Abused or neglected children often show both physical and behavioral symptoms. Older children may not talk about the problem because they fear or want to protect the offender, or they do not believe they will be taken seriously. Sometimes children report abuse to an adult they trust. These conversations should be taken seriously and acted upon.

Some symptoms are specific to certain forms of maltreatment. There are also general symptoms that can occur with all types.

General symptoms

Certain general symptoms that may suggest that a child is experiencing some type of abuse or neglect include:

• Developmental delays, which means a child does not reach developmental milestones as expected, such as starting to talk or socialize with others.
• Regression, which is losing skills already mastered and moving back to a earlier state of development.
• Failure to thrive, which is when a child's growth pattern is not in a healthy range. Both weight and height can be affected, but low weight for height and head circumference is the most common symptom. Most cases of failure to thrive are the result of problems with the immediate care of the child, the interaction between the child and the caregiver (usually the mother), or the social and emotional health of the caregiver.
• Unusual parent/child interaction. The parent may be uninterested in the child, or a child may be especially sensitive to the parent's moods and may attempt to smooth over any potential conflict. Often this appears as a type of role reversal, with the child closely monitoring and responding to the parent. Abused or neglected children may also fear their parents.
• Poor mental health, such as exhibiting low self-esteem, anxiety, depression, or suicidal tendencies.
• Sudden decline in academic performance.
• Inappropriate or problem behavior. In some cases, especially for a young child, unusual fussiness, fear, or lack of interest in activities may be noticed. Other behaviors may be disruptive. Children often act out what they have seen or experienced, such as violence or sexual activity. Older children may act out by being promiscuous or running away.

Symptoms of physical abuse

Physical abuse often results in cuts, bruises, burns, broken bones, head injuries, and abdominal injuries. These types of injuries may indicate physical abuse when:

• They are unlikely to have been caused by an accident, especially for the child's developmental stage. Geometric patterns or mirror (symmetrical) injuries are suspicious, as are those located on areas of the body that usually are protected, such as the inside of the legs and arms, the back, the genitalia, and the buttocks.
• Explanations change or do not adequately account for how an injury occurred. The history of the injury does not match the actual type of injury, its location, or how long ago it occurred.
• Evidence shows that injuries have occurred previously.
• Medical care for the injury is delayed.

Symptoms of psychological abuse