Signs of Child Abuse

Medically Reviewed by Dan Brennan, MD on March 12, 2023
6 min read

When you think of child abuse, your first thought may be of a child with bruises or other marks that raise red flags. But the signs aren’t always so clear. Abuse can be physical, sexual, or emotional. Or a child may be neglected, meaning their caregivers don’t provide for basic needs, like food or safety.

What makes abuse even harder to stop is that most of the time, the abuser is someone the child knows. They may be reluctant to say something because they may want to protect that person or they are afraid of what the abuser will do if they speak up.

It’s important to know how to recognize different types of abuse, and what you can do if you suspect it.

Child abuse happens when someone harms a child’s body or emotional health, development, and well-being. There are 4 main types.

Physical abuse means that someone hurts a child’s body or puts them in physical danger. It doesn’t matter if the child gets seriously hurt or if it leaves a mark. Any harm is abuse. It includes when someone:

  • Burns a child
  • Hits, kicks, or bites
  • Holds the child under water
  • Shakes or throws the child
  • Throws objects at the child
  • Ties up the child

Sexual abuse is any kind of sexual activity with a child, not just physical contact. It includes when someone:

  • Forces a child to take part in pornographic pictures or videos
  • Has any sexual contact with the child, from kissing in a sexual way to having sex
  • Makes phone calls or sends emails, texts, or other messages that are sexual in any way
  • Shows the child someone else’s genitals, as with “flashing”
  • Shows pornography
  • Tells “dirty” jokes or stories

Emotional abuse is a pattern of behaviors that harm a child’s emotional well-being and development. This can mean when someone:

  • Abuses others when the child is around, such as a parent, brother, sister, or pet
  • Fails to show love and affection
  • Ignores the child and doesn’t give emotional support and guidance
  • Shames, belittles, criticizes, or embarrasses
  • Teases, threatens, bullies, or yells

Neglect is when a caregiver doesn’t give the child basic care and protection, such as:

  • Clothing
  • Food
  • Heat in cold weather
  • Housing with clean living conditions
  • Medical care

Neglect is also when someone leaves the child alone for long stretches of time or under dangerous conditions.

Other types of child abuse include:

Parental substance abuse. This happens when adults neglect or harm children through the use of drugs or alcohol. It includes situations like:

  • A parent not able to care for a child because they're high on drugs or alcohol
  • Giving illegal drugs or alcohol to a child
  • Making methamphetamine (meth) while a child is around
  • A pregnant woman's abuse of drugs or alcohol, which exposes her baby to these substances

Medical neglect or abuse. A child is medically neglected when their caregivers don't provide them with needed medical or mental health treatment. Medical abuse is a rare situation in which a caregiver lies about a child's symptoms or harms them to try to get unnecessary medical attention. It's also called Munchausen syndrome by proxy.

Abandonment. Many states consider this a form of child neglect. It happens when a parent leaves a child with no support or concern for their well-being, or when the parent's location is unknown.

Human trafficking. This is basically a type of slavery. Children are trafficked when they're used for prostitution or pornography, or to beg, sell drugs, or work long hours for little pay.

Abuse can be hard to recognize. Kids can get cuts and bruises or show signs of stress for lots of reasons that are a normal part of childhood. So it helps to know specific signs to look for, and trust your gut as you look at the whole picture of the child’s physical and emotional health.

Signs of physical abuse may include:

  • Bruises, welts, or other injuries that can’t be explained or don’t match with the child’s story
  • Burns, especially from cigarettes, that can’t be explained
  • Injury marks that have a pattern, like from a hand, belt, or other objects
  • Injuries that are at different stages of healing
  • Medical or dental issues that go untreated

Kids who’ve been physically abused may also:

  • Avoid any kind of touch or physical contact
  • Be afraid to go home
  • Seem to always be on high alert
  • Wear clothing that doesn’t match the weather -- such as long sleeves on hot days -- to cover up bruises
  • Withdraw from friends and activities

Signs of sexual abuse may include:

  • Avoiding a certain person for no clear reason
  • Bloody, torn, or stained underwear
  • Bruising or bleeding around the genitals
  • Pain or itching around the genitals that might cause problems walking or sitting
  • Pregnancy or STDs, especially for children under 14 years old
  • Refusing to change clothes in front of others
  • Running away from home
  • Sexual activity or knowledge that people usually have only when they’re older

Signs of emotional abuse may include:

  • Constant worry about doing something wrong
  • Speech problems or delays in learning and emotional development
  • Depression and low self-esteem
  • Doing poorly in school
  • Extreme behavior, such as being way too obedient or way too demanding
  • Headaches and stomachaches with no clear cause
  • The child doesn’t seem close to a parent or caregiver
  • Showing little interest in friends and activities

Signs of neglect may include:

  • Always looking dirty
  • Being left alone or in the care of other young children
  • Eating more than usual at a meal or saving food for later
  • Missing a lot of school
  • Poor weight gain and growth
  • Doesn’t get medical, dental, or mental health care (medical neglect)

You may see the same signs of neglect in children whose parents or caregivers abuse alcohol or other drugs.

Signs of child trafficking could include:

  • Missing school often
  • Running away from home
  • Sudden changes in style of dress or relationships
  • Has an older "boyfriend" or "girlfriend"
  • They talk about needing to pay off a debt
  • They often care for children who aren't members of their family
  • Their responses to questions seem rehearsed


If you suspect child abuse, it’s important to report it. It isn’t a private matter or a family problem. A child’s physical and emotional well-being, and maybe even their life, could be at stake.

You don’t need proof to report abuse. If you suspect it, call your local child protective services, police, a hospital, or a hotline, such as the Childhelp National Child Abuse Hotline at 800-422-4453. You don’t have to give your name.

If you suspect child trafficking, call the National Human Trafficking Hotline at 888-373-7888.

Depending on the situation, there are many ways you can help the child:

  • If they need medical care right away, call 911.
  • Take the child to the hospital -- it’s a haven for abused children. Doctors can check for signs of abuse and give medical care.
  • Help the child stay safe. If you think someone like a babysitter or day-care worker has abused your child, keep the child away from them and contact police. If you suspect a parent or caregiver, supervise the child while they're around that person.
  • If the abuse happened at school, tell the principal about it. But report it to your local or state child protection agency, too.
  • Help the child get therapy to start healing the emotional damage of the abuse.
  • Encourage the child to talk to you about what happened. But don't make it an interrogation. Focus on listening.
  • Make sure they feel supported and know this is not their fault.
  • It’s best to not confront the abuser yourself. Instead, contact police or a child protection agency and let them handle it.