Symptoms of neglected children

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.

Products & Services

• 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.

Request an Appointment at Mayo Clinic

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

Related

Associated Procedures

Products & Services

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

Signs of child neglect | Mothers today

If you are a father or mother and really love your children, you probably cannot understand that a child can be neglected. Unfortunately, in all countries of the world there are thousands of cases of child neglect. Neglect is one of the most common forms of child abuse. This can affect the child's physical and mental health and can lead to severe long-term consequences.

Neglect is defined as "any recent act or omission on the part of a parent or guardian that presents an imminent risk of serious harm to the child." Laws often define neglect as the failure of a parent or guardian to provide necessary food, shelter, clothing, medical care, or care to the extent that the child's health, safety, and well-being is at risk.

Some countries include exceptions to the definition of negligence. For example, a parent who refuses certain medical procedures for a child on the basis of religious beliefs may receive an exemption.

Parents' finances can also be taken into account. If parents live in poverty and find it difficult to provide their children with adequate food or a home, it cannot be considered negligent if the family asks for help or does its best.

Index

• 1 Types of negligence
• 2 Risk factors for negligence
• 3 Signs
• 4 consequences of negligence
• 5 Treatment of negligence

Types of negligence

Negviat can manifest itself differently, but some of them are more common than others:

• Physical Nebbelation . Not taking care of the child's basic needs such as hygiene, clothing, food, shelter...or abandoning the child.
• Medical supervision. Refusal or delay in providing necessary medical care to a child.
• Inadequate supervision. Leaving a child at home who cannot take care of himself alone, failing to protect him from security threats, or leaving small children with inadequate caregivers.
• Emotional neglect Expose a child to domestic violence or substance abuse, fail to provide affection or emotional support.
• Neglect of education. Failure to provide children with an education in school, allowing them to miss school, or failure to meet a child's special educational needs.

Negligence risk factors

Parents must protect their children from the moment they are born, it is their natural duty. But due to some factors, there are fathers or mothers who cannot adequately meet the needs of the child. Sometimes, neglect is completely involuntary, as in the case of a new mother who does not understand the development of the baby, You may not know, because no one has told you before about how often the child feeds the child or what basic care is required.

In other cases, it may be that a parent's mental illness or drug problem may prevent their children from receiving proper and adequate care. A father under the influence of drugs will not be able to properly care for his children. There are other risk factors that may increase negligence:

• Environmental factors: poverty, lack of social support, dangerous neighborhood
• Family factors: domestic violence, family stress
• Parental factors: unemployment, low socioeconomic status, young parents, parental stress, health problems, mental illness, substance abuse or drug problems
• Infancy factors: developmental delays

Signs

Sometimes a teacher or concerned neighbor may sound the alarm when they recognize warning signs that a child is being neglected. An underweight child who barely goes to school, or a small child who plays outside all day without adult supervision, may be too suspicious.

There are signs that may indicate that parents are neglecting the child:

• Frequent absenteeism from school
• You do not have enough clothes or are not dressed for the weather
• Rob
• Ask for food or money
• Most of the time it is dirty and smells bad
• Alcohol or drug abuser
• Required medical or dental care is not available
• You lack the vaccines you need for your health
• He does not wear glasses and will need to wear them.
• Says no one is home most of the time

There are also signs that may indicate that a father or mother is not taking proper care of their children. Some of these signs are:

• Strange or irrational behavior
• Looks lethargic or depressed
• Expresses indifference to the child
• Drug or alcohol abuser
• He is almost never with his children and leaves them in the care of someone responsible.

A child's neglect is not always the result of a parent not meeting the needs of their children; sometimes options are not available due to lack of resources. When a parent is unable to care for a child due to a lack of resources, services are often provided to help the family meet the needs of the child.

Consequences of negligence

Even if a child is pulled out of a bad situation, the consequences of neglect can drag on for a long time. Here are some of the consequences a neglected child can experience:

• Problems of health and development. Malnutrition can affect brain development. Lack of proper vaccinations and health problems can lead to a host of diseases.
• Cognitive deficiencies. Lack of adequate stimulation can lead to permanent intellectual problems. Children with a history of neglect may have learning problems, delayed or impaired language development.
• Emotional problems. Neglect can lead to attachment problems, self-esteem problems, and difficulty trusting others.
• Social and behavioral problems. Neglected children may have difficulty establishing healthy relationships and may experience conduct disorder.

Negligence Treatment

The first step is to keep the child safe. Social services may seek resources and education for the family. In some cases, children may need to be placed in a different environment to avoid further harm, such as with a family member who has the resources to care for them. It can also help with appropriate interventions such as medical or educational services.

The content of the article complies with our principles of editorial ethics. To report a bug, click here.

You may be interested in

A neglected child. Don't pass by!

News, Articles.

15/02/2018

Our families are tormented by quarrels and squabbles,0175
Which we instill in them ourselves.
E. Sevrus