Signs of Child Abuse and Neglect

Child abuse and neglect occurs when a child is mistreated, resulting in injury or risk of harm. Types of child abuse and neglect are identified within four categories. The definitions include a brief summary of indicators to explain the definition. None of the indicators alone are definitive of child abuse. It is necessary to look at the family’s total functioning to determine present and impending danger.

Physical Abuse

Physical abuse refers to an action of the parent, guardian or custodian that is non-accidental and results in physical injuries, often occurring in the name of discipline or punishment.

Bruises and Welts

• On face, lips, mouth
  
• On torso, back, buttocks, thighs
• In various stages of healing
  
• Clustered, forming regular pattern
  
• Reflecting shape of article used to inflict; electric cord or belt buckle
  
• On several different surface areas; regularly appear after absence, weekend or vacation
• Subdural hemorrhage or hematomas
• internal injuries
• brain damage

Burns

• Cigar, cigarette burns, especially on soles, palms, back or buttocks
  
• Immersion burns; sock-like, glove-like, doughnut shaped on buttocks or genitalia, patterned like electric burner, iron
  
• Rope burns on arms, legs, neck or torso

Fractures

• To skull, nose, facial structure in various stages of healing
• Multiple or spiral fractures
• bone fracture-unexplained and in various stages of healing

Lacerations or Abrasions

• To mouth, lips, gums, eyes
• To external genitalia

Behavioral Indicators

• Behavioral extremes; aggressiveness or withdrawal
• Frightened of parents
• Afraid to go home
• Reports injury by parents

Physical Neglect

Physical neglect occurs when a parent, guardian or custodian fails to provide for a child’s basic needs, like food, clothing, shelter, education, medical care or supervision and abandonment. The failure to meet basic needs must represent a threat to the child’s immediate health and safety or an impending danger if there is a pattern or history of the child’s needs not being met.

Physical Indicators

• The child is malnourished, emaciated, is always hungry or begging for food, or is seldom fed nutritious food. A medical diagnosis is usually necessary to determine malnutrition.

• The child’s clothing is inappropriate or insufficient to protect the child from the weather or clothing is so dirty or smelly that it constitutes a health hazard.

• The caretakers fail to provide a home or the home is in a condition that presents a health hazard or dangers such as fire.

• The caretakers refuse to permit a child to attend school. Truancy alone does not constitute child abuse or neglect but may be an indication when considered with other family factors.

• The caretakers fail to seek medical or dental treatment for a health problem or condition that, if untreated, could represent a danger to the child.

• The caretakers fail to provide supervision of a child. The child’s age and competence, amount of time left unsupervised, time of day the child is unsupervised, and degree of parental planning for the unsupervised period must be considered. Community standards need to be considered when making judgments concerning lack of supervision.

• The child is abandoned. Abandonment is a legal term meaning contact with the child has not been attempted by the caretaker for an extended period of time.

Behavioral Indicators

• Begging, stealing food
  
• Extended stays at school; early arrival and late departure
  
• Constant fatigue, listlessness or falling asleep in class
• States there is no caretaker

Sexual Abuse

Sexual abuse and exploitation occurs when a parent, guardian or custodian commits, or allows contacts or interactions between a child and adult, where the child is used for the sexual stimulation of the parent, guardian, caretaker, or other responsible person. Sexual abuse may also be committed by a person under the age of 18, when that person is significantly older than the victim, or in a position of power and control over the child.

Physical Indicators

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

Behavioral Indicators

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

Emotional Abuse

Emotional maltreatment occurs when a parent, guardian or custodian fails to provide the emotional nurturing needed for a child’s psychological growth and development, or willfully denies the child the emotional stability necessary for proper psychological growth and development. Emotional maltreatment results in an observable or measurable impairment of the child.

Physical Indicators

• Failure to thrive is diagnosed. The child does not gain weight or meet developmental norms, despite adequate feedings and absence of physiological causes. Failure to thrive is caused by failure to emotionally nurture, cuddle and hold the child, such as leaving the child in a crib all day. The clearest indicator of failure to thrive is the placement of a child in another environment, where the child dramatically gains weight and thrives.

• The caretaker verbally abuses the child, such as constant harassment, belittling, humiliation, repeated threats or constant criticism.

• The caretaker condones, suggests or encourages the child to commit theft or prostitution.

• The child is ignored or isolated by parents physically and emotionally for long periods of time. An example includes a child who is sent to an empty room for hours or days to be isolated from the rest of the family.

• The child is placed in a position of acting as a parent to an extremely needs or inadequate parent.