Seeing the Signs: Identification and Assessment of Psychological Maltreatment
Part Three of a Four-Part Deep Dive - Reading time: 5 to 7 minutes
In Part 2 of this series, we examined how experts define psychological maltreatment (PM), including APSAC’s seven categories and the harm standard used to distinguish harmful parenting from maltreatment. But definitions raise the next critical question: how do we recognize PM when it is happening?
Identification is often challenging because PM may not leave physical injuries. There are no X-rays to confirm harm or photographs that tell the story. Instead, recognition depends on observing patterns in a child’s behavior, the dynamics between caregiver and child, and the professional skill to put the pieces together. This process requires persistence, sensitivity, and collaboration (APSAC, 2019).
The Subtle Nature of Psychological Maltreatment
Psychological Maltreatment can be hard to notice without training. Caregivers may present well in public, masking harmful behaviors in private (Stirling, 2018). Children, especially younger ones, may not have the words to describe what is happening or may think it is “normal.”
Clues are often indirect:
• A teacher observes extreme withdrawal or a fear of making mistakes.
• A pediatrician sees recurring anxiety symptoms without a clear medical explanation (Norman et al., 2012).
• A neighbor hears repeated belittling but dismisses it as “strict parenting.”
Individually, these observations may seem minor. Together, they can point to a pattern of harm that professionals trained in PM can recognize (Spinazzola et al., 2014).
Risk Factors: Clues in Context
Understanding risk factors helps professionals know where PM is more likely to occur. These risks operate at different levels:
• Child level: Developmental disabilities, chronic illness, or behavioral challenges may increase vulnerability (Baker & Brassard, 2014).
• Caregiver level: A history of maltreatment, untreated mental illness, substance use, or unrealistic expectations of children’s abilities can contribute (APSAC, 2019).
• Family level: Domestic violence, high-conflict relationships, or instability related to poverty often create conditions where PM is more likely (Glaser, 2002).
• Community level: Social isolation, violence, and lack of support services, such as affordable childcare, increase stress that can spill over into harmful interactions (Hart & Brassard, 2019).
The Role of Protective Factors
Protective factors can buffer against harm. A child with at least one emotionally responsive adult—whether a relative, teacher, or mentor—may experience fewer long-term effects (Brassard, Hart, Baker, & Chiel, 2019). Strong community networks, school connectedness, and access to mental health services can also create opportunities for earlier recognition and support (Norman et al., 2012).
A Story That Could Be Anyone’s
The following composite example illustrates how risk and protective factors can interact in children’s lives.
Maria, a 9-year-old, often comes to school anxious and withdrawn. Her teachers notice she avoids group work and cries easily when corrected. At home, her caregiver frequently calls her “lazy” and compares her unfavorably to siblings. These are risk factors: harsh criticism, emotional unresponsiveness, and family stress spilling into daily interactions (Spinazzola et al., 2014).
But Maria’s story also shows the importance of protective factors. A supportive teacher checks in with her each morning, a school counselor connects her to extracurricular activities where she feels competent, and a relative provides consistent encouragement. These relationships help buffer the harm while professionals work toward family support and intervention (Brassard et al., 2019).
Maria’s story is not about one child—it could be anyone’s. It shows how professionals and communities can play a decisive role in tipping the balance toward resilience.
Intersection with Other Forms of Maltreatment
PM rarely occurs alone. It often overlaps with physical abuse, sexual abuse, or neglect. When visible harm dominates case files, the psychological aspects may be overlooked.
For example, a child who is physically abused may also be verbally degraded, yet records focus only on the physical injury. Recognizing PM as an underlying thread in many forms of abuse is essential. APSAC guidelines emphasize that emotional safety is as important as physical safety (APSAC, 2019; Stirling, 2018).
From Suspicion to Confirmation: The Assessment Process
Identifying PM requires moving beyond suspicion to a structured assessment:
• Observation: Watching caregiver–child interactions can reveal consistent patterns, such as ignoring or belittling (Stirling, 2018).
• Interviews: Open-ended conversations with children and caregivers provide insight into experiences and stressors.
• Standardized tools: Instruments like the Child Abuse Potential Inventory (CAPI) or Child Trauma Screen help assess risk and impact (Spinazzola et al., 2014).
• Collateral information: Teachers, coaches, and relatives can offer perspectives that highlight consistent concerns across settings (Glaser, 2002).
Even with tools, assessment requires careful judgment. Cultural norms, biases, and varying thresholds for harm can shape decisions. Training that pairs the harm standard with cultural competence is critical (Hart & Brassard, 2019).
The Multidisciplinary Imperative
No single profession can reliably identify PM in isolation. Collaboration brings together different perspectives:
• Teachers notice academic and behavioral changes.
• Healthcare providers see psychosomatic symptoms.
• Social workers recognize family stress patterns.
When these insights are shared, patterns emerge more clearly, allowing for timely intervention (APSAC, 2019).
Scholar’s Corner
“Identifying psychological maltreatment requires careful, contextual evaluation, not a checklist. Psychological Maltreatment is about patterns, and patterns take time and effort to see.”
Why This Series Matters
The earlier PM is recognized, the better the chances of preventing long-term harm. Early intervention can stop harmful behaviors, provide children with therapeutic support, and help caregivers adopt healthier strategies (Norman et al., 2012). Delayed recognition allows harm to deepen, shaping a child’s view of themselves and the world.
In the final part of this series—“Breaking the Cycle: Prevention, Intervention, and Policy Solutions for Psychological Maltreatment”—we will explore strategies to prevent PM, support children and caregivers, and strengthen policies so protections are consistent everywhere.
Something to Think About
When you think about the children and families you encounter, what risk factors stand out—stress, harsh words, isolation, untreated challenges? What protective factors could be built or strengthened, even in small ways, to change the child’s experience (Brassard et al., 2019; Glaser, 2002)?
The question is not only whether you recognize patterns of harm, but also whether you can help create patterns of protection. What could you do, in your role or community, to be the adult who tips the balance toward resilience?