• An unusual discharge from the penis or the vagina. It could just be a reaction to a new soap or laundry detergent, or it could be a sign of a sexually transmitted disease (STD). Call your pediatrician for an appointment; she can culture a sample of the discharge or examine it under a microscope to determine its cause. (Most sexual abuse of preschoolers doesn't involve penetration and therefore the risk of STDs is low.)



• Repeated touching of his genitals in public, even after you have told him many times to stop. This goes well beyond just the normal frequent touching often seen in young children; it involves much more compulsive and anxious touching.



• Trying to get other children or adults to touch his genitals, or repeatedly trying to touch someone else's genitals, even after being told to stop.



• Manually stimulating or having oral or genital contact with pets.



• Repeatedly drawing pictures with the genitals as the primary focus.



• Playing with his feces. (When considering this possible symptom, keep in mind that toddlers often find feces interesting "playthings", and some smear feces as sign of protest or anger after the birth of a sibling or some other upsetting event.)



• Engaging in oral-genital sex with another child, or simulating intercourse with a peer, even if the children are clothed. Other red flags: any sex play involving a much older or younger child (by three or so years), or vaginal or anal penetration with fingers or other objects. (Note, however, that all sex play is not a cause for alarm; undressing each other, playing doctor, or "show me yours, I'll show you mine" usually are expected, harmless behaviors during the preschool years.)



• Anxiety about certain places or people. If, without apparent cause, your child appears anxious about being left in certain places or with certain people, talk to him about what is making him feel uncomfortable. If you can't get a satisfactory answer, it's reasonable to ask him once or twice if anyone touched him in a way that made him feel bad (or hurt him in any other way) and then told him not to tell; sometimes this gives a child permission to reveal he was abused. If you ask in a somewhat disinterested way (i.e., not with a lot of emotion in your voice), I don't think there is much chance of worsening the trauma. Don't grill your child.

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