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Child abuse occurs to children of both sexes and all ages, in all cultures, religions, and social classes and to children with and without disabilities. Children may be abused in a family or in an institutional or community setting by those known to them or, more rarely, by others (e.g. via the internet). They may be abused by an adult or adults or another child or children. All employees and agencies, including the voluntary sector, should be alert to signs that a child may suffering or is likely to suffer Significant Harm, which includes consideration of the following points:

• Identification of child abuse may be difficult; it normally requires both medical and social assessment;
• Avoid making assumptions about a situation and ensure a thorough assessment informs  judgement;
• Gather information in relation to an incident, including the explanation provided by the parents/carers; any injuries sustained; medical advice or assistance sought by the family and whether there was any delay in this; inconsistencies in information provided; and responses to the child by the parent or carers;
• Different types of child abuse may be present at the same time, e.g. a child who is being sexually abused may also be being physically abused. When enquiring into one type of abuse staff need to be alert to potential signs of other abuse;
• Always listen carefully to the child - pay particular attention to any spontaneous statement. In the case of children without speech or with limited language, pay attention to their signing or other means of expression, including behaviour and play;
• Any delay in seeking medical assistance or indeed none being sought at all, could be an indicator of abuse;
• Beware if explanation of an accident is vague, lacking detail, is inconsistent with the injury, or varies with each telling;
• Take note of inappropriate responses from parents or carer. Observe the child’s interaction with the parents - particularly wariness, fear or watchfulness;
• Any history or patterns of unexplained injury/illness requires careful scrutiny. The fact that the parent/carer appears to be highly attentive and concerned should not divert attention from the assessment of risk;
• Beware if the child’s injury is inconsistent with the child’s development and mobility;
• Beware if there are indications of or a history of domestic violence and abuse. Violence towards adults may also indicate violence towards children and can in itself be experienced as emotionally abusive;
• Children who are being abused often do not say and tend to perceive themselves as deserving of ill treatment. This is particularly so for children who are being emotionally abused.

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