Injuries that are inconsistent with the explanation
Injuries that reflect an article being used e.g. an iron
Bruising, especially the trunk, upper arm, shoulders, neck or finger-tip bruising
Burns/scalds, especially from a cigarette
Human bite marks
Fractures, especially spiral
Swelling and lack of normal use of limbs
Serious injury with lack of / inconsistent explanation
Untreated injuries
Psychological/emotional signs include:
Unusually fearful with adults
Unnaturally compliant to parents
Refusal to discuss injuries/fear of medical help
Withdrawal from physical contact
Aggression towards others
Wears cover up clothing
Fictitious illness by proxy - This is a psychiatric illness, whereby a parent or carer deliberately inflicts harm onto a child, normally the child's mother. The child has commonly had genuine serious illness in the first year of life and a dependency on medical attention has developed in the mother. It is very difficult to diagnose/evidence.
Female Genital Mutilation - A cultural (not religious) procedure whereby parts of female genitalia are removed - also referred to as female circumcision. This is normally undertaken on pre-pubescent girls, who are either taken abroad for procedure or "practitioners" come to the UK. There can be no anaesthetic and no sterile equipment used. Complications include serious infection, septicaemia, numerous gynaecological problems and in some cases, death.
Emotional abuse Signs include:
Acceptance of punishments, which appear excessive
Over reaction to mistakes
Continual self-depreciation
Sudden speech disorders
Fear of new situations
Neurotic behaviour (such as rocking, hair twisting, thumb sucking)
Self-harm
Extremes of passivity or aggression
Drug/solvent abuse signs inculde:
Running away
Bullying/Aggression
Overly compliant behaviour
Overeating or loss of appetite
Clingy
Fearful/withdrawn
Sleep disorders
Neglect - Physical signs include:
Tired/listless
Poor personal hygiene
Poor state of clothing
Emaciation, potbelly, short stature
Poor skin tone and hair tone
Untreated medical problems
Failure to thrive with no medical reason
Neglect - Psychological/emotional signs include:
Constant hunger
Constant tiredness
Frequent lateness/non-attendance at school
Destructive tendencies
Low self-esteem
Neurotic behaviour
No social relationships
Running away
Compulsive stealing/scavenging
Multiple accidents/accidental injuries
Sexual abuse Physical signs include:
Damage to genitalia, anus or mouth
Sexually transmitted disease
Unexpected pregnancy, especially in very young girls
Soreness to genitalia area, anus or mouth
Repeated stomach aches
Loss of weight
Gaining weight
Unexplained recurrent urinary tract infections, discharges or abdominal pain
Unexplained gifts/money
Sexual abuse: Psychological/emotional signs include:
Sexual knowledge inappropriate for the child's age
Sexualised behaviour in young children
Sexually provocative behaviour/promiscuity
Hinting at sexual activity
Sudden changes in personality
Lack of concentration, restlessness
Socially withdrawn
Overly compliant behaviour
Poor trust in significant adults
Regressive behaviour, onset of wetting - day or night