Facts for Families

Child Sexual Abuse

No. 9; Updated July 2004

Child sexual abuse has been reported up to 80,000 times a year, but the number of unreported instances is far greater, because the children are afraid to tell anyone what has happened, and the legal procedure for validating an episode is difficult. The problem should be identified, the abuse stopped, and the child should receive professional help. The long-term emotional and psychological damage of sexual abuse can be devastating to the child.

Child sexual abuse can take place within the family, by a parent, step-parent, sibling or other relative; or outside the home, for example, by a friend, neighbor, child care person, teacher, or stranger. When sexual abuse has occurred, a child can develop a variety of distressing feelings, thoughts and behaviors.

No child is psychologically prepared to cope with repeated sexual stimulation. Even a two or three year old, who cannot know the sexual activity is wrong, will develop problems resulting from the inability to cope with the overstimulation.

The child of five or older who knows and cares for the abuser becomes trapped between affection or loyalty for the person, and the sense that the sexual activities are terribly wrong. If the child tries to break away from the sexual relationship, the abuser may threaten the child with violence or loss of love. When sexual abuse occurs within the family, the child may fear the anger, jealousy or shame of other family members, or be afraid the family will break up if the secret is told.

A child who is the victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or distorted view of sex. The child may become withdrawn and mistrustful of adults, and can become suicidal.

Some children who have been sexually abused have difficulty relating to others except on sexual terms. Some sexually abused children become child abusers or prostitutes, or have other serious problems when they reach adulthood.

Often there are no obvious physical signs of child sexual abuse. Some signs can only be detected on physical exam by a physician.

Sexually abused children may develop the following:

• unusual interest in or avoidance of all things of a sexual nature
• sleep problems or nightmares
• depression or withdrawal from friends or family
• seductiveness
• statements that their bodies are dirty or damaged, or fear that there is something wrong with them in the genital area
• refusal to go to school
• delinquency/conduct problems
• secretiveness
• aspects of sexual molestation in drawings, games, fantasies
• unusual aggressiveness, or
• suicidal behavior

Child sexual abusers can make the child extremely fearful of telling, and only when a special effort has helped the child to feel safe, can the child talk freely. If a child says that he or she has been molested, parents should try to remain calm and reassure the child that what happened was not their fault. Parents should seek a medical examination and psychiatric consultation.

Parents can prevent or lessen the chance of sexual abuse by:

• Telling children that 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
• Teaching children that respect does not mean blind obedience to adults and to authority, for example, don't tell children to, Always do everything the teacher or baby-sitter tells you to do
• Encouraging professional prevention programs in the local school system

Sexually abused children and their families need immediate professional evaluation and treatment. Child and adolescent psychiatrists can help abused children regain a sense of self-esteem, cope with feelings of guilt about the abuse, and begin the process of overcoming the trauma. Such treatment can help reduce the risk that the child will develop serious problems as an adult.

For additional information see Facts for Families:
#4 The Depressed Child
#5 Child Abuse
#10 Teen Suicide
#28 Responding to Child Sexual Abuse
#62 Talking to Your Kids about Sex
#73 Self-Injury in Adolescents
#00 Definition of a Child and Adolescent Psychiatrist

See also: Your Child (1998 Harper Collins) / Your Adolescent (1999 Harper Collins)

Click here to order Your Child from Harper Collins
Click here to order Your Adolescent from Harper Collins

Excerpts from Your Child on Sexual Abuse

Many parents are unsure or squeamish about bringing up sexual matters, especially with their children. Yet, there are ways of laying the groundwork so that you can talk to your child without scaring her. Establish an open dialogue about sexual issues early on. If you introduce the subject of sex in a discussion of abuse, there is the danger that the idea of sex may become automatically linked in your child’s mind with danger and anxiety.

If you have fostered in your child a sense of ownership regarding her body, she will likely have an instinct about what is okay for her body and what is not. You build on her natural sense of ownerships of her body by letting her pick out her own clothes or wash herself in her own way. Also, avoid pushing her to kiss or hug other adults when she clearly does not want to.

Finally, when parents treat their children’s bodies with respect, children tent to demand that others treat their bodies in a similar manner. Children who are consistently hit, grabbed, or physically punished at home may feel that adults are entitled to misuse their bodies simply because they are bigger.