Session III. Signs and Symptoms/Physical Indicators

Signs and symptoms  of abuse are often difficult to spot. Some children are highly competent, making it difficult for adults to believe that anything could be wrong. Other children have with behavior issues that may be due to something other than abuse. The presence of any of the following signs does not prove that a child is being abused, but should serve as a warning signal to look further.


Physical Abuse

  • Fractures, lacerations, bruises that cannot be explained, or explanations which are improbable given the extent of the injury.
  • Burns (cigarette, rope, scalding water, iron, radiator).
  • Facial injuries (black eyes, broken jaw, broken nose, bloody or swollen lips) with implausible or nonexistent explanations.
  •  Subdural hematoma, long-bone fractures, fractures in different states of healing.
  •  Pattern of bruising, (e.g. that shows an outline of the object used) or bruises in different stages of discoloration, indicating repeated trauma over time.


  •  Failure to thrive, a child’s failure to gain normal weight at the expected rate for a normal child. A child who fails to thrive may have medical or psychosocial problems, or a combination of these.
  • Malnutrition or poorly balanced diet (bloated stomach, extremely thin, dry, flaking skin, pale, fainting).
  • Dirty, unkempt
  • Unattended medical conditions (e.g. infected minor burns, etc.

Sexual Abuse

  • Bruising around genital area
  • Swelling or discharge from vagina/penis
  • Tearing around genital area, including rectum
  • Visible lesions around mouth or genitals
  • Complaint of lower abdominal pain
  • Painful urination or defecation

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