Most people believe that child sexual abuse is extremely rare in today’s society. Sadly, this isn’t the case. As many as 1 out of 4 girls and 1 out of 6 boys experience some form of sexual abuse before the age of 18.

Children who experience sexual abuse do not typically experience it at the hands of a stranger; instead, it occurs with someone they know. Alarmingly, almost 75% of child sexual abuse is committed by family members, foster parents, or other familiar individuals.

What is child sexual abuse?

The World Health Organization (WHO) adopted a specific definition of child sexual abuse in 1999.

The definition states that: “Child sexual abuse is the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society.”

Child sexual abuse may occur between a child and an adult or a child and another child. Commonly, such sexual abuse involves coercing the child to perform sexual activities, exploiting a child through prostitution, or involving the child in pornographic performances or showing them pornographic materials.

What are the dynamics of child sexual abuse?

Sexual abuse of children is different from sexual abuse against adults. Children tend to be very trusting, especially with adults they know and rely on. Thus, those who engage in child sexual abuse tend to be older children or adults that manipulate the child’s trust to get them to engage in sexual activities.

Afterward, there is a feeling that the abuse must be hidden, lest others find out and the relationship ended.

It’s common for child sexual abuse to occur over long periods of time, sometimes even years. In some cases, it may begin at a very young age so that the child doesn’t know to expect anything different from the relationship. It usually starts very slowly, then becomes more serious over time.

Some adults can be classified as pedophiles. These individuals prefer sexual contact with children over adults and are usually strategic in their abilities to get close to children they are attracted to. In severe cases, pedophiles may share information about children online with other pedophiles.

Are there risk factors for becoming a victim of child sexual abuse?

Any child has the potential to be a victim of child sexual abuse. However, certain risk factors can increase the chances of child sexual abuse occurring. These include:

  • Being female
  • Children who are often unaccompanied or alone
  • Children who come from broken homes
  • Physically or mentally handicapped children
  • History of past abuse
  • Poverty
  • Being a part of war or another similar armed conflict
  • Children who are adopted or who have step-siblings
  • Parents with mental illness, alcohol, or drug dependency

Children who have multiple risk factors may be in more danger of possible child sexual abuse than others.

Signs of child sexual abuse

It’s important to be observant if you suspect child sexual abuse is occurring. There are several signs that a child may be experiencing sexual abuse.

These signs may manifest physically, behaviorally, or emotionally. A child’s response will be unique, and not all of these indications may be present.

Physical Signs

Common physical signs of child sexual abuse include:

  • Sexually transmitted infections
  • Unexplained injuries to the genital area
  • Pain, bleeding, or discharge in the genitals, anus, or mouth
  • Persistent or recurring pain with urination or bowel movements
  • Unexplained general ailments, such as headaches or stomach aches

Parents, caregivers, or other adults who see physical signs of sexual abuse should speak to the child and notify authorities immediately. Physical signs can provide significant evidence of child sexual abuse, while emotional and behavioral signs may be harder to decipher.

Behavioral Signs

Behavioral signs can vary tremendously but may be more apparent than physical signs. This is especially true for parents, caregivers, or other adults who are more familiar with the child’s normal behavior and realize when there are differences. Some signs include:

  • Knowledge about sexual topics that seem inappropriate for their age
  • Withdrawal from regular interactions and conversations with peers or activities they previously enjoyed
  • Desire to spend an unusual amount of time alone
  • Reluctance to leave school or other activities; not wanting to go home
  • Trying to avoid certain places or people
  • Regressing behaviors not normal for their age
  • Frequent absences from school or other activities
  • New gifts, such as money or toys with no explanation of where they came from
  • Refusing to share secrets or talk about certain things
  • Talking about a new friend that is an older child or adult
  • Removing clothing at inappropriate times
  • Drug or alcohol abuse
  • Running away from home
  • Fear of closeness with others

Any of these signs could indicate a sexual abuse problem.

Emotional Indicators

Signs of sexual abuse that cause emotional problems should never be ignored. While these signs may reflect other issues, they indicate a problem. These signs may include:

  • Self-harming or suicidal behavior
  • Nightmares, trouble sleeping, or fear of being alone at night
  • Change in mood or personality
  • New or increased depression or aggression
  • Disruption of normal eating habits
  • Decrease in self-confidence or the way they feel about themselves
  • Losing interest in school, friends, hobbies, or other things they used to care about

Emotional indicators can be serious and need to be addressed with a therapist.

What to do if you suspect someone is grooming a child for sexual abuse

Grooming is usually the first step a predator will take when they plan to sexually abuse a child. The grooming phase is a set of manipulative behaviors the abuser uses to gain access to a potential victim, coerce them to agree to the abuse, and reduce the chances of being caught.

Grooming is usually done by someone who may already be close to the child, such as a family member, coach, teacher, or youth group leader.

There is often a set pattern that occurs during the grooming process. It begins by selecting a victim based on ease of access. Next, the abuser will begin to isolate the child in some form. This may include one-on-one meetings under “normal” circumstances, such as tutoring for classes or playing sports.

During the isolation period, a sense of trust will begin to develop in the child. They may begin to feel special since the perpetrator will often use gifts and attention as a way to make the child feel they are in a caring relationship. In some manner, the child will be encouraged to keep the relationship a secret.

Once trust has developed, the abuse will begin. Initially, any touching that occurs will appear to be harmless, such as hugging or tickling. Later on, it may increase to more aggressive sexual contact. The abuser may introduce the child to pornography or discuss overtly sexual topics with them.

Abusers need to act under cover of secrecy to make their behavior seem natural. Once the abuse occurs, they will encourage their victims to keep it a secret using some form of influence or control.

What to do if you suspect child sexual abuse

If you notice behaviors in a child that lead you to suspect sexual abuse, it’s important to take action. Many state and local governments have specific laws and guidelines that establish what should happen if child sexual abuse is suspected. Make sure to familiarize yourself with them before taking action.

In the immediate interim, speak with the child to see if you can determine the cause of the behavior or other symptoms that you notice. Ensure that you remain open, engaging, and non-judgmental during the process. At no time should they feel that they are being victimized or shamed for what may have occurred.

Let them talk at a comfortable speed. Don’t treat it like an interview, but as a conversation, which they lead. If they ask questions, give them answers. Above all, let them know that they are safe with you.

Next, validate their feelings. Let them know their feelings are important, and don’t brush aside any feelings of shame. Discounting feelings may do more harm than good in the long run. If they appear numb, that isn’t unusual.

The child will need professional help if they have been sexually abused. This will need to occur with the assistance of a licensed therapist. If you are not the parent or caregiver—but an adult they trust—you’ll need to determine the best way to get them treatment.

How to respond if a child tells you they are being abused

Many children don’t report abuse for several different reasons. They may be scared of the repercussions, not realize that abuse has occurred, or not know who to tell. Thus, if a child tells you clearly that they have been abused—or uses language that indicates the potential for child sexual abuse—take notice.

When they tell you what has occurred, believe them, and engage them openly. Don’t be judgemental. Encourage the child to tell you exactly what happened in their own words. Stay calm, and tell them that their safety is important to you.

Find out the requirements in your state for reporting child sexual abuse and ensure that you follow them.

Are there any treatments for child sexual abuse?

If a child is admitted for treatment to a hospital because of sexual abuse, they will normally be assigned a team of doctors to assist them. The doctors will treat any physical ailments first, and afterward, psychotherapy will occur. The psychotherapy performed will be determined based on the type of assault the child experienced.

Trauma-based cognitive behavioral therapy is a type of therapy that is effective in lessening the symptoms of anxiety, depression, and PTSD associated with sexual abuse. It can help to address the child’s underlying thoughts and fears related to the trauma.

Children may also be prescribed medication that can help lessen the symptoms of anxiety or depression that are common in survivors of sexual abuse.

The long-term effects of child sexual abuse

If child sexual abuse remains untreated, long-term effects may occur. These can include an increased rate of depression, guilt, shame, eating disorders, dissociative patterns, sexual problems, and relationship problems.

A research survey of over 4 million individuals found that experiencing child sexual abuse results in a significantly greater likelihood of borderline personality disorder, depression, anxiety, post-traumatic stress disorder, and eating disorders.

Post-Traumatic Stress Disorder

Those with post-traumatic stress disorder that occurs as a result of child sexual abuse may experience flashbacks, nightmares, and severe anxiety. Their thoughts of the event can be uncontrollable. If left untreated, the disorder can disrupt relationships and cause self-destructive behavior.


Depression is a mood disorder that results in a persistent feeling of sadness or loss of interest. It can affect how an individual thinks or behaves. Depression can require long-term treatment, but most children, teens, and adults feel better with medication or psychotherapy.


People with anxiety disorders may have excessive worry and fear about everyday situations. These disorders often involve repeated episodes of anxiety that result in panic attacks.

Feelings of anxiety and panic may interfere with daily activities. If a child or teen develops anxiety due to sexual abuse, they will need therapy and medication to overcome it.

Eating Disorders

Since child sexual abuse is associated with the body, it’s not uncommon for victims to develop eating disorders to control the way their body appears. They may avoid eating to stay thin or develop a binge eating disorder. Eating disorders will require psychotherapy to overcome.

Awareness can help to prevent child sexual abuse

Child sexual abuse can have devastating effects on the child who experiences it and their family members and friends. But by remaining aware, you might be able to help a child who desperately needs it.

If you notice signs of child sexual abuse, take action immediately by notifying the proper authorities and adults. Doing so can prevent the abuse and potentially save a child from significant lifelong trauma.