Child Sexual Abuse

Julia Whealin, Ph.D.
National Center for PTSD


Child sexual abuse includes a wide range of sexual behaviors that take place between a child and an older person. These sexual behaviors are intended to erotically arouse the older person, generally without consideration for the reactions or choices of the child and without consideration for the effects of the behavior upon the child. Behaviors that are sexually abusive often involve bodily contact, such as in the case of sexual kissing, touching, fondling of genitals, and oral, anal, or vaginal intercourse. However, behaviors may be sexually abusive even if they don't involve contact, such as in the case of genital exposure ("flashing"), verbal pressure for sex, and sexual exploitation for purposes of prostitution or pornography.

Who are the perpetrators of child sexual abuse?
Legal definitions of what constitutes child sexual abuse usually require that the perpetrator be older than the victim. For example, in some states perpetrators must be at least five years older than their victims for the behavior to be considered child sexual abuse.

Most often, sexual abusers know the child they abuse but are not relatives. In fact, about 60% of perpetrators are nonrelative acquaintances, such as a friend of the family, babysitter, or neighbor.

About 30% of those who sexually abuse children are relatives of the child, such as fathers, uncles, or cousins.

Strangers are perpetrators in about 10% of child sexual abuse cases.

Men are found to be perpetrators in most cases, regardless of whether the victim is a boy or a girl. However, women are found to be perpetrators in about 14% of cases reported against boys and about 6% of cases reported against girls.

Child pornographers and other perpetrators who are strangers now also make contact with children using the Internet.

How does one know if a child has been sexually abused?
Researchers estimate that, in our country, about 10% of boys and 25% of girls are sexually abused.

Unfortunately, there are often no obvious signs that a child has been sexually abused. Because sexual abuse often occurs in private, and because it often does not result in physical evidence, child sexual abuse can be difficult to detect.

There is not a "child sexual abuse syndrome," or any symptom that a majority of sexually abused children exhibit.

What are some symptoms sexually abused children exhibit?
Some children may show symptoms of PTSD, including agitated behavior, frightening dreams, and repetitive play in which aspects of the abuse are expressed.

Because of their sexual abuse, children may show sexual behavior or seductiveness that is inappropriate for their age.

As a result of abuse, children, especially boys, tend to "act out" with behavior problems, such as cruelty to others and running away.

Other children "act in" by becoming depressed or by withdrawing from friends or family.

Sometimes children may try to injure themselves or attempt suicide.

What can parents and caretakers do to help keep children safe?
Talk to your children about the difference between good touch and bad touch. Tell the child that if someone tries to touch his or her body and do things that make the child feel uncomfortable, he or she should say NO to the person and tell you about it right away.

Let children know that they have the right to forbid others to touch their bodies in a bad way. Let them know that respect does not always mean doing what those in authority tell them to do. Do not tell them to do EVERYTHING the babysitter or group leader tells them to do.

Alert your children that perpetrators may use the Internet, and monitor your children's access to online websites.

Most importantly, provide a safe, caring environment so children feel able to talk freely about sexual abuse.

What should parents and caretakers do if they suspect abuse?
If a child says she or he has been abused, try to remain calm.

Reassure the child that what has happened is not his or her fault.

Seek a medical examination and psychological consultation immediately.

Know that children can recover from sexual abuse, particularly if they have the support of a caring, available parent.

Get help yourself. It is often very painful to acknowledge that your child has been sexually exploited. Parents can harm children further if they inappropriately minimize the abuse or if they harbor irrational fears related to the abuse. Therapy can help caretakers deal with their own feelings about the abuse so that they are able to provide support to their children.

What are the possible long-term effects of child sexual abuse?
If child sexual abuse is not effectively treated, long-term symptoms may persist into adulthood. These may include:

  • PTSD and/or anxiety
  • Depression and thoughts of suicide
  • Sexual anxiety and disorders
  • Poor body image and low self-esteem
  • The use of unhealthy behaviors, such as alcohol abuse, drug abuse, self-mutilation, or bingeing and purging, to help mask painful emotions related to the abuse
  • If you were abused as a child and suffer from any of these symptoms, it may help you to get help from a mental-health professional who has expertise in working with people who have been sexually abused.

Recommended Books That Address Child Sexual Abuse
Allies in Healing: When the Person You Love Was Sexually Abused As a Child, a Support Book by Laura Davis. (1991). Harperperennial Library; ISBN 0060968834

The Courage to Heal: A Guide for Women Survivors of Child Sexual Abuse by Ellen Bass and Laura Davis. (1994). Harperperennial Library; ISBN 0060950668

Trauma and Recovery: The Aftermath of Violence from Domestic Abuse to Political Terror by Judith Herman. (1997). Basic Books; ISBN 0465087302.

Shattered Assumptions: Toward a New Psychology of Trauma by Ronnie Janoff-Bulman. (1992). The Free Press; ISBN 0029160154

Victims No Longer: Men Recovering from Incest and Other Sexual Child Abuse by Mike Lew, Foreword by Ellen Bass. (1990). HarperCollins; ISBN 0060973005

Wounded Boys Heroic Men: A Man's Guide to Recovering from Child Abuse by Danial Jay Sonkin and Lenore E. A. Walker. (1998). Adams Media Corporations; ISBN 1580620108

References
Ackerman, P. T., Newton, J. E.O., McPherson, W. B., Jones, J. G., & Dykman, R. A. (1998). Prevalence of post traumatic stress disorder and other psychiatric diagnoses in three groups of abused children (sexual, physical, and both). Child Abuse & Neglect, 22, 759-774.

Boney-McCoy, S. & Finkelhor, D. (1996). Is youth victimization related to trauma symptoms and depression after controlling for prior symptoms and family relationships? A longitudinal, prospective study. Journal of Consulting and Clinical Psychology, 64, 1406-1416.

Collings, S. J. (1995). The long-term effects of contact and noncontact forms of child sexual abuse in a sample of university men. Child Abuse and Neglect, 19, 1-6.

Jumper, S. (1995). A meta-analysis of the relationship of child sexual abuse to adult psychological adjustment. Child Abuse and Neglect, 19, 715-728.

Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164-180.

Neumann, D. A., Houskamp, B. M., Pollock, V. E., & Briere, J. (1996). The long-term sequelae of childhood sexual abuse in women: A meta-analytic review. Child Maltreatment, 1, 6-16.