Talking to Children About Sexual Abuse

Talking about sexual abuse

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Margaret R. Paccione-Dyszlewski, PhD, child psychologist at Bradley Hospital, answers common questions about children and sexual abuse:

Q. How common is child sexual abuse?

A. The area of child sexual abuse is a delicate and difficult one. Because the world of child abuse is veiled in secrecy, it is difficult to estimate its prevalence or how often it occurs. Estimates indicate that each year in the U.S. over 300,000 children are sexually abused. Most experts believe that this is a very conservative estimate due to under reporting. Looking at this information in another way, one out of every four girls and one out of every six boys will be sexually abused before their 18th birthday.

Q. Many children have seen news stories about sexual abuse and might be confused or concerned. How can parents address this situation? Does it depend on the child's age?

A. Parents and other caregivers can take this opportunity to talk with children and teens about sexual abuse. Find a private and relaxed time and let your child know that you are open and willing to have an age-appropriate discussion on any concern or topic. Given the child's age and level of awareness, it is challenging for us adults to see the world as they might. Kids may not have the words to describe their concerns or formulate questions. Try to keep the tone serious and, above all, be a good listener. Kids often process information in chunks, so return to the topic when the child has had time to digest what is being said.

Q. What can parents do to protect their children?

A. Parents can build some protection by talking with children about sexual issues early and often. Early conversations can focus on teaching a child that some parts of their body are private and should not be touched except by very special adults such as Mom and Dad. Easy to understand illustrations such as "parts covered by your bathing suit are private." Terms such as "good touches/bad touches" or "okay /not okay" touches are helpful. Teach children correct terms for body parts-breast, penis, buttocks-this fosters respect for their body and gives them words to talk about these issues in the future.

Empower children to say NO when they feel uncomfortable. A child will carry well developed refusal skills into their teen years and can feel empowered to set limits in this and other areas such as bullying or substance abuse.

Q. If a child mentions that he or she has been touched inappropriately, what should parents do?

A. Create a quiet and private time to follow-up on what the child is reporting. Convey to the child that she/he is believed and that you are listening intently to what is being presented. Remember, 90% of individuals who sexually abuse children are known to the child. Resist the urge to dismiss what the child is telling you. (Oh, not Uncle Larry! or Don't ever say that about your Grandfather.) Ask for clarification if you are unclear. Questions like, "How does that make you feel?" or "What is that like for you?" can be helpful.

If you need support, contact your primary care provider. If you notice behavioral changes in your child, feel welcome to contact a therapist or the Bradley Hospital Access Center at 401-432-1364.

Q. What are the possible psychological implications of child sexual abuse?

A. Child sexual abuse is traumatic and can result in both short-term and long-term harm, including mental health problems that extend into adulthood. Some typical effects are feelings of guilt and fear, depression, post traumatic stress, eating disorders or poor self esteem. Behavioral problems such as sexualized behaviors, school/learning problems, substance abuse, self harm behaviors, sexual dysfunction in adulthood and suicide have been linked to childhood sexual abuse.

Q. Are there certain signs of sexual abuse that parents should be on the lookout for?

A. A caregiver can consider the possibility of sexual abuse when the child exhibits:

  • An increase in nightmares or other sleeping difficulties
  • Angry outbursts
  • Anxiety
  • Depression
  • Withdrawn behaviors
  • Bed wetting
  • Thumb sucking
  • Refusal to change for gym or to participate in physical activities
  • Reluctance to be left alone with a particular person or group of people

Q. What else should a caregiver know?

A. Remember, most states have mandated reporter laws. All adults in Rhode Island, for example, are required by law to report known or suspected cases of child abuse or neglect to the Department of Children, Youth and Families within 24 hours of becoming aware. 1-800-742-4453 (1-800-RI-CHILD)

In conclusion

I was talking with a friend of mine who has two grandchildren, ages 8 and 10. She told me that she sat with each of the kids privately and reminded them that she was their grandma and was interested in anything that they wanted to tell her. "There is nothing that you can't tell me or ask. If you are confused or sad or excited about something or you just want to ask about something, I am here for you." What a wonderful gift to give a child!