context: When you think of child abuse, your first thought may be of a child with bruises or other marks that raise red flags. But the signs aren't always so clear. It can be physical, sexual, or emotional. She may be neglected, meaning her caregivers don't provide for basic needs, like food or safety. What makes abuse even harder to stop is that most of the time, the abuser is someone the child knows. She may be reluctant to say something because she may want to protect that person or is afraid of what they will do if she speaks up. It's important to know how to recognize different types of abuse, and what you can do if you suspect it. Child abuse happens when someone harms a child's body or emotional health, development, and well-being. There are 4 main types. Physical abuse means that someone hurts a child's body or puts her in physical danger. It doesn't matter if the child gets seriously hurt or if it leaves a mark. Any harm is abuse. It includes when someone: Burns a child Hits, kicks, or bites Holds the child under water Shakes or throws the child Throws objects at the child Ties up the child Sexual abuse is any kind sexual activity with a child, not just physical contact. It includes when someone: Forces a child to take part in pornographic pictures or videos Has any sexual contact with the child, from kissing in a sexual way to having sex Makes phone calls or sends emails, texts, or other messages that are sexual in any way Shows the child someone else's genitals, as with âflashingâ Shows pornography Tells âdirtyâ jokes or stories Emotional abuse is a pattern of behaviors that harm a child's emotional well-being and development. This can mean when someone: Abuses others when the child is around, such as a parent, brother, sister, or pet Fails to show love and affection Ignores the child and doesn't give emotional support and guidance Shames, belittles, criticizes, or embarrasses Teases, threatens, bullies, or yells Neglect is when a caregiver doesn't give the child basic care and protection, such as: Clothing Food Heat in cold weather Housing with clean living conditions Medical care Neglect is also when someone leaves the child alone for long stretches of time or under dangerous conditions. Abuse can be hard to recognize. Kids can get cuts and bruises or show signs of stress for lots of reasons that are a normal part of childhood. So it helps to know specific signs to look for, and trust your gut as you look at the whole picture of the child's physical and emotional health. Signs of physical abuse may include: Bruises, welts, or other injuries that can't be explained or don't match with the child's story Burns, especially from cigarettes, that can't be explained Injury marks that have a pattern, like from a hand, belt, or other objects Injuries that are at different stages of healing Medical or dental issues that go untreated Kids who've been physically abused may also: Avoid any kind of touch or physical contact Be afraid to go home Seem to always be on high alert Wear clothing that doesn't match the weather -- such as long sleeves on hot days -- to cover up bruises Withdraw from friends and activities Signs of sexual abuse may include: Avoiding a certain person for no clear reason Bloody, torn, or stained underwear Bruising or bleeding around the genitals Pain or itching around the genitals that might cause problems walking or sitting Pregnancy or STDs, especially for boys and girls under 14 years old Refusing to change clothes in front of others Running away from home Sexual activity or knowledge that people usually have only when they're older Signs of emotional abuse may include: Constant worry about doing something wrong Speech problems or delays in learning and emotional development Depression and low self-esteem Doing poorly in school Extreme behavior, such as being way too obedient or way too demanding Headaches and stomachaches with no clear cause The child doesn't seem close to a parent or caregiver Showing little interest in friends and activities Signs of neglect may include: Always looking dirty Being left alone or in the care of other young children Eating more than usual at a meal or saving food for later Doesn't get medical, dental, or mental health care Missing a lot of school Poor weight gain and growth If you suspect child abuse, it's important to report it. It isn't a private matter or a family problem. A child's physical and emotional well-being, and maybe even her life, could be at stake. You don't need proof to report abuse. If you suspect it, call your local child protective services, police, a hospital, or a hotline, such as the Childhelp National Child Abuse Hotline at 800-422-4453. You don't have to give your name. Depending on the situation, there are many ways you can help the child: If he needs medical care right away, call 911. Take him to the hospital -- it's a haven for abused children. Doctors can check for signs of abuse and give medical care. If you think someone like a baby sitter or day-care worker has abused your child, keep her away from that person and contact police. Help the child get therapy to start healing the emotional damage of the abuse. Make sure she feels supported and knows this is not her fault. It's best to not confront the abuser yourself. Instead, contact police and let them handle it.