Updated 06 November 2013

Know the signs of child abuse

In this article we focus on child abuse: the types of abuse, practical tips on spotting this hidden phenomenon and what to do about it.


A baby’s body covered with cigarette burns, an emergency hysterectomy performed on a six-year-old girl after being raped, a teenage suicide after years of sexual abuse. These are the extreme cases.

For every known case of child abuse, many more children suffer in silence. Child abuse is not a “rare disease”. In fact, about a quarter of South African children have been or will be sexually abused before they turn 18. The statistics regarding physical abuse are unknown but one could speculate that they would be even more shocking.

Types of abuse and how to spot it

Childline defines child abuse as any interaction (or lack of interaction) between a child and his/her parents and/or other caregivers which results in the non-accidental harm to a child's physical and/or developmental state. They classify child abuse into four different categories, namely emotional abuse or neglect, physical abuse, physical neglect and sexual abuse.

Because child abuse is a hidden crime, it may be difficult to determine whether a child is in trouble. Some abused children never show any obvious signs. It is also possible for a child to show some of these signs even though he or she may not have been abused. Childline gives a few pointers on what to look out for.

Emotional abuse and neglect is a chronic pattern of behaviour such as belittling, humiliating and ridiculing a child. It is also the consistent failure of parents or caretakers to provide a child with appropriate support, attention and affection.

Look out for:

  • Low self-confidence
  • Withdrawal
  • Over-eagerness to please
  • Personal boundaries that are not well-defined
  • Indiscriminate display of affection or not showing affection much at all
  • Hypervigilance: Nervous and overly attentive to what is going on around them ("always looking over their shoulder")

Physical abuse
includes: cuts, fractures, bruises, shaking, burns and internal injuries.

Look out for these physical signs:

  • Unexplained bruises or marks
  • Unexplained burns
  • Fractures
  • Lacerations (cuts)
  • Abdominal injuries
  • Bite marks
  • Bruises on the head
  • Unbelievable explanations for injuries

Look out for these behavioural signs:

  • Child is nervous of physical contact with adults
  • Child cries when it is time to leave a protected environment
  • Absence from school
  • Double dressing, such as a long-sleeved jersey on a warm day
  • Slowing down in intellectual and emotional development
  • Physical neglect is the failure to provide children with adequate food, clothing, shelter and medical care. Physical neglect also includes abandonment, expulsion from home and failure to enrol children in school. It is important to distinguish between willful neglect and a parent’s failure to provide the necessities of life because of poverty and cultural norms.

Physical neglect
includes lack of proper supervision and protection, not providing a child with enough clothing, lack of medical or dental care and education, poor hygiene and depriving the child of sleep.

Look out for these physical signs:

  • Constant hunger and poor hygiene
  • Unattended physical problems (e.g. health problems)

Look out for these behavioural signs:

  • Stealing food
  • Tired and has no energy
  • No delayed gratification (cannot wait for something - wants everything at once)
  • Falling asleep in the classroom
  • Constant early arrival and leaving late from school
  • Delinquency
  • Saying there is no-one to care for him/her

Sexual abuse
is defined as acts of sexual assault and sexual exploitation of minors by parents, caregivers or strangers. It may consist of a single incident or many incidents over a long period of time. It includes fondling a child’s genitals, incest, rape, sodomy, exhibitionism and participation in child pornography and child prostitution, including child trafficking.

Look out for these physical signs:

  • Any injury, soreness, redness, swelling or itching around the genital or anal area
  • Sexually transmitted infections
  • Fluctuations in body mass
  • Pregnancy

Look out for these behavioural signs:

  • Inappropriate sexual play with self and others
  • Inappropriate sexually explicit drawings
  • Knowledge of sexual acts that is age-inappropriate
  • Seductive behaviour
  • Excessive masturbation
  • Double dressing
  • Avoidance of bathrooms
  • Late arrival or absence from school
  • Personality changes
  • Change in appetite
  • Sudden weight gain/loss
  • Self mutilation
  • Inability to concentrate
  • Locking doors
  • Very eager to please others (over-compliance)
  • Depression
  • Suicidal tendencies
  • Nightmares
  • Not wanting friends to visit at home
  • Not wanting to go home or getting home too early
  • Promiscuity
  • Prostitution
  • Running away

What to do if you suspect that a child is being abused

Many children never disclose the abuse to anyone because they have been threatened by the abuser or because they feel ashamed and somehow responsible. Children can have different ways of telling someone that they are being abused. According to Childline, a child may mention something indirectly, for example by saying: "Don't make me go to grandpa's house any more". For the child, the message is clear, but it is often misinterpreted by adults and makes the child feel even more hopeless.

Children can also disclose accidentally - here the child accidentally tells of the abuse in conversation or the abuse is seen and "caught in the act". In this situation, the child is not ready to disclose and, as a result, much care must be taken with handling these cases.

In some cases, the child makes a conscious effort to disclose and wants some control to be taken over the abusive situation.

How should one react if a child tells you that he/she is abused?

Hearing that is child is being abused is traumatic. But it is important to focus on the child’s needs in order to help him or her best. Here are a few pointers:

  • Acknowledge the child's statement
  • Do not show shock
  • Give matter-of-fact answers
  • Always speak to the child quietly and privately
  • Stay calm, reassuring and non-judgemental
  • Believe what the child tells you
  • Do not ask questions that sound like accusations
  • Tell the child that s/he is not responsible for the abuse, no matter what the circumstances
  • Do not encourage the child to tell you everything
  • Help the child by saying that you realise how difficult it is for him/her to talk about it
  • Get help for the child and report the abuse

(Photo of child on swing from Shutterstock)


Read Health24’s Comments Policy

Comment on this story
Comments have been closed for this article.

Live healthier

Exercise benefits for seniors »

Working out in the concrete jungle Even a little exercise may help prevent dementia Here’s an unexpected way to boost your memory: running

Seniors who exercise recover more quickly from injury or illness

When sedentary older adults got into an exercise routine, it curbed their risk of suffering a disabling injury or illness and helped them recover if anything did happen to them.