Any intentional harm or mistreatment to a child under 18 years old is considered child abuse. Child abuse takes many forms, which often occur at the same time.
- Physical abuse. Physical child abuse occurs when a child is purposely physically injured or put at risk of harm by another person.
- Sexual abuse. Sexual child abuse is any sexual activity with a child, such as fondling, oral-genital contact, intercourse, exploitation or exposure to child pornography.
- Emotional abuse. Emotional child abuse means injuring a child's self-esteem or emotional well-being. It includes verbal and emotional assault — such as continually belittling or berating a child — as well as isolating, ignoring or rejecting a child.
- Medical abuse. Medical child abuse occurs when someone gives false information about illness in a child that requires medical attention, putting the child at risk of injury and unnecessary medical care.
- Neglect. Child neglect is failure to provide adequate food, shelter, affection, supervision, education, or dental or medical care.
In many cases, child abuse is done by someone the child knows and trusts — often a parent or other relative. If you suspect child abuse, report the abuse to the proper authorities.
A child who's being abused may feel guilty, ashamed or confused. He or she may be afraid to tell anyone about the abuse, especially if the abuser is a parent, other relative or family friend. That's why it's vital to watch for red flags, such as:
- Withdrawal from friends or usual activities
- Changes in behavior — such as aggression, anger, hostility or hyperactivity — or changes in school performance
- Depression, anxiety or unusual fears, or a sudden loss of self-confidence
- An apparent lack of supervision
- Frequent absences from school
- Reluctance to leave school activities, as if he or she doesn't want to go home
- Attempts at running away
- Rebellious or defiant behavior
- Self-harm or attempts at suicide
Specific signs and symptoms depend on the type of abuse and can vary. Keep in mind that warning signs are just that — warning signs. The presence of warning signs doesn't necessarily mean that a child is being abused.
Physical abuse signs and symptoms
- Unexplained injuries, such as bruises, fractures or burns
- Injuries that don't match the given explanation
Sexual abuse signs and symptoms
- Sexual behavior or knowledge that's inappropriate for the child's age
- Pregnancy or a sexually transmitted infection
- Blood in the child's underwear
- Statements that he or she was sexually abused
- Inappropriate sexual contact with other children
Emotional abuse signs and symptoms
- Delayed or inappropriate emotional development
- Loss of self-confidence or self-esteem
- Social withdrawal or a loss of interest or enthusiasm
- Depression
- Avoidance of certain situations, such as refusing to go to school or ride the bus
- Desperately seeks affection
- A decrease in school performance or loss of interest in school
- Loss of previously acquired developmental skills
Neglect signs and symptoms
- Poor growth or weight gain or being overweight
- Poor hygiene
- Lack of clothing or supplies to meet physical needs
- Taking food or money without permission
- Hiding food for later
- Poor record of school attendance
- Lack of appropriate attention for medical, dental or psychological problems or lack of necessary follow-up care
Parental behavior
Sometimes a parent's demeanor or behavior sends red flags about child abuse. Warning signs include a parent who:
- Shows little concern for the child
- Appears unable to recognize physical or emotional distress in the child
- Blames the child for the problems
- Consistently belittles or berates the child, and describes the child with negative terms, such as "worthless" or "evil"
- Expects the child to provide him or her with attention and care and seems jealous of other family members getting attention from the child
- Uses harsh physical discipline
- Demands an inappropriate level of physical or academic performance
- Severely limits the child's contact with others
- Offers conflicting or unconvincing explanations for a child's injuries or no explanation at all
Child health experts condemn the use of violence in any form, but some people still use corporal punishment, such as spanking, as a way to discipline their children. Any corporal punishment may leave emotional scars. Parental behaviors that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.
Factors that may increase a person's risk of becoming abusive include:
- A history of being abused or neglected as a child
- Physical or mental illness, such as depression or post-traumatic stress disorder (PTSD)
- Family crisis or stress, including domestic violence and other marital conflicts, or single parenting
- A child in the family who is developmentally or physically disabled
- Financial stress, unemployment or poverty
- Social or extended family isolation
- Poor understanding of child development and parenting skills
- Alcohol, drugs or other substance abuse
Some children overcome the physical and psychological effects of child abuse, particularly those with strong social support and resiliency skills who can adapt and cope with bad experiences. For many others, however, child abuse may result in physical, behavioral, emotional or mental health issues — even years later. Below are some examples.
Physical issues
- Premature death
- Physical disabilities
- Learning disabilities
- Substance abuse
- Health problems, such as heart disease, immune disorders, chronic lung disease and cancer
Behavioral issues
- Delinquent or violent behavior
- Abuse of others
- Withdrawal
- Suicide attempts or self-injury
- High-risk sexual behaviors or teen pregnancy
- Problems in school or not finishing high school
- Limited social and relationship skills
- Problems with work or staying employed
Emotional issues
- Low self-esteem
- Difficulty establishing or maintaining relationships
- Challenges with intimacy and trust
- An unhealthy view of parenthood
- Inability to cope with stress and frustrations
- An acceptance that violence is a normal part of relationships
Mental health disorders
- Eating disorders
- Personality disorders
- Behavior disorders
- Depression
- Anxiety disorders
- Post-traumatic stress disorder (PTSD)
- Sleep disturbances
- Attachment disorders
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