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Not all types of child abuse display obvious signs or indications.

Children can be easy targets for someone with abusive behaviors. They are smaller than adults, not often physically intimidating, and their minds still tend to be impressionable.

Many children might not know that what they’re experiencing is abuse. If the behavior or experience is all they’ve ever known, children may believe this is how the world works.

All types of child abuse can cause harm, and it’s never acceptable at any level or form.

In the United States alone, nearly 700,000 children experience abuse each year, according to the National Children’s Alliance (NCA). While most of these cases involved parents, other children can also commit abusive behavior.

There are four primary categories of abuse children may experience:

  • neglect
  • physical
  • sexual
  • emotional

Neglect is the most common type of child abuse, followed by physical abuse and sexual abuse.

Other types of child abuse

Behavior that doesn’t clearly fall into a defined abuse category doesn’t mean it’s not abusive.

Abuse can be any inappropriate treatment or use of a child that causes harm or stems from bad intent.

Two other forms of child abuse include:

  • Medical neglect. This occurs when necessary treatment is withheld from a child or when a child is given an unnecessary level of medical care or treatments, aka Munchausen syndrome by proxy.
  • Substance misuse. This relates to the adult’s behavior. It may be present when an adult using a substance puts a child in harm’s way. For example, driving while intoxicated with a child in the car or being too intoxicated to watch a small child.
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Also known as psychological abuse, emotional abuse can be one of the most difficult to identify.

Many children who experience emotional abuse realize it years later when they’re adults and can see caregiver behaviors from a new perspective.

Emotional abuse is complex. It can be subtle and may not happen all the time. Emotional abuse can be any behavior that creates a negative sense of self-worth in a child.

This type of abuse can include behaviors such as:

  • withholding love or affection
  • shaming
  • name-calling
  • rejection
  • threatening

Symptoms of emotional abuse can include:

Physical abuse doesn’t have to take the form of a black eye. It can be:

  • a spanking that leaves a child unable to sit for days
  • bruises and welts that seem to never go away
  • injuries in places (such as the soles of the feet) that seem unusual

Children who experience physical abuse may not receive medical attention in a timely manner. They may have stories that don’t fit the injury.

Emotional symptoms of physical abuse may include:

  • fearful behaviors
  • reluctance to go home
  • mood extremes such as intense aggression, shyness, or withdrawal
  • mistrust, awareness, or avoidance of authority figures

Approximately 7% of all child abuse cases and 65% of child-on-child abuse cases are sexual abuse specific, according to the NCA.

While sexual abuse can involve physical abuse, the abuse is specific to someone engaging in a sexual act with a child.

Sexual abuse may include touching or physical sexual acts. It can also mean exposing a child to elements of a sexual nature, such as pornography or witnessing sexual acts and images.

Unlike physical abuse, sexual abuse symptoms are often more challenging to spot.

Physical symptoms may not be immediately linked to sexual experiences and may include:

  • difficulty walking or sitting
  • painful or frequent urination
  • incontinence
  • swelling, itching, or pain in the genital area
  • sexually transmitted diseases
  • reluctance to participate in physical activities, such as a gym class
  • unusual discharge from the genital area
  • bruises or bleeding

The emotional symptoms of sexual abuse may include:

  • preoccupation with sex and the genital area
  • low self-esteem
  • anxiety
  • fearfulness
  • depression

You might also notice some behavioral symptoms, such as:

  • decline in academics
  • challenges with keeping peer relationships
  • regressive behaviors (acting younger than their age)
  • increase in risk-taking behaviors

Neglect is the most common type of child abuse seen, affecting nearly 61% of children in known child abuse cases.

It can involve any scenario where a child’s basic needs aren’t being met. While this can commonly relate to clothing, food, or shelter, neglect can also involve:

  • emotional needs
  • healthcare
  • academics
  • caregiver attention

Symptoms of neglect can be physical and emotional, such as:

  • malnourishment
  • unexpected level of maturity for age
  • reluctance to go home or preference for school and other social environments
  • unmet medical needs
  • inappropriate dress
  • lengthy periods of time spent without supervision at home
  • poor hygiene
  • learning challenges
  • difficulty concentrating
  • extreme desire to please
  • hypervigilance
  • has a caretaker role over siblings

Child abuse can exhibit various signs. A child experiencing neglect, for example, may not have the same symptoms of abuse as a child living with physical abuse.

Still, some symptoms of abuse can span all categories, including:

  • unexplainable injuries
  • reluctance to go home or to a specific place
  • emotional trauma reactions, such as fear, anger, or difficulty trusting others
  • depression
  • anxiety
  • self-harm
  • nightmares
  • acting withdrawn
  • academic changes
  • acting out or increased risky behaviors
  • bullying
  • abusive or cruel behaviors toward animals or other people

Children experiencing abuse need the help of those around them.

If you, your child, or someone you know suspects a child is being abused, you can call or text the Childhelp National Child Abuse Hotline at 800-422-4453.

You can also contact your local child protective services agency or a police station.

If a child comes to you and says they’ve experienced abuse, how you react can make a lasting impression. In the moment, experts recommend:

  • remain calm
  • avoid any expression of denial, shock, or disgust at what you’ve been told
  • resist the urge to interrogate or ask doubt-oriented questions such as “are you sure?”
  • reassure the child that coming to you was the right thing and they’ve done nothing wrong
  • reach out to your local authorities as soon as possible

It can take a lot of courage and trust for a child to come forward to express what they’re going through, especially if it involves loved ones.

Offering support and reassurance can help reinforce that they’ve made the right decision.

Child abuse affects thousands of children in the United States.

Being on the lookout for more than obvious bruises and injuries may help identify a child in need sooner than later.

Sometimes we may delay action because we think we know the person accused of the abuse or that the person has an upstanding reputation. Or we may hesitate because the child has a history of not being truthful.

Child abuse allegations require immediate attention. If a child comes to you, speaking with the local authorities as soon as possible can help ensure that child’s safety.

It’s often better to be wrong about child abuse suspicions and report them rather than right but have never acted.

Agencies will allow you to remain anonymous in the reporting process.