Child Sexual Abuse

Question for Mommy MD:

Should we fear other children molesting children of the same age range?
What signs should we look for curious kids or actual kids who are causing
harm? This is a big issue bigger than most think. When our kids are
playing with other children we assume they are "safe". I am unable to find
guidelines for this. Also, please write about good information on how to deal
with actual molestation and what to tell your child. What is playing and
what is not.

It’s late and I just finished seeing my last patient of the day. She’s twelve years old and has had depression and anxiety since she was molested in second grade by her student teacher. Unfortunately this is not unusual. The American Academy of Pediatrics (http://www.aap.org/) gives the following statistic. “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.” Because most of the children that have been abused show no signs of abuse we need to rely on them to tell us what happened. Therefore sex education and prevention should start when children are young. Begin slowly and use terms that are simple and understandable. You need to teach them the correct names of their private parts (i.e., those areas that are covered up by a bathing suit) and that no one should be touching those areas. As they enter middle school and young adulthood you should expand their knowledge and give additional information as appropriate. It’s very important to listen to your children and make sure that you know who your child is hanging around. Drop in at your child’s caregiver without notice and make sure your children aren’t going to out-of-the-way places with adults or older children. - The offender is usually adults or older children and 8 out 10 times the victim knows them.

The following may be signs that someone is sexually abused:

1. Noticeable fear of a person or certain places;
2. Unusual or unexpected response from the child when asked if she was touched by someone;
3. Unreasonable fear of a physical exam;
4. Drawings that show sexual acts;
5. Abrupt changes in behavior, such as bedwetting or losing control of his bowels;
6. Sudden awareness of genitals and sexual acts and words;
7. Attempting to get other children to perform sexual acts. (Reference: American Academy of Pediatrics: Parenting Corner: Child Abuse: What is Child Sexual Abuse? http://www.aap.org/)

You can minimize your child’s risk and exposure to potential offenders, but you can also empower your child! Tell them it is okay to say no to an adult and that they can come and talk with you. Sex education is one of the most important conversations you will ever have with your child. If they can’t talk to you where are they going to go?

If you suspect that your child or someone else’s child has been sexually abused contact your pediatrician or another person of authority. They can refer you to a local center that specializes in investigating these cases. For more information on child sexual abuse or other forms of abuse, write to the National Committee for Prevention of Child Abuse, PO Box 2866, Chicago, IL 60690.

Sheila Cason M.D. F.A.A.P.