Screening: Child Abuse

Child abuse is a broad term that refers to the mistreatment of a child by another person. Legal definitions vary from state to state, but generally include physical abuse, sexual abuse, physical or emotional neglect, and emotional abuse.

Physical abuse is deliberate physical contact that causes significant pain, results in injury, or jeopardizes the child’s safety. It includes hitting, kicking, biting, shoving, shaking and burning.

Sexual abuse is the involvement of a child in any act intended for adult sexual gratification. It includes both sexual assault (with physical contact) and sexual exploitation.

Child neglect occurs when a caretaker fails to provide for the child’s basic emotional needs or the child’s physical needs, such as food, shelter, clothing, health care and education. It includes inadequate supervision, lack of medical care, lack of appropriate affection and abandonment.

Emotional abuse can occur with or without other forms of abuse. It is difficult to define or document, but generally refers to behaviors that interfere with a child’s emotional health or social development. Emotional abuse includes verbal abuse, inattention, rejection and terrorization.

Unfortunately, child abuse is an enormous problem, affecting all socioeconomic, cultural, racial and religious groups. It is important to recognize the signs and symptoms of child abuse to protect your child and other children in your community. Some children who are abused have obvious physical injuries, but in many cases, the abuse is not readily apparent.

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Detecting abuse can be difficult because it is often hard to know when normal parenting ends and abuse begins. Many parents lose their temper from time to time and even raise their voices when they are frustrated. It is normal, even wise at times, to set limits and administer appropriate punishment; children require discipline and structure along with nurturing and love. However, parenting “styles” that appear to include abuse deserve evaluation.

With any report of suspected abuse, evaluation usually involves intruding on a family’s privacy. Privacy is an important value in our society; however, the primary concern should always be for child safety. A report should never be made frivolously or because of a disagreement in parenting style, but take seriously any suspicions you have that a child is being abused.

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Some possible signs of child abuse include:

  • Unusual injuries or injuries that don’t match the child’s abilities (for example, a broken bone in a child who doesn’t yet walk or climb)
  • Injuries that can’t be explained or that have unlikely (suspicious) explanations
  • Injuries that are in the shape of an object (for example, belt buckle, coat hanger, circular cigarette burn)
  • Repeated injuries
  • Disagreement between the child’s explanation for how the injury happened and the caretaker’s explanation
  • Apparent neglect of the child’s physical needs, such as food, shelter, clothing, education, medical or dental care
  • Aggressive behavior: child may fight, have frequent tantrums, destroy property, hurt animals
  • Withdrawn behavior: child may have difficulty making friends, avoid physical contact with parents or adults, drop out of activities
  • Fearful behavior: child may seem afraid of parents or other adults, may be reluctant to go home
  • Regressive behavior: child may start acting like a younger child, for example, suck his thumb or wet the bed (but was previously toilet trained)
  • Difficulty sleeping: child may seem tired; may have lots of nightmares
  • Change in appetite: child may not feel like eating or may overeat
  • Excessive sadness or frequent crying
  • Frequent physical complaints (such as headaches, abdominal pain, etc.)
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Note that many of these signs are not unique to child abuse. Other possible causes need to be considered before conclusions about abuse are reached.

If you suspect that a child you know is being abused in any way, do something about it. Contact your local child protective services agency, emergency hotline or police department. Abuse must be reported in the state in which it occurred. If you need help finding a local number, call the National Child Abuse Hotline at (800) 422- 4453 or online at

If you are afraid that you might abuse a child or you think you may have abused a child, talk with a friend, a relative, a doctor or another trusted adult immediately. Ask them to help you find a qualified mental health professional for counseling and support right away. It is essential to your health and the health of your child that you get the help you need.

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