Skip to content
You are here: Home | Children and young people | For professionals | Child Sexual Abuse

Child Sexual Abuse

Child sexual abuse has a long-term impact on the child lasting well into adulthood and potentially causing physical and psychological problems later in life (Source: The impacts of child sexual abuse - CSA Centre). 

This type of abuse is one of the most difficult for children, young people and adults to speak about and for family members and professionals to identify, and often remains hidden even in plain sight. For further information on the experience of survivors see the Truth Project - IICSA Independent Inquiry into Child Sexual Abuse.

Sexual abuse is just as common as other forms of childhood abuse. Children who have been sexually abused may display a range of emotional and behavioural reactions which professionals should be alert to. See Effects - The National Child Traumatic Stress Network.

Infographics from the Centre of Expertise on Child Sexual Abuse highlight that: 

  • children are disproportionally likely to be victims of sexual offences 
  • 15% of girls and young women and 5% of boys and young men, are estimated to experience some form of sexual abuse before the age of 16

What is child sexual abuse?

The guidance Working Together to Safeguard Children 2023 (page 162) clearly defines sexual abuse as something that:

  • involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts, such as masturbation, kissing, rubbing, and touching outside of clothing. 
  • may include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse. 
  • can take place online, and technology can be used to facilitate offline abuse
  • is not solely perpetrated by adult males
  • can also be committed by women, as can other children 

The guidance Working Together to Safeguard Children 2023 (page 154) clearly defines child sexual exploitation as:

  • a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity.
    • (a) in exchange for something the victim needs or wants, and/or 
    • (b) for the financial advantage or increased status of the perpetrator or facilitator

In addition:

  • the victim may have been sexually exploited even if the sexual activity appears consensual
  • child sexual exploitation does not always involve physical contact; it can also occur through the use of technology
  • children and young people may not always understand that they are being sexually abused (IICSA, 2022)
  • children and young people of any age, including very young children and babies, can experience sexual abuse 

Source: Protecting children from sexual abuse.

What is contact abuse and non-contact abuse?

Contact abuse involves activities where an abuser makes physical contact with a child. It includes:

  • sexual touching of any part of the body, whether the child is wearing clothes or not
  • forcing or encouraging a child to take part in sexual activity
  • making a child take their clothes off or touch someone else's genitals 
  • rape or penetration by putting an object or body part inside a child's mouth, vagina or anus.

Non-contact abuse involves activities where there is no physical contact. It includes:

  • flashing at a child
  • encouraging or forcing a child to watch or hear sexual acts
  • not taking proper measures to prevent a child being exposed to sexual activities by others
  • making a child masturbate while others watch
  • persuading a child to make, view or distribute child abuse images, such as performing sexual acts over the internet, sexting or showing pornography to a child
  • making, viewing or distributing child abuse images 
  • allowing someone else to make, view or distribute child abuse images
  • meeting a child following grooming with the intent of abusing them, even if abuse did not take place
  • sexually exploiting a child for money, power or status (child sexual exploitation).

Source: Protecting children from sexual abuse.

Harmful sexual behaviour including child on child sexual abuse

Harmful sexual behaviour (HSB) is developmentally inappropriate sexual behaviour displayed by children and young people which is harmful or abusive. Source: Harmful sexual behaviour (HSB) or peer-on-peer sexual abuse.

Peer-on-peer sexual abuse is a form of HSB where sexual abuse takes place between children of a similar age or stage of development. Child-on-child sexual abuse is a form of HSB that takes place between children of any age or stage of development. Source: Harmful sexual behaviour (HSB) or peer-on-peer sexual abuse.

Other useful resources

Online child sexual abuse and exploitation

The information available on the CEOP website - What is online child sexual abuse, suggests that online Child Sexual Abuse and Exploitation (CSAE) offending can take a number of different forms, which include:

  • online grooming - the act of developing a relationship with a child to enable their abuse and exploitation both online and offline. Online platforms, such as social media, messaging and live streaming, can be used to facilitate this offending.
  • live streaming – live streaming services can be used by Child Sex Offenders (CSOs) to incite victims to commit or watch sexual acts via webcam. CSOs also stream or watch live contact sexual abuse or indecent images of children with other offenders. In some instances, CSOs will pay facilitators to stream live contact abuse, with the offender directing what sexual acts are perpetrated against the victim.
  • online coercion and blackmail – the coercion or blackmail of a child by technological means, using sexual images and/or videos depicting that child, for the purposes of sexual gain, for example, to obtain new IIOC or bring about a sexual encounter, financial gain or other personal gain
  • possession, production and sharing of IIOC and prohibited images (CSOs) - can use online platforms to store and share IIOC and prohibited images. Online platforms can also be used to facilitate the production of IIOC, for example screen-recording of CSEA perpetrated over live streaming.
  • indecent images of children (IIOC) - are images of, or depicting, a child or part of a child which are judged to be in breach of recognised standards of propriety. Examples of images considered to be indecent are those depicting a child engaging in sexual activity or in a sexual manner, through posing, actions, clothing etc. IIOC includes photographs, videos, pseudo-photographs and tracings.
  • prohibited images of children - are non-photographic images, for example, CGI or cartoons, which portray a child engaging in sexual activity, a sexual act being performed in the presence of a child or focus on the child’s genital or anal region.   

Other useful resources

How many children experience child sexual abuse?

A child sexual abuse briefing Statistics on child sexual abuse, published in February 2024 by the NSPCC, suggests that: 

  • an estimated 1 in 20 children in the UK have been sexually abused
  • concerns around sexual abuse have been identified for over 2,400 children in the UK who are the subject of a child protection plan or on a child protection register
  • over a third of all police-recorded sexual offences are against children
  • girls and older children are more likely to experience sexual abuse
  • the vast majority of children who experience contact sexual abuse were abused by someone they knew

However, data can only ever tell part of the story. It is important to bear in mind the limitations of the data available.

Sexual abuse is usually hidden from view. Adults in the child or young person’s life may not recognise the signs of sexual abuse and the child may be too young, too scared or too ashamed to tell anyone what is happening to them. 

Further information about the available data and statistics about child sexual abuse can be found in the briefing Statistics on child sexual abuse.

Datasets collected from 42 police forces, gives us a national snapshot, insight and analysis into the scale and nature of Child Sexual Abuse and Exploitation (CSAE)  trends in offending, including crime types, where they were committed, and presents profiles of both victims and perpetrators.

View the report and animation National Analysis of Police-Recorded Child Sexual Abuse and Exploitation Crimes Report 2022 and also the CSA Centre Infographics.

Myths and facts

There can be myths and assumptions around Child Sexual Abuse and Exploitation, which can be harmful. The following websites have some information which help to dispel those myths.

Recognising the signs of child sexual abuse

Sexual abuse is difficult for children and young people to talk about. Research, guidance and children themselves have told us to notice the signs and indicators of child sexual abuse. Children need to be listened to and professionals need to be professionally curious and ask children what is happening to them and not wait for them to tell a professional or otherwise.

See the resources: Communicating-with-children-guide and Identifying and responding to disclosures of child sexual abuse.

Not all children will recognise that they are being abused, particularly if they have been groomed. Many children will not disclose if they are being or have experienced any other type of abuse and research indicates that professionals are least confident in dealing with this category of abuse. 

The list below provides some physical, emotional and behavioural indicators that may be a sign that a child has experienced sexual abuse. This is not an exhaustive list and there are some additional resources to find out more.

  • Avoiding being alone with or frightened of people or a person they know
  • Language or sexual behaviour you would not expect them to know
  • Having nightmares or bed-wetting
  • Sudden mood changes and/or frequent crying
  • Becoming withdrawn, quiet, emotionally flat and disinterested and isolated
  • Becoming hyperactive and/or aggressive
  • School problems – poor attendance and/or poor school work
  • Alcohol or drug misuse
  • Self-harm
  • Changes in eating habits or developing an eating problem
  • Bruises
  • Bleeding, discharge, pains or soreness in their genital or anal area
  • Sexually transmitted infections
  • Pregnancy

Please note: There may be no physical signs on examination and unrecognised as there are no overt signs orbehaviours being displayed.

Signs in babies and young children

It can be difficult to recognise and identify that a baby or very young child is experiencing sexual abuse. Children at these early developmental stages can’t always communicate their experiences.

Children in their early years experiencing sexual abuse might display disruption or regression of normal development such as toilet training, eating and interacting with other children. They may also resist or become distressed with intimate care such as nappy changing. Source: (Birch, 2022; CSA Centre, 2021).

Source: Protecting children from sexual abuse.

Other useful resources

Disclosure

Disclosure is the process by which children and young people start to share their experiences of abuse with others. This can take place over a long period of time – it is a journey, not one act or action.

  • Children may disclose directly or indirectly and sometimes they may start sharing details of abuse before they are ready to put their thoughts and feelings in order
  • Not all disclosures will lead to a formal report of abuse or a case being made or a case being taken to court, but all disclosures should be taken seriously
  • It takes extraordinary courage for a child to go through the journey of disclosing abuse
  • It is vital that anyone who works with children and young people undertaking this journey is able to provide them with the support they need

Children and young people may disclose abuse in a variety of ways, including:

  • directly– making specific verbal statements about what’s happened to them
  • indirectly – making ambiguous verbal statements which suggest something is wrong
  • behaviourally – displaying behaviour that signals something is wrong (this may or may not be deliberate)
  • non-verbally – writing letters, drawing pictures or trying to communicate in other ways.

Children and young people may not always be aware that they are disclosing abuse through their actions and behaviour.

Sometimes children and young people make partial disclosures of abuse. This means they give some details about what they’ve experienced, but not the whole picture. They may withhold some information because:

  • they are afraid they will get in trouble with or upset their family
  • they want to deflect blame in case of family difficulties as a result of the disclosure
  • they feel ashamed and/or guilty
  • they need to protect themselves from having to relive traumatic events

When children do speak out, it is often many years after the abuse has taken place (McElvaney, 2015).

Source: NSPCC Recognising and responding to abuse Recognising and responding to child abuse and neglect

The following video clip, may also provide further support: (Duration 2.13 minutes).

Barriers to disclosure

There are many reasons why children and young people might find it hard to talk about their experiences of abuse or neglect. They might be reluctant to seek help because they feel they don’t have anyone to turn to for support.

They may have sought help in the past and had a negative experience, which makes them unlikely to do so again or they may not have the knowledge or words to describe their experience.

Some children and young people may also:

  • blame themselves for the abuse or feel shame or guilt - feelings which can be made worse through the use of ‘victim-blaming’ language or labelling
  • experience feelings of isolation
  • be afraid of negative reactions from parents, caregivers, peers and professionals
  • worry they will be causing trouble and making the situation worse
  • be concerned about confidentiality
  • feel too embarrassed to talk to an adult about a private or personal problem
  • feel that they will not be taken seriously
  • lack trust in the people around them (including parents) and in the services provided to help them
  • find formal procedures overwhelming
  • not know about the support services available to them, or be unable to access these services (Allnock and Kiff, 2023; Mental Health Foundation and Camelot Foundation, 2006).

Not all children and young people realise they have experienced abuse, for example if they have been groomed. Source: NSPCC Recognising and responding to abuse Recognising and responding to child abuse and neglect.

Language matters

Language is powerful. It is important to consider the words, phrases and jargon used when speaking to/about children/young people and adults. This includes language used verbally and written in files, referrals, assessments and reports. 

It is acknowledged that our language is shaped by and normalized within the cultures we work, live and spend time. Language is always changing and evolving, some previously acceptable terms may no longer be appropriate. Rarely do individuals intend to use victim-blaming language but may do so unconsciously.

Any language suggesting a child/young person is responsible for their abuse and/or crime they are subjected to must be avoided. A failure to do so may mean that the child/ren are not safeguarded appropriately. Victim blaming language may reinforce messages from perpetrators around shame and guilt. This in turn may prevent the person from disclosing their abuse as they may feel fear of being blamed by professionals. 

Victim blaming language is any language or action that implies (whether intentionally or unintentionally) that a person is partially or wholly responsible for abuse that has happened to them. It is harmful and can wrongfully place responsibility, shame or blame onto a victim, making them feel that they are complicit or responsible for the harm they have experienced. Source: Challenging victim blaming language and behaviours when dealing with the online experiences of children and young people.

Unclear language can lead to confusion, misunderstanding or even harm, as in the case of the term ‘child pornography’. This phrase, which continues to be used today, 1, 2 is a perfect example of how harmful language can be.

Child sexual abuse material is a result of children being groomed, coerced, and exploited by their abusers, and is a form of child sexual abuse. But using the term ‘child pornography’ implies it is a sub-category of legally acceptable pornography, rather than a form of child abuse and a crime. Source: NSPCC Blog: Why language matters: why we should never use ‘child pornography’ and always say child sexual abuse material.

This short video clip helps to understand the impact on young people of victim blaming language. (Duration 1.46 minutes)

Other useful resources

Adultification

National and local reviews have highlighted incidents where it appears some young people have been treated differently from their peers by professionals and the criminal justice system. As defined in statutory guidance, Working Together to Safeguard Children, the term ‘child’ refers to anyone under the age of 18.

Adultification is a type of bias which skews the perception of certain children leading to professionals viewing them as more grown up than their peers which can lead to lapses in safeguarding and unfair treatment.

There are various contexts in which adultification occurs, all of which relate to a child’s personal characteristics, socio-economic influences and/or lived experiences, for example - transphobia, homelessness, young carers, domestic abuse, poverty, being a Cared For or Care Experienced child.

Research has shown that black children are more likely to experience adultification, where professionals think about black children differently from their peers and do not recognise their own discrimination and bias. Child Q’s review where a young black girl was strip searched inappropriately is an example of adultification.

Intersectionality plays a part  in this concept. Age, gender, ethnicity and sexuality all affect how children are viewed by professionals. Black girls can be seen stereotypically as innately hypersexual and this can impact on how they are identified as victims of Child Sexual Abuse (CSA). Another stereotype is that black children are seen as resilient and strong. 

Other useful resources

In this short video, Jahnine Davis explains the adultification bias after a black schoolgirl was strip searched by police. (Duration 1.55 minutes)

Responding to concerns

If you are concerned that a child or young person has suffered harm, neglect or abuse, notify us via the following options:  

If a child is at immediate risk of harm, call the Police on 999. 

Further information can also be found on the SSP webpage Request for help and support guidelines and contact information.

The multi-agency threshold guidance, The Right Help at The Right Time, will also assist in assessing the levels of need and identifying the most appropriate support. 

Consider if there should be a medical examination

Consideration of a medical examination should be discussed during any strategy discussion held and health professionals invited/consulted as per local guidance. 

Professionals should be familiar with forensic timescales when responding to disclosures of child sexual abuse. 

Up to date information and guidance can be accessed via The Bridge Sexual Assault Referral Centre, Bristol webpage which offers further advice.

Other useful resources

Medical examinations

Forensic medical examinations

Professionals should be familiar with forensic timescales when responding to disclosures of child sexual abuse. 

Consideration of a medical examination should be discussed during any strategy discussion held and health professionals invited/consulted as per local guidance. See Health Attendance at Strategy Discussions, including flowcharts on pages 14 and 15 which provide further information about local processes.

Forensic Medical examinations for children living in Swindon and Wiltshire are conducted in Bristol at The Bridge Sexual Assault Referral Centre (SARC). Please refer to The Bridge Sexual Assault Referral Centre, Bristol webpage for up to date guidance for professionals. There is also a document titled Timescales for Medical Care which offers further advice. 

The timescales for medical care guidance indicate that The Bridge will see all children, aged 0 to 18 years, up to seven days following an allegation or suspicion of sexual assault, regardless of the type of incident.

Forensic timescales vary on the type of assault and whether or not the child is pre-pubertal or post-pubertal, however it will be the decision of the Paediatric Sexual Offences Medicine Specialist which forensic samples to take.

For all children under 18 who have experienced a recent sexual assault, please contact The Bridge and an expert will be able to provide advice, information and support.

Further information for professionals including educational resources, timescales for immediate medical care/forensic medical examinations and information booklets for children and young people, parents and carers can be found on the website Professionals – The Bridge. 

Information about Swindon and Wiltshire Sexual Assault Referral Centre also includes information about forensic medical examinations.

Other useful resources 

The following evidence-informed video will help professionals from multi-agency backgrounds better understand the role and purpose of a medical examination in situations where child sexual abuse has been disclosed or suspected. (Duration 9.46 minutes).

Video providing general information about SARC Sexual assault referral centres animation. (Duration 4.30 minutes)

Non-recent medical examinations

If the suspected sexual abuse is outside of the forensic window, see information above. A medical examination may still be appropriate as there are therapeutic benefits of a medical examination including mental health and well-being/reassurance. 

Swindon has a non-recent CSA service and will see children following a strategy discussion and social work referral. 

Dr’s at Great Western Hospital are able to offer non-recent medical examinations. There is no time limit to be offered a medical examination and its aim is to empower the young person and ensure they are getting support/reassurance.

Children should be offered a medical examination even if there is no police investigation. The safeguarding team and also The Bridge SARC should be invited to strategy discussions. 
if the individual does not wish to have a medical examination, it may be advisable to consider a sexual health referral. However, the individual should not be sent directly to the service at Carfax street.  

Further guidance is included in the SSP Health Attendance at Strategy Discussions.

The overview of the GWH Child Protection Medicals and CSA Pathways document provides further information.