Physical and Behavioral Indicators of Child Abuse and Neglect

The following indicators must not be looked at in isolation. They are to be examined as part of the overall pattern of the child.

Physical Abuse Indicators Observed in a Child

• Unexplained bruises and welts on: Face, lips, mouth, torso, back, buttocks, thighs; in various stages of healing;
• clustered, forming regular patterns, reflecting shape of article used to inflict (electric cord, belt buckle); on several different surface areas and regularly appear after absence, weekend, vacation.
• Unexplained burns: cigar, cigarette, especially on soles, palms, back or buttocks immersion burns (sock-like, glove-like, doughnut shaped on buttocks or genitalia); patterned like electric burner, iron, etc.; and rope burns on arms, legs, neck, or torso.
• Unexplained fractures: to skull, nose, facial structure; in various stages of healing; multiple or spiral fractures; and swollen or tender limbs.
• Unexplained lacerations or abrasions: to mouth, lips, gums, eyes; to external genitalia; and to backs, arms, legs, or torso.
• Human bite marks

• Wary of adult contact
• Apprehensive when other children cry
• Behavioral extremes; aggressiveness, withdrawal
• Frightened by parents
• Afraid to go home
• Reports injury by parents
• Wears long-sleeved or similar clothing to hide injuries
• Seeks affection from any adult

Behavioral Abuse Indicators Observed in a Parent/Guardian

• Seems unconcerned about child
• Takes an unusual amount of time to obtain medical care for the child
• Offers an inadequate or inappropriate explanation for the child’s injury
• Gives different explanations for the same injury
• Misuses alcohol or drugs
• Disciplines the child too harshly considering the child’s age or what he/she did wrong
• Sees the child as bad, evil, etc.
• Has a history of abuse as a child
• Attempts to conceal the child’s injury
• Takes the child to a different doctor or hospital for each injury
• Has poor impulse control

Physical Maltreatment Indicators Observed in a Child

• Consistent hunger, poor hygiene, inappropriate dress
• Consistent lack of supervision, especially in dangerous activities or for long periods
• Unattended physical problems or medical or dental needs
• Abandonment

Behavioral Maltreatment Indicators Observed in a Child

• Begging or stealing food
• Extended stays in school (early arrival and/or late departure)
• Infrequent attendance at school
• Constant fatigue, falling asleep in class
• Alcohol or drug abuse
• States there is no caretaker

Behavioral Maltreatment Indicators Observed in a Parent/Guardian

• Misuses alcohol or drugs
• Has disorganized, upsetting home life
• Is apathetic, feels nothing will change
• Is isolated from friends, relatives, neighbors
• Has long-term chronic illness
• Cannot be found
• Has history of neglect as a child
• Exposes child to unsafe living conditions
• Evidences limited intellectual capacity

Physical Emotional Abuse Indicators Observed in a Child

• Exhibits one or more of the followiing: Speech disorders, Lags in physical development, Failure to thrive

Behavioral Emotional Abuse Indicators Observed in a Child

• Habit disorders, such as sucking, biting or rocking
• Conduct disorders, such as antisocial or destructive
• Neurotic traits, such as sleep disorders, speech disorders or inhibition of play
• Psychoneurotic reactions, such as hysteria, obsessions, compulsions, phobias or hypochondria
• Behavioral extremes, such as compliant, passive, shy, aggressive or demanding
• Overly adaptive behavior, such as inappropriately adult or inappropriately infantile
• Developmental emotional or mental lags
• Attempted suicide

Behavioral Emotional Abuse Indicators Observed in a Parent/Guardian

Treats children in the family unequally
• Blames or belittles child
• Is cold and rejecting
• Withholds love
• Inconsistent behavior toward child

Physical Sexual Abuse Indicators Observed in a Child

• Difficulty in walking or sitting
• Torn, stained, or bloody underclothing
• Pain or itching in genital area
• Bruises or bleeding in external genitalia, vaginal or anal areas
• Venereal disease (especially in pre-teens)
• Pregnancy

Behavioral Sexual Abuse Indicators Observed in a Child

• Unwilling to change for gym or participate in physical education class
• Withdrawal, fantasy or infantile behavior
• Bizarre, sophisticated or unusual sexual behavior or knowledge
• Poor peer relationships
• Delinquent or runaway
• Reports sexual assault by caretaker

Behavioral Sexual Abuse Indicators Observed in a Parent/Guardian

• Very protective or jealous of child
• Encourages child to engage in prostitution or sexual acts in the presence of caretaker
• Misuses alcohol or other drugs
• Is geographically isolated and/or lacking in social and emotional contacts outside the family
• Has low self-esteem