Interviewing the sexually abused child: principles and techniques.

Abstract

The magnitude of child sexual abuse is difficult to estimate because the majority of cases are unrecognized or unreported. The National Center on Child Abuse and Neglect estimates that 170,000 children from birth to 17 years of age were sexually abused in 1982. Other estimates claim that as many as 500,000 children are sexually abused each year in the United States.’ Sexual abuse involves child victims and adult offenders from all socioeconomic, ethnic, and religious backgrounds. Although female victims are reported more often, there are probably equal numbers of male victims. Male victims may go unreported more often because the abuse usually involves a male offender, and the child and family may perceive the experience as homosexual and therefore as a threat to the young male’s masculinity. Sexual abuse refers to any sexual activity between a child and an adult (or any individual significantly older than the child), whether by force or what may appear to be consent. Children, because of their lack of knowledge of the moral, social, physical, and developmental consequences of sexual activity with an adult, are never capable of informed consent. Most often, children are engaged in the sexual activity through persuasion, misrepresentation of morals, threats, bribes, and enticement. Rarely is physical force needed to gain control over the child. Offenders misuse their position as a trusted adult authority figure to gain emotional and physical control over the victim. Children who have been sexually abused may come to the emergency department under a variety of circumstances. Some cases are more readily iden-