“Private Parts”: Helping Kids Understand Without Creating Anxiety

Dr. Caroline R Paul and Patient

Dr. Caroline R Paul and Patient

Pediatricians take pride that prevention is the backbone of their vocation. As we work with families to better the lives of their children, we emphasize preventive measures that are based on well-founded knowledge and have been shown to be effective in reducing harm to children. We have to be particularly careful in balancing guidance for a potential danger, without provoking undue anxiety and fear. One particular area is that of personal safety.

Because, this hot media topic is a very sad reality for many children, we try to always include the topic of personal safety/sexual abuse prevention during kids regular checkups. How do we convey guidance in an effective manner without causing great anxiety?

First, it is helpful to relate this material to the child in a manner that is appropriate for their age and developmental status. It is also important, both as professionals and parents, to make it part of our “common-talk” – talk that makes it comfortable for child queries and potential disclosures. We need to talk to our children with carefully chosen words and actions that do not cause undue alarm.

Many groups including schools, religious organizations, and community centers have organized programs to teach children about personal safety and protection against sexual abuse. Physicians have a very important responsibility to convey safe principles to children and their families.

Around age 3, physicians will begin to talk to a child and their families. Of course, I do not assume that I have any right to examine a child in relation to their “private parts” but I also do not assume that a child or family would know this. So I make it clear. I ask for permission from the child and let them know that, “The only reason that Dr. Paul can look at their private parts is because they said it is ok and their mom/dad/caregiver is there. No one should be looking there-right? No teachers, no coaches, no etc….” Of course, while talking to the child, I also speak to the parents about the need for them to talk to their child. I often urge families to discuss the subject later that evening and the weeks following their visit. They can start the conversation with, “Why could Dr. Paul look at your private parts?” It is striking that a common answer is, “Because she is a doctor.”

We need to stress to our children that no authority figure, such as doctors, teachers, coaches or even police, has the right to touch a child inappropriately and without his or her permission. Using the child’s visit to the doctor’s office is great way to exemplify this principle. Children are not born with this knowledge and they need to be taught it.

Besides using the physician’s visit with their child as a pivotal teaching moment, what else can parents do? Remember the earlier principles of guiding your talk based on your individual child. Use terminology that is appropriate for your child’s age, development and also for your familial cultural context. Try to be and look comfortable talking to your child –they should be comfortable coming to you with their inquisitive thoughts. And try your best to be clear about what is appropriate and inappropriate in terms of their safety without panicking them.

This is heavy material but there are many resources available to you and your family. I think you will find healthychildren.org helpful in this area. Finally, have high expectations of those who are in your child’s world: teachers, coaches, ministers, dance instructors, physicians and the like. And, teach your child to have the same appropriate expectations of these figures as well.