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Child abuse - sexualDefinition Child sexual abuse is defined as the deliberate exposure of minor children to sexual activity. With the exception of incestuous relationships, this syndrome was not clearly described until the late 1970s. The problem is far more common than had been realized. Indeed, the medical literature up through the mid-1970s contained articles about children and sexually transmitted diseases, such asgonorrhea.However, there was no discussion of where it came from. There was great reluctance in society to deal with this issue, but after three decades of examination worldwide, child sexual abuse is now considered a serious issue. Causes, incidence, and risk factors It is difficult to determine how common child sexual abuse is. It is often more secret than physical abuse. Also, the way we define sexual abuse can affect the number of people who have experienced this. Surveys of college-aged women show that 20% to 30% have had a negative sexual experience. However, most of these experiences are relatively minor, such as a man exposing his genitals to an unsuspecting woman. These types of experiences are less likely to have a significant psychological impact. The best estimate is that about 10% to 12% of women have been significantly abused. Estimating the rates of significant abuse in males is even more difficult for a few reasons. The secrecy around this issues is usually greater, and males rarely reveal abuse before age 16. The rate of significant abuse of males is about 6% to 8%, somewhat lower than that for females. Abusers are usually males and usually know the child or youth who is abused. This is the case in 80% of youth cases and over 90% in younger children. The abuser violating the trust of the younger person makes sexual abuse even more psychologically devastating. Child sexual abuse occurs in all social and economic classes of people, but it has the same type of risk factors as physical child abuse, including poverty, disordered families and abuse of alcohol and street drugs. Abusers were often physically or sexually abused themselves. A small group of repeated abusers suffer from the psychiatric disorder of pedophilia, in which the preferred sexual contact is with children. Symptoms Symptoms of child abuse are similar to those seen in clinical depression or severe anxiety and nervousness. They can include:
Social symptoms include withdrawl from normal activities, excessive fears or school failure, and disruptive behaviors such as using alcohol and street drugs or engaging in high-risk sexual behaviors. Signs and tests If there is any suspicion of child sexual abuse, the child should be examined as soon as possible by a trained healthcare professional. An examination should not be delayed for any reason. Many signs of injury are temporary. Ideally, the examination should occur within 72 hours of the event or discovery. Most pediatricians, many family medicine doctors, and most emergency room (ER) physicians have training in examining cases involving sexual abuse and can document findings appropriately. A second examination with an expert abuse examiner should be scheduled thereafter. A physician or nurse specialist can be found through child protective services program anywhere in the U.S. An examination will automatically be scheduled when suspected child sexual abuse is reported to police or child protection agencies (see discussion on reporting abuse below). It is extremely important to document physical findings related to any form of child abuse. A complete physical examination must always be performed, so that the examiner can look for any signs of physical and sexual abuse . The two forms of abuse may co-exist. Affected areas may include the mouth, throat, penis, and vagina. The hymen is a thin membrane covering the opening of the vagina. There are some normal variations to this structure, but it can be affected by abuse. Your doctor may also order blood tests to check for sexually transmitted diseases, such as syphilis and HIV. These tests can also help determine treatment. Photographs of any injuries may help establish what happened. Treatment Treatment for the physical findings of sexual abuse is the same as for any form of cuts, bruises, or scrapes. All children who have been sexually abused or traumatized in any way should receive mental health counseling. Suspicion of child sexual abuse must be reported to child protective services and the police. Medical professionals, teachers, and child care professionalsare required by law to make a report. Once a case is reported, child protection agencies and the police must investigate. If the allegation is considered true, the child must be protected from further abuse. Placement with a non-abusing parent, another relative, or a foster home may result. In physical abuse cases, the goal of child protection agencies is to re-educate an abusing caretaker and attempt reunification of the family, if safe. Support Groups Support groups for abused children, their parents, and caretakers are available and strongly recommended. Expectations (prognosis) Mental health is the major issue. Outcome depends on psychotherapy, family and social support, the nature and length of time the child was abused, and the individual characteristics of the child. Complications
Calling your health care provider If you suspect child abuse in any form, immediately call your health care provider, child protective services, or police. Prevention Prevention involves teaching children never to keep secrets and the difference between "good" and "bad" touches. Parents need to begin this work at home. Most schools now have programs to teach young school-aged children about sexual abuse and its prevention. Teenagers also need education about how to avoid rape and date rape. Constant supervision and vigilance by adults is essential to preventing all forms of child abuse. Page Content: Sexual abuse - children |
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