How to Identify Child Sexual AbuseBy Dr. Anjana Thadhani, Member Expert Panel
Child abuse is a phenomenon which occurs globally but has always been under reported and still is unacceptable to a society. It happens in many forms and could be simply spanking the child for bad behavior to gruesome sexual exploitation.
Child abuse is happening all around us but somehow we miss to recognize it most of the time. All we need is to have a High Index of Suspicion. Remember that if we only become aware of these subtle changes in the child’s behavior we may be able to pick up abuse in any form.
Behavioral History- Fear of certain people or places
- Nightmares, trouble sleeping, or other extreme fears without an obvious explanation.
- Manifested during play, writing, drawings or dreams. May include sexual or frightening images.
- Loss of appetite, sudden changes in eating habits.
- Sudden mood swings: rage, fear, anger, insecurity or withdrawal.
- Recurrent abdominal pain without identifiable etiology.
- Sudden appearance of bed-wetting, thumb sucking / other age inappropriate behaviour
- Adult-like sexual activities with toys or other children
- New words for private body parts.
- Shows resistance to bathing, toileting, or removing clothes even at appropriate situations.
- Refusing to talk about a ‘secret’ he/she has with an adult or older child.
- Talking about a new older friend.
- Suddenly having money, toys or other gifts for no apparent reason.
- Cutting, burning or otherwise intentionally harming herself or himself, i.e. drug use, alcohol abuse, sexual promiscuity, running away from home.
- Has negative self image
It is very important to probe a little into the social history, to know the type of family, the daily routine of the child, the caretaker at home etc. The socio-economic status is also important as it lets us know the scope for modifications.
Points to ponder when we think of abuse of a child- If the story keeps changing in case of any unexplained injury to any child then it is possible that the truth is not being told
- The behavior of the child and the caretaker or the parent is suspicious
- It may be possible to notice a pattern of repeated similar injuries
- Delay in seeking medical help could also point to abuse
Surprisingly child abuse is a continuous process and in most of the cases the abuser is known to the child and has easy access to the child.
Dr. AnjanaThadhani is a renowned Consulting Developmental Pediatrician in Mumbai and amother of growing children. She has been National Faculty and part of IAP-ChildRights and Protection Program a UNICEF-supported project involved in trainingof paediatricians and other healthcare workers / teachers for identificationand reporting of child abuse and neglect and its management.