A Blog From Your Kaiser Permanente Physicians

Mother talking to young daughter

Talking About Sexual Abuse

The list of what parents worry about is long! Often topping that list is fear about what can happen to our children when they’re not with us, and what others could do to harm them.

At a meeting of Kaiser Permanente’s Child Abuse Services and Prevention team I heard a statistic that rattled me: only 5% of child sexual abuse is perpetrated by a stranger. The rest? Committed by a person the child knows and may have been taught to trust. Coaches, teachers, tutors, neighbors, relatives, and babysitters, who have access to our kids, have power over them that’s often used for great good, but sadly, can also be used to harm.

Yes, let’s keep our kids safe from stranger danger. And let’s also turn our focus to helping them respond when an adult they know acts inappropriately toward them.

To explore how we can talk to our kids about this distressing topic, I asked Dr. Michele Evans, a fellow Kaiser Permanente pediatrician and an expert in child abuse prevention, for advice.

Dr. Evans explained that the earlier you begin these conversations with your children, the better.

  • Encourage open communication in your family about all topics.
  • Be willing to answer any question you’re asked, including those about sex and sexuality.
  • Answer in an age-appropriate, matter-of-fact fashion, giving simpler answers to younger children.

Teach children they can talk with you about anything. Set the standard that if they tell you the truth, you can decide together what the solution or consequence will be. You want to make a child comfortable telling you anything – even if someone else may have told them they’d get in trouble. In general, a good policy is, “We don’t keep secrets in our family.”

Teach children about respecting boundaries. The concept of “No means no” can be modeled early. For example, if you’re tickling your child and they say “Stop!” then stop right away and say, “You said stop, so I’ll stop.”

If you have young children, Dr. Evans suggested some additional ideas:

  • Teach proper names for body parts. This gives kids the ability to clearly explain what may have happened to them and permission to talk clearly. Discuss that private parts are personal and should not be touched, looked at, or photographed by anyone else.
  • Families differ on modesty in the home. It’s important that children know their family values and they can differ from other families. If it’s not okay in your family to see each other unclothed, you can say, “There’s nothing shameful about your body, but it’s private, so in our family, no one sees anyone else without at least a top and underwear on.” Or if your family is less modest, let your kids know it’s only acceptable in your home. They shouldn’t expect other people to be comfortable without clothing on.
  • Consider having an open-door policy in your home: Ask kids to leave their bedroom doors open or ajar at all times.
  • Avoid forcing children to give hugs to friends or family members if they don’t want to. Doing so would teach children to accommodate others even if they don’t feel comfortable. Instead, we want to teach our kids to trust their instincts about touch and boundaries.
  • Day cares should allow parents to visit at any time. Make the occasional unannounced visit.
  • As your kids get older and visit other homes, being involved is key. Know where kids are, who they’re with, and notice what state they’re in when they come home.

If your kids are older, open discussion is again at the core of helping them remain safe. You may want to consider these points:

  • Know where your children are going and get to know the parents of your children’s friends. If a child is spending time in someone else’s home, know who else is there. If you‘re uncomfortable with the level of supervision or something just doesn’t seem right, it’s okay to refuse to let them go.
  • Discuss the risks and benefits of social media. Consider following your kids accounts.
  • Keep a close eye on anyone giving gifts or special attention to your child.
  • Use events in the child’s school or in the news as ways to open conversations about topics of sexual abuse. Family dinners are a great time to talk. What does your teen and their friends think about consent, boundaries, dating, use of social media, etc.?

In general, and for all ages – trust your instincts. If something you hear or observe makes you uncomfortable it’s worth investigating. If your child tells you they’ve been abused, teach them to trust their instincts by taking their story seriously. Abuse can take many forms – physical, sexual, manipulation in person, or over social media by showing photographs or performing sexual acts. Contact your local police, Child Protective Services, and pediatrician for help.

Your child needs to know they can trust you to listen, believe, and act.

Disclaimer: If you have an emergency medical condition, call 911 or go to the nearest hospital. An emergency medical condition is any of the following: (1) a medical condition that manifests itself by acute symptoms of sufficient severity (including severe pain) such that you could reasonably expect the absence of immediate medical attention to result in serious jeopardy to your health or body functions or organs; (2) active labor when there isn't enough time for safe transfer to a Plan hospital (or designated hospital) before delivery, or if transfer poses a threat to your (or your unborn child's) health and safety, or (3) a mental disorder that manifests itself by acute symptoms of sufficient severity such that either you are an immediate danger to yourself or others, or you are not immediately able to provide for, or use, food, shelter, or clothing, due to the mental disorder. This information is not intended to diagnose health problems or to take the place of specific medical advice or care you receive from your physician or other health care professional. If you have persistent health problems, or if you have additional questions, please consult with your doctor. If you have questions or need more information about your medication, please speak to your pharmacist. Kaiser Permanente does not endorse the medications or products mentioned. Any trade names listed are for easy identification only.