Physical Abuse:

• Frequent injuries that are unexplained or child/parent cannot adequately explain their causes
• Burns or bruises in an unusual pattern that may indicate the use of an instrument
• Lack of reaction to pain
• Injuries that appear after the child has not been seen for several days
• Evidence of delayed or inappropriate treatment for injuries
• Injuries involve the face, backs of hands, buttocks, genital area, abdomen, back, or sides of the body
• Frequent complaints of pain without obvious injury
• Complaints of soreness or uncomfortable when moving
• Aggressive, disruptive and destructive or self-destructive behavior
• Passive, withdrawn, emotionless behavior
• Fear of going home or seeing caregivers

Sexual Abuse:

• Torn, stained or bloody underclothing
• Pain, swelling or itching in genital area
• Difficulty walking or sitting
• Sexual knowledge that exceeds developmental level
• Role reversal, overly concerned for siblings
• Significant weight change
• Suicide attempts (especially adolescents)
• Threatened by physical contact, closeness
• Extreme fear of being alone with adults especially if of a particular gender
• Sudden refusal to change for gym or to participate in physical activities
• Sexual victimization of other children
• Major change in normal mood or behavior