Signs of Sexual Abuse in Children

November 21, 2009

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Signs of Sexual Abuse in Children

by Debra W. Haffner, M.P.H., F.S.A.M.
reviewed by Robert Needlman, M.D., F.A.A.P.

For many parents, the possibility that their child may be sexually abused ranks among their greatest fears. They recognize that a preschooler or school-age child may not tell them that someone has touched him inappropriately, and they ask me how to tell if their child has been sexually abused.

There are some behaviors that might signal sexual abuse, but they also just might signal that a child has somehow come upon adult movies and television, or is distressed about something else. So, while it's important to maintain a watchful eye, don't panic if your child exhibits any of the following:

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.

What you can do
If your child is engaging in any of these behaviors, try to stay calm. It can be hard to tell whether or not abuse is involved, but you should trust your instincts and err on the side of caution. Call your pediatrician and ask for an evaluation and consultation. Consider contacting a mental health professional who specializes in child sexual abuse and assessment. If abuse is involved, seek counseling and support for your family.

There are several national organizations that also can help, including:
The National Clearinghouse on Child Abuse and Neglect
The National Committee for the Prevention of Child Abuse


RELATED INFORMATION

			Sexuality
			Sex & Sexuality

Created September 09, 2001
Reviewed December 10, 2001

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