What nonverbal sign might indicate abuse in a child during a medical history collection?

Avoiding eye contact is a significant nonverbal sign that may indicate abuse in a child during medical history collection. Children who have experienced abuse often exhibit signs of anxiety, fear, or discomfort when discussing sensitive topics or when in the presence of authority figures, which can manifest as avoiding eye contact. This behavior may signal a lack of trust or a fear of revealing information that could lead to further harm.

In contrast, expressiveness in speech, engagement with the nurse, and smiling or laughing typically suggest comfort and normal emotional responses, which may not align with the serious implications of abuse. Therefore, a child who avoids eye contact could be demonstrating a level of distress or fear that warrants further investigation and care. Identifying such nonverbal cues is crucial in a medical setting as they can be vital indicators of a child's well-being and may help healthcare professionals provide appropriate support and interventions.