All children have a right to live free from abuse.  Unfortunately the news is full of reports about child mistreatment, and people start to wonder how safe children really are.  Some think that it is a mistake to be overprotective and make children fearful, but it is important to recognize the risks and to familiarize people with the signs of abuse. 

There are more than 2.5 million cases of child abuse and neglect that are reported each year.  Some of these children will carry these scars for the rest of their lives. 

The abuser could be anyone including a parent, family member, babysitter, teacher, clergy, coach, or even a stranger (Brunswick Family and Community Services, 2002). 

Children depend on their parents to love, nurture, and protect them.  Parents have a duty to provide for the emotional and physical well being of their children.  They are responsible for keeping their children safe (Brunswick Family and Community Services, 2002).   Child abuse is common; studies show that one in four girls and one in eight boys will be sexually abused before they are 18 years old.  About one in 20 children are physically abused each year (Caring for Baby and Young Child: Birth to Age 5, Bantam, 1999).  The first step in helping abused children is learning to recognize the symptoms of child abuse.  Recognizing when a child has been abused is not easy.  Children who have been mistreated are often afraid to tell anyone because they think they will be blamed or that no one will believe them.  Parents also tend to overlook symptoms because they do not want to face the truth.  A child who has been abused needs special support and treatment as early as possible. 

The abused child will usually show signs of their maltreatment.  These signs are called “indicators”.  Some indicators are obvious, and others are not.  An individual does not have to know for sure if the abuse is happening, or know all the signs to take action.  Abused children usually show signs of their abuse either physically or behaviorally. These signs will either occurs on their bodies (physical) or in their actions

(behavior), or both.  Some indicators can be signs of more than one type of abuse.  Indicators are red flags that tell us something is not right, and whether the cause is abuse or something else. 

Child abuse is divided into four types, physical abuse, neglect, sexual abuse, and emotional maltreatment.  Although there are four types of child abuse, they are typically found in combination rather than alone.  A physically abused child for example is often emotionally maltreated as well, and a sexually abused child may be also neglected.  Any child at any age may experience any of the types of child abuse (Prevent Child Abuse America).  

Physical abuse is any physical injury or pattern of injuries inflicted or caused by a parent, parent-guardian, caregiver, or other person.  Health care providers are usually the first to identify and report physical abuse.  Some physical indicators to watch for are unexplained bruises, or welts, unexplained burns, unexplained fractures or sprains, unexplained head injuries, unexplained lacerations or abrasions, school absence correlates with appearance or injury, confinement, exposure or starvation (Division of Child and Family Services, 2006).  If a child has any of these signs, it is your moral and legal responsibility to evaluate what caused them and if they are signs of a childhood accident or abuse (How to Recognize and Respond to Child Abuse, Mulryan, 2004).

Behavior in a physically abused child can cover a wide range and depends on their developmental level and the severity and duration of abuse.  Some behavior extremes could be overly compliant, passive or undemanding, aggressiveness or withdrawal.  A young child may be wary to cling to strange adults or may seem fearful around their parents or other adults.  They may be afraid to go home or destructive to self or others.  An adolescent may show signs of antisocial behaviors, such as truancy, running away from home, stealing, or substance abuse. Problems are easier to recognize if you understand the child's emotional and social development and are familiar with their typical behavior (Division of Child and Family Services, 2004). 

            Sexual abuse includes exploitation of a child for the sexual gratification of an adult or person older than the child.  This includes any act designed to stimulate the child or perpetrator with the use of coercion, deceit, and manipulation to achieve power over the child.  Some physical indicators of sexual abuse may include bed wetting and fecal soiling, torn, stained or bloody underclothing, difficulty walking or sitting, bruises, blood or discharge from Genital or Anal areas, loss of appetite, unexplained gagging, excessive pain or itching of the genital area, venereal disease, frequent urinary or yeast infections, frequent unexplained sore throats or massive weight change (Division of Child and Family Services, 2004). 

            Behavior of a sexually abused child may be withdrawn, clingy, whiny, lack of emotional control, or crying with no provocation.  The child may show signs of poor self-esteem, or self -devaluation.  These victims are commonly chronic runaways, or suicidal.  They tend to avoid bathrooms, they engage in eating disorders, and have bizarre, sophisticated or unusual sexual behavior or excessive seductiveness or masturbation (Division of Child and Family Services, 2004). 

            Emotional abuse is a pattern of behavior that takes place over an extended period of time, where a parent fails to give proper love, direction, encouragement and acceptance.  This behavior is characterized by intimidating, belittling, constantly ignoring the child and otherwise damaging the interaction that affects a child’s healthy emotional development.  Some physical indicators of emotional abuse might be physical problems such as distress, speech disorders, delayed physical development, ulcers, asthma, and severe allergies.  They could show signs of regressive behavior, failure to thrive in infancy and early childhood, low self-esteem or substance abuse (Division of Child and Family Services, 2004). 

            Emotional abuse may cause extremes in behavior, from withdrawal to aggression, learning difficulties, nervous habits, such as nail biting or thumb sucking, or conduct disorders such as antisocial or destructive behavior.  If you have a long-term relationship with the family, you should be able to detect this type of abuse (Division of Child and Family Services, 2004). 

            Parents are responsible for meeting a child’s basic physical, educational, and emotional needs.  Failing to provide adequate food, clothing, shelter, medical care, education, supervision, and guidance is neglect (Mulryan, 2004).   Physical indicators of neglect are that the child lacks adequate food, clothing or housing, poor hygiene,

 thin stomach, unattended physical/emotional problems when required such as medical, dental, and or psychiatric services.  They lack supervision or guidance, unmet educational needs, or abandonment. 

            Typically neglect is brought to attention when a teacher reports a child who has poor hygiene or inappropriate clothing, appears listless, frequently complains of hunger, and frequently misses school without explanation.  Neighbors might report a child unsupervised, or a health care provider may report that a child is missing appointments for medical care.  Lack of knowledge, personal problems such as immaturity, substance abuse or emotional problems may also lead to child abuse or neglect (Mulryan, 2004).

            Child abuse does happen, and everyone can help to contribute to a positive, nurturing environment for children by knowing and learning how to recognize child abuse.  The behavior of children will signal abuse or neglect long before any change in physical appearance.  Becoming familiar with the behavioral and the physical indicators that are associated with all four types of child abuse, physical, sexual, emotional, and neglect is important.