Child sexual abuse is a significant, but preventable public health problem. Sexual abuse among children is a delicate and difficult topic, and one that requires sensitive and open discussion.

How common is child sexual abuse?

Because the world of child abuse is often veiled in secrecy, it is difficult to determine how often it occurs. According to the Center for Disease Control and Prevention (CDC), the data estimates that about one in four girls and one in 13 boys experience child sexual abuse at some point in childhood. Most experts believe that this is a low estimate as many cases are not reported.

An important fact for adults to keep in mind is that 91 percent of child sexual abuse is perpetrated by someone the child or child’s family knows.

What are the signs of sexual abuse that parents should watch for?

Children who have experienced sexual abuse may show signs through behavioral changes. If a child exhibits any of these signs, sexual abuse could be considered a possibility:

  • increase in nightmares or other sleeping difficulties
  • angry outbursts
  • anxiety
  • depression
  • withdrawn behaviors
  • bed wetting
  • thumb sucking
  • refusal to change for gym or to participate in physical activities
  • reluctance to be left alone with a particular person or group of people

If a child mentions that he or she has been touched inappropriately, what should you do?

If a child tells an adult about possible abuse, there are several steps a parent or caregiver should take.

  • First, create a quiet and private time to follow-up on what the child is reporting.
  • Be sure your child knows you believe what she or he is telling you. Convey to the child that you are listening intently to what is being presented.
  • Remember, over 90 percent of individuals who sexually abuse children are known to the child as a family member, friend, or care provider.
  • Resist the urge to dismiss what the child is telling you. Responses such as, “Oh, not Coach Bill!” or “Don't ever say that about your Grandfather” should be avoided.
  • Ask for clarification if you are unclear. Questions like, "How does that make you feel?" or "What is that like for you?" can be helpful.

What are the possible psychological implications of child sexual abuse?

Child sexual abuse is traumatic and can result in both short-term and long-term harm, including mental health problems that extend into adulthood. Some typical effects are feelings of guilt and fear, depression, anxiety, post-traumatic stress, eating disorders, or poor self-esteem. Behavioral problems such as school/learning problems, substance abuse, self-harm behaviors, risky sexual behaviors (those that could result in pregnancy or sexually transmitted infections), suicide, and sexual dysfunction in adulthood have been linked to childhood sexual abuse.

What can parents do to protect their children?

Talking is key. Parents can build some protection by talking with children about sexual issues early and often. These conversations should focus on teaching a child that some parts of the body are private and should not be touched except by very special adults such as Mom and Dad. There are several tips to help children understand.

  • Use easy-to-understand illustrations and explain that "parts covered by your bathing suit are private."
  • Focus on using terms such as "good touches/bad touches" or "okay/not okay" touches.
  • Teach children correct terms for body parts, such as breast, vagina, clitoris, penis, and buttocks. This helps to foster respect for their body and gives them words to talk about these issues in the future.
  • Empower children to say NO when they feel uncomfortable. A child will carry well-developed refusal skills into their teen years and can feel empowered to set limits in this and other areas such as bullying or substance abuse.

How to talk about news stories on sexual abuse with children

When children see stories on the news about sexual abuse, it can cause confusion and concern. Parents and other caregivers can take this opportunity to talk with children and teens about sexual abuse. Find a private and relaxed time and let your child know that you are open and willing to have an age-appropriate discussion on any concern or topic.

It is challenging for us adults to see the world as children might. Kids may not have the words to describe their concerns or formulate questions. Try to keep the tone serious and, above all, be a good listener. Kids often process information in chunks, so return to the topic when the child has had time to digest what is being said.

Other things to know about sexual abuse in children

Remember, most states have mandated reporting laws. All adults in Rhode Island, for example, are required by law to report known or suspected cases of child abuse or neglect to the Rhode Island Department of Children, Youth and Families within 24 hours of becoming aware. They can be reached at 1-800-RI-CHILD (1-800-742-4453).

If you need support, contact your primary care provider. If you notice behavioral changes in your child, we encourage you to contact a therapist or the Bradley Hospital Access Center online or at 1-855-543-5465.

For more tips on helping children be happy and healthy, visit the Growing section of our Lifespan Living health and wellness blog.

Margaret R. Paccione-Dyszlewski, PhD

Dr. Margaret Paccione-Dyszlewski is the director of clinical innovation at Bradley Hospital. She has more than 35 years of experience in supervisory and administrative positions as well as extensive experience with trauma patients and managing trauma-related service environments.