Recognizing Abuse and Neglect

If you suspect a child is suffering from any type of abuse neglect, report it to Indiana Department of Child Services by calling 800-800-5556.

Physical Abuse: 

Infliction of physical injury or allowing another to do so.

Possible Physical Indicators: 
Unexplained bruises, especially on “fleshy” areas
Unexplained welts
Unexplained burns
Unexplained lumps
Unexplained bumps
Unexplained fractures
Unexplained lacerations or abrasions
Hemorrhages
Burns by cigarettes
Burns by immersion
Dental/oral injuries

Potential Behavioral Indicators:
Verbally reports abuse
Too eager to please
Depression
Low self-esteem
Behavioral extremes
Role reversal
Developmental lags
Appears frightened of caretaker
Apprehensive children cry
Exaggerated startle response
School absenteeism

Behavioral Indicators of Caretaker:
Harsh disciplinarian, describes child in a consistently negative manner, defensive, conceals or misleads about child’s injuries, substance abuser.

 

Neglect:

Chronic failure to meet basic needs of a child for food, clothing, shelter, medical care, education or supervision.

Possible Physical Indicators:
Flat, bald spots on infant’s head
Dirty, smelly, torn, dirty or inappropriate clothing for the weather
Developmental lags
Underweight

Potential Behavioral Indicators:
Listless
Begging/stealing food
Constant fatigue
Alcohol or drug use
Reports being left alone

Behavioral Indicators of Caretaker:
Substance abuser, chaotic life style, apathetic, expects too much of child.

 

Sexual Abuse

Sexual Abuse: Utilization of a child for sexual gratification by an adult or older child in a position of power, or permitting another person to do so.

Possible Physical Indicators: 
Any venereal disease
Bruised/dilated genitals or rectum
Pregnancy under 16 years of age
Difficulty/pain in walking or sitting
Foreign matter in bladder, rectum or urethra
Pelvic inflammatory disease
Torn, stained or bloody underclothing
Recurrent urinary tract infections

Potential Behavioral Indicators:
Aggressive, overt sexual behavior
Drawing pictures of people with genitals or vagina
Cruelty to animals without physiological basis
Pre-mature knowledge of explicit sexual acts
Sleep disorders
Taking frequent baths
Starting fires
Self-inflicted injuries
Expresses fear of a particular person or place
Reports sexual abuse

Behavioral Indicators of Caretaker:
Extremely protective of family privacy, does not allow child to be involved in extra-curricular activities, does not want child to engage in developmentally appropriate activities i.e. dating, encourages child into prostitution, substance abuser.

Non-contact sexual offenses:
• Indecent exposure/exhibitionism
• Exposing children to pornographic material
• Deliberately exposing a child to the act of sexual intercourse
• Masturbation in front of a child

Touching sexual offenses include:
• Fondling
• Making a child touch an individual’s sexual organs
• Any penetration of a child’s vagina or anus – no matter how slight by a penis or any object that does not have a valid medical purpose

Sexual exploitation of a child is also an offense and can include:
• engaging or soliciting a child for the purposes of prostitution
• using a child to film, photograph or model pornography

What are long-term effects of child sexual abuse?
Child sexual abuse may have lifelong effects on children resulting in serious emotional problems including depression, anti-social behavior and identity confusion. Children may lose trust in adults in their lives, suffer feelings of guilt or develop self-abusive behaviors. The memories of abuse may even be suppressed until later in their adult lives.

What can we do to protect children?
• Parents can help to protect their children by teaching them that they can say “no” to a person who touches them in a way that makes them uncomfortable. Parents can make sure that their children know that they can report inappropriate behavior to them or another trusted adult and that they will be believed. Promptly reporting suspected abuse of any child is important.
• Professionals should be aware of the physical and behavioral indicators of abuse. Many professionals have the opportunity to be positive role models for parents and caregivers. In addition, professionals can encourage victims of abuse to seek support groups and therapy.
• Parents need to become educated around Protective Factors. It is an adult’s responsibility to protect a child. You can learn more by going to www.d2l.org

Emotional Maltreatment

Emotional Neglect – Chronic failure by the caretaker to provide support and affection necessary to develop a sound and healthy personality. When a child is emotionally neglected, he or she is being hurt by what is not there.

Potential Behavioral Indicators:
Low self esteem
Difficulty forming positive relationships
Eating disorders
Elimination problems
Speech disorders
Inability to trust
Sleep problems
Sadistic, masochistic
Apathetic
Suicidal
Withdrawal
Anxiety, fear
Developmental lags
Reports emotional maltreatment

Behavioral Indicators of Caretaker:
Rejecting, ignoring, terrorizing, isolating, corrupting

Emotional neglect may include:
• Habitual lack of attention, affection, emotional support or supervision
• Refusal of treatment or services recommended by school or medical personnel
• Punishing indiscriminately without teaching right from wrong
• No “family time” for shared social experiences such as meals, discussions about feelings or family outings
• Showing no interest in a child’s schoolwork, grades, hobbies or friends
• Lack of supervision with no established expectations for behavior

 

Emotional Abuse

Emotional abuse is a chronic attitude or act of a caretaker that is detrimental to the child’s development of a sound and healthy personality. Emotional abuse is often expressed in verbal abuse, making a child feel that he or she is worthless and unworthy of attention and love.

Emotional abuse may include:
• Verbal threats of bodily harm
• Mis-socialization of a child into harmful behaviors such as lying or stealing
• Demeaning a child with comments such as “you’re stupid,” “you’re no good,” “you’re ugly,” or “I hate you”

Effects of Emotional Maltreatment
• Low self esteem
• Difficulty in forming positive relationships
• Defiant behavior
• Inability to trust
• Poorly developed ability to empathize with others
• Apathy
• Elimination disorders
• Speech disorders
• Eating disorders
• Derives pleasure from hurting others
• Suicide attempts

What Can We Do To Prevent Emotional Maltreatment?
• Teach parents and caregivers to set limits, communicate directions and provide structure for children and youth with loving, rather than hurting, words.
• Tell children and youth that they are special, important, lovable, likeable and talented.
• Provide support and education to parents and caregivers who are adult supervisors of maltreatment to help break the cycle of abuse.

 

Medical Neglect

Medical neglect: even minimal health care is not being obtained for a child. This lack of health care can lead to serious harm and even death. For example, an untreated cold or flu can result in pneumonia, which can be fatal.

Signs of medical neglect include:
• Adult does not use emergency services at all, even with severe injury or illness
• When medicine is prescribed, the prescription is not filled
• Dental needs go untreated
• Regimens recommended for treatment of chronic illness not followed
• Prescribed psychological help not obtained
• Failure to thrive: Failure to thrive is a significantly underweight child, usually less than 18-months-old. Any child suffering from failure to thrive should be reported as a potential victim of neglect. Approximately 30 percent of failure to thrive cases have an organic cause and require the adult to seek medical attention for the child.
Warning signs include:
• Prominent ribs
• Thin buttocks
• Much wrinkled skin
• Spindly arms and legs

If you suspect a child is suffering from medical neglect, contact Indiana Department of Child Services. If you have questions about the health of your or any other child, contact your local health care provider, or visit the links below:
American Academy of Pediatrics provides expertise and tips for child safety and health
• Indiana Family Helpline: 1.800.433.0746 is staffed Monday through Friday, 7:30 a.m. to 5:00 p.m. and has an answering machine at all other times. Staffed by the Department of Health, they will help you locate and receive information on a range of health questions

Sources: “Child Maltreatment: A Clinical Guide and Reference,” A.E. Brodeur & J.A. Monteleone; “Field Guide to Child Welfare,” Judith Rycus & Ronald Hughes; Child Welfare Information Gateway