Which indicator among children receiving treatment might suggest child abuse?

The presence of a skull fracture in a 3-month-old infant is highly concerning and may suggest child abuse, especially given the context of the injury occurring from reportedly rolling off a changing table. Infants are not developmentally capable of rolling over in the way that older children do, which raises questions about how the fracture was sustained. Injuries such as skull fractures in very young children require careful evaluation, as they may occur due to non-accidental trauma rather than accidents that can occur in a typical household setting.

In contrast, the other scenarios presented do not inherently indicate child abuse. Behavioral issues in a 5-year-old or a shy demeanor in a 7-year-old can stem from various non-abusive situations such as family stress, developmental differences, or environmental factors. Similarly, a child with a cold that won’t go away could be suffering from a medical issue unrelated to abuse. Therefore, the specific nature of the injury described in the first scenario stands out as a significant red flag that warrants further investigation for potential abuse.