Handout

Indicators of Sexual Abuse

Physical Indicators

Most physical indicators of child sexual abuse would be found on physical exam by a medical practitioner. Other professionals rely more on behavioral, emotional, and cognitive/academic indicators in determining whether to suspect sexual abuse.

Behavioral Indicators

• Expressions of age-inappropriate knowledge of sex and sexually “pseudo-mature” behaviors
• Sexually explicit drawings
• Highly sexualized play
• Expressions of unexplained fear of a person or place
• Statements of a desire to avoid or an attempt to avoid a familiar adult
• Signs of posttraumatic stress disorder
• Nightmares
• Sleep interruptions
• Withdrawal
• A child's statement

Emotional Indicators

The highly complex emotional milieu that is created when caregiver-child boundaries have been breached, often accompanied by attempts to involve the child in collusion with real or implied threats (“this is our little secret”), is far beyond the child’s ability to understand. Not surprisingly, the child may experience a range of emotional issues including self-image problems, low self-confidence, guilt (“my fault”), shame, depression, anxiety, and mood swings.

Cognitive/Developmental/Academic Indicators

Because of the emotional maelstrom that is often inside sexually abused children, they may show difficulty learning, interrupted concentration, and academic deterioration.