**3. The words and silent stories**

The interpretation of a word depends on the development and age of the child. The language of a child is structured between the ages of 4 and 6 years 8.

However, it is informative and based on cognitive and language development despite the age. "A young child of two years may report sexual abuse directly and clearly" [9]. The words are simple and correlated to the possibilities of the child. They sometimes refer to the act of aggression, and sometimes to the pain and consequent anxiety. They are called in special circumstances of personal hygiene, diaper or clothes changing, and sometimes during a clinical examination for instance when the child shows the assaulted area.

It is often a story without words, indirect consequences on the child's behavior may suggest the diagnosis. The subjective perception of one parent or the environment will lead to a discussion on recent changes. Many signs have been described as true indices [6], and often reflect the impact of recent trauma [9]:


If the child speaks or if its behavioral consequences reveals an history of abuse, its interpretation requests a rigorous approach [2-12-7].

The first adult who received the confidence should look for an experienced professional within 2-3 days after the revelation.

There is no way for the physician to bring together suspected children and adults, even to observe the reactions of the child.

The collection of the child's speech must be done with consideration to avoid leading questions at any age as the predictive value of words is not related to age [12].

Professionals must link the interpretation of a child's speech with its emotional and cognitive development and remember that memory for detail is unstable. The perception of time is more revealing than a chronological relation of facts as many temporal expressions have no meaning for younger children [11]. Emotional factors are also significant: the child's fear related to unsuitable for any age experiences may inhibit expression.

Early sexualized behaviors of children are not in themselves proof of aggression. Within three years there may be "periods of intense masturbation" without a past sexual assault as sexual curiosity in young children is widespread [5].

Strategies for assessing the validity of the statements described by Yuille are hardly applicable in younger children [13].

At this age, repeted situations of interrogation lead to an even greater possibility for misinterpretation and this is an important argument for filmed audition strategies [5]. None of these signs as a consequence of trauma is *a priori* indicative of sexual assault, and only their association to the context will lead to the diagnosis.

The circumstances of abuse would lead to a discernment of different disorders of the child by its family. Extrafamilial abuse may lead to earlier recognition of changes in the child.

Situations of alleged sexual assault in connection with parental separation are increasingly frequent. The interpretation of anxious behavior after a weekend at the ex-spouse's home, or confusion with necessary care and intimate assaults may lead to repeated investigations and traumatic experiences. This is also the case in the same situations of actual sexual assault [1-5-7].

There is no way to support an instrumental evaluation.14 The use of sexed dolls is very controversial: the method is not recommended in the assessment of Yuille [13], and is to be used with great caution and interpretation by experts as reported by August [15]. The child can use ordinary toys (Bear, Figurines) to stage events or to describe the assaulted body parts. Older children may use drawings to express themselves. Among younger girls (less than 5 years of age), this method rarely leads to get a direct word or a specific behavioral sign, but "gives the child to see and hear something of grave concern," [16] and we must therefore raise the possibility of sexual assault.
