Child Sexual Abuse and Neglect (S2:E10)

As primary care pediatricians, it's our job to make sure kids understand how to keep their bodies safe. This is particularly challenging when children are regularly exposed to hyper-sexualized messages. Further complicating matters, it's important to remember that sexualized behaviors are a normal part of childhood development. Pediatric providers must also get to know new families, which could include sensitive conversations about the sexual abuse history of the child's parents.

Listen to experts on pediatric abuse discuss the sensitive topic of child sexual abuse

In today's episode of Charting Pediatrics, Andy Sirotnak, MD, Director of the Child Protection Team and pediatric nurse practitioner Denise Abdoo, PhD, discuss adolescent and child sexual abuse.

Navigating the topic of child sexual abuse is difficult and this patient population necessitates a delicate approach. If the child does not disclose an event, the behaviors a provider needs to monitor vary based on age. For example, school truancy, running away from home and risky sexual behaviors outside of development norms could all be cause for concern. These factors and others all influence how pediatricians approach cases of child sexual abuse.

The conversation explores indicators of sexual abuse, best practices for normalizing conversations with children and parents, key considerations for child sexual abuse prevention, how to care for these young patients and more. Perhaps most important, our experts emphasize the importance of using the right language and listening calmly before responding.

In this episode, our experts explore:

• How providers can normalize conversations around child sexual abuse with patients and families
• When concerns about child sexual abuse most commonly arise
• The most common indicators, symptoms and signs of sexual abuse in children
• Why it is critical to teach children the difference between good touch and bad touch, plus why they shouldn't share photos of their bodies or keep secrets
• What a pediatrician should do when a parent calls with concerns of possible child sexual abuse
• The key components of a sexual abuse exam and the focus on external genitalia
• The bathing suit concept for talking to children about private parts
• The importance of building the family story and why having the parents' history is crucial for treating patients of childhood sexual abuse
• The role of mental health issues in the spectrum of child sexual abuse
• Recommended follow-up care and resources to help families through child sexual abuse

Resources for providers and parents on child sexual abuse

To best support children and their families, Dr. Sirotnak recommends physicians become familiar with local child advocacy centers and victim assistance programs, use local experts in their communities and call other pediatricians for insight or resources. Online resources that pediatric providers may find useful include:

• National Child Traumatic Stress Network
• International Society for the Prevention of Child Abuse & Neglect
• Child abuse and neglect resources from the American Academy of Pediatrics (AAP)
• The Resilience Project
• Council on Child Abuse and Neglect
• The Kempe Center

Child sexual abuse prevention and treatment at Children's Colorado

Our pediatric experts are committed to responding to, treating and preventing all forms of child abuse and neglect. Children's Colorado offers the only hospital-based multidisciplinary child abuse program in Colorado. Our Child Protection team's mission is to offer comprehensive, multidisciplinary assessment, treatment and referral services for children and adolescents who may have been physically or sexually abused or neglected. Refer a patient to Children's Colorado.