Signs of Child Abuse (and How to Stop It)

baby crying
baby crying

By Jennifer Wilson

We spoke with Matthew Cox, M.D., a child abuse pediatrician at the Children's Medical Center's Referral Evaluation of At Risk Children (REACH) program in Dallas, Texas, a state with one the nation's highest abuse rates. He regularly conducts medical examinations on children to determine if their injuries are due to abuse, and works with local agencies to ensure kids' safety. This is his advice on how to prevent and report abuse, as well as how to help victims:

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Signs of Abuse
Above all else, if you suspect abuse, trust your instincts, says Dr. Cox. "Time after time we hear family members who say 'I was worried, but I didn't have any evidence,'" he says. "If you have a gut feeling, act on that concern."

Common indicators of child abuse include:

Bruises. Look for them in unusual locations such as cheeks, back, backside, or chest. Any bruise on an infant is worrisome.

Babies who fuss excessively when held. Infants 6 months and younger who are more irritable when held than if left untouched display what's known as paradoxical irritability, and it's a red flag. The baby may cry because being held hurts, perhaps as a result of bruises or even broken bones, explains Dr. Cox.

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Withdrawn personality. Children who are reluctant to interact with others may have experienced physical or emotional violence.

Where to Turn for Help
The most effective organization, the one that will do the most, is child protective services (CPS), says Dr. Cox. News stories tend to report CPS failures, and the common stereotype is that CPS automatically takes children from the home. In reality, explains Dr. Cox, kids are rarely taken from their parents. Instead, CPS works with families and connects them with community services that can help. "If anyone knows local resources, it's child protective services," he adds. (See end to locate your state's CPS agency.)

State agencies educate parents on dealing with stressful situations, such as excessive crying, sleepless nights, tantrums, and toilet training. "They can prepare families to deal with common triggers of abuse," says Dr. Cox.

Beyond that, these groups all aim to prevent abuse and help those who are affected.

Prevent Child Abuse America (; 1-800-CHILDREN) Promotes prevention through education and public-awareness outreach, and offers specific advice on how to make a report of abuse.

Childhelp (; 1-800-4-A-CHILD) With Childhelp's National Child Abuse Hotline, open 24/7, professional crisis counselors offer advice and make referrals.

Fussy Baby Network ( The Erikson Institute, a child development graduate school, offers a free "warmline," open 9am-5pm CST Monday-Friday where infant specialists help parents who need help managing their crying infant. 1-888-431-BABY.

Hope Shining/Safe Horizon (; 1-212-577-7700) This victim-assistance organization offers guidance on how to report abuse in every state.

Also, extend a hand to parents you know. Offer a sympathetic ear or free babysitting if they feel overwhelmed.

How to Help Yourself
We've all been there: The colicky baby has been screaming since 3:00 a.m. The 2-year-old is throwing the mother of all tantrums in the toy aisle. There's been one snarky comment too many from that sassy tween. During stressful times, the worst instincts can challenge even the most rational parent. What can you do?

1. "Take a break," says Dr. Cox. "I can't stress this enough."
2. Walk away.
3. Back up.
4. Count to 100.
5. Go to another area of the house.
6. Just breathe.
7. Put a crying infant in the crib where he can't be injured if he's alone, and step outside. "Colic is the worst," says Dr. Cox. "Even my physician colleagues will say this. We all need a break sometimes."
8. When you take that break, think about what you are going to do next. If you can't calm down, call someone. Ask a partner, friend, family member, or neighbor to relieve you.
9. "More often than not," says Dr. Cox, "it's that momentary lapse in judgment that leads to many of the problems we see in the clinic."

So remember that break -- it's the most important time-out you'll ever take. And before the next challenging moment arrives, write out and post a protocol for stressful moments, such as:

1. I will step away from stress when I need to.
2. I will put my child in a safe place and go outside to take a breath.
3. I will call for backup when I need it.
4. I will control myself to protect a child I love.

RELATED: Find Your State's Child Protective Services Agency

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