By Shalon Nienow, MD, FAAP
The idea that any adult would sexually abuse a child is terrifying, especially for parents and caregivers. But like any risk our children might face, we need to be able to empower them with information that will help them recognize unsafe situations. We also need to know how to respond to these situations if they occur.
Sexual abuse is a particularly difficult issue for caregivers, since there usually are no outward, easily noticed signs of the abuse. And when they are there, the signs of abuse often are vague. Learning about and being alert to potential signs of sexual abuse can help us feel more grounded and better equipped to keep our children safe.
There most important step to keeping children safe is prevention. There are key things we can teach our children that may reduce the chances they will fall prey to a sexual predator.
What we teach our kids can reduce their risks for sexual abuse
Parents and child health experts are working together to find new ways of preventing childhood sexual abuse. One promising approach is teaching children about
body autonomy, the idea that all people have the right to govern what happens to their own bodies.
How can a sense of body autonomy help prevent child sexual abuse?
Children and teens who feel in control of their bodies are less likely to fall prey to sexual abusers. And if they do suffer abuse, they are more likely to tell a trusted adult—which can make all the difference in stopping the events and subsequently helping them recover from this painful experience.
How & when to teach your child about body autonomy
Body autonomy begins with simple things you can teach your child, starting in their toddler years and reaffirming the lessons as they grow.
For example, you can teach them:
The real names of their body parts, emphasizing that it's natural and healthy to talk about all areas of our bodies
Who can look at or touch their private parts and under what conditions—like doctors to make sure that you are healthy
That it's fine to say "no" to anyone, including adults, if they don't want to be touched or hugged
That some secrets—like plans for a surprise birthday party—are safe to keep, but other secrets should always be shared with a trusted adult
7 simple steps for teaching your child body autonomy
Not sure where to start? Watch this American Academy of Pediatrics (AAP)
video, below. It walks you through 7 essential steps for teaching your child body autonomy, starting when they're very young. It includes tips and examples for opening a healthy conversation and answering your child's questions. I hope you'll share it with the adults in your child's life and other parents, caregivers, teachers and others in your community.
Your child needs to know it's safe for them to tell you anything, even if it's strange or scary.
Always affirm that you believe your child and will do everything you can to protect them from harm. Help them to understand that they will not be in trouble for telling you about information that should not be kept secret. Empower them to tell another trusted adult if they are too uncomfortable telling you.
How do we define child sexual abuse?
Child sexual abuse happens when a child or teen under 18 years old is involved in sexual activity that violates the laws or social taboos of society and that they:
Childhood sexual abuse can affect how people think, act and feel throughout their entire lives. Research links early sexual abuse with serious
health risks in adulthood, ranging from heart disease, obesity and cancer to depression, PTSD, substance use and more.
What you need to keep in mind about child sexual abuse
It is widespread. About one in every four female children and one in every 13 male children in the United States will experience some form of child sexual abuse.
Abusers are usually someone the child knows. They may be family members, relatives, friends, teachers, coaches, babysitters and other grownups in positions of power or authority, and who are trusted by the child and caregiver.
Children frequently will not disclose their abuse, often for prolonged periods of time. When children do tell, it often is not parents that they relay this information to. That can be particularly difficult for parents and why helping children to identify other safe adults in their life is key.
After being sexually abused, many children will not show any signs that they have been harmed. They may also initiate ongoing contact with their abuser.
Signs of stress in children can be an indicator of sexual abuse
For example, they might:
Withdraw from family and friends
Struggle in school
Show anger and aggression
Suffer from nightmares or extreme fears
Avoid certain adults
Have symptoms of sexually transmitted infections
When caregivers identify such signs this represents a good opportunity to ask children if anything is going on in their life that is bothering them.
Sexual abuse can happen more than once. It might go on for months or years. Children who have been previously sexually abused are also at risk for future abuse/assault events.
Abusers frequently do not use physical force. They are more likely to use words and ideas to engage a child. They often warn their victims not to tell anyone, which might make it even more difficult for a child to report what happened.
Remember
If you have any question about ways to keep your child safe from harm, including sexual abuse, talk with your pediatrician.
More information
About Dr. Nienow
 Shalon Nienow, MD, FAAP, is a member of the American Academy of Pediatrics Council on Child Abuse and Neglect Executive Committee. She is division director of child abuse pediatrics at Rady Children's Hospital in San Diego, California. She also serves as medical director at the Chadwick Center for Children and Families and clinical director of child abuse pediatrics at UC San Diego School of Medicine. As a child abuse pediatrician, she provides medical evaluations for children who may have experienced any form of abuse or neglect.
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