Clinical Reference Systems: Pediatric Advisor 10.0
Responding to Child Sexual Abuse
When a child tells an adult that he or she has been sexually
abused, the adult may feel uncomfortable and may not know
what to say or do. The following guidelines should be used
when responding to children who say they have been sexually
What to Say
- If a child even hints in a vague way that sexual abuse
has occurred, encourage him or her to talk freely. Don't
make judgmental comments.
- Show that you understand and take seriously what the
child is saying. Child and adolescent psychiatrists have
found that children who are listened to and understood do
much better than those who are not. Your response to the
disclosure of sexual abuse is critical to the child's
ability to resolve and heal the trauma of sexual abuse.
- Assure the child that he or she did the right thing in
telling about the abuse. A child who is close to the
abuser may feel guilty about revealing the secret. The
child may feel frightened if the abuser has threatened to
harm the child or other family members as punishment for
telling the secret.
- Tell the child that he or she is not to blame for the
sexual abuse. Most children in attempting to make sense
out of the abuse will believe that somehow they caused it
or may even view it as a form of punishment for imagined
or real wrongdoing.
- Finally, offer the child protection, and promise that you
will promptly take steps to see that the abuse stops.
What to Do
Report any suspicion of child abuse. If the abuse is within
the family, report it to the local child protection agency.
If the abuse is outside the family, report it to the police
or district attorney's office. Individuals reporting in
good faith are immune from prosecution. The agency
receiving the report will conduct an evaluation and will
take action to protect the child.
Parents should consult with their child's physician, who may
refer them to a health care provider who specializes in
evaluating and treating sexual abuse. The examining doctor
will evaluate the child's condition and treat any physical
problem related to the abuse, gather evidence to help
protect the child, and reassure the child that he or she is
Usually the child should also have a psychiatric evaluation
to find out how the sexual abuse has affected him or her.
It can be determined whether ongoing professional help is
necessary for the child to deal with the trauma of the
abuse. A child and adolescent psychiatrist or other expert
can also provide support to other family members who may be
upset by the abuse.
While most allegations of sexual abuse made by children are
true, some false accusations may arise in custody disputes
and in other situations. Occasionally the court will ask a
child and adolescent psychiatrist to help determine whether
the child is telling the truth or whether it will hurt the
child to speak in court about the abuse. When a child is
asked to testify, special considerations, such as
videotaping, frequent breaks, exclusion of spectators, and
the option not to look at the accused, make the experience
much less stressful.
Adults, because of their maturity and knowledge, are always
the ones to blame when they abuse children. The abused
children should never be blamed.
When a child tells someone about sexual abuse, a supportive,
caring response is the first step in getting help for the
child and reestablishing trust in adults.