February 28, 2020
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Know these 30 signs of child abuse

Drawing courtesy of moonstarsandpaper.blogspot.com
Drawing courtesy of moonstarsandpaper.blogspot.com

Medical providers, among other professionals who care for children, are required to report “reasonable cause to suspect” that a child has been or is likely to be abused or neglected.

Due to the death of an infant in Maine last year who had a previous broken bone and bruising, LD 1523 was written. This bill became law and mandates reporting to the Maine Department of Health and Human Services if children younger than 6 months or those unable to walk on their own exhibit evidence of a bone fracture, substantial or multiple bruises, subdural hematoma, burns, poisoning or injury resulting in bleeding, swelling or impairment of an organ.

The risk for not reporting a possible abuse includes a potential fine and lawsuit. Mandated reporters are protected by law and cannot be fined or sued for reporting.

Worse than a fine or lawsuit would be the knowledge that failing to take action contributed to a child’s further injury or death.

There are many indicators of abuse, both physical and behavioral, that all people should be cognizant of. These signs aren’t proof of abuse, but they may indicate an adult should explore what is happening in the child’s life.

Physical abuse

Physical indicators

  • Unexplained bruises and welts that may be clustered or that reflect the shape of the item used to inflict pain; they may regularly appear after an absence, such as a weekend or vacation.
  • Unexplained burns, such as from a cigar, cigarette, electric burner or iron; or rope burns, especially on the arms, legs, neck or torso; infected burns might indicate a delay in treatment.
  • Abdominal distention
  • Bald patches on the scalp

Behavioral indicators

  • Child feels deserving of punishment
  • Child shows behavioral extremes of aggressiveness or withdrawal
  • Child is wary of adult contact, and afraid of parents or frightened to go home
  • Child reports injury by parents


Physical indicators

  • Poor hygiene
  • Inappropriate clothing
  • Extreme fatigue or listlessness
  • Physical or medical needs that have been ignored

Behavioral indicators

  • Begging or stealing food
  • Arriving early at school or staying late; falling asleep in school
  • Child says there’s no caretaker

Sexual abuse

Physical indicators

  • Difficulty walking or sitting, or pain or itching in genital area
  • Venereal disease or pregnancy
  • Torn, stained or bloody underclothing

Behavior indicators

  • Unwilling to change for gym class
  • Withdrawal, fantasy or infantile behavior
  • Unusual sexual behavior or knowledge
  • Runs away from home
  • Reports sexual abuse by a caretaker

Emotional maltreatment

Physical indicators

  • Biting, rocking or sucking (potential habit disorders)
  • Antisocial or destructive behavior (potential conduct disorders)
  • Sleep disorders, speech disorders, inhibition of play
  • Hysteria, obsession, compulsion, phobias, hypochondria

Behavioral indicators

  • Shows extremes of compliant and passive to aggressive and demanding behavior
  • Physical, emotional or mental developmental lags
  • Attempted suicide

Learn more about indicators that can often present if a child is being abused or neglected at a conference May 1-3 in Portland featuring national expert Dr. Robert Sege and a panel of community leaders.

To view the agenda, visit the conference website: On the Path to Well-Being: Adversity, Poverty and Resilience.

Dee Kerry deHaas is executive director of the Maine chapter of the American Academy of Pediatrics.

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