Behavioral
- Lack of trust, social isolation and lack of friendships
- Nightmares
- Abrupt changes in behavior or personality
- Agression
- “Flashbacks”
- Acts of self-mutilation or self-injury
- Suicidal thoughts or attempts
- Excessive crying
- Truancy or “Runaway” behavior
- Over compliance or submissive behavior
- Temper tantrums
- School problems such as sudden drop in grades or participation
Emotional
- Self-hate
- Obsessive ideas and thoughts
- Regression to younger development stage
- Lack of affect
- Depression and/or withdrawal
- Anxiety, fear and irritability
- Low self-esteem
- Feelings of helplessness
- Excessive guilt
- Phobias
Sexual/Physical
- Fatigue and/or exhaustion
- Enuresis (wetting of pants or the bed)
- Encopresis (soiling of pants)
- Drastic changes in appetite
- Sleep disturbances
- Hypervigilance
- Increased startle response
- Avoidance of touch
- Reluctance to undress in normal settings
- Excessive masturbatory behavior
- Detailed and age-inappropriate knowledge of sexual activity
- Sexualized play with self or others
- Attempts to touch genitals or “private areas” of others (child and/or adult)
The American Academy of Pediatrics also reports the following are also common behavior changes in victims of child sexual abuse:
- Noticeable fear of a person or certain places
- Unusual or unexpected response from the child when asked if he or she was touched by someone
- Unreasonable fear of a physical exam
- Drawings that show sexual acts
- Abrupt changes in behavior, such as bedwetting or losing control of the bowels
- Sudden awareness of genitals and sexual acts and words
- Attempting to get other children to perform sexual acts