Health & Fitness

Know the signs of child abuse — and report immediately to state hotline

Child maltreatment takes many forms, including physical, sexual and emotional abuse.
Child maltreatment takes many forms, including physical, sexual and emotional abuse. Miami Herald File

It’s hard to imagine any adult intentionally hurting a child. Yet the Centers for Disease Control and Prevention (CDC) reports that nearly 700,000 children are reported to be abused every year in the United States. And many more cases go unreported and undetected. Any intentional physical or emotional harm or maltreatment to a child under 18 years of age is considered child abuse. Child maltreatment takes many forms, including:

▪ Physical abuse. Occurs when a child is purposely physically injured or placed at risk of harm by an adult. When people think of child abuse, their first thought probably is of physical abuse such as striking, kicking or shaking a child. Warning signs may include unexplained injuries, including bruises, fractures, burns or other injuries that don’t match the explanation provided.

▪ Sexual abuse. Any sexual activity with a child, such as fondling, oral-genital contact, intercourse or exposure to pornography. Warning signs may include sexual behavior or knowledge that is inappropriate for the child’s age, a sexually transmitted infection, the child’s statements that he or she was sexually abused, or abuse of other children sexually.

▪ Emotional abuse. A pattern of behavior that negatively affects a child’s emotional development and sense of self-worth. It can include verbal and emotional assault, such as continually belittling or berating a child, as well as isolating, ignoring or rejecting a child. Warning signs may include loss of self-confidence, social withdrawal, loss of interest or enthusiasm, depression, headaches or stomach aches with no medical cause, or decreased school performance.

▪ Neglect. Any action or inaction on the part of a caregiver that interferes with a child’s growth and development, including inadequate food, shelter, affection, supervision, education or medical care. Warning signs may include poor hygiene, inadequate weight gain or growth, lack of supplies to meet physical needs (clothing, school supplies), stealing food and basic supplies, poor school attendance, or parents’ failure to follow through with medical and dental care.

Most of the time, abuse happens at home. Children who are abused may feel guilty, ashamed, afraid or confused. Children often think they will be blamed or that no one will believe them if they tell.

As parents and community members, we have a responsibility to be alert to unexplainable changes in a child, either physical or behavioral. While there are no behaviors that definitively reveal abuse, it is important to watch for red flags such as:

▪ Emotional changes. Children who are abused may appear withdrawn, fearful, depressed, or even engage in self-harming behavior. Others may become outwardly angry and present as bullies.

▪ Relationship changes. Children who are victims of abuse generally have difficulty trusting others. They may withdraw from friends or usual activities and not seek comfort from their parents or caretakers like other children.

▪ Behavioral changes. Abused children often display defiant or rebellious behavior, hyperactivity and aggression.

If a child discloses abuse to you or you suspect that a child is being mistreated, encourage the child to tell you what happened. Don’t interrogate the child. Let the child tell you in his or her own words about the experience and listen. Offer comfort (“I’m sorry that happened to you”) and reassurance that he or she did nothing wrong and that the abuse is not his/her fault.

Never enter into an agreement with a child that you won’t tell, even if that means they decide not to share additional details with you. You do not need proof to speak up.

Although abuse most often occurs in families, it is not a private family matter. If you suspect a child is being abused, you need to take action to protect the child from additional harm. In Florida, everyone, including professionally mandated reporters like doctors and teachers, should contact the Florida Abuse Hotline at 1-800-96-ABUSE or visit when they know or have reasonable cause to suspect that a child has been abused, abandoned, neglected or exploited.

The Abuse Hotline Counselor will determine if the information provided meets the legal requirements to be accepted as a report for investigation. Reporting is anonymous, so you do not need to give your name. When you report a case of suspected child abuse, try to be as specific as you can with details.

A child who has been abused needs special support and treatment as early as possible. The primary concern is ensuring the safety of the child. Once safety has been established, a child abuse victim can benefit greatly from the services of a qualified mental health professional. Fortunately, the existence of a close relationship with a supportive adult can reduce the negative effects of the trauma. Be that special someone for a child you know needs help.

Susan Dandes, Ph.D., is a pediatric psychologist and clinical director of the Child Protection Team at the University of Miami Health System. For more information, visit