Child Abuse


Parents may seem evasive or inconsistent in their story due to language or cultural differences, or to being embarrassed or afraid relating to some other issue. Cultural/language difficulties may also lead to delayed care.

   What are age-appropriate normal sexual behaviors?
   Children may be injured by domestic violence via:
> being too small to get out of the way
> trying to intervene
> becoming an object of abuse
> being neglected by the abused parent, who may be focused on their own fear or depression
   Red flags with injuries:
> explanation doesn’t fit the injury as to pattern, timing, or developmental ability of child
> explanation keeps changing
> child is consistently blamed as cause of repeated injuries
> significant injuries attributed to a young sibling
> delay in seeking medical care
> history of multiple ED visits
> frequent change of primary care provider
   Parental risk factors:
> rigid, severe discipline
> strongly responds to negative behaviors, ignores child's positive behaviors
> ridicules child in public
> isolates child socially or from other family members
> seems overprotective or jealous
> unrealistic expectations of child development or behavior for age
> parent is caregiver for child with significant cognitive, physical or emotional disabilities
> child unwanted, unplanned
> lack of emotional interaction with child
> inappropriate over or under concern about injury
> partial confession
> depression
> difficulty controlling emotions, esp. anger
> substance abuse
> teen parenthood
> family stress such as divorce, job loss
Signs & Symptoms of Abuse/Neglect

Note that many of these signs and symptoms are also seen in common childhood illnesses.

Behavioral clues:

Symptom clues:

Physical clues (most common manifestations of abuse are found from skin, bone, or CNS):

[Adapted from multiple sources listed in Resources and References]

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