One of the mails I received from a patient’s sister –

Please Help. I am in Panic!

“I have a 4 yr old daughter. I have to leave her home with our maid. Yesterday, I felt she was kissing my baby a little too much (more than one would expect a maid to do). Is it possible that even women can abuse a girl child?”

Pl help. I am in panic.

XYZ – A distressed mother

CSA (Child Sexual Abuse) is neither age nor gender specific. Sexual abuse is said to have occurred when an older or more knowledgeable child or an adult uses a child for own sexual pleasure.

Even at the risk of turning paranoid, we parents must face the possibility that every child is vulnerable to sexual abuse.

You must realize that some(any)one may hurt or take advantage of your child.

We always wonder ‘My child is smart. How can my child give in?’

Well, the abuser is smart and to top it, has an agenda.

Few facts:

  • CSA involves tricking, bribing, threatening or forcing a child into sexual awareness (yes, even this is CSA) or activity.
  • Use of force or pressure is generally the last resort of an abuser as she/he is, after all, scared of being caught.
  • CSA is linear and progressive – it always begins gradually and increases over time. Since children are either dependent on or trust the abuser, physical force is rarely necessary or applied to engage a child in sexual activity.
  • The basic emotional need of a child is to gain love and approval of those close. Then, a child is trained not to question authority and made to believe that adults are always right (mostly by us parents by imposing our decisions, albeit innocently). The smart abuser takes advantage of these vulnerabilities in children.

The Billion Rupee question arises – “How to know/suspect that my child is under threat or is being abused?”

Most children will either never tell (as the abuser has tricked them into secrecy) or it is too late by the time they decide to tell – the reason for telling a parent is when either the pain or pleasure is too much to take – and in both scenarios, it is too late!

It is upto us, intelligent adults to be on the look out for behavior signs of abuse, which would at best be subtle as physical evidence of abuse is rare. Unfortunately, there is no single behavior alteration that can alone determine that a child has been sexually abused.

What to look for?

The following are some of the changes that may occur in a child who has been abused:

  • Noticeable, new fear of a person (even a parent/grand parent) or certain place (a particular room)
  • Reappearance of stammering, bed-wetting or loss of bowel control
  • Constipation, or refusal to go to toilet
  • Vague physical complaints – headache, giddiness (which are very uncommon in children)
  • Withdrawal from family, friends or usual activities
  • Changes in sleep pattern; waking up screaming due to dreams/nightmares
  • Guarded response from the child when asked if he/she was touched by someone

In older children

  • Sudden increased awareness of genitals
  • Child drawing sexual acts
  • Questions about sexual activity that are beyond his/her development

Not to forget – A child, though scared and sworn to secrecy does give hints, indirect comments or even may make an open statement (mostly about being touched as a child is also wary of sharing the details worried that he/she may not be believed) about the abuse.

Most of the parents in their rat race and / or their MAJBOORI of having to depend on someone ignore that….

And, if you do suspect that your child may be a victim, don’t panic – contact a child psychologist through your family doctor/paediatrician and let the problem be handled professionally. Many a parent have involved the abuser in learning/confirming the details as they ‘thought’ child is very close to him/her…

More info for those interested …

Sigmund Freud’s daughter Anna Freud describes child sexual abuse as the worst assault on the normal development of a child. It is profoundly disorienting and destructive for the child. The child has to deal with a degree of stimulation far beyond his/her capacity. The child gets confused about the appropriate use of power and his own role in the family. Such children have a poor self image and often appear pseudo-mature. They tend to be over-seductive but lack the age-appropriate social skills. They tend to be distrustful and hence have few friends. It may progress to the expression of hostility or depression with suicidal ideation. A child victim may show one or more of the following symptoms – Anxiety, sleep disturbances, psychosomatic disorders, anorexia, regressive symptoms such as thumb sucking, bed-wetting and nail-biting, school phobia or a refusal to go home from school, male avoidance, or a full blown post traumatic Stress Disorder, if the trauma was severe.

Dr Chander Asrani, father to three daughters and grand father to one, is a post graduate in Family Medicine. He has over 35 years in clinical practice, launched www.growingwell.com in 2000 and since then has been writing on various subjects. Know more about him at about.me/drasrani.