| Injuries that do not fit an “accidental” explanation, such as bruises on both sides of the face or body; burns with a clear line between burned and unburned skin; “falls” that result in cuts, not scrapes Repeated injuries, especially broken bones not properly tended (visible on X-ray) Fantasy play, with dominant themes of violence or sexual knowledge Slow physical growth, especially with unusual appetite or lack of appetite Ongoing physical complaints, such as stomach aches, headaches, genital pain, sleepiness Reluctance to talk, to play, or to move, especially if development is slow No close friendships; hostility toward others; bullying of smaller children Hypervigilance, with quick, impulsive reactions, such as cringing, startling, or hitting Frequent absence from school Frequent changes of address Turnover in caregivers who pick up child, or caregiver who comes late, seems high Expressions of fear rather than joy on seeing the caregiver |