Child Abuse and Neglect

Table of Contents

1. Child Abuse and Neglect
2. What is Child Abuse and Neglect?
3. Physical Abuse
4. Sexual Abuse
   1. Behavioral indicators of sexual abuse
   2. Evaluation of suspected sexual abuse
   3. Physical findings in sexual abuse examinations
   4. Evaluation of acute sexual assault
   5. Sequelae of sexual abuse
5. Child Neglect
6. When you suspect abuse or neglect
7. Domestic Violence and Children
8. Preventing Child Abuse
9. References

Behavioral indicators of sexual abuse

The most frequent initial manifestation of sexual abuse in a young child will be a change in behavior. There is no single behavioral change that is specific for sexual abuse, but the following is a partial list of behaviors that, if persistent and if there is no other obvious explanation, should raise the possibility of sexual molestation:

1. New onset of bedwetting or fecal soiling in a previously toilet-trained child;
2. Unexplained changes in sleep or appetite;
3. New fears, particularly of a particular person, or of people with certain physical characteristics;
4. Persistent or obsessive curiosity about sexual intercourse or genitalia beyond that expected for age

The mimicking actual sexual activity by a prepubertal child, particularly when the behavior closely simulates intercourse, always warrants a report to Child Protective Services, as this behavioral symptom is highly correlated with sexual abuse.