The correct answer is A. Physical abuse is the intentional use of physical force against a child that results in or has a high likelihood of resulting in harm to the child’s health, survival, development, or dignity. Examples include hitting, kicking, shaking, burning, or poisoning a child¹. Bruises are one of the common signs of physical abuse, especially if they are in different locations and stages of healing².

Choice B Reason: Sexual abuse is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent. Examples include fondling, penetration, exposure to pornography, or prostitution of a child¹. Bruises are not a specific sign of sexual abuse, although they may be present in some cases.

Choice C Reason: Emotional or psychological abuse is the intentional or unintentional acts or omissions that cause or have a high probability of causing harm to a child’s emotional development or self-esteem. Examples include humiliation, threats, isolation, rejection, or belittling a child¹. Bruises are not a sign of emotional abuse, although emotional abuse may co-occur with other types of maltreatment.

Choice D Reason: Neglect is the failure to provide for a child’s basic physical, emotional, educational, or medical needs. Examples include inadequate food, clothing, shelter, supervision, affection, education, or health care for a child¹. Bruises are not a sign of neglect, although neglect may increase the risk of accidental injuries.

Choice A Reason: Sexual abuse can involve non-contact activities such as exposure to pornography¹. This can be harmful to the child's sexual development and self-image.

Choice B Reason: Emotional abuse can be unintentional due to parental stress or mental illness¹. This does not excuse the behavior, but it may explain why some parents act in ways that hurt their children emotionally.

Choice C Reason: Neglect can be classified into physical, emotional, educational, and medical subtypes¹. Each subtype refers to the failure to provide for a specific aspect of the child's needs.

Choice D Reason: Physical abuse can occur even when there is no intention to harm the child³. For example, some parents may use excessive force or discipline methods that are inappropriate for the child's age or condition.

Choice E Reason: All types of maltreatment can have negative effects on the child's development and well-being¹. The effects may vary depending on the type, severity, frequency, duration, and context of the maltreatment.

The correct answer is D. Neglect is the failure to provide for a child’s basic physical, emotional, educational, or medical needs. Examples include inadequate food, clothing, shelter, supervision, affection, education, or health care for a child. Severe malnutrition and dehydration are signs of physical neglect.

Choice A Reason: Physical abuse is the intentional use of physical force against a child that results in or has a high likelihood of resulting in harm to the child’s health, survival, development, or dignity. Examples include hitting, kicking, shaking, burning, or poisoning a child. Severe malnutrition and dehydration are not specific signs of physical abuse, although they may be present in some cases.

Choice B Reason: Sexual abuse is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent. Examples include fondling, penetration, exposure to pornography, or prostitution of a child. Severe malnutrition and dehydration are not signs of sexual abuse, although they may affect the child's sexual health and development.

Choice C Reason: Emotional or psychological abuse is the intentional or unintentional acts or omissions that cause or have a high probability of causing harm to a child’s emotional development or self-esteem. Examples include humiliation, threats, isolation, rejection, or belittling a child. Severe malnutrition and dehydration are not signs of emotional abuse, although they may affect the child's mental health and well-being.

The correct answer is D. All of the above are common indicators of sexual abuse in children.

Choice A Reason: Difficulty walking or sitting may indicate that the child has been subjected to genital trauma or anal penetration.

Choice B Reason: Frequent urinary tract infections may indicate that the child has been exposed to sexually transmitted infections or has poor hygiene due to lack of care or supervision.

Choice C Reason: Changes in behavior or mood may indicate that the child is experiencing fear, anxiety, depression, anger, guilt, shame, or confusion as a result of the sexual abuse.

The correct answer is D. Neglect is the failure to provide for a child’s basic physical, emotional, educational, or medical needs. Examples include inadequate food, clothing, shelter, supervision, affection, education, or health care for a child. Failure to thrive is a condition characterized by poor growth and development due to inadequate nutrition and stimulation. It can be caused by neglect as well as other factors such as organic diseases or genetic disorders. Frequent infections and social withdrawal are also signs of neglect.

Choice A Reason: Physical abuse is the intentional use of physical force against a child that results in or has a high likelihood of resulting in harm to the child’s health, survival, development, or dignity. Examples include hitting, kicking, shaking, burning, or poisoning a child. Failure to thrive is not a specific sign of physical abuse, although it may be present in some cases.

Choice B Reason: Sexual abuse is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent. Examples include fondling, penetration, exposure to pornography, or prostitution of a child. Failure to thrive is not a sign of sexual abuse, although they may affect the child's sexual health and development.

Choice C Reason: Emotional or psychological abuse is the intentional or unintentional acts or omissions that cause or have a high probability of causing harm to a child’s emotional development or self-esteem. Examples include humiliation, threats, isolation, rejection, or belittling a child. Failure to thrive is not a sign of emotional abuse, although it may affect the child's mental health and well-being.

The correct answer is D. Neglect is the failure to provide for a child’s basic physical, emotional, educational, or medical needs. Examples include inadequate food, clothing, shelter, supervision, affection, education, or health care for a child. A cluttered and dirty house, an empty refrigerator, and parental conflict are signs of neglect.

Choice A Reason: Physical abuse is the intentional use of physical force against a child that results in or has a high likelihood of resulting in harm to the child’s health, survival, development, or dignity. Examples include hitting, kicking, shaking, burning, or poisoning a child. A cluttered and dirty house, an empty refrigerator, and parental conflict are not specific signs of physical abuse, although they may increase the risk of accidental injuries.

Choice B Reason: Sexual abuse is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent. Examples include fondling, penetration, exposure to pornography, or prostitution of a child. A cluttered and dirty house, an empty refrigerator, and parental conflict are not signs of sexual abuse, although they may increase the vulnerability of the child to sexual exploitation.

Choice C Reason: Emotional or psychological abuse is the intentional or unintentional acts or omissions that cause or have a high probability of causing harm to a child’s emotional development or self-esteem. Examples include humiliation, threats, isolation, rejection, or belittling a child. A cluttered and dirty house, an empty refrigerator, and parental conflict are signs of emotional abuse, as they may create a stressful and chaotic environment for the child.

Choice A Reason: Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event, such as sexual abuse. Symptoms of PTSD include re-experiencing the trauma through flashbacks, nightmares, or intrusive thoughts; avoiding reminders of the trauma; feeling numb or detached; and having increased arousal, such as being easily startled, irritable, or hypervigilant.

Choice B Reason: Depression is a mood disorder that causes persistent feelings of sadness, hopelessness, and loss of interest in activities that were once enjoyable. Symptoms of depression include low mood, low self-esteem, guilt, worthlessness, fatigue, insomnia or hypersomnia, appetite changes, weight changes, difficulty concentrating, and suicidal thoughts or behaviors.

Choice C Reason: Substance abuse is the harmful use of alcohol, drugs, or other substances that impair one's physical or mental health or social functioning. Substance abuse can be a coping mechanism for some survivors of sexual abuse, as they may use substances to numb their pain, escape their reality, or self-medicate their symptoms.

Choice D Reason: Eating disorders are serious mental health conditions that involve abnormal eating behaviors and attitudes toward food and body weight. Eating disorders can be triggered by sexual abuse, as survivors may develop distorted body image, low self-esteem, shame, guilt, or a sense of loss of control over their lives. Eating disorders can include anorexia nervosa (restricting food intake to achieve extreme thinness), bulimia nervosa (binging on large amounts of food and then purging through vomiting, laxatives, or exercise), binge eating disorder (binging on large amounts of food without purging), or other specified feeding or eating disorder (OSFED) (having symptoms of an eating disorder that do not meet the full criteria for any specific diagnosis).

Choice E Reason: All of the above are possible signs and symptoms of sexual abuse in children and adolescents. However, not all survivors of sexual abuse will develop these conditions, and not all people with these conditions have experienced sexual abuse. Therefore, it is important to assess each individual case holistically and provide appropriate support and referrals as needed.

Choice A Reason: Child abuse and neglect can occur in any family, regardless of socioeconomic status. Poverty is not a cause of child abuse and neglect, but it may increase the stress and challenges faced by families.
Choice B Reason: Children with disabilities or special needs are more likely to be abused or neglected than children without disabilities. They may have increased dependency, communication difficulties, or behavioral problems that make them more vulnerable to maltreatment.
Choice C Reason: Parents who were abused or neglected themselves are more likely to repeat the cycle with their own children. This is because they may have learned abusive behaviors from their own parents, have unresolved trauma, or lack positive parenting skills.
Choice D Reason: Child abuse and neglect can cause physical, psychological, and social problems for the child. The consequences of maltreatment can vary depending on the type, frequency, duration, and severity of abuse or neglect, as well as the child's age, developmental stage, resilience, and coping skills.
Choice E Reason: Child abuse and neglect cannot be prevented by increasing social support and resources for families alone. Prevention requires a comprehensive approach that involves multiple levels of intervention, such as individual, family, community, and societal factors. Prevention also requires raising awareness, changing attitudes and behaviors, strengthening laws and policies, and improving services for children and families.