Signs of Abuse

Childhood is a time of playfulness, tumbling, climbing and adventures.  And as such all children are liable to get scratches, bruises, bumps and cuts from time-to-time.  Therefore it is sometimes difficult to tell the difference between injuries suffered as part of a quite normal childhood, and those caused by physical abuse. 

One of the best ways to help children is learning to recognise the signs of abuse.  While these signs often take the form of physical injuries, behavioural indicators are also important  when diagnosing abuse.  The parent or other adult caregiver may also display significant indicators that point towards the presence of child abuse.

The diagnosis of child abuse will rely not only on indicators but also on a family history and a social, educational and health assessment of the child.  The list given below is therefore not, in itself, a comprehensive tool for recognising child abuse.

The Child:

Signs of Physical Abuse

Physical abuse may result in the symptoms described below.  Aside from direct physical contact, physical abuse can also be caused when a parent or caregiver feigns the symptoms of, or deliberately causes ill health to a child whom they are looking after.  Signs of physical abuse include:

• Bruises on legs before a child is mobile
• Black eyes without bruising to the forehead
• Finger tip bruising and bruises in various stages of healing
• Cigarette type burns anywhere, patterned burns (irons), rope burns. Contact burns in abnormal sites.
• Lacerations to the body or mouth
• Multiple fractures.  Evidence of old fractures.  Any fractures to children under two years old
• Fading injuries noticeable after an absence from school
• Seems frightened of parents, does not want to return home at the end of the day
• Shrinks markedly (backs away) at the approach of adults
• Suffers from frozen watchfulness  
• Constantly asks in words/actions what will happen next

Signs of Sexual Abuse

Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, whether or not the child is aware of what is happening.  The activities may involve physical contact, including penetrative or non-penetrative acts.  They may also include non-contact activities, such as involving the children in looking at, or in the production of, pornographic material or watching sexual activities or encouraging children to behave in sexually inappropriate ways. Signs of sexual abuse displayed by children include:

• Difficulty walking or sitting
• Pain/itching/bleeding/bruising/discharge to the genital area/anus
• Urinary infections/sexually transmitted diseases
• Persistent sore throats
• Eating disorders
• Self mutilation
• Refuses to change for gym or participate in physical activities
• Exhibits an inappropriate sexual knowledge for their age
• Exhibits sexualised behaviour in their play or with other children
• Lack of peer relationships, sleep disturbances, acute anxiety/fear
• School refusal, running away from home

Signs of Emotional Abuse

Emotional abuse is the persistent emotional ill-treatment of a child such as to cause severe and persistent adverse effects on the child's development.  It may involve conveying to children that they are worthless or unloved, inadequate or valued insofar as they meet the needs of another person.  It may feature inappropriate expectations being imposed on children, relative to their actual development or age.  Signs of emotional abuse displayed by children include:

• Excessive behaviour, such as extreme aggression, passivity or become overly demanding
• Children who self-harm, for instance by scratching or cutting themselves
• Is either inappropriately adult or infantile
• Children who persistently run away from home
• Children who show high levels of anxiety, unhappiness or withdrawal

Signs of Neglect

Neglect is the persistent failure to meet a child's basic physical and/or psychological needs.  This is likely to result in the serious impairment of the child's health or development.  Signs of neglect include:

• Frequent absenteeism from school
• Begs or steals money or food
• Lacks needed medical or dental care, immunizations or glasses
• Lacks appropriate clothing, e.g. for weather conditions, shoes are too small, ill-fitted clothes
• Clothes are consistently dirty
• Teeth are dirty, hair quality is poor and contains infestations
• Hands are cold, red and swollen
• The parent of adult caregiver has failed to protect a child from physical harm or danger

The Parent or Other Adult Caregiver:

• Denies existence of or blames the child for the child's problems at home or at school
• Sees and describes the child as entirely worthless, burdensome or in another negative light
• Unrealistic expectations of the child i.e. demands a level of academic or physical performance of which they are not
• Offers conflicting or unconvincing explanation of any injuries to the child
• Appears indifferent to or overtly rejects the child
• Refuses offers of help for the child's problems
• Isolated physically/emotionally

It is important to recognise that the different types of abuse often occur simultaneously.  For instance where a child is physically abused, they often suffer emotional abuse as well.  If you perceive a combination or repetition of any of the signs of child abuse then please contact the relevant social services office immediately.