For You and Your Kids: A Guide For Parents on Child Sexual Abuse

Talking about sex is not easy. Talking about sexual abuse is even harder, especially when you care about the people involved.  Unfortunately, ANY child is at risk of sexual abuse. Hoping… denying… pretending… that this can’t happen to your child is not lowering your child’s risk of being sexually abused, and it does not prepare them to get help quickly and effectively if the worst does happen. The reality of Child Sexual Abuse is a terrifying concept, but it is something that every parent needs to face because knowledge is power. 

What’s Inside: 

• Educating yourself 
• Establishing family guidelines for safety and privacy 
• Seeking help

It is important to understand that the term sexual abuse describes a wide range of experiences. Many factors affect how children react to abusive or neglectful experiences and how they recover. Most children who have been abused do not go on to abuse others, and many go on to live happy, healthy, successful lives. As parents, you will play an important role in your child’s recovery from childhood sexual abuse.

This booklet discusses how you can help children in your care by educating yourself about child sexual abuse, establishing guidelines for safety and privacy in your family, and understanding when and how to seek help if you need it. Reading this booklet alone will not guarantee that you will know what to do in every circumstance, but you can use it as a resource for some of the potential challenges and rewards that lay ahead. 

Although the term “parents” is used throughout this booklet, the information and strategies provided may be equally helpful for kinship care providers, guardians, and other caregivers. 

Educating Yourself 

One of the most useful actions that parents can take is equipping themselves with information. Parents can learn about the definitions of child sexual abuse, behaviors associated with prior sexual abuse, and how sexual abuse affects children’s trust of others. With this information in hand, it will be easier to recognize possible behaviors associated with past abuse and avoid taking them personally or feeling alarmed or uncertain if your child exhibits uncommon sexual behaviors. Most importantly, you will feel capable of responding to these behaviors in sensitive and informed ways that help both you and your child.

What Is Child Sexual Abuse? 

When a perpetrator intentionally harms a minor physically, psychologically, sexually, or by acts of neglect, the crime is known as child abuse. Child sexual abuse is a form of child abuse that includes sexual activity with a minor. A child cannot consent to any form of sexual activity, period. When a perpetrator engages with a child this way, they are committing a crime that can have lasting effects on the victim for years. Child sexual abuse does not need to include physical contact between a perpetrator and a child. Some forms of child sexual abuse include:

• Exhibitionism, or exposing oneself to a minor
• Fondling
• Intercourse
• Masturbation in the presence of a minor or forcing the minor to masturbate
• Obscene phone calls, text messages, or digital interaction
• Producing, owning, or sharing pornographic images or movies of children
• Sex of any kind with a minor, including vaginal, oral, or anal
• Sex trafficking
• Any other sexual conduct that is harmful to a child’s mental, emotional, or physical welfare

What do perpetrators of child sexual abuse look like?

Most perpetrators are someone the child or family knows. As many as 93 percent of victims under the age of 18 know the abuser. A perpetrator does not have to be an adult to harm a child. They can have any relationship to the child including an older sibling or playmate, family member, a teacher, a coach or instructor, a pastor, a caretaker, or the parent of another child. According to research, “[Child] sexual abuse is the result of abusive behavior that takes advantage of a child’s vulnerability and is in no way related to the sexual orientation of the abusive person.”

Abusers can manipulate victims to stay quiet about the sexual abuse using many different tactics. Often an abuser will use their position of power over the victim to coerce or intimidate the child. They might tell the child that the activity is normal or that they enjoyed it. An abuser may make threats if the child refuses to participate or plans to tell another adult. Child sexual abuse is not only a physical violation; it is a violation of trust and/or authority.

What to Watch for When Adults are Around Children.

Do you know an adult or older child who:

• Refuses to let a child or teenager set any of his or her own limits (tells a teenager that only a parent can decide when privacy is allowed in the home, even in the bathroom)?
• Insists on hugging, touching, kissing, tickling, wrestling with or holding a child even when the child does not want this affection?
• Is overly interested in the sexuality of a child or teen (talks repeatedly about the child’s developing body or interferes with normal teen dating)?
• Manages to get time alone or insists on uninterrupted time alone with a child?
• Spends most of his/her spare time with children and has little interest in spending time with people his/her own age?
• Regularly offers to babysit many different children for free or takes children on overnight outings alone?
• Buys children expensive gifts or gives them money for no apparent reason?
• Offers alcohol or drugs to teenagers or children when other adults are not around?
• Frequently walks in on children/teens in the bathroom?
• Allows children or teens to consistently get away with inappropriate behaviors? 

 Any one of these behaviors does not mean that a child is in danger. But if you answered “yes” to more than one of these questions, begin to ask your own questions and get help. Trust your gut.

Signs of Sexual Abuse 

For parents of adopted children, if you are parenting a child who has been removed from his or her family, you may not know for sure whether the child in your care has been sexually abused. Child welfare agencies usually share all known information about your child’s history with you; however, there may be no prior record of abuse, and many children do not disclose past abuse until they feel safe. For this reason, kinship caregivers or foster or adoptive parents are sometimes the first to learn that sexual abuse has occurred. Even when there is no documentation of prior abuse, you may suspect something happened because of your child’s behavior. 

There are no hard and fast rules about what constitutes normal sexual development and what behaviors might signal sexual abuse. Children show a range of sexual behaviors and sexual curiosity at each developmental level, and their curiosity, interest, and experimentation may occur gradually, based on their development. However, children who have been sexually abused may demonstrate behaviors that are unusual, excessive, aggressive, or explicit. There is no one specific sign or behavior that can be considered proof that sexual abuse has definitively occurred, but there are many signs that are suggestive of abuse. 

The following signs or symptoms may suggest the possibility of child sexual abuse: 

• Explicit sexual knowledge beyond the child’s developmental stage 
• Sexual preoccupation indicated by language, drawings, or behaviors 
• Inserting toys or other objects in genital openings 
• Sexual behaviors with other children that seem unusual, aggressive, or unresponsive to limits or redirection
• Excessive masturbation, sometimes in public, not responsive to redirection or limits 
• Pain, itching, redness, or bleeding in the genital areas 
• Nightmares, trouble sleeping, or fear of the dark
• Sudden or extreme mood swings: rage, fear, anger, excessive crying, or withdrawal
• “spacing out” or appearing to be in trance
• Loss of appetite, or difficulty eating or swallowing
• Cutting, burning, or other self-mutilating behaviors
• Unexplained avoidance of certain people, places, or activities
• An older child behaving like a much younger child: wetting the bed or sucking a thumb, for example
• Talking about a new, older friend
• Suddenly having money or unexplained gifts

This list of signs and symptoms is simply that: red flags designed to alert you to the fact that the child’s behaviors may reflect an underlying problem. There are other possible explanations for some of these signs, and they need to be evaluated by a trained professional who specializes in child sexual abuse. For more signs of possible sexual abuse, go to: http://www.shareanonymousng.com/warning-signs-in-children-of-possible-sexual-abuse/

Healthy Sexual Development in Children 

Children’s sexual interest, curiosity, and behaviors develop gradually over time and may be influenced by many factors, including what children see and experience and the guidance they receive from parents and caretakers. The presence of sexual behavior is not in and of itself a conclusive sign that abuse has occurred. The table below lists some of the sexual behaviors common among children of different age groups, as well as some behaviors that might be considered less common or unhealthy: 

Preschool (0 to 5 years)
Common: Sexual language relating to differences in body     parts, bathroom talk, pregnancy, and birth Self-fondling at home and in public Showing and looking at private body parts	Uncommon:  Discussion of sexual acts Sexual contact experiences with other children Masturbation unresponsive to redirection or limits Inserting objects in genital openings
School Age (6 to 12 years)
Common:  Questions about menstruation, pregnancy, sexual behavior  “Experimenting” with same-age children, including kissing, fondling, exhibitionism, and role-playing Masturbation at home or other private places	Uncommon:  Discussion of explicit sexual acts Asking adults or peers to participate in explicit sexual acts  Masturbating in public or excessively to bleeding
Adolescence (13 to 16 years)
Common:  Questions about decision-making, social relationships, and sexual customs Masturbation in private Experimenting between adolescents of the same age, including open-mouth kissing, fondling, and body rubbing Voyeuristic behaviors Sexual intercourse (more than half of 11th graders) Oral sex (approximately one-third of 15-17-year-old)	Uncommon:  Sexual interest in much younger children Aggression in touching others’ genitals Asking adults to participate in explicit sexual acts The use of force, aggression, or drugs to obtain compliance

 Talk to the child

If you are concerned about abuse, talk to the child. Keep in mind a few guidelines to create a non-threatening environment where the child may be more likely to open up to you.

• Pick your time and place carefully. Choose a space where the child is comfortable or ask them where they’d like to talk. Avoid talking in front of someone who may be causing the harm.
• Be aware of your tone. If you start the conversation in a serious tone, you may scare the child, and they may be more likely to give you the answers they think you want to hear—rather than the truth. Try to make the conversation more casual. A non-threatening tone will help put the child at ease and ultimately provide you with more accurate information.
• Talk to the child directly. Ask questions that use the child’s own vocabulary, but that are a little vague. For example, “Has someone been touching you?” In this context “touching” can mean different things, but it is likely a word the child is familiar with. The child can respond with questions or comments to help you better gauge the situation like, “No one touches me except my mom at bath time,” or “You mean like the way my cousin touches me sometimes?” Understand that sexual abuse can feel good to the child, so asking if someone is “hurting” them may not bring out the information that you are looking for.
• Listen and follow up. Allow the child to talk freely. Wait for them to pause, and then follow up on points that made you feel concerned.
• Avoid judgment and blame. Avoid placing blame by using “I” questions and statements. Rather than beginning your conversation by saying, “You said something that made me worry…” consider starting your conversation with the word “I.” For example: “I am concerned because I heard you say that you are not allowed to sleep in your bed by yourself.”
• Reassure the child. Make sure that the child knows that they are not in trouble. Let them know you are simply asking questions because you are concerned about them.
• Be patient. Remember that this conversation may be very frightening for the child. Many perpetrators make threats about what will happen if someone finds out about the abuse. They may tell a child that they will be put into foster care or threaten them or their loved ones with physical violence.

3. Report it

Reporting a crime like sexual abuse may not be easy, and it can be emotionally draining. Keep in mind that reporting abuse gives you the chance to protect someone who can’t protect themselves or stops it from happening to someone else. Depending on where you live and your role in the child’s life, you may be legally obligated to report suspicions of abuse. 

Before you report

• Tell the child that you’re going to talk to someone who can help. Be clear that you are not asking their permission. The child may not want you to report and may be frightened, especially if the perpetrator has threatened them or their loved ones. Remember that by reporting, you are involving authorities who will be able to keep the child safe.
• Ensure that the child is in a safe place. If you have concerns over the child’s safety, be sure to discuss them explicitly with authorities when you make the report. If you fear that the perpetrator will cause further harm to the child upon learning about the investigation, clearly communicate this to authorities.
• If you are not concerned that the parents are causing harm, you can consult with them prior to making a report to authorities.
• If you are a parent and are concerned that your partner or someone in your family may be hurting your child, this may be a very difficult time. It’s important to be there for your child and protect her or him… naturally, your child should be your number one priority, it’s also important to take care of yourself.
• Prepare your thoughts. You will likely be asked identifying information about the child, the nature of the abuse, and your relationship with the child. While anonymous tips are always an option, identified reporting increases the likelihood of prosecuting the perpetrator.

Dynamics of Disclosure

Disclosure of child sexual abuse is a complicated process which depends on a host of factors, such as abuse characteristics, the amount of fear or violence associated with the abuse, etc. Oftentimes, Children do not disclose abuse because they are afraid of the perpetrator who physically coerced or harmed them, or because they are threatened with consequences of disclosure that involve harm to family members or to self. Therefore, it is predictable that the more severe or frightening the abuse or the more the child is threatened post-abuse, the less likely the child would be to disclose.

Research shows that many children do not disclose sexual abuse immediately after the abuse occurs. In fact, many children do not disclose the abuse for years, if they disclose at all. Many adult survivors of child sexual abuse have never disclosed their abuse to anyone. In addition to being developmentally vulnerable, children are often manipulated to feel guilty or responsible for the abuse. These children may fear the disclosure will not be believed, and they may be concerned about consequences for the perpetrator, as often the perpetrators are familiar figures who develop complex, confusing, and ambivalent relationships with the child.

Children who had experienced greater severity of abuse are more likely to feel they cannot talk to anyone about the abuse, and they are less likely to talk to a parent or family member. Those who do not disclose immediately have more major depressive episodes and delinquency. If the Children were victimized by family members, they have far more negative consequences if they delay disclosure. These consequences include, symptoms of PTSD, negativity in childhood and self-blame, etc. Prompt disclosure buffers the impact of severe abuse, it also makes it less likely that there will be additional abuse.

Factors associated with non-disclosure of sexual abuse:

• Many children do try to tell but are not heard or no action is taken.
• Disclosure is determined by an interplay of child characteristics, family environment, community influences and societal attitudes
• There could be threats to the child, fear of the perpetrator, a lack of opportunity, a lack of understanding of child sexual abuse or a relationship with the perpetrator.
• Shame and fear of causing trouble in the family is also a huge factor, including fear of their parent’s reaction.
• Many children do not disclose out of concern about consequences for others.
• Children who are abused by a family member are less likely to disclose and more likely to delay disclosure than those abused by someone outside the family.
• Males report being reluctant to disclose because they fear being labeled a homosexual or a victim. Females delay disclosure because they feel responsibility for the abuse, and fear not being believed.
• The duration of abuse – one-off incidents of abuse compared with abuse that takes place over a significant period is also an important factor.

Other factors, such as culture and religion, may also influence willingness to report experiences of Child Sexual Abuse. Although no one value is exclusive to a particular culture, issues and values may weigh differently in different cultures and influence the ability to disclose. Examples of potential barriers to disclosure include:

• The roles of modesty; taboos and shame.
• Sexual scripts that normalize Child Sexual Abuse (e.g, it is normal for men to want sex, so abuse is a girl’s fault for tempting a man).
• The emphasis on virginity and honor.
• Girls’ reports of Child Sexual Abuse being discounted as fabricated because of their lower status within a community.
• Fear that disclosure would lead to obligations to avenge lost honor through further violence.
• Respect for elders and filial piety.
• The influence of religious beliefs and teachings.

Parenting Practices

Practitioners in the field of child development and parenting should incorporate child sexual abuse prevention and intervention strategies into parenting programs and resources. Programs and resources need to convey many important concepts:

• First and foremost, parents and other caregivers should never assume that a child would disclose to them if they were sexually abused.
• Caregivers of all kinds should teach children about child sexual abuse beginning at a very early age, as age-appropriate. Children who understand what sexual abuse is are more likely to disclose.
• Parents and other caregivers should look for non-verbal and indirect signs that could indicate child sexual abuse.
• Parents and other caregivers should be aware that disclosure may take place over a period of time, and may include recantations and inconsistencies.
• Parents and other caregivers should regularly ask the children in their care if they have been sexually abused, as age-appropriate.
• If a child does disclose, the parent or caregiver must be supportive and calm.
• Parenting public awareness campaigns should include a “Talk to your Children about Sexual Abuse” message. There is evidence that public awareness campaigns targeting children, parents and communities are an effective tool in the prevention of child abuse.

The impact of the first disclosure often determines whether the survivor will tell again. On one hand, negative responses from others may act as a deterrent to further disclosure and result in feelings of isolation and distress, as well as distrust of others. On the other hand, survivors who receive negative responses from professionals after disclosure tend to consult more professionals until they receive a positive response.

Positive responses to the disclosure has several effects on survivors’ well-being. Each telling enables the survivor to incorporate more insights into his or her story and eventually change the narrative (e.g., growing from feelings of self-blame in the abuse to understanding that only the offender should be held accountable). The repeated telling of the story has been interpreted by survivors as a healing experience.

Factors Affecting the Impact of Sexual Abuse 

If a professional has determined that a child in your care has been a victim of sexual abuse, or if you continue to suspect that the child in your care has been abused, it is important to understand how abusive experiences may affect children’s behavior. 

All children who have been sexually abused have had their physical and emotional boundaries violated or crossed in some way. Because of this, children may feel a lack of trust and safety with others. Children who have been abused may come to view the world as unsafe, and adults as manipulative and untrustworthy. As with other types of abuse or trauma, many factors influence how children think and feel about the abuse, how the abuse affects them, and how their recovery progresses. Some factors that can affect the impact of abuse or trauma include: 

• The relationship of the abuser to the child and how much the abuse caused a betrayal of trust within an important interpersonal relationship.
• How long the abuse occurred (chronicity).
• Whether the sexual abuse was extensive and there was penetration of some kind.
• The age of the child (younger children are more vulnerable and less capable of facing these challenges alone).
• The abuser’s use of “friendliness” or seduction and efforts to make the child a compliant participant.
• The abuser’s use of threats of harm or violence, including threats to pets, siblings, or parents.
• The abuser’s use of secrecy and threats to do harm or withdraw love and affection.
• Gender of the abuser being the same as or different from the child (some children are less likely to report sexual activity with same gender after the fact, and those observing or assessing for abuse may have a stronger reaction to same-sex abuse than to abuse that is male-female)
• The child’s emotional and social development at the time of the abuse.
• The child’s ability to cope with his or her emotional and physical responses to the abuse (for example, fear and arousal)
• The child’s ability to cope with his or her emotional and physical responses to the abuse (for example, fear and arousal)
• How much responsibility the child feels for the abuse (and, for example, not telling right away, not stopping it somehow, etc.)

It is very important for children to understand that they are not to blame for the abuse they experienced. Your family’s immediate response to learning about the sexual abuse and ongoing acceptance of what the child has told you will play a critical role in your child’s ability to recover and lead a healthy life. (See the last section of this booklet, Seeking Help, for more information about healing from abuse.)

Some parents may feel grave concern when children act out sexually with peers or younger children and may question why a child who has been abused, and suffered from that experience, could repeat it with someone else. Children who have experienced sexual abuse need an opportunity to process their own abuse in therapy or with a trusted trained adult to understand their thoughts and feelings and to have a chance to ask questions and achieve closure. Acting-out behaviors usually indicate that some traumatic impact of their abuse is still active and signals a need for additional attention. Responding in calm, informed ways while seeking appropriate professional help for children whose acting out persists will be important to resolving children’s sexual behavior problems. The most important lesson is learning not to over- or under-respond to problem situations and finding just the right balance of guidance and empathic care. 

If your child has a history of prior abuse, it’s important to know that he or she may be vulnerable to acting out victim or victimizing behaviors. Some children may be more likely to be bullied or exploited, and others may be angry and aggressive towards others. You may need to pay special attention to protecting some children while setting firm limits on others. In addition, some children act out when memories of their own abuse are triggered. Triggers can happen unexpectedly, for example, by seeing someone who looks like the abuser or in a situation such as being alone in a public restroom, or by a variety of circumstances that occur in daily life. Other triggers might include the scent of a cologne or shampoo or the texture of a piece of clothing or blanket. 

In addition, there are cultural differences among children about their comfort level with physical proximity, physical affection, bathing and nudity practices, hygiene, and other factors that can lead to problem situations. There are many cultures in which parents never discuss sexuality directly with their children, or in which any type of sexual activity (for example, children touching themselves) can be viewed as unacceptable or punishable. Children may thus carry shame and guilt about their bodies. 

How Can I Protect My Child from Sexual Abuse?

Be involved in the child’s life.

Being actively involved in a child’s life can make warning signs of child sexual abuse more obvious and help the child feel more comfortable coming to you if something isn’t right. If you see or hear something that causes concern, you can act to protect your child.

• Show interest in their day-to-day lives. Ask them what they did during the day and who they did it with. Who did they sit with at lunchtime? What games did they play after school? Did they enjoy themselves?
• Get to know the people in your child’s life. Know who your child is spending time with, including other children and adults. Ask your child about the kids they go to school with, the parents of their friends, and other people they may encounter, such as teammates or coaches. Talk about these people openly and ask questions so that your child can feel comfortable doing the same.
• Choose caregivers carefully. Whether it’s a babysitter, a new school, or an afterschool activity, be diligent about screening caregivers for your child.
• Talk about the media. Incidents of sexual violence are frequently covered by the news and portrayed in television shows. Ask your child questions about this coverage to start a conversation. Questions like, “Have you ever heard of this happening before?” or “What would you do if you were in this situation?” can signal to your child that these are important issues that they can talk about with you. Learn more about talking to your kids about sexual assault.
• Know the warning signs. Become familiar with the warning signs of child sexual abuse, and notice any changes with your child, no matter how small. Whether it’s happening to your child or a child you know, you have the potential to make a big difference in that person’s life by stepping in.

Encourage children to speak up.

When someone knows that their voice will be heard and taken seriously, it gives them the courage to speak up when something isn’t right. You can start having these conversations with your children as soon as they begin using words to talk about feelings or emotions. Don’t worry if you haven’t started conversations around these topics with your child—it is never too late.

• Teach your child about boundaries. Let your child know that no one has the right to touch them or make them feel uncomfortable — this includes hugs from grandparents or even tickling from mom or dad. It is important to let your child know that their body is their own. Just as importantly, remind your child that they do not have the right to touch someone else if that person does not want to be touched.
• Teach your child how to talk about their bodies. From an early age, teach your child the names of their body parts. Teaching a child these words gives them the ability to come to you when something is wrong. Learn more about talking to children about sexual assault (www.shareanonymous.com).
• Be available. Set time aside to spend with your child where they have your undivided attention. Let your child know that they can come to you if they have questions or if someone is talking to them in a way that makes them feel uncomfortable. If they do come to you with questions or concerns, follow through on your word and make the time to talk.
• Let them know they won’t get in trouble. Many perpetrators use secret-keeping or threats as a way of keeping children quiet about abuse. Remind your child frequently that they will not get in trouble for talking to you, no matter what they need to say. When they do come to you, follow through on this promise and avoid punishing them for speaking up.
• Give them the chance to raise new topics. Sometimes asking direct questions like, “Did you have fun?” and “Was it a good time?” won’t give you the answers you need. Give your child a chance to bring up their own concerns or ideas by asking open-ended questions like “Is there anything else you wanted to talk about?”

Establishing Guidelines

There are things you can do to help ensure that your child(ren) and any child visiting or living in your home experiences a structured, safe, and nurturing environment. Some children who have been sexually abused may have a heightened sensitivity to certain situations. Making your home a comfortable place for children who have been sexually abused can mean changing some habits or patterns of family life. Incorporating some of these guidelines may also help reduce parents’ vulnerability to abuse allegations by children living with them. Consider whether the following tips may be helpful in your family’s situation: 

• Make sure every family member’s comfort level with touching, hugging, and kissing is respected. Teach children about healthy and unhealthy touching. Teach them that they have the right to protest when a touch from an adult or their peers makes them uncomfortable. Do not force touching on children who seem uncomfortable being touched. Encourage children to respect the comfort and privacy of others.

• Be cautious with playful touch, such as play fighting and tickling. Tickling children is an opportunity to teach consent, boundaries and body safety. When a child yells “stop” amidst laughter while being tickled, stopping the act immediately can present the opportunity to educate that child on the reasons why you stopped and why they should also listen to others and respect their rights to enforce personal limits to body contact and boundaries. Also, for a child who has already been abused, play fighting and tickling may be uncomfortable or scary reminders of sexual abuse.

• Help children learn the importance of privacy. Remind children to knock before entering bathrooms and bedrooms, and encourage children to dress and bathe themselves if they are able. Teach children about privacy and respect by modeling this behavior and talking about it openly.
• Keep adult sexuality private. Teenage siblings may need reminders about what is permitted in your home when boyfriends and girlfriends are present. Adult caretakers will also need to pay special attention to intimacy and sexuality when young children are underfoot.

• Be aware of and limit sexual messages received through the media. Children who have experienced sexual abuse can find sexual content overstimulating or disturbing. It may be helpful to monitor music and music videos, as well as television programs, video games, and movies containing nudity, sexual activity, or sexual language. Limit access to grownup magazines and monitor children’s Internet use. In addition, limit violent graphic or moving images in TV or video games.

• Supervise and monitor children’s play. If you know that your child has a history of sexual abuse, it will be important to supervise and monitor his or her play with siblings or other children in your home. This means having children play within your view and not allowing long periods of time when children are unsupervised. Children may have learned about sexual abuse from others and may look for times to explore these activities with other children if left unsupervised. It will be important for parents and caretakers to be cautious but avoid feeling paranoid.

• Prepare and develop comfort with language about sexual boundaries. It will be important for you to be proactive in developing and practicing responses to children who exhibit sexual behavior problems. Many parents feel uncomfortable addressing the subject, so they ignore or avoid direct discussions. For example, some parents can say, “Your private parts belong to you, and it’s okay to touch them in private.” Some parents hesitate to give this kind of permission, believing it’s sinful behavior. In those cases, you might want to deliver different messages. When children have been abused, you can say, “Just like it was not okay for so-and-so to touch your private parts, it’s not okay for you to touch other people’s private parts.” You might also give clear directives, “We don’t use that language in this house,” if it’s offensive, or “I’d like you to use different words so that we can really hear what you’re saying.” Because there are so many differences in the messages parents want to convey to their children, it is useful to prepare ahead and be proactive. 

If your child has touching problems (or any sexually aggressive behaviors), you may need to take additional steps to help ensure safety for your child as well as his or her peers. Consider how these tips may apply to your own situation:

• With friends. If your child has known issues with touching other children, you will need to ensure supervision when he or she is playing with friends, whether at your home or theirs. Sleepovers may not be a good idea when children have touching problems.

• At school. You may wish to inform your child’s school of any inappropriate sexual behavior, to ensure an appropriate level of supervision. Often this information can be kept confidential by school counselor or other personnel. 

• In the community. Supervision becomes critical any time children with sexual behavior problems are with groups of children, for example, at day camp or afterschool programs. 

Keep the lines of communication open, so children feel more comfortable turning to you with problems and talking with you about anything—not just sexual abuse. Remember, however, that sexual abuse is difficult for most children to disclose even to a trusted adult and that, ordinarily, children do not volunteer information about their sexual development. 

Seeking Help

Responding to the needs of a child who has been sexually abused may involve the whole family and will likely have an impact on all family relationships. Mental health professionals (for example, counselors, therapists, or social workers) can help you and your family cope with reactions, thoughts, and feelings about the abuse. It is important to seek a behavioral health professional with a background in child development, child trauma, and sexual abuse. Before agreeing to work with a provider, ask questions about the person’s background, experience, and approach to treating children. (There is growing evidence for certain types of interventions; see page 12 for more information.) 

Impact of Sexual Abuse on the Family 

Being a parent or kinship caregiver/ a foster or adoptive parent to a child who has experienced sexual abuse can be stressful to marriages and relationships. Parenting in these situations may require some couples to be more open with each other and their children about sexuality in general and sexual problems specifically. If one parent is more involved in addressing the issue than another, the imbalance can create difficulties in the parental relationship. A couple’s sexual relationship can also be affected, if sex begins to feel like a troubled area of the family’s life. If or when these problems emerge, it is often helpful to get professional advice.

For adoptive parents, if one parent was more in favor of adopting, and the other parent merely complied, general stress can be added to the couple when children have a range of problem behaviors that require attention. Some parents develop resentful and angry or withdrawn feelings toward foster or adoptive children who take up a lot of time and energy (for example, children who need extra monitoring and supervision or transport to weekly therapy appointments). 

Parents can also feel stress because the child’s siblings may be exposed to new or focused attention on sexuality that can be challenging for them. If one child is acting out sexually, you may need to talk with siblings about what they see, think, and feel, as well as how to respond. Children may also need to be coached on what (and how much) to say about their sibling’s problems to their friends. If your children see that you are actively managing the problem, they will feel more secure and will worry less. 

When one child has been sexually abused, parents often become very protective of their other children. It is important to find a balance between reasonable worry and overprotectiveness. Useful strategies to prevent further abuse may include teaching children to stand up for themselves, talking with them about being in charge of their bodies, and fostering open communication with your children. 

Counseling for Parents and Children 

Talking with a mental health professional who specializes in child sexual abuse as soon as sexual abuse is reported or uncovered is the best way to help a child who has been a victim. Sexual abuse can cause serious problems for children that if not addressed immediately can go on to impact the victim’s emotional development, psychological development, and even the development of the child’s brain.

In the same way, talking with a mental health professional as soon as problems arise with a child who has been abused can help parents determine if their child’s behavior is cause for concern. Specialists can also provide parents with guidance in responding to their child’s difficulties and offer suggestions for how to talk with their children. A mental health professional may suggest special areas of attention in family life and offer specific suggestions for creating structured, safe, and nurturing environments. 

To help a child who has been abused, many mental health professionals will begin with a thorough assessment to explore how the child functions in all areas of life. The specialist will want to know about: 

• Past stressors (e.g., history of abuse, frequent moves, and other losses)
• Current stressors (e.g., a medical problem or learning disability) 
• Emotional state (e.g., Is the child usually happy or anxious?) 
• Coping strategies (e.g., Does the child withdraw or act out when angry or sad?) 
• The child’s friendships 
• The child’s strengths (e.g., Is the child creative, athletic, organized?) 
• The child’s communication skills 
• The child’s attachments to adults in his or her life 
• How the child spends his or her time and how much time he or she spends with TV, Internet, video games, etc.

After a thorough assessment, the mental health professional will decide if the child and family could benefit from therapy. Not all children who have been abused require therapy. For those who do, the mental health professional will develop a plan tailored to the child and to the family’s strengths and needs. 

This plan may include one or more of the following types of therapy:

• Individual therapy. The frequency and duration of therapy can vary tremendously. The style of therapy will depend on the child’s age and the therapist’s training. Some therapists use creative techniques (for example, art, play, and music therapy) to help children who are uncomfortable talking about their experiences. Other therapists use traditional talk therapy or a combination of approaches. All types of individual therapy that are evidence-based also include a component for family or parent engagement.
• Group therapy. Meeting in groups with other children who have been sexually abused or who have developed sexual behavior problems can help children understand themselves; feel less alone (by interacting with others who have had similar experiences); and learn new skills through role plays, discussion, games, and play. Group therapy for parents can also be extremely beneficial. 
• Family therapy. Many therapists will see children and parents together to support positive parent-child communication and to guide parents in learning new skills that will help their children feel better and behave appropriately. Whether or not family therapy is advised, it is vital for parents to stay involved in their child’s therapy or other kinds of treatment. Skilled mental health professionals will always seek to involve the parents by asking for and sharing information. 

There are several evidence-based programs that have been found useful for treating children who have been sexually abused and their families. Most mental health professionals stay up-to-date on recent evidence-based and practice-informed trends in mental health. Please discuss with the mental health professional you engage on the best approach for treatment and intervention. 

What to Look for in a Mental Health   

Finding a knowledgeable and experienced mental health professional is key to getting the help your family needs. Some communities have special programs for treating children who have been sexually abused, such as child protection teams and child advocacy centers. You may also find qualified specialists in your community through the organizations noted below:

• Child advocacy centers 
• Rape crisis or sexual assault centers.
• Local psychological or psychiatric association referral services.
• Child abuse hotlines (see: ….)
• Child protective services (CPS) agencies.
• Nonprofit service providers.
• University departments of social work, psychology, or psychiatry.
• Crime victim assistance programs in the law enforcement agency or in the prosecutor’s.
• Group private practices with a specialization in trauma services.

Therapy for children who have been sexually abused is specialized work. When selecting a mental health professional, look for the following:

• An advanced degree in a recognized mental health specialty such as psychiatry (M.D.), psychology (Ph.D. or Psy.D.), social work (M.S.W.), counseling (L.P.C.), Marriage and Family Therapy (M.F.T.), or psychiatric nursing (R.N.).
• Licensure to practice as a mental health professional in your State (Some mental health services are provided by students under the supervision of licensed professionals.).
• Special training in child sexual abuse, including the dynamics of abuse, how it affects children and adults, and the use of goal-oriented treatment plans.
• Knowledge about the legal issues involved in child sexual abuse, especially the laws about reporting child sexual victimization, procedures used by law enforcement and protective services, evidence collection, and expert testimony in your State.
• A willingness to work in a coordinated fashion with other professionals involved in your family’s care.

Conclusion 

Many people want to help children who have been sexually abused, but they often struggle with feelings of confusion, concern, anger, and disgust as they learn more about the abuse. You may need help to resolve these struggles and to move toward acceptance of your child’s background. 

If you were (or suspect you may have been) sexually abused as a child, dealing with your own child’s difficulties may be particularly challenging, and reading this booklet may have brought up difficult thoughts and feelings. Your courage in facing these issues and tackling a personally difficult and painful subject can be helpful to your children by demonstrating to them that sexual abuse experiences can be managed and overcome. 

Creating a structured, safe, and nurturing home is the greatest gift that you can give to all your children. Seek help when you need it, share your successes with families who may benefit from your knowledge and experience, and remember that a healthy relationship with your children allows them to begin and advance the recovery process. It is in the context of your parent-child relationship that your child learns trust and respect, two important building blocks of your children’s safety and well-being. 

Acknowledgment: 

Sercle Inc would like to acknowledge Child Welfare Information Gateway, Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau as the main source of information for this material.