| Injuries that are unlikely to be accidents, such as bruises on both sides of the face or body; burns with a clear line between burned and unburned skin |
| Repeated injuries, especially broken bones not properly tended (visible on X-ray) |
| Fantasy play, with dominant themes of violence or sex |
| Slow physical growth |
| Unusual appetite or lack of appetite |
| Ongoing physical complaints, such as stomachaches, 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 change of address |
| Frequent change in caregivers |
| Child seems fearful, not joyful, on seeing caregiver |