Signs and symptoms of abuse in a child

Child abuse - Symptoms and causes

Overview

Mayo Clinic Center for Safe and Healthy Children and Adolescents

Any intentional harm or mistreatment to a child under 18 years old is considered child abuse. Child abuse takes many forms, which often occur at the same time.

Physical abuse. Physical child abuse occurs when a child is purposely physically injured or put at risk of harm by another person.
Sexual abuse. Child sexual abuse is any sexual activity with a child. This can involve sexual contact, such as intentional sexual touching, oral-genital contact or intercourse. This can also involve noncontact sexual abuse of a child, such as exposing a child to sexual activity or pornography; observing or filming a child in a sexual manner; sexual harassment of a child; or prostitution of a child, including sex trafficking.
Emotional abuse. Emotional child abuse means injuring a child's self-esteem or emotional well-being. It includes verbal and emotional assault — such as continually belittling or berating a child — as well as isolating, ignoring or rejecting a child.
Medical abuse. Medical child abuse occurs when someone gives false information about illness in a child that requires medical attention, putting the child at risk of injury and unnecessary medical care.
Neglect. Child neglect is failure to provide adequate food, clothing, shelter, clean living conditions, affection, supervision, education, or dental or medical care.

In many cases, child abuse is done by someone the child knows and trusts — often a parent or other relative. If you suspect child abuse, report the abuse to the proper authorities.

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Book: Mayo Clinic Guide to Raising a Healthy Child

Symptoms

A child who's being abused may feel guilty, ashamed or confused. The child may be afraid to tell anyone about the abuse, especially if the abuser is a parent, other relative or family friend. That's why it's vital to watch for red flags, such as:

Withdrawal from friends or usual activities
Changes in behavior — such as aggression, anger, hostility or hyperactivity — or changes in school performance
Depression, anxiety or unusual fears, or a sudden loss of self-confidence
Sleep problems and nightmares
An apparent lack of supervision
Frequent absences from school
Rebellious or defiant behavior
Self-harm or attempts at suicide

Specific signs and symptoms depend on the type of abuse and can vary. Keep in mind that warning signs are just that — warning signs. The presence of warning signs doesn't necessarily mean that a child is being abused.

Physical abuse signs and symptoms

Unexplained injuries, such as bruises, broken bones (fractures) or burns
Injuries that don't match the given explanation
Injuries that aren't compatible with the child's developmental ability

Sexual abuse signs and symptoms

Sexual behavior or knowledge that's inappropriate for the child's age
Pregnancy or a sexually transmitted infection
Genital or anal pain, bleeding, or injury
Statements by the child that he or she was sexually abused
Inappropriate sexual behavior with other children

Emotional abuse signs and symptoms

Delayed or inappropriate emotional development
Loss of self-confidence or self-esteem
Social withdrawal or a loss of interest or enthusiasm
Depression
Avoidance of certain situations, such as refusing to go to school or ride the bus
Appears to desperately seek affection
A decrease in school performance or loss of interest in school
Loss of previously acquired developmental skills

Neglect signs and symptoms

Poor growth
Excessive weight with medical complications that are not being adequately addressed
Poor personal cleanliness
Lack of clothing or supplies to meet physical needs
Hoarding or stealing food
Poor record of school attendance
Lack of appropriate attention for medical, dental or psychological problems or lack of necessary follow-up care

Parental behavior

Sometimes a parent's demeanor or behavior sends red flags about child abuse. Warning signs include a parent who:

Shows little concern for the child
Appears unable to recognize physical or emotional distress in the child
Blames the child for the problems
Consistently belittles or berates the child, and describes the child with negative terms, such as "worthless" or "evil"
Expects the child to provide attention and care to the parent and seems jealous of other family members getting attention from the child
Uses harsh physical discipline
Demands an inappropriate level of physical or academic performance
Severely limits the child's contact with others
Offers conflicting or unconvincing explanations for a child's injuries or no explanation at all
Repeatedly brings the child for medical evaluations or requests medical tests, such as X-rays and lab tests, for concerns not seen during the health care provider's examination

Physical punishment

Child health experts condemn the use of violence in any form, but some people still use physical punishment, such as spanking, to discipline their children. While parents and caregivers often use physical punishment with the intention of helping their children or making their behavior better, research shows that spanking is linked with worse, not better, behavior. It's also linked to mental health problems, difficult relationships with parents, lower self-esteem and lower academic performance.

Any physical punishment may leave emotional scars. Parental behaviors that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.

When to see a doctor

If you're concerned that your child or another child has been abused, seek help immediately. Depending on the situation, contact the child's health care provider, a local child welfare agency, the police department or a 24-hour hotline for advice. In the United States, you can get information and assistance by calling or texting the Childhelp National Child Abuse Hotline at 1-800-422-4453.

If the child needs immediate medical attention, call 911 or your local emergency number.

In the United States, keep in mind that health care professionals and many other people, such as teachers and social workers, are legally required to report all suspected cases of child abuse to the appropriate local child welfare agency.

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Risk factors

Factors that may increase a person's risk of becoming abusive include:

A history of being abused or neglected as a child
Physical or mental illness, such as depression or post-traumatic stress disorder (PTSD)
Family crisis or stress, including domestic violence and other marital conflicts, or single parenting
A child in the family who is developmentally or physically disabled
Financial stress, unemployment or poverty
Social or extended family isolation
Poor understanding of child development and parenting skills
Alcohol, drugs or other substance abuse

Complications

Some children overcome the physical and psychological effects of child abuse, particularly those with strong social support and resiliency skills who can adapt and cope with bad experiences. For many others, however, child abuse may result in physical, behavioral, emotional or mental health issues — even years later.

Here are some examples.

Physical issues

Premature death
Physical disabilities
Learning disabilities
Substance abuse
Health problems, such as heart disease, diabetes, chronic lung disease and cancer

Behavioral issues

Illegal or violent behavior
Abuse of others
Withdrawal
Suicide attempts or self-injury
High-risk sexual behaviors or teen pregnancy
Problems in school or not finishing high school
Limited social and relationship skills
Problems with work or staying employed

Emotional issues

Low self-esteem
Difficulty establishing or maintaining relationships
Challenges with intimacy and trust
An unhealthy view of parenthood
Inability to cope with stress and frustrations
An acceptance that violence is a normal part of relationships

Mental health disorders

Eating disorders
Personality disorders
Behavior disorders
Depression
Anxiety disorders
Post-traumatic stress disorder (PTSD)
Trouble sleeping (insomnia) and nightmares
Attachment disorders

Prevention

You can take important steps to protect your child from exploitation and child abuse, as well as prevent child abuse in your neighborhood or community. The goal is to provide safe, stable, nurturing relationships for children.

Here's how you can help keep children safe:

Offer your child love and attention. Nurture and listen to your child and be involved in your child's life to develop trust and good communication. Encourage your child to tell you if there's a problem. A supportive family environment and social networks can help improve your child's feelings of self-esteem and self-worth.
Don't respond in anger. If you feel overwhelmed or out of control, take a break. Don't take out your anger on your child. Talk with your health care provider or a therapist about ways you can learn to cope with stress and better interact with your child.
Think supervision. Don't leave a young child home alone. In public, keep a close eye on your child. Volunteer at school and for activities to get to know the adults who spend time with your child. When old enough to go out without supervision, encourage your child to stay away from strangers and to hang out with friends rather than be alone. Make it a rule that your child tells you where he or she is at all times. Find out who's supervising your child — for example, at a sleepover.
Know your child's caregivers. Check references for babysitters and other caregivers. Make irregular, but frequent, unannounced visits to observe what's happening. Don't allow substitutes for your usual child care provider if you don't know the substitute.
Emphasize when to say no. Make sure your child understands that he or she doesn't have to do anything that seems scary or uncomfortable. Encourage your child to leave a threatening or frightening situation immediately and seek help from a trusted adult. If something happens, encourage your child to talk to you or another trusted adult about what happened. Assure your child that it's OK to talk and that he or she won't get in trouble.
Teach your child how to stay safe online. Put the computer in a common area of your home, not the child's bedroom. Use the parental controls to restrict the types of websites your child can visit. Check your child's privacy settings on social networking sites. Consider it a red flag if your child is secretive about online activities.

Cover online ground rules, such as not sharing personal information; not responding to inappropriate, hurtful or frightening messages; and not arranging to meet an online contact in person without your permission. Tell your child to let you know if an unknown person makes contact through a social networking site. Report online harassment or inappropriate senders to your service provider and local authorities, if necessary.
Reach out. Meet the families in your neighborhood, including parents and children. Develop a network of supportive family and friends. If a friend or neighbor seems to be struggling, offer to babysit or help in another way. Consider joining a parent support group so that you have an appropriate place to vent your frustrations.

If you worry that you might abuse your child

If you're concerned that you might abuse your child, seek help immediately. In the United States, you can get information and assistance by calling or texting the Childhelp National Child Abuse Hotline: 1-800-4-A-CHILD (1-800-422-4453).

Or you can start by talking with your family health care provider. Your provider may offer a referral to a parent education class, counseling or a support group for parents to help you learn appropriate ways to deal with your anger. If you're misusing alcohol or drugs, ask your health care provider about treatment options.

If you were abused as a child, get counseling to ensure you don't continue the abuse cycle or teach those destructive behaviors to your child.

Remember, child abuse is preventable — and often a symptom of a problem that may be treatable. Ask for help today.

By Mayo Clinic Staff

Associated Procedures

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Signs & Symptoms | Child Abuse

infants excessive crying or developmental delay
fear, anxiety, clinging
phobias
nightmares, sleeping problems
bed wetting
social withdrawal
hyperactivity
poor concentration/distractibility
decreased school performance
chronic school absenteeism
speech disorders
regressive behavior for age
seems afraid of parent
eating issues
depression, passivity
increased verbal abuse or physically aggressive behavior with others
destroys or injures objects or pets
substance abuse
self-harm such as cutting
sexualized behavior
symptoms of PTSD
avoidance of undressing
withdrawal to touch, afraid of exam
overly compliant, especially with difficult or painful parts of the exam

headaches
abdominal pain, chronic
abdominal pain, acute – blunt trauma may not show external marks – look for distention, tenderness, absent bowel sounds
vague somatic complaints, often chronic
worsening medical problems, such as asthma
frequent, unexplained sore throat
abnormal weight gain or loss
reluctance to use an extremity
difficulty walking or sitting
genital discomfort or painful urination or defecation
unexplained symptoms - look for poisoning, forced ingestion of water, salt (Munchausen by proxy)
vomiting, irritability or abnormal respiration may represent head trauma

poor hygiene
dressed inappropriately for weather
failure to thrive, poor weight gain, malnutrition
lack of care of medical needs; wound care, medication
see fractures
dislocations
see bruising
defensive injuries on forearms
bites - human bites are more superficial than animal, and show up better 2-3 days later
burns – (in 6-20% of abused children) cigarette, rope, immersion, or shape of hot object
- is the severity of the burn consistent with length of contact by history?
- cigarette burns circular, 8-10mm deep, heaped margin - may be confused with impetigo or moxibustion
- stun gun burns occur in pairs, 0. 5cm diameter and 5cm apart
- immersion burns have sharp line of demarcation without drip or splash marks
signs of restraints on axilla or extremities
trauma to ear
lacerations
traumatic hair loss
facial injuries without good explanation
oral/dental injuries, such as torn or bruised frenulum, lips, teeth, palate, tongue or oral mucosa
- injuries from non-ambulatory child may be "bottle jamming"
- lacerations or tissue damage to oral structures may come from eating utensils, scalding or caustic liquids
- scarring/bruising at corners of mouth from being gagged
- oral injuries/STDs from forced oral sex
head injury, mental status change
retinal hemorrhage
subdural hematoma
intra-abdominal trauma, usually to multiple organs
bruising, tearing, bleeding, discharge from genital or rectal area
diagnosed STD or pregnancy

[Adapted from multiple sources listed in Resources and References]

Warning!

Parents may seem evasive or inconsistent in their story due to language or cultural differences, or to being embarrassed or afraid relating to some other issue. Cultural/language difficulties may also lead to delayed care.

What are age-appropriate normal sexual behaviors?

Children may be injured by domestic violence via:

being too small to get out of the way
trying to intervene
becoming an object of abuse
being neglected by the abused parent, who may be focused on their own fear or depression

Red flags with injuries:

explanation doesn’t fit the injury as to pattern, timing, or developmental ability of child
explanation keeps changing
child is consistently blamed as cause of repeated injuries
significant injuries attributed to a young sibling
delay in seeking medical care
history of multiple ED visits
frequent change of primary care provider

Parental risk factors:

rigid, severe discipline
strongly responds to negative behaviors, ignores child's positive behaviors
ridicules child in public
isolates child socially or from other family members
seems overprotective or jealous
unrealistic expectations of child development or behavior for age
parent is caregiver for child with significant cognitive, physical or emotional disabilities
child unwanted, unplanned
lack of emotional interaction with child
inappropriate over or under concern about injury
partial confession
depression
difficulty controlling emotions, esp. anger
substance abuse
teen parenthood
family stress such as divorce, job loss

Child abuse

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Child abuse

WHO/S. Becker

Magnitude of the problem

\nChild maltreatment is a global problem with serious lifelong consequences. Although studies have recently been carried out in some low- and middle-income countries, much data is still lacking.

\nChild maltreatment is a complex and difficult issue to study. Available estimates vary widely depending on the country and the research method used. Grades depend on the following aspects:

applicable definitions of child abuse;\t
type of child abuse being studied;
coverage and quality of official statistics;
coverage and quality of surveys that require reports from victims themselves, parents or caregivers.

\nHowever, international studies show that one quarter of all adults were physically abused as children, and that 1 in 5 women and 1 in 13 men were sexually abused as children. In addition, many children are victims of emotional (psychological) abuse and neglect.

\nAn estimated 41,000 murders of children under the age of 15 occur each year. This figure underestimates the true extent of the problem, as a significant proportion of child abuse deaths are incorrectly attributed to falls, burns, drowning, and other causes.

\nIn armed conflict and refugee camps, girls are particularly vulnerable to sexual violence, exploitation and abuse by the military, security forces, other members of their communities, humanitarian workers and others.

Consequences of child abuse

\nChild abuse hurts children and families and can have long-term consequences. Abuse leads to stress, which is associated with impaired early brain development. Extreme stress can disrupt the development of the nervous and immune systems. As a result, in adulthood, people who were abused as children are at increased risk of behavioral and physical and mental health problems, such as:

committing or being a victim of violence;\t
depression;
smoking;
obesity;\n
high risk sexual behavior;
unplanned pregnancy;
Harmful use of alcohol and drugs.

\nAs a result of these behavioral and mental health consequences, abuse can lead to heart disease, cancer, suicide, and sexually transmitted infections.

\nIn addition to the health and societal impacts, child maltreatment also has economic impacts, including hospitalization costs, mental health care, child care, and long-term health costs.

Risk factors

\nRisk factors for child abuse have been identified. These risk factors are not present in all social and cultural settings, but they give a general idea when trying to understand the causes of child abuse.

Child

\nIt is important to emphasize that children are victims and should never be blamed for abuse. Some individual characteristics of a child may increase the likelihood of abuse:

a child under 4 years of age or a teenager;\n
a child who is unwanted or does not live up to parental expectations;
a child who has special needs, who cries constantly, or who has abnormal physical features.

Parents or caregivers

\nSome characteristics of a parent or caregiver may increase the risk of child abuse. Among them are the following:

difficulties associated with the newborn;\n
leaving the child unattended;
childhood abuse;
ignorance of child development or unrealistic expectations;
harmful use of alcohol or drugs, including during pregnancy;
involvement in criminal activity;
experiencing financial difficulties. \n

Relationships

\nA number of factors in relationships within families or between sexual partners, friends, and peers can increase the risk of child abuse, such as :

problems in the field of physical or mental health or development of any family member;\n
discord in the family or violence between other family members;
isolation from the community or lack of a supportive circle;
lack of support in raising a child from other family members.

Community and social factors

\nA number of characteristics of individual communities and communities can increase the risk of child abuse. They include:

gender and social inequality;
lack of adequate housing or family support services and institutions;
high levels of unemployment and poverty;
easy access to alcohol and drugs;
inappropriate policies and programs to prevent child abuse, child pornography, child prostitution, and child labor;\n
social and cultural norms that support or glorify violence against others, favor the use of corporal punishment, require strong gender roles or belittling the status of the child in the relationship between parents and children;
social, economic, health, and educational policies that lead to poor living standards or socioeconomic inequality or instability.

Prevention

\nPrevention of child abuse requires a multisectoral approach. Effective programs are those that support parents and instill positive parenting skills. They include:

Nursing home visits to parents and children for support, education, and information;\n
Parent education, usually in groups, to improve child-rearing skills, increase knowledge of child development, and encourage positive child-care strategies ; and
multi-component activities, typically including parent support and education, early childhood education, and child care.

\nOther prevention programs are also promising in some respects.

Abuse head injury prevention programs (also called shaken baby syndrome and traumatic brain injury). These are usually hospital-level programs targeting young parents prior to their discharge, educating them about the dangers of shaken baby syndrome and recommending interventions for inconsolably crying babies.
Child sexual abuse prevention programs. They are usually held in schools and teach children about the following areas:

ownership of one's body;\t
the difference between good and bad touch;
how to recognize threatening situations;
how to say \"no\";
how to tell a trusted adult about abuse.

\nSuch programs are effective in increasing protective factors against child sexual abuse (for example, knowledge about sexual abuse and protective behaviors), but data on whether such programs reduce others types of violence are absent.

\nThe earlier in a child's life such interventions are carried out, the more beneficial they are for the child (eg, cognitive development, behavioral and social competence, educational training) and for society (eg, reduced delinquency and crime).

\nIn addition, early recognition of cases, combined with ongoing care for child victims of abuse and their families, can help reduce re-abuse and its consequences.

\nFor maximum impact, prevention and care interventions are recommended by WHO as part of a four-pronged public health approach:

identifying the problem;\n
identifying causes and risk factors;
development and testing of measures aimed at minimizing risk factors;
disseminate information on the effectiveness of interventions and scale up proven effective interventions.\n

WHO activities

\nWHO in collaboration with a number of partners in the following areas:

\ n

provides technical and regulatory guidance for evidence-based child abuse prevention;\n
calls for greater international support for and investment in evidence-based child abuse prevention;
provides technical support for evidence-based child abuse prevention programs in certain low- and middle-income countries.

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Key facts

One in 5 women and 1 in 13 men report being sexually abused as children.
The consequences of child maltreatment include lifelong physical and mental health damage, and its social and professional consequences can ultimately slow down the economic and social development of a country.
Child maltreatment can be prevented - this requires a multisectoral approach.
Effective prevention programs can support parents and teach them positive parenting skills.
Continued care for children and families can help reduce the risk of re-abuse and minimize its consequences.

Child abuse is the mistreatment and neglect of children under the age of 18. It covers all types of physical and/or emotional abuse, sexual abuse, neglect, neglect and commercial or other exploitation that results in actual or potential harm to the health, survival, development or dignity of the child in the context of a relationship of responsibility, trust or power. . Intimate partner violence is also sometimes considered a form of child abuse.

Magnitude of the problem

Child abuse is a global problem with serious lifelong consequences. Although studies have recently been carried out in some low- and middle-income countries, much data is still lacking.

Child abuse is a complex and difficult issue to study. Available estimates vary widely depending on the country and the research method used. Grades depend on the following aspects:

applicable definitions of child abuse;
type of child abuse being studied;
coverage and quality of official statistics;
coverage and quality of surveys that require reports from victims themselves, parents or caregivers.

However, international studies show that one quarter of all adults were physically abused as children, and that 1 in 5 women and 1 in 13 men were sexually abused as children. In addition, many children are victims of emotional (psychological) abuse and neglect.

An estimated 41,000 murders of children under the age of 15 occur each year. This figure underestimates the true extent of the problem, as a significant proportion of child abuse deaths are incorrectly attributed to falls, burns, drowning, and other causes.

In armed conflict and refugee camps, girls are particularly vulnerable to sexual violence, exploitation and abuse by the military, security forces, other members of their communities, humanitarian workers and others.

Consequences of abuse

Child abuse causes suffering to children and families and can have long-term consequences. Abuse leads to stress, which is associated with impaired early brain development. Extreme stress can disrupt the development of the nervous and immune systems. As a result, in adulthood, people who were abused as children are at increased risk of behavioral and physical and mental health problems, such as:

committing violence or becoming a victim of violence;
depression;
smoking;
obesity;
high risk sexual behavior;
unplanned pregnancy;
harmful use of alcohol and drugs.

As a result of these behavioral and mental health consequences, abuse can lead to heart disease, cancer, suicide, and sexually transmitted infections.

In addition to health and societal impacts, child maltreatment also has economic impacts, including the cost of hospitalization, mental health treatment, child care, and long-term health costs.

Risk factors

Risk factors for child abuse have been identified. These risk factors are not present in all social and cultural settings, but they give a general idea when trying to understand the causes of child abuse.

Child

It is important to emphasize that children are victims and should never be blamed for abuse. Certain individual characteristics of a child may increase the likelihood of abuse:

child under 4 years of age or adolescent;
an unwanted child or a child that does not live up to the expectations of the parents;
a child with special needs, constant crying or abnormal physical features.

Parents or caregivers

Certain characteristics of parents or caregivers may increase the risk of child abuse. Among them are the following:

difficulties associated with the newborn;
leaving a child unattended;
childhood abuse;
ignorance of child development or unrealistic expectations;
harmful use of alcohol or drugs, including during pregnancy;
involvement in criminal activity;
experiencing financial difficulties.

Relationships

A number of factors in family relationships or between sexual partners, friends and peers can increase the risk of child abuse, for example:

a family member's physical or mental health or developmental problems;
discord in the family or violence between other family members;
isolation in the community or lack of a support circle;
lack of support in raising a child from other family members.

Community and social factors

A number of characteristics of individual communities and communities can increase the risk of child abuse. They include:

gender and social inequality;
Lack of adequate housing or family support services and institutions;
high levels of unemployment and poverty;
easy access to alcohol and drugs;
inadequate policies and programs to prevent child abuse, child pornography, child prostitution and child labor;
social and cultural norms that support or glorify violence against others, favor the use of corporal punishment, require rigid gender roles, or degrade the status of the child in parent-child relationships;
social, economic, health and educational policies that lead to poor living standards or socioeconomic inequality or instability.

Prophylaxis

A multisectoral approach is needed to prevent child maltreatment. Effective programs are those that support parents and instill positive parenting skills. These include:

Nursing home visits to parents and children for support, education and information;
Parent education, usually in groups, to improve child-rearing skills, increase knowledge of child development, and encourage positive child-care strategies; and
multi-component activities, usually including parent support and education, early childhood education and childcare.

Other prevention programs are also promising in some respects.

Abuse head injury prevention programs (also called shaken baby syndrome and traumatic brain injury). These are usually hospital-level programs targeting young parents prior to their discharge, educating them about the dangers of shaken baby syndrome and recommending interventions for inconsolably crying babies.
Child sexual abuse prevention programs. They are usually held in schools and educate children in the following areas:

ownership of one's body;
difference between good and bad touches;
how to recognize threatening situations;
how to say "no";
how to talk about abuse to a trustworthy adult.

Such programs are effective in increasing protective factors against child sexual abuse (eg, knowledge about sexual abuse and protective behaviours), but there is no data on whether such programs reduce other types of violence.

The earlier in a child's life such interventions are, the more beneficial they are for the child (eg cognitive development, behavioral and social competence, educational training) and society (eg reduction in delinquency and crime).

In addition, early recognition of cases, combined with continued care for child victims of violence and families, can help reduce re-abuse and its consequences.

For maximum impact, prevention and care interventions are recommended by WHO as part of a four-step public health approach:

problem definition;
determination of causes and risk factors;
development and testing of measures aimed at minimizing risk factors;
disseminate information on the effectiveness of interventions and scale up proven effective interventions.

WHO activities

WHO is collaborating with a number of partners in the following areas:

provides evidence-based technical and normative guidance on child maltreatment prevention;
calls for increased international support for and investment in evidence-based child abuse prevention;
provides technical support for evidence-based child abuse prevention programs in selected low- and middle-income countries.

Child abuse from a psychologist's point of view

Child abuse is any act or omission on the part of an adult responsible for the care and custody of a child that harms the child's physical, mental health and development.

Child abuse and neglect of their interests can have various types and forms, have a certain dynamics of formation and varying degrees of severity. But their consequence is always: serious damage to the health, development and socialization of the child, often a threat to his life.

Primary child abuse:

1. Physical abuse
2. Sexual abuse
3. Psychological (emotional) abuse
4. Neglect of a child's needs

PHYSICAL ABUSE - the infliction of physical injuries on a child, various bodily injuries that damage the child's health, disrupt his development or take his life. These actions can be in the form of beatings, tortures, blows, slaps, cauterization with hot objects, bites, and using a variety of objects as tools of fanaticism. Physical abuse also includes the involvement of a child in the use of drugs, alcohol, poisonous substances, or drugs that cause intoxication (for example, sleeping pills not prescribed by a doctor).

SEXUAL ABUSE OR SECURITY is the involvement of a child, with or without consent, in sexual activities with adults for the purpose of obtaining satisfaction or benefit for the latter. The consent of the child to sexual contact does not give grounds to consider it non-violent, since the child does not have free will and cannot foresee all the negative consequences for himself.

PSYCHOLOGICAL (EMOTIONAL) VIOLENCE This type of violence also includes constant lies, deception of the child, as well as demands made on the child that do not correspond to his age capabilities.

NEGLECT OF THE INTERESTS AND NEEDS OF THE CHILD - lack of proper provision of the basic needs and needs of the child in food, clothing, housing, upbringing, education, medical care by parents or persons replacing them, due to objective reasons (poverty, mental illness, inexperience) and without them. A typical example of neglect of children is leaving them unattended, which can lead to accidents.

Consequences of violence against children

Immediate effects include physical injury, damage, as well as headaches, loss of consciousness, characteristic of concussion syndrome. In addition to these signs, in children with this syndrome, hemorrhage in the eyeballs appears. The immediate consequences also include acute mental disorders in response to any kind of aggression. These reactions can manifest themselves in the form of excitement, the desire to run somewhere, hide, or in the form of deep inhibition, external indifference. In both cases, however, the child is seized with the most acute experience of fear, anxiety, and anger. Older children may develop severe depression with a sense of their own inferiority, inferiority.
Among the long-term consequences of child abuse are violations of the physical and mental development of the child, various somatic diseases, personal and emotional disorders, and social consequences.

Disorders of physical and mental development

The majority of children living in families in which severe physical punishment, scolding the child are "methods of education", or in families where they are deprived of warmth, there are signs of a delay in physical and mental development.
Abused children often lag behind their peers in height, weight, or both. They begin to walk, talk later, laugh less often, do much worse at school. These children often have bad habits: thumb sucking, nail biting, rocking. Outwardly, children look different: they have swollen “sleepy” eyes, a pale face, disheveled hair, untidy clothes, other signs of hygienic neglect - pediculosis, rashes, bad smell from clothes and body.

Miscellaneous diseases due to abuse

Illnesses may be specific to a particular type of violence. With physical violence, there are injuries to parts of the body and internal organs of varying severity, bone fractures. Sexual abuse can lead to sexually transmitted diseases. With emotional abuse, skin rashes, allergic reactions, and stomach ulcers often occur.
Regardless of the type and nature of violence, children can experience various diseases that are psychosomatic: obesity or, conversely, sudden weight loss due to appetite disorders. Often, children develop neuropsychiatric diseases such as tics, stuttering, enuresis (urinary incontinence), encopresis (fecal incontinence). Some children are re-admitted to the emergency department for accidental injuries, poisoning.

Mental characteristics of children affected by violence

Almost all children who have suffered from abuse and neglect have experienced psychological trauma, as a result of which they develop with certain personal, emotional and behavioral characteristics that negatively affect their future life.
Children who have been subjected to various kinds of violence themselves experience anger, which is most often poured out on weaker - younger children, animals. Often their aggressiveness is shown in the game; sometimes outbursts of anger have no apparent reason. Some of them, on the contrary, are overly passive, unable to defend themselves. In both cases, contact, communication with peers is disrupted.
In emotionally deprived children, the desire to attract attention by any means sometimes manifests itself in the form of defiant, sometimes even eccentric behavior. Child survivors of sexual abuse acquire age-appropriate knowledge about sexual relationships.
The most universal and severe reaction to any, not only sexual, violence is low self-esteem, which contributes to the preservation and consolidation of psychological disorders associated with violence. A person with low self-esteem experiences feelings of guilt and shame. She is characterized by a constant conviction in her own inferiority, in the fact that "you are the worst." As a result, it is difficult for a child to achieve the respect of others, success, his communication with peers is impaired.

Remember, the punishment can be replaced:

- Patience. This is the greatest virtue a parent can have.
- Explanation. Briefly explain to the child why his behavior is wrong, but just don't argue with him.
- Slowness. Don't rush to punish the child, wait until the offense is repeated.
- Award winning.
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