Following a review of the scope and definitions of child sexual assault, the paper explains the characteristics of a fixated (the habitual pedophile) and a regressed (the typical incest perpetrator) sexual offender and the differing prognosis for treatment and control. Five characteristics of the child victim's sexual assault accommodation syndrome are described; secrecy, helplessness, accommodation, delayed disclosure, and retraction. Father-daughter incest is used to illustrate this concept, but the same relations can be seen in out-of-family molestations. Psychodynamic deterrents to recognition of child sexual abuse are explored before the paper details specific indicators of assault. This discussion also considers interviewing the child victim and documenting the abuse. The author advocates interagency treatment of the sexually abused child and discusses key elements in such a program; child protection, court advocacy, outreach and availability, peer group contact, self-help, therapists' recognition and handling of the victims' continuing legacy of hurt and anger, and the importance of touch as a therapeutic tool. Also addressed are treatment strategies for adult survivors of childhood sexual assault.