The sample was composed of 134 children; 67 children who were sexually abused and ritually abused in day care centers were compared on the Child Behavior Checklist with a carefully matched group of 67 nonabused children. Findings indicated that sexually abused children had significantly more behavior problems than did the nonabused children. Sexual abuse involving ritualistic abuse was associated with increased impact as well as increased severity in the extent of the sexual, physical, and psychological abuse the children experienced. (Author abstract)