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The following signs are usually associated with abuse, but they are not definite. These signs are solely a guide to assist in identifying abuse. 

• Frequent injuries that are unexplained and/or when the child or parent cannot adequately explain injury causes such as bruises, cuts, black eyes, fractures, or burns
• Burns or bruises in an unusual pattern that may indicate the use of an instrument
• Lack of reaction to pain
• Injuries that appear after the child has not been seen for several days
• Evidence of delayed or inappropriate treatment for injuries
• Injuries involving the face, backs of hands, buttocks, genital area, abdomen, back, or sides of the body
• Frequent complaints of pain without obvious injury
• Complaints of soreness or discomfort when moving
• Aggressive, disruptive, and destructive or self-destructive behavior
• Passive, withdrawn, emotionless behavior
• Fear of going home or seeing parents

• Obviously malnourished or inadequate nutrition
• Lack of personal cleanliness
• Torn and/or dirty clothes
• Need for glasses, dental care, or other unattended medical attention
• Consistent hunger, stealing or begging for food
• Distended stomach, emaciated
• Lack of supervision for long periods of time
• Frequent absence or tardiness from school
• Regularly displays fatigue or listlessness or falls asleep in class
• Reports that no caretaker is at home
• Self-destructive behavior
• Extreme loneliness and need for affection

• Speech disorders
• Delayed physical development
• Substance abuse
• Ulcers, asthma, severe allergies
• Habit disorders (sucking, rocking, biting)
• Antisocial or destructive behaviors
• Delinquent behaviors (especially adolescents)
• Developmentally delayed

• Torn, stained, or bloody underclothing
• Pain, swelling, or itching in genital area
• Difficulty walking or sitting
• Excessive seductiveness, inappropriate sex play, or premature understanding of sex
• Role reversal, overly concerned for siblings
• Significant weight change
• Suicide attempts (especially adolescents)
• Threatened by physical contact or closeness
• Extreme fear of being alone with adults, especially if of a particular gender
• Sudden refusal to change for gym or to participate in physical activities
• Sexual victimization of other children
• Major change in normal mood or behavior