Many of these questions have been asked during a medical evaluation for child sexual abuse. The answers below are common responses.
Please note that this information does not substitute medical advice from your child's primary care provider or recommendations from other professionals.
Child Sexual Abuse involves engaging a child in activities which they don't understand, cannot consent to or those that violate social norms - such as sexual contact between parents, siblings and other family members. A child is anyone under the age of 18 years old but the age to consent to sexual activity is different in each state. The abuse can involve no contact (showing pornography, taking pictures or videos of a sexual nature, exposing genitals, etc), contact (fondling, oral contact, contact to genital or anus, etc) or sex trafficking.
Adults are responsible for ensuring that their child is in safe environment. Even in the best scenarios, attempts may be made to engage children in sexual contact. Children under the age of 12 years old who are sexually abused will know the offender in over 90% of the cases. It is important to teach children that they are in charge of their bodies and they can say "No" and then tell a grown up right away.
By talking to children about the prevention of child sexual abuse, you increase the chances that your child will know what to do and come to you if something ever happens.
When children have different names for their private parts it sometimes makes it harder to understand any inappropriate contact. For example, if a child calls their private part a "flower" and then states that someone touched their "flower," that might not be clearly understood as possible child sexual abuse.
Just as you teach a child to cross the street over a number of times, it is similar with body safety. These skills should be reinforced when there are new situations such as sleepovers, camps, or play dates.
Children are different so some may show signs and symptoms that they have been sexually abused while some children seem normal. The child may have changes in how they sleep or eat. Changes in their mood or behavior may also be seen. Some children start to perform poorly in school. There may also be physical complaints involving the anus, buttocks or oral area, urinary tract infections (UTI) , sexually transmitted infections (STIs), or pregnancy.
If your child tells you about something that made them feel uncomfortable or unsafe, that should be believed and looked into. Contact your child's health care provider on the best next steps. This might include having the doctor speak to your child alone, your child having a medical evaluation (which the physical exam often being normal), contacting Child Protective Services and/or law enforcement.
Grooming is when someone works to gain the trust of a child in order to sexually abuse them. The process can take several weeks and even up to years. Grooming can also occur online. Ways you can tell your child might be engaged in grooming include: receiving extra attention from an adult or older child, having unexplained money or gifts, change in behavior that is sexual in nature, or unexplained absences from home.
Children should be taught they will not be made to do anything with their bodies that makes them feel uncomfortable. By not forcing your child to show affection to a relative, you are teaching them "body autonomy." You are letting your child know that it is their body and they decide what happens with their body. You can help them find other respectful ways to show love to that older relative, such as a high five, a fist bump or a nice smile.
Tip: find resources and learn more about "Body Autonomy."
If a child does not feel safe or that they might not be believed, they might not tell a grown up right away. Sometimes children are threatened, fearful of upsetting others, or not really sure about what to do. Teaching body safety skills and your child understanding that they won't be in trouble for telling are important steps.
The message of body safety as described in "The Doctor Says: Let's Talk About Body Safety" can be used for all children. Ultimately, as the parent/caregiver, you know your child best. You may need to tailor some of the language of the basic message of which parts of their bodies (swimsuit areas and mouth) should not be involved, that they can say "No" and/or leave, and they must tell a grown-up right away.
It is uncommon for a child to fabricate being sexually abused. Children should be believed and action by a protective parent/adult should be taken to make sure they are evaluated. If a child has not been truthful in talking about something that may have happened to them, that should still be taken seriously. In those instances, talk therapy is often very helpful.
Often times, children are told that the act(s) of sexual abuse are "special secrets" or "secret games." Children should understand the difference between a secret and a surprise. For example, not telling their parent about the gift they are giving them for their birthday is a surprise. An adult doing things to them or having the child do things to them as a "secret," is never okay!
We have moved away from using "good touch" and "bad touch" because in some instances of sexual abuse, the act does not feel bad - and might actually feel good. The language has shifted to "safe" and "unsafe."
Children who are quiet and shy are sometimes more vulnerable and may be targeted for sexual abuse. This may include children who have developmental delays as well. According to some sources, children with disabilities are almost twice as likely to be engaged in inappropriate sexual activity. It is important to stress to your child that they can say that they have to leave and then leave. You should stress to your child that they are brave and they can leave.
You could use the "swimsuit" approach or make sure they know which areas of their bodies are private for them. The message of your older child feeling empowered to say "Stop!" or "Don't do that!" and telling a grown-up right away is the same.
Making sure that your child is with safe caregivers at all times is the best form of child sexual abuse prevention. If your child is engaged in inappropriate sexual contact or activities, your child needs to know and believe that they can come to you. Children often worry that they will be in trouble, they might feel guilt and shame, or be afraid. You have the tools to teach your child to be confident and know that they will be believed if they ever come to you. Your job then is to be there for them, avoid becoming angry (which the child might think is anger towards them), and then act on what they have told you by contacting the professionals that handle these matters.
If your child does not feel that they are believed or you don't believe them, your child could be in jeopardy of having the sexual abuse continue. Children who aren't believed can develop low self-esteem, may begin to have negative behaviors, changes in how they do in school, how they eat or how they sleep. These things could happen even if you act on what they tell you, as sexual abuse is a form of trauma.
It is estimated that there are approximately 42 million survivors of child sexual abuse. A large percentage of adults also report that they were sexually abused as a child and never told anyone. It is never too late to seek professional help for counseling and therapy. State laws vary on what could happen in certain situations but addressing the trauma of what happened can be helpful.
This site provides additional information on common questions, however, every situation is different. It is important to speak to your child's doctor or health care provider to find out what needs to happen in your specific instance.