Signs and symptoms of child sexual abuse?
Child sexual abuse (CSA) refers to the use of children (persons younger than 18 years old) in sexual activities when, because of their immaturity and developmental level, they cannot understand or give informed consent. A wide range of activities is included in sexual abuse, including contact and noncontact activities. Contact activities include sexualized kissing, fondling, masturbation, and digital and/or object penetration of the vagina and/or anus, as well as oral–genital, genital–genital, and anal–genital contact. Noncontact activities include exhibitionism, inappropriate observation of child (eg, while the child is dressing, using the toilet, bathing), the production or viewing of pornography, or involvement of children in prostitution. The sexual activities are imposed on the child and represent an abuse of the caregiver's power over the child. The sequence of activities often progresses from noncontact to contact over a period of time during which the child's trust in the caregiver is misused and betrayed.
@kakali The evaluation for suspected sexual abuse may be complicated and is often not straightforward. Frequently, nonspecific behavioral changes are the presenting symptoms prompting an evaluation and leading the health care provider to consider sexual abuse as a possible diagnosis. These nonspecific behaviors are not diagnostic of sexual maltreatment and may be observed in other situations where the child manifests stress as well. Nonspecific behavior changes that warrant consideration of the possibility of sexual abuse may include (1) sexualized behaviors, (2) phobias, (3) sleep disturbances, (4) changes in appetite, (5) change in or poor school performance, (6) regression to an earlier developmental level, (7) running away, (8) truancy, (9) aggressiveness and acting out behaviors, and/or (10) social withdrawal, sadness, or symptoms of depression.