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Child Sexual Abuse

Child sexual abuse is defined as sexual activity between an adult and a child or sexual activity between two minors if there is a significant age, size, or power difference.

It can include a range of activities such as sexual touching, sexualized talk, exposure to genitals, rape, involvement in pornography, or prostitution. Child sexual abuse is nearly always perpetrated by individuals acquainted with the child, may occur over short or long periods of time, and may be accompanied by varying levels of coercion or physical violence.

Child Sexual Abuse Prevention Toolkit

In over 90% of child sexual abuse cases, the offender is known and trusted by the victim.

How Sex Offenders Groom Children

In over 90% of child sexual abuse cases, the offender is known and trusted by the victim. “Grooming” is the process used by the offender to recruit and prepare a child for sexual victimization.

It starts when the offender targets a child. While all children are at risk for victimization, some children are more vulnerable than others. A child is especially susceptible if he or she feels unloved, has low self-esteem, has little contact with committed adults, or regularly spends time unsupervised.

Sex offenders commonly engage children by spending time with them, playing with them, showing them special attention, or giving them gifts. Older children or teens may be offered drugs or alcohol. Offenders forge an emotional bond through frequent contact, positive interactions, and by conveying to the child or teen that they "understand" or can appreciate their interests and problems. They become adult friends or confidantes.

In time, this emotional bond leads to non-sexual physical contact or physical play such as wrestling, affectionate touching, or giving back-rubs. The offender tests the child's boundaries and desensitizes the child to overt sexual touch. The offender may also expose the child to sexually explicit materials, like pornography, to further make sex seem normal and desensitize the child.

Secrecy is introduced during the grooming process and as the child starts to become uncomfortable or fearful, offenders typically use threats to keep the child from speaking up (“If you tell, I will hurt you,” “No one will believe you”). Most child victims are caught in a web of fear, guilt, and confusion as a result of grooming. Sadly, many child victims remain silent about their abuse.

Behavior Indicators of Child Sexual Abuse

Indicators of child sexual abuse are varied and should always be considered in the context of what else is happening in a child's life.

  • Unexplained changes in a child's comfort level (either attachment to or fear of) around a family member, an adult family friend, or any person in a position of trust or authority for the child.
  • Abrupt changes in performance in school or work.
  • Abrupt changes in how the child socializes, either being out with friends or being in the house more often.
  • For younger children, a sudden loss of skills, such as a toilet-trained child wetting the bed.
  • Extreme avoidance of someone the child once liked or avoidance of a certain house or room in a house.
  • Sexualized behavior, often in front of others including self-exposure, excessive masturbation, touching other people's private parts, or sexually charged language. In older children or teens, this might be seen as promiscuous behavior.
  • Language and knowledge, especially specific details, which are not appropriate to the child's age or has not been taught in school or at home.

A Prevalent Problem

One in Ten children will be sexually abused before age 18, which is likely the most prevalent health problem children face with the most serious array of consequences.


Townsend, C. (2013). Prevalence and consequences of child sexual abuse compared with other childhood experiences.

Physical Indicators of Child Sexual Abuse

  • Bruises, scratches, irritation or itching around genitals that are not consistent with explanations of how they happened.
  • Signs of any sexually transmitted or infections such as chlamydia, crabs, herpes, gonorrhea, or human papilloma virus (genital warts) for those who are not sexually active.
  • Unexplained pregnancy.
  • Tenderness or soreness around areas of penetration.
  • Blood in stool or urine that is pervasive and not explained by other conditions. Underwear is often where proof of abuse may exist.

If you suspect a case of child sexual abuse, call the Sex Abuse Treatment Center’s (SATC) 24-hour hotline at 808-524-7273 for help.