1. In the United States, childhood sexual abuse has been reported up to 160,000 times per year. Although this figure appears high, such abuse is dramatically underreported both because children are afraid to tell and because the legal process is difficult. Statistics vary, but actual abuse, whether reported or not, may occur with as many as one-third of all girls and one-fourth of all boys.

2. Once sexual abuse has been identified, the child should receive professional help. The long-term psychological effects can be devastating for children who have been sexually abused (see following item).

3. "Red flags" or symptoms that may help identify children who have been sexually abused can include unusually increased or decreased interest in sexual matters, sleep problems, school avoidance, self-harming or aggressive behaviors, seductiveness, and enactments of molestations in play.

4. Children who have experienced repeated incest may become passive and seemingly accepting of these acts over time, a process known as "the accommodation syndrome." They usually have low self-esteem and an abnormal perspective on sexuality.

5 Children who care for their abuser are often trapped between feelings of loyalty to that person and the sense that the sexual activities are wrong. Incest also affects a child's relationship with all other family members.

6. Sexual abuse of boys is seriously underreported. Like girls, boys are more commonly abused by men; these boys may experience confusion about their sexual identity and fears of homosexuality at the time of the abuse or later.

7. Children and adolescents who have been sexually abused are more likely to engage in dangerous risk-taking behaviors during adolescence, including coercive sex (as either the aggressor or the victim), unprotected sexual activity, and self-harming behaviors such as cutting, driving while intoxicated, and even suicide attempts.

8. Parents need to educate themselves about both normative and unhealthy sexual behavior in childhood, and promote good communication with their children. As a part of this, parents need to alert their children to the potential of adults touching their bodies, and encourage the children to tell them if this happens.

9. Parents need to encourage professional prevention programs in schools.

10. Parents need to pay attention to their own attitudes and behaviors around sexuality, including participation in dangerous patterns, neglect of sexuality as a healthy aspect of life, or forced sex. Children are watching and imitating, whether they acknowledge this or not.