Definition of child sexual abuse and signs that a child is a victim of sexual abuse.

Sexual abuse of children is a harsh fact of life in our society. It is more common than most people realize. Some surveys say at least 1 out of 5 adult women and 1 out of 10 adult men report having been sexually abused in childhood.

Child sexual abuse is any sexual act with a child performed by an adult or an older child. This might be fondling the child's genitals; getting the child to fondle an adult's genitals; mouth to genital contact; rubbing an adult's genitals on the child; or actually penetrating the child's vagina or anus.

Other forms of abuse can also occur that are not as easy to detect. These include showing an adult's genitals to a child, showing the child pornographic or "dirty" pictures or videotapes, or using the child as a model to make pornographic materials.

Boys and girls are abused in this way most often by adults or older children who are known to them and who can exert power over them. The victim knows the offender in 8 out of 10 reported cases. The offender is often an authority figure whom the child trusts or loves. The offender persuades, bribes, tricks, or coerces the child to engage in sex or sexual acts.

You hope that your son or daughter would tell you or someone else about it. Yet, children who are being abused often have been convinced or threatened by the abuser that they must not tell anyone about it. A child's first statements about abuse may be vague and incomplete. He may just hint about the problem. Some abused children may tell their friends about it, who may then tell an adult. Many children tell about abuse after a personal safety program is held at their school. Sometimes parents may have suspicions about abuse. Parents need to be aware of the following behavioral changes in their child; these may signal sexual abuse:

• Noticeable fear of a person or certain places
• Unusual or unexpected response from the child when asked if she 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 his bowels
• Sudden awareness of genitals and sexual acts and words
• Attempting to get other children to perform sexual acts

Physical signs of child sexual abuse may include sexually transmitted diseases such as gonorrhea. During an exam a pediatrician may also notice changes in the anal or genital areas.

If your child does reveal sexual abuse to you, the most important point is to take what your child says seriously. Many children who report sexual abuse are not believed. When a child's plea for help is ignored, he may not risk telling again. As a result, the child could remain a victim of abuse for months or years.

Listen to your child's explanation for disclosing the abuse. Make sure you report the abuse and help your child to understand that the abuse is not his or her fault. Give lots of love, comfort, and reassurance.

If you are angry, make sure you let your child know you're not angry with him. Let your child know how brave he was to tell you and that you understand how frightened and scared he feels. This is most important if the child has been abused by a close relative or family friend. Then, tell someone yourself and get help. Talk to your child's pediatrician, a counselor, a police officer, a child protective service worker, or a teacher.

Sources:

• Administration for Children and Families
• National Clearinghouse on Child Abuse and Neglect Information
• National Institutes of Health-National Library of Medicine
• U.S. Department of Health and Human Services, National Center on Child Abuse and Neglect