Physical Abuse

Physical Abuse: Definition, Indicators and Professional Response

Physical abuse is the deliberate infliction of physical harm on a child. It may involve a single incident or a pattern of behaviour that causes injury, pain, suffering or impairment.

Physical abuse can occur within families, institutions, peer groups, communities and online environments. It may be perpetrated by parents, carers, family members, other children, professionals, or individuals in positions of trust.

Children experiencing physical abuse may not disclose what is happening and concerns often emerge through injuries, behavioural changes, professional observations, or information shared by others.

This guidance should be read alongside:

What is Physical Abuse?

What is Physical Abuse?

Physical abuse may involve:

  • Hitting
  • Slapping
  • Punching
  • Kicking
  • Shaking
  • Throwing
  • Burning or scalding
  • Biting
  • Poisoning
  • Strangulation or suffocation
  • Drowning
  • Inappropriate restraint
  • Deliberately inducing illness or injury

Physical abuse may result in visible injuries, hidden injuries or serious long-term physical and emotional harm.

Children of any age may be affected, including babies and infants.

Why Physical Abuse Matters

Why Physical Abuse Matters

Physical abuse can have immediate and long-term consequences, including:

Physical Impact

  • Bruising
  • Fractures
  • Burns
  • Internal injuries
  • Brain injuries
  • Disability
  • Death

Emotional and Psychological Impact

  • Trauma
  • Anxiety
  • Hypervigilance
  • Poor emotional wellbeing
  • Attachment difficulties
  • Mental health difficulties

Developmental Impact

  • Delayed development
  • Difficulties in education
  • Social and behavioural difficulties
  • Long-term health consequences

The impact of physical abuse extends beyond visible injuries and may continue throughout a child’s life.

How Might Physical Abuse Present?

Children experiencing physical abuse may present in different ways.

Professionals should consider:

Injuries

  • Frequent injuries
  • Unexplained injuries
  • Injuries inconsistent with explanations provided
  • Delayed medical treatment
  • Multiple injuries
  • Recurring emergency department attendance

Behaviour

  • Fearfulness
  • Aggression
  • Withdrawal
  • Anxiety
  • Hypervigilance
  • Flinching when approached
  • Reluctance to go home

Relationships

  • Fear of particular individuals
  • Controlling caregiver behaviour
  • Inconsistent explanations from family members
  • Child appearing fearful during interactions with carers

No single sign confirms physical abuse. Concerns should be considered alongside the wider context, history and presentation of the child.

Signs and Indicators

Physical Indicators

Professionals should consider:

  • Unexplained injuries.
  • Injuries that do not match the explanation provided.
  • Injuries at different stages of healing.
  • Bruising in unusual locations.
  • Patterned injuries.
  • Bite marks.
  • Burns or scalds.
  • Fractures.
  • Head injuries.
  • Facial injuries.
  • Marks from restraints.
  • Signs of poisoning.

Concerning Bruising Locations

Bruising is particularly concerning when found on:

  • Ears
  • Neck
  • Face
  • Cheeks
  • Torso
  • Genital area
  • Buttocks

Particular concern should be given to bruising in very young children and infants.

Behavioural Indicators

A child may:

  • Become withdrawn or isolated.
  • Display aggressive behaviour.
  • Become anxious or fearful.
  • Appear hyper-alert.
  • Show fear of physical contact.
  • Wear inappropriate clothing to conceal injuries.
  • Demonstrate developmental regression.
  • Show changes in school attendance.
  • Self-harm.

Family and Environmental Indicators

Professionals should also consider:

  • Explanations that change over time.
  • Delay in seeking medical treatment.
  • Frequent injuries within the household.
  • Parental minimisation of injuries.
  • Concerns previously raised by professionals.
  • Domestic abuse within the home.
  • Substance misuse.
  • Poor engagement with services.

Bruising in Non-Mobile Babies

Why This Requires Immediate Action

Any bruising or unexplained mark in a child who is not independently mobile is unusual and requires immediate safeguarding consideration.

National reviews consistently identify bruising in non-mobile babies as a significant indicator of potential physical abuse.

Professionals should never assume bruising is accidental in a non-mobile infant.

What Should Professionals Do?

Where bruising or unexplained marks are identified in a non-mobile child:

  • Refer immediately to Children’s Social Care.
  • Ensure urgent medical assessment takes place.
  • Follow regional safeguarding procedures.
  • Record observations accurately.
  • Do not delay action whilst seeking further information.

Regional guidance can be accessed through:

Questions for Professional Curiosity

When physical abuse is suspected, practitioners should consider:

  • How did the injury occur?
  • Is the explanation consistent with the injury?
  • Is the explanation consistent between family members?
  • Is the explanation consistent with the child’s developmental stage?
  • Have there been previous injuries or concerns?
  • Are there patterns emerging over time?
  • Are siblings or other children also at risk?
  • What is the child’s lived experience?
  • What does the child say happened?
  • What information is held by other agencies?

Practice Considerations

See the Child

Wherever possible:

  • See the child.
  • Speak to the child.
  • Observe interactions between the child and carers.
  • Consider the child’s presentation and demeanour.

Consider the Child’s Lived Experience

Physical injuries should not be viewed in isolation.

Professionals should consider:

  • Daily care arrangements.
  • Home environment.
  • Family functioning.
  • Wider safeguarding concerns.
  • Previous agency involvement.

Avoid Investigating

Professionals should:

  • Clarify concerns where necessary.
  • Seek relevant information.
  • Make appropriate referrals.

Professionals should not:

  • Conduct investigations.
  • Ask leading questions.
  • Attempt to determine criminal responsibility.

These responsibilities sit with Children’s Social Care and Police.

What Should Professionals Do?

Immediate Risk or Serious Injury

If a child is in immediate danger, has sustained serious injuries, or requires urgent medical treatment:

Take Immediate Action

  • Call 999
  • Request emergency medical assistance and/or police attendance.
  • Inform Children’s Social Care as soon as possible.
  • Preserve evidence where appropriate.
  • Prioritise the child’s safety.

Non-Emergency Concerns

If physical abuse is suspected but there is no immediate danger:

Refer to Children’s Social Care

Children and Families Social Care (MASH)

Telephone: 0191 424 5010

Monday to Thursday: 8.30am to 5.00pm

Friday: 8.30am to 4.30pm

Out of Hours Emergency Duty Team

Telephone: 0191 456 2093

Referral Routes

Recording Physical Abuse Concerns

Accurate recording is essential.

Professionals should record:

  • Date and time.
  • Exact observations.
  • Location of injuries.
  • Size, shape and colour of injuries.
  • Who was present.
  • Child’s explanation.
  • Parent or carer explanation.
  • Child’s demeanour.
  • Actions taken.
  • Any referrals made.

Where organisational procedures permit, body maps should be completed.

Records should be factual and contemporaneous.

Information Sharing

Information should be shared promptly where there are concerns about physical abuse.

Relevant information may include:

  • Details of injuries.
  • Observations.
  • Child’s account.
  • Family explanations.
  • Historical concerns.
  • Relevant health information.
  • Previous safeguarding involvement.

Information should be shared in accordance with:

Local Guidance and Resources

South Tyneside

Regional

Professionals should refer to regional procedures relating to:

  • Physical Abuse
  • Bruising in Non-Mobile Babies
  • Child Protection
  • Information Sharing
  • Children in Need

National Resources

Key Practice Message

Physical abuse is not always obvious. Injuries should never be considered in isolation and practitioners should remain professionally curious when explanations do not fit the evidence. If you are concerned about a child, act on those concerns promptly, share information appropriately, and seek advice without delay.

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