Child Abuse Health Article

Physical abuse

The usual physical abuse scenario involves a parent who loses control and lashes out at a child. The trigger may be normal child behavior such as crying or dirtying a diaper. Unlike nonabusive parents, who may become angry at or upset with their children from time to time but are genuinely loving, abusive parents tend to harbor deep-rooted negative feelings toward their children.

Unexplained or suspicious bruises or other marks on the skin are typical signs of physical abuse, as are burns. Skull and other bone fractures are often seen in young abused children, and in fact, head injuries are the leading cause of death from abuse. Children less than one year old are particularly vulnerable to injury from shaking. This is called shaken baby syndrome or shaken impact syndrome. Not surprisingly, physical abuse also causes a wide variety of behavioral changes in children.

Sexual abuse

John M. Leventhal observes, "The two prerequisites for this form of maltreatment include sexual arousal to children and the willingness to act on this arousal. Factors that may contribute to this willingness include alcohol or drug abuse, poor impulse control, and a belief that the sexual behaviors are acceptable and not harmful to the child." The chances of abuse are higher if the child is developmentally handicapped or vulnerable in some other way.

Genital or anal injuries or abnormalities (including the presence of sexually transmitted diseases) can be signs of sexual abuse, but often there is no physical evidence for a doctor to find. In fact, physical examinations of children in cases of suspected sexual abuse supply grounds for further suspicion only 15–20% of the time. Anxiety, poor academic performance, and suicidal conduct are some of the behavioral signs of sexual abuse, but are also found in children suffering other kinds of stress. Excessive masturbation and other unusually sexualized kinds of behavior are more closely associated with sexual abuse itself.

Emotional abuse

Emotional abuse can happen in many settings: at home, at school, on sports teams, and so on. Some of the possible symptoms include loss of self-esteem, sleep disturbances, headaches or stomachaches, school avoidance, and running away from home.

Neglect

Constant hunger
Poor personal hygiene
No social relationships
Constant tiredness
Poor state of clothing
Compulsive scavenging
Emaciation
Untreated medical problems
Destructive tendencies

A child may be subjected to a combination of different kinds of abuse. It is also possible that a child may show no outward signs and hide what is happening from everyone.

underweight, develop language skills less quickly than other children, and seem emotionally needy.

Child Abuse

Although these signs do not necessarily indicate that a child has been abused, they may help adults recognize that something is wrong. The possibility of abuse should be investigated if a child shows a number of these symptoms, or any of them to a marked degree:

Sexual Abuse

Being overly affectionate or knowledgeable in a sexual way inappropriate to the child's age
Medical problems such as chronic itching, pain in the genitals, venereal diseases
Other extreme reactions, such as depression, self-mutilation, suicide attempts, running away, overdoses, anorexia
Personality changes such as becoming insecure or clinging
Regressing to younger behavior patterns such as thumb sucking or bringing out discarded cuddly toys
Sudden loss of appetite or compulsive eating
Being isolated or withdrawn
Inability to concentrate
Lack of trust or fear someone they know well, such as not wanting to be alone with a babysitter
Starting to wet again, day or night/nightmares
Become worried about clothing being removed
Suddenly drawing sexually explicit pictures
Trying to be "ultra-good" or perfect; overreacting to criticism

Physical Abuse

Unexplained recurrent injuries or burns
Improbable excuses or refusal to explain injuries
Wearing clothes to cover injuries, even in hot weather
Refusal to undress for gym
Bald patches
Chronic running away
Fear of medical help or examination
Self-destructive tendencies
Aggression towards others
Fear of physical contact—shrinking back if touched
Admitting that they are punished, but the punishment is excessive (such as a child being beaten every night to "make him/her study")
Fear of suspected abuser being contacted

Emotional Abuse

Physical, mental, and emotional development lags
Sudden speech disorders
Continual self-depreciation ("I'm stupid, ugly, worthless, etc.")
Overreaction to mistakes
Extreme fear of any new situation
Inappropriate response to pain ("I deserve this")
Neurotic behavior (rocking, hair twisting, self-mutilation)
Extremes of passivity or aggression