RCGP Safeguarding toolkit
Part 2A: Identification of abuse and neglect
Sexual abuse
Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts, such as masturbation, kissing, rubbing, and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse. Sexual abuse can take place online, and technology can be used to facilitate offline abuse. Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.
When a child or young person is sexually abused, they're forced, tricked or manipulated into sexual activities. They might not understand that what's happening is abuse or that it's wrong for the abuser to do this to them. They might be afraid to tell someone or behave as though this is normal for them to experience, both are valid for the child to be displaying. Sexual abuse can happen anywhere – and it can happen in person or online.
It's never a child's fault they were sexually abused – it is important to make sure children know this. Knowing the signs of sexual abuse can help give a voice to children.
Research indicates that only one in three children who had been sexually abused by an adult told anyone what was happening. For those abused by another child this was even less, with five out of six not speaking to anyone. This means that the majority of children being sexually abused do not tell anyone during childhood.
There are many barriers to children sharing their experiences of sexual abuse and it isn’t likely that a child will feel able to tell professionals directly what is happening or recognise that what is happening to them is abuse. Instead children may show other emotional, behavioural and physical signs.
There are numerous signs that could indicate a child is being sexually abused. Some of these signs are not specific to sexual abuse, but can be suggestive that a child is experiencing some form of distress which could be related to experience of any type of abuse or other difficult life circumstances.
Some of the signs of sexual abuse are included in the table below.
- Avoiding being alone with or frightened of people or a person they know.
- Language or sexual behaviour you wouldn’t expect them to know.
- Having nightmares or bed-wetting.
- Alcohol or drug misuse.
- Self-harm.
- Changes in eating habits or developing an eating problem.
- Changes in their mood, feeling irritable and angry, or anything out of the ordinary.
- Change in normal behaviour for the child, for example suddenly not attending education or avoiding wanting to go home/running away.
- Bruises.
- Bleeding, discharge, pains or soreness in their genital or anal area.
- Sexually transmitted infections, including in the throat.
- Pain/soreness in throat.
- Pregnancy.
- Difficulty in walking/sitting that is not usual for the child.
- spend a lot more or a lot less time than usual online, texting, gaming or using social media
- seem distant, upset or angry after using the internet or texting
- be secretive about who they're talking to and what they're doing online or on their mobile phone
- behaving as though they have to be online at a certain time, or rushing to get on their phone
- have lots of new phone numbers, texts or email addresses on their mobile phone, laptop or tablet
- expressing the need for money, this may be used if they are being blackmailed.
The Centre of Expertise on Child Sexual Abuse is an amazing resource on preventing and better responding to child sexual abuse. Much of the information in this section of the toolkit is from their resources. They have a number of very useful resources such as:
- Signs and indicators of child sexual abuse template.
- Communicating with children guide.
- Supporting parents and carers.
- Sibling sexual abuse and behaviour.