Updated June 09, 2015.
Q. I know someone that has their four year old son on Risperdal for ADHD. I have babysat for the child before and do not feel that he is in need of the medication. She has changed pediatricians five times since his time of birth for no apparent reason except that the doctor wouldn't do what she wanted them to do. I would like to know if there is anything that can or should be done about the situation. As an observer, I feel that the child is just a child and acting his age. There are times when I watch him that he has minor cuts, bruises, or even burns. His mother always has sound reasons. Are there things to look for to show abuse or neglect or something else that is underlying? Should I notify anyone of my concerns or am I being overly paranoid? Sincerely, Silent Observer
A.

Well, some people would say that you are being paranoid, but others would say that you should trust your instincts and report the situation to someone.

It is important to keep in mind that there are consequences either way, whether your report the situation or not. If you report the family and he is not being abused, then they have to deal with a child protective services investigation and the hope that they recognize that there is no abuse. On the other hand, if you don't report it and the child is being abused, there might be tragic consequences down the road if the abuse escalates.

Have you ever seen the child when he is off any medications? If not, then it is hard for you to say that he doesn't need them.

Do you believe her 'sound reasons' for those cuts, bruises, and burns? Having 'unexplained burns, bites, bruises, broken bones, or black eyes,' can be a sign of physical abuse, especially if the parent offers 'conflicting, unconvincing, or no explanation for the child's injury.'

According to the National Clearinghouse on Child Abuse and Neglect Information, the following signs may signal the presence of child abuse or neglect:

Signs of Child Abuse in The Child

• Shows sudden changes in behavior or school performance.
• Has not received help for physical or medical problems brought to the parents' attention.
• Has learning problems (or difficulty concentrating) that cannot be attributed to specific physical or psychological causes.
• Is always watchful, as though preparing for something bad to happen.
• Lacks adult supervision.
• Is overly compliant, passive, or withdrawn.
• Comes to school or other activities early, stays late, and does not want to go home.

Signs of Child Abuse in The Parent

• Shows little concern for the child.
• Denies the existence of—or blames the child for—the child's problems in school or at home.
• Asks teachers or other caretakers to use harsh physical discipline if the child misbehaves.
• Sees the child as entirely bad, worthless, or burdensome.
• Demands a level of physical or academic performance the child cannot achieve.
• Looks primarily to the child for care, attention, and satisfaction of emotional needs.

Signs of Child Abuse in The Parent and Child

• Rarely touch or look at each other.
• Consider their relationship entirely negative.
• State that they do not like each other.

For more information, see this guide to Recognizing Child Abuse and Neglect: Signs and Symptoms.