Article

Signs of Sexual Abuse in Children or Adolescents

You have an uncomfortable feeling that a child may be the victim of sexual abuse. How can you tell? You certainly don't want to raise the issue if it's not true.

Children, particularly young children, are not yet capable of describing their experiences in words. So when a child is sexually abused, he or she cannot yet put the name “sexual abuse” to what the abuser is doing or has done. Older children and teenagers may have been warned not to tell, threatened with serious harm to them or to someone they love if they tell the secret. Or they may feel guilty, thinking that the abuse is their fault and therefore not willing to talk about it. How, then, can one tell if a child or teenager has been sexually abused or is still being abused? For most victims/survivors there will be some hints that something is wrong. I outline these below.

Signs of Sexual Abuse

Every child is different. Therefore children and teenagers will respond differently to the experience of sexual abuse. Some have many symptoms and others show no easily identifiable signs to a parent or others in the environment.

If a child or teen shows none of the following symptoms it does not necessarily mean that there was no abuse.

Equally true - if a child or teenager shows some of these symptoms it may be a sign of trauma or distress originating from something other than sexual abuse. There can be many sources of trauma in a child's or adolescent's life.

How I wish that it was less complicated! However, I will help you sort things out in this article.

In general, symptoms can be divided into three groups: physical signs, behavioural and emotional signs and signs related to interpersonal relationships. Let's look at these one by one.

Without Memories, Can a Teenager Know if He or She was Sexually Abused when Younger?

Sometimes people suffer from symptoms that are generally considered symptoms of childhood sexual abuse. Without memories, they are frustrated, feel crazy and want desperately to know why they experience suicidal thoughts, self-harm, and other symptoms.

One teenager submitted a questions to Yahoo Answers and I responded. You may be interested in this brief communication on the issue of whether or not symptoms may indicate a history of childhood sexual abuse even in the absence of memories.

Physical Signs of Sexual Abuse

1	If penetration or physical stimulation is involved, there may be soreness, irritation, redness or injury in the genital area, around the anus and around or in the mouth.
2	There might be an unusual smell or discharge in the genital area, with or without venereal disease.
3	The child or adolescent might exhibit signs of pain when sitting, moving around, swallowing or when trying to go to the toilet. If abused anally they may fear emptying their bowels.
4	There may be a variety of psychosomatic symptoms for which no medical explanation can be found. For example, many abused children and adolescents suffer from frequent stomach aches and/or headaches.
5	There may be bruising or scratches that cannot be easily explained.
6	Pregnancy, when the pregnant girl denies being pregnant and/or refuses to name the father, should raise suspicions of abuse.

When the abuser is a family member or close family friend, the child or teenager might not show much physical trauma. The perpetrator knows that this would arouse suspicion; therefore, he or she may be careful not to leave any physical signs of abuse.

Behavioural and Emotional Signs

There are some behaviours that might indicate that a child or teenager was or is being sexually abused, but it is important to remember that these signs are not proof in and of themselves of sexual abuse. They do tell you that the child is distressed about something and needs help.

1	A happy and sociable child or teenager may suddenly become quiet and withdrawn, cry easily or become easily enraged. Alternatively, a generally quiet and withdrawn child or teen may suddenly become loud and aggressive. Sudden changes in behaviour or apparent changes in character point to a problem that must be explored.
2	The child or adolescent may become easily frightened or panicked, depressed, or develop phobias or compulsive behaviours. These require professional attention in and of themselves and successful therapy for these problems may or may not uncover underlying sex abuse trauma.
3	Child or adolescent victims/survivors may refuse to engage in any physical activity or sports, perhaps reluctant to wear shorts or short-sleeved shirts if there has been any cutting behaviour. Often hating their bodies, they may not want anything to do with activities involving the body.
4	They might suddenly not want to participate in an extracurricular activity that they had previously enjoyed. This may be because someone there has abused them sexually or bullied them, among other possible reasons.
5	Getting dressed or undressed may be resisted even in appropriate situations and inappropriately to age and developmental stage.
6	Play, writing or drawings may become sexually explicit or overtly violent. In contemporary society, with erotic scenes and violence in movies and on billboards everywhere, this may point to general over-stimulation and not only to sexual abuse. Similarly, whereas in the recent past greater sexual knowledge than that of a child's peers once was a clear indication of sexual abuse, in today's overly erotic world, this may not be so and one should check all possible avenues by which the child may have been exposed to sexual material in addition to the possibility of sexual abuse.
7	There may be problems falling asleep or with recurrent nightmares. There could be alternative explanations for stress or fear that expresses itself in sleep problems.
8	The child or adolescent might seem to daydream or to be disconnected with his or her surroundings to a greater extent than usual.
9	Children might regress to an earlier developmental stage, such as sucking his or her thumb or wetting the bed. If an adolescent exhibits this kind of symptom, it is likely a very serious sign of trauma.
10	The child may masturbate more frequently or more intensely than is normal for his or her age or may not be aware of doing it in public. While masturbation may naturally increase during adolescence, the teenager should be discrete about it; if not, this may be indication of a serious problem.
11	Some sexually abused children and teenagers may self-harm by overeating or becoming anorexic, by cutting their arms or legs, using alcohol or drugs, going to dangerous places and/or having frequent unprotected sex.
12	They may suffer a sudden drop in ability to concentrate in school and grades may plunge.
13	A child or adolescent may become violent with animals or other children, may light fires, steal or tell lies.

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Changes in Interpersonal Relations

1	Some victims/survivors, afraid to express their own wants or needs, may try to constantly please others.
2	They may suddenly not want to visit or be left alone with someone with whom they had previously enjoyed spending time. There could be alternative explanations for this sudden change but it should not be ignored.
3	A child might become clingy or demand more attention from a caregiver without an obvious reason for the distress. A teenager may seek the attention in a more negative or angry manner.
4	A child or teenager might suddenly show distrust of other people in a way that is inappropriate for their age or stage of development.
5	Sexually abused children may become sexually promiscuous teens. At an extreme, they may become involved in prostitution.
6	On the other hand, they may avoid all possible relations with the opposite sex.
7	Running away from home and/or school, cutting off relationships with friends, are signs of serious distress and in many cases, of sexual abuse.
8	The abused young person may not be able to distinguish affection and friendliness from sexual desire. All their interactions may have sexual undertones, a fact that makes it very difficult for them to have normal relationships.

Making Sense of All of This

If you are reading here because you are afraid that a child you know is being or has been sexually abused, they you likely want something that will give you certain and clear guidelines. You would probably like me to say: if you ticked off so many from group one, so many from group two and so many from group three, then you can be sure this child was sexually abused and if not you can be sure they were not. I cannot give you such an answer.

Sexual abuse is trauma. Remember that it is only one form of trauma that can occur in the lives of children and adolescents. Physical violence is traumatic whether it is toward the child himself or herself, toward a sibling or toward a parent. Being cursed and belittled in the home and bullied at school or in the neighbourhood are also traumatic experiences. Research is finding that emotional neglect is a very serious form of child abuse. Divorce, if particularly acrimonious, can traumatize a child or teenager, as can sudden death of a loved one.

The main difference between a trauma from which one heals and a trauma from which one does not is the response of adults in the environment. A traumatic event that can be talked about, cried over, the pain acknowledged, is a trauma the child or teenager will recover from. A secret trauma about which nobody wants to know remains a festering sore that cannot heal until it is acknowledged and worked on.

If someone you are worried about has any of the above signs of distress, it should be taken seriously. It may well be a sign of sexual abuse and it may not be. But signs of distress these are. Do not take them lightly. Do not expect the child or adolescent to grow out of them. Seek professional help for the child and for the child's family, for yourself if you are the child's parent.

Sheri Oz, Expert in Childhood Sexual Trauma

All My Articles on the Internet
Here you can find links to all my articles that will appear in different places around the Web. I am constantly adding new articles based on my clinical experience with victims/survivors of sexual trauma and their families and offenders and their families.

Updated October 1, 2012

Let me know you were here and feel free to leave questions. I will reply to them here or send them via my contact button and I will respond in a way that protects your anonymity.

Sheri_OzJan 5, 2014

Hi Jess - thanks for your question. Unfortunately, it is possible that the child was abused by one of the parents and therefore you should not talk with the parents about your suspicion. The suspicion should be reported to the child protection worker (CPW) where the child lives and let the CPW investigate. Because of the mandated reporting law, the CPW is the proper professional to handle talking with parents about suspicions of abuse.

Sheri_OzSep 30, 2012

@Roohi - you are right that children should be taught what is right and what is not and taught to tell an adult. If that adult doesn't help, they should tell another and another, until they find an adult who does help them.

RoohiJun 8, 2012

Excellent information for parents. It seems that the incidents of sexual abuse are only on the increase despite the fact that there are so many laws in place in almost every country. I think the only way to stop this or at least reduce the number of such incidents is to be active observers as parents and teachers especially. If we teach children what is right and what is not and to report to an adult when someone touches them inappropriately, I think such incidents can be stopped.

katiem2Jan 30, 2012

Good to know, this still continues to occur, I'm shocked it does and for that reason we parents need this type of information to help and ultimately prevent abuse. Thanks for putting so much time and energy into delivering vital signs of abuse as I know it must be difficult to think of, this being an issue we all must think about, no room for denial. Katie

Sheri_OzJan 21, 2012

Thank-you for your so personal response to my article. It is important to me to know that I provide information others find helpful. You are not paranoid, by the way; these days we know that one cannot just trust everyone. We need to get our heads out of the sand as a society (world-wide) and let our kids know that we are there for them for the happy times and the hard times, that we are to be turned to if they are scared or hurting. That's the most important thing.

AngelJan 21, 2012

Very informative article. I can't tell you the number of times I was touched inappropriately or in some cases taken complete advantage of as a child and young girl. I have issues with men today because of it. I just don't trust at all. It makes it difficult for my husband as he wants my complete trust. I fear this so much for my 2 daughters and have even thought about it happening to my 2 sons. I guess it happens to both when you think about it. I do NOT even like my oldest daughter spending the night with any of her friends because there are other men in the house. Just a fear that I have. Good good information here. Thanks.