NCJ Number
75579
Journal
Pediatrics Volume: 62 Issue: 3 Dated: (September 1978) Pages: 382-389
Date Published
1978
Length
8 pages
Annotation
A physician discusses the symptoms and treatment of sexually abused children and adolescents, with particular attention to incest.
Abstract
Although pediatricians are insufficiently aware of the frequency of child sexual abuse, it appears to be increasing and may be as common as physical abuse. Few empirical studies have been conducted in this area, and pediatricians tend to ascribe children's complaints of incest to fantasy. Furthermore, underreporting is massive because of family collusion and fear of public censure. Pedophilia, violent molestation and rape, and incest are defined and illustrated by several case histories. In pedophilia, the child tends to be between 2 years old and early adolescence, while the median age for incestuous behavior has been between 9 and 10 years. Males under 30 usually commit violent sexual offenses against children, but father-daughter incest often involves middle-aged men between 30 and 50. In a child under 5 years, aggressive sexual abuse results in fear states, night terrors, and regressive developmental behavior. The school age child may suddenly exhibit anxieties, fear, depression, insomnia, hysteria, weight loss or gain, school failure truancy, or running away. Symptoms of sexual abuse in adolescents include serious rebellion, delinquency, loss of self-esteem, prostitution, depression, and social isolation. The criminal justice system can be used to initiate treatment when professionals feel that rehabilitation is a realistic goal. Pedophilia can be controlled, but there is no certain cure for the aggressive sociopath who engages in violent sexual offenses. Families can be reunited after incest if both parents cooperate, but in many cases children are better served by placement in a foster or group home. A single sexual molestation by a stranger appears to be harmless to normal children living with secure and reassuring parents. All victims of violent molestation and rape, however, need sensitive care from experienced medical personnel. Incest occurring before adolescence and then stopped causes less havoc than incest during adolescence, with the exception of very young girls who have been trained to be sexual objects. Incest is ruinous for boys, but can be overcome with or without help by many girls. Child victims of sexual abuse will initially tell a physician about nonspecific complaints and should then be encouraged to discuss more serious underlying problems. Early and decisive intervention, rescue, and supportive therapy work well for sexually abused children, even if the family is not reunited.