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Child Sexual Abuse: Evaluation and Outcomes

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Evaluation, Diagnosis, and Outcomes of Child Sexual Abuse

Jessica Smith

 Penn State College of Medicine

March 2002


  1. Definition: “Sexual abuse of children refers to sexual behavior between a child and an adult or between two children when one of them is significantly older or uses coercion.  The perpetrator and the victim may be of the same sex of the opposite sex.  The sexual behaviors include touching breasts, buttocks, and genitals whether the victim is dressed or undressed; exhibitionism; fellatio; cunnilingus; and penetration of the vagina or anus with sexual organs or with objects.  Pornographic photography is usually included in the definition of sexual abuse.  It is important to consider developmental factors in assessing whether sexual behaviors between two children is abusive or normative.”5
  2. Epidemiology1: 
  3. Risk Factors4:
  4. Evaluation
  5. Outcomes4 : Psychiatric disorders, dysfunctional behaviors, neurobiological dysregulation
  6. Principles of Psychopathology in child sexual abuse4
  7. DSM-IV Diagnosis4
  8. Treatment4


  1. Gorey, K. and Donald Leslie. (1997). “The prevalence of child sexual abuse: Integrative review adjustment for potential response and measurement biases.” Child Abuse and Neglect. Vol. 21(4): 391-398.
  2. Heger, A., Ticson, L., Velasquez, O., and Bernier, R. (2002). “Children referred for possible sexual abuse: medical findings in 2384 children.” Child Abuse and Neglect. Vol. 26: 645-659.
  3. Kooiman, C.G., Ouwehand, A.W., and ter Kuile, M.M. (2002). “The sexual abuse questionnaire (SPAQ): A screening instrument for adults to assess past and current experiences of abuse. Child Abuse and Neglect. Vol. 26: 939-953.
  4. Putnam, Frank W. (2003) “Ten year research update review: child sexual abuse.” J. Am. Acad. Child Adolesc. Psychiatry. Vol. 42(3): 269-278.
  5. “Practice Parameters for the forensic evaluation of children and adolescents who may have been physically or sexually abused.” AACAP Partial text.
  6. “Guidelines for: The clinical evaluation of child and adolescent sexual abuse.” (2001). www.aacap.org/violence/guide.htm.


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