Physical abuse Signs, indicators and effects
Bumps and bruises don’t necessarily mean a child is being physically abused – all children have accidents, trips and falls.
There’s isn’t one sign or symptom to look out for that will say a child is definitely being physically abused. But if a child often has injuries, there seems to be a pattern, or the explanation doesn’t match the injury then this should be investigated.
- commonly on the head but also on the ear or neck or soft areas - the abdomen, back and buttocks
- defensive wounds commonly on the forearm, upper arm, back of the leg, hands or feet
- clusters of bruises on the upper arm, outside of the thigh or on the body
- bruises with dots of blood under the skin
- a bruised scalp and swollen eyes from hair being pulled violently
- bruises in the shape of a hand or object.
- can be from hot liquids, hot objects, flames, chemicals or electricity
- on the hands, back, shoulders or buttocks; scalds may be on lower limbs, both arms and/or both legs
- a clear edge to the burn or scald
- sometimes in the shape or an implement for example, a circular cigarette burn
- multiple burns or scalds.
- usually oval or circular in shape
- visible wounds, indentations or bruising from individual teeth.
- fractures to the ribs or the leg bones in babies
- multiple fractures or breaks at different stages of healing
- effects of poisoning such as vomiting, drowsiness or seizures
- respiratory problems from drowning, suffocation or poisoning
Things you may notice
If you're worried that a child is being abused, watch out for any unusual behaviour.
- suddenly behaves differently
- problems sleeping
- eating disorders
- wets the bed
- soils clothes
- takes risks
- misses school
- changes in eating habits
- obsessive behaviour
- thoughts about suicide
Find out more about the signs, symptoms and effects of child abuse.
Signs a baby or infant may have a head injury
There may be visible signs of an impact such as swelling, bruising or fractures.
Signs of head injuries include:
- being comatose
- respiratory problems
- unusual responses – irritable, poor feeding, lethargic, unresponsive.
Not all head injuries are caused by abuse. Sometimes there are other reasons a child may have these symptoms.
Physical abuse has long-lasting effects
Children who have been physically abused may still feel the effects long after their injuries have healed.
Being shaken, hit or physically abused in any way as a child can lead to poor physical or mental health later in life, including depressive disorders, anxiety disorders, eating disorders, childhood behavioural or conduct disorders, drug use, suicide attempts, obesity, sexually transmitted infections and risky sexual behaviour (Norman, R.E. et al, 2012).
Other long-term effects include:
- not doing as well at school or education
- criminal risk taking behaviour
- drug and alcohol problems.
"My sister's relationship with my mum was better than mine. She would get yelled at and hit, but it was me who bore the brunt of mum's anger."
Read Pete's story
Effects of shaking a baby
If a baby is shaken or thrown, they may suffer non-accidental head injuries. Shaking a baby can cause fractures, internal injuries, long-term disabilities and even death.
The most serious consequence of a non-accidental head injury (NAHI) is a brain injury which can lead to:
- learning problems
- hearing and speech impairment
- visual impairment or blindness
- behaviour problems or changes in personality
- severe brain damage
- long-term disability
Babies may suffer other injuries from the abuse such as broken bones or fractures.
Non-accidental head injuries are theand long-term disability in babies who are maltreated.
Explanation: There have been a number of research studies into outcomes for abused babies. They suggest that around 25% of children will die as a result of non-accidental injuries, and between 50 and 80% of children who survive will suffer from severe and life-changing disabilities, including learning and behavioural issues, cerebral palsy, seizures and blindness.
- Karandikar, S., et al (2004) The neurodevelopmental outcome in infants who have sustained a subdural haemorrhage from non-accidental head injury. Child Abuse Review 13(3): 178-187.
- Jayawant, S. et al (1998) Subdural haemorrhages in infants: population based study. British Medical Journal 317(7172): 1558-1561.
- Dias, M. S., et al (2005) Preventing abusive head trauma among infants and young children: a hospital-based, parent education program. Pediatrics 115(4): e470-e477.
Nearlysuffer from non-accidental head injuries each year.
Explanation: The prevalence of NAHI in the UK is estimated at around 24 per 100,000 babies under 12 months. This equates to nearly 200 babies a year.
This is likely to be an underestimate, because it is very difficult to identify non-accidental head injury when it does occur. Some babies may be injured but not taken to hospital, and others may be seen by doctors but their injuries may not be recognised as non-accidental.
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