Preventing sexual abuse in children

It's scary to think someone would sexually abuse a child, but unfortunately, it happens.

According to the Centers for Disease Control and Prevention (CDC), an estimated 1 in 4 girls and 1 in 20 boys experience sexual abuse at some point in childhood. And 91% of child sexual abuse happens by someone the child knows – possibly a family member, coach, teacher, church member or another child.

While many parents hope that this could never happen to their child, being aware is the first step in keeping your child safe.

"It's important to arm our kids with the confidence and language they need to tell us if someone sexually abuses them," says Suzanne Dakil, M.D., Child Abuse Pediatrician with Children's Health℠ and Assistant Professor at UT Southwestern.

Dr. Dakil shares insights and advice on preventing and reducing the risk of sexual abuse of children.

What is child sexual abuse?

Child sexual abuse is a type of abuse that involves any sexual behavior or act with a child. Abuse happens in a variety of ways. Someone might touch a child inappropriately, make inappropriate comments, take inappropriate photos or show the child their own private parts. Sometimes, the abuse is more aggressive.

Children cannot consent to any sexual activity. Child sexual abuse is a crime and has serious, lasting effects on the health and well-being of a child.

How to talk to children about private parts and body safety

To help protect your child from sexual abuse, be proactive. Start talking with your child about their body parts by at least age 3 or 4. Teaching your child about private parts and body safety may feel uncomfortable, but it doesn't need to be. It's an important part of keeping your child safe and healthy. Here are tips to help:

1. Teach children the names of their body parts.
   Teach children the names of their body parts early and clearly. "I'm a fan of using medical, accurate terms when teaching children about their body parts – such as penis or vagina. Whatever words you choose, be consistent," says Dr. Dakil. "Kids need to know the right language so they can describe what happens to them and your family knows how to interpret the situation."
2. Keep it simple at first.
   For example, if young siblings or cousins are in the bathroom at the same time, simply explain, "You have your body parts, and they have their parts. And we don't touch each other's parts." Speaking about body parts consistently and calmly lays the groundwork for establishing boundaries.
3. Give your child body boundaries.
   From a young age, teach your child that their private parts are their own. You can say, "Your penis is yours, and no one else should look at it or touch it. No one should ask you to touch or look at their private body parts either. Not even an aunt, uncle or teacher. If that happens, please tell me right away." Explain that their private parts are special and not something to share with others when they're little.
4. Explain the only times it's OK for someone else to look at their private parts.
   Make sure your child understands the only situations in which someone should see their private parts. "Sometimes mommy/daddy (or name of trusted caregiver) help you bathe or go to the bathroom. Sometimes, the doctor examines you to make sure you're healthy. That's OK because we're there with you and know what's happening."
5. Assure children that if something happens, they can tell you no matter what.
   Tell your child you want to know if someone is bothering them or touching their body. It's important for children to know they will never get in trouble for sharing this information. "If anyone talks with you about private parts or shows you their private parts, please tell me right away. You won't get in trouble."
6. Explain that your family does not keep body secrets.
   Sometimes a sexual perpetrator will tell the child to keep the abuse secret. Tell your child that your family does not keep body secrets and that no one, no matter who they are, should ever ask them to keep a secret about their body. This includes people they know. You can explain the difference between secrets and surprises. "We may buy a present for daddy's birthday and not tell daddy. But on his birthday, the surprise will be revealed. Our family does not keep secrets."

What are the signs of sexual abuse in kids?

To spot child sexual abuse, watch for major behavioral changes, such as:

• Aggressive or self-destructive behavior
• Bedwetting
• Changes in appetite
• Depression and anxiety
• New interest in talking about private parts (beyond a child's natural curiosity)
• Nightmares
• Poor school performance
• Sudden hesitation to be with certain adults or children or go to a certain family's home
• Sudden withdrawal from family and friends

Be aware that other issues can cause behavioral changes too, such as divorce, death, a move or something else. Some children who are victims of sexual abuse may not display any outward symptoms.

How to ask children about inappropriate touching

If you suspect your child is being abused or molested, you'll likely be upset. When you talk to your child, it's important that you try to stay calm.

"Kids don't want to upset their parents. They read your body language to know if they're going to get in trouble," says Dr. Dakil. "If you're anxious and ask pointed questions – Did someone touch you? Did this happen? – your child's response will probably be no. You might not get the truth."

Instead, ask open-ended questions. For example, if your child suddenly seems afraid to go to someone's house, say, "I've noticed you're acting differently when we talk about this person. You're a good kid. Is there something about this person that makes you uncomfortable?"

Then, give your child a chance to respond. If your child says nothing is wrong, revisit the question later. If you're still concerned, seek advice from your pediatrician or counselor.

If your child does mention sexual abuse, listen carefully. Contact your pediatrician, local child protection services or the police. The hotline for Texas child protection services is 1-800-252-5400. It's important to reassure children they are not in trouble or responsible for the abuse.

Other ways to prevent child sexual abuse

Unfortunately, there is no one way to prevent child abuse entirely. However, there are ways to lessen the risk. In addition to teaching your child about body safety and boundaries, take steps to:

• Surround your child with people you trust.
• Be aware of adults who offer children special toys, gifts and invitations.
• Enroll your child in daycare programs that have an “open door” policy for parents.
• Participate in activities whenever possible.
• Consider your family policy about playdates and sleepovers. Find out who will be there and get familiar with those who are around your child.
• Tell your child to call you if they ever feel uncomfortable in a situation.
• Create a home environment in which sexual topics can be discussed openly. As children grow older, use news reports of child sexual abuse to start discussions. Stress that children should always tell you if someone is taking advantage of them, and that you are there for them.

Learn more

The Referral and Evaluation of At Risk Children (REACH) Clinic at Children’s Health is the only clinic in the Greater Dallas area with medical providers specially trained and certified in child abuse. Learn more about the services we provide.