Detecting Child Abuse

Signs of Abuse & Negligence

Not every child will have obvious signs of abuse. However, there are some injuries that should be carefully evaluated for physical or sexual abuse and neglect. 

Physical Abuse 

  • Bruises, lacerations, or burns to protected, fleshy, or flexor surfaces—for example, inner thighs, abdomen, neck, and sides of the face, ears, and genitalia.
  • Bruises, lacerations, or burns showing an object pattern—for example, belt loop, cigarette burn, and curling iron.
  • Severe deep or extensive burns especially scald burns. (When no explanation or vague explanation is offered).
  • Arms or legs that are swollen, painful, crooked (suggesting a fracture), or not being used by the child.
  • A child that appears to be intoxicated or drugged.
  • Child (or witness) that tells you they have been hit in the face, hit with an object, whipped, punched, slapped, kicked, or beaten.
  • A child who is fearful of their parent or caretaker.

Sexual Abuse

  • Any history, statement, or witnessed incident consistent with sexual abuse.
  • Most sexually abused children will not present with acute injuries or other material evidence. “Normal” does NOT mean “Nothing happened!”

Neglect/Emotional Neglect

  • Children are left unsupervised in environments that are potentially dangerous or lethal.
  • Children that appear malnourished, starved, and/or who demonstrate deprivation behaviors such as begging for food or eating out of the trash.
  • Failure to protect or failure to provide the basic needs of the child; for example, soft drink in a baby's bottle, child found alone in the street, parenting while intoxicated.
  • Adult violence, including domestic violence, in the home.
  • Caretakers that are intoxicated (drugs or alcohol).

Common Responses of Victims & Abusers 

During the initial report or investigation of child abuse, there are common phrases that are red flags and should have further investigation.

Abusive parent

  • Denial of any knowledge regarding child’s injury - “I have no idea how she hurt her head; her 2-year-old brother plays rough with her.”
  • Vague explanation - “I think she was choking or something because she made a funny noise. I patted her back.”
  • Conflicting explanation - “She fell out of her car seat last week and today she stopped breathing and turned blue.”
  • Changing explanation initial history -“3-year-old cousin pushed her off the tricycle,” history 2 days later: “She fell on the stairs.”
  • Partial admission - “I dropped the baby by accident.”

Non-abusive parent

  • Denial of any knowledge regarding child’s injury - “I left to go to work and when I came home, he said she wouldn’t wake up.”
  • Defensive of the abuser - “I know he didn’t hurt her because he said he loved her like his own daughter.”
  • Evasive -“He gets mad sometimes and he has pushed me once before, a long time ago, but has never hurt me since.”
  • Witness - “I heard the baby crying and when he went into the room her cry changed like she was hurt.”


  • Denial - “I don’t know how I got those bruises on my back.”
  • Protective of the abuser“I got those bruises when I was crawling under the fence. I made up the part about my dad whipping me ‘cause I was mad at him for yelling at me.”
  • Truthful - “My dad got mad because I got in trouble at school for talking. He hit me with the belt 10 times.”
  • Siblings of victims who witness abuse
  • Denial of any knowledge of how the victim was injured.