Insight for Health Care Professionals

It is rare for a child to speak directly about sexual abuse. Evidence of physical trauma to the genitals or mouth, genital or rectal bleeding, sexually transmitted disease, pregnancy, unusual and offensive odors, and complaints of pain or discomfort of the genital area can all be indicators.

An aware medical practitioner may notice these symptoms during a physical examination. However, in most cases of sexual abuse, there are no physical indicators of the crime. It is rare to actually have positive medical findings upon medical examination, although such findings can provide powerful corroboration of a child’s account of sexual abuse. Most often, children who are victims of sexual abuse exhibit emotional or behavioral characteristics that may indicate distress.

The presence of any one of these indicators does not necessarily mean that the child is or has been sexually abused. Children with several of these symptoms, however, are often referred for mental health evaluations. Most disclosures from children are to trusted friends or adults in their life – the teacher, coach, pastor, grandparent or therapist.

The reaction of the adult to whom a child discloses sexual abuse can significantly impact the child’s subsequent adjustment. It is important for the adult to be respectful, caring, and believing. A response involving panic, shock, or disbelief, or an overly emotional response can negatively impact the child.

Children often feel badly and blame themselves for the sexual abuse. Therefore, a response in which the adult communicates that the abuse was not the child’s fault and that disclosing the information was the right thing to do is recommended.

Preparing the child for the potential aftermath of the disclosure is also important. For example, if the adult to whom the child disclosed is a mandated reporter, the local child protection agency or law enforcement will have to be notified. If the adult to whom the child disclosed is a non-offending parent, the parent must take steps to protect the child from further abuse, including reporting the abuse to the proper authorities.

Should charges be laid after a child's disclosure support and information for the child and family can be received through the Victim Witness Assistance Program.