Recognizing Signs of Child Abuse

Although children react differently to abuse, there are some recognized behavioral and physical signs of child maltreatment.

Indicators in the child:

  • Fear of being with a particular person: Abused children may express anxiety about being with or going places with the person abusing them. The child may also be reluctant to discuss his or her time with that person.
  • Changes in behavior: Abuse can lead to sudden changes in a child’s behavior. Children being abused may appear scared, anxious, passive, depressed, withdrawn, or excessively angry.
  • Changes in school performance and attendance: Abused children may have difficulty focusing in school or may be absent frequently.
  • Self-harming behaviors: Young people being abused may engage in risk-taking behaviors, such as using drugs or alcohol, promiscuity, carrying a weapon, or cutting themselves.
  • Changes in eating and sleeping: The stress and anxiety that abuse causes may result in changes to a child’s eating or sleeping behaviors. Some children may eat much more or much less and can show significant weight gain or weight loss. Abused children often have trouble sleeping and may appear tired or exhausted.
  • Returning to earlier behaviors: Abused children may regress and demonstrate behaviors from earlier ages, such as bed-wetting, thumb-sucking, fear of strangers, and baby talk.
  • Unexplained injuries: Visible signs of physical abuse may include unexplained broken bones, or burns or bruises in the shape of objects. Physical signs of sexual abuse are subtle but can include headaches, stomach pain, trouble walking or sitting, and urination pain.
  • Inappropriate sexual behaviors: Children who have been sexually abused may use explicit language or act out sexual scenarios with dolls, toys, or friends.
  • Lack of care or hygiene: Abused children may lack adult supervision, appear not to have received help for physical or medical problems, or look uncared for or unkempt.

Indicators in the parent:

Reporting Child Abuse and Neglect

Reporting suspected abuse and neglect is critical to protecting children and getting their families help. Although it may feel difficult, frightening, or uncomfortable to make a report, doing so could save a child’s life, stop physical injury, prevent further abuse or neglect, or allow families to receive resources or services they need.

  • You do not need evidence or actual knowledge of child maltreatment to make a report, but instead, need to have a reasonable suspicion of abuse. Once there is a report, child welfare professionals commence an investigation and support the child and family.
  • If you suspect that a child is being abused, contact your local child welfare agency. In San Francisco, make a confidential report anytime by calling the hotline at:
  • For crisis intervention services, call the TALK Line (24 hours a day, 7 days a week, 365 days a year) at 415-441-KIDS (5437).
  • If there is an emergency or you believe a child or someone in his/her household is in imminent danger, call 911.
  • When you call to report suspected child abuse, you should be prepared to provide the following information if you know it: (1) the child’s name and approximate age, (2) the location of the child, (3)the name of the offender, (4) the names of the parents or caretakers, and (5) the situation.
  • You will also be asked to provide your name, although you may remain anonymous unless you are a “mandated reporter” (a person that is legally required to report child abuse because of his/her contact with children in a professional capacity).
  • Although you do not need proof of abuse when making a report, it is important to try to be as specific as possible. You might discuss first-hand observations or beliefs, statements of the child or his/her parent(s)/caretaker(s), or concerns based on past experiences. If, after making a report, you suspect further instances of abuse, continue to report these concerns. Each report provides information about what is going on with the family and increases the likelihood that the child will get the help he/she needs.
  • You should be aware that you might never learn the outcome of a report of child abuse because of confidentiality protections.
  • See Human Services Agency of San Francisco for more information about reporting suspected child abuse.

Children’s Disclosures of Abuse

Usually, children will not talk directly about abuse or neglect. Children may (1) be afraid they or someone they love will suffer harm if the maltreatment is disclosed, (2) have promised not to tell, (3) be embarrassed or ashamed, or (4) not have the necessary vocabulary to explain the events. Instead of talking specifically about abuse or neglect, children may disclose maltreatment through indirect hints or by mentioning someone they know who has been hurt or has caused harm.

If a child discloses abuse or neglect, it is important to:

  • LISTEN to the child without giving your opinion or asking leading questions;
  • Tell the child that you believe him/her and are happy that he/she told you;
  • Reassure the child that he/she did not do anything wrong;
  • Tell the child that you will do your best to keep him/her safe;
  • Give yourself time to think, and seek help from professionals; and
  • Take any disclosure of abuse seriously, and report it. In San Francisco, call 415-558-2650 or 800-856-5553.