Risk factors, and how to spot child sexual abuse, according to the experts.

THE FAMILY

---Has economic, housing or personal problems.

---Is isolated from the community or the extended family.

---A family member has difficulty controlling anger or is dealing with physical or mental health issues or drug or alcohol issues.

---Family members appear uninterested in the care, nourishment or safety of the children.

IN CHILDREN

---Nervousness around adults, aggression around adults or other children.

---Inability to stay awake or concentrate, lost sleep or reluctance to go to bed.

---Sudden dramatic changes in personality.

---Unnatural or age-inappropriate interest in sex, such as knowing slang words they shouldn't know.

---Low self-esteem and poor hygiene.

---Dramatic behavioral change.

---Withdrawal.

---Fear of things they weren't previously fearful of, such as specific people, places and activities.

---Bed-wetting, especially in a child who has a potty-training regression.

---Private-area bruises, bleeding, pain, itching or yeast infections.

---Torn, stained or bloody underwear or missing underwear.

To report sexual abuse to Access-York's victims assistance center, call 800-422-3204.

'THE TALK' TIP

Parents should start discussions with their children about sexuality early in life, as soon as they're old enough to understand, said Rick Azzaro, chief services officer for Access-York's victims assistance center and a licensed clinical social worker. Some parents believe children become sexualized in adolescence, but they're aware of their bodies earlier, he said. Gone are the days of waiting until a child is "of age" to have "the talk," he said.

"As soon as they can understand, introduce body parts and explain the body is private," he said. "Bath time with a toddler is a wonderful time to talk about the body being private and there are boundaries people shouldn't cross."

Source: Access-York's victims assistance center, York County District Attorney Office's Child Abuse Unit, York County Office of Children, Youth and Fami lies.