Indicators of child sexual abuse
For Teachers, Workers
- Behavioural indicators of child sexual abuse
- Behavioural indicators of sibling sexual abuse
- Physical indicators of child sexual abuse
- Indicators in adults
Behavioural indicators of child sexual abuse
The following are indicators, not proof that sexual assault may have taken place.
- When a child reports sexual abuse either directly, or indirectly in a disguised way e.g. "I know a girl who..."
- Persistent and inappropriate sexual play with peers, toys, animals or themselves. e.g. child habitually inserting objects in her vagina or sexually aggressive behaviour with others, eg for a boy 'humping' toys in sexual positions.
- Detailed and overly sophisticated understanding of sexual behaviour (especially by young children).
- Sexual themes in the child's artwork, stories or play.
- Fear of going home or expressing a desire to live in a foster home or institution.
- Regressive behaviour e.g. excessive clinginess in pre-school children or the sudden onset of soiling and wetting when these were not formerly a problem.
- A child may appear disconnected or focused on fantasy worlds.
- Sleep disturbances and nightmares.
- Marked changes in appetite.
- Fear states e.g. anxiety, depression, phobias, obsession.
- Overly compliant behaviour, as often young people who have been abused have experienced extensive grooming behaviours.
- Parentified or adultified behaviour e.g. acting like a parent or spouse.
- Delinquent or aggressive behaviour.
- Arriving late at school or leaving early.
- Poor or deteriorating relationships with peers.
- Increased inability to concentrate in school and/or sudden deterioration in school performance.
- Non-participation in school and social activities.
- Unwillingness to participate in physical/recreational activities, especially if this is due to symptoms of physical discomfort.
- Truancy/running away from home.
- Excessively seductive behaviour and/or sexual activity. (This is an effect of the sexual abuse rather than a cause).
- Drug/alcohol abuse.
- Prostitution. There is a strong correlation between child sexual abuse and late teenage prostitution.
- Self-mutilation ie cutting of arms, legs, burning home made tattoos.
- Suicidal feelings and suicide attempts.
- Fear of adults of the same sex as the abuser.
- Unexplained accumulation of money or gifts.
Behavioural indicators of sibling sexual abuse
In addition to what has been listed above, sibling abuse may be indicated by:
- Siblings who behave like boyfriend and girlfriend.
- A child who fears being left alone with a sibling.
- Siblings who appear embarrassed when found alone together.
- One sibling antagonising the other but the other not retaliating (through fear, or fear of exposing the secret), or in some cases the threat of blackmail.
Physical indicators of child sexual abuse
Some sexually abused children also come to attention because of physical indicators:
- Bruises, bleeding or other physical trauma in genital or rectal area. There may be pain or problems with urination/defecation or blood-stained and/or torn underwear. The physical discomfort may cause the child to limp, perform poorly at sport, drop out of strenuous play activities or perhaps even have difficulty in sitting still.
- Foreign bodies in genital, rectal or urethral openings.
- Abnormal dilation of the urethral, vaginal or rectal openings.
- Itching, inflammation or infection of urethral, vaginal or rectal openings.
- Presence of semen.
- Trauma to breasts, buttocks, lower abdomen or thighs.
- Unusual odours from the vaginal area.
- Sexually transmitted diseases.
- Pregnancy, especially when the child refuses to reveal any information about the father of the baby and/or complete denial of the pregnancy by the child and/or her family.
- Psychosomatic illness e.g. abdominal pain, nightmares.
Anyone who observes these behavioural indicators in a child has an obligation to consider whether or not abuse is occurring and to take action if they believe that it may be.
Indicators in adults
- Low self-esteem
- Poor body image
- Baggy clothing
- Holding back or withdrawal from activities
- Approval Seeking
- Marked physical agitation
- Exaggerated startle response etc.
Red flags from Dallam (2009) Where does it hurt? in Banyard, V., Edwards, J., Kendall-Tackett, K. (eds) Trauma and Physical Health, Routledge, Oxon includes:
- Poor self-esteem
- History of chronic depression or anxiety attacks
- History of PTSD
- Eating Disorders
- Self-destructive behaviours
- Sexual dysfunction
- History of somatization or functional disorders
- Difficulty tolerating examinations, tests or procedures