Child abuse comes in many different forms such as neglect, physical abuse, fetal abuse, sexual abuse, emotional abuse, and spiritual abuse. The Child Abuse Prevention and Treatment Act (CAPTA) has these definitions: 

Child abuse and neglect - At a minimum, any recent act or failure to act on the part of a parent or caretaker, which results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or failure to act which presents an imminent risk of serious harm. 

Sexual abuse - the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, and in cases of caretaker or inter-familial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children. 


Physical neglect - Includes abandonment or inadequate supervision, and failure to provide for safety or physical needs. Includes failure to thrive, malnutrition, unsanitary conditions, or injuries from lack of supervision. 

Educational neglect - Includes not enrolling child in school, or allowing child to engage in chronic truancy. 

Emotional neglect -
Includes withholding of affection or attention, failure to provide psychological care, ignoring the child’s emotional needs. 

Medical neglect - 
Includes delay or denial of dental or health care, or withholding medical care due to religious beliefs. Some states will not prosecute due to withholding of health care due to religious beliefs but court orders are occasionally obtained to save a child's life. 
Neglect Indicators 
  • Poor hygiene, including lice, scabies, severe or untreated diaper rash, bedsores, body odor  
  • Squinting  
  • Unsuitable clothing; missing key articles of clothing (underwear, socks, shoes); overdressed or underdressed for climate conditions  - Untreated injury or illness  
  • Lack of immunizations  
  • Indicators of prolonged exposure to elements (excessive sunburn, insect bites, colds)  
  • Height and weight significantly below age level 


Physical abuse is the most obvious form of abuse. It is an act that results in physical injury to a child. Punching, beating, kicking, biting, burning, breaking bones, hair pulling and shaking a baby are examples of physical abuse. 

Physical Abuse Indicators
  • Recurrent injuries with unexplained, guarded, implausible, or inconsistent explanations 
  • Oddly shaped or patterned bruises or lacerations (from an object)  
  • Uncommon locations for injury (underarms, neck, back, genitals, stomach, thighs)  
  • Lacerations  
  • Burns (cigarette, immersion)  
  • Welts 
  • Broken bones and intracranial trauma  
  • Hair loss  
  • Wearing long sleeve clothing out of season  
  • Hesitation on showing certain body parts (not dressing out for P.E.)  
  • Acts out aggression on others  
  • Fear, withdrawal, depression  
  • Fantasies, art work, or threats related to violence  
  • Regression  
  • Nightmares, insomnia  

Sexual abuse is any misuse of a child for sexual pleasure or gratification. It is the involvement of children in sexual activities that they do not fully comprehend, that they are unable to give informed consent to and/or that violates societal taboos.   

Non-touching sexual abuse - Indecent exposure or  exhibitionism, exposure to pornographic material or any  sexual act, including masturbation.  

Touching sexual abuse – Fondling, making a child touch  an adult’s or another child’s sexual organs, penetration of a  child’s vagina or anus by an adult or an object, and any  other sexual act with a child.  

Sexual exploitation - Engaging a child for the purposes of  prostitution or using a child to film or photograph  pornographically. 

Sexual Abuse Indicators

  • Compulsive masturbation, teaching others to masturbate  
  • Excessive curiosity about sex or seductiveness  
  • Sexual acting out with peers, others  
  • Bruises or bleeding in external genitalia or stained, torn, bloody underclothing  
  • Frequent, unexplained sore throats, yeast or urinary infections.  
  • Bed-wetting, soiling, playing with feces  
  • Complains of pain or itching in genitalia  
  • Difficulty in sitting or walking  
  • Excessive bathing  
  • Withdrawn or aggressive  
  • Sexually transmitted diseases  
  • Pregnancy, especially in early adolescence  
  • Sexual inference in school artwork  
  • Substance abuse  
  • Legal issues  
  • Overly compulsive behavior  
  • Fears and phobias  
  • Running away  
  • Sleep problems  
  • Fire starting  
  • Depression  
  • Somatic symptoms (stomach aches, headaches, etc.)  


“When it comes to damage, there is no real difference between physical, sexual and emotional abuse. All that distinguishes one from the other is the abuser’s choice of weapons.”- Andrew Vachss 

- Emotional abuse is a pattern of behavior that can seriously interfere with a child's positive development, psyche and self-concept. 

- Emotional abuse is hard to identify due to no physical evidence. 

- Rejection and Ignoring – Telling a child in a variety of ways that he or she is unwanted, having a lack of attachment, showing no interest, not initiating or returning affection, and/or not listening to the child. Not validating feelings. Breaking promises. Cutting the child off while he or she is speaking. Pretending to hear concerns, but then disregard them. 
- Shame and Humiliation - Telling a child he or she is stupid, etc. or evoking criticism when performance is not perfect. Judging what the child does as wrong, inferior, or worthless. Using reproaches such as "You should be ashamed of yourself," or "Stop crying or I'll give you something to cry about." Pride is also a feeling that is often met with shameful condemnations, such as "Who do you think you are, Mr. Big Shot?" 
- Terrorizing – Accusing, blaming, insulting, criticizing, punishing and threatening with abandonment, physical harm, or death. Sabotaging success by making unreasonable demands or labeling the person as a loser. Taking advantage of the person’s weakness or manipulating. Slandering. 
- Isolating – Not allowing the child to engage with peers or activities, keeping a child in a room or small area, and not exposing the child to stimulation. Withholding information. 
Corrupting - Engaging children to witness or participate in criminal acts such as stealing, drug dealing etc. Telling lies to avoid justifying actions or ideas. 

Emotional Abuse Indicators
  • Hiding his or her eyes  
  • Lowering his or her gaze  
  • Biting lips or tongue  
  • Forcing a smile  
  • Fidgeting  
  • Annoyance  
  • Defensiveness  
  • Exaggeration  
  • Confusion or denial  
  • Feeling of nakedness, defeat, alienation or lack of worth  
  • Regression  
  • Poor self-esteem  
  • Angry acts  
  • Withdrawal  
  • Insecurity  
  • Alcohol or drug abuse  
  • Depression  
  • Suicide  
  • Difficulty in relationships  
  • Eating disorders  
  • Sleep disorders/nightmares  
  • Speech disorders  
  • Developmental delays  
  • Nervous disorders or somatic symptoms 

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