| Indicators of Abuse (children) |
| ~Repeated injuries that are not properly treated or are inadequately explained; ~Unusual behavior ranging from disruptive and aggressive to passive and withdrawn; ~Child acts as parent toward siblings or toward parents; ~Disturbed sleep (bed-wetting, nightmares, fear of sleeping alone, needing a night light); ~No appetite or overeating; ~Reports being hungry; ~Sudden drop in grades or participation; ~Child may report abuse; ~Unexplained bruises, especially in various stages of healing; ~Unexplained burns, especially cigarette or immersion burns; ~Unexplained fractures, lacerations, or abrasions; ~Unexplained injuries regularly appearing after absence, weekend, vacation, etc. ~Human bite marks (less than 3 centimeters between canines); ~Swollen areas; ~Abandonment; ~Consistent lack of supervision; ~Consistent hunger, inappropriate dress, poor hygiene; ~Lice, distended stomach, emaciation; ~Inadequate nutrition; ~Torn, stained, or bloody underwear; ~Pain, swelling, or itching in genital area; ~Difficulty walking or standing; ~Bruises or bleeding in genital area; ~Sexually transmitted diseases; ~Frequent urinary tract or yeast infections; ~Speech disorders; ~Delayed physical development; ~Substance abuse; ~Ulcers, asthma, severe allergies; ~Self-destructive behaviors; ~Arrives at school early or stays late; ~Chronic runaway (adolescents); ~Complains of soreness or moves uncomfortably; ~Wary of adult contact; ~Listless, tired constantly, falls asleep in class; ~Steals food, begs for food from classmates, hoards food; ~Reports that no parent nor caretaker is home; ~Frequently absent or tardy; ~Extreme need for affection or loneliness; ~Excessive seductiveness; ~Massive weight change; ~Suicide attempts; ~Inappropriate or premature sex play or understanding of sex; ~Habit disorder (sucking, rocking, biting); ~Antisocial, destructive; ~Neurotic traits (sleep disorders, inhibition of play); ~Delinquent behavior; ~Seems frightened of parents; ~Wears long sleeves to hide injuries; ~Afraid to go home, shows little separation anxiety; ~Seeks affection from any adult; ~Unsafe living conditions; ~Somatic problems (always feels yukky); ~Is pregnant; ~Poor self-esteem, peer relationships; ~Is overly adaptive, inappropriately infantile or adult; ~Exhibits emotional, physical, or mental delays; ~Poor social skills, low frustration tolerance, academic dysfunction; ~Fear of failure, overly high standards, reluctance to play; ~Fears consequences of actions, often leading to lying; ~Overly compliant, too well-mannered; ~Excessive and seemingly obsessive neatness and cleanliness; ~Self-mutilation; ~Injuries to the mouth, genital, or anal areas (bruising, swelling, sores, infection); ~Reverts to bed-wetting and soiling; ~Fire setting; ~Lacks trust in others, inability to "have fun;" ~Injuries that form a shape or pattern that may look like the object used to make the injury; ~Bald patches on the child's head; ~Repeated poisonings and accidents; ~Describes self as bad, needing punishment; ~May flinch if touched unexpectedly; ~Sad, cries frequently; ~Poor memory and concentration; ~Pain experiences in elimination; ~Seems anxious when other children cry; ~Whispering speech. |
| Indicators of Abusive Parents: |
| ~Seems unconcerned about the child; ~Takes an unusual amount of time to seek medical care for the child; ~Offers inadequate or inappropriate explanations for child's injuries; ~Gives different explanations for the same injury; ~Misuses drugs or alcohol; ~Disciplines the child too harshly for the mistake or for the child's age; ~Sees the child as evil or bad; ~Has a history of abuse; ~Attempts to conceal the child's injuries; ~Takes the child to a new doctor for each injury; ~Has an unorganized, upsetting home life; ~Is apathetic, feels that nothing will ever change; ~Is isolated from friends, family, relatives, neighbors; ~Has long-term, chronic illness; ~Cannot be found; ~Has a history of neglect; ~Role reversal with the child; blurred boundaries; ~Very protective, jealous, controlling; ~Encourages child to participate in prostitution, sexual acts in the presence of the caregiver; ~History of sexual abuse; ~Low self-esteem, poor self-image; ~Incapacitated mother; ~Makes harsh and/or destructive responses to the child's requests; ~Threatens or terrorizes the child; ~Believes that the child entices his/her own poor treatment; ~Treats children in the family unequally; ~Doesn't seem to care much for the child's problems; ~Blames or belittles the child; ~Is cold and rejecting; ~Withholds love; ~Has unrealistic expectations; ~May not have age appropriate expectations of the child; ~Jealous; ~Poor impulse control; ~Marital problems; ~Psychotic or psychopathic; ~Emotionally immature and impulsive. |
| Shaken Baby Syndrome information here is from the National Center on Shaken Baby Syndrome website. |
| Common symptoms of Shaken Baby syndrome: ~lethargy/ decreased muscle tone ~extreme irritability ~decreased appetite, poor feeding or vomiting for no apparent reason ~grab-type bruises on arms or chest are rare ~no smiling or vocalizations ~poor sucking or swallowing ~rigidity or posturing ~difficulty breathing ~seizures ~head or forehead appear larger than usual or fontanelle appears to be bulging ~inability to lift head ~inability of eyes to focus or track movement or unequal size of pupils Physical consequences of shaking an infant or toddler: ~The brain rotates within the skull cavity, injuring or destroying brain tissue. ~When shaking occurs, blood vessels feeding the brain can be torn, leading to bleeding around the brain. ~Blood pools within the skull, sometimes creating more pressure within the skull and possibly causing additional brain damage. ~Retinal bleeding is very common. Immediate Consequences: ~Breathing may stop or be compromised ~Extreme irritability ~Seizures ~Limp arms and legs or rigidity/posturing ~Decreased level of consciousness ~Vomiting; poor feeding ~Inability to suck or swallow ~Heart may stop ~Death Long-Term Consequences: ~Learning disabilities ~Physical disabilities ~Visual disabilities or blindness ~Hearing impairment ~Speech and/or language disabilities ~Cerebral Palsy ~Seizures ~Behavior disorders ~Cognitive impairment; problems with memory and attention; severe intellectual disability ~Paralysis (some particularly traumatic episodes leave the child in a coma) ~Death |
| Preventing Shaken Baby Syndrome ... It is 100% preventable. Finding ways to alleviate parental stress when the baby seems inconsolable can significantly reduce the risk. One method is Dr. Harvey Karp's Five S's: **Shushing (Using white noise, or rhythmic sounds that mimic the whir of noise in the womb, with things like vacuum cleaners, hair dryers, clothes dryers, a running tub, or a white noise CD.) **Side/ Stomach positioning (Placing the baby on the left side to help digestion or on the belly while holding him or her.) **Swaddling (Wrapping the baby up snugly in a blanket to help him or her feel more secure.) **Swinging gently (Rocking in a chair, using an infant swing, or taking a car ride to help duplicate the constant motion the baby felt in the womb.) If a baby in your care won't stop crying, you can also try the following: **Make sure that the baby's basic needs are met (hungry? wet? lonely? etc.); **Check for illness, fever, swollen gums; **Rock or walk with the baby; **Sing or talk to the baby; **Offer the baby a pacifier or a noisy toy; **Take the baby for a ride in the stroller or the car; **Hold the baby close against your body and breathe calmly and slowly, hum or sing ... **Call a friend or relative for support or to take care of the baby while you take a break; **If nothing else works, put the baby on his or her back in the crib, close the door, and check on the baby in 10 minutes; **Try a bath; **Just go outside, get some fresh air; **Call your child's doctor if nothing seems to be helping your infant, in case there is a medical reason for the fussiness. |
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