Signs & Symptoms

Due to intimidation and threats, most children don’t express their trauma experiences of sexual abuse through words. Instead, children use behaviours to indirectly tell us. Dr Peter Levine and Maggie Kline state that “What makes sexual abuse so devastating is that it violates the deepest core of the child’s formative sense of self”(4).

Some of these behaviours are part of the neurodivergent experience, but the key is to notice the subtle, sudden or obvious changes in behaviour. The change in behaviour may have occurred years before and then over time, with accumulated trauma experiences, the behaviour has intensified. A child may display several of the following symptoms:

Physical Symptoms

• Hyperarousal behaviour: they are in a ‘revved up’ internal state, even though no other stimulation is present. The stimulation comes from the nervous system that they can’t turn down. When the child is scared or highly stressed, whether the danger is real or perceived, increased heart rate and breathing make it possible for their internal ‘engines’ to go from idle to high speed within seconds, even though the child may appear calm(4).
• Lethargy and fatigue
• Chronic headaches and stomach pain
• Sensitive digestion, gut issues, diarrhoea and constipation
• See Physical Symptoms list above 

Behavioural Symptoms

• Night terrors are an example of hyperarousal. This stirred up state may keep them awake at night and/or nervous during the day. Deep relaxation is impossible until the excess energy is released.
• Difficulties falling asleep and staying asleep
• Repeated nightmares can tell us that the child is re-experiencing a traumatic event
• Hypervigilance and an exaggerated startle response. When hyperarousal symptoms become chronic they can begin to resemble ADHD. Unfortunately, far too often traumatised children are misdiagnosed with this disorder and medicated inappropriately.
• Exaggerated responses like displays of emotional turmoil and protests to routine outings or activities. An endless barrage of questions in an attempt to maintain control: “who will be there; who else? How long will we be there?”
• Hallmark symptom is a body-override called dissociation which can look like distractability and forgetfulness to numbness in parts of the body and amnesia for parts of childhood. Often children live in a dream-like state with a sense of not feeling ‘real’. While helping children to distance themselves from unbearable pain, dissociation interferes with the ability to be in one’s body.
• Children who have been sexually violated feel so different from others that they can become isolated and finding friendships difficult
• Symptoms may appear years after the initial abuse occurred. For instance, in adolescence when the child has realised how wrong it was. Dealing with feelings of guilt and shame and not wanting to be in their body.
• Mimics abuse through repetitive role-play with toys or animals. The toys could be displayed on top of the other, doing an act to the other or could display destructive actions, switching roles between perpetrator and victim.
• Unexpected anxiety attacks when the child is triggered by something that reminds them of a traumatic event.
• Unexplained fear of toileting, bathing or cars which could indicate a setting abuse took place in
• The development of new fears (separating from an adult, meeting strangers, new challenges)
• Development of Phobias
• Excessively withdrawn and shy
• Dampening of pleasurable feelings (loss of fun). Where there was enjoyment, there is no longer any.
• Sudden changes in mood or behaviour around certain people
• Reluctance to go with a certain person, but doesn’t explain why
• Displays anxiety and worry
• Doesn’t like to be alone
• Clingy to caregiver or more dependent on caregiver
• Fixates on their own safety or the safety of others
• Exaggerated startle response (; if someone walks past or touches them and they flinch or jump back)
• Frequent crying or irritability (you may find the child crying alone)
• Behaviour changes. They were outgoing, now they appear shy; they had a good appetite, now they don’t eat; they were easy going, now they are agitated; they were energetic, now they are lethargic.
• A significant difference in personal hygiene, sleeping habits, school performance, or emotional responses to situations
• Changes in eating behaviour. Over-eating or loss of interest in eating. Development of an eating disorder.
• Restlessness (overactive nervous system)
• Exaggerated emotional responses (over-reacts)
• Avoidance behaviours
• Aggressive behaviours
• Non-compliance and oppositional behaviours
• Increased intensity or frequency of meltdowns (‘emotional releases’)
• Abrupt mood swings: rage reactions
• Regressive behaviours, wanting a bottle, thumb sucking, bed wetting, loses language or fine and gross motor skills could previously do. Wants to sleep with a caregiver(5).
• Sexualised behaviour that is not age appropriate: french kissing, touching adults or other children’s genitals; simulating intercourse or other sexual activity with adults, other children, toys or animals; using seducive or sensual gestures with an adult, or masturbating in public. Sexual knowledge, language, and/or behaviours that are unusual and inappropriate for their age (6)
• Refusal to change for sport or participate in physical activities
• Starts wearing baggy clothes to hide their body or starts dressing provocatively or wears revealing clothing
• Statements like “I don’t want to sleep at Dads anymore”; “Dad watches me go to the toilet”; “Uncle … walks in on me when I’m in the shower’ or “I don’t like Aunty …”
• Depression
• Propensity to run away
• Abuses drugs or engages in promiscuous sex. Drug and alcohol use may occur unusually early.
• Flashbacks
• ‘Too perfect’ behaviour (submissive, people pleaser)
• Unexplained Rebellion
• May be fidgety
• Failing school grades
• Cruelty to animals
• Bullying or being bullied
• Fire setting
• The child’s energy can be wild and unmanageable which makes caring for them challenging
• Because the world is now perceived as a dangerous place, healthy risk taking is avoided
• Recklessness and attraction to dangerous situations: increased risk taking behaviour
• A sense of powerlessness and/or helplessness