Child sexual abuse can take place within the family, by a parent, step-parent, sibling or other relative; or outside the home, by a friend, neighbour, child care person, teacher, or stranger. When sexual abuse has occurred, a child can develop a variety of distressing feelings, thoughts and behaviours. No child is psychologically prepared to cope with repeated sexual stimulation. Even a two or three year old, who cannot know that sexual activity is wrong, will develop problems resulting from the inability to cope with the overstimulation. The long-term emotional and psychological damage of sexual abuse is devastating for the child. The problem should be identified, the abuse stopped, and the child should receive professional help.

The child of five or older, who knows and cares for the abuser, becomes trapped between affection or loyalty for the person, and the sense that the sexual activities are terribly wrong. If the child tries to break away from the sexual relationship, the abuser may threaten the child with violence or loss of love. When sexual abuse occurs within the family, the child may fear the anger, jealousy or shame of other family members, or be afraid the family will break up if the secret is told.

A child who is the victim of prolonged sexual abuse usually develops low self-esteem, a feeling of worthlessness and an abnormal or distorted view of sex. The child may become withdrawn and mistrustful of adults, and may become suicidal. Some children who have been sexually abused have difficulty relating to others, except on sexual terms. Some sexually abused children become child abusers or prostitutes, or have other serious problems when they reach adulthood.

Sexually abused children may develop the following: unusual interest in or avoidance of all things of a sexual nature, sleep problems or nightmares, depression or withdrawal from friends and family, seductiveness, statements that their bodies are dirty or damaged, fear that there is something wrong with them in the genital area, refuse to go to school, delinquency/conduct problems, secretiveness, aspects of sexual molestation in drawings, games or fantasies, unusual aggressiveness, or suicidal behavior.

Child sexual abusers can make the child extremely afraid of complaining. Only when special effort helps the child to feel safe, can the child talk freely. If a child says that he or she has been molested, parents should try to remain calm and reassure the child that what happened was not their fault. Parents should seek medical examination and psychiatric consultation. Parents can prevent or lessen the chance of sexual abuse by telling children that if someone tries to touch their body and do things that make them feel funny, say NO to that person and inform them right away, and by teaching children that respect does not mean blind obedience to adults or the baby sitter.