Child sexual abuse is the sexual exploitation or use of a child by an adult. This holds true whether or not a child is a "willing" participant. The discussion of facts and myths about child sexual abuse emphasizes that child sexual abuse includes more than sexual intercourse, child sexual abuse happens often, it is usually perpetrated by someone known to the child, it does not usually involve force, and it happens to boys as well as girls. Physical indicators that a child has been sexually abused include the child's complaints of pain, swelling, or itching in the genital or anal areas; psychosomatic complaints; bedwetting; and venereal disease. Behavioral indicators include changes in sleep patterns, prolonged objections to attending day care/school, fear of strangers, frequent bathing, radical swings in mood or behavior, and inappropriate sexual activity and knowledge. The molesting adult is often unable to have satisfying relationships with other adults and seeks out children for relationships and intimacy. Since a child is in the process of learning behavior from adults, the child usually has no frame of reference for assessing the appropriateness of the sexual abuse. When the child senses that the behavior is not acceptable to others, he/she is too afraid to tell others about it. Child victims often blame themselves for what has happened. Children can be prepared to resist inappropriate sexual behavior toward them by receiving age-appropriate sexual information from responsible adults. Adults who suspect that a child is being sexually abused should call appropriate authorities for advice on what to do.