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.
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:
Fondling a child’s genitals, breasts, or anus for sexual pleasure or other unnecessary reasonPlaying sexual games or making a child touch someone else’s genitalsInserting objects or body parts (fingers, tongue, or penis) inside the vulva, vagina, mouth, or anus of a child, for sexual pleasure or other unnecessary reasonNon-touching behaviors
Exposing genitals to a childShowing pornography to a childMaking sexual remarks to a childHaving a child pose, undress, or perform in a sexual fashion (including for photographs)Peeping into bedrooms and bathrooms
In most 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.
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 bloodyDifficulty walking or sittingRedness, pain, bleeding, or bruising in the external genital area, vagina, or anal areaUnusual discharge from the vagina or anus
or sore throats
Sexually transmitted infectionsPregnancy
and feelings of suicide
Lack of trustChange 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 hysteriaLow self-esteem
Depression with physical complaints such as:
Headache, stomachache, or chest pain
InsomniaFatigueLoss of appetite
Behavioral Signs ClingingSleep problemsBed-wetting, thumb sucking, or loss of bowel controlFear of undressing, or wearing extra layers of clothingFear of going to the bathroom, refusal to have a bowel movement, or constipationDifficulty making friendsGetting to school early and staying late, to avoid being at homeMarked fear of a person (including parents) or certain placesPromiscuity, seductive behavior, or age inappropriate interest in sexual mattersPersistent, inappropriate sex play with peers or toys, or excessive masturbationTruancy or dropping school performanceRunning away from homeAbusing alcohol or drugs
- 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.
- Take what the child says seriously.
- Listen carefully and compassionately
to the child and answer questions honestly.
- Be positive.
Child abuse is
the child’s fault. Reassure the child they are not to blame. Tell the child that you are proud of them for speaking up. Give lots of love, comfort, and reassurance.
- Respect the child’s privacy.
Don’t pressure the child to talk about the abuse. The child will talk about it at their own pace. Don’t discuss the abuse in front of people who don’t need to know about it.
- Report the abuse
to the local authorities as soon as possible. They can help keep the child safe and provide assistance and resources.
- 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.
- Get help from a variety of sources: the child’s pediatrician, a counselor, a police officer, a child protective service worker, or a teacher.
- Do not prevent the child from talking about the abuse.
- Do not confront the offender. Keep the child away from the suspected person. Notify the authorities and let them handle the legal process.
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.
Child abuse. Nemours Kids Health website. Available at: http://kidshealth.org/parent/positive/talk/child_abuse.htm. Updated January 2012. Accessed October 1, 2014.
Child sexual abuse. American Academy of Child and Adolescent Psychiatry website. Available at:
http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Child_Sexual_Abuse_09.aspx. Updated March 2011. Accessed October 1, 2014.
Lahoti SL, McClain N, et al. Evaluating the child for sexual abuse. Am Fam Physician. 2001;63(5):883-893.
McDonald KC. Child abuse: Approach and management. Am Fam Physician. 2007;75(2):221-228.
Responding to child sexual abuse. American Academy of Child & Adolescent Psychiatry website. Available at: http://www.aacap.org/AACAP/AACAP/Families_and_Youth/Facts_for_Families/Facts_for_Families_Pages/Responding_To_Child_Sexual_Abuse_28.aspx. Updated March 2011. Accessed October 1, 2014.
Sexual abuse. American Academy of Pediatrics Healthy Children website. Available at:
http://www.healthychildren.org/English/safety-prevention/at-home/Pages/Sexual-Abuse.aspx. Updated August 7, 2013. Accessed October 1, 2014.
Warning signs. Stop It Now website. Available at:
http://www.stopitnow.org/warnings. Accessed October 1, 2014.
What is considered child sexual abuse? Stop It Now website. Available at: http://www.stopitnow.org/warning_signs_csa_definition. Accessed October 1, 2014.
Last reviewed September 2014 by Michael Woods, 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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