Given the fact that child sexual abuse may affect more than one third of our population, our current resources and expertise are sorely inadequate to address the problem, especially among very young children. We are at a crossroads in this field. Public awareness and improved clinical techniques have done much to bring this issue to the forefront, but already there is a public backlash of disbelief, including accusations of hysteria and witch hunting.

The backlash that is now occurring in some preschools threatens to deprive children of the nourishment and affection that is so important to healthy development and so rewarding to children as well as teachers. Workshops assisting parents and teachers to explore these issues in a safe environment might help adults to confront some of these very sensitive issues.

Parents and providers of care for children are clearly much better educated about the symptoms of sexual abuse than was the case a decade ago. More importantly, because the symptoms are frequently so subtle, children are finally being educated about the problem.

Specialized diagnostic centers and specialized units in existing agencies should be available in every community, so that suspected victims of child sexual abuse can receive thorough, sensitive assessments by experienced professionals.

Wherever possible, medical, psychosocial, and law enforcement evaluations should be coordinated and jointly conducted in one place in order to prevent duplication and minimize investigatory trauma to children.

Retractions of initial disclosure of sexual abuse are common among young children and should not be assumed to be indicative that abuse did not occur. In general, the longer the period of legal intervention involving the prospect of testifying, and the more family disruption involving hostility and denial by significant adults in the child's life, the more likely the young child will be to recant.

No discipline, whether medical, legal, or clinical in orientation, holds sole responsibility for what should be done with cases involving preschool age victims; no discipline has all the resources or all the answers. However, professionals in all disciplines who interview, diagnose, or treat alleged young victims of sexual abuse should have two things in common: ...

Along with technical advances have come a series of common realizations or themes that now reverberate throughout the field and within most communities struggling to respond to this problem. The most significant of these includes the recognition that (1) no single agency or discipline can or should be totally responsible for management of child sexual abuse cases; ...

The effectiveness of prevention education that also emphasizes immediate disclosure of abuse must be evaluated.

Prevention programs need to include encouragement of appropriate touching and nurturance.

Preparent education and training of child care providers needs to be available on issues of child sexual abuse, sexuality as it relates to developmental stages of children, and confronting molestation in one's own past.

The recent upsurge of sexual abuse in child care settings suggests that these children and their families are in special need of preventive education. Presentations to young children are most likely to be understood and retained when they are given over a period several short sessions, using language and tools that will help them to pass the difficult concepts presented.

Basic training in child sexual abuse needs to be included in curricula in professional programs for all those who deal with abused children or their families.

Specialty training, perhaps leading to certification, is necessary for those whose work centers on child abuse (e.g., police officers, child protective service personnel, family court judges, and attorneys). The training should include discipline specific as well as cross discipline education and experience.