Sexual abuse is more likely to be identified through behavioral indicators, rather than by physical indicators.

PHYSICAL INDICATORS

4 Difficulty in walking or sitting
4 Anxiety related illnesses, such as anorexia or bulimia
4 Discomfort in urinating or defecating
4 Recurrent urinary infections
4 Evidence of physical trauma, to the oral, genital or anal areas, manifested as bleeding, discharge, soreness and/or itching
4 Bruising and other injury to breasts, buttocks and thighs and other parts of the body
4 Sexually transmitted disease in a child of any age
4 Unexplained pregnancy

BEHAVIOURAL INDICATORS
Behavioral indicators in and of themselves do not constitute abuse. Together with other indicators they may warrant a referral.
4Learning problems, inexplicable fall in academic grades, poor memory and concentration
4Reluctance to participate in physical or recreational activities
4Regression to younger behaviour, such as thumb-sucking, acting like a baby, bedwetting and/or speech difficulties
4Tendency to cling or need constant reassurance
4Sudden accumulation of money or gifts
4Complaining of headaches, stomach pains or nausea without a physiological basis
4Fatigue and sleeping difficulties
4Poor self-care/personal hygiene
4Depression
4Social withdrawal (such as poor or deteriorating relationships with adults and peers)
4Developing fears, phobias and anxieties (A fear of a specific place related to abuse, a particular adult, refusing to change
       into sports/swimming clothes)
4Wearing of provocative clothing, or layers of clothes to hide injuries and/or to appear unattractive
4Sexual knowledge, behavior, or use of language not appropriate to age level
4Sexual inference in children's recreational activities such as drawing, playing, singing etc.
4Sexually abusive behavior towards other children, particularly younger or more vulnerable than themselves
4Age inappropriate sexual behavior.
4Child running away from home/school.
4Self-injurious behavior, like alcohol or drug abuse, body-mutilation, getting in trouble with law, suicide attempts

Effects of Child Sexual Abuse
The effects of child sexual abuse vary from child to child with each child developing his/her own coping mechanism. The effects are dependent on a host of factors, the primary ones being age of the child, sex of the child, the relationship with the abusers, frequency of abuse and availability rof support systems etc. But some of the more common effects of child sexual abuse recorded are:
4 Distrust of others and themselves.
4 Terror and anxiety.
4 Shame, guilt, and self-hatred.
4 Alienatation from their bodies.
4 Isolation and withdrawal from people and activities.
4 Powerlessness, depression, and extreme passivity.
4 Anger.
4 Obsession with sex or complete aversion to it.
4 Questioning their sexuality and gender.
4 Drug and alcohol use, abuse and addiction.
4 Eating disorders.
4 Perfectionism and workaholism.
4 Mental illness and suicide.
4 Sexual offending.