Program Management
C.E.S.P. 3-19: Recognizing Child Abuse
Date Revised: 5-1-2001
Supersedes: 4-23-2001
Type of Child Abuse/Neglect:
I. Physical Abuse:
A. Physical Indicators:
Unexplained Bruises and Welts:
• on face, lips, mouth
• on torso, back buttocks, thighs in various stages of healing
• clustered, forming regular patterns
• reflecting shape of article used to inflict (electric cord, belt buckle)
• on several different surface areas
• regularly appear after absence, weekend, or vacationUnexplained Burns:
• cigar, cigarette burns, especially on soles, palms, back, or buttocks
• immersion burns (sock-like, glove-like, doughnut-shaped on buttocks or genitalia)
• patterned like electric burner, iron, etc.
• rope burns on arms, legs, neck, or torso
Unexplained Fractures:
• to skull, nose, facial structure
• in various stages of healing
multiple or spiral fracturesUnexplained Lacerations or Abrasions:
• to mouth, lip, gums, eyes
• to external genitalia
B. Behavioral Indicators:
• Wary of adult contacts.
• Apprehensive when other children cry.
• Behavioral extremes:
aggressiveness, or withdrawal
• Frightened of parents
• Afraid to go home
• Reports injury by parents
II Physical Neglect
A. Physical Indicators
• Consistent hunger, poor hygiene, inappropriate dress
• Consistent lack of supervision, especially in dangerous activities or for long periods
• Unattended physical problems or medical needs
• Abandonment
B. Behavioral Indicators
• Begging, stealing food
• Extended stays at school (early arrival and late departure.
• Constant fatigue, listlessness, or falling asleep in class
• Alcohol or drug abuse
• Delinquency (e.g., thefts)
• States there is no caretaker
III. Sexual
A. Physical Indicators
• Difficulty in walking or sitting
• Torn, stained, or bloody underclothing
• Pain or itching in genital area
• Bruises or bleeding in external genitalia, vaginal, or anal areas
• Venereal disease, especially in preteens
• Pregnancy
B. Behavioral Indicators
• Unwilling to change for gym or participate in physical education class
• Withdrawal, fantasy, infantile behavior
• Bizarre, sophisticated, or unusual sexual behavior or knowledge
• Poor peer relationships
• Delinquent or run away
• Reports sexual assault by caretaker
IV. Emotional Maltreatment
A. Physical Indicators
• Speech disorders
• Lags in physical development
• Failure-to-thrive
B. Behavioral Indicators
• Habit disorders (sucking, biting, rocking, etc.)
• Conduct disorders (antisocial, destructive, etc.)
• Neurotic traits (sleep disorders, inhibition of play)
• Psychoneurotic reactions (hysteria, obsession, compulsion, phobias, hypochondria)
• Behavior extremes:
compliant, passive aggressive, demanding
• Overly adaptive behavior:
inappropriately adult
inappropriately infant• Developmental lags (mental, emotional
• Attempted suicide