The Signs of Child Sexual Abuse

Being a parent sometimes means thinking about things we would rather not think about at all. Sometimes, the safety and well-being of our children means confronting issues that are painful and frightening.

The possibility that our child could be the victim of sexual abuse by an adult-- or even an other child-- is something that all parents need to carefully consider, no matter how uncomfortable the idea might make us feel.

Recent news stories of sexual abuse against children by trusted adults like teachers highlight the risks that today's children and young adults face in the modern world.

How can a parent spot the signs of sexual abuse? How can you reduce the risk that your child will be a victim of sexual abuse? Knowing the answers to these questions is not a guarantee that your child will not become a victim, but can go a long way in helping you protect the people who mean the most in your life.

Let's start by learning about the signs of sexual abuse in children. There are a variety of signs and signals that your child may have been sexually abused. The Child Welfare Information Gateway website at, a valuable resource devoted to the safety and well-being of children created by the U.S. Department of Health and Human Services, lists some of the signs.

They suggest that you consider the possibility of sexual abuse when your child:

--Has difficulty walking or sitting

-- Suddenly refuses to change for gym or to participate in physical activities

-- Reports nightmares or bed wetting

-- Experiences a sudden change in appetite

-- Demonstrates bizarre, sophisticated, or unusual sexual knowledge or behavior

-- Becomes pregnant or contracts a venereal disease, particularly if under age 14

-- Runs away

-- Reports sexual abuse by a parent or another adult caregiver

According to the site, you should consider the possibility of sexual abuse when a parent or adult caregiver:

--Is unduly protective of the child or severely limits the child's contact with other children, especially of the opposite sex

-- Is secretive and isolated

-- Is jealous or controlling with family members

Darkness To Light at is another great organization whose mission is to reduce child sexual abuse and raise public awareness about this important issue.

They point out some of the physical signs of sexual abuse:

-- redness, rashes or swelling in the genital area

--urinary tract infections

--physical problems associated with anxiety, such as chronic stomach pain or headaches

However, the organization warns that victims of sexual abuse do not necessarily exhibit physical signs of the abuse, and that the absence of physical indications does not mean an absence of abuse. It is more common to see emotional or behavioral signals, such as "too perfect" behavior, withdrawal, depression, or unexplained anger and rebellion.

A very important fact: Darkness To Light cautions us that some sexually abused children may exhibit no signs of abuse at all.

While a sexually abused child may exhibit only a few of these signs, if your child exhibits multiple signs, then you should consider the possibility that your child may have been sexually abused.

What to do next?

Childhelp is a national non-profit organization dedicated to victims of child abuse and neglect. Founded in 1959, the organization operates the National Child Abuse Hotline at 1-800-4-A-CHILD (1-800-422-4453). The hotline is staffed by professional crisis counselors who are available 24 hours a day, seven days a week, to help answer your questions about child abuse. The call is free and anonymous (just don't use your cell phone if you want to ensure that your call is a secret). Through interpreters, the hotline can provide assistance in 140 languages. For more information about this wonderful organization, please see their website at

Prevention is the Best Medicine

While it may be not be easy to spot sexual abuse, parents need to do their best to prevent sexual abuse before it happens.

The American Academy of Pediatrics suggests that we begin preventative measures as early as 18 months by teaching children the proper names for body parts. They also suggest that parents teach children about the "private parts" of the body and how to say "no" to sexual advances during the critical period from 3-5 years of age. See their article Sexual Abuse Prevention: What to do if you suspect child sexual abuse, to learn more.

The Internet is a fabulous tool that can connect us to each other and enable us to share community and information like never before, but unfortunately it can also be used by sexual predators to find victims more easily. Older children and young adults are often largely unaware of the risks of their online activities, and it is important for parents to educate themselves, and in turn educate their children, on the do's and don'ts of using the Internet.

The FBI has provided an informative starting point on this topic: A Parent's Guide to Internet Safety. I recommend that all parents read this page to learn the basics of online safety and make it a top priority to learn more about this critical aspect of their children's lives.

Perhaps the best way to prevent sexual abuse is to become more involved with your child. Are you spending enough time with your children? Listening to them carefully when they speak to you? Do you know who your children are spending time with?

While it may not be possible to be with your child every minute of every day, knowing as much as you can about the people who inhabit your child's world can dramatically reduce the risks of sexual abuse for your child.

Web Resources

For more information on understanding and preventing sexual abuse in children, please visit these websites:

Child Welfare Information Gateway

A Parent's Guide to Internet Safety

Seven Steps to Protecting our Children: Preventing, Recognizing, and Reacting Responsibly to Child Sexual Abuse

Sexual Abuse Prevention: What to do if you suspect child sexual abuse

Click here to check out Dr. Manny's book The Check List (Harper Collins, 2007).

Dr. Manny Alvarez is the managing editor of health news at, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.