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Common symptoms of physical, emotional, and sexual abuse
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It can be really scary if you think your child or a child you know is being abused. Recognizing common signs and symptoms can play a big part in putting a stop to any abusive situations and ensuring the child’s safety. Child abuse can be physical, emotional, and/or sexual, and the signs for each may differ. Keep reading to learn what behaviors to look out for if you suspect child abuse or neglect. If you notice any of these signs, contact the police or your local child protective services office immediately.

Things You Should Know

  • Reverting to outgrown behaviors, being overly submissive or aggressive, and a lack of attachment to a caregiver are signs of emotional abuse.
  • Signs of physical abuse include unexplained injuries (bruises, bites, scratches, etc.), fear of caregivers, and sudden changes in behavior.
  • Children who have been sexually abused may have an inappropriate knowledge of sex, fear physical touch, and have trouble sitting or walking.
Section 1 of 5:

Signs of Physical Abuse

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  1. It’s normal for infants and toddlers to get a few bumps and bruises while they curiously explore their surroundings. However, if a child you know is coming to you with numerous severe injuries, that’s a major reason to be concerned. This can include things like burns, bites, bruises, broken bones, or black eyes. Marks from abuse often appear in places where children don’t normally get hurt, such as their back, buttocks, torso, or thighs. [1]
    • Take note if the injuries seem to be oddly shaped, such as bruises that resemble a person’s hand or footprint.
    • Keep in mind that some forms of physical discipline, like mild spankings, are not necessarily abuse.
    • The child might also wear heavy clothing even in the hottest weather to try and hide their abused body. So look for that sign of physical abuse. [2]
  2. An infant or toddler who has been abused by someone at home may not want to go home. They may avoid their parents or other caregivers—for instance, by forcefully clinging to a teacher at preschool when it’s time to go home. [3]
    • Mild separation anxiety is common among infants and toddlers and does not necessarily indicate abuse.
    • Keep in mind that just because a child seems afraid of their caregiver, it doesn’t automatically mean that that caregiver is being abusive. If there’s a problem, someone else at home may be the cause.
    • Not wanting to go home is normal if the child is in a place they consider fun. However, if the place isn't somewhere they find particularly fun, or if they seem more fearful than sad or angry, or if it happens all the time, it might be a sign.
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  3. It’s common for an abused child to suddenly act differently. For example, you might notice that a normally active and outgoing toddler has become much more withdrawn or quiet. Or if they are normally very gentle but have suddenly become aggressive, this might be a sign that they’re being abused. Sudden anxiety, fear, and/or depression are also key signs. [4]
    • For example, a child you know might have really liked playing outside, but now they’re very afraid when you suggest going out.
    • Infants and young toddlers can also show changes in behavior. For example, they may become overly fussy without any explainable cause.
    • This might also be a sign of some other trauma that isn't abuse. If you don't know which it is, perhaps get a child psychologist's opinion.
  4. If a child has been the victim of abuse, it’s unlikely that they’ll be able to fully understand what has happened to them. As a result, they may talk a lot about violent or traumatic events, or about hurting themselves or others. They may also become very aggressive with other people. [5]
    • For example, if you’ve noticed a child talking a lot about wanting to hurt other kids or suddenly becoming obsessed with violent games, this might be a sign of abuse.
    • If you work at the child’s school or daycare and notice them suddenly fighting with other kids or bullying them, it’s a good idea to step in and ask the child why they’re behaving so aggressively.
  5. It’s natural for infants and toddlers to sometimes be picky eaters. However, if the child seems to have significantly changed how they eat without a clear cause (such as experiencing a growth spurt or being sick), this might be a sign they’ve been abused. Changes in eating caused by stress, anxiety, or fear may cause them to stop eating or to overeat. A noticeable sign is if they gain or lose a lot of weight in a relatively short period of time. [6]
    • Child abuse can also sometimes lead to children developing eating disorders, due to children who are abused are constantly being shamed and they may develop body image issues because of it.
    • Signs a child has an eating disorder are believing themselves to be too fat, trying to make themselves throw up (especially after eating), eating a lot more or a lot less than usual (without some clear other cause like a growth spurt), unusual behaviour around food (such as cutting it into small pieces), wanting to eat alone, seeming stressed around mealtime, seeming malnourished, and other psychological distress such as depression or anxiety attacks. If your child shows signs of an eating disorder, regardless of whether it was caused by abuse, seek professional help immediately.
  6. An infant who normally sleeps through the night may begin to wake up multiple times throughout the night. Or, a toddler may talk about having nightmares frequently. These are both signs of possible abuse. Another symptom is being more tired during the day and not having a lot of energy. [7]
    • Nightmares are more common among younger children than older people, but if it's happening more than usual, or if the nightmares have a recurring theme and/or keep the child awake, it might mean some kind of trauma (whether abuse or a different kind of trauma).
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Section 2 of 5:

Signs of Sexual Abuse

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  1. It’s totally normal for a child to be curious about things like how babies are made and the differences between boys and girls. However, if a toddler seems to know a lot about sex at such a young age, or if they talk about it frequently, this may be a red flag suggesting they’ve been sexually abused. [8]
    • For example, it’s concerning if a child is explaining sexual acts in graphic detail.
  2. A child that has been sexually abused may experience some physical trauma as a result. If you notice that a child is having trouble walking or sitting, or if they complain about pain when they do so, it’s reasonable to suspect sexual abuse. [9]
    • Another sign is if a child complains about pain or itching in their genital area. This might also mean a UTI or a yeast infection, but it could be abuse if it's paired with other signs. [10]
  3. If a child has suffered from sexual abuse, they might be afraid of changing or taking off their clothes in front of you or other people. Or you might notice that they’re afraid of one specific person. For example, they may outright refuse to change, or a young child might cry or throw a tantrum. [11]
  4. If you notice that a child shies away when you try to hug them or touch them in any other way, this could be a cause for concern. Of course, some children just aren’t too fond of physical touch. But if you notice a dramatic change, such as your child demanding hugs every night and suddenly stopping one day, this might be a sign that they’ve been abused. Another example would be if a toddler or infant starts crying when you approach them or try to touch them. [12]
    • If you notice that a child looks afraid when others try to approach them, this is a major reason to be concerned.
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Section 3 of 5:

Signs of Emotional Abuse

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  1. Abuse can make children feel insecure, and they may begin acting younger than their age. For example, a potty-trained child may begin to wet the bed again, or they may start sucking their thumb again despite having stopped a long time ago. [13] This is a very common sign of emotional abuse, and other types of abuse as well, that you should definitely not ignore. This kind of behavior mainly happens in younger children.
    • Other examples include a sudden fear of the dark or strangers, memory problems, and a loss of acquired language skills (going from full sentences to broken phrases, forgetting words, etc.).
    • Regression could also be a response to a different kind of trauma, or to a change in the child's life. Children usually regress because of some sort of stress, and they regress back to a time where they felt happier and safer. This is why a child who has been abused might start sucking their thumb again like they had done when they were younger.
  2. Infants and toddlers are both naturally interested in pleasing adults and testing boundaries. However, children who have been abused may go to one extreme or another. You might notice that a child only wants to do what adults say, or they may be constantly defiant or demanding towards you. [14]
    • For example, if a child throws a tantrum every time you ask them to do something, this may be a reason to worry.
    • On the other hand, a child who easily submits whenever you ask them to do something might also be a cause for concern, especially if they seem afraid of you.
  3. Infants and toddlers often share a rather deep emotional attachment with their parents or guardians. However, children who have been abused by their caregivers might act distant from or apathetic toward them. For example, when their caregiver comes to pick them up at daycare, you may notice that the child doesn’t run to them excitedly as other children might. The child may also avoid being touched by their caregiver and may not turn to them when they’re upset. [15]
  4. A child being emotionally abused by someone may show slower signs of development than what is considered normal. They may hit certain developmental milestones later than others, and may regress easily. For example, you may notice that a toddler still isn’t walking even at 2 years old. They may also have trouble speaking and forming full sentences. Another sign is if they aren’t easily pacified when having a tantrum. [16] They may also experience regressions.
    • This might also be a sign of a disability or an alternate neurotype (for instance, late walking might mean they need a wheelchair, or trouble speaking might mean they're autistic).
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Section 4 of 5:

Signs of Neglect

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  1. If a child is constantly absent from daycare or school with no clear cause, like being sick or on vacation, it’s possible that their caregiver is neglecting them. If you work at their daycare or school, you may notice that they also begin to behave differently, such as becoming more withdrawn or aggressive with other children or teachers. [17]
    • Whether you’re a concerned parent or a staff worker, don’t hesitate to ask the child’s caregiver what the reason for their absence was. Ask in a polite but direct way by saying something like, “We haven’t seen Tommy in a while. Is everything alright?”
    • Take note if the caregiver seems reluctant to talk about the situation or if they lie about it.
    • For example, they may say, "We went to visit his grandparents on the other side of the country," even though you know their grandparents live in the same city. This is a good reason to be suspicious.
  2. Caregivers who neglect their children may not bathe them properly or maintain their personal hygiene. For example, a child may be dirty, have overgrown hair or fingernails, or may have severe body odor. In the case of infants, they may be left in dirty diapers, and their caregiver may not bathe them regularly. [18]
  3. A neglectful caregiver might not dress their baby or toddler appropriately for the weather. For example, it’s reasonable to suspect child neglect if you notice a toddler playing outside in the winter and not wearing a thick winter coat. Another case would be if you notice a child almost never wearing shoes. [19]
  4. A very extreme sign of neglect is if a caregiver isn’t taking their child to get proper medical exams and treatment. This includes things like sending a child to daycare or school when they're sick, not giving them required vaccinations, leaving dental issues unchecked, or not giving them glasses when they clearly need them. [20]
  5. A neglectful caregiver may not provide their child with enough food. In these cases, you might notice the child asking for food or even stealing it. If they repeatedly come to daycare or school without lunch, this could be a sign of neglect. [21]
    • It is sometimes normal for kids, especially very young ones, to steal food and other things, but be on alert if the child seems desperate and isn’t just being mischievous.
  6. At such a young age, infants and toddlers should not be left alone for long periods of time. If you notice that a child’s caregiver isn’t around and they often leave their child unsupervised, this might be a red flag signaling neglect. Be wary if they seem to be leaving a child outside to play by themself without any supervision, leaving them home alone for a long period of time, or not attending to a crying infant right away. [22]
    • If you think the child has been left in a potentially dangerous situation, don’t hesitate to call your local child protective services or the police.
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Section 5 of 5:

How to Handle Suspected Abuse

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  1. If the child is able to verbally communicate (which may not be the case for young infants), pull them aside to ask them about the situation. Ask them direct questions that they can answer easily, such as “Has someone been touching you?” or “Did someone hit you?” Allow the child to talk freely and be sure to reassure them that they won’t get in trouble for telling you. [23]
    • Keep your tone light and casual. If you sound too serious, the child may be scared and become unwilling to share.
    • Take notes about what the child says to present as evidence later when you make your report.
    • If your child tells you they’ve been abused, never just brush it off and never assume that they are lying. Kids rarely lie about being abused if they actually aren’t. In fact, the opposite more often happens. A lot of times, children who are abused try to cover it up and not tell anyone.
  2. Locate the number for your local child protective services office to make a report or dial 911 if the child is in danger. Another option is to call the Childhelp National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453). [24]
    • Anyone can make a report concerning suspected child abuse, and you have the option to remain completely anonymous.
    • When you make your report , give a full and honest account of what you’ve seen and any suspicions you may have.
    • If you’re reporting on behalf of another child and don’t suspect their caregiver to be causing the abuse, talk to the caregiver before reporting and let them know about the situation.
  3. Until the authorities have been notified and an investigation is underway, make sure that the child is kept safe from their possible abuser. For example, if you suspect your child’s teacher to be the perpetrator, take your child out of school for a few days while the investigation is underway. Don’t threaten the suspected abuser or directly confront them. [25]
    • If you suspect a child’s caregiver to be abusing them, contact another member of the child’s family to look after them or have them stay at daycare or school.
  4. Beyond helping with the medical side of abuse injuries, a pediatrician can help you contact the police and child protective services to start an investigation. They may tell you to take the child to the hospital where doctors can make an initial diagnosis, do tests, and give them treatment. They might also refer you to a special clinic or a child psychologist to help the child deal with and understand their emotions. [26]
    • If you suspect a child is being abused, you have the option to take them to the hospital where the doctor can contact child protective services.
    • Make sure to show the authorities any evidence of the abuse, such as pictures of injuries, attendance records, or statements from the child.
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Expert Q&A

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  • Question
    If you don't know who the abuser is, will the abused child still be taken away?
    Laura Marusinec, MD
    Board Certified Pediatrician
    Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.
    Board Certified Pediatrician
    Expert Answer
    If you suspect child abuse, you should report it to the police right away, even if you don't know who the abuser is. The police or a social worker will investigate, and the child will be removed from any situation that could be dangerous for them. If there isn't any evidence or concern that the parent or caregiver has abused the child, the police will most likely not take the child away from them while they continue to investigate.
  • Question
    If you have a picture of possible child abuse or injuries, who can you talk to to see if it really is purposeful child abuse?
    Laura Marusinec, MD
    Board Certified Pediatrician
    Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.
    Board Certified Pediatrician
    Expert Answer
    Bring your child and the photos to your child's pediatrician right away. They take a look at the pictures and you child, and can help you decide if there's a reason to suspect abuse. If so, they'll contact local social workers or child protective services to look into the possible abuse and investigate the abuser.
  • Question
    What should you do if the child's parents are divorced and you suspect the father of sexual abuse?
    Laura Marusinec, MD
    Board Certified Pediatrician
    Dr. Marusinec is a board certified Pediatrician at the Children's Hospital of Wisconsin, where she is on the Clinical Practice Council. She received her M.D. from the Medical College of Wisconsin School of Medicine in 1995 and completed her residency at the Medical College of Wisconsin in Pediatrics in 1998. She is a member of the American Medical Writers Association and the Society for Pediatric Urgent Care.
    Board Certified Pediatrician
    Expert Answer
    This is always a tough situation. First, make sure you're not just angry at the father and making rash accusations. If you do have concrete reasons to suspect that he may be abusing the child, talk to the child if possible. Bring them to a pediatrician and explain what you are worried about and why. The pediatrician can then contact local social workers and child protective services. They'll continue to work with you to find out if the child has been abused.
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      Warnings

      • If you believe a child is in immediate danger of abuse, contact the police or your local child protective services office right away.
      • Don't be afraid to raise concerns. The risk of being wrong is a much smaller consequence than an abused child without help.
      • Abuse is not restricted to any one type of child. Any child could be abused, no matter how they look, who their family is, or where they come from.
      • Children are constantly developing, so it is normal to see some variation in behavior and emotions from day to day. If you see a consistent pattern of warning behavior, however, or evidence of a potentially severe or imminent threat, take action.
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      About This Article

      Article Summary X

      While it can be hard to tell if a toddler or baby is being abused, certain behavioral and emotional signs should alert you to contact the authorities. For example, it’s common for abused children to suddenly act differently, like a child who is typically outgoing becoming withdrawn. Notice if the child also falls back on behaviors that they have outgrown, like a potty-trained child wetting the bed again or a toddler who no longer sucks their thumb reverting to that behavior. Look for eating changes as well, like a loss of appetite despite feeling fine or eating so much food that they gain weight rapidly. The child may also seem afraid to leave school or daycare or not want to go with a caregiver. This can also be a sign that the child is being abused either by that person or by someone else in the house. If you suspect a child is being abused, talk to a pediatrician right away since they can contact the authorities to start an investigation. To learn how to observe physical signs of abuse in a toddler or baby, keep reading!

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