This document discusses signs and symptoms of child abuse and neglect, as well as characteristics of abusers and dynamics of sexual abuse. It notes that the majority of abusers are parents or relatives of the victim. Suspicions of abuse should be raised if a caregiver's story changes, there is a history of domestic violence, or medical attention is delayed for a child's injury. Abusers often overreact, have low self-esteem, use harsh discipline, and view children negatively. Sexual abusers are usually trusted adults, not strangers, and look to take advantage of secrecy and a child's helplessness to avoid disclosure and detection of their crimes.