Massachusetts Medical Society: Protecting Your Child from Sexual Abuse

Protecting Your Child from Sexual Abuse

Facts and Tips for Parents and Caregivers

Together we can prevent the sexual abuse of children.

Fact: Child sexual abuse happens in both rural and urban areas, at all economic and educational levels, and across all racial and cultural groups.

Saying "no" to an older -- and more powerful -- person is hard for children.

Parents can teach their children:

  • that it is okay to say "no"

  • to recognize behaviors that don't feel right

  • how to get help when they need it

What is child sexual abuse?

Any sexual activity between an adult and a child or adolescent (as well as between an adolescent and a child) is sexual abuse. This includes both touching and nontouching behaviors.

  • Touching includes everything from fondling to intercourse.

  • Nontouching includes exposing oneself to a child, taking sexually explicit or provocative photographs of a child, and showing pornography to a child.

While exploring sexuality is a normal and healthy part of growing up, there may be times when children are involved in activities with one another that are not healthy. Pay attention when one child exhibits the following characteristics:

  • Is larger in size and is more than 3 years older in age;

  • Has greater mental, emotional, or physical ability; or

  • Uses power through threats, bribes, or physical force

Who sexually abuses children?

Most people who sexually abuse children look and act just like everyone else. It's hard to face the fact that someone the child knows -- and even likes or loves -- might be an abuser. Most abusers are either family members (fathers, mothers, stepparents, grandparents, uncles, aunts, and cousins) or another trusted adult -- not a stranger.

Abusers usually build up to the abuse slowly. At first, most children do not fully understand what is happening. By the time they are being abused, children often believe that they are to blame for what is happening. This is because the abuser has told them so.

People who sexually abuse children often appear friendly and trustworthy. Following are some signs to watch out for in people -- including family members and other trusted adults -- who come in contact with children:

  • Finds reasons to be alone with children -- outings or special trips without other adults.

  • Often has a "special" child friend and usually wants to be alone with that child. May give this child lavish gifts or pay unusual attention to the child.

  • Makes sexual comments involving children.

  • Makes sexual comments either to or in front of children, or comments to others about a child's body or sexuality.

Tips to help protect your child

Talking with your child is one of the best ways to protect your child. Good communication and trust are key to giving your child the confidence to say "no" to possible abuse. It's good to start early and talk often about this and other safety matters. Here are some simple rules that even young children can be taught:

  • No secrets. "No one should ever tell you to keep a secret from me -- one that might make me mad if I found out. An adult who cares about you will never ask you to do this."

  • All body parts have names. No matter what names your family uses for penis, vagina, breasts, and buttocks, talk to your child about these body parts in an open and honest way. When we don't talk about these parts of our bodies, we send the message that they are not to be spoken about. Abusers rely on children to follow their parents' lead of not talking about "private parts." "All parts of your body have names. These are _______."

  • Adults should not touch certain parts of your body. "Adults and older children have no business "playing" with your private parts. When I help you with washing or wiping yourself -- that is not the same as playing. Doctors and nurses help you by examining these body parts -- but it's not a secret."

  • Adults don't need help with their bodies. "Adults and older children will never need help from you with their private parts. If you are asked to help with washing someone's private parts, please come and tell me right away. I will not be angry with you."

Take the opportunity to weave these simple messages into everyday conversations and situations.

How can I tell if my child has been sexually abused?

Physical signs of sexual abuse are not common. If you are becoming concerned about unusual levels of anxiety or behavior change in your child, this can be a sign of sexual abuse -- or of many other childhood stresses. Following are some common examples of behavior seen in children who have been sexually abused:

  • New words for private body parts that were not learned at home.

  • Sexual activity with toys or other children, sexual play with dolls, or asks others to behave in a sexual way.

  • Does not want to talk about a "secret" involving an adult or older child.

  • Not wanting to be left alone with a certain babysitter, friend, relative, other child, or adult. Sometimes, a child's behavior might change when left with a certain person -- for example, going from talkative and cheery to quiet and distant.

If your child tells you that sexual abuse is occurring, take it seriously. Listen to what your child is saying and call your child's doctor right away.

What can I do if I think sexual abuse has occurred?

If you believe abuse is happening, begin by simply asking your child, "You seem unhappy. What's troubling you? I love you and I won't get mad at you -- no matter what you tell me."

Often, child sexual abuse is not obvious. This makes many people who think abuse is happening uncertain. They may not want to share what they are thinking with others. Concerned adults can call or visit the child's doctor. Other resources include the police, the Department of Social Services, and confidential help lines.

By working together -- parents, health care providers, and other adults in our communities -- we can prevent the sexual abuse of our children.

For additional information or help when you know or suspect that a child is being abused, contact:

  • Your doctor or your child's doctor

  • Massachusetts Department of Social Services (DSS):

    • Call (617) 748-2000 or visit to find the office that serves your community.

    • Child At Risk Hotline: (800) 792-5200
  • Massachusetts Child Sexual Abuse Prevention Partnership: (617) 742-8555

  • Massachusetts Society for the Prevention of Cruelty to Children (MSPCC): (617) 587-1500

  • National Children's Alliance: (800) 239-9950 or visit www.nca-online.orgto locate the Child Advocacy Center nearest you.

  • STOP IT NOW!: 1-888-PREVENT (1-888-773-8368); Monday through Friday, 9:00 a.m. to 5:00 p.m. Anonymous and confidential advice about your options if you suspect someone of abusing a child, or if you are sexually abusing a child.

To order additional copies of this card, please contact:
Massachusetts Medical Society
Public Health and Education
860 Winter Street
Waltham, MA 02451-1411
Phone: (800) 322-2303

This tip card is part of a series originated by R. Sege, M.D., Ph.D., Floating Hospital for Children at Tufts-New England Medical Center/Tufts University School of Medicine, Boston, and developed with the Massachusetts Medical Society's Committee on Violence.

Author: Jetta Bernier, M.A.

The information in this tip card was compiled by Massachusetts Citizens for Children, Inc. and its program, Prevent Child Abuse Massachusetts. We acknowledge the following organizations for contributing information: Care For Kids, Ontario Health Ministry, Canada; From Darkness to Light, Charleston, South Carolina; Kempe Children's Center, Denver, Colorado; Stop It Now! Haydenville, Massachusetts.

Funding was provided in part from the Centers for Disease Control and Prevention award, #R49/CCR118602-03.

The information contained in this publication does not constitute legal advice and should not be used as a substitute for the medical care and advice of your pediatrician or other doctor. Indicators and recommendations may vary based on individual facts and circumstances.

© Copyright 2004 Massachusetts Medical Society

This card may be duplicated for distribution without profit.

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