Signs of Child Sexual Abuse

Signs of Child Sexual Abuse

 

Child sexual abuse is the exploitation of a child for the gratification or profit of an adult. Sexual abuse can range from exhibitionism and fondling to intercourse or use of a child in the production of pornographic materials. Sexual abuse also may result in physical injury or be accompanied by other signs of abuse or neglect. Sexual abuse generally is perpetrated by someone known to the child and frequently continues over a prolonged period of time. Often it does not involve sexual intercourse or physical force. The incidence is estimated at 100,000 to 250,000 cases per year; however this type of abuse is difficult to detect and confirm.

 

 

PHYSICAL SIGNS

 

Any of the following physical signs may indicate abuse:

  • Difficulty in walking or sitting
  • Thickening and/or hyperpigmentation of the labial skin (especially when it resolves during out-of-home placement)
  • Horizontal diameter of vaginal opening that exceeds 4mm in prepubescent girls
  • Torn, stained, or bloody underclothing
  • Bruises or bleeding of the genitalia, perineum, or perianal area
  • Vaginal discharge and/or pruritus
  • Recurrent urinary tract infections
  • Gonococcal infection – Pharynx, Urethra, Rectum, Vagina
  • Syphilis
  • Genital herpes
  • Trichomonas
  • Chlamydial infection when resent beyond first six months of life (may be present at birth up to 6 months)
  • Lymphogranuloma venereum
  • Nonspecific vaginitis
  • Candidiasis
  • Pregnancy
  • Sperm or acid phosphatase on body or clothes; sperm in the urine of a female child
  • Lax rectal tone

 

BEHAVIORAL SIGNS

 

Children may display a wide range of psychological reactions to sexual abuse. Reactions depend on the age of the child, emotional maturity, nature of the incident, duration of sexual abuse, and the child’s relationship to the offender. The child may:

  • Confide in a relative, friend, or teacher; the disclosure may either be overt or subtle and indirect
  • Become withdrawn and daydream excessively
  • Evidence poor peer relationships
  • Experience poor self-esteem
  • Seem frightened or phobic, especially of adults
  • Experience distortion of body image
  • Express general feelings of shame or guilt
  • Exhibit a sudden deterioration in academic performance
  • Show pseudomature personality development
  • Attempt suicide
  • Exhibit a positive relationship toward the offender
  • Display regressive behavior
  • Display enuresis (wetting self) and/or encopresis (soiling self)
  • Engage in excessive masturbation
  • Engage in highly sexualized play
  • Become sexually promiscuous
  • Have a sexually abused sibling.
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