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Preying on the child

Sexual abuse of children is only just coming into the open. DR. PREETHI MENON looks at how to deal with this trauma.

THE seven-year-old girl came with a history of frequent crying spells coupled with loss of interest in studies and playing. During the sessions with the doctor, her mother would never leave her alone. Finally, the girl broke down: "when dad was doing dirty things to me, where were you?" The marriage ended in divorce when the mother found courage to face her husband. But it took many months to help the child deal with the trauma and the guilt that she was responsible for her parents' split.

Sexual abuse in children has been occurring for centuries, but has come to the attention of the child health/welfare agencies only recently. The World Health Organisation (WHO) describes a possibility of one out of every four girls and one out of every six boys being sexually abused. In India since the reporting is poor, the exact picture is not clear. We do come across many children who, on detailed interviewing, describe these traumatic incidents. Many recover completely but many live with this, often not even remembering the real reason for the hidden internal trauma.

When an adult involves a child in sexual activities for his/her gratification, the child is said to be sexually abused. Every child is vulnerable to sexual abuse. The abuse may be verbal, physical or emotional. It can involve forcing, tricking, threatening or pressuring. This is an abuse of power and a violation of a child's right to a normal, healthy, trusting relationships. It can deprive a child of his/her capacity to enjoy "childhood" leading to immediate and long-term complications, beginning with emotional or behavioural problems, abnormal sexual behaviour or psychiatric disorders. Learning difficulties, aggressive behaviour, suicidal tendencies and drug abuse are common after effects.

The factors that influence the outcome are: The age of onset of abuse; the frequency; the period of abuse; the relationship with the abuser; nature of the act; events subsequent to the abuse and the support systems.

A 14-year-old was forced to undergo sexual intercourse with her paternal uncle from early childhood through her adolescence. She lived in a joint family where her mother was not allowed any opinion. One day, both the mother and daughter threw themselves before a speeding train.

Of the factors mentioned above, the most important is the support by an understanding family.

As concerned adults what is our role? Our duty is to protect our children and the first step is to create awareness.

Children should be equipped with proper coping skills without being unduly frightened. Along with general discussions on safety measures against fire, water, diseases, we should also talk to them in simple language about self-protection against sex abuse.

The teaching should come from the family, teachers and any one, who is willing to talk and listen to children.

The parents should create a family atmosphere where the children are free to discuss any problems with them.

Similarly the teachers should allow their wards the freedom of communication.

Remember a silent child does not mean, "all is fine with me." Support them and protect them.

* * *

Common symptoms

Bodily complaints: aches especially headache, frequent urinary infections, genital itching and unexplained bleeds.

Behavioural changes: withdrawal, gloominess, school problems. Excessive or poor personal hygiene, sleep disturbances, fear. Boys may turn aggressive while girls find solace in self-destructive behaviour including suicide. Older children may turn to drugs and antisocial activities or run away from home.

Psychiatric symptoms: anxiety, depression adjustment disorders, frequent reliving of trauma even after cessation.

Many adults, on interview with a psychiatrist, talk of early sexual trauma. A young lady, obsessed with excessive cleanliness, on hypnosis described how she was abused by her grandfather. It can also affect their sexual life.

There is also the problem of sexualised behaviour. A child may show sexual interest in others, i.e. sexual play with other kids, toys or animals. Instead of getting angry, the parents should think of the possibilities of sexual abuse.

* * *

Listen to them

Never blame the child.
Stress that he/she is not
at fault.
Believe the child.
Do not over react or show
anger; the child may
misinterpret it.
Encourage them to talk. Do not
silence them, at the same time
do not pressurise them.
Discuss the issue in private.
Reassure and extend support.
Seek professional help.

* * *

Points to be stressed while teaching children about sexual abuse.

The names of all body parts and the freedom to talk about them.

The knowledge that their body belongs to them and nobody can violate this even by touching, without their permission.

The difference between safe and unsafe touches, which make them feel uncomfortable or dirty.

The ability to say" NO."

The courage to report to a supporting adult.

The knowledge that these rules apply not only to strangers alone but to known people too. This is important in abuse by a family member.

In India, children are taught to be polite and obedient. This may force them to agree to any act, including sexual abuse. Teach them to see the difference and talk about it.

Reporting an incident can protect the child from further abuse and prevent other children from being abused.

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