International Centre for Missing & Exploited Children

| June 2020

Definitions, signs and indicators of abuse

Adapted from AISA Child Protection Handbook and World Health Organization

Child protection concerns include suspected, alleged, self-disclosed, or witnessed abuse of a child by
anyone which must be investigated and followed by appropriate action. Child Abuse constitutes “all
forms of physical and emotional ill treatment, sexual abuse, neglect or negligent treatment or
commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival,
development or dignity.”

A person may abuse a child by inflicting harm, or by failing to act to prevent harm. Children may be
abused in a family or in an institutional or community setting; children may be abused online or in person
by individuals known to them, or more rarely, by a stranger. Children may experience multiple forms of
abuse simultaneously. Most child abuse is inflicted by someone the child knows, respects or trusts. All
adults should understand reasons children may not talk about abuse they might have experienced.

Signs and indicators may or may not be present and may not indicate abuse.

PHYSICAL ABUSE may involve hitting (with hand or other item), punching, shaking, throwing, poisoning,
biting, kicking, burning or scalding, drowning, suffocating, sustained physical activity or sustained
physical restraint, or otherwise causing intentional physical harm to a child.

Signs of physical abuse that may or may not be present: — Bruises, burns, sprains, dislocations, bites,
cuts — Improbable excuses given to explain injuries — Injuries which have not received medical attention
— Injuries that occur to the body in places that are not normally exposed to falls, rough games, etc. —
Repeated urinary infections or unexplained stomach pains — Refusal to discuss injuries — Withdrawal
from physical contact — Arms and legs kept covered in hot weather — Fear of returning home or of
parents being contacted — Showing wariness or distrust of adults — Self-destructive tendencies — Being
aggressive towards others — Being very passive and compliant — Chronic running away

EMOTIONAL ABUSE is the persistent emotional ill treatment of a child so as to cause severe and adverse
effects on a child’s emotional development. It may involve: conveying to children that they are worthless
or unloved; that they are inadequate or valued only if they meet the needs of another person; age or
developmentally inappropriate expectations being imposed on children; causing children frequently to
feel frightened; the exploitation or corruption of child’s innocence. Some level of emotional abuse is
involved in all types of ill-treatment of a child, though it may also occur alone.

Signs of emotional abuse that may or may not be present: — Physical, mental and emotional
development is delayed — Highly anxious — Showing delayed speech or sudden speech disorder — Fear
of new situations — Low self-esteem — Inappropriate emotional responses to painful situations —
Extremes of passivity or aggression — Drug or alcohol abuse — Chronic running away — Compulsive
stealing — Obsessions or phobias — Sudden under-achievement or lack of concentration — Attention-
seeking behavior — Persistent tiredness — Lying

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 International Centre for Missing & Exploited Children
| June 2020

Definitions, signs and indicators of abuse cont.

Excerpted from AISA Child Protection Handbook and World Health Organization

SEXUAL ABUSE involves forcing or enticing a child to take part in sexual activities, whether or not the
child is aware of what is happening. The activities may involve physical contact, including penetrative or
non-penetrative acts such as kissing, rubbing and touching inside or outside of clothing. They may
include non-contact activities, such as voyeurism, involving children in the production or viewing of
pornographic material, encouraging children to behave in sexually inappropriate ways, or performing
sexual acts in their presence. In some counties this includes the grooming of children in preparation for
abuse, including on the Internet.

Signs of sexual abuse that may or may not be present: — Pain or irritation to the genital area —
Discharge from genitals — Difficulty with urination — Infection, bleeding — Sexually Transmitted Diseases
— Fear of people or places — Aggression — Regressive behavior, bed wetting or stranger anxiety —
Excessive masturbation/Sexually provocative — Stomach pains or discomfort walking or sitting — Being
unusually quiet and withdrawn or unusually aggressive — Sleep disruptions, nightmares — Attention
deficits — Suffering from what seem physical ailments that can’t be explained medically — Showing fear
or distrust of a particular adult — Mentioning receiving special attention from an adult or a new “secret”
friendship with an adult or young person — Refusal to continue with school or usual social activities —
Age inappropriate sexualized behavior or language

NEGLECT is the persistent failure to meet a child’s basic physical, medical, social, or physiological
needs, likely to result in serious impairment of the child’s health or development.

Some indicators of neglect that may or may not be present: — Medical or dental needs unattended —
Lack of supervision — Consistent hunger — Inappropriate dress — Poor hygiene — Inadequate nutrition —
Fatigue or listlessness — Self-destructive — Extreme loneliness — Extreme need for affection — Failure to
grow — Poor personal hygiene — Frequent lateness or non-attendance at school — Low self-esteem —
Poor social relationships — Compulsive stealing — Drug or alcohol abuse — Reluctance to return home

LONG TERM IMPACT OF UNMITIGATED CHILD ABUSE The impact of child abuse can persist for a lifetime
after the abuse has been committed. Impacts are academic, medical, physical, psychological and
emotional. Some victims of abuse are resilient and thus manage to function and survive. Research has
established the relationship between long-term child abuse and lifetime negative health and well-being
impact, especially if the children do not get appropriate support to help them cope with trauma.

Long term impact of child abuse: — Poor educational achievement — Inability to complete
responsibilities — Inability to live according to plan/ability — Inability to care for self — Inability to coexist,
cooperate or work with others — Lack of self-confidence, prone to addiction/substance abuse — Inability
to express love / or accept love — Inability to lead family, constant health problem — Prone to mental
health problems — Low self-esteem, depression and anxiety — Post-traumatic stress disorder (PTSD) —
Attachment difficulties — Eating disorders — Poor peer relations, rage disorders, self-harming behavior
(e.g., cutting, suicide attempts)

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 International Centre for Missing & Exploited Children
| June 2020

Definitions, signs and indicators of abuse cont.

SEXUAL EXPLOITATION refers to the transactional nature of some forms of abuse. It is a form of sexual
abuse where children are sexually exploited for money, power or status. It can involve violent,
humiliating and degrading sexual assaults. In some cases, young people are persuaded or forced into
exchanging sexual activity for money, drugs, gifts, affection or status. Consent cannot be given, even
where a child may believe they are voluntarily engaging in sexual activity with the person who is
exploiting them. Child sexual exploitation doesn't always involve physical contact and can happen online.
A significant number of children who are victims of sexual exploitation go missing from home and
education at some point.

Signs of sexual exploitation that may or may not be present: — Signs of sexual abuse — Unexplained gifts
or new possessions — Associate with other young people involved in exploitation — Have older boyfriends
or girlfriends — Suffer from sexually transmitted infections or become pregnant — Suffer from changes in
emotional well-being — Fear of people or places — Abuse drugs and alcohol — Go missing for periods of
time or regularly come home late — Regularly miss school or education or go missing from education.

ONLINE SEXUAL ABUSE & EXPLOITATION is the sexual abuse of children using digital technology. This
commonly includes grooming children with a sexual motive, creating, viewing and distributing child
sexual abuse material (child pornography and self-produced sexual images or ‘sexts’) and coercing and
blackmailing children for sexual purposes. This abuse may be perpetrated by individuals or gangs, young
people or adults and may include in person contact or only online contact. As technology advances, new
forms of this crime emerge. Children with unsupervised use, high usage, low digital knowledge, low self-
esteem, poor digital literacy skills (sharing of passwords, insufficient privacy settings, etc.) may be
especially vulnerable, but any child with digital access, boys or girls, may be victimized.

Signs of online grooming, abuse or exploitation that may or may not be present: — Secretive behavior —
Unexplained gifts or new possessions —Late night or excessive internet use — Anxiety — Withdrawal from
family/friends/interests — Suicide ideation/self-harm — Poor educational achievement, attention deficits
— Sleep disruption — Increase in followers or contacts —- New devices and/or platforms — New usage
patterns —- Avoidance of online use or certain online platforms or apps.

Additional child protection concerns and forms of abuse:

Witness to domestic violence (DV)
Female Genital Mutilation (FGM)
Extremism / Radicalization
Trafficking (for sexual or labor purposes)