The paediatrician and the sexually abused child

Sexual abuse is an aspect of cruelty to children which merits greater scientific attention. It has potential for damaging the mental health of the victim and intergenerational cycles of this behaviour pattern may develop. The paediatrician is in a position to detect children at risk and may be able to intervene. Three types of sexual abuse are described (i) single sexual attacks which may be accompanied by physical violence: (ii) sexual exploitation of children for financial gain, and (iii) longstanding sexual relationships, generally between girls and father figures; these are far the most common. Although it is hard to separate the effects of premature sexual experience from other adverse environmental influences. the child victim of longstanding sexual abuse emerges immature, with considerable confusion as to her role in the family, and with constricted personality development. Her primary motivation is attention seeking, and she adopts sexual activity with an adult as a means of survival in often deplorable conditions. The sensitivity of management following the assault being made public is an important factor in determining eventual adjustment.