Is masturbation a sign of child abuse?

Karen Kay Imagawa, MD, shares advice for parents on whether or not their young child's masturbating is a sign of sexual abuse and red flags they should look for
Is A Child Who Is Masturbating A Sign Of Sexual Abuse?
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Is masturbation a sign of child abuse?

I actually get asked a lot from, not only healthcare professionals, but from families, whether or not a child who is masturbating is that a sign of sexual abuse. Well just keep in mind that masturbating is normal, it's pretty universal, often times seen in toddlers and pre-schoolers. Most children have masturbated before they're 5-6 years of age, so, again, keeping in mind that it is a normal thing that a child does; now when do you become concerned? I would become more concerned when they're compulsively masturbating, when a child would rather masturbate than go out and play, or would rather masturbate than do the daily activities that they would normally do. That would raise a red flag, and make me a little bit more suspicious. In addition, if along with the masturbating or chronic masturbating, they also have other sexuallzed behaviors that would be inappropriate for that developmental level of that child, so if the child wasn't exposed to some sort of sexual activity, they shouldn't be displaying that because they wouldn't know how to do certain things; so keeping in mind that masturbation is normal; it's pretty universal among children, however, there can be some red flags when it becomes more compulsive, when they would rather do that than playing, and when it's associated with other sexualized behaviors. So what do you do when your child masturbates? Because it can be embarrassing, it can be uncomfortable for parents. It's letting children know that there are some things you do in private and some things you do in public, and this is just one of those things you're just going to go to your bedroom and do. Also, often times when your child is taking a nap, you might find them masturbating, just a very casual comment - "Get you hand out of your pants, time to go to sleep." The more of a big deal you make about it, the bigger deal it becomes, so the more anxious parents become about it, the more anxious the child becomes about it, and often times that can make them want to masturbate more. You'll typically see masturbation during times when the child is just kind of hanging out, they're relaxing, they're about to go to sleep, although sometimes it can be embarrassing because it can happen in the middle of the restaurant and you just need to let your child know, "Oh, hand out of your pants" and, "That's something that we do in private." Don't freak out if your child starts masturbating, but do be concerned if there are other red flags that are associated with it.

Karen Kay Imagawa, MD, shares advice for parents on whether or not their young child's masturbating is a sign of sexual abuse and red flags they should look for


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Karen Kay Imagawa, MD

Director of the Audrey Hepburn CARES Center, Children's Hospital Los Angeles

Karen Kay Imagawa, MD: Director, Audrey Hepburn CARES Center, Director, Developmental-Behavioral Pediatrics Program, Division of General Pediatrics; Children's Hospital Los Angeles. Karen Kay Imagawa, MD, is also the Assistant Professor of Pediatrics at USC’s Keck School of Medicine and is a full-time attending within the Department of Pediatrics, Division of General Pediatrics, at Children’s Hospital Los Angeles (CHLA). She received her medical degree at the University of California, Los Angeles, and is board certified in General Pediatrics, Developmental-Behavioral Pediatrics, and Child Abuse Pediatrics.  Dr. Imagawa has made significant contributions to program development at CHLA: She is currently the Director of the Joint General Pediatrics – USC University Center for Excellence in Developmental Disabilities (UCEDD) Developmental-Behavioral Pediatrics Program ,expanding the program to its current position with the largest number of board-certified developmental-behavioral pediatricians (7) in a Southern California program, and was integral in establishing the ACGME accredited Developmental-Behavioral Pediatrics Fellowship program at CHLA . Dr. Imagawa is also one of the founders and the Director of the Audrey Hepburn CARES Center at CHLA, a multifaceted interdisciplinary child protection center involving evaluation, treatment, prevention, education and research in the field of child maltreatment.  Dr. Imagawa is a court appointed expert (730 paneled expert in both Criminal and Dependency Court) in the field of child abuse, and was actively involved in the development of the Foster Care Hub at CHLA, one of seven designated Hubs in Los Angeles County that were initially established to provide forensic, medical, and mental health screenings for newly detained children entering the foster care system.  She previously served on the advisory group for The California Medical Training Centers formulating standardized training in child abuse, and collaborated on a task force to develop standards at the state level for mental health care for child victims of trauma. She is a medical consultant for the Inter-agency Council on Child Abuse and Neglect (ICAN – the official county agency which coordinates the development of services for the prevention, identification and treatment of child abuse and neglect), having participated in various medical task forces establishing protocols and best practice standards for the evaluation and treatment of suspected victims of child abuse, included those with developmental disabilities. Dr. Imagawa’s strength as a clinical educator is also seen in her dedication to education and training. She has been invited to participate in numerous speaking engagements, as well as requests from the media and entertainment industry, involving a variety of topics in the fields of child abuse and/or developmental-behavioral pediatrics. 

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