There are a number of physical signs and behaviors that could indicate abuse or neglect. Most of these behaviors can also be found in children who are not being abused - very few are absolute proof of abuse or neglect. Children who are victims of abuse may show a few or many of the signs listed below and may also have other symptoms that are not listed here. This information was adapted from two guides by the Massachusetts Department of Social Services(1,2) as a general overview of some of the most common indicators of child abuse and neglect.
• Signs of Physical Abuse
• Signs of Sexual Abuse
• Signs of Emotional Abuse
• Signs of Neglect
Physical Signs:
• Unexplained bruises, burns,
cuts, broken bones, human bite marks, bald spots, or other physical injury
• These wounds may:
- Be in a similar shape on different parts of the body
- Be shaped like the object used to inflict them (i.e. a belt buckle or cigarette)
- Be clustered together, forming a regular pattern
- Be in various stages of healing
- Appear on the child repeatedly after spending time with the abuser
Behavioral Signs:
• Running away from home
often
• Going to school early and
staying late
• Fearful of adults
• Fearful of going home (or
to a caretaker’s house)
• Irrational fears
• Thumb sucking, nail biting,
rocking, or uncontrollable crying
• Constant anger or temper
tantrums
• Extremely aggressive, withdrawn,
or overly compliant
• Emotional neediness
• Hurting him/herself or other
children
• Threatens or attempts suicide
• Often absent from school
or distracted while at school
• Trouble in school
• Low self-esteem, depression
• Constant worrying and tenseness
Physical Signs:
• Sexually transmitted disease
• Pregnancy in a young non-sexually
active child
• Pregnancy in a non-sexually
active adolescent
• Frequent urinary tract or
genital infections
• Bruises or bleeding in the
genitals or anal areas
• Torn, stained, or bloody
underwear
While there are no physical signs in most cases of sexual abuse, if a child reports sexual abuse, it is important to seriously consider that the child’s statements may be accurate. The following warrant follow-up:
• Personalized statement
that he/she was sexually abused
• Knowledge of sexual matters
inappropriate for the child’s age (especially in young children; older
children could have acquired information from peers without a parent’s
knowledge)
• Sexual drawings
• Sexual acting out with younger
children, peers, or adults
• Sexual acting out with animals
or toys
• Excessive or compulsive
masturbation (i.e. in public or to the extent that the behavior interferes with
the child participating in normal childhood activities)
• Promiscuity (many sexual
partners) or prostitution
The following symptoms and/or behaviors are only cause for concern of possible
sexual abuse when they occur in association with a disclosure of sexual abuse
or if the child has been exposed to a a known sexual offender. When observed
in isolation, they are definitely cause for concern and require intervention,
but may be indicative of some type of problem other than sexual abuse:
• Sudden change in behavior
• Trouble relating to peers
• Trouble in school
• Running away
• Threatens or attempts suicide
• Self harm (cutting or burning)
• Eating disorders (anorexia,
bulimia, or overeating)
• Alcohol or drug abuse
• Going to school early and
staying late
• Low self-esteem, depression
• Emotional neediness
• Trouble sleeping, nightmares,
or bedwetting in an older child
• Hurting animals
• Setting fires
• Extremely aggressive, withdrawn,
or fearful
• Criminal activity
If you have a question about a behavior, it is best to ask your child’s pediatrician whether that behavior is normal for your child’s age.
Behavioral Signs:
• Suspicious, untrusting,
anxious, distracted
• Poor eye contact
• Antisocial or withdrawn
• Thumb sucking, nail biting,
rocking, or uncontrollable crying
• Low self-esteem, depression
• Trouble in school
• Running away
• Trouble sleeping
• Irrational fears or compulsiveness
• Very worried about pleasing
adults
• Emotional neediness
• Angry when not feeling in
control
• Suicide threats or attempts;
self-harm
• Alcohol or drug abuse
Physical Signs:
• Appears withdrawn
• Speech disorders, stuttering
• Nervous tic
• Hair missing because of
pulling, nails bitten
• Overweight
• Self-inflicted injuries
• Slow physical development
• Ulcers, asthma, severe allergies
Physical Signs:
• Always hungry, dirty, or
inappropriately dressed
• Often unsupervised for long
periods of time
• Medical problems that are
not taken care of
• Abandonment
• Lice or skin infections
• Starvation
• Slow to grow and/or speak
Behavioral Signs:
• Begging or stealing food
• Often tired, weak, or listless
• Often absent or late to
school
• Extremely aggressive, withdrawn,
or fearful
• Very shy or very demanding
of attention
• Emotional neediness
References:
(1) Massachusetts Department of Social Services. 51-A
Mandated Reporting: What Schools Need to Know. 1996.
(2) Massachusetts
Department of Social Services. Investigation Training: Evidence and Indicators
of Maltreatment. March 2002.