Child sexual abuse includes the following touching behaviors.

• Touching a child's genitals (penis, testicles, vulva, breasts, or anus) for sexual pleasure or to meet the needs of the older child or adult.
• Making a child touch someone else's genitals, or playing sexual ("pants-down") games.
• Putting objects or body parts (like fingers, tongue or a penis) inside the vulva or vagina, in the mouth, or in the anus of a child for sexual pleasure or to meet the needs of the older child or adult.

Between an adult and a child

All sexual touching between an adult and a child is sexual abuse. The touching does not have to be forced or cause pain to the child to be considered sexual abuse – in fact, in many situations the behavior is made to seem more like a game. The child may willingly participate in the sexual activity, or say “yes” when asked permission, yet it is still considered sexual abuse. The child may not know that the activity is sexual, yet it is still considered sexual abuse. For example, when someone gets sexually aroused holding a child on their lap and rubs the child against them, that is sexual abuse even if the child enjoys sitting on their lap.

Among children and youth

Sometimes sexual touching between children that is reported to authorities will not be investigated due to closeness in age. This does not mean that a child hasn’t been harmed or confused by the sexual touching. If the children are disturbed or upset about the sexual touching or seem to feel guilty or ashamed, it may be appropriate to seek specialized help for one or both children. At a minimum, both children need to learn about appropriate boundaries and how to handle similar situations in the future .