The debate about sex offenders has raged anew among Iowans in general and lawmakers at the statehouse, following the March 25 kidnapping and killing of a ten-year-old girl in Cedar Rapids. But while much of the talk is about the sex-offender registry and identifying strangers with a criminal history, an Iowa pediatrician says most of the time it’s not a stranger who abuses a child. In 70 to 80-percent of the cases, the person who abuses a child sexually is known to that child, is a relative or family acquaintance. Doctor Rizwan Shah says it’s important to remember where the danger lies when you’re teaching children things that may keep them safe from sexual abuse. We need to make children aware that no matter who makes a statement or gesture that makes the child uncomfortable, or crosses “safe” boundaries regarding a child, that child should tell someone about it. And when a child comes to tell something to the adults caring for him or her, the doctor says those adults should listen carefully. “Listen very carefully,” the doctor cautions, explaining that depending on their age and developmental level children may have varying ability to communicate their fears and anxieties. Also, if some kind of sexual abuse has happened, they may not be able to comprehend some acts fully because they’re too young. Children may use a different term or reference when trying to explain abuse that’s happened to them, the doctor says. “Pay attention,” Shah says, “have them describe what they’re saying. It’s O.K. to ask questions.” She says the adult can ask a child what they’re trying to say and whether they’re afraid of something or somebody. She says lines of communication are important to keep open between parents and children, even if what they say sometimes sounds abnormal or silly. “If it is important enough for your child to talk to you, it’s very important for you to listen to your child.” Last year Iowa’s Department of Human Services confirmed that 14-thousand, 499 children were victims of abuse, 68-percent of those cases of neglect, termed “denial of critical care” by the agency. Doctor Rizwan Shah is director of the Regional Child Protection Center at Des Moines’ Blank Children’s Hospital. The Center provides services for abused and neglected children and their families in central Iowa.