Which finding in a school-age child is a manifestation of physical abuse?

• A. Bruises at various stages of healing
• B. Frequent headaches
• C. Sleep difficulties
• D. Poor appetite

Answer: (A)

Repeated injuries with bruises at different stages of healing signal ongoing physical trauma and nonaccidental injury in a school-age child. The body’s bruises evolve in color and size as they heal, so seeing multiple bruises at various healing stages suggests injuries occurred over time rather than from a single accident. Other options—frequent headaches, sleep difficulties, or poor appetite—have many possible causes, such as headaches from tension or vision issues, sleep problems from stress or disorders, and appetite changes from illness or other factors, and are not specific indicators of abuse. The combination of injuries at varying stages is the strongest cue pointing toward physical abuse.