Tuesday, November 13, 2007

Inappropriate Touching - Is it Child Sexual Abuse?

Question for Mommy MD:

Dear Dr. Cason,

I’m not sure where to start. I have a 4 year old little girl who pulled her cousins pants down a couple of days ago. I marked it as just curiosity and took the chance to open the floor for questions.

Then today I caught her with the same cousin who is two. He had his pants down and was lying on the floor; she had her mouth on him. I’m so full of mixed feelings and have asked her all kinds of questions. She said no one has done this to her or told her to do it. I can’t imagine when it could have happened but I do plan on having her checked.

But my question is:

Is it possible that this is still curiosity or is this a symptom of being molested and how can I get her to tell me?

I am a survivor of rape that took place for 13 years. I have always been protective, and I just don’t understand how it would have gotten pass me if someone had done this to her. Any thoughts would be greatly appreciated.


Dear Anonymous,

I’m sorry for your pain at this difficult time. It must be hard to suspect something and yet not know what the future holds for your child and your life. We all want to feel that our children
are 100% safe and when something threatens that, it’s devastating.

I can tell you that I am suspicious. Children are very curious at this age and it can be difficult to tell when a child is merely playing or actually imitating something she’s seen or been required to perform. But it sounds concerning enough that you must go see your pediatrician and they will refer you to the nearest facility that is trained to investigate such cases. They will help you to make sense of her actions. There is no way to “make” her tell you. In fact I would avoid overly questioning her. As pediatricians, we are trained as well to not overly question a young child. You want her response to be authentic and not merely a regurgitation of comments that are made to her. Your local Child Protective Services (CPS) is specialized in the interview process. Yes there is a specific way you must ask the question as to avoid leading the child or influencing her response. For this reason I leave the interview for the experts.

For yourself, as a survivor of sexual abuse there are many issues that you will need to work through. I hope that this has happened for you already. If not please seek counseling. There are wonderful individuals that can help you heal. Also know that you can be your child’s biggest advocate. You’ll have to balance your emotions in this transitional time until you find the answers. But trust the experts and talk with your pediatrician.

I’m glad that you took this opportunity to discuss and answer deeper questions with your child. No matter how this turns out, you’ll need to continually do this with her. I’ve had a lot of people, particularly women with a history of molestation, feel uncomfortable bringing up “private” issues. As parents we need to get over this. A penis is a penis, and a vagina is a vagina. There’s nothing inherently wrong with the words or the parts of the body. But they are private and kids need to be taught what’s appropriate. This way they can recognize when something doesn’t
seem right and tell an adult that they trust.

Please see my previous articles on “Playing House” and “Child Sexual Abuse”. I have listed signs that may be present when someone is sexually abused. I wish you and your little girl well. Please don’t hesitate to ask any further questions.

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, MD

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