Child sexual abuse is an often taboo subject that is difficult to talk about. Like all forms of sexual victimization, child sexual abuse is often hidden, can cause shame, self-blame and mostly happens by someone well known to the child. When a child is abused by a caregiver, lines of trust are blurred as they are manipulated and silenced for the gratification of another. Child sexual abuse may be a single encounter or it may be ongoing for weeks, months or even years. Because of their great ability to adapt and resilient nature, children often show no physical signs of child sexual abuse.