Find a doctor
Programs and services
Pregnancy and beyond » CPR and first aid » Doc Talk » Kids/parents » Support groups » Women's Health Center » Professional education »Classes and events
Visiting hours » Parking » Privacy statement » Joint Commission » Recommended links » Release of information »Patient/visitor information
Request an appointment » Request a prescription » Pay your bill » Send a gift » Send a card » Medical library login » Recommended links »Online services About Sanford Health Health information
Sanford Health Dakota Children's Advocacy Center:
Child sexual abuse overview
Child sexual abuse is a national epidemic. It affects boys and girls of all ages. In fact, this is a problem that directly affects millions of children around the world. Child sexual abuse is not rare. There is an estimated 39 million survivors of childhood sexual abuse in America today, and based on prevalence data from adults, about 500,000 children are sexually abused each year in the US. In contrast, each year in the United States, there are 12,400 new cases of childhood cancer diagnosed and 18,000 new cases of juvenile diabetes diagnosed. It also affects more children than those diagnosed with asthma or ADHD.
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 use for the sexual stimulation of the perpetrator or an observer. Sexual abuse can include:
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. Children can be sexually abused by another child or adolescent. 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). 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.
Disclosure can be a scary and difficult process for children. Some children who have been sexually abused may take weeks, months or even years to fully reveal what was done to them. Many children never tell anyone about the abuse. In general:
Disclosure is often a difficult process for children. It is rarely a one-time event in which an interviewer sits down with a child and the child tells everything. Children often tell their stories over a period of time and some never fully tell what happened. Delayed disclosures are more common then not. Many children will never tell. Reasons many children don’t disclose include:
Additionally, to most children telling means something very different then it does to adults. Children will say “Uncle Joe hurt me” and will assume adults know what they are talking about and will react to keep them safe. They don’t understand or comprehend why adults would need more information.
What do I do if a child discloses?
Recantation is common among children who disclose sexual abuse; approximately 23 percent of children who disclose sexual abuse later recant. Studies show that most children who recant are telling the truth when they originally disclose. Recantation is largely a result of familial adult influences rather than a result of false allegations. Children are more likely to recant when they are younger, abused by a parent figure and who lacked support from the non-offending caregiver. Interestingly, children who were placed in foster care immediately following the disclosure of sexual abuse were slightly less likely to recant then those children who remained with family members. Finally, when looking at reaffirmation rates, the esearchers noted that 48.3 percent of the children who recanted their statements of sexual abuse eventually reaffirmed at least some part of those statements.
When deliberate false allegations are made, they appear more likely to come from adults than from children. False allegations made by children range in studies between 0.05 percent and 5 percent. Risk situations for adults making false allegations include divorce or custody disputes and adults with mental health problems. Multiple studies reflect much lower rates of false reports of abuse during custody and parenting time disputes than is commonly believed. Less than 2 percent of contested cases involve allegations. A study looking of 7,600 cases looked at all forms of abuse and neglect. Of that 7,600, they found only 4 percent to be intentionally false. False reports were made by the following:
In divorce and custody situations, false allegations were higher (3 percent vs. 12 percent). Non-custodial parents made 43 percent of intentionally false allegation. False allegations for neglect were far more common than abuse.
In the very small number of cases in which children make false allegations, they are likely to be adolescents, children with mental health problems and children making false allegation to get themselves out of difficult situations. Very young children may also be the source of fictitious reports, but these usually derive from inappropriate questioning techniques. However, research indicates that children’s failure to report actual sexual abuse constitutes a greater challenge for professionals than false allegations of sexual abuse.
Children with no emotional reaction
Often there are times when you will encounter children who have been abused and they are emotionally upset, angry about the abuse or show extreme embarrassment. This will most often occur with children who are abused by strangers or when the abuse is a one-time incident. Children who are abused by someone they know and/or are victims of chronic abuse may suffer from depression and thus present with no emotion or a matter-of-fact stance. Sometimes it can be difficult to believe that the incident occurred, especially violent abuse, when the child’s disclosure does not involve any emotion. The fact that the child may be depressed should be taken into account when making the assessment of the child’s statements.