Source: Texas Health Resources http://www.texashealth.org

(back to top)

Source:National ClearingHouse on Child Abuse and Neglect Information,
http://nccanch.acf.hhs.gov/pubs/usermanuals/caregive/ 

(back to top)

Signs of Physical Abuse in Children

Physical signs can be the easiest to identify. Child abuse should be suspected when similar injuries are recurrent and the explanation does not fit the type of injury. Young children frequently have accidents that may result in injuries to their elbows, chins, noses, foreheads, and other bony areas. However, bruises and marks on the soft tissue of the face, back, neck, buttocks, upper arms, thighs, ankles, backs of legs, or genitals are more likely to be caused by physical abuse. Several bruises in different stages of healing can also point to abuse. The age of bruises usually follows this pattern: red, blue, black-purple, dark green tint, then pale green to yellow.

Internal injuries to the head and abdomen can be hard to detect. Internal abdomen injuries can cause swelling, tenderness, and vomiting. Internal head injuries can cause swelling, dizziness, blackouts, retinal detachment, and bilateral black eyes.

Examples of behavior signs pointing to physical Abuse:

• Daniel (21/2 years old) is usually picked up by his mother. When his father comes to get him he screams and hides behind his family child care provider's legs. Earlier that day his provider overheard him playing with the dolls. He said, "I told you no wet pants. Now I'll beat your butt."
• Peter (31/2 years old) resists his teacher's offers to tuck him in at naptime or sit in her lap to hear a story. In the past he has been a very affectionate child.
• Kathy (4 years old) causes havoc all morning when she repeatedly grabs toys from the other children. She spends the afternoon in the book corner sitting by herself and stroking her blanket.

(back to top)

Signs of Neglect in Children

Signs of neglect are not always clear, and are generally chronic where physical abuse is episodic. It is important to look for reoccurring patterns.

Examples of signs that point to neglect:

• Five-year-old Andrea tells her teacher she is tired this morning because her 6-month-old brother, Max, woke her up. She says, "My mommy wasn't home yet so I made Max a bottle and gave it to him. Then he finally went back to sleep."
• Geraldine (41/2 years old) tells her father that she is very hungry because she didn't have any lunch. When he asks her why she didn't eat, Geraldine says that her teacher took lunch away from her and her friend because the two girls were playing instead of eating.
• David (4 months old) arrives at his family childcare home with a severe diaper rash. The family child care provider, Mrs. Taylor, lets his mother know and asks for permission to use some ointment that will heal David's skin and protect it from further irritation. The mother says, "If you've got the time to put that greasy stuff on, go ahead." Mrs. Taylor uses the ointment all week and the rash goes away. She gives the mother the tube to take home and use over the weekend. On Monday morning David arrives with the rash again. This pattern is repeated over a 4-week period.

(back to top)

Signs of Sexual Abuse in Children

A child who has been sexually abused can exhibit both physical and behavioral signs. While routinely caring for young children the caregiver may notice torn, stained or bloody underclothing or bruises or bleeding in the child's external genitalia, vaginal, or anal area. If a child complains of pain or itching in the genital area or pain when walking or sitting, the caregiver should watch to see if it is a recurring problem.

Behavioral signs can include showing excessive curiosity and knowledge about sexual activities and genitalia, and fear of a specific place such as the bathroom or a bed.

Examples of signs that point to sexual abuse:

• Five-year-old Marci displays precocious sexual behavior. Frequently, her teacher sees her off by herself masturbating. One afternoon, her teacher heard her asking one of the boys if he would show her his penis. On another occasion, the teacher saw her laying the dolls on top of each other. Marci whispered to one of the dolls, "I promise not to hurt you."
• A teacher is helping Jason (age 4) get to sleep at naptime. For several weeks, Jason has been having a hard time settling down. When he does fall asleep, he sometimes wakes up crying about monsters. Today, he turns to his caregiver and says, "I've got a secret, but I can't tell you what it is."
• The children in the preschool room are sitting at the table with their caregivers eating lunch. Nancy (31/2 years old) is wiggling around in her seat a lot. Her caregiver asks her if she needs to go to the bathroom. Nancy says, "No, it's not that. My bottom hurts where Gary poked me." Gary is her 15-year-old brother.

(back to top)

Signs of Emotional Abuse in Children

This type of abuse is the most difficult to identify because the signs are rarely physical, and may not show up until the child is older. Sometimes children will exhibit facial tics, rocking motion, or odd reactions to adults in authority. Also, it may be difficult to discern between behaviors of emotionally abused and emotionally disturbed children, as the signs can be similar.

Examples of signs of emotional abuse:

• Each time he comes to pick up Nathan (51/2 years old), Mr. Wheeler makes fun of his son's efforts. Typical comments include: "Can't you button that coat right. You never get the buttons lined up with the holes. You look like an idiot." "What's that a picture of? Is that the only color you know how to use?" "Can't you climb to the top of the climber yet? All those other kids climbed to the top. What's the matter with you, are your legs too short?"

Emotional abuse may also result from family violence, that is, children witnessing physical and emotional assaults between their parents. An example follows:

• Martina is making her first home visit to the Peterson family: Mrs. Peterson and her three young children. She rings the doorbell and waits a long time for Mrs. Peterson to come to the door. She can hear lots of noise inside the apartment: loud music, adults arguing, and children crying. She rings the bell again, thinking that perhaps they did not hear her. Finally, the door opens and a man pushes his way past her. She looks inside and sees Mrs. Peterson bent over and holding her stomach. The three children are standing in the kitchen doorway holding onto each other. They look very scared, but they are not crying.

Emotional maltreatment may also take place in a child care setting when an early childhood professional uses words that belittle or shame a child, gives the child dirty looks, or consistently ignores a child. An example follows:

• Yolanda (3 years old) was so busy playing with her friends in the house corner that she wet her pants instead of using the toilet. Ms. Warner notices the girl's wet pants and walks over to the house corner. With her hands on her hips, Ms. Warner sternly says, "Well, Yolanda, I see that you aren't just playing house, you really are a baby. Only a baby would wet her pants. You're going to have to go back to the baby room if you can't keep your pants dry. Only big girls who can use the toilet can be in this room." Yolanda bursts out crying and runs to find the other teacher in the room.

When trying to identify emotional or other types of abuse it is important to take in consideration the cultural differences that exist in the United States. The children and families of America represent many cultures and ethnic groups and it is important to remain sensitive to the differences between cultural child-rearing practices that are different and those that are defined by law as abusive or neglectful.

Source:National ClearingHouse on Child Abuse and Neglect Information,
http://nccanch.acf.hhs.gov/pubs/usermanuals/caregive/

(back to top)

Signs and symptoms of sexual abuse include but are not limited to:

• bruises around the breasts or genital area;
• unexplained venereal disease or genital infections;
• unexplained vaginal or anal bleeding;
• torn, stained, or bloody underclothing; and
• an elder's report of being sexually assaulted or raped.

(back to top)

Emotional Abuse of Elders

• being emotionally upset or agitated;
• being extremely withdrawn and non communicative or non responsive;
• unusual behavior usually attributed to dementia (e.g., sucking, biting, rocking); and
• an elder's report of being verbally or emotionally mistreated.

Signs and symptoms of neglect include but are not limited to:

• dehydration, malnutrition, untreated bed sores, and poor personal hygiene;
• unattended or untreated health problems;
• hazardous or unsafe living condition/arrangements (e.g., improper wiring, no heat, or no running water);
• unsanitary and unclean living conditions (e.g. dirt, fleas, lice on person, soiled bedding, fecal/urine smell, inadequate clothing); and
• an elder's report of being mistreated.

Signs and symptoms of self-neglect include but are not limited to:

• dehydration, malnutrition, untreated or improperly attended medical conditions, and poor personal hygiene;
• hazardous or unsafe living conditions/arrangements (e.g., improper wiring, no indoor plumbing, no heat, no running water);
• unsanitary or unclean living quarters (e.g., animal/insect infestation, no functioning toilet, fecal/urine smell);
• inappropriate and/or inadequate clothing, lack of the necessary medical aids (e.g., eyeglasses, hearing aids, dentures); and
• grossly inadequate housing or homelessness.

Signs and symptoms of abandonment include but are not limited to:

• the desertion of an elder at a hospital, a nursing facility, or other similar institution;
• the desertion of an elder at a shopping center or other public location; and
• an elder's own report of being abandoned.

(back to top)

Financial Abuse of Elders

• sudden changes in bank account or banking practice, including an unexplained withdrawal of large sums of money by a person accompanying the elder;
• the inclusion of additional names on an elder's bank signature card;
• unauthorized withdrawal of the elder's funds using the elder's ATM card;
• abrupt changes in a will or other financial documents;
• unexplained disappearance of funds or valuable possessions;
• substandard care being provided or bills unpaid despite the availability of adequate financial resources;
• discovery of an elder's signature being forged for financial transactions or for the titles of his/her possessions;
• sudden appearance of previously uninvolved relatives claiming their rights to an elder's affairs and possessions;
• unexplained sudden transfer of assets to a family member or someone outside the family;
• the provision of services that are not necessary; and
• an elder's report of financial exploitation.

Source: National Center on Elder Abuse,
www.elderabusecenter.org 

(back to top)

Signs and Symptoms of Sibling Abuse

Survivors of sibling abuse & sibling sexual abuse often display signs of Post Traumatic Stress Disorder (PTSD). The symptoms are the result of traumatic events with which the survivor is unable to cope. Complex Post Traumatic Stress Disorder (CPTSD) is a relatively new term, first used by Judith Herman in her book Trauma & Recovery, and is used to distinguish symptoms and situations of CPTSD from those of PTSD.

CPTSD is frequently seen in survivors of trauma, abuse and control extending over months or years. There may also be signs of disassociative identity disorder or DID. Many of the symptoms of DID will also be found on the other lists of symptoms caused by severe trauma.

• Some people with DID may have a tendency toward self-persecution, self-sabotage, and violence. The violence may be self-inflicted and/or directed at the outside.
• Denial serves to reinforce the damage. The person will have problems that may last for a lifetime if they do not receive treatment.
• Survivors of sibling abuse & sibling sexual abuse often display signs of Post Traumatic Stress Disorder (PTSD). The symptoms are the result of traumatic events with which the survivor is unable to cope. Complex Post Traumatic Stress Disorder (CPTSD) is a relatively new term, first used by Judith Herman in her book Trauma & Recovery, and is used to distinguish symptoms and situations of CPTSD from those of PTSD.
• CPTSD is frequently seen in survivors of trauma, abuse and control extending over months or years. There may also be signs of dissociative identity disorder or DID. Many of the symptoms of DID will also be found on the other lists of symptoms caused by severe trauma.
• Some people with DID may have a tendency toward self-persecution, self-sabotage, and violence. The violence may be self-inflicted and/or directed at the outside.

This is a list of symptoms or warning signs that abuse is taking place or may have taken place. These are generally encountered in magnified proportions.

• Failure to thrive
• Weight loss/gain
• Anxiety and/or depression
• Listlessness
• Phobias or irrational/inexplicable fears
• Personal space/privacy issues
• Difficulty with authority
• Passivity
• Low self esteem
• Nightmares
• Anger
• Emotional outbursts
• Frequent illness
• Withdrawal
• Sympathy Issues
• Difficulty sleeping/insomnia or fear of the dark
• Some abused children and adult survivors may participate in:
• Addictive behavior
• Self destructive behavior
• Self injury
• Suicide threats and/or attempts
• Aberrant sexual behavior
• Prostitution

Some abused children may become:

• Aggressive
• Disruptive
• Hyperactive
• Impulsive
• Negative

Adult survivors of abuse including sibling abuse may suffer from some of these symptoms. These symptoms may vary in degree according to type and duration of abuse. Recognizing symptoms is an important first step in recovery.

Next Section ->
Return to: Resources and Information About Family Violence