Child abuse prevails in many different forms: physical, emotional, psychological, and sexual. Physical abuse arises when a child is physically injured or put in a situation that could result in harm. Emotional abuse occurs when a child’s emotional well-being or self-esteem is injured. This may include isolating a child, ignoring a child, rejecting a child, or verbal and emotional assault. Psychological abuse is similar to emotional abuse and results from intentionally inflicting mental pain or instilling fear or violence in a child. Sexual abuse refers to any sexual activity with a child. This could be in the form of fondling, taking inappropriate pictures of children, oral or genital contact, intercourse, etc. With sexual abuse, children are typically abused by people they know and are often close relatives to the child. Statistically speaking, this happens close to 90% of the time. Additionally, child neglect is also considered a form of abuse and is described as the failure to provide a child with adequate food, a place to live, proper affection, supervision, education, or healthcare. For more information, refer to the 2022 Minnesota Statute 260C.007 Subd. 5. Child Abuse section.1
Signs, Symptoms, and Red Flags
Taking into account that a child may feel confused, ashamed, or guilty for being a victim of abuse, it is crucial to observe potential signs and symptoms of child abuse.
Some possible red flags to be on the lookout for include withdrawal from activities, friends, or family, displaying behaviors that could be labeled as defiant or rebellious, recurrent tardies in school, and possible lack of care from guardians or parents. Additional red flags such as behavioral changes (i.e., anger, aggression, hyperactivity, etc.), sudden decrease of self-confidence, troubles sleeping, nightmares, self-harm, and suicide attempts should also be kept in mind.
A variety of signs can be dependent upon the type of abuse and can differ depending on the situation. In terms of physical abuse, injuries that do not match with the developmental ability of the child, do not correlate with the explanation given, or unexplained injuries are specific warning signs. Regarding sexual abuse, specific warning signs to look out for could include (1) pregnancy, (2) sexually transmitted infections, (3) pain, bleeding, or injuries to the genitals or anus, (4) sexual behavior or knowledge that is inappropriate for the child’s age, and (5) a child disclosing that they were or are being sexually abused. Signs and symptoms for emotional abuse include delayed emotional development, diminished self-esteem or self-confidence, social withdrawal, lack of interest or enthusiasm, avoidance of some situations (i.e., refusal to attend school), or if the child appears to desperately seek affection. Lastly, poor growth, lack of or poor personal hygiene/cleanliness, lack of supplies or clothing, low record of school attendance, lack of appropriate medical attention, and hoarding/stealing food are considered to be signs and symptoms of child neglect.
What are the Effects of Child Abuse on the Stages of Behavioral Development?
Child abuse can have an effect on children in different ways and can depend on the stage of behavioral development. Because enduring abuse may translate into lifelong consequences, it is important to understand the effects that abuse has depending on a child’s age and developmental level.
This is a crucial period in a child’s development. During infancy, the brain is heavily undeveloped and is incredibly susceptible to negative external environmental effects. For example, shaken baby syndrome can severely affect the infant’s health, potentially leading to consequences such as learning disabilities, problems with vision or hearing, cognitive dysfunction, or mental retardation. Previous studies have indicated that children who experienced physical abuse shows changes in the structure of their brains, including smaller lateral ventricles, corpora callosa, and intracranial and cerebral volume. Consequences of abuse can also clinically manifest at a later point in life, ranging from no apparent effects to permanent disability. Additionally, high catecholamine and cortisol levels increase as a stress response resulting from abuse. These increased levels have been linked to brain cell destruction and disruption of healthy brain connections, leading to negative effects on behavioral development. Signs of infant abuse to take notice of would include nightmares, sleep disturbances, and night terrors. This can be noticed via caregiver observation. In infancy, the central nervous system (CNS) is still developing so overstimulation can occur within the CNS, leading to night terrors, nightmares, or sleep disturbances. This CNS overstimulation can be a result of abuse.
At this stage, children tend to react to stress by expressing emotions such as anger. When stress is coupled with any form of abuse, children tend to feel highly distressed and frustrated. Aggressive behavior and arguments/fights with caregivers or friends can be seen as a result of excessive anger within a child. This response is amplified more when physical abuse is present.
The reactions to abuse that children have at this stage of development is similar to younger children. Nonetheless, by 4 and 5 years old, children may display their reactions to abuse differently based on sex. Girls tend to internalize their behavioral attitudes through social withdrawal and depression, and often have somatic symptoms like abdominal pain and headaches. On the contrary, boys are more likely to externalize their emotions by expressing large amounts of aggression, anger, and through verbal bullying.
Primary School Age
In this stage, peer interactions lead to further development in children. Children who are abused tend to struggle with school and are often absent. School struggles may include a lack of interest in school, lack of concentration in class, poor academic performance, and minimal friendships.
Teens who have been abused may experience depression, anxiety, or might be socially withdrawn. Moreover, living in violent situations often leads to runaway attempts where environments are perceived to be safer. Adolescents who have experienced abuse are more likely to engage in a multitude of risky behaviors such as drinking, smoking, drug use, gang involvement, early sexual activity, and prostitution. Often, psychiatric disorders are seen in teens who have been abused as well.
Given the impacts of child abuse on the varying developmental stages, it is crucial for caregivers to be observant of these signs to take action and to support their children.
By: Kristen Jones
Mayo Foundation for Medical Education and Research (2021). Child abuse. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/child-abuse/symptoms-causes/syc- 20370864
Odhayani, A.A., Watson, W.J., & Watson, L. (2013). Behavioural consequences of child abuse. Canadian Family Physician, 59(8), 831-836.