Indicators and signs

Abuse, neglect and exploitation can take many forms. Being aware of common indicators may improve your ability to recognise and respond to them. Although no single behaviour is an absolute indicator of abuse, neglect and exploitation, some examples are included below.

Physical abuse

Physical indicators:

• unexplained cuts, abrasions, bruising or swelling
• unexplained burns or scalds, cigarette burns
• rope burns or marks on arms, legs, neck, torso
• unexplained fractures, strains or sprains; dislocation of limbs
• bite marks
• dental injuries
• ear or eye injuries.

Behavioural signs:

• avoidance of particular staff, fear of a particular person
• sleep disturbances
• changes in behaviour (e.g. unusual mood swings, uncharacteristic aggression)
• changes in daily routine, changes in appetite
• unusual passivity, withdrawal
• self-harm, suicide attempts
• inappropriate explanations of how injuries occurred
• excessive compliance to staff.

Sexual abuse

Physical indicators:

• direct or indirect disclosure of abuse or assault
• trauma to the breasts, buttocks, lower abdomen or thighs
• difficulty walking or sitting
• pain or itching in genital and/or anal area; bruising, bleeding or discharge
• self-harm, abuse, suicide attempts
• torn, stained or blood-stained underwear or bedclothes
• sexually transmitted diseases, pregnancy
• unexplained money or gifts.

Behavioural signs:

• sleep disturbances
• changes in eating patterns
• inappropriate or unusual sexual behaviour or knowledge
• changes in social patterns
• sudden or marked changes in behaviour or temperament
• anxiety attacks, panic attacks, clinical depression
• refusal to attend usual places (e.g. work, school, respite)
• going to bed fully clothed
• excessive compliance to staff.

Psychological/emotional abuse

Physical indicators:

• speech disorders
• in the case of a child, lags in physical development, failure to thrive
• injuries sustained from self-harm or abuse
• suicide attempts
• anxiety attacks.

Behavioural signs:

• self-harm or self-abusive behaviours
• challenging/extreme behaviours
• excessive compliance to staff
• very low self-esteem, feelings of worthlessness
• clinical depression
• marked decrease in interpersonal skills
• extreme attention-seeking behaviour.

Chemical abuse

Physical indicators:

• withholding of prescribed medication
• abuse of prescribing rights by staff/over-administration of medication.

Behavioural signs:

• persistent over-activity
• unusual levels of confusion/disorientation.

Financial abuse

Physical indicators:

• no access to, or unwarranted restrictions on, personal funds or bank accounts
• no records, or incomplete records kept of expenditure and purchases
• no inventory kept of significant purchases
• person controlling the finances does not have legal authority
• misappropriation of money, valuables or property
• forced changes to a person's will
• persistent failure to produce receipts
• receipts indicating unusual or inappropriate purchases.

Behavioural signs:

• person has insufficient money to meet normal expenses
• person is persistently denied outings and activities due to a lack of funds.

Denial of access to legal system/remedies

Physical indicator:

• consistent denial of telephone or Internet access.

Behavioural signs:

• person does not seek privacy to undertake activities normally undertaken in private
• person indicates they have no-one to speak to about things they are unhappy about.

Systemic abuse

Physical indicators:

• no program or inadequate/inappropriate program developed for client
• not endeavouring to use staff of the same gender to perform personal duties for clients
• providing staff with insufficient training on duty of care and policies and practices related to preventing abuse.

Behavioural signs:

• person is persistently provided support that does not meet the requirements of their service package
• person refuses part of their service support due to feeling uncomfortable with particular staff members.

Neglect

Physical indicators:

• physical wasting, unhealthy weight levels
• poor dental health
• food from meals left on face and/or clothes throughout the day
• dirty, unwashed body and/or face, body odour
• person always wearing the same clothes
• ill-fitting and/or unwashed clothes
• person is always over- or underdressed for the weather conditions
• food is consistently poor quality, insufficient, inedible and/or unappetising.

Behavioural signs:

• constant tiredness
• persistent hunger
• unexpectedly poor social/interpersonal skills
• signs of loss of communication and other skills
• staff member, service provider, carer or support person consistently fails to bring the person to appointments, events, activities
• person is persistently denied opportunities to socialise with others in the community.