Signs of Child Physical Abuse

Physical abuse is when someone deliberately causes a child physical harm. In a pharmacy this often becomes apparent through an injury, visible pain, limited movement, or an explanation that does not match what you see.

You are not expected to diagnose the injury or determine exactly how it happened.

A child may come into the pharmacy with bruising, soreness, or limited movement, but physical abuse is not always obvious. Often the strongest sign is a mismatch between the child’s appearance and the accompanying explanation. The child may flinch when an adult moves suddenly, pull away from touch, seem unusually watchful, or look frightened about leaving with the person accompanying them. Sometimes concern comes from the adult’s account because the story changes, feels implausible, or does not fit the child’s age and development.

What You Might Notice

Physical abuse often raises concern because several details do not fit together. For example, a child may have a visible injury, appear to be in pain, and be silent while a parent answers every question. No single detail proves abuse, but the overall picture can feel wrong.

• Unexplained injuries or repeated accounts of accidents.
• An account that changes, feels vague, or does not match the presentation.
• A child who appears fearful, guarded, reluctant to move, or in pain.
• An adult who seems aggressive, dismissive, or overly controlling.

If an injury or explanation does not feel right, it is safer to record and share the concern than to dismiss it.

What Level 2 Practice Looks Like

Context matters. A single bruise on its own may mean little, but repeated injuries, frequent emergency supplies, or a pattern of distress around one adult can indicate greater risk. You might also notice a child trying not to upset the adult or looking to them before answering simple questions.

You do not need proof before acting. If you are concerned, make a factual note of what you saw, what was said, and who was present. Then follow the pharmacy's safeguarding process promptly. Early action matters because physical abuse can escalate, and the brief moment when you notice something may be crucial.