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Signs of Physical Abuse
Child Abuse Basics

Updated July 15, 2007

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Child Abuse

Physical abuse of children includes any nonaccidental physical injury caused by the child's caretaker. It may include injuries sustained from burning, beating, kicking, punching, and so on. While the injury is not an accident, neither is it necessarily the intent of the child's caretaker to injure the child. Physical abuse may result from extreme discipline or from punishment that is inappropriate to the child's age or condition, or the parent may experience recurrent lapses in self-control brought on by immaturity, stress, or the use of alcohol or illicit drugs.

Some children are more susceptible to being maltreated than others. Some require a great deal of care (e.g., premature babies or disabled or developmentally delayed children), and others may be difficult to raise (e.g., hyperactive children, children with behavioral problems). These children would fare well in some families, but not in other families where the burden is too great for the parents to cope with the special needs of these children.

Regardless of whether the child has special needs or not, signs of physical abuse often are difficult to interpret with absolute certainty and may be confused with normal childhood injuries, such as bruises.

Behavioral Clues That May Indicate Child Abuse

Although there are many other potential indicators, the abused child may:

Be aggressive, oppositional, or defiant
Cower or demonstrate fear of adults
Act out, displaying aggressive or disruptive behavior
Be destructive to self or others
Come to school too early or not want to leave school—indicating a possible fear of going home;
Show fearlessness or extreme risk taking
Be described as "accident prone"
Cheat, steal, or lie (may be related to too high expectations at home)
Be a low achiever (to learn, children must convert aggressive energy into learning; children in conflict may not be able to do so)
Be unable to form good peer relationships
Wear clothing that covers the body and that may be inappropriate in warmer months (be aware that this may be a cultural issue as well)
Show regressive or less mature behavior
Dislike or shrink from physical contact—may not tolerate physical praise such as a pat on the back)

Since children typically receive bruises during the course of play or while being active, the leading or bony edges of the body, such as knees, elbows, forearms, or brows, are most likely to be bruised. The soft tissue areas, such as cheeks, buttocks, and thighs, are not normally injured in such circumstances. Additionally, bruises received during the normal course of childhood activity are rarely in distinct shapes, such as a hand, belt buckle, or adult teeth marks. Bruises in soft tissue areas or in distinct shapes are much more indicative of physical abuse.

Unlike bruises, abuse directed to the abdomen or the head, which are two particularly vulnerable spots, often are undetected because many of the injuries are internal. Injuries to the abdomen can cause swelling, tenderness, and vomiting. Injuries to the head may cause swelling in the brain, dizziness, blackouts, retinal detachment, or even death. Referred to more recently as the "shaken baby" syndrome, violent shaking can cause severe damage in children at any age.