Hesperian Health Guides

How can I know if my child has been abused?

In this chapter:

When young children are abused, they may be afraid to tell you. Often the abuser warns the child not to say anything. Sometimes the child fears he did something wrong. Or he may not know how to communicate what happened.

Since children do not always communicate about abuse, you need to watch for possible signs. The following signs are not always the result of abuse, but they should always cause concern, especially if a child shows several of the signs.

Some physical signs include:

  • unexplained pain, swelling, redness or bleeding of the mouth, the genitals or around the anus area.
  • torn or bloody underwear.
  • difficulty passing urine or stool, or blood in the urine or stool.
  • unusual discharge from the vagina, penis or anus, or a sexually transmitted infection (STI).
  • bruises, headaches, or belly aches.


Sexually abused children may:

  • stop bathing, or wash themselves more than usual, or refuse to get undressed.
  • play sexually with other children or with toys, in a more knowing way or more often than you would expect for their age.
  • know more about sex than other children their age.


Child victims of violence, including sexual abuse, may:

  • seem very fearful, sensitive and watchful, or suddenly become afraid of certain people or places, or want to be only with their parents.
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  • be secretive or want to be alone most of the time.
  • start acting in a younger, more baby-like way.
  • become more violent and aggressive.
  • try to run away from home.
  • feel sad most of the time, or show no feelings at all.
  • have difficulty sleeping because of bad dreams, fears of the dark, and bed-wetting.
  • be afraid of touch or physical activities.

If you suspect abuse

Try to stay calm. Encourage your child to show you what has happened or what she knows.

To get more information, set up play situations with your child. Pay careful attention to what he shows you because he may not have enough words or signs to explain himself clearly. With your voice and your expressions, make sure your child knows you believe him and will not punish him.