While it’s vitally important to know and see the signs, it’s also critical to ask the individual you suspect may be experiencing abuse about their situation. Most people with I/DD that have experienced abuse state that they were never asked about being abused, neglected or exploited. If the suspected victim discloses abuse, neglect or exploitation, please report it even if the details are inconsistent.


Physical signs of abuse may include:

Questionable bruises, scrapes, cuts, welts, and burns; bite marks; imprint injuries (marks shaped like fingers, thumbs, hands); sudden/unexplained hearing loss; broken/missing teeth; spotty balding (from pulled hair); eye injuries (black eyes or detached retinas); vaginal or rectal pain, trauma to genital area, frequent urinary tract or yeast infections, painful urination, incontinence (in someone who was previously toilet-trained); sudden onset of psychosomatic complaints (persistent stomach aches and headaches); sudden difficulty walking or sitting; repeated dislocated joints, multiple fractures; or unexplained coma (often resulting from shaking).(2)

Physical signs of neglect may include:

Poor grooming and/or hygiene, presence of lice, smell of urine or feces on the person, dirty or soiled clothing; weight loss; poor skin condition (rashes, open wounds, bedsores); dehydration; lack of necessary adaptive aids (glasses, hearing aids, braces, walkers); improper medication management; lack of medical/dental care; or lack of supervision.(2)

Behavioral signs of abuse may include:

Aggressive behavior including yelling, hitting; acting out what was done to victim by replicating the assaultive act upon others; violent drawings/stories; fearfulness of abuser, of others in general (may be age or gender specific), or of specific places; sudden fear of bathing or toileting; sudden noncompliance; sudden detachment/withdrawal; sudden uncomfortableness with physical contact; regression from skills already mastered; sudden interest in sexual matters, onset of increased sexual conduct, inappropriate displays of affection; self-harm; self-molestation (replicating assaultive act upon oneself); onset of new fears; sudden social anxiety or phobia; persistent anger; change in appetite, change in energy level, change in interest in normal activities, irritability/mood swings, depression; changes in sleep patterns, onset of nightmares; onset of lying; cruelty to animals; selective mutism (previously verbal individual stops talking); or any unexplained and unusual change in behavior.(1,2)

Financial Exploitation of those with I/DD

Financial exploitation of those with I/DD directly affects the victim’s ability to lead an independent life by limiting their ability to afford the basic necessities of life, such as food, rent payments and medicine.(1)

If you suspect financial exploitation, please report it.

Financial exploitation signs may include:

Sudden decrease in bank account balances; sudden changes in banking practices (large withdrawals); sudden problems paying bills, buying food or other necessities; sudden changes in wills or other financial documents; unexplained disappearance of money or valuable possessions.(1)


1 From the website of the Agency for Persons with Disabilities, Tallahassee, FL
2 Baladerian, N.J. (1997). Recognizing abuse and neglect in people with severe cognitive and/or communication impairments. Journal of Elder Abuse and Neglect, 9(2), 93-105.