Child sexual abuse: recognition and response when there is a suspicion or allegation

Child sexual abuse is a clear violation of children's rights with known lifelong devastating consequences. It occurs across all ages, sexes and cultures. Cases are underreported and may not be disclosed at first due to its secretive and hidden nature. It is clear that children do try to disclose but are not always heard or believed. In this paper we delve deeper into the recognition and response to suspected cases of child sexual abuse and the importance of working within a multidisciplinary team to best safeguard the victims. We emphasise the importance of asking questions in a direct, empathic and developmentally appropriate manner, such that the child feels believed and supported. The physical and behavioural changes are described in suspected cases and possible differential diagnoses. We propose a holistic model to the management and prevention of child sexual abuse based on the ecological approach to child maltreatment.