Physical abuse means deliberately hurting a child or young person. It includes:
In severe cases, some of the behaviours by a carer that may result in harm include:
Bruises suspect child maltreatment if:
a child or young person has bruising in the shape of a hand, ligature, stick, teeth mark, grip or implement.
there is bruising or petechiae (tiny red or purple spots) that are not caused by a medical condition (for example, a causative coagulation disorder) and if the explanation for the bruising is unsuitable, for example, on immobile child.
Bites, lacerations (cuts), abrasions and scars suspect child maltreatment if:
there is a report or appearance of a human bite mark that is thought unlikely to have been caused by a young child.
child has lacerations, abrasions or scars and the explanation is unsuitable. Such as on areas usually protected by clothing (for example, back, chest, abdomen, axilla, genital area)
Thermal and cold injuries suspect child maltreatment if:
a child has burn or scald injuries:
Fractures suspect child maltreatment if:
a child has one or more fractures in the absence of a medical condition that predisposes to fragile bones (for example, osteogenesis imperfecta, osteopenia of prematurity) or if the explanation is absent or unsuitable. Presentations include:
Intracranial injuries suspect child maltreatment if:
a child has an intracranial injury in the absence of major confirmed accidental trauma or known medical cause, in one or more of the following circumstances:
Eye trauma suspect child maltreatment if:
a child has retinal haemorrhages or injury to the eye in the absence of major confirmed accidental trauma or a known medical explanation, including birth related causes.
Spinal, visceral, oral and general injuries suspect physical abuse if:
a child presents with signs of a spinal injury (injury to vertebrae or within the spinal canal) in the absence of major confirmed accidental trauma. Spinal injury may present as:
a child has an intra-abdominal or intrathoracic injury in the absence of major confirmed accidental trauma and there is an absent or unsuitable explanation, or a delay in presentation. There may be no external bruising or other injury.
a child has an oral injury and the explanation is absent or unsuitable.
if there is no suitable explanation* for a serious or unusual injury.
Further information:
NSPCC and Cardiff University Department of Child Health. (2012a). Core Info: Bruises on Children. (Accessed 29/7/2019).
NSPCC and Cardiff University Department of Child Health. (2012b). Core Info: Fractures in Children. (Accessed 29/7/2019)
NSPCC and Cardiff University Department of Child Health. (2012d). Core Info: Oral Injuries and Bites on Children.* (Accessed 29/7/2019)
NSPCC and Cardiff University Department of Child Health. (2012e). Core Info: Thermal Injuries on Children. (Accessed 29/7/2019)
NSPCC and Cardiff University Department of Child Health. (2014a). Core Info: Head and Spinal Injuries in Children. (Accessed 29/7/2019)
Fabricated and Induced Illness a practical guide for paediatricians (Accessed 29/7/2019)
Welsh Assembly Government. Safeguarding Children in whom Illness is Fabricated or Induced – Supplementary guidance to Safeguarding Children: Working Together Under the Children Act 2004. 2008.