According to the U.S. Department of Health and Human Service, child sexual abuse (CSA) is defined as:

“(A) the employment, use, persuasion, inducement, enticement or coercion of any child to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or
(B) the rape, molestation, prostitution or other form of sexual exploitation of children or incest with children;…”

More specifically, child sexual abuse may include fondling a child’s genitals, masturbation, oral-genital contact, digital penetration, vaginal intercourse and anal intercourse. Child sexual abuse is not solely restricted to physical contact; such abuse could include non-contact abuse, such as exposure, voyeurism and child pornography.

Sexual acts may include the following:

• Touching of a child’s genital by an adult;
• An adult telling the child to touch the adult’s or another’s genitals;
• Exposure of the genitals, including photographing the child’s genitals or the child in a sexual position;
• An adult masturbating in front of a child;
• Rubbing (masturbating) against a child;
• Oral sex performed on a child or telling a child to perform oral sex;
• Any type of penetration of a child’s vagina or anus, however slight, by a penis, finger, tongue or other object;
• Exposing a child to pornography or using a child in pornography;
• Talking, commenting and/or teasing a child in sexual ways.

For discussion of various definitions of CSA (including civil, criminal and clinical) and more detailed description of “sexual acts” see Child Welfare Information Gateway

Other definitions have noted that CSA includes:

• asking or pressuring or inciting a child to engage in sexual activities (regardless of the outcome);
• sexual touching or fondling (even if fully clothed);
• engaging in sexual activity in the presence of a child;
• causing a child to watch a sexual act;
• exposure of genitals to a child;
• viewing a child’s genitalia or breasts without contact;
• inappropriate sexual conversation;
• arranging or facilitating commission of a child sex offence;
• meeting a child following sexual grooming;
• using a child to produce child pornography.

Notes:

1. A child cannot consent to any sexual activity with an adult or older adolescent, so it is not the victim’s fault.  They did not cause it and they are not to blame in any way, despite what they may have been told.
2. The legal age of consent for sexual activity varies in each jurisdiction. The age provisions regarding a possible defence for young offenders also vary. For example, some jurisdictions have special provisions if the younger party was aged 12 years or older and the offender was not more than say 2 years older than the younger person.
3. Even if a Statute of Limitations bars legal proceedings, any abuser should admit guilt, seek treatment and be willing to be publicly identified to prevent further abuse.
4. CSA can be male-male, male-female or female-female.

SIGNS AND SYMPTOMS

Signs and symptoms of child sexual abuse in a child may include:

• Physical signs of sexual abuse in children are not common, although redness, rashes or swelling in the genital area, urinary tract infections or other such symptoms should be carefully investigated. Also, physical problems associated with anxiety, such as chronic stomach pain or headaches, may occur. Has difficulty walking or sitting.
• Becomes pregnant or contracts a venereal disease, particularly if under age 14.
• “Too perfect” behavior; withdrawal and depression; unexplained anger and rebellion.
• Runs away.
• Reports sexual abuse by a parent or another adult.
• Sexual behavior and language that are not age-appropriate.

Be aware that in some children there are no signs whatsoever.

If you find physical signs that you suspect as sexual abuse, have the child physically examined immediately by a professional who specializes in child sexual abuse.

(CSOM-Center for Sex Offender Management-US Dept of Justice)