Dealing With Child Sexual Abuse
Last month was very active at Texas Children's in observance of Child Abuse Awareness and Prevention Month. As we begin May, I wanted to discuss a subject that is particularly difficult for parents and professionals alike — dealing with child sexual abuse. I know of no people who find this an "easy" topic. A smart woman and former supervisor of mine told me once that "sexual abuse usually does not injure the body, but it devastates the soul."
There probably is nothing more difficult than a child coming to you, and telling you that they have been molested. That child is most likely very frightened about how you will react. Will you be angry with them as perhaps the abuser told them you would be? Will you shun them or look on them as "damaged"? Many other questions run through their minds. For these reasons, most never tell, and sadly they are often repeatedly abused.
The other sad truth is that physical symptoms of sexual abuse are frequently non-specific. Even at the start of my career, regressive behaviors were often seen as universal warning signs of sexual abuse (bedwetting of a potty trained child was often seen as almost definitive of sexual abuse). However, we now know that this is not necessarily so. Regressive behaviors indicate that a child is under stress. The stress may be sexual abuse, or it may be starting school, or fighting parents, or coming the the hospital.
So, what to do?
Unfortunately, we live in a society where child sexual abuse occurs. As people who care about the safety of children, it's our duty to listen to our children. Look for changes in a child's behavior, and then talk to them about it. Be open and honest, and ensure them that you love them unconditionally — no matter what! We do not recommend that non-professionals regularly check for sexual abuse by physical examination. We do recommend that you start a dialogue very early on about safety, and one component of this is sexual abuse.
I recommend the following to parents in our EC:
- Explain to children that parts of their bodies covered up by their swimsuits are private parts. No one has the right to touch them there. Sometimes they need help with cleaning and wiping, but otherwise no one touches them there.
- Teach them the names of their private parts (i.e. vagina, penis and so forth). This will remove any ambiguity if a child makes an outcry of sexual abuse.
- Periodically have discussions regarding safety. At first, you may need to ask them if they remember their "private parts". Ask them if anyone has touch their private parts. If they say "no", you're done.
- If they says "yes", you need to become super parent/caregiver. Stay calm. If you can't, it's best not to continue right now. The child is probably scared of telling, and your strong reaction may reinforce their feelings of fear. If you proceed, calmly ask then who touched them? Where did it happen? When did it happen last? Explain to the child that she did the right thing, and that you love her. This is the most important thing you will do. If a child makes an outcry, always assume it to be true, until investigated by the proper authorities and a disposition is determined.
- Call for help as needed. You may call CPS at (800) 252-5400, the Harris County Children's Assessment Center at (713) 986-3300, your local law enforcement agency, or your child's health care provider for help. If you believe that a child was molested you must call CPS and/or law enforcement.
If your child tells you their doctor touched them when being examined for UTI, for example, they did their job. Your job would be to determine if you thought that was appropriate. If you have questions about this or any other type of touching, ask questions until you have the answers you need.