Indicators of Child Abuse

-  Indicators are the signs, symptoms or clues which may mean that a child has been abused or may be at risk for abuse. 
-  Indicators do not prove that a child has been abused. They are clues that should warn people that a child may need help. 
-  Indicators may be seen in the child’s physical health or behaviour, as well as those of the child’s caregivers. 
-  Adults who abuse children may show certain behaviours and attitudes that make other people worry if they should be caring for children.

Possible Indicators of Neglect

Physical Indicators In Children
- an infant or young child may:
  - not be growing as expected
  - be losing weight
  - have a “wrinkly old face” 
  - look pale 
  - not be eating well

- not dressed properly for the weather
- dirty or unwashed
- bad diaper rash or other skin problems
- always hungry
- lack of medical and/or dental care
- signs of deprivation which improve with a more nurturing environment (e.g., hunger, diaper rash)

Behavioural Indicators In Children
- does not show skills as expected
- appears to have little energy
- cries very little
- does not play with toys or notice people
- does not seem to care for anyone in particular
- may be very demanding of affection or attention from others
- older children may steal food, drink alcohol or take drugs, break the law
- takes care of a lot of their needs on their own 
- has a lot of adult responsibility at home
- discloses neglect (e.g., says there is no one at home)

Possible Indicators of Physical Abuse

Physical Indicators In Children
- bruises in the same area of the body
- bruises in the shape of an object (e.g., spoon, hand/fingerprints, belt)
- burns:
  - from a cigarette
  - in a pattern that looks like an object (for example, iron)

- wears clothes to cover up injury, even in warm weather
- patches of hair missing
- signs of possible head injury: 
  - swelling and pain 
  - nausea or vomiting
  - feeling dizzy
  - bleeding from the scalp or nose

- signs of possible injury to arms and legs:
  - pain
  - sensitive to touch
  - cannot move properly
  - limping

- breathing causes pain
- difficulty raising arms
- human bite marks
- cuts and scrapes inconsistent with normal play 
- signs of female genital mutilation (e.g., trouble going to the bathroom)

Behavioural Indicators In Children
- cannot remember how injuries happened
- the story of what happened does not match the injury
- refuses or is afraid to talk about injuries
- is afraid of adults or of a particular person
- does not want to be touched
- may be very:
  - aggressive
  - unhappy
  - withdrawn
  - obedient and wanting to please
  - uncooperative

- is afraid to go home
- runs away 
- is away a lot and when comes back there are signs of a healing injury
- does not show skills as expected
- does not get along well with other children
- tries to hurt him/herself (e.g., cutting oneself, suicide)
- discloses abuse

Possible Indicators of Sexual Abuse

Physical Indicators In Children
- a lot of itching or pain in the throat, genital or anal area
- a smell or discharge from the genital area
- underwear that is bloody
- pain when: 
  - trying to go to the bathroom
  - sitting down 
  - walking
  - swallowing 

- blood in urine or stool
- injury to the breasts or genital area: 
  - redness
  - bruising
  - cuts
  - swelling 

- pregnancy

Behavioural Indicators In Children
- copying the sexual behaviour of adults
- knowing more about sex than expected
- details of sex in the child’s drawings/writing
- sexual actions with other children or adults that are inappropriate
- fears or refuses to go to a parent, relative, or friend for no clear reason
- does not trust others
- changes in personality that do not make sense (e.g., happy child becomes withdrawn)
- problems or change in sleep pattern (e.g., nightmares)
- very demanding of affection or attention, or clinging
- goes back to behaving like a young child (e.g., bed-wetting, thumb-sucking)
- refuses to be undressed, or when undressing shows fear
- tries to hurt oneself (e.g., uses drugs or alcohol, eating disorder, suicide)
- discloses abuse

Possible Indicators of Emotional Abuse

Physical Indicators In Children
- the child does not develop as expected
- often complains of nausea, headaches, stomach aches without any obvious reason
- wets or dirties pants
- is not given food, clothing and care as good as what the other children get
- may have unusual appearance (e.g., strange haircuts, dress, decorations)

Behavioural Indicators In Children
- is unhappy, stressed out, withdrawn, aggressive or angry for long periods of time
- goes back to behaving like a young child (e.g., toileting problems, thumb-sucking, constant rocking)
- tries too hard to be good and to get adults to approve
- tries really hard to get attention
- tries to hurt oneself (e.g., uses drugs or alcohol, suicide)
- criticizes oneself a lot
- does not participate because of fear of failing
- may expect too much of him/herself so gets frustrated and fails
- is afraid of what the adult will do if s/he does something the adult does not like
- runs away
- has a lot of adult responsibility
- does not get along well with other children
- discloses abuse