Physical neglect – Includes abandonment or inadequate supervision, and failure to provide for
safety or physical needs. Includes failure to thrive, malnutrition, unsanitary conditions, or injuries
from lack of supervision.
 Educational neglect – Includes not enrolling child in school, or allowing child to engage in chronic
 Emotional neglect - Includes withholding of affection or attention, failure to provide psychological
care, ignoring the child’s emotional needs.
 Medical neglect – Includes delay or denial of dental or health care, or withholding medical care due
to religious beliefs. Some states will not prosecute due to withholding of health care due to
religious beliefs but court orders are occasionally obtained to save a child's life.

Neglect Indicators

 Poor hygiene, including lice, scabies, severe or untreated diaper rash, bedsores, body odor
 Unsuitable clothing; missing key articles of clothing (underwear, socks, shoes); overdressed or
underdressed for climate conditions
 Untreated injury or illness
 Lack of immunizations
 Indicators of prolonged exposure to elements (excessive sunburn, insect bites, colds)
 Height and weight significantly below age level



Physical abuse is the most obvious form of abuse. It is an act that results in physical injury to a child.
Punching, beating, kicking, biting, burning, breaking bones, hair pulling and shaking a baby are
examples of physical abuse.

Physical Abuse Indicators:

 Recurrent injuries with unexplained, guarded, implausible, or inconsistent explanations
 Oddly shaped or patterned bruises or lacerations (from an object)
 Uncommon locations for injury (underarms, neck, back, genitals, stomach, thighs)
 Burns (cigarette, immersion)
 Broken bones and intracranial trauma
 Hair loss
 Wearing long sleeve clothing out of season
 Hesitation on showing certain body parts (not dressing out for P.E.)
 Acts out aggression on others
 Fear, withdrawal, depression
 Fantasies, art work, or threats related to violence
 Nightmares, insomnia


 Fetal alcohol Syndrome (FAS) – Caused from the consumption of alcohol during pregnancy.
 Drugs – tobacco, marijuana, cocaine, methamphetamines, heroin, PCP, LSD.
Indicators of fetal abuse due to FAS
 Mental retardation
 Prenatal and postnatal growth deficiency
 Facial malformations
 Central nervous system dysfunction
 Varying degrees of major organ dysfunctions
 Developmental delays

Indicators of fetal abuse due to drug usage

 Low birth-weight
 Premature birth
 Developmental delays
 Behavioral and learning problems
 Drug dependency and subject to withdrawal (tremors, sleeplessness, muscle spasms, and difficulties
 Susceptibility to HIV



Sexual abuse is any misuse of a child for sexual pleasure or gratification. It is the involvement of children in
sexual activities that they do not fully comprehend, that they are unable to give informed consent to and/or
that violates societal taboos.
Non-touching sexual abuse - Indecent exposure or
exhibitionism, exposure to pornographic material or any
sexual act, including masturbation.
Touching sexual abuse – Fondling, making a child touch
an adult’s or another child’s sexual organs, penetration of a
child’s vagina or anus by an adult or an object, and any
other sexual act with a child.
Sexual exploitation - Engaging a child for the purposes of
prostitution or using a child to film or photograph

Sexual Abuse Indicators

 Compulsive masturbation, teaching others to masturbate
 Excessive curiosity about sex or seductiveness
 Sexual acting out with peers, others
 Bruises or bleeding in external genitalia or stained, torn, bloody underclothing
 Frequent, unexplained sore throats, yeast or urinary infections.
 Bed-wetting, soiling, playing with feces
 Complains of pain or itching in genitalia
 Difficulty in sitting or walking
 Excessive bathing
 Withdrawn or aggressive
 Sexually transmitted diseases
 Pregnancy, especially in early adolescence
 Sexual inference in school artwork
 Substance abuse
 Legal issues
 Overly compulsive behavior
 Fears and phobias
 Running away
 Sleep problems
 Fire starting
 Somatic symptoms (stomach aches, headaches, etc.)



“When it comes to damage, there is no real difference between physical, sexual and emotional abuse. All
that distinguishes one from the other is the abuser’s choice of weapons.”- Andrew Vachss
 Emotional abuse is a pattern of behavior that can seriously interfere with a child's positive
development, psyche and self-concept.
 Emotional abuse is hard to identify due to no physical evidence.
 Rejection and Ignoring – Telling a child in a variety of ways that he or she is unwanted, having a
lack of attachment, showing no interest, not initiating or returning affection, and/or not listening to
the child. Not validating feelings. Breaking promises. Cutting the child off while he or she is
speaking. Pretending to hear concerns, but then disregard them.
 Shame and Humiliation –Telling a child he or she is stupid, etc. or evoking criticism when
performance is not perfect. Judging what the child does as wrong, inferior, or worthless. Using
reproaches such as "You should be ashamed of yourself," or "Stop crying or I'll give you something
to cry about." Pride is also a feeling that is often met with shameful condemnations, such as "Who
do you think you are, Mr. Big Shot?"
 Terrorizing – Accusing, blaming, insulting, criticizing, punishing and threatening with
abandonment, physical harm, or death. Sabotaging success by making unreasonable demands or
labeling the person as a loser. Taking advantage of the person’s weakness or manipulating.
 Isolating – Not allowing the child to engage with peers or activities, keeping a child in a room or
small area, and not exposing the child to stimulation. Withholding information.
 Corrupting - Engaging children to witness or participate in criminal acts such as stealing, drug
dealing etc. Telling lies to avoid justifying actions or ideas.

Emotional Abuse Indicators

 Hiding his or her eyes
 Lowering his or her gaze
 Biting lips or tongue
 Forcing a smile
 Confusion or denial
 Feeling of nakedness, defeat, alienation or lack of worth
 Poor self-esteem
 Angry acts
 Alcohol or drug abuse
 Difficulty in relationships
 Eating disorders
 Sleep disorders/nightmares
 Speech disorders
 Developmental delays
 Nervous disorders or somatic symptoms



 Mind control or thought reform.
 The misuse of a position of power, leadership, or influence to further the interests of someone other
than the individual who needs help.
 Psychological, sexual, and/or physical abuse by members of a specific religion or cult.
 Withholding medical care in lieu of prayer.
 Using religious texts for justifications for abuse.
 Psychological, sexual, and/or physical assault committed by one or more people whose primary
motive is to fulfill a prescribed ritual or satisfy the perceived needs of a deity or other being. This
may include exorcisms or sacrifices.
 Satanic or Sadistic Ritual Abuse (SDA) is an organized, secret, often multi-generational group who
engage in mutilation, ritual killing, cannibalism, drinking of blood, systematic torture to produce
robot-like, programmed, children, etc.
Common Characteristics of Abusive Groups
 Authoritarian – The group claims to have been established by God and leaders in this system claim
the right to command their followers. Followers may be told that God will bless their submission
even if the leadership is wrong.
 Image Conscious –History, character flaws, etc are misrepresented or denied to validate the revered
image of the group. Irrationally high standards are placed upon followers and their failure to live up
to these standards is a constant reminder of the follower's inferiority to his or her leaders.
 Suppresses Criticism – Questions or open discussions about issues are not allowed. The group or
religion is promoted as favored by God and a person who questions becomes the problem rather
than the issue he or she raised. Questioning anything is considered a challenge to authority and
doubting God.

Spiritual/Ritual Abuse Indicators

 Child believes he or she is evil or causes others to be evil
 Mistrust of others outside the group
 Strong fear of God
 Overly obedient or perfectionistic
 Strong feelings of shame or guilt
 Programmed statements or behaviors
 Sleep problems or nightmares


By ChildHelp




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