Child Sexual Abuse

Child Sexual Abuse

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 The child may become withdrawn and mistrustful of adults, and can become suicidal.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 external signs of child sexual abuse. Some signs can only be detected on physical exam by a physician.

TABLE 1: TYPES OF SEXUAL ABUSE (OF CHILDREN)Non-Contact
· Photographing the child for sexual purposes
· Showing the child pornographic materials
· Sexualized talk with the child
· Making fun of or ridiculing the child's sexual development, preferences, or organs
· Verbal and emotional abuse of a sexual nature
· Exposing genital area to child for sexual gratification
· "Peeping" in on child while dressing, showering, using the restroom
· Masturbating in front of the child
· Making the child witness others being sexually abusedContact
· Touching the child sexually
· Invasive care of the child's genitals
· Stripping the child to hit/spank; obtaining sexual gratification out of hitting
· Making the child touch the adult sexually
· Making the child masturbate the adult
· Making the child engage in oral sex
· Making the child engage in vaginal or anal intercourse
· Making the child engage in prostitution
· Making the child engage in sexual activity with animals
Sexually abused children may also 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.

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.

Child psychopathology is the manifestation of psychological disorders in children and adolescents. Oppositional defiant disorder, attention-deficit hyperactivity disorder, and pervasive developmental disorder are examples of child psychopathology. Counselors, social workers, psychologists and psychiatrists who work with mentally ill children are informed by research in developmental psychology, developmental psychopathology, clinical child psychology, and family systems.


Child development refers to the biological and psychological changes that occur in human beings between birth and the end of adolescence, as the individual progresses from dependency to increasing autonomy. Because these developmental changes may be strongly influenced by genetic factors and events during prenatal life, genetics and prenatal development are usually included as part of the study of child development. Related terms include "developmental psychology", referring to development throughout the lifespan and "pediatrics", the branch of medicine relating to the care of children. Developmental change may occur as a result of genetically-controlled processes known as maturation, or as a result of environmental factors and learning, but most commonly involves an interaction between the two.
Age-related development terms are: newborn (ages 0–1 month); infant (ages 1 month – 1 year); toddler (ages 1–3 years); preschooler (ages 4–6 years); school-aged child (ages 6–13 years); adolescent (ages 13–18).[1] However, organizations like Zero to Three and the World Association for Infant Mental Health use the term infant as a broad category, including children from birth to age 3, a logical decision considering that the Latin derivation of the word infant refers to those who have no speech, The optimal development of children is considered vital to society and so it is important to understand the social, cognitive, emotional, and educational development of children. Increased research and interest in this field has resulted in new theories and strategies, with specific regard to practice that promotes development within the school system. In addition there are also some theories that seek to describe a sequence of states that comprise child development.
Facts for Families
Not all children grow from infancy through their adolescent years without experiencing some bumps along the way. While every child is unique and special, sometimes they encounter emotions, feelings or behavior that cause problems in their lives and the lives of those around them. Families often worry when their child or teenager has difficulty coping with things, feels sad, can't sleep, gets involved with drug, or can't get along with family or friends.
The AACAP developed Facts for Families to provide concise and up-to-date information on issues that affect children, teenagers, and their families. The AACAP provides this important information as a public service and the Facts for Families may be duplicated and distributed free of charge as long as the American Academy of Child and Adolescent Psychiatry is properly credited and no profit is gained from their use.