5 Signs of Child Abuse You Should Never Ignore

Child abuse is an uncomfortable issue, but it’s important to take it seriously. Sadly, some form of child abuse affects 1 in 4 children. It’s a significant cause of childhood injury and death. 

Everyone can play a role in protecting and advocating for kids. To help keep children safe, learn the signs of child abuse and what to do if you have concerns.

What are different types of child abuse?

Child abuse is when someone takes part in or withholds care that leads to potential or actual harm of a child. Types of child abuse include:

• Physical abuse: This includes beating, shaking, burning, and biting.

• Sexual abuse: This is when children are involved in sexual activities they don't understand and can’t give consent to.

• Emotional or psychological abuse: This includes verbal abuse, humiliation, and actions that scare a child. This can result in mental health issues for the child.

• Medical child abuse: This is a rare form of abuse where a child gets unnecessary medical care. This is often due to a caregiver exaggerating or making up a child’s symptoms of illness.

• Neglect: This is the most common form of child abuse and may include inadequate supervision and unmet needs.

5 signs of child abuse

Child abuse can be hard to spot because the child may not have the language or understanding to describe what happens to them. This is why knowing the signs of child abuse may help a child get the assistance they need. 

Here are five signs of possible child abuse. 

1. The explanation for an injury doesn’t make sense

To figure out if an injury is from an accident or abuse, consider if the story about the injury makes sense. For example, an infant isn’t likely to get a serious injury from a fall. So this explanation is a red flag for a child of this age. That’s because young infants aren’t able to move around much. This makes falls and accidents less likely in this age group.

2. Many injuries at different stages of healing

Children have accidents. So an accident that causes an injury, like a broken bone from a fall, isn’t an automatic concern for abuse. But it may be a red flag if a child has many serious injuries at the same time. 

This is especially true if there are many injuries at different stages of healing. This can be a sign of separate abuse events that happened over time.

3. Bruises or injuries in concerning areas or patterns

Active toddlers and children often have bumps and bruises in common areas like the shins, knees, and forehead. But it’s less common to have accidental bruising in other areas of the body. And this might be a sign of physical abuse.

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It’s a red flag to see multiple bruises on the:

• Torso

• Ear

• Neck

• Genitalia

• Hands

• Feet 

4. Opening up about being harmed

In some cases, a child who can speak may directly tell you that they have been harmed. Always take a statement like this seriously until proven otherwise.

If a child tells you that they have been harmed, make sure the child knows that they’re safe with you. You can ask questions to get more information and contact the child protective agency in your area.

5. Sexual behavior that is inappropriate for their age

Young children have a normal curiosity about their bodies and sexuality. But their behaviors are typically appropriate for their developmental age. Signs of sexual abuse in a child can be more subtle, so catching red flags can be tough. 

Certain behaviors that fall outside the norm for sexual development include: 

• Repeatedly undressing in front of others

• Trying to watch others undress 

• Touching the genitals of others

Keep in mind that these signs don’t mean there has definitely been child abuse. But this behavior is a signal to take a closer look or to contact authorities who can look into it.

What are the symptoms of child abuse?

Symptoms of child abuse can vary depending on the age of the child. Abused children may have symptoms like: 

• Fearful behavior

• Irritability

• Sleep problems

• Unexplained abdominal pain or headaches 

• Sud­den bed-wetting (especially if the child is already toilet trained)

• Failing grades in school

• Overly affectionate behavior

• Social withdrawal

• Thoughts or comments about suicide 

Possible complications of child abuse

Beyond pain and suffering, abuse can lead to long-lasting physical and emotional health issues. Let’s take a closer look at long-term effects of abuse in a child.

Disability

All abuse is harmful and tragic, but the type and severity of physical injuries can vary. Certain injuries, like abusive head trauma, can cause permanent harm or disabilities. 

Disabling injuries from child abuse can include:

• Deformities

• Vision and hearing problems

• Epilepsy

• Cerebral palsy

• Developmental delays 

Behavioral problems

Child abuse also negatively affects the social and emotional development of a child. Some behavior problems that can happen as a result of child abuse include:

• Aggressive behavior

• Conduct disorders

• Depression or anxiety

• Failing grades in school

• Decreased cognitive function

Chronic stress

Experts believe child abuse can also lead to toxic stress. This can affect many body systems leading to physical and emotional health problems. Chronic stress can affect:

• The brain

• The stress response

• Immune system function

These changes are associated with physical and behavioral health trouble even decades after the abuse.

What to do if you suspect a child is being abused

You can always reach out to a child protective agency if you suspect child abuse. Each state has a system of agencies that can receive and respond to possible child abuse and neglect reports. 

Some states require anyone to report concerns of child abuse. But most states require that only certain professionals must report possible abuse. These mandatory reporters include: 

• Social workers

• Medical and mental health professionals

• Teachers

• Childcare providers

• Law enforcement officials

Reporting abuse is not something to take lightly. But you don’t have to be 100% certain that there’s abuse. Having a nagging suspicion or seeing a red flag is enough to make a call. The child protective services agency will decide what to do with the information and whether to investigate further.

Resources and support for domestic violence

Identifying and reporting child abuse can be very difficult. But remember that you have support. If you suspect that a child is being abused, contact:

• Childhelp® National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453) 

• Child Welfare Information Gateway 

• National Children's Alliance 

• Do Right By Kids 

• Your pediatrician

For immediate help, call 911.

Why trust our experts?

Written by:

Louisa Salisbury, MD

Louisa Salisbury, MD, is a licensed, board-certified general pediatrician. She received a bachelor’s degree in human development from the University of California, San Diego, and obtained her medical degree from the University of Vermont Robert Larner College of Medicine.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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