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Indicators of abuse and neglect of children

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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.

  • History of previous harm to the child.
  • Social or geographic isolation of the child or family, including lack of access to extended family or supports.
  • Abuse or neglect of a sibling.
  • Family history of violence including injury to children.
  • Domestic or dating violence.
  • Abuse of alcohol or other drugs, and inability to arrange for education.
  • Deficiency in functional parenting skills required to provide safety, welfare and wellbeing.
  • Significant problems in managing the child’s behaviour or their engagement with any educational options.
  • Unrealistic expectations of a child given their age or stage of development.
  • Failure to allow the child to participate in age-appropriate decision making.
  • Involvement in criminal activities such as stealing and fighting.
  • Significant problems relating to the child.
  • 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.
  • Social isolation.
  • Difficulty in maintaining long-term peer relationships.
  • Persistently negative themes in artwork and creative writing.
  • Homelessness.

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 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 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 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 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 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