Signs & Symptoms of Child Abuse and How to Help

By Gaan Akers, LPC, NCC | April 11, 2018

April is National Child Abuse Prevention Month. Since 1983, National Abuse Prevention Month has served as a reminder to communities across the nation to protect America’s children from abuse and promote healing for victims of child abuse. Although we should always work to prevent child abuse, April is the time of year for communities to join together and spread awareness about its effects and prevention.

Childhood abuse is a difficult topic that evokes painful emotions for many families. A lot of individuals fear that a child will suffer the effects of abuse for a lifetime. Children who were abused may feel like there is no way out of a traumatic past. National Child Abuse Prevention Month is not only about raising awareness in hopes to prevent child abuse, but it is also a great opportunity for community members to spread hope.

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Life does not end when abuse occurs. Children who experienced abuse can heal and grow beyond their traumatic experiences to live as healthy, productive adults. As part of National Child Abuse Prevention Month, we would like to share important information about child abuse. Here we will look at the signs of abuse and what you can do to help an abused child. Let’s prevent child abuse together and encourage healing.

Child Abuse Victims of Neglect

Child Abuse and Neglect Statistics

Child abuse is an epidemic in America. The greatest percentage of children are victims of neglect, with the Department of Health and Human Services reporting in 2020 that about three-fourths or 76.1% of victims were neglected. The same report said that 16.5% experience physical abuse, while 9.4% are sexually abused. It also found that in 2020, there were over 3 million Child Protective Services investigations or other investigations into child abuse.

Child abuse can happen in any family, and many children die each year as a result of neglect or physical abuse. Abuse is widespread and can have devastating consequences. Consider the following:

  • It is estimated that about 2.38 per 100,000 children died from abuse and neglect in 2020.
  • The United States loses almost five children every day due to neglect or abuse.
  • Between 2019 and 2020, at least 18% of children in the United States experienced two or more adverse experiences, which can include abuse and neglect.
  • Over 70% of children who died because of abuse or neglect were under three years old.
  • Children and teenagers living in poverty are five times more likely to experience neglect or abuse.
  • In 2020, about 43 out of every 1,000 children had at least one maltreatment report.
  • Abuse happens across all ethnic groups and income and educational levels.

Child Abuse Death & Neglect Statistics

Why do adults abuse children? Common reasons for child abuse include:

  • Alcohol or substance abuse: Children whose parents abused drugs or alcohol were found to be three times more likely to be abused, and four times more likely to be neglected than families who do not abuse drugs or alcohol.
  • A history of abuse: About 30% of children who are abused will grow up to abuse their children.

Although the statistics are alarming, there is hope. Through understanding and awareness, we can each spread the message about the reality of child abuse and help children and families seek the treatment they need.

Child Abuse Types & Methods

The Different Types of Child Abuse

Child abuse is when a parent or caregiver fails to act or acts in a way that causes harm to a child. Not every sign of injury or illness means that a child is being abused, but sometimes a deeper investigation is warranted.

There are four major types of abuse most states recognize, and abuse can happen to children of any age. The four major types of abuse are:

1. Neglect

Neglect is defined as the failure of a parent or caregiver to provide for a child’s basic needs. Neglect includes:

  • Physical: Failure to provide food, shelter or supervision
  • Medical: Failure to provide medical treatment
  • Educational: Failure to make sure a child receives education
  • Emotional: Failure to meet a child’s emotional needs or provide psychological care
  • Substance abuse: Some states recognize substance abuse by a parent or caregiver as a form of neglect if a parent harms the child due to substance abuse. A parent might sell or give drugs or alcohol to a child, manufacture drugs in the presence of a child or be unable to supervise and care for a child as the result of drug use.

2. Physical Abuse

Physical abuse occurs when a caregiver or parent physically injures a child non-accidentally. This may include:

  • Punching
  • Beating
  • Kicking
  • Shaking
  • Hitting
  • Biting

Even if a caregiver or parent does not intend to hurt a child, they are still physically abusive if they treat a child with violence. While many parents still use spanking to discipline a child, it is now widely discouraged and has been proven to lead to worse behavior, not better. Over 28% of adults report having been physically abused as a child.

3. Sexual Abuse

Sexual abuse is any sexual activity with a minor and does not have to include physical contact. Sexual abuse includes any activities by a parent, caregiver or another guardian such as:

  • Fondling
  • Intercourse
  • Incest
  • Rape
  • Indecent exposure
  • Sexual exploitation
  • Exposure to pornography
  • Any sexual activity that is harmful to a child physically or emotionally

Sexual abuse is an epidemic in itself, with one in nine girls under and one in 53 boys under age 18 becoming victims of sexual abuse by an adult.

4. Emotional Abuse

Also known as psychological abuse, emotional abuse prevents a child from experiencing self-worth. A parent or guardian who emotionally abuses a child regularly criticizes, rejects or threatens a child. They may also withhold love or affection from a child. Emotional abuse is not easy to prove but is usually present when other forms of abuse are taking place.

5. Medical Abuse

Medical abuse occurs when a child receives medical care that is deemed unnecessary or harmful. One or both parents often exaggerate a child’s symptoms or invent them entirely. In some cases, a parent may purposely make their child ill.

The parents insist that something is wrong with the child, even if a doctor or physician does not see anything of concern. One common type of medical abuse — also considered a mental health condition — is Factitious Disorder Imposed on Another (FDIA), formerly known as Munchausen syndrome by proxy.

Signs and Symptoms of Child Abuse

Each type of abuse shows its own set of signs and symptoms, but all types of abuse can lead to psychological disorders down the road. Some children may feel ashamed or guilty about the abuse, so it’s important to know when to reach out for help. Behavioral issues like delinquent behavior, self-injurious behavior and relationships problems might be present with any abuse case. Other general symptoms of abuse and neglect to look out for include:

  • A sudden change in behavior
  • Learning difficulties with no known reason
  • A desire not to go home
  • Hesitant to be around the parent or guardian
  • Reports abuse
  • Symptoms of depression or anxiety
  • Tries to run away

You may not know how to spot child abuse, especially when physical marks are not present, but here are some of the specific warning signs and symptoms of each type of abuse.

1. Signs and Symptoms of Physical Abuse

The signs and symptoms of physical abuse include:

  • Bruises, burns, broken bones or other signs of injury that have no known cause
  • Handprints or marks that appear to be from an object
  • Injuries that are healing at different times
  • Medical issues left untreated
  • Fear of a parent or guardian
  • Fear of adults
  • Abuseing animals or pets
  • Wearing long sleeves to cover up marks even if the weather is warm outside
  • Avoiding physical contact
  • Withdrawing from friends and family
  • Reporting abuse

Parents may display the following signs resulting from physically abusing their child:

  • Telling stories that do not add up about injuries or not being able to explain injuries
  • Describes child in a negative way
  • Has a history of abuse
  • Uses harsh discipline

2. Signs and Symptoms of Neglect

Children who are neglected may display the following signs:

  • Be often left alone or cared for by other children
  • Have poor hygiene
  • Lack of medical, mental or dental care
  • Frequently miss school
  • Steal money or food
  • Eat an unusual amount or hide food
  • Need new or weather-appropriate clothing
  • Say they are home alone a lot

Caregivers may:

  • Seem indifferent toward the child
  • Abuse substances or alcohol
  • Seem depressed
  • Seem unable to recognize the problem

3. Signs and Symptoms of Sexual Abuse

Children who have been sexually abused may display the following signs and symptoms:

  • Have trouble sitting or walking
  • Refuse to change in front of others
  • Have nightmares
  • Wet the bed at an older age
  • Have a change in appetite
  • Run away
  • Display sexual behavior or inappropriate knowledge
  • Report sexual abuse
  • Get attached to strangers or new adults quickly
  • Show bruising or bleeding around the genitals
  • Experience pain or itching around the genitals
  • Sexually abuse other children
  • Be pregnant or have a sexually transmitted disease

Sexually abusive parents or caregivers may:

  • Limit child’s contact with other children
  • Act overprotective of the child
  • Be secretive
  • Isolate themselves and the child
  • Act jealous or controlling toward other family members

4. Signs and Symptoms of Emotional Abuse

Children who are victims of emotional abuse may:

  • Constantly worry they are doing something wrong
  • Experience delays in learning, emotional development or speech
  • Experience depression
  • Have low self-esteem
  • Do poorly in school
  • Display physical symptoms such as headaches or stomach issues with no known causes
  • Lack interest in activities or friends
  • Not seem close to a parent or caregiver
  • Appear desperate for attention
  • Act overly adult-like or infantile
  • Say they are not attached to the parent

An emotionally abusive parent may:

  • Constantly blame or belittle the child
  • Show a lack of concern for the child and does not seek help for the child’s problems
  • Reject the child

5. Signs and Symptoms of Medical Abuse

Children who have experienced medical abuse may:

  • Describe strange or unusual symptoms
  • Have a long history of hospitalizations, tests and procedures
  • Have symptoms or stated conditions that do not align with the results of tests, labs or imagery
  • Appear to only have symptoms when they are at home or with the caregiver
  • Have signs of chemicals in the urine, blood or stool

Parents or caregivers who engage in medical abuse may:

  • Bring the child to the doctor or hospital to request evaluations and tests repeatedly
  • Report symptoms or conditions that are not witnessed or detectable by medical professionals
  • Remain at the child’s bedside or nearby as often as possible
  • Talk in extensive detail about the symptoms, conditions and care received

Behavioral Effects of Child Abuse

The Effects of Child Neglect and Abuse

Child abuse has lifelong consequences on victims. With at least one in seven children having experienced some form of neglect or sexual, physical or emotional abuse in 2020, we need to take the initiative to put an end to the cycle. With a strong support system and the right treatment, abuse survivors can heal and empower others to do the same.

  • Impaired brain development: The abused child may not properly develop cognitive skills, which has long-term effects on academic abilities and mental health.
  • Poor physical health: Adults who experienced childhood abuse are more likely to experience health conditions such as heart disease, lung disease and diabetes. Abuse has been linked to adolescent obesity as well.
  • Psychological conditions: Depression, anxiety, low self-esteem, eating disorders, personality disorders, post-traumatic stress disorder (PTSD), attachment disorders and life-threatening behaviors that can include suicidal thoughts and gestures are all tied to childhood abuse. Research suggests that people who have experienced physical abuse as a child are two times more likely to develop depression and anxiety later in life.
  • Relationship issues: Abuse victims may struggle to trust others. Children may also grow up to accept abuse as a normal part of relationships.
  • Substance abuse: Victims of childhood abuse have a 40% higher chance of using drugs during early adolescence than children who were not abused.
  • Behavioral issues: Adolescents are more likely to engage in unprotected sex, skipping school, abusing drugs and other delinquent activities as a consequence of abuse. Adults are nine times more likely to engage in criminal activity if they experience childhood neglect and abuse.
  • Abusive to others: Children who were raised abused are more likely to continue the cycle of abuse.
  • Reproductive health concerns: Child abuse victims often engage in sexual activity earlier in life and have unsafe sex that can lead to sexually transmitted infections or unintended pregnancy.
  • Limited education and employment: Many victims of child abuse have a decreased chance of getting a well-rounded education and have fewer job opportunities.

Abuse has a major economic impact on society as well. In 2015, the average lifetime cost per victim of childhood abuse and neglect in the United States was over $830,000 per victim. Costs include:

With that said, it is important to bring the effects of child abuse to the public’s attention. Some may not realize the severity of abuse and how it can have a serious impact on a child’s development and well-being. As a community, it is our responsibility to protect children from harm and help create safe environments that nurture growth. We are all affected by child abuse in one way or another. While physical bruises fade over time, the wounds of abuse can last much longer if never addressed. Here are some of the effects of child abuse:

  • Impaired brain development: The abused child may not properly develop cognitive skills, which has long-term effects on academic abilities and mental health disorders.
  • Poor physical health: Adults who experienced childhood abuse are more likely to experience health conditions such as heart disease, lung disease and diabetes. Abuse has been linked to adolescent obesity as well.
  • Psychological issues: Depression, anxiety, low self-esteem, eating disorders, personality disorders, post-traumatic stress disorder (PTSD), attachment disorders and suicide attempts are all tied to childhood abuse. According to the Centers for Disease Control and Prevention (CDC), as many as 80 percent of adults meet the criteria for at least one mental health issue diagnosis before age 21 as a result of childhood abuse.
  • Relationship issues: Abuse victims may struggle to trust others. Children may also grow up to accept abuse as a normal part of relationships.
  • Substance abuse: Victims of childhood abuse are 1.5 times more likely to use drugs than children who were not abused.
  • Behavioral issues: Adolescents and young adults are more likely to engage in unprotected sex, skipping school, abusing drugs and other delinquent activities as a consequence of abuse. Adults are 28 percent more likely to engage in criminal activity if they experience childhood neglect and abuse.
  • Abusive to others: Children who were raised abused are more likely to continue the cycle of abuse.

Abuse has a major economic impact on society as well. In 2010, the average lifetime cost per victim of childhood abuse and neglect in the United States was $210,012 per victim. Costs include:

  • Medical bills
  • Productivity losses
  • Child welfare costs
  • Criminal justice costs
  • Special education

Effective prevention can help reduce the financial and emotional burden of childhood abuse for everyone involved.

Child Abuse Treatment Options

Child abuse can be devastating for victims and impacts all members of the family. Fortunately, with proper treatment, there are ways to overcome the effects of abuse and rebuild family relationships. Treatment duration varies with each child and the severity of abuse they suffered. The goal of abuse treatment is to:

  • Encourage the child to talk and think about the abuse without feeling embarrassed
  • Help the child recognize and express their feelings related to the abuse
  • Help reduce behavioral issues resulting from the abuse
  • Help the child change negative thinking patterns and learn to view themselves and others in a healthy way
  • Teach the child coping skills
  • Educate the child about self-protection
  • Teach a child about normal relationships and help them learn to trust again

The key to healing from abuse is with therapy. Therapy treatment options include:

  • Cognitive behavioral therapy (CBT): Cognitive behavioral therapy like dialectical behavior therapy (DBT), helps a child cope with painful memories and feeling associated with the trauma of abuse. Behavioral therapy teaches healthy coping skills for dealing life stressors and decreases life-threatening behaviors and other behaviors that reduce the quality of life.
  • Child-parent psychotherapy: This form of treatment helps the parent and child build a stronger relationship. Parents will learn the cause of the abuse and ways to deal with difficult and frustrating situations as a parent, as well as healthy parenting skills.

Parents also benefit from psychotherapy in ways that include:

  • Helping them learn better coping mechanisms for stressful events and common life frustrations
  • Learning about the root cause of the child abuse
  • Getting educated on healthy parenting strategies

What to Do If You Suspect Child Abuse

We can all work together to help children work through abuse, and you should never be afraid to report child abuse. Child abuse allegations are serious, but the consequences of not reporting child abuse are far more substantial. If a child tells you they are being abused or if you suspect abuse, follow these steps:

  • Encourage the child to speak: It might be tough not to want to find out all the answers right away, and you will probably experience difficult emotions. However, make it a priority to let the child speak and listen to them and remain calm.
  • Let the child know it is not their fault: A child may feel guilty or like they are to blame for the abuse. Remind them that it is not their fault in any way and that the abuser is to blame.
  • Let them know you are there: Tell the child you are there for them to listen to them or talk. Tell them you want to help them in any way you can.
  • Report the abuse: Contact the police or child protective services (CPS) about the abuse. They will take the next step to make sure the child is safe. If abuse happened at school, tell the principal and let CPS know.
  • Get medical help: If the child shows any signs of injury, help them get medical attention immediately.
  • Help them stay safe: Separate the child from the abuser and keep an eye on them until help is available. Do not hesitate to ask for support from local support groups.

If you or the child are in immediate danger, call 911. Otherwise, you can contact one of multiple child abuse hotlines, such as:

Anyone can report child abuse or neglect. Some individuals are mandatory reporters based on their jobs, including:

  • Teachers and other school personnel
  • Social workers
  • Health care workers
  • Child care providers
  • Law enforcement
  • Therapists or other mental health professionals

In some states, anyone who suspects child abuse is considered a mandatory reporter. If you suspect child neglect or abuse, taking action is essential.

When you report, be honest and clear about the behaviors and concerns that lead you to the decision. For example, if you’ve noticed any of the signs and symptoms listed above, you need to report all of them.

CPS will receive your report and decide if they need to investigate. They will talk with the child and caregivers to determine how the child is unsafe and offer support and other services to stop the abuse or neglect.

Contact Hillside® for Help

We can all make a difference when it comes to preventing child abuse. Share your knowledge with others and strive to bring child abuse prevention awareness to your community. Although April is National Child Abuse Prevention Month, make it a goal to prevent child abuse every day — because every child deserves the chance to grow, learn and feel loved.

If you suspect child abuse or neglect or if your child needs treatment as a result of abuse, Hillside® is here to help in many different ways. Hillside® provides Intensive In-home Therapy for clients ages 6-24 and various treatment options to help children suffering from behavioral issues, often resulting from abuse. Other services we offer include:

  • Outpatient DBT therapy with a licensed therapist with a focus on the individual, family or group
  • Individualized treatment through residential, outpatient, community intervention and foster care services
  • Treatment Foster Care which provides a stable, nurturing family environment for children
  • Community Intervention provides in-home support to prevent hospitalization or to ease the transition home
  • A Residential Program for comprehensive longer-term treatment
  • Animal Assisted Therapy which helps children develop and practice important relationship skills
  • Horticulture Therapy which uses plant and a garden landscape to promote well-being
  • Theraplay® which is an interactive, fun relationship-based treatment method

Founded in 1888, Hillside® is one of Atlanta’s oldest nonprofit organizations, providing behavioral and mental health services for children and families. It is our mission to help children and families thrive. Do not wait to help a child in need of safety and treatment — contact Hillside® today.

Child Abuse Therapy in GA


  • Gaan Akers, LPC, NCC

    Director of Clinical Education & Outreach - Gaan has been working with children, adolescents, and families for over 10 years in various settings. In her current role, she provides education and training for mental health professionals, parents, and the community. She lives in Atlanta with her husband. In her free time, she enjoys reading, hiking, climbing, and cooking. She is a donut aficionado and a national park enthusiast!

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Current Version
May 9, 2024
Written By: Angie Hoke
Edited By: Angie Hoke
April 11, 2018
Medically Reviewed By: Angie Hoke