A provider’s perspective: What you need to know about child sexual abuse

Child sexual abuse impacts about 1 in 4 girls and 1 in 13 boys in the United States.

Content disclosure: This post will discuss the challenging but very important topic of child sexual abuse. 

In Kentucky, the number to call to report suspected child abuse is (877) 597-2331 (KY-SAFE1). The National Child Abuse Hotline, (800) 422-4453 (4-A-CHILD), offers professional crisis counselors who can provide intervention, information and referrals to emergency, social service and support resources. Calls are confidential. In Kentucky, everyone is mandated to report a reasonable suspicion that maltreatment has occurred. Reporting child abuse and neglect is the right thing to do, and it’s the law.

It was at the height of the pandemic, and I found myself on a video call with my patient’s mom as she experienced a living nightmare.

“Your daughter is being assessed for child sexual abuse.”

Like me, this patient’s mom was a health care professional. As a travel nurse, she was in the middle of her night shift several states away and had stepped away from her patients to learn that her child had been brought to the emergency department. I explained to her that I was a sexual assault nurse examiner and that I would be providing medical-forensic care, including evidence collection, for her daughter. I watched as her eyes overflowed with tears, fear and countless questions: How could this have happened? Will my daughter be OK?  What can I do to help? 

These are not uncommon questions. In fact, for each of the approximately 300 children assessed for sexual abuse each year in Norton Children’s emergency departments, there are numerous caregivers and loved ones echoing these questions. 

An all-too-common problem

Child sexual abuse is an especially distressing form of child abuse and a common phenomenon, with about 1 in 4 girls and 1 in 13 boys in the United States affected. Child sexual abuse is defined as any sexual activity with a child (anyone under 18 years old) where consent is not or cannot be given.

It can take various forms, including physical contact (such as touching or other sexual activity with a child), noncontact abuse (such as exposing a child to sexual materials or activities) and online abuse (such as grooming or sextortion). Over 90% of child sexual abuse is perpetrated by someone close to the child, such as a caregiver.

Preventing child sexual abuse

As difficult as it can be to talk about, child sexual abuse is a prevalent, yet preventable, problem in our society, and it is essential that we shed light on this issue to protect children and support the survivors among us. Preventing child sexual abuse requires a collective effort from parents, caregivers, educators and communities.

Here are four critical steps we can take to protect children from sexual abuse:

1.     Empower children to have control over their own bodies

  • Create an environment where children feel comfortable discussing sensitive topics with a trusted adult. 
  • Encourage open, developmentally appropriate conversations about body safety, boundaries and appropriate versus inappropriate touching. 
  • Teach your children the real names for their body parts and explain to them under what circumstances it may be OK for someone to look at or touch their private areas. 
  • Help children establish personal boundaries and empower them to say “no” to other children or adults when they feel those boundaries are being crossed or when they don’t want to have others in their personal space (for example, tell them it’s OK to decline a hug). 

2.     Empower children to practice online safety

  • Teach your children about the potential dangers they may encounter online, including grooming, sextortion, cyberbullying and inappropriate content, and help them understand the importance of privacy and the risks associated with sharing personal information online.
  • Encourage your children to talk to you if they encounter anything that makes them uncomfortable or if they have any questions about their online activities.
  • Establish clear rules and boundaries for internet and phone use, such as limiting screen time, requiring devices to be used in common areas and prohibiting sharing personal information with strangers online.
  • Familiarize yourself with the online platforms your children use. Consider using parental control tools or monitoring software to help keep track of their online interactions.
  • Encourage your children to trust their instincts and seek help if they feel threatened or coerced online. Let your children know that they can always come to you for support and guidance. Reassure them that you are there to help them navigate any challenges or difficulties they may encounter online.

3. Educate

  • Educate yourself and others about the signs of child sexual abuse and how to respond if you suspect abuse. Recognizing the signs of child sexual abuse can be challenging, as many children may not disclose their experiences out of fear, shame or confusion. However, there are signs that may indicate abuse, such as unexplained injuries or bruising, particularly in the genital or anal area, symptoms of sexually transmitted infections, displaying sexual knowledge or behaviors that are not age-appropriate, sudden changes in behavior (such as withdrawal, aggression, or mood swings), fear or reluctance to be alone with certain individuals, or avoidance of specific places or activities without obvious reasons.
  • Ensure that any places caring for children (for example, child care or nurseries) are implementing thorough screening processes and providing training for their workers to identify and prevent potential risks of abuse.

4. Report suspected child sexual abuse·    

  • If you suspect that a child is being sexually abused or is being sexually exploited online, report it immediately to the appropriate authorities, such as child protective services or law enforcement. Time is of the essence in such situations, so don’t hesitate to take action to ensure the child’s safety. It’s crucial to take action to protect the child and hold perpetrators accountable.
  • In Kentucky, the number to call to report suspected child abuse is (877) 597-2331 (KY-SAFE1).
  • The National Child Abuse Hotline is (800) 422-4453 (4-A-CHILD).

By working together as a community, we can create safer environments for all children and empower them to thrive, free from harm. Together, let’s stand up against child sexual abuse and work toward a future where every child is safe, valued and protected.

Joelle Hirst, BSN, R.N., SANE A/A, SANE P/A, SANE-A, is a sexual assault nurse examiner and the manager of Norton Children’s pediatric forensic nurse examiner program.