Indicators of Abuse
(children)
   ~Repeated injuries that are not properly treated or are       
inadequately explained;
   ~Unusual behavior ranging from disruptive and aggressive to
passive and withdrawn;
   ~Child acts as parent toward siblings or toward parents;
   ~Disturbed sleep (bed-wetting, nightmares, fear of            
sleeping alone, needing a night light);
   ~No appetite or overeating;
   ~Reports being hungry;
   ~Sudden drop in grades or participation;
   ~Child may report abuse;
   ~Unexplained bruises, especially in various stages of          
healing;
   ~Unexplained burns, especially cigarette or immersion
burns;
   ~Unexplained fractures, lacerations, or abrasions;
   ~Unexplained injuries regularly appearing after absence,     
weekend, vacation, etc.;
   ~Human bite marks (less than 3 centimeters between        
canines);
   ~Swollen areas;
   ~Abandonment;
   ~Consistent lack of supervision;
   ~Consistent hunger, inappropriate dress, poor hygiene;
   ~Lice, distended stomach, emaciation;
   ~Inadequate nutrition;
   ~Torn, stained, or bloody underwear;
   ~Pain, swelling, or itching in genital area;
   ~Difficulty walking or standing;
   ~Bruises or bleeding in genital area;
   ~Sexually transmitted diseases;
   ~Frequent urinary tract or yeast infections;
   ~Speech disorders;
   ~Delayed physical development;
   ~Substance abuse;
   ~Ulcers, asthma, severe allergies;
   ~Self-destructive behaviors;
   ~Arrives at school early or stays late;
   ~Chronic runaway (adolescents);
   ~Complains of soreness or moves uncomfortably;
   ~Wary of adult contact;
   ~Listless, tired constantly, falls asleep in class;
   ~Steals food, begs for food from classmates, hoards food;
   ~Reports that no parent nor caretaker is home;
   ~Frequently absent or tardy;
   ~Extreme need for affection or loneliness;
   ~Excessive seductiveness;        
   ~Massive weight change;
   ~Suicide attempts;
   ~Inappropriate or premature sex play or understanding of   
sex;
   ~Habit disorder (sucking, rocking, biting);
   ~Antisocial, destructive;
   ~Neurotic traits (sleep disorders, inhibition of play);
   ~Delinquent behavior;
   ~Seems frightened of parents;
   ~Wears long sleeves to hide injuries;
   ~Afraid to go home, shows little separation anxiety;
   ~Seeks affection from any adult;
   ~Unsafe living conditions;
   ~Somatic problems (always feels yukky);
   ~Is pregnant;
   ~Poor self-esteem, peer relationships;
   ~Is overly adaptive, inappropriately infantile or adult;
   ~Exhibits emotional, physical, or mental delays;
   ~Poor social skills, low frustration tolerance, academic       
dysfunction;
   ~Fear of failure, overly high standards, reluctance to play;
   ~Fears consequences of actions, often leading to lying;
   ~Overly compliant, too well-mannered;
   ~Excessive and seemingly obsessive neatness and            
cleanliness;
   ~Self-mutilation;
   ~Injuries to the mouth, genital, or anal areas (bruising,        
swelling, sores, infection);
   ~Reverts to bed-wetting and soiling;
   ~Fire setting;
   ~Lacks trust in others, inability to "have fun;"
   ~Injuries that form a shape or pattern that may look like     
the object used to make the injury;
   ~Bald patches on the child's head;
   ~Repeated poisonings and accidents;
   ~Describes self as bad, needing punishment;
   ~May flinch if touched unexpectedly;
   ~Sad, cries frequently;
   ~Poor memory and concentration;
   ~Pain experiences in elimination;
   ~Seems anxious when other children cry;
   ~Whispering speech.
Indicators of
Abusive Parents:
   ~Seems unconcerned about the child;
   ~Takes an unusual amount of time to seek medical care for the
child;
   ~Offers inadequate or inappropriate explanations for child's
injuries;   
   ~Gives different explanations for the same injury;
   ~Misuses drugs or alcohol;
   ~Disciplines the child too harshly for the mistake or for the child's
age;
   ~Sees the child as evil or bad;
   ~Has a history of abuse;
   ~Attempts to conceal the child's injuries;
   ~Takes the child to a new doctor for each injury;
   ~Has an unorganized, upsetting home life;
   ~Is apathetic, feels that nothing will ever change;
   ~Is isolated from friends, family, relatives, neighbors;
   ~Has long-term, chronic illness;
   ~Cannot be found;
   ~Has a history of neglect;
   ~Role reversal with the child; blurred boundaries;
   ~Very protective, jealous, controlling;
   ~Encourages child to participate in prostitution, sexual acts in the
presence of the caregiver;
   ~History of sexual abuse;
   ~Low self-esteem, poor self-image;
   ~Incapacitated mother;
   ~Makes harsh and/or destructive responses to the child's
requests;
   ~Threatens or terrorizes the child;
   ~Believes that the child entices his/her own poor treatment;
   ~Treats children in the family unequally;
   ~Doesn't seem to care much for the child's problems;
   ~Blames or belittles the child;
   ~Is cold and rejecting;
   ~Withholds love;
   ~Has unrealistic expectations;
   ~May not have age appropriate expectations of the child;
   ~Jealous;
   ~Poor impulse control;
   ~Marital problems;
   ~Psychotic or psychopathic;
   ~Emotionally immature and impulsive.
Shaken Baby Syndrome
information here is from the National Center on Shaken Baby
Syndrome website.
Common symptoms of Shaken Baby syndrome:
   ~lethargy/ decreased muscle tone;
   ~extreme irritability;
   ~decreased appetite, poor feeding or vomiting for no apparent reason;
   ~grab-type bruises on arms or chest are rare;
   ~no smiling or vocalizations;
   ~poor sucking or swallowing;
   ~rigidity or posturing;
   ~difficulty breathing;
   ~seizures;
   ~head or forehead appear larger than usual or fontanelle appears to be bulging;
   ~inability to lift head;
   ~inability of eyes to focus or track movement or unequal size of pupils.

Physical consequences of shaking an infant or toddler:
   ~The brain rotates within the skull cavity, injuring or destroying brain tissue;
   ~When shaking occurs, blood vessels feeding the brain can be torn, leading to bleeding around the brain;
   ~Blood pools within the skull, sometimes creating more pressure within the skull and possibly causing additional brain damage;
   ~Retinal bleeding is very common.

Immediate Consequences:
   ~Breathing may stop or be compromised;
   ~Extreme irritability;
   ~Seizures;
   ~Limp arms and legs or rigidity/posturing;
   ~Decreased level of consciousness;
   ~Vomiting; poor feeding;
   ~Inability to suck or swallow;
   ~Heart may stop;
   ~Death.

Long-Term Consequences:
   ~Learning disabilities;
   ~Physical disabilities;
   ~Visual disabilities or blindness;
   ~Hearing impairment;
   ~Speech and/or language disabilities;
   ~Cerebral Palsy;
   ~Seizures;
   ~Behavior disorders;
   ~Cognitive impairment; problems with memory and attention; severe intellectual disability;
   ~Paralysis (some particularly traumatic episodes leave the child in a coma);
   ~Death.
Preventing Shaken Baby Syndrome ...

It is 100% preventable.

Finding ways to alleviate parental stress when the baby seems inconsolable can significantly reduce the risk. One method is Dr. Harvey
Karp's Five S's:

   **Shushing (Using white noise, or rhythmic sounds that mimic the whir of noise in the womb, with things like vacuum cleaners, hair
dryers, clothes dryers, a running tub, or a white noise CD.)

   **Side/ Stomach positioning (Placing the baby on the left side to help digestion or on the belly while holding him or her.)

   **Swaddling (Wrapping the baby up snugly in a blanket to help him or her feel more secure.)

   **Swinging gently (Rocking in a chair, using an infant swing, or taking a car ride to help duplicate the constant motion the baby felt in
the womb.)


If a baby in your care won't stop crying, you can also try the following:

   **Make sure that the baby's basic needs are met (hungry? wet? lonely? etc.);
   **Check for illness, fever, swollen gums;
   **Rock or walk with the baby;
   **Sing or talk to the baby;
   **Offer the baby a pacifier or a noisy toy;
   **Take the baby for a ride in the stroller or the car;
   **Hold the baby close against your body and breathe calmly and slowly, hum or sing ...
   **Call a friend or relative for support or to take care of the baby while you take a break;
   **If nothing else works, put the baby on his or her back in the crib, close the door, and check on the baby in 10 minutes;
   **Try a bath;
   **Just go outside, get some fresh air;
   **Call your child's doctor if nothing seems to be helping your infant, in case there is a medical reason for the fussiness.