your questions about mental health services at the
Child Advocacy Center
What is Sexual
and Physical Abuse?
Sexual abuse is any interaction between a child and adult or older child in which the child is used for the sexual stimulation of the perpetrator or an observer. Sexual abuse often involves direct physical contact, touching, kissing, fondling, rubbing, oral sex, or penetration of the vagina or anus. Sometimes a sex offender may obtain gratification by exposing himself/herself to a child, or by observing or filming a child removing his or her clothes. Offenders often do not use physical force, but may use play, deception, treats, or other coercive methods to engage children and maintain their silence.
Physical abuse is any physical act by a caregiver that results in a child been hurt or injured. Usually, physical abuse is not a one-time event, but a pattern of repeated, deliberate acts. Caregivers may not understand that what they are doing is abusive. They may consider it normal punishment that is warranted by the child’s misbehavior.
Abuse affects both boys and girls of all ages from infancy through adolescence. In fact, this is a problem that affects millions of children across all social, ethnic, religious, and cultural groups around the world.
Psychological Impact of Abuse
It is not unusual for a child to develop some post-traumatic stress reactions that will respond to treatment. Others, particularly those who have suffered multiple traumas, may develop post-traumatic stress disorder, depression, and/or anxiety. The Adverse Childhood Experiences study documents that the more traumatic experiences one has, the more likely one is to have problems with substance abuse, depression, anxiety, and some chronic health problems in the long-term. As one child expressed, “ Abuse is like a boomerang—if you don’t deal with it—it can come back to hurt you.” On the other hand, children who have support of an understanding caregiver and effective treatment, CAN recover without long-term effects.
Post-traumatic Stress Reactions
Hyper-arousal: nervous, jumpy, heightened startle response, reacts strongly to any anxiety-producing situation.
Re-experiencing symptoms: relive some aspects of the experience, nightmares, generalized fears, physiological responses to stress.
Avoidance: a child avoids exposure to traumatic reminders, and sometimes avoids thinking about the abuse altogether. Reactions to, and avoidance of, traumatic reminders can generalize into other aspects of a child’s life.
Affect regulation difficulties: difficulty regulating emotions, increased irritability, anger, sadness, withdrawal behaviors, increase in oppositional behaviors and/or tantrums.
Trauma-Related Behaviors in Toddler or School Age Children
In a very young child, you might see traumatic play in which the child may act out running away from a “bad man” over and over again. The play may or may not be specific to the abuse. You may see other signs of stress, an increase in oppositional or withdrawn behaviors, tantrums, or nightmares. The child may talk about his/her body being “hurt” or “dirty.”
How Do I
Know My Child Needs Therapy?
If your child displays any of the signs and symptoms of traumatic stress or if you have any concerns about your child, then you should take him or her for an evaluation. A therapist who has experience working with children who’ve been abused can help you determine whether your child needs help. Some children will not need help at all, but many will need some help. Some children may just need a therapist to provide information so they can understand more about what happened to them. When we evaluate children, we look for symptoms of traumatic stress, depression, and anxiety. We also try to find out if they have any unrealistic beliefs or ideas about the event. It is common for children to blame themselves, or to feel they could have prevented it. It’s important to explore these “distorted” ideas because they can continue to cause problems in a child’s life. We also evaluate for any signs of difficulty in school, social, or family life due to the abuse.