A city-wide study of children aged 16 or under included all cases of child sexual abuse requiring investigation within 12 months. Data on 144 children were collected from police, social services and pediatricians. Follow-up was by questionnaires and interviews with involved professionals at 4 weeks, 9 months, and 2 years after investigation. Initially, two-thirds of children showed emotional or behavioral indicators of disturbance, commonly sleep disturbance, temper tantrums, and depression. Over time, there was a substantial increase, with anxiety, and depression, suicide attempts, substance abuse, lack of interaction with peers and sexualized behavior showing increases over the study's duration. Age, gender, abuse, and perpetrator characteristics did not show strong effects initially. Children involved in criminal proceedings were at particular risk. No improvement was evident over time. Tables, references