Know the warning signs of child sexual abuse

October 31, 2019 | by Sangita Rangala, MD, FAAEM
Categories: Healthy Driven Moms

Sexual abuse is a deplorable and heinous crime, especially when it happens to a child.

Every nine minutes, child protective services finds enough evidence to substantiate a claim of child sexual abuse, although we know child sexual abuse occurs much more frequently.

Child sexual abuse includes any kind of inappropriate sexual act or behavior with a child. It may also include non-physical contact (e.g., masturbation in the presence of a child, showing pornographic images to a child). 

Research shows that the greatest risk to children doesn’t come from strangers, but from friends and family. Abusers may also be teachers, coaches or instructors, caretakers, and others in positions of authority.

An abuser may look and act just like everyone else, but the trauma they inflict is utterly devastating. Child sexual abuse can seriously damage a child’s cognitive, social and emotional development, and cause lifelong issues. Learn how to protect your child from sexual abuse.

Child sexual abuse isn’t always easy to spot. RAINN (Rape, Abuse & Incest National Network) provides warning signs. Many of these warning signs alone may not indicate abuse, however when the signs are multiple or excessive, it may warrant contacting your child’s primary care physician or, if needed, seeking further evaluation.

Physical signs

  • Bleeding, bruises or swelling in genital area
  • Bloody, torn or stained underclothes
  • Difficulty walking or sitting
  • Abnormally frequent urinary or yeast infections
  • Abnormal pain, itching or burning in genital area

Behavioral signs

  • Significant changes in hygiene, such as refusing to bathe or bathing excessively
  • Trouble in school (absences, drop in grades)
  • Inappropriate sexual knowledge or behaviors
  • Night terrors or bedwetting in a previously potty trained child
  • Phobias, depression, anxiety, PTSD
  • Regressive behaviors, such as thumb sucking
  • Angry outbursts, tantrums
  • Withdrawn behavior, mistrustful of adults
  • Overly protective and concerned for siblings, or assumes a caretaker role
  • Running away from home or school
  • Shrinking away from normal physical contact
  • Self-harm, substance abuse, high-risk behaviors, suicidal thoughts or behaviors (especially in adolescents)

Although many children who have been sexually abused show signs, many others do not. If your child tells you that someone makes them uncomfortable, listen. If you suspect something isn’t right, don’t ignore it.

And, if your child discloses any sexual abuse, believe them. Children who have been sexually abused need a great deal of support so they can have the best chance at a full and healthy recovery. Your child’s primary care physician is a good first step for questions, and he/she can refer you to psychological counseling and community resources.

Care Center for sexually abused children, teens, special needs adults

Since 1991, the Care Center at Edward Hospital has provided medical care in a calm and caring environment for children, teens and special needs adults who are known or suspected to have been sexually abused. Our compassionate and knowledgeable staff uses a warm and empowering approach to restore your child’s sense of dignity and well-being. For more information or to make a referral to the Care Center, please call 630-527-3288. Learn more about the Care Center.

To talk to someone anonymously, call the National Child Abuse Hotline at 800-4-A-CHILD (422-4453), anytime, 24/7.

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If a friend says they were sexually assaulted, start with “I believe you.”


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