Sexual abuse is when a person uses his or her power over a child and involves the child in any sexual act. It can include fondling, genital stimulation, mutual masturbation, oral sex, using fingers, penis or objects for oral, vaginal and/or anal penetration, inappropriate sexual language, sexual harassment, voyeurism, exposing oneself, sexual exploitation, as well as technology-assisted sexual abuse. This can involve exposing the child to sexual abuse images and/or videos or involving a child in the making of sexual abuse images and/or videos commonly known as child pornography or involvement in the sex trade (prostitution) or human trafficking (Crosson-Tower, 2020; Tufford, 2020; Jonson-Reid & Drake, 2018; Rimer & Prager, 2016).

Signs of sexual abuse may include (but are not limited to):

• Re-enactment of abuse using dolls, drawings or friends
• Clinging
• Thumb-sucking
• Sudden fear of the dark
• Change in behaviour
• Behaviour extremism—aggressiveness or withdrawal
• Recurrent nightmares or disturbed sleep patterns
• Perfectionism
• Loss of appetite for no apparent reason or excessive appetite
• Bedwetting
• Avoidance of undressing or wearing extra layers of clothes
• Abrupt decline in school performance
• Request to change something. E.g., Child, “I want to take baseball now, not swimming lessons. I don’t like swimming lessons anymore.”
• Frequent sore throats or urinary infections
• Soreness in the genitals
• Constant sadness
• New possessions that are unexplained (gifts from the perpetrator)
• Young child overly focused on private parts
• Publicly masturbates
• Imitates sexual acts
• Sexualized interactions
• Graphically imitates or re-enacts adult sexual acts
• Unexplained stomach aches/headaches
• Encopresis, Enuresis
• Breaches personal boundaries
• Draws sexually explicit behaviour
• Hates their gender
• Tells sexualized jokes
• Preoccupied with pornography
• Coerces others to engage in sexual activity without their consent
• Sends naked provocative pictures of oneself or others with malicious intent

(“Child Abuse and Neglect,” n.d.; Crosson-Tower, 2020; Durrant et al., 2006; Fallon et al., 2020; Jonson-Reid & Drake, 2018; Ontario Association of Children’s Aid Societies, 2022; Fallon et al., 2020; Public Health Agency of Canada, 2012; Rimer & Prager 2016; Sedlak et al., 2010; Toronto Children’s Aid Society, n.d.; Tufford 2020).