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4050-CINDICATORS OF CHILD ABUSE AND NEGLECT

Appendix C

 

INDICATORS OF CHILD ABUSE AND NEGLECT

 

Indicators of Physical Abuse

HISTORICAL

Delay in seeking appropriate care after injury.

No witnesses.

Inconsistent or changing descriptions of accident by child and/or parent.

Child's developmental level inconsistent with history.

History of prior "accidents".

Absence of parental concern.

Child is handicapped (physically, mentally, developmentally) or otherwise perceived as "different" by parent.

Unexplained school absenteeism.

History of precipitating crisis

PHYSICAL

Soft tissue injuries on face, lips, mouth, back, buttocks, thighs or large areas of the torso;

Clusters of skin lesions; regular patterns consistent with an implement;

Shape of lesions inconsistent with accidental bruise;

Bruises/welts in various stages of healing;

Burn pattern consistent with an implement on soles, palms, back, buttocks and genitalia; symmetrical and/or sharply demarcated edges;

Fractures/dislocations inconsistent with history;

Laceration of mouth, lips, gums or eyes;

Bald patches on scalp;

Abdominal swelling or vomiting;

Adult-size human bite mark(s);

Fading cutaneous lesions noted after weekends or absences;

Rope marks.

BEHAVIORAL

Wary of physical contact with adults;

Affection inappropriate for age 

Extremes in behavior, aggressiveness/withdrawal;

Expresses fear of parents;

Reports injury by parent;

Reluctance to go home;

Feels responsible (punishment "deserved");

Poor self-esteem;

Clothing covers arms and legs even in hot weather.

Indicators of Sexual Abuse

HISTORICAL

Vague somatic complaint;

Excessive school absences;

Inadequate supervision at home;

History of urinary tract infection or vaginitis;

Complaint of pain; genital, anal or lower back/abdominal;

Complaint of genital itching;

Any disclosure of sexual activity, even if contradictory.

PHYSICAL

Discomfort in walking, sitting;

Evidence of trauma or lesions in and around mouth;

Vaginal discharge/vaginitis;

Vaginal or rectal bleeding;

Bruises, swelling or lacerations around genitalia, inner thighs;

Dysuria;

Vulvitis;

Any other signs or symptoms of sexually transmitted disease;

Pregnancy.

BEHAVIORAL

Low self-esteem;

Change in eating pattern;

Unusual new fears;

Regressive behaviors;

Personality changes (hostile/aggressive or extreme compliance);

Depression;

Decline in school achievement;

Social withdrawal; poor peer relationship;

Indicates sophisticated or unusual sexual knowledge for age;

Seductive behavior, promiscuity or prostitution;

Substance abuse;

Suicide ideation or attempt;

Runaway.

Indicators of Emotional Abuse

HISTORICAL

Parent ignores/isolates/belittles/rejects/scapegoats child

Parent's expectations inappropriate to child's development

Prior episode(s) of physical abuse

Parent perceives child as "different"

PHYSICAL

(Frequently none);

Failure to thrive;

Speech disorder;

 Lag in physical development;

Signs/symptoms of physical abuse.

BEHAVIORAL

Poor self-esteem

Regressive behavior (sucking, rocking, enuresis)

Sleep disorders

Adult behaviors (parenting sibling)

Antisocial behavior;

Emotional or cognitive developmental delay;

Extremes in behavior - overly aggressive/compliant;

Depression;

Suicide ideation/attempt.


Indicators of Physical Neglect

HISTORICAL

High rate of school absenteeism;

Frequent visits to school nurse with nonspecific complaints;

Inadequate supervision, especially for long periods and for dangerous activities;

Child frequently unattended; locked out of house;

Parental inattention to recommended medical care

No food intake for 24 hours;

Home substandard (no windows, doors, heat), dirty, infested, obvious hazards;

Family member addicted to drugs/alcohol.

PHYSICAL

Hunger, dehydration;

Poor personal hygiene, unkempt, dirty;

Dental cavities/poor oral hygiene;

Inappropriate clothing for weather/size of child, clothing dirty; wears same clothes day after day;

Constant fatigue or listlessness;

Unattended physical or health care needs;

Infestations;

Multiple skin lesions/sores from infection.

BEHAVIORAL

Comes to school early, leaves late;

Frequent sleeping in class;

Begging for/stealing food;

Adult behavior/maturity (parenting siblings);

Delinquent behaviors;

Drug/alcohol use/abuse.

 

Revised:  9/1/2020

 

Approved 9/1/2020
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