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Child Sexual Abuse: Know the Warning Signs


Whether you are a parent, teacher, or someone else who cares for and loves children, the best defense against sexual abuse is to educate yourself and your children about it.

What Is Child Sexual Abuse?

Child sexual abuse involves an adult engaging in any type of sexual activity with a child or adolescent. It may also involve an adolescent engaging in sexual activity with a younger child.

There are different forms of sexual abuse. Like other forms of abuse, it can be physical, verbal, or emotional. It may be subtle enough that a child does not know what’s happening, but only feels uncomfortable. According to the organization Stop It Now, child sexual abuse includes:

  • Touching behaviors such as:
    • Fondling a child’s genitals, breasts, or anus for sexual pleasure or other unnecessary reason
    • Playing sexual games or making a child touch someone else’s genitals
    • Inserting objects or body parts (fingers, tongue, or penis) inside the vulva, vagina, mouth, or anus of a child, for sexual pleasure or other unnecessary reason
  • Non-touching behaviors such as:
    • Exposing genitals to a child
    • Showing pornography to a child
    • Making sexual remarks to a child
    • Having a child pose, undress, or perform in a sexual fashion (including for photographs)
    • Peeping into bedrooms and bathrooms

    In many cases of sexual abuse, the child knows the offender. The offender is often someone the child trusts or loves, such as a parent, neighbor, or relative.

Signs and Symptoms of Child Sexual Abuse

Children often don’t tell others about sexual abuse because they feel frightened, ashamed, and confused. Their abusers often convince them that it must be kept a secret. Be alert for the following potential warning signs:

Physical Signs

  • Underwear that is torn, stained, or bloody
  • Difficulty walking or sitting
  • Redness, pain, bleeding, or bruising in the external genital area, vagina, or anal area
  • Unusual discharge from the vagina or anus
  • Frequent, unexplained urinary infections or sore throats
  • Sexually transmitted infections
  • Pregnancy

Emotional Signs

  • Clinical depression and feelings of suicide
  • Lack of trust
  • Change in response to adults or older children (although males account for most cases of abuse, don’t rule out the possibility of female abusers)
  • New fears or hysteria
  • Low self-esteem
  • Depression with physical complaints such as:
    • Headache, stomachache, or chest pain
    • Insomnia
    • Fatigue
    • Loss of appetite

Behavioral Signs

  • Clinging
  • Sleep problems
  • Bed-wetting, thumb sucking, or loss of bowel control
  • Fear of undressing, or wearing extra layers of clothing
  • Fear of going to the bathroom, refusal to have a bowel movement, or constipation
  • Difficulty making friends
  • Getting to school early and staying late, to avoid being at home
  • Marked fear of a person (including parents) or certain places
  • Promiscuity, seductive behavior, or age inappropriate interest in sexual matters
  • Persistent, inappropriate sex play with peers or toys, or excessive masturbation
  • Truancy or dropping school performance
  • Running away from home
  • Abusing alcohol or drugs
When You Suspect Sexual Abuse
  1. Stay calm. If you show anger or disgust, the child might take it personally. Don’t panic or overreact. This is a difficult experience and the child needs help and support.
  2. Take what the child says seriously.
  3. Listen carefully and compassionately to the child and answer questions honestly.
  4. Be positive. Child abuse is never the child’s fault. Reassure the child that he or she is not to blame. Tell the child that you are proud of him or her for speaking up. Give lots of love, comfort, and reassurance.
  5. Respect the child’s privacy. Don’t pressure the child to talk about the abuse. The child will talk about it at his or her own pace. Don’t discuss the abuse in front of people who don’t need to know about it.
  6. Report the abuse to the local Child Protection Agency as soon as possible. They can help keep the child safe and provide assistance and resources.
  7. Take the child for a medical exam in case there might be physical injury, damage, or disease that has resulted from the abuse. An exam may also provide important evidence.
  8. Get help from a variety of sources: the child’s pediatrician, a counselor, a police officer, a child protective service worker, or a teacher.
  9. Do not prevent the child from talking about the abuse.
  10. Do not confront the offender in front of your child. Such a confrontation could be very distressful and harmful to the child.
How to Help Prevent Sexual Abuse

Here are some ways that parents can help lessen the chance of sexual abuse:

  • Tell children, “If someone tries to touch your body and do things that make you feel funny, say NO to that person and tell me right away."
  • Teach children that respect does not mean blind obedience to adults and to authority.
  • Encourage professional prevention programs in the local school.
  • Know the people who spend time around your child, especially caregivers.
  • Communicate frequently and openly with your child in a non-judgmental way.

RESOURCES:

American Academy of Pediatrics
http://www.aap.org/

American Psychological Association
http://www.apa.org/

CANADIAN RESOURCES:

About Kids Health
http://www.aboutkidshealth.ca/

Canadian Red Cross
http://www.redcross.ca/

SOURCES:

Child sexual abuse. American Academy of Child and Adolescent Psychiatry website. Available at: http://www.aacap.org/cs/root/facts_for_families/child_sexual_abuse. Accessed March 28, 2006.

Responding to child sexual abuse. American Academy of Child & Adolescent Psychiatry website. Available at: http://aacap.org/page.ww?name=Responding+to+Child+Sexual+Abuse&section=Facts+for+Families. Updated March 2011. Accessed September 10, 2012.

Safety & prevention: sexual abuse. HealthyChildren.org website. Available at: http://www.healthychildren.org/English/safety-prevention/at-home/Pages/Sexual-Abuse.aspx. Updated January 12, 2012. Accessed September 10, 2012.

Warning signs. Stop It Now website. Available at: http://www.stopitnow.org/warnings. Accessed September 10, 2012.

What is considered child sexual abuse? Stop It Now website. Available at: http://www.stopitnow.org/warning_signs_csa_definition. Accessed September 10, 2012.



Last reviewed September 2012 by Brian P. Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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