Physical Abuse - the infliction of harm upon a child by a parent or caregiver.

Signs The Child May Exhibit Frequent or unexplained bruises or injuries Nervousness/Fear around adults Reports injury by a parent or another adult caregiver Aggression toward adults, other children, and/or pets Fractures in unusual places Avoids physical contact with others Gives inconsistent account of injuries, burns, etc. Wets bed/Behavior Regresses No emotion when hurt Truancy Wears inappropriate clothing on hot days to hide injuries Moves/Walks awkwardly Runs Away Drug/Alcohol Abuse

Signs The Parent May Exhibit Offers conflicting, unconvincing, or no explanation for the child's injury Describes the child as "evil," or in derogatory terms Uses harsh physical discipline with the child Has a history of abuse as a child Economic stress History of alcohol or drug abuse Low tolerance for frustration Does not respond appropriately to child's pain Little or no interest in child's well-being Inability to appropriately control or express anger Parents who were themselves abused

Studies demonstrate physically abused children are prone to mental illness, homelessness, crime, and unemployment. Physical abuse negatively impacts the child, the family, the community, and ultimately, all of society.

Neglect - Neglect is the chronic failure of a parent/caregiver to provide for a child's basic needs. Neglect can be physical, educational, or emotional. It is the most common form of abuse and results in the majority of child deaths.

Signs The Child May Exhibit Frequently absent from school Begs/steals food or money Lacks needed medical or dental care, immunizations or glasses Consistently dirty and has severe body odor Lacks sufficient clothing for the weather States there is no one at home to provide care Appears exhausted Poor home conditions that pose health and safety risks Frequently left unsupervised or alone for periods of time Speaks of violence in his/her household Persistent head lice/untreated

Signs The Parent May Exhibit Appears to be indifferent to the child Seems apathetic or depressed Is abusing alcohol or other drugs Repeated spousal abuse in the child's presence Routinely does not follow up on recommendations made concerning the child Fails to keep appointments and/or refuses help from school or other resources History of abuse or neglect as a child Failure to provide supervision of child Rarely touches or talks to child

Physical neglect: not providing adequate food/clothing, medical care, supervision, or weather protection (hat or coats). It can also include abandonment.

Educational neglect: failure to provide appropriate schooling or special educational needs, allowing excessive truancies.

Psychological neglect: lack of emotional support and love.

Sexual abuse
Child sexual abuse is a life altering traumatic event, not only for the child, but also for the entire family unit. Questions and complicated feelings abound. It is important to realize your child and family are not alone. CARES and other committed social service agencies are here to help.

Not surprisingly, the effects of sexual abuse on children vary widely. Most children will not discuss the abuse immediately. However, these children may attempt to alert their family and friends through their actions (behaviors) of a problem. Some children hide the abuse and their feelings so well, even their closest loved one will not know something is bothering them.

Why? Children are amazingly sensitive and caring. They may not disclose due to fear of being punished, thinking they have done something wrong, or being scared someone they love will be in trouble. They also may have been threatened. Many perpetrators will make threats to harm the children's parents, pets, favorite toy, or them, if they tell.

The courage of children who do tell is enormous. Often the task of overcoming their fears and the intimidation of the perpetrator causes children to not tell all the details of the abuse at one time. Disclosures of abuse come slowly, in bits and pieces. In some cases, all the details may never be known other than to the perpetrator and the child.

Children who have been sexually abused are not damaged or broken. They are, however, in need of encouragement, support, and treatment. Providing the child with a safe, harmonious family environment, and seeking therapeutic intervention are important factors in a child's victory over sexual abuse.

Signs a Child May Exhibit Recurrent urinary tract/ kidney infections Pain/itching in the anal/genital areas Damaged underclothing Difficulty walking/ sitting Demonstrates unusual sexual knowledge/ behavior Eating disturbances Anxiety/Depression Secretiveness Suicidal behavior Refusal to go to school/delinquency Venereal disease, especially in preteens Pregnancy None

Concerning Things A Child Might Say I have a secret I played the Tickle Game You will get mad at me if I tell you An adult gave me this toy for doing... Statements that their bodies are dirty or damaged, or fear that there is something wrong with them in the genital area

Signs a Perpetrator May Exhibit Unduly protective of the child/jealous of child and friends Severely limits the child's contact with other children, especially of the opposite sex Is secretive and isolated Abuses alcohol/ drugs Encourages exhibitionism Voyeuristic/ seductive to child Exposes child to pornographic pictures Freely talks or boasts about sexual themes with child

Did You Know?

• Children seldom lie about sexual abuse. They are more likely to deny abuse than fabricate it.
• A trusted friend or family member, as opposed to a stranger sexually abuses most children. 85-90% involves a perpetrator known to the child. 35% involve a family member.
• Being that often the perpetrator is someone close to the child, the child may have mixed feelings. The child may love the offender but hate his/her actions.
• In majority of cases, there is no physical evidence abuse occurred. This does not mean the child has lied about the sexual abuse.
• Young children, ages 1-3 may masturbate during bath time or diaper changes. This behavior becomes concerning if scabbing, bruising, excessive redness occurs or if it appears repetitive and compulsive.
• Preschool age children may look at each other for gender differences on the playground. This behavior becomes concerning when a child is touching or asking another child to do inappropriate sexual acts.
• 1 in 4 girls and at least 1 in 6 boys is sexually abused in some way by the age of 18.
• The average offender is involved with over 70 children in his/her "career" of offending.
• Many sexually abused children recant their initial disclosure. This is often due to stress and a desire for all things to "return to normal." This does not mean the child's initial disclosure was untrue.
• 88% of cases of sexual abuse are never disclosed by the child.

Parents can prevent or lessen the chance of sexual abuse by:

1. Tell children "if someone tries to touch your body and do things that make you feel funny, say NO and tell me right away." Inform children to tell an adult and to keep telling until someone makes it stop.
2. Teach children to report to you if any adult asks them to keep a secret.
3. Help your children feel loved and secure. Encourage them. Spend time with them. Make sure they know you love them, even when they do something wrong.
4. Tell children they can rely on you to believe and protect them if they tell you about abuse.
5. Teach your children the proper names of body parts. This knowledge gives children correct language for understanding their bodies, for asking questions, and for telling about abuse.
6. Provide teaching for your child in short, easily understood, and age appropriate sentences. Don't try to teach this information all at one sitting. Keep your own tone and attitude casual. Make sure your teachings are consistent.
7. Set up a family safety plan, which is easy to remember. List for yourself whom to call for advice, information, and help.

Your emotions may run the gamut from denial, anger, helplessness, shock, numbness, repulsion, guilt, self-blame, hurt and betrayal, to even concerns about money. The most important thing to remember is you and your support are the most important factors affecting your child's recovery. Here are some key steps to take:

• Provide safety, love and support. Make sure your child understands it is not his/ her fault. Don't coach or pressure your child to talk.
• Keep calm. It is important to remember you are not angry with your child, but at what happened. Children can mistakenly interpret anger or disgust as directed towards them.
• Return to a normal routine as soon as possible.
• See that your child receives therapy as soon as possible.
• Find help for yourself. Connect with an advocate or counselor who specializes in recovery.
• Keep your child away from the person suspected of the abuse.
• If the child tells you of sexual abuse immediately after it occurred, do not bathe the child, or wash or change his or her clothes. You may destroy valuable evidence. Call the authorities.
• Remember to give attention to your other children.
• Don't ask why they didn't say "no" or tell sooner, this can increase their guilt.
• Don't urge the child to forget.
• Don't let your child believe the misery or pain in the family is because she/he told about what is happening.

Emotional maltreatment
An act or the failure to act by parents or caregivers, which causes or could cause serious behavioral, cognitive, emotional, or mental disorders. Any act which causes harm to a child's ability to think, reason, or have feelings.

Signs The Child May Exhibit Is either inappropriately adult or inappropriately infantile Behavior extremes-aggressive or withdrawn Depression Sleep disturbances Eating disturbances Is always watchful as if preparing for something bad to happen Failure to grow and reach developmental milestones Poor self-esteem Destructive behavior Child rocks, sucks, bites self Overly demanding Is delayed in physical or emotional development Has attempted suicide Reports a lack of attachment to the parent

Signs The Parent May Exhibit Constantly blames, belittles, or berates the child Is unconcerned about the child Overtly rejects the child Tolerates repeated exposure to violence Withholds affection Shows preferential treatment when there is more than one child in the family Indifferent to child's problems or welfare Refuses to consider offers of help for the child's problems