4.3 Outline the possible signs, symptoms, indicators and behaviours that may cause concern in the context of safeguarding

This guide will help you answer 4.3 Outline the possible signs, symptoms, indicators and behaviours that may cause concern in the context of safeguarding.

When you work with children and young people, it is important to recognise early signs that they may be at risk. These signs can be physical, emotional, behavioural or related to their environment. Safeguarding is about protecting children from harm, abuse, neglect and exploitation. Knowing what to look for helps you act quickly and appropriately.

Signs, symptoms, indicators and behaviours may differ depending on the type of abuse or neglect. They can also vary between children depending on their age, development and personal circumstances. Recognising them early can prevent harm from escalating. Some changes will be obvious, others will be more subtle. Your role is to stay alert, notice what is unusual for that child, and share your concerns according to your setting’s safeguarding procedures.

Physical Abuse

Physical abuse is when someone causes deliberate physical harm to a child. This could include hitting, shaking, burning, poisoning or causing injury in other ways. Some injuries may be explained by accidents, but repeated or unusual injuries should raise concern.

Possible signs include:

• Bruises in unusual places such as the back, abdomen, ears or neck
• Bruises in the shape of an object, such as a belt or handprint
• Burns or scalds, especially with clear outlines or patterns
• Bite marks that are human in origin
• Fractures or broken bones with inconsistent explanations
• Frequent injuries with vague or changing explanations
• Wearing long sleeves or clothing inappropriate for the weather to hide injuries

Children may also show changes in behaviour. They may flinch when touched, appear wary of physical contact, or become aggressive or withdrawn. A child who avoids going home or expresses fear of certain adults could be experiencing physical harm.

Emotional Abuse

Emotional abuse happens when a child is made to feel worthless, unloved or inadequate. It can involve constant criticism, threats, rejection, or unreasonable demands. Over time, this can affect a child’s emotional health and development.

Indicators may include:

• Low self-esteem or extreme lack of confidence
• Overly anxious, fearful or withdrawn behaviour
• Difficulty making and keeping friendships
• Developmental delays without a clear medical cause
• Avoidance of eye contact or looking constantly at the floor
• Excessive need for approval and reassurance
• Sudden changes in speech, such as stammering
• Self-harm behaviour, such as scratching or cutting

A child facing emotional abuse might seem much older or younger than their age in how they speak and act. They may not want to talk about home life, or they could seem desperate to please adults at all costs.

Sexual Abuse

Sexual abuse involves forcing or persuading a child to take part in sexual activities. This can include both physical contact and non-contact activities such as showing sexual images, encouraging sexual behaviour, or making inappropriate comments.

Signs may be:

• Difficulty walking or sitting
• Pain, itching or bruising in genital or anal areas
• Sexually transmitted infections or unexplained pregnancy
• Knowledge of sexual behaviour that is not appropriate for their age
• Sexual drawings, language or play that are explicit
• Sudden changes in behaviour, such as aggression, withdrawal, or anxiety
• Avoidance of certain people or places without explanation
• Problems with sleep, including nightmares or night terrors

Sexual abuse can cause deep fear and shame. A child may avoid talking about what happened or may give indirect hints. They might show strong emotional reactions when certain topics are mentioned. Being observant of both physical and behavioural signs is important.

Neglect

Neglect is when a child’s basic needs for food, shelter, clothing, medical care, education or supervision are not met. This can cause serious harm to their health and development. It can be long-term or happen in specific periods.

Possible indicators:

• Consistently dirty clothing or poor hygiene
• Unwashed hair, skin rashes or untreated medical problems
• Being underweight or constantly hungry, stealing or hoarding food
• Clothing unsuitable for the weather
• Frequent absences from school without explanation
• Tiredness or falling asleep in class regularly
• Living in unsafe or unsanitary home conditions
• Lack of supervision, often left alone or cared for by other children

Neglected children may seem withdrawn, have poor social skills or appear uninterested in learning. They might not trust adults to meet their needs and may rely on themselves more than is normal for their age.

Child Sexual Exploitation (CSE)

CSE is a form of sexual abuse where a child is manipulated, deceived or coerced into sexual activities, often in exchange for gifts, money or attention. Exploitation may happen in person or online.

Warning signs:

• Having unexplained gifts, money, expensive clothing or items
• Secretive behaviour around phone or internet use
• Older friendships or relationships with adults
• Staying out late, going missing from home or school
• Sudden changes in appearance or clothing style
• Withdrawn or anxious behaviour, avoiding former friends
• Reluctance to explain where they have been

Children involved in CSE may believe they are in a genuine relationship, making it harder for them to recognise abuse. They may feel loyalty or fear towards the abuser.

Child Criminal Exploitation (CCE) and County Lines

CCE involves using a child to commit crimes, often related to drugs, theft or violence. County lines refers to gangs exploiting children to transport and sell drugs across different areas.

Possible indicators:

• Being found in areas far from home with no reasonable explanation
• Carrying large amounts of cash, drugs or multiple mobile phones
• Missing school for long periods
• Association with older individuals involved in crime
• Unexplained injuries or possessions
• Involvement in fights or carrying weapons
• Sudden drop in school performance

Children may not see themselves as victims in these cases. They can be threatened or manipulated into compliance.

Domestic Abuse Exposure

Children who witness domestic abuse between adults at home can be affected emotionally and physically. Even if they are not directly hurt, they may suffer long-term harm.

Warning signs:

• Aggressive behaviour towards others
• Extreme anxiety or fearfulness
• Depression or withdrawal from activities
• School attendance and performance problems
• Protective behaviour towards one parent
• Regressive behaviours such as bedwetting

Living in a violent household can lead to emotional trauma, poor mental health and difficulties in forming healthy relationships.

Fabricated or Induced Illness (FII)

FII occurs when a parent or carer deliberately causes or invents a child’s illness. This is a serious safeguarding concern.

Indicators may include:

• Frequent medical visits without clear diagnosis
• Symptoms only witnessed by the parent or carer
• Treatments that do not match the child’s stated condition
• The child appearing healthier away from the parent
• Excessive concern about minor health issues by the carer

Being alert to inconsistencies in medical records and what you see in person is important.

Behavioural Changes

Across many forms of abuse or neglect, behaviour is often the first noticeable change.

Possible concerning behaviours:

• Sudden mood swings or emotional outbursts
• Withdrawal from friends and activities they once enjoyed
• Fear of certain people or places without reason
• Reluctance to go home
• Repeated absences or lateness to school
• Regression in skills such as speech or toileting
• Self-harm behaviours or talk of self-harm

A child’s behaviour must be considered alongside other signs. One symptom alone may not suggest harm, but patterns often point to risk.

Environmental Indicators

Sometimes the surroundings can raise safeguarding concerns before any direct signs appear in the child.

Examples include:

• Home in poor condition with hazards such as broken fixtures or exposed wiring
• Lack of safe places to sleep or inadequate bedding
• Evidence of drug or alcohol misuse in the home
• Presence of violence or intimidation between household members
• Lack of basic facilities such as heating or water

Being aware of these can help you make a fuller picture of risk.

Recognising Patterns

Children may show more than one of the signs mentioned across different categories. Repeated observations build up a clearer understanding of what may be happening. It is important to keep written records and share them with the designated safeguarding lead in your school or workplace. Do not assume someone else has noticed or reported the same signs.

When recording, write exactly what you see or hear. Avoid adding your own assumptions. State dates, times, direct quotes from the child, and specific descriptions of injuries or behaviour.

Taking Action

Spotting a possible sign of harm means you must act according to safeguarding policy. You may be the first person to notice a concern. Passing that concern on can protect the child.

Your action steps are usually:

• Record what you saw or heard
• Report promptly to the designated safeguarding lead
• Do not confront the suspected abuser yourself
• Do not promise secrecy to the child, but explain you need to share information to keep them safe

Sometimes signs may turn out to have an innocent explanation, but it is never wrong to raise a concern.

Final Thoughts

Recognising possible signs, symptoms, indicators and behaviours linked to safeguarding is part of your duty to protect children. You do not need to diagnose abuse or confirm it happened. Your role is to notice changes, keep an open mind and report through the correct channels.

By staying alert to both obvious and subtle signs, you help to create a safety net for each child in your care. Consistent observation, good record keeping and following safeguarding procedures give children a better chance of receiving help at the right time. Safeguarding is about acting before harm becomes worse, and every concern you share could make a difference to a child’s life.