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.