Building a Culture of Safety

2.2 Child Abuse, Neglect and Maltreatment

Child abuse and neglect deeply impact children’s health, safety, and development. Child care providers spend many hours with children and know them well. Because of this, providers play an important role in recognizing concerns and helping to protect children.

Children may experience harm in many environments, including their homes, child care, or other places where they spend time. Child care providers are in a unique position to notice, protect, report and ensure a safe environment for children. This will include child care activities, field trips, transportation and wherever and whenever the children are in care.

Select each button below to learn the definition and signs and symptoms of each type of abuse or neglect.

Physical abuse

Physical injury of a child that indicates a child’s health or welfare is harmed or at substantial risk of being harmed.

Signs and Symptoms:

Unexplained bruises, burns, bites, fractures, or black eyes
Injuries that do not match the explanation given
Act scared, anxious, depressed, withdrawn or aggressive
Fear of going home or fear of certain adults
Flinching or shrinking away from adult contact
Sudden changes in sleep, eating, or behavior

Sexual abuse

Any unwanted or nonconsensual sexual activity or behavior forced upon someone. This includes actions such as molestation, rape, sexual assault, exposure, exploitation, or coercion.

Signs and Symptoms:

Pain, bruising, or bleeding in the genital area
Difficulty walking or sitting
Sudden changes in behavior or fearfulness
Nightmares, bedwetting, or running away
Sexual knowledge or behavior not typical for their age

Emotional or psychological abuse

This type of abuse can include behaviors like constant criticism, humiliation, threats, rejection, or manipulation. It may also involve isolating children from others, causing fear or anxiety, or making the child feel worthless or unloved.

Signs and Symptoms:

Extreme behavior such as aggression or withdrawal
Developmental regression or unusually immature behavior
Difficulty forming attachments to caregivers
Decline in learning or self-care abilities

Neglect

The failure to give proper care and attention to a child, including supervision, nutrition, medical care, attention, or leaving a child unattended where the child’s health or welfare is harmed or a child is placed in substantial risk of harm.

Signs and Symptoms

Poor hygiene or consistent body odor
Lack of adequate clothing for the weather
Frequent hunger or asking others for food
Untreated medical or dental needs
Reports being left alone or without care

Maltreatment

Any act, or failure to act that results in death, serious physical or emotional harm, or sexual abuse or exploitation, or that present an imminent risk of serious harm.

Signs and Symptoms:

Unexplained injuries or frequent injuries
Poor hygiene, malnutrition, or consistently inappropriate clothing for weather
Sudden changes in behavior or emotional state
Developmental or learning delays that are not being addressed
Excessive fear of caregivers or reluctance to go home

Adapted from the Maryland Department of Human Services, Child Protective Services

A teacher thinks while sitting at the children's cubbies.

Take a look at your program

Child care providers play an important role in noticing when something may not be right. Small changes in behavior or interactions can sometimes signal that a child needs help.

What types of situations or circumstances might cause concern and prompt you to make a report?
How would you approach documenting and reporting concerns if you began to notice a pattern of concerning behaviors?
How would you respond if you observed behavior from an adult that raised concerns about a child’s safety?

Trusting your observations and taking concerns seriously can help protect a child who may need help.