Recognition of Sexual Abuse in Children

Although sexual abuse of children has likely been present for ages, its recognition in the United States and other countries has dramatically increased in the past 5 years. Reported cases, which represent an unknown fraction of actual cases, now account for approximately 25% of all abuse and neglect reports. Local, county, and state agencies are staggering under the load, and many are relying heavily on pediatricians to assist them in their work.DEFINITIONSexual abuse can be defined as the engaging of a child in sexual activites that the child does not understand, to which the child cannot give informed consent, or which violate the social taboos of society. This definition is broad and includes intrafamilial and extrafamilial forms and all types of sexual activities (eg, exhibitionism, fondling, child pornography, oral, anal, and genital sexual contact).The interface between