Parenting the Sexually Abused Child
This article was prepared by the National
Adoption Information Clearinghouse for parents
adopting a sexually abused child, however the information is
relevant for any parent who finds their child has been abused.
As a prospective adoptive parent, you may have some valid
concerns about sexual abuse. You may wonder what the special
needs are of children who have been sexually abused and whether
you will be able to meet those needs. By acquiring more
knowledge, you will feel more confident in taking on the
challenges and rewards of adopting a child with special needs.
Many parents who have already adopted sexually abused children
feel that their greatest obstacle was lack of information about
sexual abuse in general; about their particular child's history;
and about helpful resources such as support groups, skilled
therapists and sensitive reading materials. This article will
provide you with some basic information about child sexual abuse
as well as some special considerations for parents who adopt
Is Child Sexual Abuse?
Child sexual abuse is any forced or tricked sexual contact by an
adult or older child with a child. Usually the adult or older
child is in a position of power or authority over the child.
Physical force is generally not used, since there is usually a
trusting relationship between the adult or older child and the
child who is abused.
There are various types of sexual activity which may take place.
It can include open mouth kissing, touching, fondling,
manipulation of the genitals, anus or breasts with fingers,
lips, tongue or with an object. It may include intercourse.
Children may not have been touched themselves but may have been
forced to perform sexual acts on an adult or older child.
Sometimes children are forced or tricked into disrobing for
photography or are made to have sexual contact with other
children while adults watch.
Child sexual abuse does not always involve physical touching. It
can include any experience or attitude imposed on a child that
gets in the way of the development of healthy sexual responses
or behaviors. For example, a child may be a victim of
"emotional incest." If a mother tells her son, in
great detail, about her sexual exploits, or if a father promises
his daughter that she will be his life partner when she turns
18, these would be scenarios in which the child could be
considered sexually abused. Siblings who are aware of a brother
or sister's victimization, but are not actually abused
themselves, may also suffer many of the same effects as an
In addition, some children experience ritualistic and/or satanic
abuse. Ken Wooden, founder of the National Coalition for
Children's Justice, defines ritualistic abuse as a bizarre,
systematic continuing abuse which is mentally, physically, and
sexually abusive of children, and for the purpose of implanting
Often Does Child Sexual Abuse Occur?
Estimates are that approximately 1 in 4 girls and 1 in 8 boys
experience sexual abuse in some way before they are 18. Data on
how many of these children live in foster or adoptive homes are
not available. Foster care and adoption social workers are now
saying they believe the percentages of boys and girls in foster
care who have been sexually abused are much higher than in the
general population, perhaps as high as 75%. Many came into
foster care initially because of sexual abuse and others are
children who were re-victimized while in foster care, either by
an older foster child or by an adult.
Behaviors or Signs Might You See in a Child Who Has Been
While no one sign or behavior can be considered absolute proof
that sexual abuse has occurred, you should consider the
possibility of sexual abuse when one or several of these signs
or behaviors are present.
Scratches, bruises, itching, rashes, cuts or injuries,
especially in the genital area
Pregnancy in (young) adolescents
Blood or discharge in bedding or clothes, especially underwear
Aggressive behavior towards younger children
Advanced sexual knowledge for the child's age
Seductive or "sexy" behavior towards adults or peers
Pseudo-mature behavior (for instance, a girl who is eight and
dresses like a 16 year-old, wears makeup and generally acts
"too old for her age," or a young boy who attempts to
be his mother's "man" in every sense of the word)
Regressed behavior (for example, the child who has been toilet
trained starts wetting the bed)
Excessive masturbation, masturbation in public places,
difficulty with being re-focused to another behavior
Poor relationships with peers
Fear of a particular person, place or thing (for example, if the
abuse occurred in the bathroom, the child may show fear in that
Sudden or extreme changes in behavior (for instance, a
previously good student starts having trouble with school work,
a child who was not sad before starts crying frequently or
acting sad, or a formerly cooperative child acts defiantly or is
uncooperative or unusually overly cooperative)
Eating disorders (overeats, undereats)
Additional Behavioral Signs in Pre-teens and Adolescents
Self-mutilation (the child may repeatedly pick at scabs, cut
him/ herself with a razor blade, bite his/her finger or arm,
burn him/ herself with a cigarette)
Threatening or attempting suicide
Using drugs or alcohol
Becoming promiscuous (a child is sexually active without
discrimination, or just has that reputation)
Being prudish (the child avoids any sexuality, does not see him/
herself as a sexual being in any way)
Isolating self or dropping friends
Pre-occupation with death (the child may write poems about
death, may ask a lot of questions about death, such as
"What does it feel like and where do people go?")
Some Additional Behavioral Signs in Children Who Have Been
Sadistic play (for example, mutilation of dolls or small
Pre-occupation with death
Increased agitation on certain dates which represent satanic
high holy days
A constant fear of harm and extreme fear of being alone
All Children Affected Equally by Child Sexual Abuse?
There is a myth that all children who have been sexually abused
are "damaged goods" and that the damage is for life.
In fact, with guidance and support a child who has experienced
sexual abuse can certainly recover and go on to live a happy,
successful life with loving and trusting relationships. However,
there are many factors which influence the extent of the child's
trauma and subsequent healing process. Some of these are:
The age of the child when the abuse began. Children abused very
early in life may carry body or sensory memories of the abuse
but will not have the words to express their rage. One adult
survivor of sexual abuse figured out, with the help of therapy,
that the reason she became sexually stimulated when she heard
and felt a room fan was because a fan had always been on when
she was molested as a child. Children who are abused
pre-pubescently, during the time when their sexuality is
emerging, may carry greater effects of the abuse.
The relationship of the primary perpetrator to the child. A
child's trust of his/her primary caretaker is central to their
relationship. Therefore, when abuse occurs in this context, the
betrayal is intensified.
How long the abuse occurred. The longer the abuse occurred, the
more likely the victim is to feel that he/she should have been
able to stop it and thus he or she feels more
Whether there was violence involved. In most cases where the
abuse included violence or potential violence (that is, the
victim was made to understand that without cooperation there
would be violence) the child will have experienced additional
trauma and therefore damage to his/her development
The social system available to the child at the time of abuse.
The child who had someone to tell about the abuse will suffer
less than the child who had no one to tell. And even in some
cases where the support system is available, the child may
choose not to tell for fear of the consequences. For example,
the child may think, "If I tell my father that my brother
is abusing me and he believes me, then my father may do
something drastic like hurt my brother or send me to jail."
When children reveal their secrets, the response of adults will
vary. It is important to stay as calm as possible so as not to
further traumatize the child. The rage you may feel is natural,
but the child may perceive that it is directed at him or her.
The child needs a safe, supportive atmosphere in which to talk.
Children also benefit enormously from hearing that this has
happened to other children, male and female.
Ego development of the child at the time of the abuse. If the
child has a firmly established concept of his or her sexual
identity, the abuse will have less impact. Children who are
abused by a same sex perpetrator often have deeply felt fears
about whether this means they are homosexual. One way in which
parents can help allay this fear is to explain that our bodies
have many nerve endings. If these nerve endings are stimulated,
they will react. For example, if a bright light hits your eyes,
your first response will be to blink or to shade them from the
light. A simple concept to use with children is that of
tickling. If a child is ticklish, he or she will laugh when
tickled. It does not matter whether the person tickling is male
or female; the child is reacting to the experience.
If the perpetrator is of the opposite sex, questions of identity
may also come into play. For example a boy who is abused by a
woman and is not aroused, may doubt his masculinity. If he is
aroused physically, but not emotionally, he may equally doubt
his masculinity. The same identity issues for girls may hold
If the child has a positive self-concept, that is, if he or she
feels valued at the time the abuse occurred, there will be fewer
repercussions. In fact, children with good self-esteem are more
likely to feel they can say no and/or tell someone about the
Boys Who Are Abused Have Special Issues?
Boys who are sexually abused face some additional problems
because of persistent myths in our society. Males are rarely
viewed as fitting the victim role. When boys get hurt, they are
often told "act like a man," "don't be a
sissy," "control your emotions." The message to
boys is to stand on their own two feet and to take care of
themselves. Under these circumstances, a male victim is less
likely to tell and therefore cannot begin a healing process.
This increases the chances that he may take on the role of the
victimizer in an attempt to master his own experience.
A further complication for boys is that the media portray boys
who have sexual experiences with older women as going through a
"rite of passage" rather than as victims of sexual
exploitation. Movies such as "Summer of '42" and
"Get Out Your Handkerchiefs" are prime examples of
About Juvenile Sex Offenders?
Some children who have been sexually abused go on to abuse other
children. While this is a serious problem, the exact percentage
of sexual abuse victims who become abusers is not known.
It is important to realize that these children are victims as
well as offenders and need to receive counseling from qualified
therapists who understand both aspects of the problem. The
therapist must be able to be empathic and understanding of the
"victim" but confrontational with the
Victimizers have triggers that precede their behavior. For
example, a child may abuse another child when he or she finds
him or herself in a vulnerable or stressful situation. Sometimes
this is because he or she lacks control or power. This may be
when the child gets called a name at school or believes he or
she is being punished unfairly. The therapist must help the
child to not only recognize his/her own individual triggers but
also, to understand the consequences of acting out these
In other instances, past experiences have left the child overly
sexually stimulated. The child needs education and suggestions
of alternative positive behaviors to replace the sexually
Do Parents Need to Know When Adopting a Child Who Has
Experienced Sexual Abuse?
Parents who adopt children who have experienced sexual abuse
need the wisdom of Solomon, the strength of Hercules and the
patience of Mother Theresa. If you fall short in any of these
areas, do not despair. You are in good company. Perhaps, more
important is your desire to help a young person grow into a
healthy, trusting adult. This is a privilege and one which
brings real satisfaction to those who have adopted.
What Do Parents Need to be Aware of About Themselves?
It is very important for you as prospective adoptive parents to
be honest with yourselves and with your adoption worker about a
number of things:
Is there a history of sexual abuse in either the mother or
father's past? If there is, how were those experiences resolved?
Did you decide to "just forget about it" and chalk it
up as one of those things that just happened? Or did you get
help, from your parents, a teacher, a minister, a therapist or
someone who could help you work through your feelings about
having been abused? Parents with unresolved abuse experiences in
their history may be at greater risk for either abusing the
child again, or for keeping too much physical and emotional
distance, for fear of abusing the child. Parent/Survivors in
local support groups regularly address these phenomena.
How comfortable are you as prospective parents, with your own
sexuality and with your sexual relationship(s)? Can you talk
comfortably about sex? Do you give yourselves permission to
acknowledge your own sexual feelings, thoughts, fantasies and
fears? Do you have a well- established relationship which allows
for direct and open communication? A child who has been sexually
abused may need to talk about what happened to him or her. The
child's behavior may be seductive or blatantly sexual at times.
A parent must be able to deal with this.
In addition, there are some other issues that are important for
adoptive parents to consider. They are:
A willingness to "be different," or experience
embarrassing situations, at least for a while. Children who have
been sexually abused may behave toward their adoptive parents in
ways which are different than non-abused children. For example,
Lisa, age 8, began shouting loudly, in public places like the
supermarket, that her father had abused her. In fact, it was her
biological father and not her adoptive father who had abused
her, but the strangers in the supermarket obviously did not make
An ability to wait for the child's commitment while not putting
off making your own. An abused child is often untrusting and
tied to the past. A child may repeatedly test your commitment to
him or her. She or he may feel that if you really and truly saw
her or him as they are, with all the scars, that you would not
really want him or her.
Many parents have the hope that their love will immediately ease
the mistrust their child has of the world and all its adults.
What one adoptive parent learned was "love has a different
meaning for my daughter. To her, it's simply a deal: You do this
for me and I'll do that for you. What a shock to discover that
love is not enough." A true, trusting love based on more
than just bargaining can come to pass with a sexually abused
child, but it will take time, consistency and patience.
A sense of humor. As with most situations in life, a good hearty
Do Parents Need to be Aware of About Their Child Who Has Been
Children who have experienced sexual abuse will probably need
help in learning new behaviors and ways of relating. Some of the
behaviors and emotions you may see expressed by your child are:
Withdrawal: Overwhelmed by the feelings she or he has
experienced, the child may retreat physically or emotionally. As
a parent, you may feel confused or resentful. It can be very
isolating to have someone close to you tune you out. Unless you
think there is danger of physical harm to the child or others,
the best course of action is to reassure the child that you care
and that you will provide the limits and boundaries that your
Mood Swings: A moment's tenderness can quickly explode into
anger. The child may be full of confidence one day, only to sink
into despair the next. It is difficult to see someone you care
about in pain, but you cannot control the feelings of someone
else. Point out that these mood swings are occurring. Do not
allow yourself to be unfairly blamed. Try to stay calm and
accepting that sometimes the child does not even know when or
why his/her mood swings are occurring. Crying jags can be part
of these mood swings. Accept that it is beyond your power to
make it all better. Sometimes when a parent tries to rescue a
child from his or her pain, he or she ends up feeling guilty,
resentful and frustrated when it does not work. When a
caterpillar is emerging from the cocoon, it must have a period
of time to build strength in its wings. If the butterfly is
released from its cocoon before its time, its strength will be
diminished and it will not be able to survive on its own.
Anger: The first target for the child's angry feelings may be
the person he or she has come to feel the safest with -- you.
When a person's angry feelings are completely out of proportion
to what is going on, it probably has nothing to do with the
present situation. Something in the present is triggering and
re-stimulating old memories and feelings. The safety of the
current situation allows these feelings to be expressed.
Recognize that this is actually a sign of health, but do not
accept unacceptable behavior; and never expose yourself to
You can assure your child that you are willing to work out the
problem at hand, but in a safe and supportive manner. For
example, a child may be offered a pillow to beat on in order to
vent his or her anger.
Unreasonable Demands: Some children learn the survival skills of
manipulation and control. They may feel entitled to make
unreasonable demands for time, money or material goods. It is
important not to play into or get trapped by these demands. You
need to maintain a healthy relationship with your child. This
will help the child reduce these demands.
Sexual Behaviors: Since the abuse was acted out sexually, the
child needs help in sorting out the meaning of abuse, sex, love,
caring and intimacy. Some children may try to demand sexual
activity, while others may lose interest in any form of
closeness. Think of all the needs that are met through sex:
intimacy, touch, validation, companionship, affection, love,
release, nurturance. Children need to be re-taught ways that
these needs can be met that are not sexual.
A child who has been sexually abused may feel:
I am worthless and bad
No person could care for me without a sexual relationship
I am "damaged goods" (no one will want me again)
I must have been responsible for the sexual abuse because
it sometimes felt good physically
it went on so long
I never said "no"
I really wasn't forced into it
I never told anyone
I hate my body
I am uncomfortable with being touched because it reminds me of
I think I was abused but sometimes I think I must have imagined
I blame my (biological) mother or father for not protecting me
but I can't talk about it; I don't want to hurt him/her
A child who has been sexually abused will benefit from clear
guidelines that set the rules both in the home and outside.
These kinds of rules will help provide the structure, comfort
and security which all children need to grow into healthy
adults. Experts in the field of adoption and child sexual abuse
believe these guidelines are particularly important during the
first year after placement, when the child is working hard to
establish new relationships with his/her adoptive family and to
The following guidelines address topics with specific reference
to children who have been sexually abused.
Privacy: Everyone has a right to privacy. Children should
be taught to knock when a door is closed and adults need to role
model the same behavior.
Bedrooms and Bathrooms: These two locations are often
prime stimuli for children who have been sexually abused, since
abuse commonly occurs in these rooms.
By the time children enter first grade, caution should be used
about children of the opposite sex sharing bedrooms or bath
It is not advisable to bring a child who has been sexually
abused into your bed. Cuddling may be overstimulating and
misinterpreted. A safer place to cuddle may be the living room
Touching: No one should touch another person without
permission. A person's private parts (the area covered by a
bathing suit) should not be touched except during a medical
examination or, in the case of young children, if they need help
with bathing or toileting.
Clothing: It is a good idea for family members to be
conscious of what they wear outside of the bedroom. Seeing
others in their underclothes or pajamas may be overstimulating
to a child who has been sexually abused.
Saying "No": Children need to learn that it is
their right to assertively say "no" when someone
touches them in a way they do not like. Help them to practice
Sex Education: All children, including the child who has been
sexually abused, need basic information about how they develop
sexually. They also will benefit from an atmosphere in which it
is OK to talk about sex. Appropriate words for body parts, such
as penis, vagina, breasts and buttocks, will give the child the
words to describe what happened to him or her. Suggestive or
obscene language is sometimes a trigger for old feelings for a
child who was sexually abused, and should not be allowed.
No "Secrets": Make it clear that no secret
games, particularly with adults, are allowed. Tell children if
an adult suggests such a game, they should tell you immediately.
Being Alone With One Other Person: If your child is
behaving seductively, aggressively or in a sexually acting out
manner, these are high risk situations. During those times, it
is advisable not to put yourself in the vulnerable position of
being accused of abuse. In addition, other children may be in
jeopardy of being abused. Therefore, whenever possible during
these high risk situations, try not to be alone with your child
or allow him/her to be alone with only one other child.
Wrestling and Tickling: As common and normal as these
childhood behaviors are, they are often tinged with sexual
overtones. They can put the weaker child in an overpowered and
uncomfortable or humiliating position. Keep tickling and
wrestling to a minimum.
Behaviors and Feelings: Help children differentiate
between feelings and behaviors. It is normal to have all kinds
of feelings, including sexual feelings. However, everyone does
not always act on all the feelings he or she has. Everyone has
choices about which feelings he or she acts on, and everyone
(except very young children) must take responsibility for his or
her own behavior.
Our Child and Family Need Professional Help?
It is very likely that at some time or other parents of a child
who was sexually abused will need professional help and support
for themselves and their child. The type of therapy that will be
the most helpful, that is, individual, couple or family therapy,
will depend on a family's particular situation. When a child is
being seen in individual therapy, it is important that the
parents, who have the primary responsibility for the child, be
in close contact with the therapist, or included in the therapy.
Try to choose a therapist who is knowledgeable about both sexual
abuse and adoption issues and with whom you feel comfortable. If
parents are not familiar with the therapy resources in their
area, they may want to ask their adoption agency or local mental
health center for a referral. There are also some resources
listed at the end of this paper which may be helpful with
referrals to therapists who are knowledgeable about sexual
Support groups for adoptive parents or sexually abused children
and support groups for victims/survivors are another helpful
resource. Adoptive parents who have had a chance to talk with
others who understand the experience of parenting a sexually
abused child say that this kind of sharing is very useful.
Dr.Nicholas Groth, a leading psychologist in the field of sexual
abuse, along with many children and adult victims/survivors, say
that groups for children can be most effective in the healing
process. The opportunity to talk and share with other children
who have also experienced sexual abuse reduces a child's sense
of isolation and belief that he/she is the only one to whom this
has ever happened.
the Healing Ever Completed?
Recovery from child sexual abuse is an on-going process. As this
process unfolds, the child will ideally move from victim to
survivor to thriver. Developmental stages, particularly
adolescence and young adulthood, may trigger old feelings about
the abuse. For example, the time when an adolescent's body
begins to develop physically, or when he or she marries, or
becomes a parent may restimulate old feelings and memories.
As discussed earlier, so many factors can influence the extent
of the damage to the abused child. While adoptive parents cannot
erase what happened to their child earlier in his/her life, you
have a wonderful opportunity to provide your child with new,
healthier experiences. Those who have made the commitment to
parenting a sexually abused child say that the rewards of
helping a child grow into a healthy, vibrant adult are very
This paper was written for the National Adoption Information
Clearinghouse by Rosemary Narimanian of Philly Kids Play It Safe
and Julie Marks of the National Adoption Center in 1990.
Freeman, Lory. It's My Body. Parenting Press, Inc., Seattle, WA,
Gil, Eliana. I Told My Secret: A Book for Kids Who Were Abused.
Launch Press, California, 1986.
Hindman, Jan. A Very Touching Book...for Little People and for
Big People. McClure-Hindman Associates, Durkee, OR, 1985.
Satullo, J. It Happens to Boys Too. RCC Berkshire Press, 1989.
Sweet, Phyllis. Something Happened to Me. Mother Courage Press,
Racine, WI, 1981.
Sweet, Phyllis. Alice Doesn't Babysit Anymore. McGovern and
Mulbacker, Oregon, 1985.
For Parents and Professionals
Bass, Ellen and Davis, Laura. The Courage to Heal, A Guide for
Women Survivors of Child Sexual Abuse. Harper & Row, New
Father Flanagan's Boys Home. Sexually Abused Children in Foster
Care. Boys Town, Nebraska. May be ordered by contacting Father
Flanagan's Boy's Home, Boys Town Center, Family Based Programs,
Boys Town, NE, 68010, (402) 498-1310.
Gil, Eliana. Outgrowing the Pain. Launch Press, California,
Gil, Eliana. Children Who Molest: A Guide for Parents of Young
Sex Offenders. Launch Press, California, 1987.
Lew, Mike. Victims No Longer: Men Recovering From Incest and
Other Sexual Child Abuse. Nevraumont Publishing Company, New
Maltz, Wendy and Holman, Beverly. Incest and Sexuality.
Lexington Books, Lexington, MA, 1986.
McFadden, Emily Jean. Fostering the Child Who Has Been Sexually
Abused. Eastern Michigan University, Ypsilanti, MI, 1986.
McFarlane, Kee and Cunningham, Carolyn. Steps to Healthy
Touching: A Treatment Workbook for Kids 5-12 Who Have Problems
With Sexually Inappropriate Behavior. Kidsrights, Mount Dora,
Parents Anonymous of Delaware. All In My Family. Parents
Anonymous, DE, 1987.
Burgess, Ann; Hartman, Carol; McCormick, Arlene; and Janus, Mark
David. Adolescent Runaways, Causes and Consequences. Lexington
Books, Lexington, MA, 1987.
Finkelhur, David. Child Sexual Abuse, New Theory & Research.
The Free Press, New York, 1984.
James, Beverly. Treating Traumatized Children. Lexington Books,
Lexington, MA, 1989.
James, Beverly and Nasjleti, Maria. Treating Sexually Abused
Children and Their Families. Consulting Psychologists Press,
Inc., Palo Alto, CA, 1983.
MacFarlane, Kee and Waterman, Jill. Sexual Abuse of Young
Children. The Guildford Press, New York, 1986.
Sgroi, Suzanne. Handbook of Clinical Intervention in Child
Sexual Abuse. Lexington Books, Lexington, MA, 1988.
The National Resource Center on Child Sexual Abuse provides
information, resources and technical assistance to organizations
and professionals on child sexual abuse. It publishes the
"Round Table" Magazine and offers training for
professionals. It also maintains lists of treatment programs for
victims in various parts of the country. Write to the Center at
106 Lincoln Street, Huntsville, AL 35801, or call (205) 533-KIDS
The National Clearinghouse on Child Abuse and Neglect collects
and disseminates information on child sexual abuse. It will do
research upon request on a particular subject at a very low
cost. It also has general publications which you can request.
Write to the Clearinghouse at 330 C Street, SW, Washington, DC
20447 or call at 1-800-394- 3366. Website:
The National Adoption Information Clearinghouse maintains a list
of adoption experts who have expertise in many areas of
adoption, including the adoption of children who have
experienced sexual abuse. Contact the Clearinghouse for
referrals to these experts by writing the Clearinghouse at 330 C
Street, SW, Washington, D.C. 20447 or by calling 703-352-3488 or
The C. Henry Kempe National Center for the Prevention and
Treatment of Child Abuse and Neglect provides training,
consultation, research and program development on all forms of
abuse and neglect. Write to the Center at 1205 Oneida Street,
Denver, CO 80220, or call at 303-321-3963.
The National Adolescent Perpetrator Network is housed at the C.
Henry Kempe Center (see above). It can provide professionals and
parents with a bibliography on juvenile sex offenders and with
referrals to treatment programs for adolescent offenders. It
also operates a Perpetration Prevention Project which provides
training to professionals and paraprofessionals on
"Understanding the Sexual Behavior of Children." Write
to the Network at 1205 Oneida Street, Denver, CO 80220, or call
The National Runaway Switchboard is a 24 hour crisis line for
runaway youth and children considering running away. The
Switchboard offers limited problem solving in a confidential,
non- judgmental manner. It also offers a message service and a
referral service for youth in need of shelter. Call
This material may be reproduced and distributed
without permission; however, appropriate citation must be given
to the National
Adoption Information Clearinghouse.
you are going to work with ritual abuse survivors, you
must also get educated if you want to be effective. And
you must learn to be humble. Trauma survivors do not need
to be around ignorant, modern-day Pharisees. Survivors in
pain need people who will connect with them on an
emotional level, get right down in there where they are,
and listen. --Kathleen Sullivan