Caring For Kids What Parents Need Know About Sexual Abuse

caring
for
K DS
What Parents
Need to Know about
Sexual Abuse
This project was funded in part by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS).
caring
for
K DS
What Parents
Need to Know about
Sexual Abuse
This product was developed by the Child Sexual Abuse Committee of the National Child Traumatic Stress Network,
comprised of mental health, legal, and medical professionals with expertise in the field of child sexual abuse.
This project was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department
of Health & Human Services (HHS). The views, policies, and opinions expressed are those of the authors and do not
necessarily reflect those of SAMHSA or HHS.
National Child Traumatic Stress Network

Established by Congress in 2000, the National Child Traumatic Stress Network (NCTSN) is a unique collaboration of
academic and community-based service centers whose mission is to raise the standard of care and increase access to
services for traumatized children and their families across the United States. Combining knowledge of child development,
expertise in the full range of child traumatic experiences, and attention to cultural perspectives, the NCTSN serves as a
national resource for developing and disseminating evidence-based interventions, trauma-informed services, and public
and professional education.
Suggested Citation
National Child Traumatic Stress Network Child Sexual Abuse Committee. (2009). Caring for Kids: What Parents Need
to Know about Sexual Abuse. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
Introduction
If you have just discovered that your child or a child you care about has been
sexually abused, it may feel as if your world is falling apart. But there is hope.
Other caring adults have been where you are.
Caring for Kids: What Parents Need to Know about

Sexual Abuse, is designed to give you the information
you’ll need to help support children who have
experienced sexual abuse. From dealing with the
shock of disclosure to coping with the emotional
impact of navigating the legal system, these resources
will help you and your child move past the pain, and
realize that it is possible to transcend trauma.
In addition to helping you to recognize child sexual

abuse and cope with its aftermath, this toolkit
provides resources that can help you to keep children
and adolescents safe. Caring for Kids includes
information on understanding sexual development
in children and on how to talk to children about
sexual issues and body safety, as well as information
for teens on acquaintance rape and how to reduce
their risk of victimization.
caringforK DS: What Parents Need to Know about Sexual Abuse

The National Child Traumatic Stress Network
www.NCTSN.org
Contents
Child Sexual Abuse Fact Sheet:
For Parents, Teachers, and Other Caregivers
Question & Answers about Child Sexual Abuse:

An Interview with Esther Deblinger, PhD
What to Do If Your Child Discloses Sexual Abuse:

Information for Parents and Caregivers
Coping with the Shock of Intrafamilial Abuse
Acquaintance Rape:
Information for Parents
Preventing Acquaintance Rape:

A Safety Guide For Teens
What Do I Do Now?
A Survival Guide for Victims of Acquaintance Rape
Sexual Development and Behavior in Children:

Understanding and Coping with Sexual Behavior Problems in Children:

Child Sexual Abuse:

Coping with the Emotional Stress of the Legal System
caringforK DS: What Parents Need to Know about Sexual Abuse

www.NCTSN.org
Child Sexual Abuse Fact Sheet
For Parents, Teachers, and Other Caregivers

What is child sexual abuse?
Child sexual abuse is any interaction between a child and an adult (or another child) in which the
child is used for the sexual stimulation of the perpetrator or an observer. Sexual abuse can include
both touching and non-touching behaviors. Touching behaviors may involve touching of the vagina,
penis, breasts or buttocks, oral-genital contact, or sexual intercourse. Non-touching behaviors can
include voyeurism (trying to look at a child’s naked body), exhibitionism, or exposing the child to
pornography. Abusers often do not use physical force, but may use play, deception, threats, or other
forms of coercion to engage children and maintain their silence. Abusers frequently employ persuasive
and manipulative tactics to keep the child engaged. These tactics—referred to as “grooming”—may
include buying gifts or arranging special activities, which can further confuse the victim.
Who is sexually abused?

Children of all ages, races, ethnicities, and economic backgrounds are vulnerable to sexual abuse.
Child sexual abuse affects both girls and boys in all kinds of neighborhoods and communities, and
in countries around the world.
How can you tell if a child is being (or has been) sexually abused?
Children who have been sexually abused may display a range of emotional and behavioral reactions,
many of which are characteristic of children who have experienced other types of trauma. These
reactions include:
■■ n increase in nightmares and/or other sleeping difficulties
A
■■ Withdrawn behavior
■■ Angry outbursts
■■ Anxiety
■■ Depression
■■ Not wanting to be left alone with a particular individual(s)
■■ Sexual knowledge, language, and/or behaviors that are inappropriate for the child’s age
Although many children who have experienced sexual abuse show behavioral and emotional
changes, many others do not. It is therefore critical to focus not only on detection, but on prevention
and communication—by teaching children about body safety and healthy body boundaries, and by
encouraging open communication about sexual matters.
Why don’t children tell about sexual abuse?

There are many reasons children do not disclose being sexually abused, including:
■■ Threats
of bodily harm (to the child and/or the child’s family)
■■ Fear of being removed from the home
■■ Fear of not being believed
■■ Shame or guilt
If the abuser is someone the child or the family cares about, the child may worry about getting that
person in trouble. In addition, children often believe that the sexual abuse was their own fault and
may not disclose for fear of getting in trouble themselves. Very young children may not have the
language skills to communicate about the abuse or may not understand that the actions of the
perpetrator are abusive, particularly if the sexual abuse is made into a game.
What can you do if a child discloses

that he or she is being (or has been)
sexually abused?
If a child discloses abuse, it is critical to stay calm,

listen carefully, and NEVER blame the child. Thank
the child for telling you and reassure him or her of your
support. Please remember to call for help immediately.
If you know or suspect that a child is being or has
been sexually abused, please call the Childhelp®
National Child Abuse Hotline at 1.800.4.A.CHILD
(1.800.422.4453) or visit the federally funded Child
Welfare Information Gateway at:
http://www.childwelfare.gov/responding.
If you need immediate assistance, call 911.
Many communities also have local Children’s Advocacy
Centers (CACs) that offer coordinated support and
If a child discloses abuse, it services to victims of child abuse (including sexual
is critical to stay calm, listen abuse). For a state-by-state listing of accredited CACs,
carefully, and NEVER blame visit the website of the National Children’s Alliance
(http://www.nca-online.org/pages/page.asp?page_
the child. id=3999).
caringforK DS: Child Sexual Abuse Fact Sheet

2 April 2009
Child Sexual Abuse Myths and Facts
Myth: Child sexual abuse is a rare experience.
Fact: Child sexual abuse is not rare. Retrospective research indicates that as many as 1 out of 4 girls
and 1 out of 6 boys will experience some form of sexual abuse before the age of 18.1 However,
because child sexual abuse is by its very nature secretive, many of these cases are never reported.
Myth: A child is most likely to be sexually abused by a stranger.

Fact: Children are most often sexually abused by someone they know and trust. Approximately
three quarters of reported cases of child sexual abuse are committed by family members or other
individuals who are considered part of the victim’s “circle of trust.”2
Myth: Preschoolers do not need to know about child

sexual abuse and would be frightened if educated about it.
Fact: Numerous educational programs are available to
teach young children about body safety skills and the
difference between “okay” and “not okay” touches. These
programs can help children develop basic safety skills
in a way that is helpful rather than frightening. For more
information on educating young children, see Let’s talk
about taking care of you: An educational book about body
safety for young children, available at www.hope4families.
com/Lets_Talk_Book_Information.html.
Myth: Children who are sexually abused will never recover.

Fact: Many children are quite resilient, and with a
combination of effective counseling and support from
their parents or caregivers, children can and do recover
from such experiences.
Myth: Child sexual abuse is always perpetrated by adults.

Fact: Twenty-three percent of reported cases of child
sexual abuse are perpetrated by individuals under the
age of 18.3 While some degree of sexual curiosity and
exploration is to be expected between children of about the
same age, when one child coerces another to engage in adult-like sexual activities, the behavior
is unhealthy and abusive. Both the abuser and the victim can benefit from counseling.
Myth: Talking about sexual abuse with a child who has suffered such an experience will only
make it worse.
Fact: Although children often choose not to talk about their abuse, there is no evidence that
encouraging children to talk about sexual abuse will make them feel worse. On the contrary,
treatment from a mental health professional can minimize the physical, emotional, and social
problems of these children by allowing them to process their feelings and fears related to the abuse.

www.NCTSN.org 3
Tips to Help Protect Children from Sexual Abuse
1. Teach children accurate names of private body parts.
2. Avoid focusing exclusively on “stranger danger.” Keep in

mind that most children are abused by someone they know
and trust.
3. Teach children about body safety and the difference between

“okay” and “not okay” touches.
4. Let children know that they have the right to make decisions
about their bodies. Empower them to say no when they do
not want to be touched, even in non-sexual ways (e.g.,
politely refusing hugs) and to say no to touching others.
5. Make sure children know that adults and older children

never need help with their private body parts (e.g., bathing
or going to the bathroom).
6. Teach children to take care of their own private parts

(i.e., bathing, wiping after bathroom use) so they don’t
have to rely on adults or older children for help.
7. Educate children about the difference between good Children are most
secrets (like surprise parties—which are okay because often sexually
they are not kept secret for long) and bad secrets (those
that the child is supposed to keep secret forever, which are abused by someone
not okay). they know and trust.
8. Trust your instincts! If you feel uneasy about leaving a child
with someone, don’t do it. If you’re concerned about possible sexual abuse, ask questions.
The best time to talk to your child about sexual abuse is NOW.
References
1. Centers for Disease Control and Prevention. (2005). Adverse Childhood Experiences Study: Data and Statistics. Atlanta, GA:
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved January 12,
2009 from: http://www.cdc.gov/nccdphp/ace/prevalence.htm
2. U.S. Department of Health and Human Services, Administration on Children, Youth, and Families. (2007). Child
Maltreatment 2005. Washington, DC: U.S. Government Printing Office. Retrieved January 12, 2009 from
http://www.acf.hhs.gov/programs/cb/pubs/cm05/cm05.pdf
3. Snyder, H. N. (2000). Sexual assault of young children as reported to law enforcement: Victim, incident, and offender
characteristics. Washington, DC: U.S. Department of Justice, Office of Justice Programs, Bureau of Justice Statistics.
Retrieved January 12, 2009 from http://www.ojp.usdoj.gov/bjs/pub/pdf/saycrle.pdf
This product was developed by the Child Sexual Abuse Committee of the National Child Traumatic Stress Network, comprised of mental
health, legal, and medical professionals with expertise in the field of child sexual abuse.
This project was funded by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human
Services (HHS). The views, policies, and opinions expressed are those of the authors and do not necessarily reflect those of SAMHSA or HHS.
Questions & Answers about Child Sexual Abuse
An Interview with Esther Deblinger, PhD
Defining Abuse
Q: What is child sexual abuse?

A: Sexual abuse is any interaction between a child and an adult or older child in which the child is
used for the sexual stimulation of the perpetrator or an observer. Sexual abuse often involves direct
physical contact, touching, kissing, fondling, rubbing, oral sex, or penetration of the vagina or anus.
Sometimes a sex offender may receive gratification just by exposing himself to a child, or by observing
or filming a child removing his or her clothes. Offenders often do not use physical force, but may use
play, deception, threats, or other coercive methods to engage youngsters and maintain their silence.
Q: When would you consider sexual activity between two children abuse?
A: Activity in which there is a clear power difference between them and one child is coercing the
other—usually to engage in adult-like sexual behavior—generally would be viewed as abuse. This is
very different from behavior in children of about the same age that reflects normal sexual curiosity
and mutual exploration (such as playing doctor).
Frequency and Risk
Q: How common is sexual abuse among children of
different ages?
A: Sexual abuse affects both boys and girls of all ages from
infancy through adolescence. In fact, this is a problem that
directly affects millions of children across all social, ethnic,
religious, and cultural groups around the world. While the
overall rates of child sexual victimization seem to have
declined since 1993, children and adolescents are still
more likely than adults to suffer a sexual assault.
Q: Are any particular children at increased risk?
A: Unfortunately, child sexual abuse is very common.

All children are vulnerable. However, some children may Child sexual abuse is a
be more likely to be victimized because sex offenders problem that breeds in
often target children who seem more vulnerable and
less likely to tell, such as those who suffer emotional,
secrecy. Speaking openly
developmental, or physical challenges. Research suggests and publicly about it will
sexual abuse is even more common among these children. enhance efforts at prevention.
Q: Who are the most common perpetrators?
A: The majority are male, although a small percentage is female. Sexual offenders are not “dirty old
men” or strangers lurking in alleys. More often, they are known and trusted by the children they victimize.
They may be members of the family, such as parents, siblings, cousins, or non-relatives, including family
friends, neighbors, babysitters, or older peers. There’s no clear-cut profile of a sex offender. Some
offenders were sexually abused as children, but others have no such history. Some are unable to function
sexually with adult partners and so prey on children, while others also have sexual relations with adults.
Child sexual abuse is so hard for most people to comprehend that we want to believe it only happens
when an offender is under the influence of alcohol or drugs, but that’s not usually the case.
Very frequently, abusers are repeat offenders and a significant percent are adolescents.
Prevention Is Key
Q: Is there any way to prevent abuse?
A: There are many actions that we can take as a society to reduce the prevalence of child sexual abuse,
although it is probably not possible for any parent or caring adult to guarantee a child’s protection.
Child sexual abuse is a problem that breeds in secrecy, so simply speaking openly and publicly about
it will enhance efforts at prevention.
It is critically important to educate our children. They need to know that their bodies belong to them and
that they don’t have to go along with everything an adult tells them to do. It is important to teach children
the proper names for their genitals.
caringforK DS - Questions & Answers about Child Sexual Abuse: An Interview with Esther Deblinger, PhD
2 April 2009
We must encourage them to feel comfortable talking to their parents about their bodies without
embarrassment, and teach them what kind of touching is okay between a child and an adult, and what
is not. Parents should explain to children that offenders may try to trick them into keeping the “not okay”
touching a secret. It is important that we help them to understand the difference between secrets and
surprises. We can remind children not to keep secrets and that no matter what an offender might say, it’s
okay for the child to tell. Finally, when children are brave enough to disclose sexual abuse, it is important
that we respond by doing everything we can to protect them, enforce the laws against the perpetrators,
and offer effective medical and mental health care. We can help children to recover from such experiences
and protect other children in the process.
The Impact of Abuse on Children

Q: What is the psychological impact of child sexual abuse?
A: In the short term, it’s not unusual for a child to develop some post-traumatic stress reactions that will
respond to treatment. Others—particularly those who have suffered multiple traumas and received little
parental support—may develop post-traumatic stress disorder, depression, and anxiety. Their ability to trust
adults to take care of them may also be jeopardized. Sadly, when children do not disclose sexual abuse
and/or do not receive effective counseling, they can suffer
difficulties long into the future. As one child expressed
it, “Abuse is like a boomerang. If you don’t deal with it, it
can come back to hurt you.” On the other hand, children
who have the support of an understanding caregiver and
effective treatment can recover without long-term effects.
Q: What are the signs of post-traumatic stress reactions?
A: Three types of symptoms occur with post-traumatic

stress reactions:
Hyperarousal means that the child is nervous and jumpy, has a heightened startle response, and
may react more strongly to any anxiety-producing situation.
Reexperiencing means that the child may keep seeing mental images linked to the abuse, or relive
some aspects of the experience, either while awake or during sleep in the form of nightmares. A child
may have other sleep disturbances, such as insomnia or frequent awakenings. Younger children
are more likely to have generalized fears or nightmares about other scary things, such as monsters
chasing them. With an older child, the nightmares are more likely to be directly related to the trauma.
Reexperiencing also includes reactions to traumatic reminders: any thing, person, event, sight, smell,
etc., connected to the abuse. For example, if the perpetrator had a beard, the child might start to feel
frightened and uncomfortable, usually without knowing why, around any man with a beard. Even being
touched by another person may become a traumatic reminder.
Avoidance means that a child avoids exposure to traumatic reminders, and sometimes avoids
thinking about the abuse altogether. So, for example, if the abuse occurred in the basement, the
child may avoid going into any basement. Reactions to—and avoidance of, traumatic reminders—can
become generalized. A child may begin with fear of one particular basement that generalizes to
reactions to and avoidance of all basements, and from that to any room that in any way resembles a
basement. Avoidance can seriously restrict a child’s activities–an important reason to seek help early.

www.NCTSN.org 3
Q: What other trauma-related behaviors might you see in a toddler or school age child?
A: In a very young child you might see traumatic play in which the child re-enacts some aspect of the
experience. For example, a child may act out running away from a “bad man” over and over again.
The play may or may not be specific to the sexual abuse. You might see other signs of stress, an
increase in oppositional or withdrawn behavior, tantrums, or nightmares. The child might engage in age-
inappropriate sexual behavior such as trying to engage another child in oral-genital contact or simulated
intercourse. The child might talk about her body as being “hurt” or “dirty.” Of course, children may have
these problems for other reasons, so you cannot assume they mean the child has been abused.
Q: Is the impact of sexual abuse different in adolescents?
A: The basic symptoms of post-traumatic stress are similar, but as children grow up and develop
more autonomy, the difficulties they can get into may be more serious. Teenagers have more access
to substances, so to cope with hyperarousal and reexperiencing, they might be more likely to abuse
substances. High-risk behaviors might also include
indiscriminant sexual behavior. A teenager avoiding
traumatic reminders may withdraw socially.
Self-cutting and suicidal behaviors are also more
common among adolescents. However, with parental
support and effective treatment, adolescents can avoid
or overcome these problems.
Q: What’s the long-term impact of sexual abuse?
A: Research has repeatedly shown that child sexual

abuse can have a very serious impact on physical and
mental health, as well as later sexual adjustment.
Depending on the severity of and number of traumas
experienced, child sexual abuse can have wide-
reaching and long-lasting effects on an individual’s
physical and mental health. Sexual abuse also tends to occur in the presence of other forms of
child maltreatment and life adversity. The Adverse Childhood Experiences study documents that the
more traumatic experiences one has, the more likely one is to have problems with substance abuse,
depression, anxiety, and some chronic physical conditions.1
Discovering Abuse
Q: What should a parent do if sexual abuse is suspected?
A: Although this is not easy for a concerned parent, it’s important to remain as calm and supportive as
possible. A parent shouldn’t grill a child for every detail, or ask numerous questions. Reassure the child
that he/she is not to blame and ask a few gentle open-ended questions or prompts (e.g., “Tell me more
about that.” “Who did that?” “Where were you when that happened?”). Parents may contact a mental
health professional with expertise in child trauma, or, alternatively, a pediatrician may help parents
determine if their suspicions are reasonable. Also, every state has a child protection agency that will
take a report and launch an investigation if warranted. Many states have laws that require persons who
have reasons to suspect child abuse to report their suspicions to Child Protective Services.
caringforK DS - Questions & Answers about Child Sexual Abuse: An Interview with Esther Deblinger, PhD
4 April 2009
Q: Is it common for children not to tell even their parents that they’ve been abused?
A: Delayed disclosures are common and are not a reflection of a poor parent-child relationship.
Sometimes children will say that they didn’t want to “hurt” or “upset” their parents because they love
them so much. Child sexual abuse is, by its very nature, secretive. It almost always occurs when the
child is alone with the offender. An offender may directly threaten physical harm to the child or beloved
family members if he or she tells, or coerce the child with promises, gifts, or other verbal persuasion.
It’s common for children to blame themselves, fear punishment, or be afraid that they will not be
believed. A child may feel embarrassed and ashamed. The avoidance, which is part of post-traumatic
stress reactions, may make a child simply try to forget what happened. Many children who have
experienced sexual abuse grow up before they tell anyone about what happened.
Healing and Recovering Together

Q: Does every child who is sexually abused need treatment?
A: At the very least, sexual abuse is very confusing for a child. Often there’s an investigation that
requires the child to speak to a police officer or other professional. It’s helpful for parent and child
to have support from a mental health professional and assistance in understanding the abuse and
reactions to it. In many cases, a child may not need lengthy, intensive therapy, but it’s helpful for
the child and parent to sit down with a trained professional and talk through what has happened, to
make sure the child understands and feels safe talking about his or her feelings. Children may blame
themselves or hold other unrealistic ideas or beliefs about the abuse (cognitive distortions) that need
to be corrected.
Parents may also benefit from talking to a professional who can assist them in overcoming the distress
naturally associated with discovering that their child has been sexually abused. One approach to
treatment, involving parents and children, that has received considerable scientific support is Trauma-
focused Cognitive Behavioral Therapy. There is increasing evidence that, with support from a caring
adult and high quality treatment, many children and parents effectively recover and may feel stronger
and closer as a family in the aftermath of a traumatic experience.

www.NCTSN.org 5
Suggested Reading for Children and Families
Freeman, L. (1982). It’s MY body. Seattle, WA: Parenting Press, Inc.
Girard, L.W. (1992). My body is private. Morton Grove, IL: Prairie Paperbacks, Albert Whitman
and Company.
Ottenweller, J. (1991). Please tell! A child’s story about sexual abuse. Center City, MN: Hazelden
Foundation.
Spelman, C.M., (2000). Your body belongs to you. Morton Grove, IL: Prairie Paperbacks, Albert
Whitman and Company.
Stauffer, L., & Deblinger, E. (2003). Let’s talk about taking care of you: An educational book
about body safety. Hatfield, PA: Hope for Families.
References
1. Felitti, V.J., Anda, R.F., Nordenberg, D.F., Williamson, D. F., Spitz, A.M., Edwards, V.J., et al.
(1998). Relationship of childhood abuse and household dysfunction to many of the
leading causes of death in adults: The Adverse Childhood Experiences (ACE) study.
American Journal of Preventive Medicine, 14, 245-258.
About Esther Deblinger, PhD

Dr. Esther Deblinger is a member of the National Child Traumatic Stress Network and Co-Director
of the Child Abuse Research Education & Service (CARES) Institute, University of Medicine and
Dentistry of New Jersey - School of Osteopathic Medicine. A licensed clinical psychologist,
Dr. Deblinger has conducted extensive clinical research examining the mental health impact of
child abuse and the treatment of post-traumatic stress disorder (PTSD) and other abuse-related
difficulties. She has authored numerous scientific articles and book chapters, and published four
books including Treating Sexually Abused Children and Their Nonoffending Parents: A Cognitive
Behavioral Approach. Dr. Deblinger is a co-developer of Trauma-Focused Cognitive-Behavioral
Therapy (TF-CBT), an empirically validated treatment for child sexual abuse that has evolved as
the clear standard of care for children and adolescents who have experienced abuse and trauma.
ences
What to Do If Your
Child Discloses Sexual Abuse

What is disclosure?
Disclosure is when a child tells another person that he or she has
Fast Fact
been sexually abused. Disclosure can be a scary and difficult process
Sexual abuse
for children. Some children who have been sexually abused may take affects many
weeks, months, or even years to fully reveal what was done to them. families. It is
Many children never tell anyone about the abuse. In general: estimated that
1 in 4 girls and
■■ Girls are more likely to disclose than boys 1 in 6 boys are
sexually abused.1
■■ School-aged children tend to tell a caregiver
■■ Adolescents are more likely to tell friends
■■ Very young children tend to accidentally reveal abuse, because they don’t have as much
understanding of what occurred or the words to explain it
Children are often reluctant to tell about being sexually abused. Some reasons for this reluctance
may include:
■■ Fear that the abuser may hurt them or their families

■■ Fear that they will not be believed, or will be blamed and get in trouble
■■ Worry that their parents will be upset or angry
Fast Fact ■■ Fear that disclosing will disrupt the family, especially if the
In studies of adults perpetrator is a family member or friend
who were sexually
abused as children, ■■ Fear that if they tell they will be taken away and separated from
2 out of 3 said they their family
never told anyone
about the abuse Disclosure can be particularly difficult for younger children who have limited
during childhood.2 language and developmental abilities. If the child does not understand that
the abuse was wrong, this may also lead the child not to tell.
What should I do if I suspect my child
Therapy Can Help
has been sexually abused? To learn more about how therapy can
help your child overcome the effects
If you think your child may have been sexually abused, of sexual abuse, see The National
it is okay to talk to your child about it. You may first Child Traumatic Stress Network’s
want to access some resources to learn more about video, The Promise of Trauma-Focused
child sexual abuse, such as The National Child Treatment for Child Sexual Abuse,
Traumatic Stress Network’s Child Sexual Abuse available at http://www.nctsn.org/
Fact Sheet at http://www.nctsn.org/nccts/asset. nccts/asset.do?id=1151&video=true.
do?id=1216.
For help finding a therapist, try:
It is important to remain calm in speaking to children ■■ The National Child Traumatic
who may have been sexually abused. You can ask Stress Network’s Finding Help page:
children directly if anyone has touched their bodies http://www.nctsn.org/nccts/nav.
in a way that they did not like or has forced them to do do?pid=ctr_gethelp
things that they did not want to do. If you are concerned
about talking to your child about abuse, you might want ■■ The American Association for
to seek help from your child’s pediatrician or a mental Marriage and Family Therapy’s
health provider who is knowledgeable about child Therapist Locator page:
sexual abuse. http://www.therapistlocator.net
What should I do if my child discloses

sexual abuse?
Your reaction to the disclosure will have a big effect
on how your child deals with the trauma of sexual
abuse. Children whose parents/caregivers are
supportive heal more quickly from the abuse.3,4
To be supportive, it is important to:
■■ Stay calm. Hearing that your child has been

abused can bring up powerful emotions, but
if you become upset, angry, or out of control,
this will only make it more difficult for your
child to disclose.
■■ Believe your child, and let your child know
that he or she is not to blame for what
happened. Praise your child for being brave
and for telling about the sexual abuse.
■■ Protect your child by getting him or her away
from the abuser and immediately reporting
the abuse to local authorities. If you are
Children whose parents or not sure who, to contact, call the ChildHelp®
caregivers are supportive heal National Child Abuse Hotline at
1.800.4.A.CHILD (1.800.422.4453;
more quickly from the abuse. http:// www.childhelp.org/get_help)
or, for immediate help, call 911.
caringforK DS: What to Do If Your Child Discloses Sexual Abuse - Information for Parents and Caregivers
2 April 2009

■■ Get help. In addition to getting medical care to address any physical damage your child may
have suffered (including sexually transmitted diseases), it is important that your child have
an opportunity to talk with a mental health professional who specializes in child sexual abuse.
Therapy has been shown to successfully reduce distress in families and the effects of sexual
abuse on children. Many communities have local Children’s Advocacy Centers (CACs) that
offer coordinated support and services to victims of child abuse, including sexual abuse.
For a state-by-state listing of accredited CACs, visit the website of the National Children’s
Alliance (http://www.nca-online.org/pages/page.asp?page_id=3999).
■■ Reassure your child that he or she is loved, accepted and an important family member. Don’t
make promises you can’t keep (such as saying you won’t tell anyone about the abuse), but let
your child know that you will do everything in your power to protect him or her from harm.
■■ Keep your child informed about what will happen next, particularly with regard to legal
actions. (For more information on helping abused children cope with the stress of
dealing with the legal system, see the National Child Traumatic Stress Network’s factsheet,
Child Sexual Abuse: Coping with the Emotional Stress of the Legal System, available on the
web at http://nctsn.org/nctsn_assets/pdfs/caring/emotionlaimpactoflegalsystem.pdf.
I have heard that some children who disclose sexual abuse

later “take it back.” Does this mean they were lying?
No. In fact, attempting to “take it all back”—also known as recantation—is common among children
who disclose sexual abuse. Most children who recant are telling the truth when they originally disclose,
but may later have mixed feelings about their abuser and about what has happened as a result of
the disclosure. Some children have been sworn to secrecy by the abuser and are trying to protect the
secret by taking it back. Some children are dealing with issues of denial and are having a difficult time
accepting the sexual abuse. In some families, the child is pressured to recant because the disclosure
has disrupted family relationships. A delay in the prosecution of the perpetrator may also lead a child
to recant in order to avoid further distressing involvement in the legal process. A very small percentage
of children recant because they made a false statement.
Books That Can Help

Freeman, L. (1987). It’s MY body: A book to teach
young children how to resist uncomfortable
touch. Seattle, WA: Parenting Press. Ages 3-8;
also available in Spanish.
Lowery, L. (1995). Laurie tells. Minneapolis, MN:

Carolrhoda Books, Lerner Publishing Group. Age
11 and up.
Ottenweller, J. (1991). Please tell! A child’s story

about sexual abuse. Center City, MN: Hazelden
Foundation.
Stauffer, L., & Deblinger, E. (2003). Let’s talk

about taking care of you: An educational book
about body safety. Hatfield, PA: Hope for Families.
Version for preschool children also available.

www.NCTSN.org 3
The idea that something like this could happen to my child is completely
overwhelming. What can I do to cope with my own feelings?
If you suspect that your child has been abused, try to get support by talking to someone else before
talking to your child about the sexual abuse. If your child has already disclosed the abuse, hearing
the details may be profoundly upsetting to you, particularly if the abuser is someone you know and
thought you could trust. (For more information on such “intrafamilial” sexual abuse, see the National
Child Traumatic Stress Network’s factsheet, Coping with the Shock of Intrafamilial Sexual Abuse:
Information for Parents and Caregivers, available at http://nctsn.org/nctsn_assets/pdfs/caring/
intrafamilialabuse.pdf.
Your feelings may range from denial, anger, and sadness, to frustration and helplessness. If you
yourself are a survivor of child sexual abuse, the discovery that your child has been abused may
also bring up your own painful and unresolved feelings and memories. Getting help for yourself is an
important part of being able to get help and support for your child. You can contact the Rape, Abuse,
and Incest National Network (RAINN) at 1-800-656-HOPE or www.rainn.org for help finding support
in your area. The U.S. Department of Justice’s Office for Victims of Crime (http://www.ojp.usdoj.gov/
ovc/) has resources and a web forum to communicate with others on topics such as child abuse,
victim’s rights, court preparation, and more.
Books That Can Help

Adams, C., & Fay, J. (1992). Helping your child
recover from sexual abuse. Vancouver, WA:
University of Washington Press.
Brohl, K., & Potter, J.C. (2004). When your child

has been molested: A parents’ guide to healing
and recovery. (Revised ed.). San Francisco:
Jossey-Bass, A Wiley Imprint.
Daugherty, L. (2006) Why me? Help for victims

of child sexual abuse (even if they are adults
now). (4th ed.). Roswell, NM: Cleanan Press, Inc.
References
1. Centers for Disease Control and Prevention. (2005). Adverse Childhood Experiences Study: Data and Statistics. Atlanta,
GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Retrieved
January 12, 2009 from: http://www.cdc.gov/nccdphp/ace/prevalence.htm
2. London, K., Bruck, M., Ceci, S.J., & Shuman, D.W. (2005). Disclosure of child sexual abuse. What does the research tell us
about the ways that children tell? Psychology, Public Policy, and Law, 11 (1), 194-226.
3. Paredes, M., Leifer, M., & Kilbane, T. (2001). Maternal variables related to sexually abused children’s functioning, Child
Abuse & Neglect, 25 (9), 1159-1176.
4. Lovett, B.B. (2004). Child sexual abuse disclosure: Maternal response and other variables impacting the victim. Child and
Adolescent Social Work Journal, 21 (4), 355-371.
Coping with the Shock
of Intrafamilial Sexual Abuse
What Is Intrafamilial Sexual Abuse?

Intrafamilial sexual abuse means sexual abuse that occurs within the family. In this form of abuse,
a family member involves a child in (or exposes a child to) sexual behaviors or activities. The “family
member” may not be a blood relative, but could be someone who is considered “part of the family,”
such as a godparent or very close friend.
The discovery that someone you love and trust has sexually abused your child is extremely stressful
and can bring up intense feelings of shock, rage, confusion, denial, disbelief, and guilt. Dealing with
these reactions—and helping your child recover from the abuse—requires time, strength, and support
from your extended family, your community, and from professionals in law enforcement,
child protection, and mental health services. Although it
may be difficult, it is important to notify law enforcement By ending the secrecy
if your child discloses sexual abuse. This is an important
step in keeping your child safe. surrounding sexual
abuse, you can help your
Facing the reality of intrafamilial sexual abuse can be painful.
But by ending the secrecy surrounding sexual abuse, you can
family to heal and protect
help your family to heal and protect and nurture your child so and nurture your child.
that he or she can grow into a healthy, successful adult.
The Effect of Intrafamilial Sexual Abuse on Children

Did you know?
When children are abused by adults who are supposed to protect them from
More than half
of all children harm, their ability to trust and rely on adults may be shattered. Knowing that
who are sexually the abuser is liked—or even loved—by other family members makes it all the
abused are more difficult for children to tell others about the abuse.
abused by a
parent or other Children who have been abused by a family member are more likely to blame
relative.1 themselves for the abuse than those who are abused by someone outside the
family unit. This is particularly true of older children, who may be all too aware
of the effect that disclosing the abuse will have on other family members.
As a result, it can take victims of intrafamilial sexual
abuse weeks, months, or longer to let anyone know
that they’ve been abused,2 and even longer to reveal
all the details. Children from cultures that frown on
talking about sex or sexuality (See Box) may be even
more reluctant to tell.
After disclosing, children and adolescents who have

been sexually abused by a family member are often
tormented by self doubt, self blame, fear of the abuser,
and distress over what their disclosure has done to the
family. Sometimes, in a desperate attempt to make
everything better in the family, they may change their
story or even deny that the abuse occurred.
Recanting, or “taking back” the disclosure is common It can take victims of intrafamilial
and does not mean that children were lying about the sexual abuse weeks, months, or
abuse. When the abuse is caused by a family member,
children may feel pressure to recant because of how
longer to let anyone know that
the disclosure is affecting the family or because of a they’ve been abused.
lack of family support.
Seeking help from a counselor who specializes in child

Cultural Challenges sexual abuse can help your child and your family to
Virtually every culture has spoken and unspoken cope with what has happened. Counseling can reduce
rules about sex and sexuality. These rules can the stress and other effects of sexual abuse on your
make it even more difficult for children to ask for child and your family. With the proper help, your child
help when they have been abused and the family can overcome and heal from the abuse
For example, in cultures that place a high value that has occurred.
on female virginity, a girl who has been sexually
abused may feel that she has been disgraced
and is now “damaged goods” whom no one The Effect of Intrafamilial Sexual Abuse
would want to marry. This can lead to feelings of on the Family
shame that in turn lead to further secrecy.
Boys who have been sexually abused may Sexual abuse of a child by a trusted adult also puts
experience shame and self-doubt. Boys who tremendous strain on relationships within the family.
have been sexually abused by a male may Some family members may find it hard to believe the
struggle with a commonly-held misconception abuser could do such a thing, and take sides (or feel
that this makes them gay. pressured to take sides) over who is telling the truth.
Although your cultural beliefs are important, Family members may also struggle with how to manage
it is necessary to focus on the physical and their divided loyalties toward the abuser and the victim.
emotional health of your child. Remember that Even in families that accept that the abuse occurred,
the sexual abuse is not your fault and does reactions to the abuser may run the gamut from “lock
not reflect negatively on your family or you as him up and throw away the key” to “hate the sin but
a parent. Seek guidance from people in your love the sinner.” Tensions may arise when different
community that you trust, such as religious family members have different opinions about loyalty,
leaders, medical professionals, or others who fairness, justice, forgiveness, and responsibility.
will be supportive.
caringforK DS: Coping with the Shock of Intrafamilial Sexual Abuse - Information for Parents and Caregivers
2 April 2009
If you are a mother whose child has been abused by a spouse or boyfriend, it can take a great deal of
courage to stand up for your child. Some of the challenges you may face include:

■■ Dealing with family members who don’t believe the abuse occurred or who continue to
maintain their relationship with the abuser
■■ The possibility of economic hardship if you are financially dependent on the abuser
■■ Possible loss of friends and acquaintances when they learn your partner is a child abuser
■■ M
aking sense of conflicting advice from friends, family, or religious leaders—who may think
you should forgive the perpetrator—and child protection and legal authorities who expect you
to end your involvement with the perpetrator
For many mothers, the greatest challenge is dealing with their own reactions to the child’s disclosure.
If your child tells you that he or she has been sexually abused, your response can play a powerful role
in his or her process of healing from the abuse.
Coping with Your Own Reactions

Echoes of Past Pain
Your initial reactions to the disclosure of sexual abuse by a For much of human history, children
family member may include shock, rage, confusion, denial, who revealed sexual abuse were
and disbelief. If you yourself were a victim of sexual abuse rarely believed or supported.
as a child, the disclosure may stir up even stronger reactions Children who disclosed abuse
and confusion (See Box). faced negative reactions ranging
from being told to keep quiet—or
forget— about the abuse to being
Do not be surprised if you go through a painful period of berated and punished for “telling
doubting your child, particularly if the abuser is someone lies.” In addition to suffering from
you love or depend on, such as a spouse, boyfriend, or the effects of the abuse itself, such
grandparent. Because the abuser is almost certain to deny children grew up feeling betrayed
the abuse, you may find yourself in the difficult position of and abandoned by the people who
having to decide which family member is telling the truth, should have protected them.
and having to weigh the consequences of believing one If you are a survivor of child sexual
over the other. abuse, the discovery that your own
child has been abused—especially
For many parents, it is relatively easy to believe that abuse by a family member—can bring up
has occurred when the victim is a very young child. But when a host of painful and unresolved
the victim is an adolescent, many parents find themselves feelings and memories. Getting help
doubting the truth of what their child has told them. for yourself is an important part
of being able to provide support
for your child. You can contact the
Adolescence is a rocky time for parents and children
Rape, Abuse, and Incest National
alike, when tensions run high and tempers flare. Sadly, Network (RAINN) at 1-800-656-
adolescents who have been sexually abused are even more HOPE or http://www.rainn.org for
likely to exhibit the kinds of behavior problems that lead to help in finding support in your area.
tension, resentment, and miscommunication.
If your child is an adolescent, you may find yourself wondering if he or she was in some way responsible
for the abuse. You may wonder whether he or she could have resisted, or question why it took so long for
him or her to tell you. If your child disclosed the abuse to someone else—such as a teacher or friend—
you may also be dealing with feelings of confusion, anger, and guilt about his or her not confiding in you.
And if the abuser is your spouse or partner, you may even find yourself feeling betrayed, as if your
partner and child were “cheating” on you.

www.NCTSN.org 3
As painful as these reactions can be, they are not
unusual, and working through your doubts and fears
will be critical not only to your child’s recovery, but
to your own.
It is important to remember that power takes many

forms, and that your adolescent may have felt
coerced in ways that were not directly physical.
For example, if your partner is in a position of power
and has control over financial resources, over
disciplining the adolescent, and over your attitude
and reactions to your child, your child may have been afraid that rejecting sexual advances or fighting back
would only cause more problems in the family. In fact, many perpetrators “buy” their victims’ silence through
veiled or overt threats of all the bad things that could happen if their victims disclose the abuse.
Don’t let your natural and understandable feelings

of confusion and doubt override the fact that the
One Family’s Story perpetrator is always at fault. If, in the heat of your
Christina was a 12-year-old girl whose father, own pain and distress, you accuse your adolescent
Michael, had been sexually abusing her for
of betrayal instead of acknowledging that your child
more than a year. One night, a neighbor called
the police to report a violent argument between was the victim, he or she may begin to experience
Christina’s parents. When the police and Child dangerous—and potentially damaging—self-doubt.
Protective Services representative interviewed This can be particularly devastating if he or she
Christina, she told them what Michael had been experienced normal sexual arousal during the abuse,
doing to her and was removed from the home. even though it was unwanted and forced. This is not
At first, Christina’s mother, Joanna, did not unusual and should not be taken as evidence that the
support or believe her daughter. Joanna was adolescent “wanted” or was seeking out the abuse.
financially dependent on her husband and terrified
of his violent temper. A recent immigrant, she had If you are struggling with feelings of anger or betrayal
no family in the States, and was embarrassed to towards your abused child or teen, ask yourself: “What
talk about Michael’s behavior with her few friends. would it take for me to 1) believe my child, 2) not be
When Michael had been violent with her in the angry at my child, and 3) not feel betrayed by my child?”
past, Joanna had always told herself that it was
because she was not a good enough wife, but The answer is often revealing. For many parents:
that he was a good father and could be trusted
with their daughter. It took Joanna several months
■■ Believing your child means facing the fact that
to recognize that she was a victim of domestic
violence, and to accept that her daughter had a person you have trusted and loved has
indeed been sexually abused. betrayed, lied to, and used you and your child
The hardest part for Joanna was to realize just ■■ Letting go of anger means redirecting your anger
how wrong she had been and to let go of her away from your child and towards the person who
illusions about Michael. It was crucial for Joanna perpetrated the abuse
to receive help that would allow her to understand
that the problem lay with Michael, not with her.
■■ Letting go of feeling betrayed means recognizing
Once she could acknowledge this, she was able the real source of the betrayal—the perpetrator.
to believe her daughter, and to begin healing from To move forward, you will need to accept that
her own experience of abuse. Only then could much of what you believed about this person was
Christina and Joanna restore the trust in their not true. By letting go of old beliefs, you can help
mother-daughter relationship. your child—who has also been betrayed—to heal
more fully
caringforK DS: Coping with the Shock of Intrafamilial Sexual Abuse - Information for Parents and Caregivers
4 April 2009
Even parents who believe their child from the start may struggle with guilt at not having been able to
prevent the abuse, or not realizing that something was wrong before the child told. In such cases, it is
helpful to remember that even though hindsight is 20/20, none of us have the power to read minds
or predict the future. Many of the “clues” that seem clear when looking back are nonspecific behaviors
(for example, increased irritability, poor sleep, etc.) that even a mental health professional may not have
recognized as signs that the child was being sexually abused.
Moving Forward
Non-offending parents are the single most important resource
that children have after they have experienced intrafamilial abuse.3
As hard as it may be to report sexual abuse that has been
perpetrated by a family member, this is the best thing you can
do to help your entire family heal, including the person who
perpetrated the abuse. If you are not sure who to contact, call
the ChildHelp® National Child Abuse Hotline at 1.800.4.A.CHILD
(1.800.422.4453; http://www.childhelp.org/get_help).
Effective treatment is available to help you and your child move

forward—together—towards a happy and healthy future.4,5
Children can recover from sexual abuse, with the help of protective,
supportive parents. For more information on treatment options, see
The National Child Traumatic Stress Network’s video, The Promise
of Trauma-Focused Treatment for Child Sexual Abuse, available at
http://www.nctsn.org/nccts/asset.do?id=1151&video=true.
Many communities have local Children’s Advocacy Centers
(CACs) that offer coordinated support and services to victims of Children can recover
child abuse, including sexual abuse. For a state-by-state listing of from sexual abuse, with
accredited CACs, visit the website of the National Children’s Alliance
(http://www.nca-online.org/pages/page.asp?page_id=3999).
the help of protective,
supportive parents.
References
1. U.S. Department of Health and Human Services, Administration on Children Youth and Families. (2007).
Child Maltreatment 2005. Washington, DC: U.S. Government Printing Office.
2. London, K., Bruck, M., Ceci, S.J., & Shuman, D.W. (2005). Disclosure of child sexual abuse: What does the research tell
us about the ways that children tell? Psychology, Public Policy, and Law, 11 (1), 194–226.
3. Deblinger, E., Lippmann, J., Steer, R. (1996). Sexually abused children suffering posttraumatic stress symptoms: Initial
treatment outcome findings. Child Maltreatment, 1 (4), 310-321.
4. Cohen, J.A., Mannarino, A.P., Deblinger, E. (2006). Treating trauma and traumatic grief in children and adolescents.
New York: Guilford Press.
5. Deblinger, E., Stauffer, A.H. (1996). Treating sexually abused children and their non-offending parents: A cognitive-
behavioral approach. Thousand Oaks, CA: Sage.
Acquaintance Rape
What is acquaintance rape?

Acquaintance rape is when somebody a teen knows—a boyfriend or girlfriend, a friend, a classmate,
or even someone they just met—uses coercion (including drugs or alcohol), violence, or threats to
force unwanted oral, vaginal, or anal sex. When this happens in a dating relationship, it is commonly
known as “date rape.”
How common is acquaintance rape? As many as one in four

Unfortunately, acquaintance rape is very common. In some
young women reported
surveys, as many as one in four young women reported being being verbally or
verbally or physically pressured into having sex during the past physically pressured
year,1 while one in 10 high school girls—and one in 20 boys—
reported being forced into sex at some point in their lives.2 into having sex during
More than one third of acquaintance rape victims are between the past year.
the ages of 14 and 17.3
How can I help protect my teen from acquaintance rape?

Although the blame for rape always lies with the rapist, there are some factors that can
increase a teen’s risk of acquaintance rape. These include:1, 4-7
■■ Frequently
drinking to the point of being drunk or unable to resist sexual advances
■■ Using recreational drugs that impair judgment or make it difficult to resist sexual
advances
■■ Outdated beliefs about sexual roles, such as thinking that someone who pays for
a date has the right to expect sex
■■ Prior history of rape or sexual victimization
Parents can help teens stay safe by giving them the information and
Books That Can Help
support they need to make smart choices and avoid risky situations.
Haffner, D.W. (2008).
Beyond the big talk: Parents can give their teens reliable information about sexual
Every parent’s guide to intercourse (including ways to protect themselves from sexually
raising sexually healthy transmitted disease and pregnancy), alcohol, drugs (including “date
teens, 2nd edition. New rape” drugs such as Rohypnol
York: Newmarket Press. and GHB), and the qualities of
healthy relationships.
Murray, J. (2000). But
I love him: Protecting
your teen daughter Talking about these topics can
from controlling, be hard, but the more open and
abusive dating honest you are with your teen,
relationships. New the more likely it will be that he
York: HarperCollins or she will turn to you with any
Publishers, Inc. questions and concerns. In fact,
in a recent survey of American
high school students, 9 out of
10 teens said it would be easier to delay sexual activity if they
were able to have “more open, honest conversations” with their
parents about sexual issues.8 For help in what to say and how to
say it, try some of the additional resources listed in Table 1.
Table 1: Additional Resources for Keeping Teens Safe

General information on acquaintance rape and prevention
Advocates for Youth, Parents’ Sex Ed Center http://www.advocatesforyouth.org/parents/index.htm
Committee for Children http://www.cfchildren.org/issues/abuse/preventdaterape

Preventing sexual harassment and date rape
Domestic Violence and Sexual Assault Coalition http://www.dvsac.org/resources/parents-date-rape.cfm

Date rape: What you need to know
National Childhood Traumatic Stress Network http://nctsn.org/nctsn_assets/pdfs/caring/preventingac-

Preventing acquaintance rape: quaintancerape.pdf
A safety guide for teens
Information on date rape drugs
Cleveland Clinic Journal of Medicine http://www.ccjm.org/content/68/6/551.full.pdf

Date rape drugs: What parents should know
Federal Bureau of Investigation http://www.fbi.gov/hq/ood/opca/outreach/clubdrugs/

Tips for parents: The truth about club drugs clubdrug.htm
Parents. The Anti-Drug. http://www.theantidrug.com/DRUG_INFO/drug_info_ghb_

Rohypnol & GHB: How to avoid date rape drugs rohyphol.asp
caringforK DS: Acquaintance Rape - Information for Parents and Caregivers

2 April 2009
What should I do if my teen is a victim of acquaintance rape?
First and foremost, stay calm. Your teen may have exercised poor judgment and broken the rules
by violating curfew, sneaking out of the house, drinking, or even using drugs, but rape is not a
punishment for poor judgment. Even if your teen engaged in risky or inappropriate behavior, he
or she did not ask for or deserve to be raped. It is understandable to
feel angry and upset, but it is important to aim your anger at
the perpetrator and not at your teen.
Get medical attention as soon as possible, even if your teen doesn’t

look hurt or doesn’t want to see a doctor. Make sure that your teen
does not change clothes, shower, or brush his or her teeth. The
medical team and law enforcement may need to collect evidence
from your teen’s clothing and body.
Contact law enforcement to report the rape, and encourage

your teen to share as much information as possible. Also, seek
counseling for your teen. A counselor who specializes in sexual
abuse can help you and your teen cope with what happened.
Medical professionals and law enforcement officers can guide you Aim your anger at the
in finding help. You can also contact your local mental health service perpetrator and not
agency, child advocacy center, or child trauma center. For additional
info on where to seek help, see the additional resources in Table 2.
at your teen.
Table 2: Help If Your Teen Has Been Raped

General information on acquaintance rape and prevention
Domestic Violence and Sexual Assault Coalition http://www.dvsac.org/resources/help-family.cfm

How to help a friend or family member who’s been raped
National Childhood Traumatic Stress Network http://nctsn.org/nctsn_assets/pdfs/caring/

What do I do now? A survival guide for victims of acquaintancerapeguideforvictims.pdf
acquaintance rape
National Children’s Alliance http://www.nca-online.org/pages/page.

State-by-state listing of Children’s Advocacy Centers, asp?page_id=3999
community-based facilities dedicating to providing
support and care to victims of child abuse (including
sexual abuse and rape)
Rape, Abuse & Incest National Network (RAINN) http://www.rainn.org/get-help/help-a-loved-one

Help a loved one
Substance Abuse and Mental Health Services http://pathwayscourses.samhsa.gov/vawc/

Administration, Center for Substance Abuse Prevention vawc_8_pg3.htm
What to do if your child is raped or sexually assaulted

www.NCTSN.org 3
References
1. Rickert, V.I., Wiemann, C.M., Vaughan, R.D., & White, J.W. (2004). Rates and risk factors for sexual violence among an
ethnically diverse sample of adolescents. Archives of Pediatrics and Adolescent Medicine, 158 (12), 1132-1139.
2. Howard, D.E., & Wang, M.Q. (2005). Psychosocial correlates of U.S. adolescents who report a history of forced sexual
intercourse. Journal of Adolescent Health, 36 (5), 372-379.
3. Warshaw, R. (1988). I never called it rape: The Ms. report on recognizing, fighting, and surviving date and acquaintance
rape. New York: Harper and Row Publishers.
4. Greenfeld, L.A. (1997). Sex offenses and offenders: An analysis of data on rape and sexual assault. Washington, DC: U.S.
Department of Justice. Retrieved March 1, 2009 from http://www.ojp.usdoj.gov/bjs/pub/pdf/soo.pdf
5. Curtis, D.G. (1997). Perspectives on acquaintance rape. Commack, NY: American Academy of Experts in Traumatic Stress.
Retrieved March 1, 2009, from http://www.aaets.org/article13.htm
6. Sampson, R. (2002). Acquaintance rape of college students. Washington, DC: U.S. Department of Justice, Office
of Community Oriented Policing Services. Retrieved March 1, 2009, from
http://www.popcenter.org/problems/pdfs/Acquaintance_Rape_of_College_Students.pdf
7. O’Keefe, M.E. (2005). Teen dating violence: A review of risk factors and prevention efforts. Harrisburg, PA: VAWnet, a
project of the National Resource Center on Domestic Violence/Pennsylvania Coalition Against Domestic Violence.
Retrieved March 1, 2009, from http://new.vawnet.org/category/Main_Doc.php?docid=409
8. Albert, B. (2004). With one voice: America’s adults and teens sound off about teen pregnancy. Washington, DC: National
Campaign to Prevent Teen Pregnancy. Retrieved March 1, 2009, from
http://www.thenationalcampaign.org/resources/pdf/pubs/WOV_2004.pdf
Preventing
Acquaintance Rape
a safety guide for teens

Acquaintance rape is when somebody you know—a boyfriend or girlfriend, a friend, a classmate,
or even someone you just met—uses coercion (including drugs or alcohol), violence, or threats
to force unwanted oral, vaginal, or anal sex. When this happens in a dating relationship, it is
commonly known as date rape.
How common is acquaintance rape?

Unfortunately, acquaintance rape is very common. In some surveys, as many Did you
as one in four young women reported being verbally or physically pressured know?
75% of se
into having sex during the past year,1 while one in 10 high school girls—and xual
assaults a
one in 20 boys—reported being forced into sex at some point in their lives.2 re
committed
by
someone
that the
Can guys get raped? victim kno 3
ws.
Yes. Guys can get raped and it has nothing to do with their sexual
orientation, appearance, physical size, or strength. Guys can be raped by family members or
other people they trust, as well as by strangers. If a guy gets raped, that does not mean he is gay.
a SAFETY GUIDE for teens

a safety guide for teens
What are date rape drugs?
An acquaintance may slip drugs into your drink to try to make it easier
to victimize you. Being drugged without your knowledge makes consent Did you
know?
impossible. ANY drug, even alcohol, can put you at risk. Drugs commonly 28% of rap
e
used in acquaintance rape include: victims are
assaulted
by their
* Rohypnol (pronounced row-HIP-nal; also called roofies) is a sedative boyfriends
and
35% are s
that can make you feel sleepy, slur your speech, make it difficult to exually
assaulted
walk, make you black-out, and cause amnesia. by
relatives. 4
* GHB is a depressant that may cause nausea, vomiting, dizziness,
heart problems, seizures, black-outs, and, in some cases, coma.
* Ketamine (pronounced keet-ah-meen; also called Special K) is
an animal tranquilizer that can cause delirium, loss of memory,
depression, and long-term memory and cognitive difficulties.
What can I do to be safe?

* Expect respect and keep away from people who don’t show
you respect.
* Be clear about your limits: let the other person know what
you want and don’t want to do. You have the right to change
your mind, to say “no,” or to agree to some sexual activities
and not to others.
* Don’t allow a person to touch you if it makes you
uncomfortable. If your limits are reached or you sense
danger, speak your mind and act immediately. Make a
scene if necessary.
ing
* Avoid excessive drinking or drugs. They reduce your ability to sive drink
think and communicate clearly. Being drunk or high does not oid exces
Av a k e it
. They m
give anyone permission to assault you. or drugs nd
o think a
harder t a r ly .
* Pour your own beverage and keep it in sight. Date rape drugs te cle
communica
can be put into drinks and are often undetectable.
* Don’t hang out in places that keep you isolated from others.
Although you may feel you can take care of yourself, it is always
wise to be careful. Fast Fa
ct
38% of
* Trust your instincts. If you feel that a person is not trustworthy or acquainta
nce
a situation is unsafe, leave. rape victim
s
are 14-17
* Have a back-up plan. For example, if you’re going out to a party in
years old. 5
a different neighborhood, make sure someone you trust knows where
you’re going. Have a person you can call to come and get you if you
need to leave without your original ride.

2 www.NCTSN.org
reality check: acquaintance rape myths & facts
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For Additional Information on Staying Safe, Visit. . .

* 911Rape → www.911rape.org
* National Sexual Violence Resource Center → www.nsvrc.org
* Project Respect → www.yesmeansyes.com
* Rape, Abuse & Incest National Network (RAINN) → www.rainn.org
* The Date Safe Project → www.thedatesafeproject.org/pledge_for_action.htm
* The Safe Space → www.thesafespace.org
References
1. Rickert, V.I., Wiemann, C.M., Vaughan, R.D., & White, J.W. (2004). Rates and risk factors for sexual violence among an
ethnically diverse sample of adolescents. Archives of Pediatrics and Adolescent Medicine, 158(12), 1132-1139.
2. Howard, D.E., & Wang, M.Q. (2005). Psychosocial correlates of U.S. adolescents who report a history of forced sexual
intercourse. Journal of Adolescent Health, 36(5), 372-379.
3. Greenfeld, L.A. (1997). Sex offenses and offenders: An analysis of data on rape and sexual assault. Washington, DC:
U.S. Department of Justice. Retrieved January 12, 2009 from http://www.ojp.usdoj.gov/bjs/pub/pdf/soo.pdf
4. Bohmer, C., & Parrot, A. (1993). Sexual assault on campus: The problem and the solution. New York: Lexington Books.
National Child Traumatic Stress Network Child Sexual Abuse Committee. (2009). Caring for Kids: What Parents Need to Know about Sexual
Abuse. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
What Do I Do Now?
a survival guide for victims of acquaintance rape

Acquaintance rape is when somebody you know—a boyfriend or girlfriend, a friend, a classmate,
or even someone you just met—uses coercion (including drugs or alcohol), violence, or threats
to force unwanted oral, vaginal, or anal sex. When this happens in a dating relationship, it is
commonly known as date rape.
Did you
Should I call 911? know?
28% of rap
e
victims are
Yes. Rape is a serious crime and you should report it. Do not worry about assaulted
getting into trouble if you were partying, drinking, taking drugs, or violating by their
boyfriends
curfew. The police are concerned with your health and your safety. And and
35% are s
exually
remember, calling the police and filing a report does not mean that you assaulted
by
have to press charges. relatives.1
Do I need a medical exam?

Yes. Call someone you trust—an adult or friend---and ask him or her to take you to the hospital.
Do not shower, eat or drink anything, brush your teeth, go to the bathroom, or change your
clothes before you go. The medical team and law enforcement need to find out whether you are
hurt and need to collect evidence from your clothing and your body during the medical exam.
You may also receive emergency contraception to prevent pregnancy. While the medical exam
may be uncomfortable and embarrassing, it will not be painful.
a survival guide for teens
Should I see a counselor?
Yes. You may find it difficult to cope with what has happened to you.
Fast Fa
A counselor can help you work through your feelings and take steps toward ct
Although yo
healing. With help and support—and your own strength and resilience—you ung
people are
can get through this and move on with your life. reluctant to
speak out
abo
You can start by talking to your school counselor or school nurse. They can dating viole ut
refer you to a counselor in your community who specializes in working with nce,
those who
teens who have been raped. You can also contact the National Sexual do often fi
nd
Assault Hotline operated by the Rape, Abuse & Incest National Network talking he
lpful.²
(RAINN) at 1-800-656-HOPE or http://www.rainn.org/get-help/national-
sexual-assault-online-hotline. They can direct you to a rape crisis center
in your community. (You can find additional online resources in Table 1.)
The important thing is to talk to somebody about what happened.

The traumatic experience of rape does not have to ruin your life.
table 1: getting help

911Rape Sponsored by the Rape Treatment
http://www.911rape.org/ Center at Santa Monica-UCLA Medical
home Center, this site offers support for
sexual assault victims as well as a safe,
anonymous way to learn how to get help
after a sexual assault.
After Silence On this website, you will find a support

http://www.aftersilence. group, message board, and chat room
org/index.php for survivors of rape, sexual assault,
and sexual abuse.
pport—
National Center for Toll free helpline—1-800-FYI-CALL p and su
With hel gth
Victims of Crime, Teen (1-800-394-2255, 8AM to 8PM EST), own stren
offers supportive counseling, practical and your can get
Action Partnership r es il ie nce—you
information, and referrals to local and move on
http://www.ncvc.org/tvp/ h this and
community resources and victim’s t h r o u g
main.aspx?dbID=DBTeenA
r life.
ctionPartnership788
advocates. with you
Rape, Abuse & Incest In addition to the toll free hotline

National Network (RAINN) mentioned above on this factsheet,
http://www.rainn.org/ RAINN offers general information Fast Fa
on sexual assault, tips for what do ct
38% of
following an attack, information on acquainta
how to help loved ones who have been nce
rape victim
raped, and a search page for finding s
are 14-17
local rape crisis centers. years old. 3

2 www.NCTSN.org
Common Reactions to Acquaintance Rape
The experience of being raped by someone you thought you could trust can bring up a wide range
of complicated emotions, including guilt, self-doubt, and worries that the rape was somehow your
fault. Working through these feelings is an important part of the healing process, and will help you
move on with your life.
In Table 2, you will find some common concerns and some misconceptions about acquaintance
rape, and common sense answers you can focus on to deal with some of these mistaken beliefs.
table 2: making sense of your reactions

After a sexual assault you may . . . The truth is . . .
Blame yourself (for example, wonder if you were flirting too It’s not your fault, no matter how you acted or what you wore.
much or wearing clothes that were too sexy).
Worry that it’s your fault for accepting a drink that was It’s not your fault. You didn’t know the drink was drugged.
drugged.
Worry that you will get in trouble with the police if you were The police are more concerned with your health and safety.
drinking because you are a minor.
Feel ashamed, angry, sad, different, lonely, anxious, All of these feelings are normal and the bad feelings will not last
betrayed, depressed, or as if you will never be able to trust forever. Talking to a counselor can help you work through all of
anyone again. these feelings.
Feel guilty or confused because you know your attacker. Most sexual assaults are committed by someone the victim
knew. It wasn’t your fault and you could not predict this.
Have nightmares about the assault or have your mind filled This is normal, too and will not last forever. Counseling can help
with images of the assault even when you are trying not to you learn to deal with these images.
think about it.
Worry about how your friends will react if they find out (Will Your real friends will be supportive and will not take sides.
they believe you or take sides?). Besides, your well-being is more important than what other
people think.
Worry about how your family will react if they find out. This might be hard for them to accept at first, but your family
loves you and will be supportive. Again, counseling can help your
family as well as you.
Think that nobody understands how you feel and you are A lot of teens have gone through this and you have the support
all alone. of people who care about you.
References
1. Bohmer, C. & Parrot, A. (1993). Sexual assault on campus: The problem and the solution. New York: Lexington Books.
2. Jackson, S.M., Cram, F., & Seymour, F.W. (2000). Violence and sexual coercion in high school students’ dating relationships.
Journal of Family Violence, 15, 23-36.
National Child Traumatic Stress Network Child Sexual Abuse Committee. (2009). Caring for Kids: What Parents Need to Know about Sexual
Abuse. Los Angeles, CA & Durham, NC: National Center for Child Traumatic Stress.
In partnership with:
Sexual Development and Behavior in Children
Your five-year-old daughter is playing in her room with a couple of friends.

You hear a lot of giggling and squealing.
When you open the door to check on the kids, you find them sitting on the
floor with their panties off, pointing at and touching each other’s genitals.
What do you do?
Every day, parents around the world are faced with situations like this. Being caught off-guard by
young children’s self-exploration and curiosity about body parts and sexual issues is one of the
uncomfortable realities of parenting, and can raise a host of troubling questions, such as, “Is my
child normal?” “Should I be worried?” “What should I say?”
Although talking with children about bodily changes and sexual matters may feel awkward, providing
children with accurate, age-appropriate information is one of the most important things parents can
do to make sure children grow up safe, healthy, and secure in their bodies.
Sexual Development and Behavior in Young Children: The Basics

Like all forms of human development, sexual development begins at birth. Sexual development
includes not only the physical changes that occur as children grow, but also the sexual knowledge
and beliefs they come to learn and the behaviors they show. Any given child’s sexual knowledge
and behavior is strongly influenced by:
■■ The child’s age1-3 “Young people do not wake up on their

thirteenth birthday, somehow transformed
■■ What the child observes (including the into a sexual being overnight. Even young
sexual behaviors of family and friends)4 children are sexual in some form.”5
■■ What the child is taught (including cultural Heather Coleman, PhD & Grant Charles, PhD
and religious beliefs concerning sexuality University of Calgary, Alberta, Canada and
The University of British Columbia, Vancouver, B.C.
and physical boundaries)
Very young and preschool-aged children (four or younger) are naturally immodest, and may display
open—and occasionally startling--curiosity about other people’s bodies and bodily functions, such
as touching women’s breasts, or wanting to watch when grownups go to the bathroom. Wanting to be
naked (even if others are not) and showing or touching private parts while in public are also common in
young children. They are curious about their own bodies and may quickly discover that touching certain
body parts feels nice. (For more on what children typically do at this and other ages, see Table 1.)
As children age and interact more with other children (approximately ages 4–6), they become more
aware of the differences between boys and girls, and more social in their exploration. In addition to
exploring their own bodies through touching or rubbing their private parts (masturbation), they may
begin “playing doctor” and copying adult behaviors such as kissing and holding hands. As children
become increasingly aware of the social rules governing sexual behavior and language (such as the
importance of modesty or which words are considered “naughty”), they may try to test these rules by
using naughty words. They may also ask more questions about sexual matters, such as where babies
come from, and why boys and girls are physically different. (For more, see Table 1.)
Age Uncommon/Problematic Behaviors

Table 1: Common Sexual Behaviors in Childhood1, 3, 6
Preschool ■■ Exploring and touching private parts, in public and in private

children ■■ Rubbing private parts (with hand or against objects)
(less than
4 years) ■■ Showing private parts to others
■■ Trying to touch mother’s or other women’s breasts
■■ Removing clothes and wanting to be naked
■■ Attempting to see other people when they are naked or undressing (such as in the
bathroom)
■■ Asking questions about their own—and others’—bodies and bodily functions
■■ Talking to children their own age about bodily functions such as “poop” and “pee”
Young ■■ Purposefully touching private parts (masturbation), occasionally in the presence of others
Children ■■ Attempting to see other people when they are naked or undressing
(approximately
4-6 years) ■■ Mimicking dating behavior (such as kissing, or holding hands)
■■ Talking about private parts and using “naughty” words, even when they don’t understand
the meaning
■■ Exploring private parts with children their own age (such as “playing doctor”, “I’ll show you
mine if you show me yours,” etc.)
School-Aged ■■ Purposefully touching private parts (masturbation), usually in private

Children
■■ Playing games with children their own age that involve sexual behavior (such as “truth or
(approximately
dare”, “playing family,” or “boyfriend/girlfriend”)
7-12 years)
■■ Attempting to see other people naked or undressing
■■ Looking at pictures of naked or partially naked people
■■ Viewing/listening to sexual content in media (television, movies, games, the Internet,
music, etc.)
■■ Wanting more privacy (for example, not wanting to undress in front of other people) and
being reluctant to talk to adults about sexual issues
■■ Beginnings of sexual attraction to/interest in peers
caringforK DS: Sexual Development and Behavior in Children - Information for Parents & Caregivers
2 April 2009
Once children enter grade school (approximately ages 7–12), their
awareness of social rules increases and they become more modest
and want more privacy, particularly around adults. Although self touch
(masturbation) and sexual play continue, children at this age are
likely to hide these activities from adults. Curiosity about adult sexual
behavior increases—particularly as puberty approaches—and children
may begin to seek out sexual content in television, movies, and
printed material. Telling jokes and “dirty” stories is common. Children
approaching puberty are likely to start displaying romantic and sexual
interest in their peers. (For more, see Table 1.)
Although parents often become concerned when a child shows

sexual behavior, such as touching another child’s private parts, these
behaviors are not uncommon in developing children. Most sexual play
is an expression of children’s natural curiosity and should not be a
cause for concern or alarm. In general, “typical” childhood sexual play
and exploration:

■■ Occurs between children who play together regularly and know each other well
■■ Occurs between children of the same general age and physical size
■■ Is spontaneous and unplanned
■■ Is infrequent
■■ Is voluntary (the children agreed to the behavior, none of the involved children seem
uncomfortable or upset)
■■ Is easily diverted when parents tell children to stop and explain privacy rules
Some childhood sexual behaviors indicate more than harmless curiosity, and are considered sexual
behavior problems. Sexual behavior problems may pose a risk to the safety and well-being of the
child and other children. (For more on this topic, see the National Child Traumatic Stress Network’s
factsheet, Understanding and Coping with Sexual Behavior Problems in Children: Information for
Parents and Caregivers at http://nctsn.org/nctsn_assets/pdfs/caring/sexualbehaviorproblems.pdf.)
Sexual behavior problems include any act that:
■■ Is clearly beyond the child’s developmental stage (for example,

a three-year-old attempting to kiss an adult’s genitals)
■■ Involves threats, force, or aggression
■■ Involves children of widely different ages or abilities (such as
a 12-year-old “playing doctor” with a four-year-old)
■■ Provokes strong emotional reactions in the child—such as
anger or anxiety
Responding to Sexual Behaviors

Situations like the one described at the beginning of this handout can be unsettling for parents.
However, these situations also offer excellent opportunities to assess how much children understand
and to teach important information about sexual matters.
The first step is to try to figure out what actually happened. To do this, it’s important to stay calm.
Staying calm will allow you to make clear decisions about what you say and/or do, rather than acting
on strong emotions.
www.NCTSN.org 3
To remain composed, try taking a long, deep breath, counting to ten, or even closing the door and
stepping away for a couple of minutes before saying anything. In the case described above, a parent
might calmly tell the children that it’s time to get dressed and then ask each child to go to a different
room in the house. After taking a few moments to collect his or her thoughts—and to consult with a
spouse or partner if feeling very unsettled— the parent could then talk to each child one-on-one.
When talking to children about sexual behaviors, it’s important to maintain a calm and even tone of
voice and to ask open-ended questions as much as possible, so the children can tell what happened
in their own words, rather than just answering yes or no. So, in this case, a parent might ask each child:
■■ What were you doing? Myth: Talking about sex with my

children will just encourage them to
■■ How did you get the idea? become sexually active.
■■ How did you learn about this?
Fact: In a recent survey of American
■■ How did you feel about doing it? teens, 9 out of 10 teens said it
would be easier to delay sexual
In the opening scenario, all of the children involved were activity and prevent unwanted
about the same age, had been playmates for some time, pregnancy if they were able to have
and seemed to be enjoying their game. So, it’s likely the “more open, honest conversations”
children were just curious and playing around and that no one with their parents on these topics.7
was upset about what happened. If you encounter a situation When you talk honestly with your
children about sexual issues, you
where the children are a little embarrassed but otherwise not
can give them the knowledge and
distressed, this can present an ideal opportunity for teaching skills they need to keep safe and
the children about healthy boundaries and rules about sexual to make good decisions about
behavior. relationships and intimacy.
Educating Children about Sexual Issues

Just because a behavior is typical doesn’t mean the behavior should be ignored. Often, when children
participate in sexual behavior it indicates that they need to learn something. Teach what the child needs
to know, given the situation. In this case, for example, the parent might teach the children that it’s okay to
be curious about other people’s bodies, but that private parts should be kept private, even with friends.
Although children usually respond well when parents take the time to give them correct information and
answer their questions, it is important to provide information that is appropriate to the child’s age and
developmental level. In Table 2, you will find an overview of some of the most important information and
safety messages for children of various ages. Keep in mind that you do not need to bombard children
with information all at once. Let the situation—and the child’s questions—guide the lessons you share.
The important thing is to let children know that you are ready to listen and to answer whatever questions
they may have.
Too often, children get the majority of their sexual education from other children and from media sources
such as television shows, songs, movies, and video games. Not only is this information often wrong, it
may have very little to do with sexual values that parents want to convey. Explicit adult sexual activities
are sometimes found during “family time” television shows, in commercials, and on cartoon/children’s
channels, and can have an influence on children’s behaviors.
Controlling media exposure and providing appropriate alternatives is an important part of teaching
children about sexual issues. Get to know the rating systems of games, movies, and television shows
and make use of the parental controls available through many internet, cable, and satellite providers.
4 April 2009
However, don’t assume that just by activating those controls you will be taking care of the situation.
It’s very important for you to be aware of what your children are watching on television and online, and
make time to watch television with them. When appropriate, you can use this time as a springboard to
talk about sexual or relationship issues, and to help children develop the skills to make healthy decisions
about their behavior and relationships.
Table 2: What to Teach When8

Preschool children (less than 4 years)
Basic Information Safety Information

■■ Boys and girls are different ■■ The difference between “okay” touches (which are comforting,
pleasant, and welcome) and “not okay” touches (which are
■■ Accurate names for body parts of boys and girls intrusive, uncomfortable, unwanted, or painful)
■■ Babies come from mommies ■■ Your body belongs to you
■■ Rules about personal boundaries (for example, ■■ Everyone has the right to say “no” to being touched, even by
keeping private parts covered, not touching other grownups
children’s private parts)
■■ No one—child or adult--has the right to touch your private parts
■■ Give simple answers to all questions about the
body and bodily functions. ■■ It’s okay to say “no” when grownups ask you to do things that
are wrong, such as touching private parts or keeping secrets
from mommy or daddy
■■ There is a difference between a “surprise”--which is something
that will be revealed sometime soon, like a present—and a
“secret,” which is something you’re never supposed to tell.
Stress that it is never okay to keep secrets from mommy and
daddy
■■ Who to tell if people do “not okay” things to you, or ask you to
do “not okay” things to them
Young Children (approximately 4-6 years)

■■ Boys’ and girls’ bodies change when they get older. ■■ Sexual abuse is when someone touches your private parts or
asks you to touch their private parts
■■ Simple explanations of how babies grow in their
mothers’ wombs and about the birth process. ■■ It is sexual abuse even if it is by someone you know
■■ Rules about personal boundaries (such as, ■■ Sexual abuse is NEVER the child’s fault
keeping private parts covered, not touching other
children’s private parts) ■■ If a stranger tries to get you to go with him or her, run and tell a
parent, teacher, neighbor, police officer, or other trusted adult
■■ Simple answers to all questions about the body
and bodily functions ■■ Who to tell if people do “not okay” things to you, or ask you to
do “not okay” things to them
■■ Touching your own private parts can feel nice, but
is something done in private
School-Aged Children (approximately 7-12 years)

■■ What to expect and how to cope with the changes ■■ Sexual abuse may or may not involve touch
of puberty (including menstruation and wet
dreams) ■■ How to maintain safety and personal boundaries when
chatting or meeting people online
■■ Basics of reproduction, pregnancy, and childbirth
■■ How to recognize and avoid risky social situations
■■ Risks of sexual activity (pregnancy, sexually
transmitted diseases) ■■ Dating rules
■■ Basics of contraception
■■ Masturbation is common and not associated with
long term problems but should be done in private

www.NCTSN.org 5
If you are unsure of what to say to your child about sexual issues, don’t be afraid to do some research.
In addition to talking to your pediatrician or doctor, you can turn to online resources such as the Sexuality
Information and Education Council of the United States’ (SIECUS) Families Are Talking websites (listed
below). There are also several excellent books available on talking to children about sexual issues, as
well as books that you and your children can read together. (For a partial listing, see Table 3.)
Table 3: Additional Resources for Communicating with Children About Sexual Issues
For You
Books Haffner, Debra W. (2008). From diapers to dating: A parent’s guide to raising sexually healthy
children-- from infancy to middle school, 2nd edition. New York: Newmarket Press.
Author Debra Haffner provides practical advice and guidelines to help you talk to children and
early adolescents about sexuality. Includes techniques to identify and examine your own sexual
values so that you can share these messages with your children.
Hickling, Meg. (2005). The new speaking of sex: What your children need to know and when they
need to know it. Kelowna, BC, Canada: Wood Lake Publishing, Inc.
This update of the bestselling More Speaking of Sex is packed with no-nonsense, accurate,
and gently funny information on sexuality and sexual health. Author Meg Hickling dispels
misconceptions and unhealthy beliefs about sex, provides guidelines on how to talk with children
at various stages of their development, and offers examples of how to answer tough questions.
Roffman, Deborah M. (2002). But how’d I get in there in the first place? Talking to your young child
about sex. New York: Perseus Publishing.
Sexuality and family life educator Deborah Roffman provides clear, sensible guidelines on how
to talk confidently with young children about sexual issues, including how to answer sometimes-
awkward questions about sexuality, conception, and birth.
Roffman, Deborah M. (2001). Sex and sensibility: The thinking parent’s guide to talking sense about
sex. New York: Perseus Publishing.
This book is designed to inspire honest communication about sexuality between parents and their
children. It focuses on the core skills parents need in order to interpret and respond to virtually any
question or situation, with the goal of empowering children through knowledge.
Online The Committee for Children offers tips on how to teach children about safe touch
Resources (http://www.cfchildren.org/issues/abuse/touchsaferules/) as well as general information on how
to talk to your child about sexual issues (http://www.cfchildren.org/issues/abuse/touchsafety/).
The Sexuality Information and Education Council of the United States’ (SIECUS) Families Are Talking
websites contain a wealth of information and resources to help you talk with children about sexuality
and related issues (http://www.familiesaretalking.org and http://www.lafamiliahabla.org).
For Your Children
Books Bell, Ruth. (1998). Changing bodies, changing lives: Expanded 3rd edition: A book for teens on sex
and relationships. New York: TimesBooks.
For ages 9 and up. Designed to help young people make informed decisions about their lives,
Changing bodies, changing lives provides answers to tough questions about how the body works
and about sex, love, and relationships. It’s packed with illustrations, checklists, and resources,
as well as stories, poems, and cartoons from hundreds of teenagers.
Brown, Laurie Krasny. (2000). What’s the big secret? Talking about sex with girls and boys. New York:
Little, Brown Books for Young Readers.
For ages 4–8. This colorful and chatty book uses illustrations, cartoons, and very accessible text
to explain the basics of anatomy, reproduction, pregnancy, and birth. Also discusses feelings,
touching, and privacy.
Hansen, Diane. (2007). Those are MY private parts. Redondo Beach, CA: Empowerment Productions.
For ages 4–8. This short, easy-to-read book uses colorful illustrations and catchy rhymes to teach
children that no one—relative, friend or neighbor—has a right to touch them in a way that makes
them feel uncomfortable.
6 April 2009
For Your Children (continued)
Harris, Robie H. (2006) It’s NOT the stork: A book about girls, boys, babies, bodies, families and friends.
Somerville, MA: Candlewick Press.
For ages 4 and up. This lively, engaging book uses two cartoon characters--a curious bird
and a squeamish bee--to give voice to the many emotions and reactions children experience
while learning about their bodies. The information provided is up-to-date, age-appropriate, and
scientifically accurate, and is designed to help kids feel proud, knowledgeable, and comfortable
about their bodies and how they were born.
Harris, Robie H. (2004) It’s perfectly normal: Changing bodies, growing up, sex, and sexual health.
For ages 10 and up. Providing accurate, unbiased answers to nearly every imaginable question,
from conception and puberty to birth control and AIDS, It’s perfectly normal provides young people
with the information they need to make responsible decisions and to stay healthy.
Harris, Robie H. (2004) It’s so amazing!: A book about eggs, sperm, birth, babies, and families.
For ages 4 and up. It’s so amazing! provides answers to children’s questions about reproduction,
sex, and sexuality. The comic-book style artwork and clear, lively text reflects an elementary-
school child’s interest in science and how things work. Throughout the book, a curious bird and
a squeamish bee help tell the story of how a baby is made--from the moment an egg and sperm
join, through pregnancy, to birth. It’s so amazing! also addresses and provides reassuring, age-
appropriate information on love, sex, gender, families, heterosexuality, homosexuality, sexual
abuse, and HIV and AIDS, while giving children a healthy understanding of their bodies.
Madaras, Lynda. (2007). The “What’s happening to my body?” book for girls, revised 3rd edition.
New York: Newmarket Press.
Madaras, Lynda. (2007). The “What’s happening to my body?” book for boys, revised 3rd edition.
New York: Newmarket Press.
For ages 10 and up. These books—part of the acclaimed “What’s Happening To My Body?” book
series by the same author—provide sensitive straight talk on children’s changing bodies, diet
and exercise, romantic and sexual feelings, and puberty in the opposite sex. They also include
information on sensitive topics such as eating disorders, sexually transmitted diseases, steroid
use, and birth control.
Mayle, Peter. (2000). “What’s happening to me?” An illustrated guide to puberty. New York: Kensington
Publishing.
For ages 9–12. For more than 20 years, “What’s happening to me?” has been helping young
people—and their parents—navigate the “time in between” childhood and adolescence.
Mayle, Peter. (2000). Where did I come from? The facts of life without any nonsense and with
illustrations. New York: Kensington Publishing.
For ages 4–8. Dedicated to “red-faced parents everywhere,” Where did I come from? covers the
basic facts of sexuality from physiology to love-making, orgasm, conception, growth inside the
womb, and childbirth. The illustrations are clear and realistic, and the text does an excellent job
of explaining things in an age-appropriate way.
Schaefer, Valorie. (1998) The care & keeping of you: The body book for girls. Middleton, WI: Pleasant
Company Publications.
For ages 7-12. This “head -to- toe” guide addresses the variety of changes that occur with puberty,
and answers many of the questions girls have, from hair care to healthy eating, bad breath to bras,
periods to pimples, and everything in between.
Parents play a pivotal role in helping their children develop healthy

attitudes and behaviors towards sexuality. Although talking with
your children about sex may feel outside your comfort zone, there
are many resources available to help you begin and continue the
conversation about sexuality. Providing close supervision, and
providing clear, positive messages about modesty, boundaries and
privacy are crucial as children move through the stages of childhood.
By talking openly with your children about relationships, intimacy,
and sexuality, you can foster their healthy growth and development.

www.NCTSN.org 7
References
1. Friedrich, W. N., Fisher, J., Broughton, D., Houston, M., & Shafran, C. R. (1998). Normative sexual behavior in
children: a contemporary sample. Pediatrics, 101 (4), E9.
2. Hornor, G. (2004). Sexual behavior in children: normal or not? Journal of Pediatric Health Care, 18 (2), 57-64.
3. Hagan, J. F., Shaw, J. S., & Duncan, P. (Eds.). (2008). Theme 8: Promoting healthy sexual development and
sexuality. In Bright futures: Guidelines for health supervision of infants, children, and adolescents
(3rd ed.) (pp. 169-176). Elk Grove Village, IL: American Academy of Pediatrics.
4. Friedrich, W. N., Grambsch, P., Broughton, D., Kuiper, J., & Beilke, R. L. (1991). Normative sexual behavior in
children. Pediatrics, 88 (3), 456-464.
5. Coleman, H., & Charles, G. (2001). Adolescent sexuality: A matter of condom sense. Journal of Child and Youth
Care, 14 (4), 17-18.
6. American Academy of Pediatrics (2005). Sexual Behaviors in Children. Elk Grove, IL: American Academy of
Pediatrics. Retrieved February 15, 2009 from
http://www.aap.org/pubserv/PSVpreview/pages/behaviorchart.html
7. Albert, B. (2004). With one voice: America’s adults and teens sound off about teen pregnancy.
Washington, DC: National Campaign to Prevent Teen Pregnancy. Retrieved March 1, 2009, from
http://www.thenationalcampaign.org/resources/pdf/pubs/WOV_2004.pdf
8. National Guidelines Task Force. (2004). Guidelines for comprehensive sexuality education: Kindergarten-12th
grade, 3rd edition. New York, NY: Sexuality Information and Education Council of the United States.
Retrieved March 1, 2009, from http://www.siecus.org/_data/global/images/guidelines.pdf
This product was developed by the Child Sexual Abuse Committee of the National Child Traumatic Stress Network in partnership with the
National Center on Sexual Behavior of Youth.
In partnership with:
Understanding and Coping with

Sexual Behavior Problems in Children

Sexual exploration and play are a natural part of childhood sexual development, and help children
not only to learn about their own bodies, but about the social and cultural rules that govern sexual
behavior. (For more on this topic, see the National Child Traumatic Stress Network’s factsheet,
Sexual Development and Behavior in Children: Information for Parents and Caregivers at
http://nctsn.org/nctsn_assets/pdfs/caring/sexualdevelopmentandbehavior.pdf.)
Some childhood sexual behaviors, however, indicate more than harmless curiosity. In some cases,
sexual behaviors pose a risk to the safety and well-being of the child and other children in his or her
world. These sexual behavior problems tend to continue even after the child has been told to stop
or limit the behavior, and usually have one or more of the following characteristics:1-3
■■ Are clearly beyond the child’s developmental stage (for example, a three-year-old attempting
to kiss an adult’s genitals)
■■ Involve threats, force, or aggression
■■ Involve inappropriate or harmful use of sexual body parts (for example, inserting objects
into the rectum or vagina)
■■ Involve children of widely different ages or abilities (such as a 12-year-old “playing doctor”
with a four-year-old)
■■ Are associated with strong emotional reactions in a child—such as anger or anxiety
■■ Interfere with typical childhood interests and activities
Sexual behavior problems frequently involve other children, including younger children, siblings,
and friends. No one knows how many children develop sexual behavior problems during their lives.
Although the number of cases being referred to child protective services and the juvenile justice
system has risen over the last two decades, it is not clear if these referrals represent a true increase
in the number of children with sexual behavior problems, increased public recognition of the problem,
or a combination of both.
It is known, however, that sexual behavior problems:
■■ Are not limited to any particular group of children

■■ Occur in children across all age ranges, socioeconomic levels, cultures, living
circumstances, and family structures
■■ Are not related to children’s sexual orientation
Some children with sexual behavior problems have married parents, some have divorced parents.
Some have abuse histories, while others have no history of abuse or other trauma. But children
with sexual behavior problems are all children first. And with proper treatment, children with sexual
behavior problems can learn to have respect for themselves and others, and to demonstrate healthy
boundaries and behaviors.
Causes of Sexual Behavior Problems

There are many possible reasons why children may show sexual
behaviors that are inappropriate or unexpected for their age. In general,
children’s sexual behavior problems are rarely about sexual pleasure.
In fact, these behaviors are much more likely to be related to anxiety,
traumatic experiences, curiosity, poor impulse control, or other factors.
Some of the factors that have been linked to the development of sexual
behavior problems include:
■■ Exposure to traumatic experiences, such as abuse, natural

disasters, or accidents
■■ Exposure to violence in the home
■■ Excessive exposure to adult sexual activity or nudity in the
home (including media exposure through television or the
Internet)
■■ Inadequate rules about modesty or privacy in the home
■■ Inadequate supervision in the home, often as a result of
parental factors such as depression, substance abuse, or
frequent absences due to work
Children with sexual behavior problems often show other behavioral and
social difficulties, including:
■■ Impulsiveness and a tendency to act before they think

■■ Difficulties following rules and listening to authority figures at home, in school and in the
community
■■ Problems making friends their own age and a tendency to play with much younger children
■■ A limited ability to self soothe (calm themselves down), so they may touch their own genitals
(masturbate) as a way to release stress and calm down
caringforK DS: Understanding and Coping with Sexual Behavior Problems in Children - Information for Parents & Caregivers
2 April 2009
Although some children who have sexual behavior problems have a history of being sexually abused,
many children who act out sexually have NOT been sexually abused. Sexual abuse may be suspected
when a child:
■■ Reports that another person has touched his or her private parts
■■ Has had contact with a known sexual abuser
If you know or suspect sexual abuse of a child who

is displaying sexual behavior problems, contact your
state’s child welfare authorities immediately to conduct
an investigation. If you are not sure who to contact,
contact the ChildHelp® National Child Abuse Hotline at
1.800.4.A.CHILD (1800.422.4453; also online at http://
www.childhelp.org/get_help). You can also visit the website
of the federally funded Child Welfare Information Gateway
at http://www.childwelfare.gov/responding/how.cfm.
For additional information on recognizing and preventing

sexual abuse, visit Stop it Now! (http://www.stopitnow.org)
and the National Child Traumatic Stress Network
(http://www.nctsn.org/nccts/nav.do?pid=typ_sa_prom).
When Your Child Has Sexual Behavior Problems

One of the most stressful situations a parent or caregiver can face is finding out that their child has
acted out in a sexual way. It can be difficult to know what to do. If you discover that your child has a
sexual behavior problem, you may experience a range of reactions, including:
■■ Difficulty believing that the sexual behavior really happened

■■ Anger--at your child, at the other children involved, at yourself, and at the world in general
■■ Feeling upset with or withdrawing from your child
■■ Sadness and depression
■■ Guilt and shame
■■ Isolation
■■ Disappointment, in your child and yourself
■■ Confusion and uncertainty, especially if it is unclear why your child is sexually acting out
■■ Nightmares and other traumatic stress reactions, particularly if you were sexually
abused as a child
Whatever your reaction, know that—with support—you and your child can move beyond this stressful
time. You are not alone—many other parents have had to cope with children’s sexual behavior
problems and have experienced similar emotions and reactions. Problem sexual behaviors in
children are quite responsive to treatment--particularly when caregivers are actively involved in
treatment--and future sexual behavior problems can be prevented.

www.NCTSN.org 3
Even though children with sexual behavior problems are much like children with other types of
behavioral problems, people may react more strongly to these problems because they are sexual
in nature. As you move forward in getting help for your child, keep in mind that children with sexual
behavior problems are—first and foremost—children. Your child may have made a poor decision,
but he or she can learn to make good decisions.
Treatment Options for Children with Sexual Behavior Problems

Active involvement of parents or other caregivers is essential to maximize the benefits of treatment
for children with sexual behavior problems. Treatment should be conducted by a licensed mental
health professional with specific knowledge of:
■■ Child development (including sexual development)

■■ Childhood mental health issues, including attention
deficit hyperactivity disorder (ADHD), posttraumatic
stress disorder (PTSD), and other reactions to child
trauma
■■ The relationship between social environment and
sexual behaviors
■■ Scientific research on treatment for childhood mental
health disorders and sexual behavior problems
■■ Cultural variations in parenting and attitudes toward Children with sexual
sexuality
behavior problems are—first
Once you have chosen a therapist, he or she will do an and foremost—children.
evaluation to decide how to best help your child and your
family. This evaluation will typically include:
■■ Talking to the you, other caregivers, and other adults involved in your child’s life
■■ Talking to your child (particularly if the child is six years of age or older)
■■ Asking caregivers, and perhaps teachers, to fill out information checklists about your child
■■ Psychological testing of your child
The therapist should talk with you about what he or she found out from the evaluation, including:
■■ Whether the behavior is common or an indication of a sexual behavior problem

■■ What other concerns or issues may need to be addressed with treatment
■■ What supports and protective factors are present in the family and community
Several types of treatment have been shown to be helpful for children with sexual behavior problems
and their families. During treatment, the therapist will work directly with your child. The therapist will
also teach you and other caregivers how to:
4 April 2009
■■ Implement rules about private parts and sexual
behaviors Myth: All children with sexual
behavior problems grow up to be
■■ Use parenting strategies that prevent and sex offenders.
reduce sexual and other behavior problems
Fact: Children who receive
■■ Address sexual education topics with your child treatment for their sexual behavior
problems rarely commit sexual
■■ Support abuse prevention strategies and skills
offenses or abuse as adults.
■■ Enhance communication skills and improve the One study followed a group of
quality of your relationship with your child children for 10 years after they
were treated. The vast majority
Other treatment characteristics that may be helpful (98%) did not commit sexual
include addressing the following topics with the child offenses of any kind, and the
in an age-appropriate way: group as a whole was no more
likely to commit sexual offenses
than children with a past of only
■■ Privacy rules, sexual behavior rules, and nonsexual behavior problems.4
boundary rules
■■ Abuse-prevention skills
■■ The labeling and expressing of feelings and skills to reduce distress
■■ Impulse-control strategies and decision-making skills
■■ Social skills
Most children with sexual behavior problems can benefit

from outpatient therapy. Outpatient therapy allows the child
to stay in the home and community and usually involves the
child, the parents, and other important caregivers and family
members. Outpatient therapy is relatively short term, and
can often be completed in three to six months if the family
regularly attends therapy sessions, actively participates in
services, and practices skills between sessions.
Some children will require more intensive treatments. These

include inpatient treatment and residential care. These
options are generally reserved for more severe cases, such
as children who:
■■ Have severe psychiatric disorders, such as psychotic symptoms (like hearing voices)
■■ Exhibit highly aggressive or coercive sexual behaviors or sexual behavior problems that
continue even when they get treatment and are closely supervised by their parents
■■ Have suicidal ideations (including specific plans for killing themselves)
■■ Have specific plans to physically harm others
For more information on treatment options for children with sexual abuse
problems, see the Association for the Treatment of Sexual Abusers’ (ATSA)
Report of the Task Force on Children with Sexual Behavior Problems,
available online at http://www.atsa.com/pdfs/Report-TFCSBP.pdf.

www.NCTSN.org 5
When choosing an inpatient or residential facility, look for a program that:
■■ Allows you to be actively involved in your child’s treatment

■■ Provides the least restrictive environment while providing needed safety measures
■■ Limits the number of other changes in the child’s life (such as school placement or after-
school activities)
■■ Has a clear plan for transitioning your child back into your home, including assisting you
in taking any needed safety measures
Sexual Behavior Problems: Keeping All Children Safe

Protecting other children is an important concern when dealing with children who have sexual
behavior problems, particularly if they have acted out with other children in the past. Children who
have had sexual behavior problems typically can attend school and otherwise interact with other
children as long as they:
■■ Receive treatment for their sexual behavior problems

■■ Have appropriate supervision in the school setting, such as direct supervision by an adult
during unstructured times like recess or lunch
In such cases, direct communication between the family, the therapist, and school personnel is
important, so that a safety or supervision plan can be developed as needed.
Children who have sexually acted out with their siblings present a unique challenge for parents
and therapists. Children who have experienced problematic sexual behaviors at the hands of their
brothers or sisters can have a wide range of responses. Sexual behavior that was threatening,
aggressive, or painful can have a profound negative effect on other children. Other factors that
may increase the traumatic effect of sexual abuse by a sibling include:
■■ The length of time that the behaviors took place (sexual behaviors that occur over a
longer period of time are more problematic)
■■ How many times the behaviors happened
■■ The type and closeness of the relationship among the children
■■ How well the child was functioning before the sexual interaction (children who were
doing poorly before the sexual behaviors are more likely to be negatively affected)
■■ The response and support received from parents or other caregivers
Some children who experience sexual abuse show almost no reaction or trauma symptoms,
while others may experience reactions such as nightmares, a heightened startle response, and
avoidance of the sibling or anything that reminds them of the event. Still others develop symptoms
of depression, anxiety (such as difficulty in separating from parents), behavior problems, social and
peer problems, or even inappropriate sexual behaviors themselves.
6 April 2009
If your child has sexually acted out with another child in your home, you will need to consider the
safety and well being of all your children when deciding what course to take with the child who has
sexual behavior problems. If other children in the home express concern about living with their sibling
or are showing signs of traumatic stress, the best course for all concerned may be placement outside
of the home. Alternative placements may include a relative’s home, a foster home, or inpatient or
residential treatment. Below are some issues to consider
when making decisions about where this child will live:
■■ Can you provide close visual supervision for

this child and still respond to the needs of your
other children?
■■ What safety measures can you take to
increase the level of supervision and
safety in your home? (For example, changes
in sleeping arrangements.)
■■ How severe were the child’s sexual behavior
problems and how well is the child responding
to supervision and treatment? Children with
highly aggressive or intrusive sexual behavior,
despite treatment and close supervision, Children who have experienced
should not live with other young children until problematic sexual behaviors
this behavior is resolved.
at the hands of their brothers
Planning for sibling contact and reunification should or sisters can have a wide
not be done alone. Before bringing a child with sexual range of responses.
behaviors back into your home, you will need to work
with a knowledgeable support team to help make safety
and treatment decisions. In addition to working with a qualified treatment provider, you may
want help from child protective services or juvenile services. You may also want to take advantage
of informal support from relatives, friends, and other supportive adults.
Together, you and this team can develop a clear safety plan for bringing your child back into your
home. All members of the family should be involved in developing this plan, and everyone should
agree with, understand, and be capable of following it. This plan should include:
■■ Rules for the children

■■ Activities the children can do and are encouraged to be able to do
■■ Responsibilities of the caregivers in charge of the children in the home
■■ Rules for all family members regarding privacy, boundaries, and supervision
Remember, the reunification process will—and should—take time, starting with brief visits, and
increasing in frequency and duration as you and your family implement the safety plan. Raising a
child who has sexually acted out with another child can be incredibly stressful. Many parents and
caregivers are so focused on supporting and caring for their children that they forget how important
it is to take care of themselves. As you move forward in helping your child heal, be sure to stay aware
of your own needs, and seek professional help if informal supports are not enough.

www.NCTSN.org 7
For more information on sexual behavior problems in children, visit the
National Center on Sexual Behavior of Youth, http://www.ncsby.org.
References
1. Friedrich, W. N., Fisher, J., Broughton, D., Houston, M., & Shafran, C. R. (1998). Normative sexual behavior
in children: a contemporary sample. Pediatrics, 101 (4), E9.
2. American Academy of Pediatrics (2005). Sexual Behaviors in Children. Elk Grove, IL: American Academy
of Pediatrics. Retrieved February 15, 2009 from
http://www.aap.org/pubserv/PSVpreview/pages/behaviorchart.html
3. Hagan, J. F., Shaw, J. S., Duncan, P. (Eds.). (2008). Theme 8: Promoting healthy sexual development and
sexuality. In Bright futures: Guidelines for health supervision of infants, children, and adolescents
(3rd ed.) (pp. 169-176). Elk Grove Village, IL: American Academy of Pediatrics.
4. Carpentier, M. Y., Silovsky, J. F., & Chaffin, M. (2006). Randomized trial of treatment for children with sexual
behavior problems: Ten-year follow-up. Journal of Consulting and Clinical Psychology, 74 (3), 482-488.
This product was developed by the Child Sexual Abuse Committee of the National Child Traumatic Stress Network in partnership with the
National Center on Sexual Behavior of Youth.
Child Sexual Abuse:
Coping with the Emotional Stress of the Legal System
Children and adolescents who have been sexually abused frequently face the prospect of going to
court. Although legal action can be an important step in helping children and families move forward
and recover from the trauma of child sexual abuse, it can also add to the stress of coping with life
after the abuse.
If your family is involved in a legal action related to child sexual abuse, knowing what to expect can
help your child or adolescent cope with the stress. You can help prepare yourself and your family
by learning more about the role of the legal system, common concerns about legal action, and
suggested strategies to cope with the legal process at different stages.
Understanding the Role of the Legal System in Child Sexual Abuse Cases
Your level of control and input will vary depending on the type of legal action that is involved. When
your family is involved in legal action, it can be helpful to understand the different types of cases
and their goals. Some of the most common types of legal cases are listed below.
■■ In criminal cases, the goal is to protect society as a whole. The prosecuting attorney’s
role is to represent the entire community, not just the child who has been abused.
The prosecutor decides how the case is conducted, and whether charges are filed or
dismissed.
The lack of control over important decisions in criminal cases can be frustrating and
distressing for victims and their families, particularly when their wishes differ from those of
the prosecuting attorney, or when the verdict or sentencing is not what they had expected.
■■ In private civil cases (custody cases, restraining orders, suits against the abuser for personal
injury, etc.), the goal is to ensure the best interests of the child and/or to obtain financial
restitution for the emotional and physical costs of the abuse.

Because the parent, guardian, and/or child are
the ones bringing the suit, they make the important
decisions about how to conduct the case, and may
be responsible for some of the court fees. A
guardian ad litem (see “Court Q & A” box on
page 4) may be appointed by the court to
represent the child’s interests, but in private
civil cases this will usually be at the expense of
one of the parties.
■■ In child protection cases, the goal is to protect

the child when there is evidence that the child
has been abused by a parent, guardian, or
other primary caregiver. During child protection Legal action can be an
hearings, decisions may be made to remove the
child or adolescent from the family and place important step in helping
them in the temporary custody of a foster home families move forward.
or other placement.
■■ As with criminal cases, in child protection cases the government files the legal action, which
means that the family does not have the right to dismiss the case. A guardian ad litem (See
Box, p. 4) will be appointed to represent the child’s interests at the government’s expense.
Understand that the goal of these actions is not to punish the parent or caretaker, but to
protect the safety and well-being of the child.
Common Concerns about Taking Legal Action

Many abused children, adolescents and their families are worried about getting involved with the court
process. They may want to get on with their lives and leave the abuse in the past. They may be afraid of
losing their privacy, or feel embarrassed or ashamed about what happened. They may worry that going
to court will cause more trauma and pain. These are all understandable concerns.
However, if children or adolescents have been sexually abused, it is also possible that the legal system
can be of help to them and their families. In addition to giving children and adolescents a chance to stand
up for their rights and speak out against those who hurt them, participation in a criminal prosecution or a
civil suit assures them that there are people who support them and believe them, and that they are trying
to make sure the offender is held responsible for what was done.
Table 1 lists some of the most common concerns about going to court in child sexual abuse cases, and
suggests methods of coping with or reducing those concerns.

Also keep in mind that there may be local support groups, crisis centers, child and civil rights law firms,
and Legal Aid agencies that provide free support services for court related cases. In addition, many
communities have Children’s Advocacy Centers (CACs) that offer coordinated support and services to
victims of child abuse, including sexual abuse. For a state-by-state listing of accredited CACs, visit the
website of the National Children’s Alliance (http://www.nca-online.org/pages/page.asp?page_id=3999).
If you are experiencing difficulty in getting the answers you need from the legal system, these groups can
be of assistance in contacting the court system for you.
caringforK DS: Child Sexual Abuse - Coping with the Emotional Stress of the Legal System
2 April 2009
Table 1. Going to Court—Fears and Realities
Fear Reality
Loss of privacy Frequently when the victim is a child or adolescent, lawyers can ask that TV cameras be
barred from the courtroom and that only necessary people be allowed to remain there,
such as witnesses and law enforcement officers. Many cases never become high profile,
and settle quietly out of court.
The court will do everything it can to protect your privacy, and responsible reporters have
policies not to disclose the name of a child victim. However, it is possible that some
people in your community will know—or think they know—who is involved. If this occurs,
it can help to talk to school staff, spiritual leaders, and other parents about how they
will handle the curiosity and questions of other children.
It is important to reassure your child that it is the abuser, not your child, who is
responsible for what is happening. Getting appropriate treatment for your child is often
the best step you can take in helping your child deal with issues of loss of privacy.
Fear of retaliation Defendants in criminal cases are usually under court order to have no contact with the
victim and the victim’s family while the case is pending. This may also be true in child
custody or child protection cases. If you or your child are concerned about safety, you can
take steps to make yourselves feel more secure. Several suggestions are included below.
■■ Notify the child’s daycare or school of the situation, and make it clear that the abuser
is to have no contact with your child.
■■ Keep a cell phone handy, ideally one with picture-taking capability, to document any
instance where the abuser is violating any no-contact court order.
■■ Encourage children or adolescents to talk about their fears. Be honest about the
likelihood of a particular fear actually happening, and do your best to keep unrealistic
fears in check.
■■ Report threats or concerns about safety (e.g., calls in the middle of the night, etc.) to
law enforcement, your crime victim advocate and/or the prosecuting attorney or civil
attorney representing you and your family. All of these professionals can potentially
take steps to address your safety.
■■ Obtain information about a civil protective order. Child sexual abuse cases are
frequently covered by domestic violence protective order laws and other types of
protective orders, which are free and carry no court costs to obtain.
Financial worries Keep in mind that children are often sensitive to parents’ financial worries, and may
(e.g., missing work blame themselves for causing financial stress. Assure your child that he or she is not to
to go to court, paying blame for the situation, and that resources are available to help. Ask your child protective
for legal, medical, services worker, crime victim advocate, and/or other involved professionals for advocacy
and possible resources.
and/or mental health
services) Many states and communities offer financial assistance, including funds for crime victim
compensation even if the case is not prosecuted or does not result in a conviction. These
types of funds generally cover payments for necessary medical/mental health services
for sexually abused children. Some also offer compensation for lost work time and other
expenses related to prosecution of criminal acts. Ask your local law enforcement, civil
attorney, prosecutor’s office, crime victim advocate, or child protective services worker
for information.
Missing school Talk to school administration about allowing children to finish schoolwork on a schedule
for court and that takes into account their abuse-related needs. Designate a particular teacher or staff
other necessary member that the student can turn to if she or he feels overwhelmed during school hours.
appointments

www.NCTSN.org 3
Coping with the Court Process: Step by Step
Step 1: The Investigative Phase

Court Q & A
During the investigative phase, several different agencies The judge appointed a guardian
may be involved in the investigation of the case. The ad litem for my child. What does
immediate issues to be addressed may include establishing this mean?
whether sexual abuse has occurred, who abused the child,
Guardian ad litem means
where the abuse occurred, and how to ensure the child’s guardian at law. This is a
immediate and future safety. Other issues focus on the person appointed by the judge
child’s medical and psychological needs, and the child may to advocate for the best interests
need a medical exam or a psychological assessment. For of the child in a particular case.
example, medical testing for injuries or sexually transmitted Appointment of a guardian ad
diseases, or counseling support for symptoms of depression, litem usually happens in cases
anxiety, or sudden changes in mood may be necessary. where the child disagrees with
the parent or caretaker about
The early investigative phase is a time when many things how to proceed or where there
is evidence that the caretaker
happen quickly and all at once. Sometimes the information
may have been involved in or in
may be confusing, overwhelming, or even conflicting some way responsible for the
between different service providers involved in the case. abuse. (For example, by failing to
It is also a time when children, adolescents, and families protect the child against harm by
are called upon to make many important and potentially another person.)
difficult decisions and changes, such as:
■■ Whether to have a medical exam or interview
As you navigate the ■■ Whether to cooperate with law enforcement and child
protective services to help build the case and keep the
legal process, keep child or adolescent safe from further harm
in mind that the most ■■ Whether to cut off contact with the abuser
important consideration ■■ Whether to arrange for counseling or mental health
is the safety and well- treatment
being of your child.
As you navigate the legal process, keep in mind that the most
important consideration is the safety and well-being of your child. If you are confused by the legal jargon,
getting conflicting information from different people, or just feeling overwhelmed, don’t hesitate to reach
out for help. For information about mental health treatment for your child, go to www.NCTSN.org.
At this phase of the legal process, the full impact of disclosing sexual abuse becomes real, and your child
or adolescent may be forced to talk about the abuse with people who are complete strangers. This can
lead to a number of difficult reactions, including:
■■ Conflicted feelings about the abuser, especially if he or she is someone the child or adolescent
likes, admires, or loves
■■ Guilt about the effect his or her disclosure is having on the abuser’s family
■■ Self-doubt or embarrassment if he or she has unclear or confusing memories about the
specifics of the abuse or feels that they may have invited the abuse
4 April 2009
Children and adolescents should be reassured that neither the abuse nor the impact of the resulting
legal process is their fault. The abuser is the sole person responsible for the harm, and for setting
the legal system into motion. Obtaining appropriate mental health counseling can help children and
adolescents deal with both the trauma of the abuse and the stresses and confusion involved in the
legal process. Over time, children, adolescents and their families become increasingly familiar and
comfortable with the investigators and professionals involved in the case, and may even find them to
be a source of comfort and empowerment as the legal process goes on.
If either you or the government decide not to go forward with a criminal or child protective services legal
case related to the child sexual abuse, you may feel at a loss because the service providers who were
assisting you are suddenly no longer there. It is important to continue to reach out for help from the
victim advocacy community if you feel you or your child needs it. This may include continuing to learn
about alternative legal choices such as civil protective orders, obtaining financial assistance, or seeking
counseling for yourself and your child.
Sometimes when a case is dropped, families can feel betrayed by the process because they wanted the
offender to be held more accountable. It can be a harsh reality for families to learn that the legal system
relies on obtaining enough evidence to go forward to trial, rather than on the beliefs of the family and
other professionals that the child was indeed abused.
Step 2: Going to Trial Court Q & A

I feel like no one is talking to us about
Once the decision is made to go forward with the case, the what is going on with this case. What
whirlwind of the initial investigation usually stops and there can I do to find out more?
may be a lull as lawyers prepare for the trial. In many, if not In every state, law enforcement and
most, criminal and civil legal cases the case never actually prosecuting attorneys are required to
goes to trial. Instead, it is settled before the trial date, either provide crime victims with information
with a guilty plea to a lesser charge (in criminal court) or a about their rights in the system. If
negotiated settlement (in civil court). For some families, such there is conflict between the family’s
out of court settlements may be a relief—a way of moving on interests and the government, families
and putting the case behind them. For others, plea bargains can get information about the case
and about the rights of victims from
and negotiated settlements may make the family feel as if
government victim witness assistants.
they or the system are giving in or that the punishment has
not been adequate.
If the case does go to trial, children or adolescents may have

many questions about what will happen in court. The answer
will depend on the child’s age; younger children need shorter
answers and less detail than older ones. For example, it
is normal for children to be worried that the person who
hurt them might try to do so again, or will try to get back at
them for “telling.” It is generally enough to reassure younger
children that abusers know that the police can arrest them
if they come near the child or family. With older children
and adolescents, it can help to explain that the abuser is
under a court order to have no contact, and to describe
the penalties the abuser would face for violating the order.
Such explanations also give adult caretakers the chance to
reassure children and adolescents that the responsibility for
the abuse belongs to the abuser, no matter what.

www.NCTSN.org 5
When your child asks whether the abuser will be held accountable for the abuse, it is important to
be both honest and reassuring. Children and adolescents should know that no matter what happens
in court, they are supported and believed, and the abuse was not their fault. Adults can talk with
their children about the feelings that led to the question, and about their own feelings. If children or
adolescents show signs of behavioral or emotional distress related to the abuse or court involvement,
this may be a good time to explore treatment options.
During the trial, giving court testimony can be stressful, but it can also be empowering, offering the child
or adolescent the opportunity to tell their side of the situation. Hearing others testify can sometimes be
just as emotional as testifying. Your child may feel angry or sad when hearing about the experiences of
parents or siblings, or feel outraged if he or she believes that witnesses are lying.
Tips for Helping Children Cope with the Stress of a Trial

Maintain normal routines. Younger children especially feel more secure when their daily lives follow predictable
patterns. Don’t let life revolve around the case or the abuse. Set regular times to do ordinary family things together,
such as playing board games, helping with homework, or going to the movies together.
Set normal expectations. In order to feel safe and secure in their world, children (even adolescents) need parents
to make and keep the rules. Although you may be tempted to “let things slide” because of the stresses your child is
experiencing, big changes in routine may actually tell your child that he is now somehow different. Try to maintain
schoolwork, chores, and behavioral expectations as much as possible.
Expect the unexpected. Don’t be surprised if your child acts a little younger than his or her age during this time.
Stressed children often revert to behaviors they’ve grown out of; it’s their way of expressing that they don’t feel so sure
of themselves just now. Responding with reassurance and empathy will help. If your child begins to frequently act in ways
that worry you, though, you may want to consider counseling for her or him.
Don’t make life all about the trial. Let your child decide when to talk about court-related issues, and provide him
or her with plenty of reminders and opportunities to just be a kid. if you have concerns that your child is very worried,
scared, ashamed or embarrassed about something and isn’t talking about it, try to bring out feelings with general
questions like “Is there something on your mind?” or “You look like something’s bothering you,” rather than asking
directly about court. Choose a time when you’ll be able to continue the conversation once it’s begun, in case it’s a
long one.
Avoid information overload. Part of what makes court involvement so stressful is that parents and children have no
control over how—and when—the case will move forward. The court’s plans can change suddenly, and court schedules
often depend on the timing of other events. How much you tell your child will depend on your child’s specific needs
and desires. Abuse takes choice away from the victim, so any choices your child can appropriately be given will be
empowering. For example, if a trial is rescheduled, your child might want to know the new date—even if it’s months
away—or may not want to know until its time to start preparing for the trial.
Build supports outside the family. Normal family supports can become splintered during child sexual abuse cases,
particularly when the abuser is a family member. It may be useful to make a list of everyone in your community who can
help when needed. If you are religious, a church, synagogue, or mosque may be a place of healing and hope. (If you
experience judgment or blame at your place of worship, don’t hesitate to seek a more welcoming environment to meet
your spiritual needs.) Look outside of your immediate circle of friends and relatives, especially if that circle is small, or
if it contains people who can’t, don’t want to, or don’t know how to support you and your family. Many communities have
organizations that exist just to help children and families in this kind of crisis. Please see the resource list at the end of
this document for places to contact.
Take care of yourself. You can’t support your child if you’re at the end of your rope. Be aware of your own physical and
emotional needs. Make every effort to eat well, get a decent night’s sleep, and exercise as much as possible. If you need
a break, give yourself permission to get what you need and turn to others for help. Pushing away troubling feelings will
only make them come out in another (usually unhealthy) way. While it may be tempting to get a “quick fix” on tough days
by using alcohol or drugs, these substances can actually make it harder for your body to recover from stress. If you find
yourself drinking or taking drugs to escape painful feelings, recognize this as a clear sign that you need to get help.
6 April 2009
Just going to court can have a dramatic emotional impact, particularly if it is the first time your child
has seen the offender since he or she disclosed the abuse. You may be worried about sharing a
waiting room in the courthouse with the defendant, hostile witnesses or family members loyal to the
offender. If this is the case, law enforcement, attorneys, and court personnel can often arrange a
variety of safety measures for your time in court, including accompanying you to and from the parking
lot, providing separate waiting areas, and many other measures. A tour of the court facility before
the trial, and knowing where the safety officers are positioned, can be a reassuring experience for
children, adolescents and their families. Feel free to
ask for as much information as you wish from the
service providers involved in your case. You have the
right to know what is happening in your case, to inform
the attorneys of what you would like to have happen,
and to provide victim impact statements or other
feedback to the attorneys involved.
Step 3: Coping with the Verdict and Moving On

Once the case is over, you may feel a range of
emotions regardless of the actual outcome. If the
abuser is convicted, you may be very relieved, feel
dissatisfied with the plea agreement or sentencing
decision, or feel surprisingly “let down.” If the abuser
was a close family member, there may also be
sadness and grief mixed in with the satisfaction. You have the right to know what
If the abuser is acquitted, the resulting anger, fear,
and sadness may be difficult to face. However, is happening in your case.
remember that support services are available both
during and after the court case. Also remember
to reassure the child or adolescent that the court does not determine
whether the abuse happened or not, but rather whether there is enough
evidence to show that it did. Although the court system tries to find the
truth, it cannot ever determine whether something really happened or not.
Simply ending such a long ordeal can be very emotional, and you and
your child will need a great deal of support so that you can adjust to
life after the trial, and get back to a normal school and work schedule.
Once your case is completed, friends and family may feel that it is okay
to ask your child questions about the case or the abuse. It is important
to protect your child or adolescent from such intrusive questions. Clearly
communicate to friends and family that your child is still healing both
from the abuse and from the stress of the legal experience.
For most families, the decision in the civil or criminal trial related to
child sexual abuse is the end of the legal process. However, for some
there are other legal actions pending, such as a family court action. Less
commonly, the defendant may file an appeal claiming the trial court
made an error and seek to overturn the decision. Legal advocates and
mental health and community service providers may also provide ongoing
support to families when the legal matters take longer than expected.

www.NCTSN.org 7
Additional Resources
The Judicial Council of California, Administrative Office of the Courts, Center for Families,
Children and the Courts (www.courtinfo.ca.gov/programs/cfcc) offers a children’s activity book,
What’s Happening in Court, with an interactive website component, designed to help children
prepare for civil and criminal court. All materials are available in English and Spanish.
The National Center for Missing & Exploited Children’s (www.missingkids.com) Just in Case series
includes practical suggestions for parents of children testifying in court. Go to the “Resources for
Parents and Guardians” section of the web site, click on “More Publications” under “Featured
Publications” to find the series. (Other titles in the series relate to preventing exploitation of children.)
The National Children’s Alliance (www.nca-online.org) offers a state-by-state listing of accredited

Children’s Advocacy Centers, community-based facilities where members of the child protection, law
enforcement, prosecution, victim advocacy, medical and mental health communities provide abused
children and their families with comprehensive, coordinated services and support.
The American Bar Association Center on Children and the Law (www.abanet.org/child) offers a range
of resources and publications on the legal process in civil and criminal child abuse and neglect cases.
The Rape, Abuse, and Incest National Network (RAINN, www.rainn.org) can help you locate a rape
and sexual abuse response agency near you, and provides links to other helpful resources. They can
be reached toll free at 800-656-HOPE (656-4673).

Caring For Kids What Parents Need Know About Sexual Abuse

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National Child Traumatic Stress Network

Caring for Kids: What Parents Need to Know about

In addition to helping you to recognize child sexual

caringforK DS: What Parents Need to Know about Sexual Abuse

Question & Answers about Child Sexual Abuse:

What to Do If Your Child Discloses Sexual Abuse:

Coping with the Shock of Intrafamilial Abuse

Preventing Acquaintance Rape:

Sexual Development and Behavior in Children:

Understanding and Coping with Sexual Behavior Problems in Children:

Child Sexual Abuse:

caringforK DS: What Parents Need to Know about Sexual Abuse

For Parents, Teachers, and Other Caregivers

Who is sexually abused?

Why don’t children tell about sexual abuse?

What can you do if a child discloses

If a child discloses abuse, it is critical to stay calm,

caringforK DS: Child Sexual Abuse Fact Sheet

Myth: A child is most likely to be sexually abused by a stranger.

Myth: Preschoolers do not need to know about child

Myth: Children who are sexually abused will never recover.

Myth: Child sexual abuse is always perpetrated by adults.

The National Child Traumatic Stress Network

2. Avoid focusing exclusively on “stranger danger.” Keep in

3. Teach children about body safety and the difference between

5. Make sure children know that adults and older children

6. Teach children to take care of their own private parts

An Interview with Esther Deblinger, PhD

Q: What is child sexual abuse?

Q: Are any particular children at increased risk?

A: Unfortunately, child sexual abuse is very common.

Q: Who are the most common perpetrators?

The Impact of Abuse on Children

Q: What are the signs of post-traumatic stress reactions?

A: Three types of symptoms occur with post-traumatic

The National Child Traumatic Stress Network

Q: Is the impact of sexual abuse different in adolescents?

Q: What’s the long-term impact of sexual abuse?

A: Research has repeatedly shown that child sexual

Healing and Recovering Together

The National Child Traumatic Stress Network

About Esther Deblinger, PhD

Information for Parents and Caregivers

■■ Fear that the abuser may hurt them or their families

What should I do if my child discloses

■■ Stay calm. Hearing that your child has been

I have heard that some children who disclose sexual abuse

Books That Can Help

Lowery, L. (1995). Laurie tells. Minneapolis, MN:

Ottenweller, J. (1991). Please tell! A child’s story

Stauffer, L., & Deblinger, E. (2003). Let’s talk

The National Child Traumatic Stress Network

Books That Can Help

Brohl, K., & Potter, J.C. (2004). When your child

Daugherty, L. (2006) Why me? Help for victims

Information for Parents and Caregivers

What Is Intrafamilial Sexual Abuse?