Physical Abuse
Physical abuse is the use of force that can result in physical injury to a child.
What Is Physical Abuse?
Physical abuse is any act that results in physical injury to a child or adolescent. However, children and adolescents exposed to physical threats and aggression have similar outcomes, whether or not a physical injury occurred. Although there are cases where child abuse occurs outside the home, most often children are abused by a caregiver or someone they know, not a stranger.
Physical abuse is the second most common form of child maltreatment. Each year, approximately three million cases of child abuse are reported. Almost 5.5 million children are involved.
Physical abuse can have long-lasting effects on a child’s development. Children who are abused physically can develop child traumatic stress. They are also at risk for depression, anxiety, social difficulties and behavioral problems (such as aggression, rule-breaking behavior or substance use).
Children of all ages, races, ethnicities and socioeconomic backgrounds are at risk for physical abuse. Children ages 0-3 are most susceptible to physical abuse and serious injuries. Every day, five children die from child abuse. Most of these children are under three years old.
If you see any of the following signs, please get help right away.
What Symptoms Should You Look For?
You should suspect that physical abuse has occurred when:
- A child discloses physical abuse.
- It's hard to see how the injuries could have been caused by an accident. Maybe the injuries have a pattern. They could be in a straight line or a circle. Or the injuries could be located on areas of the body that usually are protected. It could be the inside of the legs and arms, the back, the genitals, and the buttocks.
- Injuries attributed to accidents that could not have occurred given the child’s age (for example, an immersion burn on a child too young to walk or crawl).
- The explanation for the injury changes, or the explanation is just not believable.
- There are signs that the child has been hurt before. It could be new injuries over the scars of healed ones.
- Frequent physical injuries that are attributed to the child being clumsy or accident-prone.
- The child hasn’t received medical care for his or her injury.
Beyond the injuries themselves, there may be other indicators of physical abuse, such as:
- Habitual absence from or lateness to school without a credible reason. Parents may keep a child at home until physical evidence of abuse has healed.
- A child comes to school wearing long-sleeved or high-collared clothing on hot days (to hide injuries).
- Awkward movements or difficulty walking (a child in pain or suffering from the aftereffects of repeated injuries).
The emotional effects of physical abuse can last long after the visible wounds have healed. The child victims of physical abuse may have more problems in their home lives, at school, and in dealing with peers than children from non-abusive environments.
Some psychological and emotional effects of child physical abuse include:
- Low self-esteem
- Excessive fear and anxiety
- Eating disorders
- An inability to concentrate (including ADHD)
- Hostility towards others, even friends and family members
- Depression
- Apathy and lethargy
- Aggression
- Sleep issues – insomnia, excessive sleepiness
Many children who have been abused may distrust others. Children who have experienced long-term abuse may struggle with basic social skills and have difficulty communicating naturally as other children can.
Why Don’t Children Tell About Physical Abuse?
There are many reasons why children don’t want to “tell on” their abusers:
- Fear that their parents/caregivers will be mad at them or will hurt them worse for telling.
- The child does not want to get the abuser into trouble.
- The fear of being removed from the home.
- A belief that it’s okay for their parents/caregivers to hurt them.
- The fear of not being believed.
- Shame or guilt.
- The belief that they deserved the abuse for their “bad” behavior.
How Is Physical Abuse in Children Diagnosed?
Physical abuse can be difficult to recognize unless children are obviously injured or the abuse is witnessed by other people.
When doctors suspect physical abuse, they look for signs of other types of abuse. They also fully evaluate the physical, environmental, emotional and social needs of the child.
Doctors observe interactions between the child and the caregivers whenever possible. Doctors document the child's history by writing down exact quotes and taking pictures of any injuries.
Physicians and mental health professionals are legally obligated to report all suspected cases of abuse or neglect to state authorities.
How Can I Seek Help for Children Suffering From Physical Abuse?
A child who has been abused needs special support and treatment as early as possible. The longer they continue to be abused or are left to deal with the situation on their own, the less likely the child is to make a full recovery.
If you suspect physical abuse, get help immediately through a pediatrician or local child protective agency. The pediatrician can detect and treat medical injuries or ailments, recommend a therapist and provide necessary information to investigators.
In any case of abuse, the child's safety is of primary concern. They need to be in a safe environment free of the potential for continuing abuse.
Medical Reviewer: Lea Taylor, PhD, Nationwide Children's Hospital
Date Last Reviewed: 7/23/2025
The information provided here is only for general reference and should not take the place of medical care or patient education. If you have any questions, please call your child's care team.
