Child Sexual Abuse of Girls

Child sexual abuse is a common and devastating problem affecting as many as 15 to 30% of girls. Perpetrators of child sexual abuse are more likely to be male; most often someone known to the child. It is now well established that child sexual abuse is a non-specific risk factor for both internalizing and externalizing disorders in girls and adult women, and is associated with neurobiological dysregulation in both childhood and adulthood. Children’s exposure to sexual abuse continues to be underrecognized and underdetected. Generally, sexual abuse of a child is detected when a child discloses to another person. A comprehensive assessment is the first step in determining the treatment needs for a child who has been sexually abused and should include evaluation of risk for recurrence, as well as the child’s behavioral, emotional and cognitive functioning and the family environment, including level of support. Cognitive-behavioral therapy for sexually abused children with symptoms of posttraumatic stress disorder (PTSD) shows the best evidence for reducing subsequent impairment; however, it is important to consider the child’s context and risk of recurrence when determining treatment needs. Although the main focus of sexual abuse prevention has been on education programs aimed at children, and offender management, it remains unknown whether such programs actually prevent child sexual abuse. Most information about sexual abuse of girls is based on studies from high-income countries; further research is needed to improve our understanding of child sexual abuse experienced by children in low and middle-income countries and global strategies for prevention.