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In
the Spotlight
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| October
04, 2000 |
Sexual
Abuse: What You Need To Know
By Aleena Suryadevara,
M.D.
PersonalMD.com Medical Contributor
|
 Sexual
abuse involves any sexual activity with a child. This includes sexual
contact that is accomplished by force or threat of force, regardless
of age of the participants, and all sexual contact between an adult
and a child, regardless of whether there is deception or the child
understands the sexual nature of the activity.
Incidence:
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38
percent of girls are sexually abused before the age of 18.
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16 percent of boys are sexually abused before the age of 18.
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In 1994, there were 345,400 sexual abuse cases reported to the child
protective services in the U.S.
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90-95 percent of all sexual abuse cases go unreported to the police.
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Fabricated sexual abuse reports constitute 1 to 4 percent of reported
cases.
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An
average of 5.5 children per 10,000 enrolled in day care are sexually
abused, while an average of 8.9 children out of 10,000 are abused
in the home.
Who
Are The Most Common Perpetrators?
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In
most cases, the child knew the sex offender; with girls, 29 percent
were relatives and 60 percent were acquaintances and with boys,
16 percent were relatives and 44 percent were acquaintances.
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Children
who grow up in a family where there is domestic violence are 8 times
more likely to be sexually molested within that family.
What
Signs And Symptoms Should
I Look For In A
Person Who Is Sexually Abused?
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Sleep
disturbances (nightmare, fear of the dark, trouble falling asleep,
frequent awakening).
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Changes in eating habits (weight loss, weight gain, change in appetite).
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Regressive behaviors (clinging, thumb-sucking, diminished bladder
control).
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Excessive or inappropriate fears (especially of something familiar).
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Hostile or aggressive behavior.
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Repeated somatic complaints without any known physical etiology.
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Decline in academic performance (school avoidance, poor peer relations).
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Withdrawal
from family and friends.
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Diminished
interest in previously anticipated events.
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Decline
in personal appearance.
Remember,
however, that absence of such behaviors does not mean that the child
has not been abused. In fact, up to 40 percent of sexually abused
children may not show any of the expected abuse-related problems.
More importantly, we must remember that these symptoms can also be
the result of many other things, such as divorce, separation from
caretaker, or a death or loss in the family.
What To Expect At The Doctor's Office
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A
complete physical checkup with special emphasis on oral, perineal,
and anal areas is normal (photographs and drawings to document findings
may be done if needed) - often a colposcope is used, this takes
a magnified picture of the area so that everything can be clearly
visualized.
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Careful
interview is usually done to obtain information about who is in
the family, if there is any significant medical or legal history,
the child's health history and current health status, the child's
developmental level, if there are any behavioral indicators, the
family's attitude and practices regarding privacy, nudity, sexuality,
bath and bed time patterns and allegations or suspicion of possible
sexual abuse are important.
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Detailed
information regarding the child's initial disclosure if the event
is also obtained, this includes the parent or primary caregiver's
interpretation of the child's statement and/or behavior regarding
possible sexual abuse, also we must find out if the primary caregiver
believes the child.
An accurate
recording of the information obtained is always critical, because
it is common for court proceedings to take place months or even years
after allegation were initially made, so detailed written and/or taped
documentations regarding evaluation procedures are important.
What Are The Most Common Treatments?
It is widely accepted that treatment is indicated for most children
who have been sexually victimized. Individual therapy is the most
common form of therapy for sexually abused children, although group
and family therapy are also employed frequently. Topics frequently
covered are feelings about the abuse and offender, corrective information
about abuse and offenders, education regarding sexuality, sexual abuse
prevention material preparation for the court, and identification
of a support system.
How Do I Prevent Sexual Abuse To My Children?
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Education
of adolescents and young children about sex, including healthy sexuality,
during the preteen and teenage years to enhance knowledge about
what is safe and unsafe (rather than what is right and wrong) is
extremely important.
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Making
sure the child has someone both at home and outside in whom they
can confide or tell their "secrets".
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Training
of professionals and volunteers who work with children on how to
identify abuse.
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Education
of family members and providing support that enhances early attachment
and bonding when babies are first born.
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Stressing
media messages that create an environment in which prevention programs
and concepts are emphasized.
Copyright
© 2000 PersonalMD.com. All rights reserved.
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