Skip to main content

Recognizing the Warning Signs of Child Abuse and Neglect

Child abuse and neglect can have a devastating impact on children and families. Sometimes the signs are obvious, but often they are subtle. Staff members may not feel confident in their abilities to recognize child abuse and neglect. A director’s role is to ensure staff have the training and resources they need to learn the signs and behavioral indicators of child abuse and neglect. You can help them process information and support them as they make the decision to report their suspicions. This lesson will help you learn to recognize signs of abuse or neglect that happen in home settings and institutional settings. It will also help you teach staff to identify some common signs and behavioral indicators of child abuse and neglect. 

Objectives
  • Identify examples of behaviors that might indicate familial and institutional abuse.
  • Observe children for signs of abuse and neglect.
  • Ensure annual staff training occurs to teach staff to identify the signs and behavioral indicators of child abuse and neglect.

Learn

Know

The staff members you work with do their best every day to keep children safe. Suspecting child abuse or neglect can be the most difficult professional experience they encounter. It is an experience that can challenge them personally and professionally. Your role is to help staff learn the signs and behavioral indicators of child abuse and neglect. You can help them process information and support them as they make the decision to report their suspicions.

To do this important work, we must be able to recognize when a child is in harm’s way. Look for the following signs from the Child Welfare Information Gateway fact sheet on Child Abuse and Neglect (U.S. Department of Health and Human Services).

The child:

  • Shows sudden changes in behavior
  • Has not received help for physical or medical problems brought to the parents’ attention
  • Is always watchful, as though preparing for something bad to happen
  • Lacks adult supervision
  • Is overly compliant, passive, or withdrawn
  • Comes to the program or other activities early, stays late, or does not want to go home

The parent:

  • Shows little concern for the child
  • Denies the existence of—or blames the child for—the child's problems in the program or at home
  • Asks caregivers to use harsh physical discipline if the child misbehaves
  • Sees the child as entirely bad, worthless, or burdensome
  • Demands a level of physical or cognitive performance the child cannot achieve
  • Looks primarily to the child for care, attention, and satisfaction of emotional needs

The parent and child:

  • Rarely touch or look at each other
  • Do not respond to each other after a separation (i.e., at pick-up time)
  • State they do not like each other

It’s not always easy to recognize child abuse and neglect. Remember that any one of these signs by itself does not necessarily mean a child has been abused. Often a pattern or combination of behaviors will lead to the suspicion that a child is experiencing abuse or neglect. The attachment at the end of the Learn section provides additional examples and scenarios of child abuse and neglect. Watch this video to learn about the long-term effects of abuse and neglect.

Long-term Effects of Child Abuse and Neglect

Learn about the long-term effects of abuse and neglect

Supervise & Support

A Reasonable Suspicion of Child Abuse or Neglect

It is not uncommon for staff members to doubt themselves when they suspect child abuse or neglect. In many ways, this is human nature: we want to see the best in families and co-workers. Unfortunately, doubting oneself about suspicions of child abuse or neglect can be very dangerous. You must help staff members learn to recognize the signs that constitute a reasonable suspicion. You can also help them learn to follow their instincts. You can begin doing this by simply helping them understand the term suspicion. A suspicion is an unsubstantiated belief that something is wrong. It is an inkling or a feeling, based on observation or experience, that a child is being mistreated. Staff members do not need to prove that child abuse or neglect is occurring. They do not need to investigate. They do not even need to know who the suspected abuser is. If they think a child has been harmed or is in danger of being harmed, they have a reasonable suspicion of child abuse or neglect. The Observe section of this lesson will provide more examples of staff members who have a reasonable suspicion of child abuse or neglect. 

Helping Staff Recognize Reasonable Suspicions

Take steps to help staff know when to report

Here are a few additional signs that staff members have reasonable suspicions:

  • Staff member tells you he fears for the child’s safety
  • Staff member comes to you upset about a child’s condition or an interaction
  • Staff member has had a pattern of experiences that “don’t feel quite right” with a family or colleague regarding a child
  • Staff member wants to make a report. Do not discourage a staff member who wants to make a report.

Collaborating with FAP

Your Family Advocacy Program (FAP) can provide training and technical support around recognizing child abuse and neglect. The best trainings are often developed in collaboration between you and the FAP staff. Reach out to the FAP office on your installation. Learn about the resources they can provide. They are only a phone call away, and they can help you and staff members talk through what you have observed. They can help recognize whether or not a reasonable suspicion of child abuse or neglect has occurred.

Getting Help: Family Advocacy Programs

Your FAP team can help you recognize the signs of child abuse and neglect

Ask Questions and Open the Lines of Communication

All children get hurt occasionally: bumps, bruises, and scrapes can be signs of healthy exploration. Sometimes, more serious accidents happen as well: a child pulls a cup of hot tea down on herself or a child is involved in a car accident. Sometimes a medical condition causes symptoms that mimic abuse. To be most effective at protecting children from child abuse and neglect, we must be able to differentiate between accidents and abuse. Conversations are a powerful tool for doing so. Whenever you or a staff member notices an injury or symptom in a child, ask the family member about it. This is a standard part of caregiving and shows that your program takes an interest in the child’s well-being. Here are some tips for asking questions:

  • Ask open-ended questions. You might say, “Ouch. That looks like it hurts. What happened?”
  • Show concern and empathy: “I bet that was pretty scary. How did it happen?”
  • Make sure it’s an OK time to talk, and be prepared to get help if the family needs it. “Is it OK to ask you about Geri’s bruises? Do you have a minute?”
  • Find out if there is anything else you should know about the injuries. “I’m glad you took her to the doctor. Is there anything we should do to make her comfortable during the day? Or is there anything she shouldn’t do?”

In most cases the family member will give you a clear and accurate account of what happened. For older toddlers, preschoolers, and school-age children, you should also ask the child what happened. You might suspect child abuse or neglect if:

  • The child’s answer and the adult’s answers do not match or if two different adults give conflicting stories about how the injury happened. For example, a child has scratches all over her face. At drop-off, her dad says she got them from a child at a birthday party. At pick-up, her mom says she got them from the family cat.
  • The story does not seem consistent with the child’s developmental level. For example, you might suspect abuse if a parent says a 4-month-old climbed out of a crib and got hurt.
  • The story is not consistent with the injuries. For example, a child has burn marks on his hands that look almost like gloves—his hands were clearly submerged in something hot. His mother says the child accidentally grabbed a pot off the stove. Accidental burn injuries usually show some kind of splatter patterns as the child pulls away.

Understand and Discuss Age-Specific Risks:

Internet Predators and Cyber-Bullying

School-age children are growing up in a world of online social networks. They may have access to websites where they have “friends” they have never actually met. Staff members must be on the lookout for signs that a child is engaged in dangerous or inappropriate relationships online. You will learn more about this in the Safety lesson. Make sure that you and all staff members can monitor children’s Internet usage, and make sure they know never to meet a person they only know online. To keep children safe, make sure you and program staff:

  • Can always see the monitors when children are on computers
  • Check browser histories
  • Install software that blocks questionable content
  • Talk to school-age children about safe internet use

Remember that many school-age children have access to the internet at all times on smartphones or handheld devices. Help staff members talk to school-age children about safe phone use and texting. Discuss boundaries related to sharing images and content. Make sure children feel safe talking to an adult if (a) they receive inappropriate content from another child or an adult or (b) they are being asked to share inappropriate content or images of themselves. Also be aware of staff members’ phone use in the program: make sure staff members know appropriate boundaries for communication with children.

All staff must also be on the lookout for children who are being victimized online. This victimization can come from other children, but it can also come from adults. There have been several high-profile stories in the media of children being taunted, harassed, belittled, and insulted online. Sometimes, these stories come to light after the child commits suicide. Many victims are under the age of 12. Observe for the signs of emotional abuse that you will read about later in the lesson.

Crushes and Predatory Relationships

Later in the school-age period, children may begin to show an interest in sex and romantic relationships. It’s not unusual for children to have “boyfriends” and “girlfriends.” It’s also not unusual for school-age children to have crushes on teachers or school-age program staff. As a Manager, you must remain alert for these situations and handle them appropriately. Enforce your program’s Guidance and Touch Policy with all staff members. Teach staff members how to respond if an older child does something that makes you uncomfortable: sits on a staff members lap, squeezes in next to an adult on the couch, or grabs a staff members hand. Make sure staff members know to avoid being alone with a child. Make sure staff members know that they should never share images, videos, jokes, or content that are sexual or romantic in nature.

Remember that you and program staff are working with young children and pre-teens. Although the child might have a crush, sexual activity or sexual touching is never consensual. If you suspect that a child is being sexually abused by a staff member, another adult, or a teen, you must make a report. You will learn about reporting procedures in the next lesson.

Examples of Staff or Volunteer Behavior in Youth-Serving Organizations

Appropriate
Verbal Communication
  • Praise
  • Positive reinforcement for good work or behavior
Inappropriate/Harmful
Verbal Communication
  • Sexually provocative or degrading comments
  • Risqué jokes
Appropriate
Physical Behavior
  • Patting a child on the back
  • Holding the hand of a young school-age child as they get off the bus
  • Brief hugging as long as the child appears comfortable and the contact is not romanticized or sexually intimate
Inappropriate/Harmful
Physical Behavior
  • Patting the buttocks
  • Intimate, romantic, or sexual contact
  • Corporal punishment
  • Showing or involving a child in pornographic activities

Source: U.S. Centers for Disease Control and Prevention
http://www.cdc.gov/violenceprevention/pdf/PreventingChildSexualAbuse-a.pdf

Support Program Practices that Promote Recognition of Abuse and Neglect

  • Get to know all of the children in your program and their families. In large programs, this can be challenging. It is critical, though. You will be a much more effective resource for staff members if you know the children and families yourself. Talk to families every day. Learn children’s names.
  • Be a resource on child development. Some changes in a child’s behavior can be startling for staff members—but are completely typical. For example, it’s not unusual for toddlers to have bruises all over their legs or on their heads. Falling is a part of learning to walk and run! Young children may be scared of certain adults as part of typical “stranger anxiety.” Pre-teens might be moody or occasionally say they hate their parents. Knowing these developmental stages can help you know recognize when a child’s behavior goes beyond what is typically expected.
  • Offer trainings in collaboration with your installation’s FAP on child abuse identification and reporting.
  • Offer trainings in collaboration with your local Child Protective Services (CPS) agency on child abuse identification and reporting.
  • Develop respectful communication skills. You will need these skills to communicate with staff members and families. If a staff member has a concern about a child, listen and help the staff member feel heard. You might say, “It sounds like you are concerned about Samantha. Tell me what you’ve noticed.” If you have a concern about a child, ask about it. Ask open-ended questions that focus on the child’s well-being. “Is it OK if I ask you about Jordan’s bruises?” or “I’ve noticed that Tasha hasn’t seemed like herself lately. Is everything OK?” If something doesn’t seem right, gather as much information as you can.
  • Learn about the cultures of the children in your program. Some cultures have rituals or healing practices that might be mistaken for signs of abuse. Staff members might have questions, and you can help them find answers. When in doubt, though, encourage staff members to make a report. CPS FAP, law enforcement and CPS will decide whether abuse has occurred.
  • Communicate the reporting procedures for your state or installation. You will learn more about this in the next lesson.

There are signs often associated with particular types of child abuse and neglect. Download and print the attachment in the Apply section for a complete list. It is important to note, however, that these types of abuse are more typically found in combination than alone. A physically abused child, for example, is often emotionally abused as well, and a sexually abused child also may be neglected. Remember, there are two kinds of abuse to remain aware of: familial and institutional. The signs and behavioral indicators you see in children may be similar for each. Remember, though, that it is not your job to investigate or interview a child or family. The “You Say” section is just meant as a helpful resource for those times when you must make a split-second decision about how to respond. In many cases, it is best just to report what you observed rather than to pry for more information. It is possible to bias a child’s testimony or to make a family defensive before an investigation begins. Always proceed with caution and remember that your role is to report rather than to investigate.

Observe for Signs of Abuse or Neglect in the Family

Below you will see four scenarios that might make you suspect child abuse or neglect is occurring in a family. At the end of the Learn section, you will find an attachment with additional scenarios related to physical abuse, sexual abuse, emotional abuse, and neglect from infancy through school-age. Download the attachment and reflect on the scenarios. You can use the scenarios with staff to discuss what should be done to protect each child.

Observe for Signs of Abuse or Neglect in the Family

 

Physical Abuse

Scenario

You See a Suspicion of Physical Abuse:

An infant caregiver comes to you in tears. A 6-month-old baby has been out of the program for a week. Her parents said they had family in town and decided not to bring her in. During a diaper change on her first day back, the infant caregiver noticed purple, brown, and yellow bruises on the baby's inner thighs and buttocks. When the caregiver asked the baby's father about the bruises, he said she fell from the crib with the rails up. The caregiver knows the baby does not yet pull up or climb, so this explanation seemed unlikely. She tells you something doesn't feel right, but she doesn't know what to do.

You Say

Say to the Caregiver:

  • "It sounds like you're concerned about the baby. Let's write down everything you've noticed."
  • "I heard you say you're not sure what's going on. I wonder if you suspect something is wrong…"
  • "Remember, we don't have to investigate maltreatment or have a definitive answer. Do you think she was harmed? Do you think she is unsafe? If you answer yes, we need to make a call."

You Do

Take Action:

Stay with the caregiver if she needs your support while making a report to FAP, law enforcement and CPS. She does not need to investigate any further. She can simply call FAP, law enforcement, and CPS and report what she saw and heard.

Observe for Signs of Abuse or Neglect in the Program

Below you will see four scenarios that might make you suspect child abuse or neglect is occurring in your facility or by staff members (institutional abuse or neglect). At the end of the Learn section, you will find an attachment with additional scenarios related to physical abuse, sexual abuse, emotional abuse, and neglect from infancy through school-age. Download the attachment and reflect on the scenarios. You can use the scenarios with staff to discuss what should be done to protect each child.

Observe for Signs of Abuse or Neglect in the Program

 

Physical Abuse

Scenario

You See a Suspicion of Physical Abuse:

A staff member in the pre-toddler room has had a very hard day. Fiona, 18 months, has been crying and throwing herself on the floor for 10 minutes. It's time to get the kids outside. In frustration, the staff member grabs Fiona by the top of the arm and yanks her up to walk. She squeezes so hard that Fiona has bruises around her upper arm in the shape of a hand.

You Say

Say to the Staff Member:

  • "I think you need to go take a break in the office right now. I'll cover the classroom and be up to talk in a few minutes."

You Do

Take Action:

  • Call FAP, law enforcement, and CPS.
  • Talk to management and make sure the staff member is removed from settings with children while the incident is investigated.
  • Support staffing in the classroom to ensure adequate supervision.
  • Follow procedures for incident reporting and notifying the family.

Remember that every employee of the child development programs has a legal and ethical obligation to report suspicions of child abuse and neglect. The first step in doing so is recognizing when a child has been harmed or is in imminent risk of harm. Learning to recognize the signs of abuse and neglect is equally important for you and the direct care staff members. Take time to make sure you know what to look for and how to help staff members spot the signs.

Explore

You have a dual responsibility to (a) recognize signs of abuse and neglect and (b) ensure staff members can recognize signs of abuse and neglect. Take some time to think about where you as a staff are and where you need to be.

If you were to conduct random spot checks in your building, would all staff members know the signs and behavioral indicators of abuse and neglect? Download and print the Program Reflection activity. In it, you will find a list of scenarios. Use them to ensure staff members can recognize signs of abuse and neglect. You can discuss a scenario during a staff meeting or use them as booster with individual staff members who need support.

Apply

Download and print this Fact Sheet entitled Recognizing the Signs and Symptoms of Child Abuse and Neglect. Make sure you are familiar with its contents and can describe the signs of abuse and neglect that you might see.

Glossary

Emotional abuse:
A pattern of behavior by adults that seriously interferes with a child’s cognitive, emotional, psychological or social development
Familial abuse and neglect:
Abuse or neglect performed by a parent, guardian, or member of the family
Guidance and touch policy:
The policy your program has developed that describes the boundaries of acceptable and unacceptable discipline procedures and ways of touching children.
Institutional abuse and neglect:
Abuse or neglect that takes place outside of the child’s home and is performed by someone in a supervisory role over the child (teacher, scout leader, etc.)
Neglect:
Failure by a caregiver to provide needed, age-appropriate care although financially able to do so or offered financial or other means to do so (U.S. Department of Health and Human Services, 2007)
Physical abuse:
Non-accidental trauma or injury
Sexual abuse:
The involvement of a child in any sexual touching, depiction, or activity

Demonstrate

Which of the following scenarios might make you suspect child abuse or neglect?
True or false? Parents are the only people who abuse or neglect children.
As you are greeting families at the front desk, a child comes in with new bruises on his face. What should you do first?
Which of the following is not a sign of institutional abuse or neglect?
Which of the following is not a sign of familial abuse or neglect?
References & Resources

Center for the Study of Social Policy (2020). Strengthening Families: A Protective Factors Framework. https://cssp.org/our-work/projects/protective-factors-framework/

Centers for Disease Control and Prevention. (n.d.). Violence Prevention. http://www.cdc.gov/violenceprevention/

Harper Browne, C. (2014). The Strengthening Families Approach and Protective Factors Framework: Branching out and reaching deeper. Washington, D.C.: Center for the Study of Social Policy. https://cssp.org/wp-content/uploads/2018/11/Branching-Out-and-Reaching-Deeper.pdf

Military Family Advocacy Programs. http://www.militaryonesource.mil/abuse/service-providers

National Institutes of Health (2011). Shaken Baby Syndrome. Bethesda, MD: U.S. National Library of Medicine. https://medlineplus.gov/ency/article/007578.htm

Seibel, N. L., Britt, D., Gillespie, L. G., & Parlakian, R. (2006). Preventing Child Abuse and Neglect. Washington, DC: Zero to Three: Center for Infants, Toddlers and Families.

U.S. Department of Health and Human Services (n.d.). Stopbullying.gov: Cyberbullying. https://www.stopbullying.gov/cyberbullying/what-is-it/index.html

Zero to Three: Center for Infants, Toddlers and Families. (2006). The Prevalence of Child Abuse and Neglect. https://www.zerotothree.org/resources/91-the-prevalence-of-child-abuse-and-neglect