Recognizing Child Abuse and Neglect

Abuse and neglect can take many forms, and it’s not always easy to notice if you’re not sure what to look for. We’ve compiled signs of maltreatment that should serve as red flags if you notice a child displaying one or more.

Please note: we do not take reports of abuse. If you suspect a child is suffering from any type of abuse or neglect, please report it to the Indiana Department of Child Services by calling 1-800-800-5556.

Physical abuse includes the infliction of physical injury or allowing another to do so. Physical indicators may include:

  • Unexplained bruises, especially on “fleshy” areas of a child (buttocks, face, neck, backs of the legs)
  • Any unexplained bruises on infants… (remember, “We don’t bruise ‘til we cruise”)
  • Unexplained injuries
  • Unexplained lacerations or abrasions
  • Hemorrhages
  • Burns by cigarettes
  • Burns by immersion
  • Dental/oral injuries

Potential behavioral indicators may include:

  • 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

Potential behavioral indicators in abusive caretakers may include:

  • Harsh disciplinarian
  • Describes child in a consistently negative manner
  • Defensive
  • Conceals or misleads about child’s injuries
  • Substance abuser

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

Neglect is the chronic failure to meet the basic needs of a child for food, clothing, shelter, medical care, education, or supervision. Physical indicators may include:

  • Flat, bald spots on infant’s head
  • Dirty, smelly, torn, or inappropriate clothing for the weather
  • Developmental lags
  • Underweight

Potential behavioral indicators may include:

  • Listless
  • Begging/stealing food
  • Constant fatigue
  • Alcohol or drug use
  • Reports being left alone

Behavioral indicators in negligent by caretakers may include:

  • Substance abuser
  • Chaotic life style
  • Apathetic
  • Expects too much of child

Sexual abuse is the 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. Physical indicators may include the following, but please keep in mind physical indicators are not always present, even upon medical exams:

  • 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 may include:

  • Aggressive, overt sexual behavior
  • Drawing pictures of people with genitals or vagina
  • Cruelty to animals without physiological basis
  • Premature 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 in sexually abusive caretaker may include:

  • 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
  • Engages in the sexual exploitation of the child
  • Substance abuser

Non-contact sexual offenses include:

  • 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 may 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 human trafficking
  • Using a child to film, photograph, or model pornography
  • Sexual Abuse images

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, substance abuse, and unhealthy relationships. Children may lose trust in adults in their lives, suffer feelings of guilt, or develop self-abusive behaviors.

What can we do to protect children?

It is an adult’s responsibility to protect children from sexual abuse.  Become educated about sexual abuse prevention, and ask all youth serving organizations what they are doing to protect your child from sexual abuse.

Parents need to teach their children the correct names of body parts.

Caregivers and 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 survivors of abuse to seek support groups and therapy.

Parents need to become educated around Protective Factors. Again, it is an adult’s responsibility to protect a child. You can learn more by going to

Emotional neglect is the chronic failure by the caretaker to provide the 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’s not there. Behavioral indicators can include:

  • Low self-esteem
  • Difficulty forming positive relationships
  • Eating disorders
  • Elimination problems
  • Speech disorders
  • Inability to trust
  • Sleep problems
  • Lack of empathy
  • Self-harming behaviors
  • Apathetic
  • Suicidal
  • Withdrawal
  • Anxiety, fear
  • Developmental lags
  • Reports emotional maltreatment

Behavioral indicators of emotionally negligent caretakers can include:

  • 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 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”
  • Being exposed to domestic violence

Effects of emotional abuse may include:

  • 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 abuse?

  • 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, likable, 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 occurs when 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.
  • 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