Observable signs of trauma that may indicate violence

Children and young people will respond to experiences of family violence in different ways and some will not show any outward signs, and may perform equal to, or better than their peers. However, there is a range of observable signs of trauma that may indicate family violence identified through evidence and research. The tables below provide some of the observable signs of trauma which may indicate a child or young person is experiencing family violence or other health and wellbeing issues. Table 1: General observable signs of trauma that may indicate family violence is occurring for children or young people

Signs of family violence or trauma can manifest as either physical, emotional or behavioural and can include: • being very passive and compliant • internal injuries • showing wariness or distrust of adults • wearing long-sleeved clothes on hot days in an • demonstrating fear of particular people and attempt to hide bruising or other injury places • being excessively friendly to strangers • poor sleep patterns and emotional dis- • being excessively clingy to certain adults regulation • a strong desire to please or receive validation • becoming fearful when other children cry or from certain adults shout • excessive washing or bathing • developmental regression (i.e. reverting to bed- • unclear boundaries and understanding of wetting) relationships between adults and children • bruises, burns, sprains, dislocations, bites, cuts • excessive sexualised behaviour/advanced • fractured bones, especially in an sexual knowledge where a fracture is unlikely to have occurred • violence or sexualised behaviour to other accidentally children. • poisoning

Table 2: Observable signs of trauma that may indicate family violence for babies and toddlers: a baby (under 18 months) • excessive • extreme wariness of new people • excessive passivity • no verbal ‘’ (such as imitating sounds) • underweight for age • frequent illness • significant sleep and/or feeding difficulties • anxiety, overly clingy to primary caregiver. • reactions to loud voices or noises a toddler • as for baby (under 18 months), and: • poor • excessive irritability • delayed mobility • excessive compliance • blood in nappy, underwear. Table 3: Age-related signs of trauma that may indicate family violence for children and young people: a pre-schooler • extreme clinginess • displaying maladaptive behaviour such as • significant sleep and/or eating difficulties frequent rocking, sucking and biting • poor concentration in play • aggression towards others • inability to empathise with other people • adjustment problems (e.g. significant difficulties moving from kindergarten to school) • frequent illness • anti-social play or lack of interest in engaging • poor language development and/or significant with others. use of ‘baby talk’ a primary school-aged child • rebelliousness, defiant behaviour • excessive washing • limited tolerance and poor impulse control • frequent illness • temper tantrums or irritability, being aggressive • complaining of headaches or stomach pains or demanding • self-harm • physical abuse or cruelty to others, including • displaying maladaptive behaviour pets • displaying aggressive behaviour • avoidance of conflict • displaying sexual behaviour or knowledge • showing low self-esteem unusual for the child’s age • extremely compliant behaviour, being passive, • telling someone sexual abuse has occurred tearful or withdrawn • complaining of pain going to the toilet • excessively oppositional or argumentative behaviour • enacting sexual behaviour with other children • risk-taking behaviours that have severe or life- • excessive masturbation threatening consequences • being frequently hungry • lack of interest in social activities • being poorly nourished • delayed or poor language skills • stealing food • experiencing problems with schoolwork • having poor hygiene • poor social competence (few or no friends, not • wearing inappropriate clothing (e.g. wearing getting on well with peers, difficulties relating to summer clothes in winter) adults) • staying at school outside school hours • acting like a much younger child • being unsupervised for long periods • poor school performance • not having their medical needs attended to • often being tired and/or falling asleep in class • being abandoned by their . • poor coping skills • sleep issues • bed wetting an adolescent • as for primary school aged children, and also: • suicidal ideation • school refusal/avoidance (absenteeism/ • risk-taking behaviours disengagement) • anxiety • criminal or antisocial behaviours, including • pregnancy using violence against others • controlling or manipulative behaviour • eating disorders • obsessive behaviour • substance abuse • homelessness or frequent changes in housing • depression arrangements.

Table 4: Signs of trauma that may indicate family violence is occurring for adults

Form Signs of trauma that may indicate family violence is occurring for adult victims Physical • bruising • complications during pregnancy • fractures • gastrointestinal disorders • chronic pain (neck, back) • sexually transmitted diseases • fresh scars or minor cuts • strangulation. • terminations of pregnancy Psychological • depression • sleep problems • anxiety • impaired concentration • self-harming behaviour • harmful alcohol use • eating disorders • legal and illegal drug use • phobias • physical exhaustion • somatic disorders • suicide attempts. Emotional • fear • feelings of worthlessness and • shame hopelessness • anger • feeling disassociated and emotionally numb. • no support networks Social/financial • homelessness • no friends or family support • unemployment • isolation • financial debt • difficulties. Demeanour • unconvincing explanations of any • be accompanied by their partner, injuries who does most of the talking • describe a partner as controlling or • needing to be back home by a certain prone to anger time and becoming stressed about • anxiety in the presence of a partner this • recent separation or divorce • reluctance to follow advice.