Actions such as making sexual comments, using a child in pornographic films, and having him view pornographic materials are considered abuse even though they don't involve contact. Sexual abuse with contact includes fondling, intercourse or any other sort of penetration, and oral sex, regardless of whether the action is performed on the child or the child performs it. Most reported cases of incest involve a female victim and a male perpetrator. Physical signs associated with penetration include pregnancy, sexually transmitted diseases, and vaginal or anal injuries. But don't assume that penetration didn't occur just because the child doesn't have physical indicators.
Behavioral signs count too.
For example, a young child may have precocious or sophisticated sexual knowledge or behavior. An adolescent may defy authority, run away from home, or engage in promiscuous activities. Consistently belittling, embarrassing, blaming, rejecting, or withholding love and affection from a child amounts to emotional abuse. If you work with families on a long-term basis, you're in a good position to detect this type of abuse. What you can watch for are certain patterns of adult behavior and environmental stressors that are common to many cases.