Age-related signs of Abuse

Ages 0-3
 Signs of physical injury
 Signs of physical illness, especially to
genital or urinary systems
 Unusual fussiness
 Refuses his/her favorite food
 Becomes extremely shy
 Exhibits a sudden or unusual fear of
strangers
 Ages 0-3
 Shows a lack of enjoyment of his/her
favorite play things
 Clings to parents as if fearful
 Experiences great difficulty getting to sleep
 Suffers from frightening dreams
 Regresses to an earlier pattern of behavior
 Regression of skills
 Ages 0-3
 Experiences a loss of his/her sense of
security
 Becomes unable to adjust to his/her
normal schedule
 Manifests any change from normal
behavior pattern such as:
 Ages 0-3
* Feeling ugly
* Very concrete symptoms- hitting self
in eye, etc.
* Difficulty cuddling
* Seeking attention from any adult
 Ages 4-12
 A sign of physical injury
 Signs of physical illness, with a variety of
symptoms from recurrent headaches,
upset stomachs, or urinary tract infections
 Exhibits sudden shyness
 Suffers from frightening dreams
 Experiences great difficulty getting to
sleep
 Ages 4-12
 Refuses his/her favorite foods
 Suffers from depression
 Exhibits some loss of memory
 Worries excessively, interrupting his/her
normal life pattern
 Exhibits a fear of specific adults
 Has a sudden and unwarranted fear of the
dark
 Ages 4-12
 Exhibits extreme fear of being alone
 Shows regression in patterns of behavior
or skills
 Exhibits a change in school relationships,
including possible fighting and the sudden
inability to adjust
 Shows lack of enjoyment in his/her
favorite TV shows, movies, games, or
other activities
 Ages 4-12
 Seems easily distracted as though his/her
mind is wandering
 Manifests a change in his/her attitude
 Manifests a change in his/her pattern of
normal behavior
 Acts out in a sexual manner, appearing
more knowledgeable about sex than
his/her peers.
 Ages 4-12
 Develops a pseudomature character, taking over
specific parental responsibilities in the home ( a
sign predominately associated with incest)
 Bedwetting
 Excessive masturbation
 Approaching strangers for affection
 Dependency issues
 School phobia
 Ages 4-12
 Excessive lying or manipulation
 Use of precocious sexual language
 Cruelty or excessive concern for animals
 Fear or aversion to sports
 Phobia
 Emotional lability
 Recurrent nightmares
 Lack of joy
 Ages 4-12
 Shame
 Excessive or total lack of interest in dating
 Excessive drug or alcohol use
 Self-injury
 Eating disorders
 Problems with boundaries:
– Difficulty saying “no”
– Problems with closed doors
– Excessive modesty or nudity
 Ages 4-12
 Intrusive behavior with siblings, parents,
or friends
 Blocked feelings or memories
 Rejection issues are primary
 Early sexual acting out
 Ages 13-19
 Manifests signs of physical injury
 Manifests signs of physical illness,
headache, stomach cramps, urinary tract
infections
 Suddenly refuses food
 Suffers from sudden and violent dreams
 Manifests difficulty in getting to sleep
 Seems in depths of depression
 Ages 13-19
 Exhibits inability to concentrate
 Shows irritability or manifests angry
outbursts toward others
 Exhibits a sudden and unwarranted fear of
the dark
 Has a sudden lapse of enjoyment in dating
 Feels an unexplainable fear of being left
alone
 Ages 13-19
 Worries excessively, interrupting his/her
normal life patterns
 Experiences a loss of memory
 Exhibits fear of specific adults
 Exhibits a change in his/her level of
scholastic achievement
 Acts out the sexual encounter with sibligns
or friends
 Ages 13-19
 Experiences a lack of enjoyment of his/her
favorite activities
 Makes an attempt to run away from home
 Contemplates suicide
 Appears passive or overly compliant n
behavior
 Behaves seductively with the opposite sex
 Ages 13-19
 Manifests a deviation from his/her normal
patterns or attitudes
*Lack of interest in dating
* Promiscuity
* Excessive drug/alcohol use
* Self-injury
* Eating disorder ( too much or too little)
 Ages 13-19
 Problems with boundaries:
– Saying “no” to friends
– Closing doors
– Excessive modesty/nudity
– Being intrusive with friends, parents, siblings
 Ages 13-19
 Blocked memories/feelings
 Lack of joy
 Shame
 Rejection issues are primary
 Dependency issues
 Truancy
 Early marriage/early pregnancy/early
sexual experience
 Ages 13-19
 Lying and manipulation
 Cruelty or excessive concern for animals
 Excessive masturbation
 Signs of Credibility
Important information to keep in mind
during the interview process. What
enhances and what will detract from a
child’s allegation of sexual abuse
 Credibility of Language
Increase of Decrease of
credibility credibility
- Uses own language - Adult terms
- Facts stay the same - Rote phrases
even if the vocabulary - Lack of details
changes
- Gives details
- Tells from a child’s
viewpoint
 Credibility of Affect
Increase in Decrease of
credibility credibility
- Congruent with - Inappropriate
allegations allegations
 Credibility of Behavior
Increase in Decrease in
Credibility Credibility
- Seductive - No behavioral changes
- Precocious
- Regressed
- Guarded
- Somatic
- Complaints
 Credibility of Cognitive
Development
Increase in Decrease in
Credibility Credibility
- Differentiates fact - Impaired reality
from fantasy testing
 Credibility of Memory
Increase in Decrease in
Credibility Credibility
- Good recall of details, - Vague
including - Evasive
sensorimotor - Prior abuse may
- Absence of denial confuse allegation
- Idiosyncratic detail
 Credibility of Motives
Increase in Decrease in
Credibility Credibility
- Absence of secondary - Possible secondary
gain gain
- Need parent’s
approval
 Credibility of Play
Increase in Decrease in
Credibility Credibility
- Sexual Themes - Sexual themes absent
- May reenact trauma,
exaggerates or avoids
sexual features
 Credibility of Drawings
Increase in Decrease in
Credibility Credibility
- Will show - Will not show
characteristics of characteristics of
sexually abused sexually abused
children children
 Credibility of History
Increase in Decrease in
Credibility Credibility
- Progressive sexual - Other medical history
activity over time to explain heightened
- Delayed disclosure sexual concerns
- Child threatened to
keep secret
- Psychological coercion
- Sex rings, rituals,
pornography
 Credibility of Physicality
Increase in Credibility Decrease in Credibility
- Gonorrhea under age 14 - Normal physical exam in
other than newborn spite of history of
- Strong indicators, penetration.
hymenal disruption, anal
scars or relaxation,
gonorrhea of rectum or
vagina, other venereal
diseases