Child Maltreatment - Sexual Abuse

What is sexual abuse?

Sexual abuse of a child occurs when someone has sexual contact with anyone younger than 18 years old. It includes kissing, showing genitals to the child, fondling the child's genitals, showing sexual materials, or using force to have sex. Sexual exploitation, which includes child prostitution and pornography, is also sexual abuse. Parents, guardians, foster parents, relatives, or a carer of a child may be responsible for sexual abuse.

What causes sexual abuse?

The exact cause of sexual abuse of a child is not known. Poor, violent, or crowded living conditions may be one of the reasons why it occurs. The following are other possible causes and conditions that may increase your child's risk of sexual abuse:

• Risks related to your child:
  
  
  • Your child is 6 years old or younger.
    
    
  • Your child has learning or memory problems.
    
    
  • Your child has long-term conditions or special needs.
    
    
  • Your child has no relatives or friends who can take care of him.
  
  
• Risks related to the people your child is around:
  
  
  • Your child has a single or a teenaged parent.
    
    
  • Your child is around someone who drinks alcohol or uses drugs.
    
    
  • Your child is around someone who has a history of family violence, such as physical, sexual, or other abuse.
    
    
  • Your child is around someone who has a personality disorder, depression, or another mental illness.
    
    
  • Your child is around someone who has stress due to work or financial problems.
    
    
  • Your child is around someone who lacks knowledge about the normal development of a child.

What are the signs and symptoms of sexual abuse?

Your child may act strange or differently, have changes in behavior or moods, or trouble sleeping. He may be depressed, fearful, or have sexual behaviors that are not right for his age. A sexually abused child may also be physically abused. Your child may also have any of the following:

• Scratches, bruises, or bite marks
  
  
• Marks from objects used for restraining, such as belts, ropes, or electrical cords
  
  
• Cuts or scars in the genital area
  
  
• Pain or difficulty urinating or having a bowel movement
  
  
• Pain or itchiness in the genital area
  
  
• Sores, growths, or small blisters in the genital area
  
  
• Blood or discharge from the genital area
  
  
• Stains in his clothing
  
  
• Pregnancy

How is sexual abuse diagnosed?

Your child's caregiver will examine your child's body closely to look for injuries caused by physical or sexual abuse. Your child may be asked if he has been touched, kissed, forced to have sex, or photographed naked. Caregivers may also want to know who the abuser is, and how long the abuse has been happening. Your child may also need any of the following tests:

• Blood and urine tests: These tests may be done to check for health problems, such as a sexually transmitted infection, other infections, physical injury to an organ, or pregnancy.
  
  
• Culture and smear exam: A sample of discharge may be tested for sexually transmitted infections (STIs).
  
  
• Forensic tests: Hair strands and samples of stains or discharge from the skin, clothing, a blanket, or the scene of the abuse may be examined.
  
  
• Pelvic exam: Girls may need to have this exam so caregivers can check any injuries that may have resulted from the abuse.
  
  
• Colposcopy: This procedure uses a small scope and light on the end. It is used to see the inside of your child's vagina and cervix to check for injuries.

How is sexual abuse treated?

A child who has been sexually abused may be admitted to a hospital or placed in a foster home. Special services may be offered to ensure the child's safety and health.

• Counseling: Sexual abuse may cause your child to feel scared, depressed, or anxious. Your child's caregiver may suggest that your child see a counselor to help him with how he feels.
  
  
• Medicines: Caregivers may give your child medicine to help ease his pain. He may need antibiotic medicine or a tetanus shot if there is an open wound. Medicines may also be given if he has other medical conditions.
  
  
• Surgery: Your child may need surgery to treat injuries. Damaged tissues may be repaired if there is a wound or cut, especially in the genital area.

What are the risks of sexual abuse?

If sexual abuse is not treated, your child may develop serious health and mental problems. Sexual abuse may lead to injuries, unwanted pregnancies, and can be life-threatening. Your child's behavior may change, and he may develop other serious problems. These include alcohol or drug use, depression, and problems with his self-esteem, mood, friendships, and relationships. He may even have thoughts of harming himself or others.

How can I care for a child victim of sexual abuse?

• Rest: Let your child rest if he needs to. Tell your child's caregiver if your child has trouble sleeping.
  
  
• Report sexual abuse: It may be hard to report child sexual abuse, but it is very important. Caregivers can help your child if he is at risk for or is a victim of sexual abuse. Caregivers are required by law to report sexual abuse. Your child may need to leave his current living situation and be placed in foster care to protect him from the abuse.

Where can I find support and more information?

• American Academy of Family Physicians
  11400 Tomahawk Creek Parkway
  Leawood , KS 66211-2680
  Phone: 1- 913 - 906-6000
  Phone: 1- 800 - 274-2237
  Web Address: http://www.aafp.org
  

When should I contact my child's caregiver?

Contact your child's caregiver if:

• Your child is sad or depressed most of the time, or frightened of other people.
  
  
• Your child has new signs and symptoms since his last visit.
  
  
• You have questions or concerns about your child's condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

• Your child feels that he cannot cope with the abuse, or his recovery from it.
  
  
• Your child has blood or foul-smelling discharge coming from his genital area.
  
  
• Your child has problems sleeping, urinating, or having bowel movements.
  
  
• Your child has trouble breathing, chest pain, or a fast heartbeat.
  
  
• Your child feels like hurting himself or someone else.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

Learn more about Child Maltreatment - Sexual Abuse