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Page 15 of 17 Appendix 1 - Signs and Symptoms of Abuse Physical Injury Where the explanation of an injury is not consistent with the injury or with the stage of development of the child. Where there are changes of explanation or no explanation. Where there has been an unreasonable delay in seeking medical advice. Recurring injuries, even when the explanation on each occurrence appears adequate. This may indicate a lack of supervision or possible medical problems. Bruises of different ages on the child at any one time, other than on common sites of accidental injury in a child of that age. Facial bruising, particularly round the mouth, eyes or ears. Unexplained or inadequately explained burns, bite marks, severe bruising or any combination of these. Poisoning, particularly where there is more than one incident.
Neglect Failure to thrive (with no medical reason). Stealing or gorging food. Lack of appetite and increased feeding difficulties. Poor hygiene or inadequate clothing (taking family circumstances into account). Lack of appropriate supervision. Developmental delay. Poor school attendance or academic achievement. Persistent failure to seek or to follow any necessary medical or nursing advice. Poor peer group relationships, but attention-seeking from adults. Physical signs of long-standing neglect, including poor growth, thinning hair, protuberant abdomen and persistently cold, reddened hands and feet.
Emotional Abuse Impaired ability for enjoyment. Low self esteem and sense of worthlessness. Eating disturbances or growth failure. In severe cases, actual physical signs of deprivation, as described under previous section - Neglect, may be apparent.
Sexual Abuse Physical signs: Eating problems/anorexia; Physical symptoms such as stomach pains, headaches etc; Persistent or recurrent urinary tract infections or discharge; Sexually transmitted disease; Pregnancy. Behavioural signs: Over sexualised behaviour; Withdrawn, overtly compliant behaviour; Mood swings, depression and suicidal behaviour; Self-mutilation, low self-image; School refusal, truancy; Drug and alcohol abuse.
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