4 Misunderstood Signs of Child Abuse: A Sexual Assault Nurse Speaks Up

4 Misunderstood Signs of Child Abuse: A Sexual Assault Nurse Speaks Up

People naturally want to see evidence of damage done from an accident or a crime. Whether it’s the smashed front end of a car from a wreck, or a bruised eye after an argument, we want to see the wound, the stitches, the blood. We want proof. 

We are socialized to believe that we have to see an injury to know it happened.  

Herein lies the problem with proving sexual assault. About 95% of the time, there are no visible injuries. Proving sexual assault from physical evidence is incredibly difficult. 

Parents, professionals and anyone working with children need to understand four common myths about evidence of child abuse. Being abused is traumatic, and sometimes adults can make the experience even more difficult when they doubt a child because they don’t see the signs that they expected.

1. Why we can’t expect physical evidence of abuse

It’s hard for people to grasp the concept that a child could be assaulted, but have no visible injuries.

Let me start off by saying, you’ve probably been taught incorrectly about female anatomy your whole life. Entire cultures have practices and beliefs strongly tied to the female hymen that are based on myths, fear, and control. 

To set the record straight, females do have a hymen, but there is no membrane, skin covering, or “cherry” blocking the entrance of the vagina. Instead, a hymen is a stretchy, open ring of tissue that leads to the entrance of the vagina. The hymen is open from the day a female is born. It stretches a huge amount and can start healing within hours if injury does occur. 

Since the hymen is already open, elastic, and already healing by the time an examiner sees a patient for sexual assault, there are typically no visible injuries. There is no bruising, bleeding, or a “torn hymen” to be assessed. 

Another complicating factor is that most perpetrators do not sexually assault children in a way that will leave a visible injury. They don’t want to raise suspicion, and they want repeated access to that child. So most of the time they do not violently injure their victims.  

A child having a “normal” genital exam doesn’t mean that he or she wasn’t sexually assaulted. 

2. What about DNA?

If a child doesn’t have injuries, how else can we prove he or she was sexually assaulted? DNA.

Finding a perpetrator’s DNA on a child’s body or genitals can be hugely helpful in corroborating a disclosure of sexual assault. 

However, this is very difficult with children because often a lot of time lapses before an exam. Disclosing abuse is a process. On average, most children do not speak up until 2 years after an assault. Most perpetrators groom their victims over time, and it can be difficult for children to have the understanding or language to name their abuse.  

Most pediatric forensic programs won’t swab a patient for DNA if it’s more than 72 hours after the assault. It’s highly unlikely any DNA will still be on a patient’s body after that time frame. Studies with children show that typically 24 hours after an assault, the only DNA recovered is on clothing. 

Imagine that a 3-year-old discloses abuse to her mom, but she’s too young to understand time frames. It’s a guessing game of when she was assaulted. By the time she arrives for evidence collection, it’s likely there isn’t any DNA left. Semen can stay in the cervix for much longer than 72 hours, but speculums are not used on pre-pubescent children, as they are extremely painful prior to puberty. For most children, DNA is inadvertently washed off, sweated off, or wiped off before they ever speak up about their abuse. 

Because of this, unfortunately DNA is not always available as evidence.

Prepare your young kids to be safe with Good Pictures Bad Pictures Jr: A Simple Plan to Protect Young Minds CLICK HERE to learn how to protect kids ages 3-6 from the dangers of pornography.

3. Consistent reports are rare – why we need to believe a child’s disclosure

What evidence should be accepted?

The most important consideration and best proof is a child’s disclosure of abuse. 

That means we have to believe and act when a child says he or she has been assaulted. Too many people are quick to doubt a child’s disclosure, or will even call the child an outright liar. 

The reality is that children do tell the truth about abuse. Research shows that only a tiny percentage of children lie about abuse, and at times it’s due to coercion from adults or caregivers. Most children under-report their abuse, and only tell a small portion of what happened. 

Many kids try to gauge if their vulnerable information will be believed, or if they will be shamed into silence. Especially when the abuser was a family member or someone they know. Will their parents be willing to listen? The pressure to be silent is so deep, and when parents are upset or don’t believe the child, the child may change their story to protect themselves. Some studies show that over 90% of children who recant their abuse later say it was indeed true.

 Sexual assault is traumatic. Because of that, memories are stored differently inside the brain. This means timelines, disclosures, and stories may not always add up.  That doesn’t discount a disclosure. Rather, it proves the event was indeed traumatic to the brain. 

The vast majority of children are sexually assaulted by someone they know and trust. This makes disclosure even more difficult. 

Our first and best response to a child reporting that they have been abused is to believe them and get help.

Related: Sexual Assault Expert Warns of Heartbreaking Trend Among Children

4. Fight, flight or freeze – all are normal defense mechanisms

Regarding trauma, when the brain senses that it is in danger, it releases a cascade of chemicals. We have a “fight” or “flight” response–or another less known response to trauma–”freeze.” During a sexual assault, most victims freeze. 

It’s not a choice, it’s a reaction. 

You have to shut down to survive that moment. It can leave a survivor with little to no physical injuries. There may not be any scratch marks, bruises, or visible genital injuries. 

There probably won’t be a report of trying to flee, or screaming “no” during the attack. This notion is a glamorized Hollywood version of assault that doesn’t exist for most victims. 

You can watch Heidi Olson’s presentation at the Child-on-Child Harmful Sexual Behavior Symposium here:

Understanding myths can help kids in crisis

Look at what most of us think is needed for a burden of proof: 

  • DNA
  • Visible injuries
  • Repeatedly telling a story the same way over and over
  • Aggressively trying to defend themselves

It’s nearly impossible to produce those things with a child who has experienced sexual assault. 

Most young victims cannot repeatedly tell their story linearly. They were too afraid and unprepared to fight back. They do not have injuries, and the DNA from a perpetrator is gone. 

Unfortunately, because of this, many cases are found to be “unsubstantiated.” That is, there isn’t enough proof to move forward in a criminal investigation. When we read stories in the media of “unsubstantiated” claims, meaning, no visible injuries seen from a SANE (Sexual Assualt Nurse Examiner) exam or lack of DNA found in a rape kit, it DOES NOT mean a sexual assault didn’t occur. 

Sexual assault is rampant. It occurs with devastating frequency, and is prevalent in all demographics and areas of society. When a child discloses that they have been assaulted, it’s imperative to believe them.

They need you! 

Related: The 3 Big Red Flags of Sexual Abuse

What to do if a child reports abuse to you

There are some key messages that are important for children and young people to hear in their parents’ words and actions:

  • I believe you.
  • I don’t blame you in any way; I blame the abuser.
  • The abuse says nothing about you or who you are. I don’t see you any differently (apart from recognizing your strengths in surviving it).
  • I trust your sense of who might be the best person to talk to (e.g. me, your other parent, other family, friends, a therapist or counselor).
  • If there is someone else you’d like to talk to, I can help to organise this.
  • You can always talk to me at any point. Different feelings can come up further down the line.
  • There is a way forward from any difficulties and intense emotions.

From Think U Know 

If you suspect abuse, RAINN has steps for how to talk to the child and report abuse when needed.

Protect them. Empower them. Help them heal. Even if a sexual assault case never makes it to court or a perpetrator denies all responsibility, a child’s disclosure should be treated with the utmost respect. 

You can be a source of support and comfort that can make a huge difference in a child’s life.

Get our free Body Safety Toolkit to help your kids be safe from abuse. 

Click the image below!

Sexual Assault Expert Warns of Heartbreaking Trend Among Children

Sexual Assault Expert Warns of Heartbreaking Trend Among Children

I am a Sexual Assault Nurse Examiner (SANE) at a large children’s hospital. My job is to collect evidence, look for injuries, provide support, and testify in trials for victims of sexual assault. If you’ve ever heard of a “rape kit”, SANE nurses are the ones who collect the evidence that goes inside of these kits.

child sexual abuse

I remember distinctly where I was sitting several years ago when my gut told me something was off. I have learned from more experienced nurses that “trusting your gut” often gives insight into unspoken but vital pieces of a situation. I was talking to the parents of a 5-year-old girl who had been sexually assaulted by her 12-year-old brother. The father of the children stumbled upon the assault, so there were no questions as to what kind of violation took place. As the tearful parents grieved and asked, “Why would our son do this?” my mind pondered those same questions.

Why would kids abuse other kids?

Here is the reality – children learn these types of sexually aggressive behaviors. Children don’t instinctively act out sexual violence on each other. They don’t instinctively want to violate or push sexual boundaries with their siblings or younger children. These things are learned. Of course, some children who act out in sexually harmful ways have been victimized themselves, but my intuition told me that there is an unspoken factor fueling many assaults.

Many sexual assaults occur because of what young perpetrators have been exposed to via screens. Children watch violent sexual acts, with no previous direction or insight into what is normal, healthy sexual behavior, and then perform these sexual acts on other children. This is extremely concerning as pornography is more accessible and violent than ever. Which correlates with the rise of child-on-child sexual abuse.

As my mind raced over these thoughts, the mother of the children blurted out,

“Well, we have found a lot of porn on our son’s phone lately. Do you think that has anything to do with this?”

I knew in that moment that these two things were completely intertwined.

The unexpected perpetrators

When I became a SANE nurse, I thought the typical perpetrator was most likely going to be a creepy old man in his 60s who lured kids into his basement with lollipops, but I was so wrong. The biggest age range of perpetrators that I see in my hospital are children. In fact, for the third year in a row, our biggest age range of people committing sexual assaults are children ages 11-15 years old.

Let that sink in for a minute.

These kids aren’t even old enough to drive. Yet they are committing the most sexual assaults in our region. To put this in an even better perspective, my hospital sees one of the highest volumes of sexual assault victims in the United States. So our numbers are large, meaning these young perpetrators are not an anomaly.

I was alarmed by the number of 11, 12, and 13-year-old perpetrators I was seeing. I started looking through our past sexual assault victim’s stories and found hundreds and hundreds of records of sexual assault survivors who were perpetrated on by another child. Pornography is often a main factor, and sometimes the only factor, that influenced a child to act out in a sexually harmful way.

Related: Three Ways to Guard Against Child Sexual Abuse

The truth about pornography and child sexual abuse

As I have studied our data, and seen more and more patients, I realize that it’s imperative that we understand the way that pornography is creating devastating effects for children across our country.

The children that I see are not in a vacuum. Stories of child-on-child sexual abuse are ringing out all over the world. The trend is growing rapidly. With pornography being so widespread and easily accessible, more and more children are viewing and subsequently acting out what they see on vulnerable children. Often their younger relatives. It’s not just young boys – we see young girls who are perpetrators as well.

The solutions are not quick or easy. There’s shame involved with families who have a child sexually act out on another child. Most families do not want to admit that this tragedy has occurred within their family. There are not many specialized therapy groups or any court mandated services that cater to this issue, so there are limited resources for healing. To compound the issue, we live in a culture that continuously normalizes pornography and refuses to acknowledge the ugly truth that it fuels sexual assault and rape culture.

In these quiet moments of tragedy in the Emergency Department, while the dust settles and families try to make sense of what is happening, I hear the truth. I clearly see the correlations. I hear the confessions that pornography influenced child sexual abuse. I hear the truth that pornography was created of a victim, shown to a victim, or was the direct reason why a child acted the way he or she did.

Related: The 3 Big Red Flags of Sexual Abuse

Pornography normalizes violence

I have seen things that I cannot write about, violence that is hard to fathom, let alone explain, moments that have left me nauseated and in tears. Things are inflicted upon beautiful, innocent children at the hands of other children. Brutal assaults are carried out by the hands of teenage boys who believe that sexual violence is “normal.”

I see kids who think that anal and oral sex are normal before you’ve even gone through puberty. I come face-to-face with stories about kids who do not listen when a victim repeatedly tells them “No!” Why? Because they’ve seen the violence, the strangulation, the slapping, the name-calling of women a thousand times in pornography and they think that it is “normal.”

Then they act it out, leaving behind a wake of destruction for themselves and their victims.

Your kids can build powerful pornography defense skills by sitting beside you to read Good Pictures Bad Pictures: Porn-Proofing Today’s Young Kids and learning the CAN DO plan.

Have you wanted to talk to your kids about pornography, but didn’t know what to say?! I’ve felt that way for quite some time and finally found a solution – Good Pictures Bad Pictures…I highly recommend this book to all people with children. A must have for all parents! –Amazon Review, March 14, 2014. CLICK HERE to learn more about Good Pictures Bad Pictures: Porn-Proofing Today’s Young Kids.

Many victims of this rising trend

There are so many heartbreaking elements to this subject. And it’s important to remember that the perpetrators are also victims. While I do not condone their actions and stand with victims of sexual assault, children who are acting out sexually are also victims of a culture that has not protected them. A culture that allows them to be exposed to sexual violence while calling it “normal.” A culture that does not offer services for children who are viewing pornography and who are acting out. A culture that changes childhood from a time of adventure, innocence, and wonder and fills it with airbrushed naked bodies and violent sexual acts. Too many kids in this generation have been sexualized since they could look at a screen.

The United States is seeing thousands upon thousands of our children who are being sexually assaulted every year. Which means thousands of children are deemed perpetrators every year. It has been estimated that one-third to 66% of all perpetrators of child sexual abuse are children themselves (17 years old and younger.) This reality has massive ramifications on both sides of the equation in terms of mental illness and adverse health outcomes.

What will the world be like in 20 years if an entire generation of adults have experienced sexual violence and trauma at the hands of each other?

Watch Heidi Olsen talk with Protect Young Minds founder, Kristen Jenson, at the Coalition to End Sexual Exploitation Summit.

We can do something about child-on-child sexual assault

My gut instinct proved to be right. Pornography is fueling one of the worst secrets of our time. Childhood innocence is being destroyed at lightning speed.

The good news is that now that we are aware, we can take action and change the trajectory of this terrible trend now! Here are some things you can do:

  • If a child says they were assaulted, believe them! Research shows that children (and adults, for that matter) do not lie about sexual assault. They should be met with responses like, “You’re really brave for telling me that. Thank you.”
  • One of the best things that a parent can do is to respond with compassion. Whether your child was the one assaulted or your child was the one who has been struggling with pornography and acting out, they should be met with grace and acceptance. When shame is taken out of the equation, there are much better chances of children healing, growing, and speaking up in the future.
  • Assure them that you are going to help them through this for as long as it takes.
  • Protect the child who has been assaulted. Never put them in situations with the perpetrator. To interact with the perpetrator is unsafe and re-traumatizing.
  • Get professional help. Kids’ brains need help sorting out trauma and early sexualization. Therapy is needed for both children who have been assaulted and children who have acted out in harmful sexual ways.
  • Talk to children about the dangers of pornography. Children often accidently stumble upon porn while searching innocently online. Talk to your children and make it safe for kids to speak up when they see something. Check your children’s screens and devices frequently. Children who habitually look at porn are more likely to act out. Know what your kids are looking at.
  • Prepare your children to protect amazing bodies – their own and others. Teach them that other people should never be touching or taking pictures of their private areas. At the same time, teach them they should never touch or take pictures of others’ private areas.
  • Educate others about online safety. Raise awareness of the correlation between sexual assault and pornography. Talk about keeping kids safe. The more people understand, the better chance we have to protect our kids.

My last piece of advice is, “Go with your gut.” If something doesn’t seem right with your child, it’s not. Create a safe space where your child knows they can disclose that they have been abused or are struggling with what they’ve seen online. Assure your children that they will be met with kindness and protection rather than shame or denial. Safety and validation from a caregiver make all the difference in the world in a child’s healing process.

I know this topic is heavy and overwhelming. The fact is, if we don’t know, we can’t change anything. We need to realize the insidious world that pornography is creating for our kids. In fact, it is creating a significant public health crisis in our society.

This rising trend does not have to continue this way! We can provide services to help children heal from sexual trauma. We can treat young offenders. We can prepare children to reject pornography and abuse – now. The sooner we teach them, the safer they will be. Please share this article and help all those who care for and influence children be prepared to take action on this issue.

Help your kids practice what to think, say, and do in a red flag situation with our free Body Safety Toolkit below.

Protect Young Minds is collaborating with National Center on Sexual Exploitation and National Catholic University of America to raise awareness of this rising problem. Please register to join us for this important national symposium in person or online.

NCOSE Protect Young Minds Symposium on Child on Child Harmful Sexual Behavior