Indicators of abuse and neglect of children

How to use the indicators of abuse

The presence of indicators of abuse does not prove a child or vulnerable adult has been or is being abused.

Indicators of abuse provide guidance on possible concerns and potential causal relationships. They should act as a trigger, encouraging people to consider whether an injury, behaviour or disclosure raises the possibility that a child may be at risk of significant harm from abuse or neglect.

Some indicators are sufficient as single signs to prompt you to make a report to relevant authorities. Others are meaningful when they co-exist with a range of indicators.

The absence of indicators does not necessarily mean a child is safe. Some maltreated children will not display any noticeable symptoms. Equally, many of the indicators listed may be the consequence of other factors aside from abusive or neglectful care.

Children who have experienced abuse will often experience more than one type of maltreatment. For example, there is a strong propensity for sexual abuse to co-exist with psychological or emotional abuse.

Indicators of abuse need to be considered in the context of a child’s circumstances and other vulnerabilities. For example, a child suffering from hemophilia will likely suffer more frequent and serious bruising than other children. In this instance the bruising does not indicate physical abuse, but questions of adequate medical treatment and general care may arise.

Interpretation of indicators always involves adopting the child’s perspective and having the individual at the centre of consideration. The focus is on the possible consequences of the actions or inactions of the child’s parents, carers or other responsible persons.

It is important to discuss your concerns for a child with a person experienced with and trained in interpreting the indicators of abuse. As a diocesan worker or member of our faith communities, or parent or carer of a child in receipt of a diocesan service, you are able to contact the Office of Safeguarding to discuss your child-related concerns:

P: 4979 1390 (Mon-Fri, 9am-5pm)
E: childprotection@mn.catholic.org.au

Generic indicators of abuse

There is a class of global or generic indicators, and these indicators are present in any of the various classifications of abusive conduct.

Life circumstances of the abused child

Established history of aggression, violence or previous harm to the child or their siblings.
Child having a physical disability or sensory impairment.
Child having a developmental delay or being neurodiverse.
Child suffering from mental illness.
Child identifying as other than heterosexual or gender diverse
Child being ‘invisible’ to the wider community, no support services or chronic failure to attend school.

Issues affecting the parents or caregivers ability to care

Substance dependency and an inability or unwillingness to arrange for education and other key social supports for the child.
Deficiency in functional parenting skills required to provide safety, welfare and wellbeing.
Significant problems in managing the child’s behaviour or feeling unable to relate or emotionally invest in the child.
Unrealistic expectations of a child given their age or stage of development.
Failure to allow the child to participate in age-appropriate decision making.
Uncontrolled or poorly managed mental health issues for one or more carers
Multiple carers or transient partners
Persistent criminality, enmeshment in criminogenic networks and domestic or partner violence.

Generic indicators

The child gives some indication the injury or event did not occur as stated.
The child tells you they have been abused.
The child tells you they know someone who has been abused, but may be referring to themselves.
Someone else such as a relative, friend, acquaintance or sibling tells you the child may have been abused.
Poor concentration.
Sleeping problems such as nightmares and bed-wetting.
Marked changes in behaviour or mood, escalation in risk-taking behaviours, tantrums, aggressiveness, withdrawal.
Child complains of stomachaches and headaches despite no physical findings.
Self-harming behaviour such as cutting or burning.
High level of risk-taking behaviours such as climbing up cliff faces while intoxicated.
Difficulty in maintaining long-term peer relationships.
Persistently negative themes in artwork and creative writing.
Poverty and overcrowding in the family home
Multiple homes, transient living arrangements and homelessness
Social or geographical isolation (lack of support networks)

Particular indicators of abuse

The following section provides detailed information on the indicators of child abuse from the five classifications generally used to describe the consequences of the harmful behaviour inflicted on children. Each classification has detailed information available to you when you expand the relevant subheading listed below.

Indicators of neglect

Indicators in children:

poor standards of hygiene leading to social isolation
scavenging or stealing food
extended stays at school, public places, other homes
focus on basic survival
extreme longing for adult affection
flat and superficial way of relating, lacking a sense of genuine interaction
anxiety about being dropped or abandoned
self-comforting behaviour, such as rocking or sucking
non-organic failure to thrive
delay in developmental milestones
loss of “skin bloom”
poor hair texture
untreated physical problems
staying with friends and acquaintances for prolonged periods, rather than at home
resources not provided that would allow the child to care adequately for themselves, for example, access to washing or food
exposure to serious risks through non-attendance at school, for example, crime, anti- social behaviour, drug and alcohol abuse.

Indicators in parents or carers:

failure to provide adequate food, shelter, clothing, medical attention, hygienic home conditions or leaving the child inappropriately without supervision
inability to respond emotionally to a child
child left alone for long periods
keeping a child at home from school to care for others
parent or carer actively avoids contact with the school to discuss attendance issues, despite extensive and repeated efforts
depriving of or withholding physical contact or stimulation for prolonged periods
failure to provide psychological nurturing
one child treated differently, for example, scapegoated
absence of social support from relatives, other adults or social networks
parent/carer has agreed to services and/or support but has not taken this up, or co-operated within a reasonable timeframe.

Indicators of physical abuse

Indicators in children:

facial head and neck bruising
lacerations and welts from excessive discipline or physical restraint
explanation offered by the child is not consistent with the injury
other bruising and marks that may show the shape of the object that caused it, for example, a hand-print or buckle
bite marks and scratches where the bruise may show a print of teeth and experts can determine whether or not it is an adult bite
multiple injuries or bruises
ingestion of poisonous substances, alcohol, drugs, or major trauma
dislocations, sprains, twisting
fractures of bones, especially in children under three years
burns and scalds
head injuries where the child may have indicators of drowsiness, vomiting, fits or retinal haemorrhages suggesting the possibility of the child having been shaken
aggressive or violent behaviour towards others, particularly younger children
explosive temper that is out of proportion to precipitating event
being constantly on guard around adults and cowering at sudden movements.

Indicators in parents or caregiver:

direct admissions by parents or carers that they fear they may injure the child
family history of violence, including previous harm to children
history of their own maltreatment as a child
repeated presentations of the child to health or other services with injuries, ingestions or with minor complaints
marked delay between injury and presentation for medical assistance
history of injury that is inconsistent with the physical findings
history of injury that is vague, bizarre or variable.

General indicators of female genital mutilation (FGM):

having a special operation associated with celebrations
reluctance to be involved in sport or other physical activities when previously interested
difficulties with toileting or menstruation
anxiety about forthcoming school holidays or a trip to a country that practises FGM
older siblings worried about their sisters visiting their country of origin
long periods of sickness.

Indicators of psychological / emotional abuse

Indicators in children:

feelings of worthlessness about life and themselves
inability to value others
lack of trust in people and expectations
lack of interpersonal skills necessary for adequate functioning
extreme attention-seeking or risk-taking behaviour
other behavioural disorders, for example, disruptiveness, aggressiveness or bullying
avoiding all adults
being obsessively obsequious to adults
difficulty in maintaining long-term significant relationships
being highly self-critical.

Note: Arguably children sustain psychological harm from all types of abuse.

Indicators in parents or carers:

constant criticism, belittling, teasing of a child or ignoring or withholding praise and affection
excessive or unreasonable demands
persistent hostility and severe verbal abuse, rejection and scapegoating
belief that a particular child is bad or evil
using inappropriate physical or social isolation as punishment
situations where an adult’s behaviour harms a child’s safety, welfare and well-being
exposure to domestic violence.

General indicators a child could be at risk of forced marriage:

anxiety about a forthcoming family holiday overseas
sudden announcement the child is engaged
running away from home
older siblings left school early or were married early
controlling behaviour by family members
leaving school suddenly, unexpected absence or non-return from holidays.

Indicators of sexual abuse

Indicators in children:

describe sexual acts, for example, “Daddy hurts my wee wee”
direct or indirect disclosures
age-inappropriate behaviour and/or persistent sexual behaviour
self-destructive behaviour, drug dependence, suicide attempts, self-mutilation
persistent running away from home
going to bed fully clothed
regression in developmental achievements in younger children
being in contact with a known or suspected perpetrator of sexual assault
unexplained accumulation of money and gifts
being upset after using the internet or phone
becoming secretive about online activities and mobile phone use
bleeding from the vagina or external genitalia or anus
injuries such as tears or bruising to the genitalia, anus or perineal region
sexually transmitted diseases
adolescent pregnancy
trauma to the breast, buttocks, lower abdomen or thighs
particularly negative reactions to adults of only one sex
sexually provocative
desexualisation, for example, wearing baggy clothes in order to disguise gender. Eating disorders may be a possible indicator in this category
artwork or creative writing with obsessively sexual themes
preoccupation with causing harm to men they suspect are homosexual
engaging in violent sexual acts and talking about these acts
knowledge about practices and locations that are usually associated with prostitution.

General indicators of child’s stress should be considered such as:

poor concentration at school
sleeping/bedtime problems, for example, nightmares bed-wetting
marked changes in behaviour or mood, tantrums, aggressiveness, withdrawal
child complains of stomachaches and headaches, but with with no physical evidence.

Indicators in parents, carers, siblings, relatives, acquaintances or strangers:

exposing a child to prostitution or child pornography or using a child for pornographic purposes
intentional exposure of child to sexual behaviour in others
has committed/been suspected of child sexual abuse
inappropriate curtailing, or jealousy regarding age-appropriate development of independence from the family
coercing child to engage in sexual behaviour with other children
verbal threats of sexual abuse
family denial of adolescent’s pregnancy
perpetration of spouse abuse or physical child abuse.

Offenders use a range of tactics including force, threats and tricks to engage children in sexual contact, and to then silence them. They may also try to gain the trust and friendship of parents in order to obtain access to children.

Indicators of being exposed to domestic violence

Indicators in children:

pre-term and low birthweight baby
slow weight gain in infants
difficulties with sleeping
unexplained physical injuries
eating disorders, such as anorexia and bulimia
uses alcohol and drugs
psychosomatic complaints
defiant at school, particularly with female teachers
frequently absent from school, and poor academic achievement
delayed or problematic language development
over-protects mother or fears leaving mother at home
poor concentration, disruptive
regressive, aggressive or violent behaviour
clingy, dependent, sad and secretive
stealing
depressed and suicide attempts
takes extreme risks
physically and verbally abusive to siblings, parents, peers
sexually abusive
homeless or stays away from home for prolonged time
socially isolated.

Indicators in adult victims:

injuries do not fit the cause/history given
bite marks
unwanted pregnancy or sexually transmitted infection through coerced sex/refusal to use contraceptives
bruising/other injuries, especially if pregnant
unexplained miscarriage or stillbirth
nutritional/sleep deprivation or disorders
alcohol and drug abuse
psychosomatic complaints
anxious, depressed and suicidal thoughts and attempts
low self-esteem
socially isolated
submissive and withdrawn
repeated and/or after-hours presentations at emergency departments
seldom or never makes decisions without referring to partner
fears reprisal
frequent absences from work/studies.

Indicators in adult perpetrator:

physical signs of the victim fighting back, such as facial scratches and injuries to hands
presents as the victim of abuse, discrimination or allegation of abuse
admits to some violence but minimises its frequency and severity
visible rough handling of victim/children/pets
impresses as overly concerned about suspected victim
threatens to commit acts of violence
is unable to control angry outbursts
always speaks for partner/children
believes he “owns” partner/children
describes partner as incompetent or stupid
holds rigidly to stereotypical gender roles
jealous of partner, lacks trust in her or anyone else
does not allow partner or child to access service providers alone