Checklist of Possible Indicators of Abuse and Neglect - Preventing and Reporting Child Abuse

Physical Abuse: Physical Indicators
Bruises, welts, and bite marks	Depends on location of injuries, severity, circumstances, frequency, and age of child On face, lips, mouth, neck, wrists, ankles On both eyes or cheeks (accidents usually injure only one side of the face) Clustered, forming patterns reflecting the shape of an article (child was struck with something) In the form of a hand (grab mark) on several different surface areas of skin On torso, back, buttocks, thighs In various stages of healing regularly appearing after absence, weekend, vacation Note: People of color such as African/American and Asian infants and children may have areas of darker pigment on their skin (known as Mongolian spots) which are not bruises, but rather a type of birthmark.
Lacerations (cuts) or abrasions (scrapes)	Depends on location of injuries, severity, circumstances, frequency, and age of child To mouth, lips, gums, eyes On back or arms, legs or torso
Burns	Depends on location of injuries, severity, circumstances, frequency, and age of child Cigar, cigarette, especially on soles, palms, back, buttocks Scalding water immersion (sock-like, glove-like, doughnut shaped on buttocks or genitalia) Patterned, like curling iron, electric iron, burner, etc. Rope burns on arms, legs, neck, torso
Fractures	To jaw and nasal structures To skull, facial structures Skeletal trauma accompanied by other injuries, such as dislocations Multiple or spiral fractures Fractures ‘accidentally’ discovered in the course of an exam or in various stages of healing
Head Injuries	Subdural hematoma (a hemorrhage beneath the outer covering of the brain, due to severe hitting or shaking) Retinal hemorrhage or detachment, due to shaking ‘whiplash shaken baby syndrome’ Eye injury (such as black eye) Tooth or frenulum (under the tongue) injury Absence of hair and/or hemorrhaging beneath the scalp, caused by vigorous hair pulling
Munchausen Syndrome by Proxy	Munchausen Syndrome by Proxy is a pattern of parental behavior in which a child is frequently brought into medical care with symptoms suggestive of parentally induced or fabricated illness. An example might be a parent seeking attention by repeatedly causing a child to ingest quantities of laxatives sufficient to cause diarrhea and dehydration, thus requiring hospitalization.