The definition of child abuse has only recently been extended to include sexual abuse (Burgess, Groth, Holstrom, & Sgroi, 1978; Finkelhor, 1979; Herman, 1981). The pioneering work of Kempe and colleagues (Kempe, Silverman, Steele, Droegemueller, & Silver, 1962) directed the attention of both the public and professionals to severe physical abuse in their description of the battered child syndrome. It is not acknowledged that not only are a substantial number of children victim to physical abuse, but a substantial number are also victim to sexual abuse.

There are many ways in which child sexual abuse differs from physical abuse, but probably the most significant difference lies in the lack of visible external scars to corroborate its occurrence. Consequently, the substantiation of sexual abuse becomes a question of who is believed: the alleged perpetrator, who more often than not denies the abuse, or the child victim, who alleges it. Further, in contrast to physical abuse cases, which are mostly heard in children's courts, sexual abuse cases, at least in North America, England, Australia, and New Zealand, are usually dealt with in criminal courts. The alleged perpetrator of sexual abuse is charged with a criminal offense and the child victim is often required to testify in a criminal court.

Because there is rarely a witness to sexual abuse and very often no physical evidence, the case therefore is a trial of the child victim's word against the adult perpetrator's word.