Concerns for physical abuse exist when a caregiver uses physical force on a child such that injury to the child occurs or could occur. Examples of physical abuse may include:

• Bruises
• Welts
• Cuts
• Abrasions
• Fractures
• Burns/scalds
• Contusions
• Loss of teeth
• Bloodied nose
• Sprains
• Brain or neurological damage
• Death
• Subdural hemorrhage
• Internal injuries
• Poisoning
• Gunshot wounds
• Physical punishment of an infant
• Shaking infant or preschooler
• Striking children with an object when any of the following occur: The child is struck some place other than the buttocks; A bruise or injury results; The number of strikes is more than one or two; Done frequently; or Used on preschoolers.
• Striking children on or about the head and face
• Striking children with a closed hand
• Throwing children in such a manner that there is risk of injury
• Kicking a child
• Biting a child
• Forcing a child to ingest a noxious substance, i.e. tobacco, alcohol, soap, pepper, Tabasco sauce, etc.
• Forced feeding

There may be concerns for a child’s safety when a child:

• Has an unexplained injury
• Has serious injury requiring medical attention or hospitalization
• Has a sibling who was abused which resulted in injury, death, or dysfunction
• Experiences heightened the level of pain or injury; e.g., cigarette burns, an instrument is used
• Parent’s motivation to teach or discipline seems secondary to inflicting pain and/or injury
• Parent has no remorse
• Parent does not acknowledge any guilt or wrong doing and they intended to hurt the child
• Parent shows no empathy for the pain or trauma the child has experience and they intended to hurt the child
• History and circumstantial information are incongruent with the parent’s explanation about injuries and conditions
• Parent’s verbal expressions do not match their emotional response and there is not a believable explanation
• Parent’s regrets are unbelievable, self serving, or associated more with getting caught than what was done
• Parent shows no recognition of wrong or inappropriate behavior, or demonstrates a self-righteous attitude and believes actions were justified
• Parents view their abusive behavior as a parental right
• Parent’s explanations for serious maltreatment are inconsistent or change over time