MUSC Child Abuse Pediatrics : Sexual Abuse
- What is child sexual abuse?
- Some common signs and symptoms of sexual abuse
- How do we prevent child sexual abuse?
- Resources
What is child sexual abuse?
Child sexual abuse is any type of sexual activity or threat of such that is forced upon a child and may include showing a child sexual images, asking a child to look or touch the child’s genital areas, asking the child if the perpetrator can see or touch the victim’s ano-genital areas, or any penetration of an orifice of the child by any body part of the perpetrator or other object. One in five children is sexually abused. Children often are more likely not to disclose sexual abuse, often because in our society it is “not talked about” or associated with being “dirty,” as well because children are often abused by adults that are known to them.
The legal age for consent in South Carolina is sixteen.
Some common signs and symptoms of sexual abuse:
Each child can be affected by sexual abuse in his or her own individual way. Some common signs and symptoms of sexual abuse include but are not limited to enuresis, encopresis, sexually acting out, painful urination, pain to genitals and/or anus, recurrent urinary tract infections, genital discharge, and a sexually transmitted disease.
Sexual behavior can be normal for a child’s age while other behaviors offer important clues to possible sexual abuse.
Age 0-3 years
- Alarming signs:
- Fear and resistance to being undressed or having diapers changed
- Redness, swelling, cuts, bruises to the anal or genital area; blood in diapers or panties; any type of discharge noted in diapers or panties
- Mimicking adult behaviors like tongue kissing, inserting objects into vagina or anus of self or others
- Testing positive for a sexually transmitted disease
- Normal sexual behaviors:
- Touching self as part of exploration
- Noticing body parts on self or others without any sexual connotation
- Lack of modesty
- Becoming curious about other’s body parts – touching a woman’s breasts, touching sexual parts of peers out of curiosity
- Interest in “potty” behavior
- Physiological response to genital stimulation (goose bumps, penile erection)
Age 3-6 years
- Alarming behaviors:
- Saying they “do not like someone” without giving a reason – ask what they do not like about that person
- Sleep problems, nightmares
- Wetting, soiling themselves after successful potty training
- Any simulated sexual behaviors
- Agitation or aggression toward others, including animals
- Depressed or withdrawn behavior
- Normal sexual behaviors:
- Curiosity about own and other’s private parts
- Good to set up rules regarding self-touch (masturbation) being a private behavior
- Development of understanding regarding modesty and privacy
Age 6-12 years
- Alarming behaviors:
- Imitation of sexual behaviors performed alone or with others – try to figure out how the child learned such behavior
- Depression, avoidance of certain persons, anxiety that is unexplained
- Physical complaints such as a “stomachache”
- School difficulties -behavioral issues, poor performance, resistance to going to school
- Telling someone outside of the family (peer, teacher) about the abuse
- Pregnancy, sexually transmitted disease contraction
- Normal sexual behaviors:
- More respectful of social norms regarding the privacy and discreteness of issues such as sex and bathroom activities – may giggle with discussing such things, may not understand the meanings of certain words related to such behaviors
- Important to reinforce rules regarding modesty and privacy with younger children who may still express curiosity towards their own bodies and those of others
Age 12-18 years
- Alarming behaviors:
- Sexual promiscuity
- Poor peer relationships
- Anxiety, anger, poor self-esteem, depression
- Pregnancy, STD
- Drug/alcohol abuse
- Eating disorder
- Sleep disturbance or other physical disturbance
- Normal sexual behaviors
- Interest in sexual activity will increase as children enter puberty – this is a good time to give children good information about the changes going on in their bodies, how to manage their urges/impulses, and the values regarding healthy relationships
How do we prevent child sexual abuse?
Child sexual abuse is preventable, and like physical abuse, it is an adult problem. Important steps that parents and caregivers can take to prevent child sexual abuse include teaching children about their bodies and body safety rules, as well as identifying key people in the child’s life that they can talk to if any of the body safety rules are broken.
Resources
The Dee Norton Low Country Children’s Center (DNLCC)
1061 King Street Charleston, SC 29403
843-723-3600 or www.dnlcc.org
DNLCC is a non-profit organization dedicated to serving victims of child abuse and neglect in Charleston and Berkeley counties. Our mission is to keep children safe from abuse, and when abuse occurs, to work with our community to bring healing to these children and their families. By bringing together child protective services, law enforcement, medical, legal, educational, and mental health professionals, DNLCC provides a coordinated approach to helping children and their families at no cost. Since the opening in 1991, DNLCC has helped over 18,000 children and their families.
DorchesterChildren’s Center (DCC)
303 East Richardson Ave. Summerville, SC 29483
843-875-1551 or www.dorchesterchildren.org
DCC is a 501 c (3), non-profit organization developed to help victims of child abuse and neglect in Dorchester and Berkeley Counties. Our mission is to provide a multi-disciplinary, evidence-based approach to providing services to children and families at no cost. DCC has served over 4000 children and their families since opening in 2004.
Tri-county Department of Social Services
- Charleston Department of Social Services 843-953-9422 or 843-953-9550
- Berkeley Department of Social Services 843-719-1158
- Dorchester Department of Social Services 843-821-0444
The Department of Social Services is a state agency that is required by state law to identify and protect children and vulnerable adults who have been or may have been abuse or neglected by their parents, guardian, caretaker, or relatives. Any suspicion of child abuse or neglect should be reported to your local DSS.
People Against Rape (PAR)
Hotline Local 843-745-0144
Hotline Toll Free 1-800-241-7273
www.peopleagainstrape.org
PAR provides supportive and crisis counseling to victims and family members of sexual assault and intimate violence. PAR provides information and referrals about medical and legal proceedings, as well as provides support by accompanying victims to any medical or legal proceedings and offers group support, resources, referrals and public education. Bilingual advocacy services are also available.
