The Diagnosis of Child Sexual Abuse

Why is it important to diagnose child sexual abuse? Kempe, in an address to the International Association for Child Abuse and Neglect in 1979, drew the professional communities' attention to 'the serious plight of sexually abused children'. He described this as the final stage in the communities' recognition of patterns of child abuse. This cyclehad commencedwith his recognition of'The Battered Child Syndrome' in the early 60s. The sexuality of children has long been a recognised'fact of life'. But children's descriptions of sexual activities with adults—particularly parents—hasbeen considered a form of wish fulfilment,and therefore a fantasy, rather than hav ing a basis in reality. Children's tendency to withdraw their statements and to be inconsistent in reporting confirmed such a view.It is, however, now recognisedthat such behav iour may be more in the nature of an 'accommodation' to a family demand to maintain 'secrecy', than because of there being no abuse.1 A gradually accumulating body of evidenceindicates that sexual abuse of children is not only far more prevalent than was previously thought, but also far more traumatic in its short and long-term effects,including: