Physical evidence of abuse is rare, but may include bladder and urinary infections, scratching and painful genitals (especially during urination), and torn, stained or bloody undergarments. While there is no single behavior that positively indicates a child has been sexually abused, sudden or extreme changes in behavior should be considered as a possible reaction to abuse. Even still, some children may not show any changes in behavior.

The following are behavior changes that may occur in children who have been sexually abused:

• Fear or dislike of certain people or places
• Seductive or “sexy” behavior towards adults or peers
• Problems in school; poor grades
• Withdrawal from family, friends or usual activities
• Advanced sexual knowledge for the child’s age
• Regressed behavior, such as bedwetting
• Eating disorders; eating very little or excessive eating
• Hostility or aggressive behaviors
• Drug or alcohol problems
• Suicidal thoughts or attempts