When you think about hurting kids, one of the first thing that comes to mind is children who have been abused or neglected.  Over 1.2 million children suffer harm from child abuse or neglect per year. That equates to 17.1 children per 1,000 or approximately 1 in every 58 children. When children who are endangered by abuse or neglect are added to those figures, the numbers rise to over 2.9 million kids or 39.5 per thousand. That equates to one in every 25 children. The reach and magnitude of abuse and neglect are as varied as the forms of abuse and the types of children who experience it.

In the article “When The Bough Breaks,” Martin Johnson wrote:

“Perhaps the most important part of understanding child abuse is realizing the depth of physical and emotional pain the child victim must feel. As adults in ministry to children, we can see the crisis intellectually, yet it’s extremely difficult for us to genuinely empathize with the hurt and isolation the child feels – unless we’ve felt it too. And sometimes we simply don’t recognize that real, serious, ongoing abuse is taking place in the homes of some of the children we minister to every week. Sometimes, we just don’t realize the problem.”

WHAT ARE ABUSE AND NEGLECT?

Most laws at the federal and state level cover abuse and neglect inflicted by parents and other child caregivers and do not extend to harm caused by other people which are covered under other statutes. The minimum standards set by federal law define child abuse and neglect as:

• Any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or
• An act or failure to act which presents an imminent risk of serious harm.

These laws are then further refined and explained at the state level. For a listing of abuse and neglect laws for your state, visit the State Statutes Search webpage at The Child Welfare Information Gateway of the U.S. Department of Health and Human Services. This page allows you to search for a variety of state statutes including the definitions of abuse and neglect.

Abuse can take many forms including Emotional, Physical or Sexual.  Likewise, neglect can be further classified as Emotional, Physical, Medical or Educational.

WHAT ARE THE SIGNS OF ABUSE?

The signs listed in this section may be indicators of abuse and neglect. The existence of one sign or even the prolonged existence of one sign does not necessarily prove the existence of abuse of neglect and may be related to other factors.

General Signs and Information

• Shows sudden changes in behavior or school performance
• Has not received help for physical or medical problems brought to the parents’ attention
• Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes
• Is always watchful, as though preparing for something bad to happen
• Lacks adult supervision
• Is overly compliant, passive, or withdrawn
• Comes to school or other activities early, stays late, and does not want to go home

Physical Abuse

• Burns
• Bites
• Bruises
• Welts
• Lacerations or Cuts
• Broken bones
• Black eyes
• Hair loss
• Fading bruises or other marks
• Seems frightened of parents and protests or cries when it is time to go home
• Shrinks at the approach of adults
• Seems always watchful or on alert for something bad to happen
• Reports injury by a parent or another adult caregiver
• Injuries appear to have a pattern (as from a foreign object)
• Uncommon location for injuries (e.g., underarms, neck, back, stomach, thighs)
• Shies away from touch
• Flinches at sudden movement
• Appears afraid to go home
• Wears inappropriate clothing (e.g., a coat on a warm day) to cover up bruises
• Recurring injuries with inconsistent, implausible or guarded explanations
• Hesitation regarding showing certain body parts
• Acts out aggression on others
• Fear
• Withdrawal
• Depression
• Has fantasies, artwork or threats of violence
• Regression
• Nightmares
• Insomnia
• Conflicting, unconvincing, or no explanation for the child’s injury

Emotional Abuse

• Shows extremes in behavior, such as overly compliant or demanding behavior, extreme passivity, or aggression
• Is inappropriately adult (parenting other children, for example)
• Is inappropriately infantile (frequently rocking or head-banging, for example)
• Excessively withdrawn, fearful or anxious about doing something wrong
• Is delayed in physical or emotional development
• Has attempted suicide
• Reports a lack of attachment to the parent
• Doesn’t seem to be attached to caregiver
• Dramatic changes in behavior
• Unusual fears for the child’s age
• Inability to react with emotion
• Inability to develop emotional bonds with others
• Hides eyes
• Lowered gaze
• Biting lips or tongue
• Forcing a smile
• Fidgeting
• Annoyance
• Defensiveness
• Exaggeration
• Confusion or denial
• Feeling of nakedness, defeat, alienation or lack of worth
• Regression
• Poor self-esteem
• Angry acts
• Withdrawal
• Insecurity
• Alcohol or drug abuse
• Depression
• Difficulty in relationships
• Eating disorders
• Sleep disorders/nightmares
• Speech disorders
• Developmental delays
• Nervous disorders or somatic symptoms

Sexual Abuse

• Has difficulty walking or sitting
• Suddenly refuses to participate in physical activities
• Reports nightmares or bedwetting
• Experiences a sudden change in appetite
• Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior
• Becomes pregnant or contracts a venereal disease, particularly if under age 14
• Runs away
• Reports sexual abuse by a parent or another adult caregiver
• Makes a strong effort to avoid a specific person without an obvious reason
• Compulsive masturbation and teaching others to masturbate
• Excessive curiosity about sex or sexuality
• Stained, torn or bloody underclothing
• Frequent, unexplained, sore throats, yeast or urinary tract infections
• Bed wetting
• Soiling pants
• Playing with feces
• Complaints of pain or itching in genitalia
• Excessive bathing
• Withdrawn or aggressive
• Sexual inference in artwork
• Overly compulsive behavior
• Fears and phobias
• Sleep problems
• Fire starting
• Somatic symptoms (e.g., stomach aches, headaches, etc.)

Neglect

• Is frequently absent from school
• Begs or steals food or money
• Lacks needed medical or dental care, immunizations, or glasses
• Is consistently dirty and has severe body odor
• Lacks sufficient clothing for the weather
• Is frequently unsupervised, left alone or allowed to play in unsafe conditions
• Abuses alcohol or other drugs
• States that there is no one at home to provide care
• Poor hygiene including lice, scabies, severe or untreated diaper rash, bed sores
• Squinting
• Untreated injury or illness
• Lack of immunizations
• Indicators of prolonged exposure to the elements (sunburn, insect bites, etc.)
• Height and weight significantly below age level

For more information on potential signs of abuse and neglect, please consult Recognizing Child Abuse and Neglect: Signs and Symptoms from The Child Welfare Information Gateway of the U.S. Department of Health and Human Services.

REPORTING SUSPECTED CHILD ABUSE OR NEGLECT

To find out who to call in your state, visit the State Child Abuse Reporting Numbers page at the Child Welfare Information Gateway. The Child Welfare Information Gateway also includes a listing of Toll-Free Crisis Hotline Numbers that you should keep on file.

You can also contact Childhelp®. Childhelp® is a national organization providing crisis assistance and other counseling and referral services. The Childhelp National Child Abuse Hotline is staffed 24 hours a day, 7 days a week, with professional crisis counselors who have access to a database of 55,000 emergency, social service, and support resources. All calls are anonymous. Contact them at 1.800.4.A.CHILD (1.800.422.4453).

SOURCES OF ADDITIONAL INFORMATION

Most of the information in this article was garnered from the following sources. While we have not attempted to site individual sources for each piece of information presented, we are grateful to these resources for providing the information in this article.

• What Is Child Abuse and Neglect? (April 2008), Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.
• Child Maltreatment Surveillance: Uniform Definitions for Public Health and Recommended Data Elements, Version 1.0 (January 2008), Department of Health and Human Services: Centers for Disease Control and Prevention National Center for Injury Prevention and Control.
• Fourth National Incidence Study of Child Abuse and Neglect (NIS–4) (2010), Sedlak, A.J., Mettenburg, J., Basena, M., Petta, I., McPherson, K., Greene, A., and Li, S., Report to Congress. Washington, DC: U.S. Department of Health and Human Services, Administration for Children and Families.
• Recognizing Child Abuse and Neglect: Signs and Symptoms (June 2007), Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.
• Toll-Free Crisis Hotline Numbers (May 2011), Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.
• State Child Abuse Reporting Numbers (September 2011), Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.
• Definitions of Child Abuse and Neglect (February 2011), Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.
• Clergy as Mandatory Reporters of Child Abuse and Neglect: Summary of State Laws (April 2010), Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.
• Mandatory Reporters of Child Abuse and Neglect: Summary of State Laws (April 2010), Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.
• Child Abuse FAQs (Accessed 09/02/2011), Faith Trust Institute.
• Signs and Symptoms (Accessed 09/02/2011), Arizona Child Abuse Info Center.
• Fact Sheet: Emotional Child Abuse (Accessed 09/02/2011), Prevent Child Abuse America.
• Principals of Working With Traumatized Children (Accessed 09/02/2011), Perry, Bruce.
• Johnson, Martin, When the Bough Breaks (Accessed 09/14/2011), ChildrensMinistry.com
• Hayes, Alley & Wagner, Nate, They Are In Our Midst (Accessed 09/14/2011), ChildrensMinistry.com
• State Statutes Search, Department of Health and Human Services: The Child Welfare Information Gateway of the U.S.

Excerpted and adapted from the article “CHILD ABUSE AND NEGLECT – DEFINING, RECOGNIZING AND REPORTING IT AND THE INCREASED RISK FOR CHILDREN OF DIVORCE, COHABITATION, AND SINGLE PARENT FAMILIES” published in multiple parts in 2011 by our partner organization Divorce Ministry 4 Kids.