Of 180 children admitted to La Ribida Children's Hospital and Research Center (Illinois) with a suspicion of having been sexually abused, 138 met the State's criteria for proven sexual abuse, and 30 percent of those children had a sexually-transmitted disease. One-third of the children with proven abuse were under four years of age. Of the children with proven abuse, ultimately 40 percent had a custody change. Only an initial outcry of abuse was associated with an increased probability of a change of custody. A change in custody was not found to be related to the patient's age, sex, the perpetrator's relation to the child or access to the home, the presence of sexually transmitted disease, whether the child was also physically abused, or whether the child had had developmental delay. There is an absence of discernible guidelines in the juvenile court's decision concerning custody change of a sexually-abused child. 2 tables, 12 references. (Author abstract modified)