Possible Signs of Abuse
Not every child will have obvious signs of abuse. However, there are some injuries that should be carefully evaulated for physical abuse. Those injuries include bruises, burns, fractures or head injuries.
Injuries that should be carefully evaluated for physical abuse
(bruises, burns, fractures)
Age 0–6 months: Any injury.
Age 6 months or older:
- Bruises, lacerations, or burns to protected, fleshy, or flexor surfaces—for example, inner thighs, abdomen, neck, and sides of the face, ears, and genitalia.
- Bruises, lacerations, or burns showing an object pattern—for example, belt loop, cigarette burn, and curling iron.
- Severe deep or extensive burns especially scald burns.
- Arms or legs that are swollen, painful, crooked (suggesting a fracture), or not being used by the child.
- Child that appears to be intoxicated or drugged.
- Child (or witness) that tells you they have been hit in the face, hit with an object, whipped, punched, slapped, kicked or beaten.
- Child who is fearful of their parent or caretaker.
Findings that should be carefully evaluated for sexual abuse
- Any history or statement or witnessed incident consistent with sexual abuse.
- Most sexually abused children will not present with acute injuries or other material evidence. “Normal” does NOT mean “Nothing happened.”
Findings that should be carefully evaluated for neglect
- Children left unsupervised in environments that are potentially dangerous or lethal.
- Children that appear malnourished, or starved and/or who demonstrate deprivational behaviors such as begging for food or eating out of the trash.
- Disregard of one or more basic child care needs—for example, soft drink in baby bottle, child found in street, failure to place child in auto safety seat or belt.
Other situations that merit a closer inspection of children for abusive injuries
- Adult violence, including domestic violence, in the home.
- Caretakers that are intoxicated (drugs or alcohol).
Note: A child may have findings suggesting more than one form of abuse or neglect.
