DANVILLE -- The Jerry Sandusky-Second Mile scandal has placed child abuse and its victims in the spotlight.
One of the most shocking figures, according to the Rape, Abuse and Incest National Network, is that more than 90 percent of sexual abuse victims know their assailants. Other statistics show that one of six women and one in 33 men are victims of sexual assault at some point in their lives.
Commonly, the culprit is a nonbiologically-related adult living with the family, said Dr. Pat Bruno, medical director of Geisinger's Child Advocacy Center of the Central Susquehanna Valley.
The abusers might give the victims gifts or other signs of affection as a way of keeping them quiet, he said. The perpetrators will usually not try to physically harm the children because they are receiving sexual gratification from them.
Abusers can try to intimidate a child to keep quiet. A common threat is that if the child tells anyone, the family will split up.
"No matter how bad things are at home, it's their home," Bruno said. People "have to remember how difficult it is" for the kids, he said.
One of the most important things adults can do for young victims is to believe them when they say they have been hurt.
"It may be the one and only time the child discloses it," Bruno said.
"That initial disclosure and how it is received can impact greatly" the recovery of a child, said Dr. Nicole Quinlan, a pediatric psychologist with Geisinger.
Short-term effects can include difficulty sleeping, increased sadness or anxiety, trouble in school and withdrawing from friends. Long-term effects can be depression, eating disorders, poor self-esteem and changes in behavior.
"Sexual abuse is traumatizing, but it can also be confusion," Quinlan said.
Some warning sings of abuse are "more obvious than others," she said. Some of these include a child coming home with unexplained pain or injuries to the genitals or elsewhere on the body; stains or blood on a child's underwear; a child having difficulty sleeping or an increase in nightmares; changes in moods or outbursts of anger; changes in appetite; displaying knowledge of sexual language or behavior inappropriate for the child's age; and increased anxiety, such as not wanting to be away from the house or around other people.
If a child is reluctant to be left alone with a certain person, it may not necessarily be about sexual abuse but it should be considered, Quinlan said.
The most important things for a child to keep in mind about sexual abuse is that "it's not their fault and that they can heal," said Melissa DeBaro, coordinator at Geisinger's Child Advocacy Center.
"It's not often that kids report immediately," she said. It can be weeks, months or even years later that a child opens up about an incident.
As damaging as a sexual assault can be, DeBaro said, "It's possible to heal and lead a normal life."