The objectives of this study were to examine: (a) behavior in
children evaluated for sexual abuse, (b) the stability of their
behavior over 4 months, and (c) the relationship between aspects of
the abuse and the children's behavior. The Child Behavior Checklist
(CBCL) was completed by parents of 93 prepubertal children evaluated
for sexual abuse and 80 nonabused children matched on age, gender, and
race. A follow-up CBCL was completed after 4 months by 45% of parents
of abused children. Sexually abused children had significantly more
behavior problems than comparison children, including depression,
aggression, sleep and somatic complaints, hyperactivity, and sexual
problems. At follow-up, only those children who initially had
externalizing behavior in the clinical range improved
significantly. During the initial evaluation, behavior problems were
associated with the child's disclosure of abuse and during follow-up,
behavior problems were associated with abnormal physical
findings. However, behavior problems were not related to
characteristics of the abuse or perpetrator, likelihood of abuse, or
therapeutic services. The persistence of behavior problems suggests
that children suspected of having been sexually abused should receive
an assessment of their psychological status and careful follow-up.