Psychosocial Indicators of Child Sexual Abuse

by Child Welfare Information Gateway

(Page 3 of 4)

Comparable efforts to identify the psychosocial indicators of child sexual abuse have been made by mental health professionals. In 1985, 100 national experts in sexual abuse met to develop criteria for the "Sexually Abused Child Disorder," in the hope that it would be included in the Diagnostic and Statistical Manual Three-Revised (DSMIII-R). It was not, but the effort remains important. The criteria of the "Sexually Abused Child Disorder" differentiate three levels of certainty (high, medium, and low) and vary by developmental stage. These criteria include both sexual and nonsexual indicators.

The work of Friedrich focuses on sexualized behavior, indicators unlikely to be found in other traumatized or normal populations. His Child Sexual Behavior Inventory has been field-tested on 260 children between 2 to 12 years of age, who were alleged to have been sexually abused and 880 children not alleged to have been sexually abused. It was found to reliably differentiate the two types of children. However, a substantial proportion of children in Friedrich's research, determined sexually abused, are not reported to engage in sexualized behavior. Moreover, children who learn about sex from nonabusive experiences may engage in sexualized behavior.

In this manual, a two-category typology of behavioral indicators is proposed:

• sexual indicators, generally being higher probability indicators; and
• nonsexual behavioral indicators, usually considered lower probability.

Sexual Indicators

Sexual indicators vary somewhat depending on the child's age. The discussion of these indicators will be divided into those likely to be found in younger sexually abused children (aged 10 or younger) and those likely to be found in older sexually abused children (older than age 10). However, this distinction is somewhat arbitrary, and within these two groups there are children at very different developmental stages. Finally, indicators that are important for children of all ages are noted.

Sexual Indicators Found in Younger Children

These behaviors are high-probability indicators because they represent sexual knowledge not ordinarily possessed by young children.

Statements indicating precocious sexual knowledge, often made inadvertently.

• A child observes a couple kissing on television and says that "the man is going to put his finger in her wee wee."
• A child comments, "You know snot comes out of Uncle Joe's ding dong."

Sexually explicit drawings (not open to interpretation).

• A child draws a picture of fellatio.

Sexual interaction with other people.

• Sexual aggression toward younger or more naive children (represents an identification with the abuser).
• Sexual activity with peers (indicates the child probably experienced a degree of pleasure from the abusive activity).
• Sexual invitations or gestures to older persons (suggests the child expects and accepts sexual activity as a way of relating to adults).

Sexual interactions involving animals or toys.

• A child may be observed sucking a dog's penis.
• A child makes "Barbie dolls" engage in oral sex.

The reason sexual knowledge is more compelling when demonstrated by younger children than older ones is that the latter may acquire sexual knowledge from other sources, for example, from classes on sex education or from discussions with peers or older children. Even younger children may obtain knowledge from sources other than abuse. However, children are not likely to learn the intimate details of sexual activity nor for example, what semen tastes like and penetration feels like without direct experience.

Another indicator often cited is excessive masturbation. A limitation of this as an index of sexual abuse is that most children (and adults) masturbate at some time. Thus, it is developmentally normal behavior, which is only considered indicative of sexual abuse when "excessive." However, a determination that the masturbation is excessive may be highly subjective. The following guidelines may be helpful.

Masturbation is indicative of possible sexual abuse if:

• Child masturbates to the point of injury.
• Child masturbates numerous times a day.
• Child cannot stop masturbating.
• Child inserts objects into vagina or anus.
• Child makes groaning or moaning sounds while masturbating.
• Child engages in thrusting motions while masturbating.

About the Author

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Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.