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How can I tell whether my child has been abused?
If your child spends any amount of time away from you – whether it's with a babysitter, with a trusted family friend or relative, or at daycare – it's natural to be concerned about his safety. And like any parent, you've probably wondered whether you'd be able to tell if your child was being mistreated.
Some parents mistakenly overlook signs of abuse because they don't want to face what's happening. Most abusers are family members, which makes the situation even harder to accept. On the other hand, even when you do keep an eye out for the physical symptoms and behavioral changes that may point to abuse, it can be tricky to figure out exactly what's going on.
"You're always playing a guessing game," says Kathy Baxter, director of the San Francisco Child Abuse Council. "A child could have many other reasons for being fussy or becoming withdrawn. But parents are really good at knowing their children, so you have to try to put together a picture and go with your gut instinct."
If your child is old enough to communicate well, Baxter suggests regularly asking him questions such as, "Did anything happen to you today that you didn't like?" or "Have you ever been frightened at daycare?" If he's in the habit of telling you what makes him uncomfortable, he'll be more likely to tell you when anything is seriously amiss.
"When it comes to abuse and neglect, most kids tell the truth," Baxter says. "But in most cases, they are reluctant. They don't want to get the person in trouble. They feel guilty. They may feel it happened because they were bad."
If your child can't tell you what's going on (because he's too young or not very communicative), pinpointing abuse can be even more difficult. What you can do is keep a close eye on him for signs that all is not well.
Some parents discover signs of abuse – such as internal bleeding and injuries – only when they take their child to the doctor because he won't stop crying or is being excessively fussy. Emotional abuse (such as threats or constant criticism) is even harder to detect.
About 3 million child abuse reports are made nationally every year, and the highest risk population is children younger than 5 years of age, says Baxter.
Signs to watch for
A child who has been physically abused may:
- Cry and put up a fight when it's time to go to daycare or a sitter's or appear frightened around the caregiver or other adults. (Of course, this could also be a normal reaction to separation. Again, you'll need to factor in other things, including your instincts.)
- Show other sudden changes in behavior or performance at daycare or school.
- Come home with unexplained bruises, abrasions, burns, broken bones, black eyes, cuts, bite marks, or other injuries. Repeated injuries of any type are a warning sign. Any rib fracture, long bone fracture, or bruising in a baby who isn't yet walking or very mobile should raise concerns about abuse.
If your child is still a baby, learn the signs of shaken baby syndrome (SBS) – which doctors call abusive head trauma. Read our complete article on SBS.
SBS usually happens when babies are shaken in anger. In extreme cases, the abuse involves hitting a child's head against a hard object, like the wall or the floor. When a baby has SBS, even severe injuries may not be immediately visible.
Shaken baby injuries usually happen to children who are younger than a year old, although the syndrome sometimes shows up in kids as old as 5.
A baby with SBS may seem glassy-eyed and appear rigid, lethargic, and irritable. He may also have a decreased appetite, have difficulty feeding, or be vomiting. A combination of any of these symptoms with unexplained bruising in an infant is a strong indicator of abuse.
In severe cases, a baby may be unable to focus on an object or lift her head. Or she may be unconscious or have difficulty breathing. She may also have seizures or be in a coma.
If you suspect your child is suffering from SBS, call 911 right away. Every moment counts in terms of minimizing the damage from a baby's head injury.
A child who has been emotionally abused may:
- Display behavioral problems or changes such as shunning a parent's affections – or becoming excessively clingy. Abused children often show extremes in behavior: A normally outgoing and assertive child may become unusually passive, while a generally mild child may act in an aggressive manner.
- Become less talkative or stop communicating almost completely, or display signs of a speech disorder, such as stuttering.
- Act inappropriately adult or infantile. For example, a child may either become overly protective and "parental" toward other children or revert to behaviors like rocking and head banging.
- Complain of headaches or stomachaches that have no medical causes. He may lose his appetite.
- Exhibit fearful behavior, such as nightmares or trouble sleeping. Or he may act as if he's waiting for something bad to happen.
A child who has been sexually abused may:
- Have pain, itching, bleeding, or bruises in or around the genital area.
- Have difficulty walking or sitting, possibly because of genital or anal pain.
- Demonstrate sexual knowledge, curiosity, or behavior beyond his age (obsessive curiosity about sexual matters, for example, or seductive behavior toward peers or adults).
- Be secretive or want to be alone much of the time.
Keep in mind, though, that most children who are sexually abused have no physical findings or complaints whatsoever.
Signs to watch for in your child's caregiver
No parent wants to think his child's caregiver is abusive or neglectful – especially if the caregiver is a family member. But don't hesitate to act if your child's caregiver:
- Offers conflicting or unconvincing explanations for bruises or injuries
- Offers no explanation for bruises or injuries
- Describes your child in an extremely negative way
- Constantly belittles your child
- Seems indifferent to your child
- Is apathetic or depressed
- Abuses drugs or alcohol
- Starts to behave irrationally
- Is secretive or isolated, or acts extremely jealous or controlling with family members
- Seems harsh when it comes to discipline. (Abuse often results from excessive or inappropriate physical discipline.)
If you have concerns about the possibility of abuse, don't delay in taking action. The sooner you address the problem, the better for your child.
Read up on what to do if you suspect child abuse.
And if you're concerned that you may be or may become abusive with your child, seek help. Parenting can be difficult and frustrating. Reach out to a friend or relative who can help you take care of your child. Or call a local family support center or community mental health agency.
A crying baby is the most common trigger for shaking or other abuse. Learn 12 reasons babies cry and how to soothe them.