The 5 boys and 22 girls all received psychiatric evaluations at a child guidance clinic in 1978. The sexual abuse was the reason for the evaluation in most cases, but in a few, it became known only during the evaluation. Each evaluation took place during a 3-hour period on 1 day. Sixteen of the 22 girls were molested by fathers or father surrogates; 4 of the 5 boys were molested by male age-mates. Twenty-six children had psychiatric diagnoses ranging from adjustment reactions to psychosis. Preschool children had problems with sleeping, nightmares, and bodily complaints; school-aged children with masturbation, school and home behavior problems, and withdrawal. Adolescents were more often depressed and suicidal than were younger children. One boy used no defense mechanisms, and three other children showed mainly undefended anxiety with gross stress reactions. Boys used mainly immature defense mechanisms; only one boy used any neurotic coping maneuvers. Girls used many immature mechanisms and also a variety of neurotic ones. The youngest children had the fewest identified defense mechanisms. The duration of the abuse did not affect the defense mechanisms used. The support each child received from a close adult following disclosure of the abuse affected the use of defense mechanisms. Lengthy clinical remediation is needed to prevent these youths from passing sexual victimization on to their own children. Table and 3 references.