Warning signs of child abuse and neglect

Signs of physical abuse

• Bruising, welts or burns that cannot be sufficiently explained, particularly bruises on the face, lips and mouth of infants or on several surface planes at the same time

• Unusual bruising patterns that reflect the shape of the instrument used to cause injury (e.g., belt, wire hanger, hairbrush, hand, human bite marks)

• Clusters of bruises, welts or burns, indicating repeated contact with a hand or instrument

• Injuries on the body where children usually do not get hurt (e.g., the torso, back, buttocks, thighs, neck)

• Burns that are insufficiently explained, e.g., cigarette burns 

  • Immersion burns including marks indicating dunking in a hot liquid, including “stocking” and “glove” burns on feet and hands, or “doughnut” shaped burns on buttocks and genitalia

  • Rope or restraint burns on the arms, hands, neck or legs

  • Dry burns caused by forced contact with a hot surface (e.g., a clothes iron, hair curler, heater or stove)

• Lacerations and abrasions of the lip, eye, or to any part of a child’s face

• Tears in the tissue of the gums, possibly as a result of force-feeding

• Laceration or abrasion to external genitalia

• Absence of hair or hemorrhaging beneath the scalp due to vigorous hair pulling

• Withdrawn, fearful or extreme behavior

Signs of possible neglect

Child or youth

• Shows sudden changes in behavior or school performance
• Is frequently absent from school or child care
• Has not received help for physical or medical problems brought to parent or caregiver’s attention
• Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes
• Is always watchful, as though preparing for something bad to happen
• Begs or steals food or money
• Lacks adult supervision
• Is consistently dirty and has severe body odor
• Lacks sufficient clothing for the weather

Parent or caregiver

• Denies the existence of, or blames the child for, problems in school
• Shows little concern for the child
• Is abusing alcohol or drugs
• Seems apathetic or depressed

Signs of possible sexual abuse

Perceptible Signs of Sexual Abuse

• Difficulty walking or sitting
• Pain or itching in the genital area
• Torn, stained or bloody underclothing
• Bruises or bleeding in external genitalia
• Frequent complaints of stomachaches or headaches
• Venereal disease
• Frequent urinary or yeast infections
• Pregnancy

Behavioral Signs of Sexual Abuse

• Withdrawal or chronic depression
• Inappropriate sex play or premature understanding of sex
• Feeling threatened by physical contact, closeness
• Promiscuity
• Running away from home
• Child is “parentified” or overly concerned for siblings
• Poor self-esteem, lack of confidence
• Peer problems, lack of involvement with friends
• Extreme weight change
• Suicide attempts or threats; especially with adolescents
• Hysteria, lack of emotional control
• Sudden school difficulties
• Unprovoked cruelty to animals

Signs of possible sexual exploitation or human trafficking

• Instability in life functioning: Youth lacks access to basic needs, including stable shelter, and is unable to engage in activities expected of her/his age
• Relationships: Youth’s relationships are concerning, placing him/her at risk or in danger
• Finances and belongings: Youth has money or material goods that are incongruent with her/his life circumstances
• Use of technology: Youth’s use of internet, cell phone or social media involves social or sexual behavior that is atypical for his/her age
• Physical health: Youth has significant health problems related to sexual activity and lack of access to basic needs
• Risky behaviors: Youth engages in dangerous or risky behaviors, e.g., spending time with abusive partners or in locations where exploitation is known to occur, running away or staying away overnight, using substances)
• Trauma exposure/signs: Youth has been exposed to traumatic circumstances and/or exhibits signs and emotional symptoms of trauma exposure
• Coercion and grooming: Youth exhibits behaviors or otherwise indicates he/she is being controlled or coerced by another person
• Exploitation: Youth has been exposed to sexual exploitation or victimization