A child who's being abused may feel guilty, ashamed or confused. The child may be afraid to tell anyone about the abuse, especially if the abuser is a parent, other relative or family friend. That's why it's vital to watch for red flags, such as: 
Withdrawal from friends or usual activities
Changes in behavior — such as aggression, anger, hostility or hyperactivity — or changes in school performance
Depression, anxiety or unusual fears, or a sudden loss of self-confidence
Sleep problems and nightmares 
An apparent lack of supervision
Frequent absences from school
Rebellious or defiant behavior
Self-harm or attempts at suicide
 Specific signs and symptoms depend on the type of abuse and can vary. Keep in mind that warning signs are just that — warning signs. The presence of warning signs doesn't necessarily mean that a child is being abused. Physical abuse signs and symptoms 
Unexplained injuries, such as bruises, broken bones (fractures) or burns
Injuries that don't match the given explanation
Injuries that aren't compatible with the child's developmental ability
 Sexual abuse signs and symptoms 
Sexual behavior or knowledge that's inappropriate for the child's age
Pregnancy or a sexually transmitted infection
Genital or anal pain, bleeding, or injury
Statements by the child that he or she was sexually abused
Inappropriate sexual behavior with other children
 Emotional abuse signs and symptoms 
Delayed or inappropriate emotional development
Loss of self-confidence or self-esteem
Social withdrawal or a loss of interest or enthusiasm
Depression
Avoidance of certain situations, such as refusing to go to school or ride the bus
Appears to desperately seek affection
A decrease in school performance or loss of interest in school
Loss of previously acquired developmental skills
 Neglect signs and symptoms 
Poor growth
Excessive weight with medical complications that are not being adequately addressed
Poor personal cleanliness
Lack of clothing or supplies to meet physical needs
Hoarding or stealing food
Poor record of school attendance
Lack of appropriate attention for medical, dental or psychological problems or lack of necessary follow-up care
 Parental behavior Sometimes a parent's demeanor or behavior sends red flags about child abuse. Warning signs include a parent who: 
Shows little concern for the child
Appears unable to recognize physical or emotional distress in the child
Blames the child for the problems
Consistently belittles or berates the child, and describes the child with negative terms, such as "worthless" or "evil"
Expects the child to provide attention and care to the parent and seems jealous of other family members getting attention from the child
Uses harsh physical discipline
Demands an inappropriate level of physical or academic performance
Severely limits the child's contact with others
Offers conflicting or unconvincing explanations for a child's injuries or no explanation at all
Repeatedly brings the child for medical evaluations or requests medical tests, such as X-rays and lab tests, for concerns not seen during the health care provider's examination
 Physical punishment Child health experts condemn the use of violence in any form, but some people still use physical punishment, such as spanking, to discipline their children. While parents and caregivers often use physical punishment with the intention of helping their children or making their behavior better, research shows that spanking is linked with worse, not better, behavior. It's also linked to mental health problems, difficult relationships with parents, lower self-esteem and lower academic performance. Any physical punishment may leave emotional scars. Parental behaviors that cause pain, physical injury or emotional trauma — even when done in the name of discipline — could be child abuse.