Child abuse, also known as maltreatment, is common. It is important to understand and reduce the risks of abuse for your child and be familiar with the signs of abuse and neglect. About 4 million cases of child abuse and neglect involving almost 7 million children are reported each year. The highest rate of child abuse is in babies less than one year of age, and 25 percent of victims are younger than age three. The majority of cases reported to Child Protective Services involve neglect, followed by physical and sexual abuse. There is a lot of overlap among children who are abused, with many suffering a combination of physical abuse, sexual abuse, and/or neglect. Types of abuse and neglect Physical abuse occurs when a child's body is injured as a result of hitting, kicking, shaking, burning or other show of force. One study suggests that about 1 in 20 children has been physically abused in their lifetime. Signs and symptoms It is not always easy to recognize when a child has been abused. Children who have been maltreated are often afraid to tell anyone, because they think they will be blamed or that no one will believe them. Sometimes they remain quiet because the person who abused them is someone they love very much, or because of fear, or both. Parents also tend to overlook signs and symptoms of abuse, because it is hard to believe it could happen or they fear what might happen if people found out. However, a child who has been abused needs special support and treatment as early as possible. The longer children continue to be abused or are left to deal with the situation on their own, the harder it is for them to be able to heal and develop optimally physically and mentally. Here are some physical signs and behavioral changes in children who may have experienced abuse or neglect: Physical signs Non-mobile infant with any injury Bruises to the torso, ears, or neck in a child less than four years of age Any injury (bruise, burn, fracture, abdominal or head injury) that is not consistent with the way the injury is said to have happened, that cannot be adequately explained, or that is inconsistent with the child's developmental capabilities The child discloses abuse or neglect Failure to gain weight (especially in infants) or sudden dramatic weight gain Genital pain, bleeding, or discharge A sexually transmitted disease - @dr.tommymartin