Can you give me an experts advise on whether a child 10-12 years of
age could be alledgely sexually abused more than 250 times in one year
and not show
signs of abuse when examined by a physician? Or would the signs of old
sexual abuse make it impossible for a physician to tell if the abuse
is current or old?

Hello gladys1-ga,

In most cases, physical signs of sexual abuse are not common, no
matter how often the abuse occurs. Of course, with certain ways of
sexual abuse, such as any sort of penetration of a child, you would
think there would be signs, however, being that the human body is
built the way it is, sometimes it can be very hard to tell.

Example: You would think with vaginal intercourse, a female child
would have her hymen broken from the abuse. However, that's not a
definitive sign of abuse, as it ca break from many activities, or the
child's own natural curiosity. Horseback riding, gymnastics, accident,
injury... all can be causes.

More information:
http://www.starmatrimonials.com/hymen.asp?acode=
http://www.webster-dictionary.org/definition/Hymen

Google Search: Hymen Breaking
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=hymen%20breaking&btnG=Google+Search

Also, if your considering that there would be signs of abuse from
sodomy during the abuse, that can also not be evident as the rectum is
meant to be elastic, and without tearing, can return to it?s original
state very quickly.

Now, Sexual abuse is not always involving penetration. Sexual Abuse
Can Be Physical, Verbal, or Emotional. It can include touching,
exposing children to adult material, such as films and pictures,
having a child pose in a sexual fashion, a child being watched by an
adult, such as a ?peeping tom? scenario, or rape. The best definition
for this is: Sexual abuse involves forcing, tricking, threatening, or
pressuring a child into sexual awareness or activity.

 ?Physical evidence of abuse is rare. Therefore, we must look for
behavior signs. Unfortunately, there is no one behavior alone that
definitely determines a child has been sexually abused. ?
From http://www.coolnurse.com/sexual_abuse.htm

Typically, the signs of sexual abuse are as follows.
	Depression

	Eating Disorders

	Sleep disturbances

	Nightmares

	Physical complaints

	School problems

	Withdrawal from family, friends, or usual activities

	Excessive bathing or poor hygiene

	Anxiety

	Running away

	Passive or overly pleasing behavior

	Low self-esteem

	Self-destructive behavior

	Hostility or aggression

	Drug or alcohol problems

	Sexual activity or pregnancy at an early age; promiscuity

	Suicide attempts

	Copying adult sexual behavior

	Sexual play with other children, themselves, toys or pets

	Displaying sexual knowledge, through language or behavior, that is
beyond what is normal for their age

	Unexplained pain, swelling, bleeding or irritation of the mouth,
genital or anal area; urinary infections; sexually transmitted
diseases

	Hints, indirect comments or statements about the abuse


So, as you can see, it?s much more psychological symptoms that prevail.

Once again, mentioned here?
?Unfortunately, there are often no obvious signs that a child has been
sexually abused. Because sexual abuse often occurs in private, and
because it often does not result in physical evidence, child sexual
abuse can be difficult to detect.?
http://www.ncptsd.org/facts/specific/fs_child_sexual_abuse.html

If the child had been abused before, and there were physical signs of
evidence, such as scarring, or the hymen being broken, etc, it would
make it much harder to determine when the signs came from. One of the
best things I could suggest is if the child tells you that she has
been abused; ask a physician to do a ?rape kit? on them, searching for
bodily fluids of another. This would be an accurate determinate, but
must be done ASAP after the abuse. Most signs disappear within 24-72
hours, and it?s best if the child has not bathed or cleaned up.
?The attacker may have left behind pieces of evidence such as clothing
fibers, hairs, saliva or semen that may help identify him. In most
hospitals, a "rape kit" is used to help collect evidence. A rape kit
is a standard kit with little boxes, microscope slides and plastic
bags for collecting and storing evidence. Samples of evidence may be
used in court.?

http://familydoctor.org/x1976.xml

Google Search: Rape Kit
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=rape%20kit&btnG=Google+Search

In addition, being that physical evidence can be so hard to locate, I
recommend you speak with a therapist and an organization in your area
to report this suspected abuse, such as the Department of Human
Services or similar agency in your area.

?Therefore, correctly diagnosing abuse is often complex. Conclusive
physical evidence of sexual abuse is relatively rare in suspected
cases. For all of these reasons, when abuse is suspected, an
appropriately trained health professional should be consulted.?

http://www.apa.org/releases/sexabuse/

In addition, you may want to read this journal article about signs of
abuse that are physical and other information. You may want to take it
with you if you?re going to have your child physically examined for
signs of sexual abuse.

?Because the examination findings of most child victims of sexual
abuse are within normal limits or are nonspecific, the child's
statements are extremely important. The child's history as obtained by
the physician may be admitted as evidence in court trials; therefore,
complete documentation of questions and answers is critical. A careful
history should be obtained and a thorough physical examination should
be performed with documentation of all findings. When examining the
child's genitalia, it is important that the physician be familiar with
normal variants, nonspecific changes and diagnostic signs of sexual
abuse. Judicious use of laboratory tests, along with appropriate
therapy, should be individually tailored. Forensic evidence collection
is indicated in certain cases. Referral for psychologic services is
important because victims of abuse are more likely to have depression,
anxiety disorders, behavioral problems and post-traumatic stress
disorder. (Am Fam Physician 2001;63:883-92.)?

http://www.aafp.org/afp/20010301/883.html

Additional Google Search: sexual abuse with no physical evidence
://www.google.com/search?hl=en&ie=UTF-8&oe=UTF-8&q=sexual%20abuse%20with%20no%20physical%20evidence&btnG=Google+Search

Therefore, in conclusion, yes, it could be possible that a child of
that age may show no physical signs of being abused, no matter how
many times. Psychological symptoms prevail much more. In addition,
previous abuse signs that are physical could cloud the diagnosis of
new signs.


If this answer requires further explanation, please request
clarification before rating it, and I'll be happy to look into this
further.
Nenna-GA
Google Answers Researcher

I would think it would depend laregly on what kind of physical abuse took place.

tutuzdad-ga

Sexually abused has been broadly defined, sometimes vaugly, So
tutuzdad is correct. In some cases it will matter if the child is male
or female. My guess is most physicians are not, and don't want to be
expert witnesses.   Neil

Physical Child abuse could be as simple as an inappropriate touch, so
I would say Yes, it is possible.

Yes, is possible. If you are not sure about your child having been
abused as he or she refuses to talk about it, look for other smaller
signs of imbalance.  Such as: chronic nailbiting to possibly the point
of bleeding, bed wetting, picking at sores, violent hair twirling,
actual cutting of themselves, over or undereating, withdrawal from or
seclusion from people in general. As time progresses and they have to
continue to live with this horror the fear may begin to manifest
itself in any of the above mentioned behavioral patterns.  Even the
area on themselves they would begin to mutilate would be indicative of
what kind of physical abuse took place.  Survivor