From the Courier-Journal, Sept. 4, 2015
Recent stories reported in the press surrounding issues of child sexual abuse present an opportunity to discuss some key issues surrounding the topic which are important for the public to understand.
Child sexual abuse and sexual assault are significant concerns in society today with the most common perpetrators of sexual abuse being someone known to the child. The often-thought-of “stranger assaults and abuse” are actually very rare.
Child sexual abuse can include but not be limited to the following: contact for sexual purposes, molestation, statutory rape, prostitution/human trafficking, pornography, exposure, incest, as well as other forms of sexual exploitation. Research has shown that approximately 15-30 percent of female and 5-15 percent of male children are exposed to sexual abuse and 5-10 percent of female and up to 5 percent of male children are exposed to sexual abuse involving penetration.
It is important for all members of the public to remember that in Kentucky all citizens are mandated by law to report suspected child maltreatment when they are presented with reasonable cause to suspect that it is occurring. This includes child sexual abuse.
When a child makes statements to an adult that raises these concerns it can often be very difficult for that adult to hear and may often cause a sense of shock or dismay in the adult; however, it is important to maintain a calm demeanor and provide supportive statements without asking excessive questions. In addition to reporting the abuse to the authorities, it is vital to seek medical attention when appropriate, and if unsure whether medical attention is needed, to call and speak with the child’s pediatrician for guidance.
Children who have been sexually abused can present with varying degrees of signs and symptoms. These may include any or none of the following: daytime wetting accidents, night time bed wetting, soiling (stool) accidents, depression, anxiety, fear, sleep disturbance, appetite changes, self-esteem problems, interpersonal relationship problems, regression of development, sexualized behavior, change in school behavior, blood in urine, burning with urination, unexplained genital/oral bruising, or sexually transmitted disease as well as possible pain, bleeding, discharge, or lesions of the vagina, penis, anus or mouth.
While being vigilant and reporting suspicions of child sexual abuse is important, the strongest way to combat the issue is prevention. It is important to educate children about proper names to call the penis, vagina, buttocks and breast and to teach them that these areas are private and it is not okay for other people have the child see or touch those areas on the other person nor is it appropriate for other people to ask to see or touch those areas on the child. A child should be taught that this includes anyone and not just strangers; however, teaching about danger from strangers is also important.
Children also need to understand that if anyone touches them or asks them to do anything uncomfortable, they need to tell an adult and that it is okay for them to tell. In addition to teaching children, awareness and knowledge for all professionals and caregivers who interact with children are important regarding signs to watch for as well as how to talk to kids about preventing sexual abuse.
To report suspected sexual abuse in Kentucky, call the Kentucky Child Protection Hotline toll-free 24/7 at (877) KYSAFE1 / (877) 597-2331. In Indiana, call the Indiana Child Abuse and Neglect Hotline toll-free 24/7 at (800) 800-5556. Children may also be brought to the Emergency Department at Kosair Children’s Hospital.
By remaining vigilant and properly educating children as well as the community that cares for children we can help to prevent, recognize and properly care for children who have been sexually abused.
Vinod B. Rao, M.D., F.A.A.P. – is a pediatrician at the University of Louisville with expertise in child sexual abuse