three conditions are required for child abuse to occur: a special kind of child, a crisis or series of crises, and the potential in the parent for abuse. Thus, the factors leading to child abuse are complex, just as is the treatment for it. Paraverbal therapy is a multisensory approach for working with children. This approach utilizes many avenues of communication, including auditory, visual, tactile, and kinesthetic. Paraverbal maneuvers involve the child in communication through rhythmic sounds, developmental movement, and touch (Heimlich, 1983). Many paraverbal therapy techniques use words and materials metaphorically. In metaphoric techniques, the chant or song used appears to be about something other than the client, while on another level it allows the client to communicate about emotions and events too threatening to deal with directly. Often, this is done through having the client improvise words to a familiar song either completely or at points where the therapist leaves spaces for the client to fill in words or phrases. Heimlich (1983) suggests that “after sensorimotor maneuvers have opened up com-