What are the indicators of child sexual abuse?

What are the indicators of child sexual abuse? This is one of the most commonly asked questions, and there is no simple answer.  Children cope and communicate in a variety of ways and often do not feel safe enough to discuss their abuse.  Because most children are not physically injured as a result of sexual abuse, the way in which a child behaves or express the abuse can vary.  Some children will disclose or tell about the abuse while others may instead give “hints” about the abuse.  A child’s age and development may also impact the way in which he or she reveals the abuse.  Below is a summary of some of the most common indicators of sexual abuse in a child.

Behavioral Indicators:

·         Lack of trust, social isolation and lack of friendships

·         Nightmares

·         Abrupt changes in behavior or personality

·         Aggression

·         “Flashbacks”

·         Acts of self-mutilation or self-injury

·         Suicidal ideations or attempts

·         Excessive crying

·         Truancy or “Runaway” behavior

·         Over compliance or submissive behavior

·         Temper tantrums

·         School problems such as sudden drop in grades or participation

Emotional Indicators:

·         Self hate

·         Obsessive ideas and thoughts

·         Regression to younger development stage

·         Lack of affect

·         Depression and/or withdrawal

·         Anxiety, fear and irritability

·         Low self-esteem

·         Feelings of helplessness

·         Excessive guilt

·         Phobias

Sexual/Physical Indicators:

·         Fatigue and/or exhaustion

·         Enuresis (wetting of pants or the bed)

·         Encopresis (soiling of pants)

·         Drastic changes in appetite

·         Sleep disturbances

·         Hypervigilance

·         Increased startle response

·         Avoidance of touch

·         Reluctance to undress in normal settings

·         Excessive masturbatory behavior

·         Detailed and age-inappropriate knowledge of sexual activity

·         Sexualized play with self or others

·         Attempts to touch genitals or “private areas” of others (child and/or adult)

The American Academy of Pediatrics (http://www.aap.org/) reports the following are also common behavior changes in victims of child sexual abuse:

·         Noticeable fear of a person or certain places

·         Unusual or unexpected response from the child when asked if she or he was touched by someone

·         Unreasonable fear of a physical exam

·         Drawings that show sexual acts

·         Abrupt changes in behavior, such as bedwetting or losing control of the bowels

·         Sudden awareness of genitals and sexual acts and words

·         Attempting to get other children to perform sexual acts

Other more obvious signs of sexual abuse include:

·         Sexually Transmitted Diseases or “STDs” such as Gonorrhea or Chlamydia. 

·         Pregnancy