Child abuse is more than bruises and broken bones. While physical abuse might be the most visible sign, other types of abuse, such as emotional abuse or child neglect, also leave deep, long lasting Scars. All types of child abuse and neglect leave lasting scars. Some of these scars might be physical, but emotional scarring has long lasting effects throughout life, damaging a child’s sense of self, ability to have healthy relationships, and ability to function at home, at work and at school. Some effects include: Lack of trust and relationship difficulties. If you can’t trust your parents, who can you trust? Abuse by a primary caregiver damages the most fundamental relationship as a child—that you will safely, reliably get your physical and emotional needs met by the person who is responsible for your care. Without this base, it is very difficult to learn to trust people or know who is trustworthy. This can lead to difficulty maintaining relationships due to fear of being controlled or abused. It can also lead to unhealthy relationships because the adult doesn’t know what a good relationship is. Core feelings of being “worthless” or “damaged.” If you’ve been told over and over again as a child that you are stupid or no good, it is very difficult to overcome these core feelings. You may experience them as reality. Adults may not strive for more education, or settle for a job that may not pay enough, because they don’t believe they can do it or are worth more. Sexual abuse survivors, with the stigma and shame surrounding the abuse, often especially struggle with a feeling of being damaged.  Trouble regulating emotions. Abused children cannot express emotions safely. As a result, the emotions get stuffed down, coming out in unexpected ways. Adult survivors of child abuse can struggle with unexplained anxiety, depression, or anger. They may turn to alcohol or drugs to numb out the painful feelings. Types of child abuse: There are several types of child abuse, but the core element that ties them together is the emotional effect on the child. Children need predictability, structure, clear boundaries, and the knowledge that their parents are looking out for their safety. Abused children cannot predict how their parents will act. Their world is an unpredictable, frightening place with no rules. Whether the abuse is a slap, a harsh comment, stony silence, or not knowing if there will be dinner on the table tonight, the end result is a child that feel unsafe, uncared for, and alone.  Emotional child abuse Sticks and stones may break my bones but words will never hurt me? Contrary to this old saying, emotional abuse can severely damage a child’s mental health or social development, leaving lifelong psychological scars. Examples of emotional child abuse include: - Constant belittling, shaming, and humiliating a child. - Calling names and making negative comparisons to others. - Telling a child he or she is “no good," "worthless," "bad," or "a mistake." - Frequent yelling, threatening, or bullying. - Ignoring or rejecting a child as punishment, giving him or her the silent treatment. - Limited physical contact with the child—no hugs, kisses, or other signs of affection. - Exposing the child to violence or the abuse of others, whether it be the abuse of a parent, a sibling, or even a pet. Child neglect Child neglect—a very common type of child abuse—is a pattern of failing to provide for a child's basic needs, whether it be adequate food, clothing, hygiene, or supervision. Child neglect is not always easy to spot. Sometimes, a parent might become physically or mentally unable to care for a child, such as with a serious injury, untreated depression, or anxiety. Other times, alcohol or drug abuse may seriously impair judgment and the ability to keep a child safe. Older children might not show outward signs of neglect, becoming used to presenting a competent face to the outside world, and even taking on the role of the parent. But at the end of the day, neglected children are not getting their physical and emotional needs met. Physical child abuse Physical abuse involves physical harm or injury to the child. It may be the result of a deliberate attempt to hurt the child, but not always. It can also result from severe discipline, such as using a belt on a child, or physical punishment that is inappropriate to the child’s age or physical condition. Many physically abusive parents and caregivers insist that their actions are simply forms of discipline—ways to make children learn to behave. But there is a big difference between using physical punishment to discipline and physical abuse. The point of disciplining children is to teach them right from wrong, not to make them live in fear. Helping an abused or neglected child What should you do if you suspect that a child has been abused? How do you approach him or her? Or what if a child comes to you? It’s normal to feel a little overwhelmed and confused in this situation. Child abuse is a difficult subject that can be hard to accept and even harder to talk about. Just remember, you can make a tremendous difference in the life of an abused child, especially if you take steps to stop the abuse early. When talking with an abused child, the best thing you can provide is calm reassurance and unconditional support. Let your actions speak for you if you’re having trouble finding the words. Remember that talking about the abuse may be very difficult for the child. It’s your job to reassure the child and provide whatever help you can. Tips for talking to an abused child: Avoid denial and remain calm. A common reaction to news as unpleasant and shocking as child abuse is denial. However, if you display denial to a child, or show shock or disgust at what they are saying, the child may be afraid to continue and will shut down. As hard as it may be, remain as calm and reassuring as you can. Don’t interrogate. Let the child explain to you in his or her own words what happened, but don’t interrogate the child or ask leading questions. This may confuse and fluster the child and make it harder for them to continue their story. Reassure the child that they did nothing wrong. It takes a lot for a child to come forward about abuse. Reassure him or her that you take what is said seriously, and that it is not the child’s fault. Safety comes first. If you feel that your safety or the safety of the child would be threatened if you try to intervene, leave it to the professionals. You may be able to provide more support later after the initial professional intervention. Reporting child abuse and neglect Child Abuse Reporting: Making Your Voice Heard. Tips for communicating effectively and getting results If you suspect a child is being abused, it’s critical to get them the help he or she needs. Reporting child abuse seems so official. Many people are reluctant to get involved in other families’ lives. Understanding some of the myths behind reporting may help put your mind at ease if you need to report child abuse I don’t want to interfere in someone else’s family. The effects of child abuse are lifelong, affecting future relationships, self-esteem, and sadly putting even more children at risk of abuse as the cycle continues. Help break the cycle of child abuse. What if I break up someone’s home? The priority in child protective services is keeping children in the home. A child abuse report does not mean a child is automatically removed from the home - unless the child is clearly in danger. Support such as parenting classes, anger management or other resources may be offered first to parents if safe for the child. They will know it was me who called. Reporting is anonymous. In most states, you do not have to give your name when you report child abuse. The child abuser cannot find out who made the report of child abuse. It won’t make a difference what I have to say. If you have a gut feeling that something is wrong, it is better to be safe than sorry. Even if you don’t see the whole picture, others may have noticed as well, and a pattern can help identify child abuse that might have otherwise slipped through the cracks.