TYPES
OF INDICATORS
OF
MALTREATMENT and INDICATORS
These
are three types of indicators that provide clues to help tune in to needs or
danger.
Visible
signs
B.
Behavior indicators
A
typically happy child becomes angry, quiet, misbehaving
C.
Environmental indicators
Adult
guardian(s) view a child as different or difficult to manage
Adult(s)
have unrealistic expectations of a child
Adult(s)
are unaware of age appropriate behavior
Social
isolation of a family
Severe
personal problems such as drug addiction, alcoholism or mental illness
Family
crises of unemployment, ill health, or death
Physical
Indicators of Physical Abuse
Bruises,
Welts, Lacerations
In unusual patterns, or distinctive shapes
In clusters
On the face - especially on
an infant
On the face, buttocks back or thighs
In various stages of healing
Of gum tissue – caused by forced feeding
On external genitals
Burns
Immersion
burns, such as: “stocking burns,” “glove burns,” or doughnut-shaped
burns on the buttocks
Cigarette-type
burns: especially on the palms of hands, soles of feet or genitals
Friction
of tether burns: on wrists, ankles or neck, possible rope burns from
confinement.
Dry
burns: such as those caused by an iron, radiator grates or stove burners
Fractures,
Dislocations, Injuries
Spiral
fractures
Stiff,
swollen, enlarged joints
Multiple
fractures
Unexplained
fractures or dislocations
Fractures
in various stages of healing
Absence
of hair
Hemorrhaging
beneath scalp caused by pulling hair
Nasal
or jaw fractures
Abdominal
injuries
Behavior
Indicators of Physical Abuse
The
behavioral indicators of physical abuse are varied and are influenced by the:
Severity
and frequency of the abuse
Age
of the child at the onset of abuse
Nature
of the child’s relationship to the abuser
Availability
of supportive persons, and
The
child’s genetic endowment for coping
A
child who is abused at an early age, frequently and severely, may exhibit some
or all of these behavior characteristics:
Has
unusually neat eating habits
Is
overly compliant to avoid confrontation
Lacks
curiosity
Rarely
exhibits enjoyment
Is
fearful of physical contact
May
appear autistic
Is
excessively self-controlled – cries little
Is
under-developed for age/stage, due to efforts being directed to self-protection.
An
older child, who is less severely, or less often abused, may exhibit these
behaviors:
Is timid; easily frightened
Has psychosomatic complaints
Craves affection; indiscriminate attachment to strangers
Protects adults and affirms love for abusing adult(s)
Experiences language delay
Has difficulty in school in spite of normal ability
Has
sporadic temper tantrums
Assumes
role of parent; or is extremely immature in parent/child interactions
A
child who is mildly, infrequently or inconsistently abused at an older age, may
exhibit these characteristics:
Hurts other children
Is manipulative
Shows extreme aggressiveness
Is demanding and has temper tantrums
Is hyperactive and has a short attention span
Shows lag in development
May seem accident prone or clumsy
Other
overall behavioral indicators of physical abuse, may include, the child:
Requests punishment
Punishes other children
Is afraid to go home
Is afraid of adults
Exhibits behavior extremes or drastic behavior changes
Reports injuries that seem unbelievable
Is extremely aggressive or withdrawn
Is uncomfortable when other children cry
Has poor self-concept
Is self-mutilating
EMOTIONAL
ABUSE
Physical
Indicators of Emotional Abuse
Eating
disorders
Nightmares
or restlessness
Wets
the bed
Speech
disorders
Fails
to thrive
Exhibits
developmental lags physically, emotionally and/or mentally
Hyperactive
Behavior
Indicators of Emotional Abuse
Rocking
behavior
Frequently
bangs head
Poor
peer relations; seeks adult contact
Overly
eager to please; unrealistic goal setting
Views
abuse as being warranted; or feels responsible for abuse
Exhibits
noticeable change in behavior
Excessively
anxious; impatient
Depressed;
apathetic; passive; withdrawn
Exhibits
aggressive or bizarre behavior; even fits of screaming
Exhibits
inconsistent behavior
Runs
away from home; attempts suicide
Low
self-esteem; self-depreciation; lacks self confidence
Sabotages
personal chances of success
Unable
or unwilling to express feelings, needs or problems
NEGLECT
Neglect
is, the consistent failure by a parent or caretaker to provide a child (under
18) with appropriate care, support, attention or affection. Most reported
neglect cases involve lack of proper food, shelter, clothing, medical care,
education opportunities, protection and supervision. Some neglect occurs as a
result of ignorance. Other forms of neglect involve deliberate maltreatment of a
minor.
Physical
Indicators of Neglect
Inadequate
supervision (abandonment; unattended)
Inadequate
clothing for weather conditions
Poor
hygiene (frequently dirty; scaly skin)
Lack
of necessary medical or dental care (untreated illness or injury)
Inadequate
nutrition (hungry)
Lack
of safe, warm, sanitary shelter
Engages
in dangerous behavior due to lack of supervision
Abnormal
height to weight ratio
Chronically
tired or listless
Appears
to be overworked or exploited
Behavioral
Indicators of Neglect
Failure
to thrive – especially among infants
Poor
attendance
Chronic
lateness
Squinting
Poor
learning
Steals
or begs for food. Child may collect and save food.
Comes
early and stays late at events
Lethargic
behavior
Uses
drugs or alcohol
Engages
in sexual misconduct, such as acting out or even prostitution
Runs
away from home, attempts suicide
Extremely
dependent or detached
Delinquent
behavior, such as vandalism or stealing
Assumes
adult responsibilities at home
States
frequent absence of parent/guardian
Possible
Environmental Circumstances of Neglect
A large family with marital disruptionj
Long term parental illness
Indifferent parental attitude
Situational stress, such as unemployment
Lack of materials resources
Possible
Behaviors of Neglectful Guardians
Apathetic
Frequently
unkempt
Craving
excitement or change
Desire
to be rid of the demands of a child
Lack
of interest in the child’s activity
Low
acceptance of child’s dependency needs
Lacking
parental skills
Little
planning or organization of care of child
Neglectful
parents frequently were victims of the same type of parenting that they now
provide for their children.
SEXUAL
ABUSE
Sexual
abuse is exploitation of a child for the sexual gratification of another person.
Incest is sexual abuse within a family. Sexual abuse is difficult to detect
outside the clinical setting.
Physical
Indicators of Sexual Abuse
Physical
evidence of sexual abuse, if present at all, tends to be temporary. The physical
trauma is not exposed. There is a general lack of awareness of the prevalence of
child sexual abuse and lack of confidence in detecting it.
Pain
or irritation of genitals.
Bruises,
swelling or bleeding in genital or anal region
Sexually
transmitted disease
Torn,
bloody and/or stained underclothing
Is
pregnant
Unexplained
infections (sore throat, yeast or urinary infections)
Vaginal
or penile discharge
Wets
beds
Behavior
Indicators of Sexual Abuse
The
victim is usually reluctant to reveal the abuse. These behavioral indicators are
frequently the best or only signs you may have.
Behavior
extremes
Avoids
dressing or changing clothes in front of others
Wears
lots of clothing, especially to bed
Withdrawn;
isolated; fearful; anxious; self-mutilating
Reluctance
to participate in recreational activity
Regression
(may appear mentally disabled)
Inappropriate
understanding of sex for age
Reluctance
to be alone with a particular person
Pre-occupation
with sexual organs of self, parents or other children
Persistent
and inappropriate sex play with peers or toys
Fear
of touch; self-consciousness
Sexual
promiscuity; seductive behavior
Obsessively
clean
Psychosomatic
complaints (headaches, backache)
Delinquent
or aggressive behavior
Engages
in fantasy or infantile behavior
Poor
peer relationships
Either
avoids or seeks out adults
Environmental
Indicators
Prolonged
absence of one parent
Overcrowding
of living conditions
Alcoholism
Social
and/or geographical isolation
Inter-generational
pattern of incest
Parental
characteristics such as extreme protection of child, jealousy of child, refusing
to allow child social contact, distrusting child, accusing child of sexual
promiscuity.
Information Provided or Adapted
from:
For
Their Sake, Becca Cowan Johnson
It
Shouldn’t Hurt to be a Child, North Dakota Department of Human
Services
Identifying
Possible Signs of Child Abuse,