This article tells you what to do if you suspect a child has been sexually abused.
Alternative Names
Sexual abuse - children
Information
One in four girls and one in ten boys are sexually abused before they turn 18.
Sexual abuse of children is any activity that the abuser does to get sexually aroused, including:
Touching a child's genitals
Rubbing the abuser's genitals against a child's skin or clothing
Putting objects into a child's anus or vagina
Tongue kissing
Oral sex
Intercourse
Sexual abuse can also happen without physical contact, such as:
Exposing one's own genitals
Having a child pose for pornography
Having a child look at pornography
Masturbating in front of a child
Signs of Sexual Abuse in Children
Suspect sexual abuse when children:
Tell you that they are being sexually abused
Have trouble sitting or standing
Won't change for gym class
Have sexually transmitted diseases or become pregnant
Know about and talk about sex
Run away
Have adults in their lives that keep them from having contact with other adults
Keep to themselves and seem to have secrets
Sexually abused children might have:
Bowel control problems, such as soiling themselves (encopresis)
Eating disorders (anorexia nervosa)
Genital or rectal problems, such as pain when going to the bathroom, or vaginal itch or discharge
Headaches
Sleep problems
Stomach aches
Sexually abused children may also:
Use alcohol or drugs
Engage in high-risk sexual behaviors
Get poor grades in school
Have a lot of fears
Not want to do their normal activities
When to Contact Your Doctor
If you think a child has been sexually abused, get the child examined by a health care provider.
Find a provider that knows about sexual abuse. Most pediatricians, family medicine providers, and emergency room providers have been trained to examine people that have been sexually abused.
Have the child examined right away or within 2 to 3 days of discovering the abuse. The signs of sexual abuse don't last long, and the provider may not be able to tell if you wait too long.
During the exam, the provider will:
Look for signs of physical and sexual abuse. The provider will check the child's mouth, throat, anus, and penis or vagina.
Do blood or other tests to check for sexually transmitted diseases and pregnancy.
Take photographs of any injuries, if needed.
Treatment
Get the child any needed medical care. Also get mental health counseling for the child. Active support groups that can help include:
Rape, Abuse & Incest National Network -- www.rainn.org
Know that providers, teachers, and child care workers are required by law to report sexual abuse. If abuse is suspected, child protection agencies and the police will investigate. The child must be protected from abuse. The child may be placed with a non-abusing parent, another relative, or in a foster home.
References
Carrasco MM, Wolford JE, Eichman AL. Child abuse and neglect. In: Zitelli BJ, McIntire SC, Nowalk AJ, Garrison J, eds. Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 6.
Marcdante KJ, Kliegman RM. Child abuse and neglect. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2019:chap 22.
Review Date:
10/22/2022
Reviewed By:
Charles I. Schwartz, MD, FAAP, Clinical Assistant Professor of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, General Pediatrician at PennCare for Kids, Phoenixville, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
