Many signs and symptoms indicate possible abuse. No single sign indicates abuse, but the presence of several signs may indicate a possible victim. The behavioral signs are similar to those of depression. They include withdrawal or aggressive behavior, self-destructive acts like substance abuse or promiscuity, imposition of sex on other children, preoccupation with genitalia, refusal to dress for physical education classes, and low self-esteem. Children often try to communicate that something is wrong, but it is difficult. The teacher should believe the child's report, emphasize that the child is not at fault, and acknowledge the child's conflicts. The teacher should never make a promise that cannot be kept, such as a promise to keep the information secret. The teacher should also know the local resources, never ask the incest victim why he or she let the incest go on so long, cooperate with child protective workers, and be supportive to victims seeking help. Prevention programs that incorporate basic health education principles can help prevent child sexual abuse. Annotated list of 7 programs and resources.