Recognizing Sexual Abuse in Children

Recognizing Sexual Abuse in Children

If you work with or around children, you are likely coming into contact with those who have been sexually abused in the past, or may even be in the midst of an abusive situation. While this may sound shocking or hard to believe, statistics suggest that about 1 in 4 girls and 1 in 6 boys are victims of sexual abuse at some point in their childhood.

Frequency and Reporting
While some may want to downplay the seriousness of sex offenses in a misguided belief that most involve underage but “consenting” teenagers, they are mistaken. The average age for childhood sexual abuse to occur is 9 years old.

Most of the children (between 80 and 90 percent) never tell anyone about the abuse. It is kept hidden by the child, only to complicate the already devastating results that sexual abuse has on a child. In fact, our society’s sexual abusers rely on the shame and guilt associated with sexual abuse in order to avoid being caught. This leaves the abuser free to continue in a destructive pattern that preys upon the most unsuspecting and vulnerable members of our society, and further complicates the ramifications of abuse in the victim who has no way to process the event(s) alone.

The Signs of Sexual Abuse in Children
Since the problem we face is so rampant and the likelihood of sexual abuse being reported by a child voluntarily is so low, it is vital to lean about some of the possible signs or patterns that a sexually abused child may exhibit. All people who work with children need to become educated in recognizing these signs in order to combat the prevalence of sexual abuse in our society and to provide all children with a safe environment and society in which to grow and develop.

Obviously the presence of one or some of the signs or behaviors discussed below do not necessarily mean sexual abuse is taking place, but they should definitely raise red flags, and merit a closer look at the child’s situation with the possibility of follow up.

Personality or Behavior Change as an Indicator
One of the key factors to keep in mind when dealing with recognizing abuse is that sudden or dramatic changes in personality and behavior should be taken into account. Changes in personality or behavior might include:

  • Sudden drop in school grades/Sudden school difficulties
  • Sleep disturbances/Changed sleeping patterns
  • Emotional changes/Abrupt mood swings
  • Change in attitudes toward authority/Hostility
  • Changes in physical appearance/Lack of self-care/Changes in dress
  • Sudden sexualized behavior
  • Changes in or disturbance of development/Regressive behavior such as bed-wetting, thumb sucking
  • Change in appetite/Loss of appetite/Avoiding eating or meal time
  • Changes in sociability / Loss of interest in hobbies, friends / Increased aggression toward others

Indicators of Sexual Abuse in Children (would you call these static?)
It is harder to detect change in a child if they are not well known to you, or you see them on an infrequent  basis. Below are some basic signs to watch for that can be indicators of sexual abuse. They are divided into categories of physical, behavioral, educational, sleep, and sexual indicators. Again, a child who exhibits one or more of these signs is not necessarily a victim of sexual abuse. Your responsibility as a caregiver, teacher, children’s worker, etc. is to be aware of the signs and to be prepared to deal with any possible revelations of sexual abuse of a child in your care.

Physical Indicators
Physical indicators of abuse may be the most obvious but least likely to be observed indicators, unless you are working with very young children.

  • Sexually-transmitted disease
  • Bruising/bleeding in rectal, thigh, and/or genital areas
  • Complaints of stomach and abdominal pain
  • Recurrent urinary tract infections, yeast infections
  • Drastic weight loss/gain
  • Signs of exhaustion/lack of sleep
  • Signs of intoxication after spending time w/adult or older adolescent

Behavioral Indicators

  • Regressive behavior that is developmentally inappropriate such as bed-wetting or thumb sucking.
  • Acting out: This will exhibit in a child’s willingness to risk negative attention with their disruptive behaviors.
  • Running away
  • Threats or attempts of suicide or self destructive behavior: older children especially may engage in physically self destructive activities that may include cutting, severe limitations on food intake and talking about, asking questions about, or even attempting suicide.

Educational Indicators
Many of the tell tale signs of abuse in this category have been discussed in the previous section on patterns in behavior changes, but there are static signs as well. Truancy and skipping class as well as difficulty concentrating may be indicative.

Sleep Indicators
A child that frequently and unexplainably seems tired, sleeps in full daytime clothing, has sleep disturbances, nightmares, or an extreme fear of bedtime or sleeping may be exhibiting signs of sexual abuse.

Sexual Indicators
“Child sexual abuse has been defined by the American Academy of Pediatrics as the engaging of a child in sexual activities that the child cannot comprehend, for which the child is developmentally unprepared and cannot give informed consent, and violate the social taboos of society.ii” This definition is especially helpful when considering some of the sexual indicators of abuse:

  • Excessive masturbation
  • Age-inappropriate sexual knowledge
  • Sexualized play
  • Seductive behavior
  • Promiscuity
  • Boundary issues

What to do if a Child Reveals Sexual Abuse to You
If a child reveals sexual abuse to you, you must take the allegations seriously and you must take action.

In many cases, there is a legal as well as an ethical compunction to act. You should always be aware of the reporting requirements at your workplace or organization. Certainly the revelation of sexual abuse of a child is an upsetting and frightening experience, but you must remain focused on the child and taking the necessary steps to prevent further occurrence and bring intervention.

Adults should communicate love and concern, not fear, embarrassment, or indecision when discussing the allegations of abuse with the child. Try to remain calm and focus on helping the child. You may process your own emotions at a later time. You should immediately reinforce the child by telling them that they did the right thing in coming to an adult about the situation. Reassure them that this is not their fault, and that you will help them. Your next step is to be sure that the accused perpetrator has no further access to the child. Do not conduct your own investigation of the charges. You must contact local law enforcement or child protective services immediately. You should make the appropriate authorities at your workplace or organization aware of the situation, but it is your responsibility to follow through on the situation and help the child who has confided in you.

i Pediatrics, Child Sexual Abuse. Ann S Botash, MD, Director, Child Abuse Referral and Evaluation Program, Professor and Vice Chair for Educational Affairs, Department of Pediatrics, State University of New York Upstate Medical University