Child sexual abuse is any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer. A central characteristic of any abuse is domination of the child by the perpetrator through deception, force, or coercion into sexual activity. Children, due to their age, cannot give meaningful consent to sexual activity.

Child sexual abuse includes touching and non-touching behaviors:

• sexual kissing
• inappropriate touching or fondling of the child’s genitals, breasts, or buttocks
• masturbation
• oral-genital contact
• sexual or digital (with fingers) penetration
• pornography (forcing the child to view or use of the child in)
• child prostitution
• exposure or “flashing” of body parts to the child
• voyeurism (ogling of the child’s body)
• verbal pressure for sex

What Are The Effects of Sexual Abuse?

• Not all sexually abused children exhibit symptoms (some estimate up to 40% of children are asymptomatic) however others experience serious and long-standing consequences.
• Child sexual abuse can result in both short-term and long-term harm, including mental health problems that extend into adulthood.
• Sexual abuse can affect psychological, emotional, physical, and social domains of the child’s life, including increased risk for
  • Depression
  • Guilt
  • Fear
  • Post-traumatic stress disorder (PTSD)
  • Dissociative and anxiety disorders
  • Eating disorders
  • Poor self-esteem
  • Somatization, i.e., the expression of distress in physical symptoms
  • Chronic pain
• Behavioral problems can include
  • Sexualized behavior – which brings elevated risk for pregnancy and sexually transmitted infections
  • School/learning problems
  • Substance abuse
  • Destructive behavior
  • Sexual dysfunction in adulthood
  • Criminality in adulthood
  • Suicide

What Are The Effects of Sexual Abuse?

Consider the possibility of sexual abuse when the child exhibits:

• An increase in nightmares and/or other sleeping difficulties
• Angry outbursts
• Anxiety
• Depression
• Difficulty walking or sitting
• Withdrawn behavior
• Pregnancy or contraction of a venereal disease, particularly if under age 14
• Propensity to run away
• Refusal to change for gym or to participate in physical activities
• Regressive behaviors depending on their age (e.g., return to thumb-sucking or bed-wetting)
• Reluctance to be left alone with a particular person or people
• Sexual knowledge, language, and/or behaviors that are unusual and inappropriate for their age

Take it very seriously when a child reports sexual abuse by a parent or another adult caregiver. Consider the possibility of sexual abuse when the parent or other adult caregiver:

• Is unduly protective of the child or severely limits the child’s contact with other children, especially those of the opposite sex
• Is secretive and isolated
• Describes marital difficulties involving sexual relations or family power struggles.

What steps can parents/caregivers take to prevent and minimize risk for sexual abuse?

Teach your children

• Basic sexual education – a health professional can provide basic sexual education to your children if you feel uncomfortable doing so.
• That sexual advances from adults are wrong.
• To communicate openly – they should feel free to ask questions and talk about their experiences. Make it clear that they should feel free to report abuse to you or any other trusted adult. If you’re concerned about possible sexual abuse, ask questions.
• The difference between good secrets (those that are not kept secret for long) and bad secrets (those that must stay secret forever).
• The difference between “okay” and “not okay” touches.
• Accurate names for their private parts and how to take care of them (i.e., bathing, wiping after bathroom use) so they don’t have to rely on adults or older children for help.
• That adults and older children never need help with their own private parts.
• That they can make decisions about their own bodies and say “no” when they do not want to be touched or do not want to touch others (even refusing to give hugs).

Make sure that you know your child’s friends and their families. If you feel uneasy about leaving your child with someone, don’t do it.

What should parents/caregivers do if they suspect abuse?

• Give the child a safe environment in which to talk to you or another trusted adult.
• Encourage the child to talk about the abuse, but be careful to not suggest events that may not have occurred.
• Guard against displaying emotions that would influence the child’s telling of the information. Listen, stay calm, and remain supportive of the child with words and gestures.
• Reassure the child that he or she did nothing wrong.
• Seek assistance for the child from a psychologist or other licensed mental health provider.
• Arrange for a medical examination for the child. Select a medical provider who has experience in examining children and identifying sexual and physical trauma. It may be necessary to explain to the child the difference between a medical examination and the abuse incident.
• Many states require that individuals who know or suspect that a child has been sexually abused must report the abuse to local law enforcement or child protection officials.
• In all 50 states, medical personnel, mental health professionals, teachers, and law enforcement personnel are required by law to report suspected abuse.

What treatments are available for children and adolescents who have been sexually abused?

• There are a number of empirically validated treatments for children who have been sexually abused
  • Individual therapy
  • Family therapy
  • Group therapy
  • Trauma-focused cognitive behavioral therapy
  • Child-centered therapy
• There is no “one size fits all” treatment for sexual abuse. Therapists may take a range of approaches to treatment depending on the individual characteristics of the child and the length of treatment.
• Recovery is possible – children can be very resilient and with a combination of effective treatment and support from parents/caregivers, they do recover from abuse.

Information reprinted from the American Psychological Association website. See more at http://www.apa.org/pi/families/resources/child-sexual-abuse.aspx