Takeaway
Clinicians should care for younger patients who have experienced sexual abuse with sensitivity. Prompt reporting, referral to treatment, and attention to the patient's emotional readiness are essential to facilitating healing.
Lifelong learning in clinical excellence | October 8, 2026 | 4 min read
By Jennifer Serico, PhD, Kennedy Krieger Institute
As a clinician specializing in culturally humble trauma-informed care, my job is listening to the hard stories—often the most heartbreaking and painful experiences in a person’s life. I feel honored that patients and families trust me with their stories and am deeply committed to partnering with them in healing.
When working with patients who’ve experienced sexual abuse, their safety and mental health are top priorities. But what happens when systems and stressors interfere with their ability to move forward in healing? For example, when a young child shares their experience of sexual abuse with me, but then, after I document and report it, becomes too scared or overwhelmed during the interview to tell their story to a stranger. Or when sexual abuse is reported within a family system, it can shatter the family and leave the child and parent isolated. These stories are real and affect far too many people.
Child sexual abuse
Child sexual abuse is a global health concern that can significantly shift a child’s life trajectory without adequate support and care. In a recent review, the global prevalence of child sexual abuse was high with 14 in 100 females having reported child sexual abuse. In the U.S., the rates are even higher—the CDC reports that at least one in four girls and one in 20 boys experience child sexual abuse. Further, according to the CDC, child sexual abuse occurs approximately 90% of the time at the hands of someone the child or the child’s family knows and trusts.
Child sexual abuse may be single incident or chronic, and any young person who experiences it is at high risk for developing trauma symptoms. Trauma symptoms, especially in youth, are easily conflated with symptoms of ADHD, as well as with symptoms of anxiety and depression—this is why it’s particularly important to understand the timeline of onset of symptoms, and assess for trauma when caring for a young patient.
Physiological symptoms of trauma include difficulty sleeping, headaches, and stomachaches. When untreated, the impact of child sexual abuse can be pervasive and significantly impact a child’s emotional, behavioral and cognitive functioning, interpersonal relationships, risk behaviors, and long-term health outcomes.
So, what can we do to reduce the instances of child sexual abuse and support young patients and families in navigating such a traumatic experience with healing and justice?
1. Prevention
Sexual abuse isn’t always framed as something that can be prevented, however the work of public health colleague Dr. Elizabeth LeTourneau outlines a number of strategies and interventions focused on prevention. Explore the Johns Hopkins MOORE website to learn more.
2. Assessment
It’s essential to screen children and adolescents for recent traumatic events, given the impact these experiences can have on their emotional, physical, and spiritual well-being. Many excellent websites provide education and support, including:
National Child Traumatic Stress Network — Screening and Assessment
International Society of Traumatic Stress Studies — Child/Adolescent Trauma Assessments
National Center for PTSD — Child Measures of Trauma and PTSD
3. Making the call
Calling Child Protective Services (in the U.S.) can feel stressful and overwhelming, and we may worry about the potential fallout for the family. It’s helpful to remind ourselves that Child Protective Services was developed in the interest of keeping children safe and that this is essential when a child is reporting sexual abuse. If you’re concerned about the child’s ability to engage in the process, ask the parent or caregiver what they need regarding advocacy and support. Support parents or caregivers in accessing additional resources.
4. Support referrals for trauma-informed treatment
If the child has the capacity to talk about their experiences, Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is the gold-stand treatment. For younger children, enhancing safety and support is essential. Child-Parent Psychotherapy (CPP) is an evidence-based treatment model for children ages 0-5. If a child is exhibiting significant behavioral difficulties following a sexual abuse experience, another evidence-based treatment model, Parent-Child Interaction Therapy may be recommended. At Johns Hopkins, The Center for Child and Family Traumatic Stress offers these and other interventions to address child sexual abuse.
Finally, are some further resources to explore:
Interventions to support children and young people who have experienced sexual abuse
Updated guidelines for the medical assessment and care of children who may have been sexually abused
Examining the short and long-term impacts of child sexual abuse
This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.