Child sexual abuse clearly has immediate identifiable effects, consistent symptom patterns, adverse long-term effects on both sexes, and is suspected as the underlying ideology of a number of mental health disorders that have been resistant to treatment. These include borderline and multiple personalities. However, there are difficulties in establishing a linear relationship between sexual abuse in childhood and a specific outcome in adulthood. Since 1976, the incidents of reported child sexual abuse have risen an estimated 27 percent. The role of reconstituted families in the increased incidents, and the effect of increased awareness of sexual abuse on teachers and other child care providers are discussed. Recommendations are that effort be directed to locating the underlying causes of child sexual abuse, so social policy for prevention can take accurate aim at the source of the problem; and that prevention programs directed to children not prevent development of crucial trust. Specific recommendations for future research are made. 24 references. (Author abstract modified)