info:Child sexual abuse
Child sexual abuse is the deliberate
exposure of minor children to sexual activity. This means a child is
forced or talked into sex or sexual activities by another person. Such
abuse includes:
- Oral sex
- Pornography
- Sexual intercourse
- Touching (fondling)
Causes
Society was reluctant to deal with child sexual abuse a few decades ago. Today, it is considered a serious issue.
It
is difficult to determine how often child sexual abuse occurs, because
it is more secret than physical abuse. Children are often scared to tell
anyone about the abuse. Many cases of abuse are not reported.
Abusers
are usually men. They tend to know the person they are abusing. The
abuser violates the trust of the younger person, which makes the sexual
abuse even more devastating.
Child sexual abuse occurs in all social and economic classes of people. It has the same type of risk factors as physical child abuse, including:
- Alcohol and drug abuse
- Family troubles
- Poverty
Abusers sometimes have a history of physical or sexual abuse themselves.
A small group of repeated abusers have the psychiatric disorder, pedophilia. Their preferred sexual contact is with children.
Symptoms
Symptoms of sexual abuse in chlildren are similar to those of depression or severe anxiety and nervousness. They can include:
- Bowel disorders, such as soiling oneself (encopresis)
- Eating disorders, such as anorexia nervosa
- Genital or rectal symptoms, such as pain during a bowel movement or urination, or vaginal itch or discharge
- Repeated headaches
- Sleep problems
- Stomach aches (vague complaints)
Children who are abused may:
- Display disruptive behaviors such as using alcohol and street drugs or engaging in high-risk sexual behaviors
- Do poorly in school
- Have excessive fears
- Withdraw from normal activities
Exams and Tests
If
you suspect a child has been sexually abused, the child should be
examined as soon as possible by a trained health care professional. Most
pediatricians, many family medicine doctors, and most emergency room
(ER) doctors have been trained to examine cases involving sexual abuse.
Do
not delay a doctor's exam for any reason. Many signs of injury related
to sexual abuse are temporary. The exam should be done within 72 hours
of the event or discovery.
A complete physical exam must always be
performed, so that the examiner can look for any signs of physical and
sexual abuse. The two forms of abuse may exist together.
Affected
areas may include the mouth, throat, penis, anus, and vagina, including
the hymen. The hymen is a thin piece of tissue covering the opening of
the vagina. It can be affected by abuse.
Your doctor may also order blood tests to check for sexually transmitted diseases, such as syphilis and HIV, and pregnancy in females. These tests can help determine treatment.
Photographs
of injuries may help establish what happened. It is extremely important
to write down symptoms due to any form of child abuse.
An exam
will automatically be scheduled when suspected child sexual abuse is
reported to police or child protection agencies. A second exam with an
expert abuse examiner should be scheduled after the first exam. A doctor
or nurse specialist can be found through child protective services
programs anywhere in the United States.
Treatment
Treatment
for the physical signs of sexual abuse is the same as for any types of
cuts, bruises, or scrapes. The patient may need medicines to prevent or
treat sexually transmitted diseases. Older females may receive medicines
to prevent pregnancy.
All children who have been sexually abused or traumatized in any way should receive mental health counseling.
Any
suspicion of child sexual abuse must be reported to child protective
services and the police. Medical professionals, teachers, and child care
professionals are required by law to make a report.
Once a case
is reported, child protection agencies and the police must investigate.
If the report is considered true, the child must be protected from
further abuse. The child may be placed with a non-abusing parent,
another relative, or a foster home.
Support Groups
Support
groups for abused children, their parents, and caretakers are available
and strongly recommended. The following organizations may provide more
information:
Child Help USA - www.childhelpusa.org
Prevent Child Abuse America - www.childabuse.org
Rape, Abuse & Incest National Network - www.rainn.org
Outlook (Prognosis)
The biggest issue is the child's mental health. The outcome depends on:
- Family and social support
- The child's personality
- The length of time the child was abused and the type of abuse
- Therapy
Possible Complications
- Anxiety disorders
- Depression
- Eating disorders
- Post-traumatic stress disorder (PTSD)
- Sleep disorders
- Unsafe sexual activities
When to Contact a Medical Professional
If you suspect child abuse in any form, immediately call your health care provider, Child Protective Services, or police.
Prevention
Prevention
involves teaching children never to keep secrets and the difference
between "good" and "bad" touches. Parents need to begin this work at
home. Most schools now have programs to teach young school-aged children
about sexual abuse and its prevention.
Teenagers also need to be taught how to avoid rape and date rape.
Constant supervision and vigilance by adults is essential to preventing all forms of child abuse.
Alternative Names
Sexual abuse - children
References
Johnson CF. Abuse and neglect of children. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 36.
source:http://www.nlm.nih.gov/medlineplus/ency/article/007224.htm
