I am so very sorry. This is truly a sad sad story. I hope the evil monster is put away forever. May i ask a very personal but serious question as i feel it would help other victims? Please forgive my invasion and if you feel it inappropriate dont answer.
In my girls case, it was touching and molesting...there were no visual signs on yhem ohysically.
In ypur case it sounds violent and rape involved frequently.....were there any visual signs...or physical signs on your childs body yhat would alert someone if that situation happens to them? I cannot even imagine. Thank you and i am sooo sorry this happened.

I am NOOOOO expert, but here's a thought: this trauma goes so deep, it's like being thrown into the deep end of a pool; it takes time to surface. To survive this trauma, kids have to bury so much, so deeply, that it may seem as if the trauma is gone. When they finally get to a point of safety -- reaching the "air" again -- they are so depleted that they gasp and struggle -- people reaching the surface are now safe, but they can look as if they're dying! This is a real contrast to the smoothness of their underwater activity. In other words, all the shock that went IN can finally come OUT. So it makes sense that you're seeing this NOW, when you thought everything should be getting better -- and it is, it just looks like they're suddenly worse. if your current trauma therapist is unable or unwilling to address the startles and tics, you may want to consult an occupational therapist to help your sons come up with replacement behaviors. These are my uneducated guesses, but they may give you some context for understanding what you're seeing.

Dear CathyMathy, first of all, I am sorry for your girls and "happy"/ relieved (what stupid words to use, sorry, but I cannot find another) to hear that for them it was "only" touching and molesting for them. PTSD seems to be rarer when the abuse does not include rape (anal, oral).
However, and as far as I have read / learnt since entering the sad world of parents whose children have been sexually abused, most victims do not present any physical signs of sexual abuse, EVEN when it includes rape, for two main reasons: i) the heal very quickly, and ii) usually disclosure arrives days, even weeks after the abuse took place.
That said... unfortunately, yes, my eldest had visual, physical signs of abuse (rape), checked by forensic specialists at the police station. There was already a healing/scarring process (the last rape - not the only - had taken place around 1 week before disclosure) but sings were still visible.
But, once again, having no visual signs do not mean that the act did not take place, this is why it is so important to listen to what the child says or shows in play therapy, etc. (depending on the age and his or her verbal development).

One thing my child's therapist explained to me is that we never forget. Even if our brain "memory" is not telling us, our "body" memory remembers. I may not have explained that well. For the rest of our children's lives, their memory may be stirred and they will emotionally and/or physically react to an anniversary of an event, a scent that was present during the abuse, a feeling or emotion touching the surface, a place, a vision, a time of year.

Placing myself in your shoes, I would ask the doctor for an update on your levee's progress. Perhaps it is time for an adjustment?

Love and healing to you and your lovees

Dear Naive1,
Thank you for your hindsight and yes, you are already an expert! Your comments are always useful and sound (and healing) to me. Well - I have spent three hours now surfing and trying to find info about PTSD and they say exactly what you are saying (maybe less clearly and with lots of medical terms, but the ultimate message is the same). PTSD symptoms should not be a great cause for alarm for parents, since they are a part of the healing process. At the same time, therapy and family support is vital for the victims, who need to be treated calmly and patiently even during the startles and tics so as not to "crystalize" or perpetuate the symptoms. The therapist has been asking lots of questions to my eldest, opening the wound, in order to re-elaborate the narrative of the abuse and re-significate what has happened. She feels some things had been buried prematurely in my son' s mind and need to be elaborated. Maybe this is why my son is acting out. He even cries when he cannot put a bad memory aside. Yesterday night, during his shower, he started pushing his head and complaining "Mom, I cannot help thinking of grandfather, Mom, help me!". It was horrible. I was so helpless.

My child has PTSD as the result of abuse trauma. Her symptoms didn't present until 6 months following the trauma incident. We had no idea what we were dealing with but fortunately we were referred to an excellent therapist who was able to correctly assess her.
From what you have said in your post, I wonder if your son is experiencing anniversary reaction? If you have not heard of it, it is associated with PTSD and typically occurs near the date of the initial trauma. Our child experiences anniversary reaction over a two week period surrounding the date of trauma. Our child becomes becoming more nervous, anxious, and on edge than usual. Various sounds "trigger" extreme emotional outbursts. We do a lot of assuring. Our therapist also encourages us to make new memories on the actual anniversary date. Last year we took a family trip. Hope this helps.

Yes, this also happens to my daughter on anniversaries.

Oh i am so very sorry for what you are going through and your children. I have had concerns also of ptsd for my daughter which led me to doing the parent child interactive therapy which my kids counselor said is very helpful with young children my daughter is four. it has been the best thing it has made our parenting me and my husbands much stronger and better which i think is so helpful when dealing with behaviors. My daughter has been so wounded that my husband and i are doing everything to ensure it doesnt inadvertently continue with our parenting. Although we will make mistakes we are doing what we can.

I did play therapy and my daughter did not like it when she introduced anything related to the abuse. The counselor did not want to in my opinion force anything. My daughter on her own has adopted her own story that basically she kicked him away. Because of her age it makes it very difficult to work through with her. Her behaviors and ptsd has dimished not to say though if the counseling wasnt bringing up more it wouldn't return. I think it makes sense that this woyld be happening given the therapy. Processing trauma at any age looks horrible in the process but in the end i hope it pproves to be. In the meantime...

We did lots of work on privacy we read books and had firm rules about getting dressed and bathes and going potty. My kids were 6, 5 and just 4. So imagine they used to bathe together, get dressed etc not a big deal and at first it was reallu frustrating for all if us. But i just reminded myself everytime even when my daughter wanted to get changed down to her underwear in the same room as her brothers that even when i have to seem like i am punishing her i am showing her that her body is important that it belongs to her and that it will be respected. She may not appreciate it now but later i hope it speaks to her value. He didnt do that right. Granted had the abuse not happened i wouldn't have thought anything about it. Im hoping that by me making it important she will whether she is with me or not she will respect her right to privacy and others. I work on this amongst her sibblings and us. My husband and i give privacy if at all possible unless they need help. I help my daughter and my husband the boys.

I have also done this to help my daughter sleep i play the laulaby station on pandora music and anything art what not engages the brain in a way that overrides the right brain. So maybe he can draw or paint or listen to classical music as long as music is not attached to the abuse this can help. I played music every night for my kids to fall asleep to right after and even now very regularly. A book on tape. Sometimes i pray with them and then put on music. The good news is antedote the counseling is already at work it will take awhile but it will happen little by little. I found also time there is no replacing it...they have to rebuild a new set of memories and now over a year after i am finally seeing some fruit from this. Blessings.

This just popped in also write out the memory or if he can have him write it out and the do something physically with it place it in a God box or under a rock. Very helpful to me force it into a contained space the physically make it smaller i folded the paper as tiny as i could. Not sure on a child but could try. Breaking glass in a safe area helps with anger. Kids take things very litterally if you say you are giving the memory to God to hold they can take it just like that.

Thank you! I do understand what you meant with visible signs...the scars are definitely for each of our children and they all leave marks that last a lifetime. I was trying to find out perhaps physical signs that we could use to look out for, and what yhey were? I have no experience in these but perhaps there was and i was uneducated. If yhis dubject is tpo intrusive or too psinful than by all means disreagard and focus on the healing. Peace and love to you and your family.

Physical warning signs

Physical signs of sexual abuse are rare, however, if you see these signs, take your child to a doctor. Your doctor can help you understand what may be happening and test for sexually transmitted diseases.

Pain, discoloration, bleeding or discharges in genitals, anus or mouth
Persistent or recurring pain during urination and bowel movements
Wetting and soiling accidents unrelated to toilet training

from
http://www.parentsprotect.co.uk/warning_signs.htm

I know this is wayyyy out of reach for many, but I still wanted to share this thought. I have never been sexually abused and strange but I wish I did have a better understanding of what my children are experiencing so I could know what they need.
Sounds like you have complete chaos at home - unfortunately my son is acting the same way. Facial tics, pinching n bruising his sisters (my MIL was using this as form of punishment) choke holding his sisters, and making false promises of candy / money to get his little sisters to touch him.
Knowing all this I started conversation w a friend n said "when this is over I'm hiring a psychologist nanny!" My friend responded - get a LCSW nanny. At least in our area, LCSWs are not highly compensated professionals and the income of a nanny may be the same or exceed what he/she may otherwise make.
Sounds like with all this acting out among your children (if Ur married or not) if may benefit you if you're able to forgo some other expenses and look to afford a social worker rightI'm your own home. With all this acting out, you almost cannot have enough supervision for the kids anyway.
I know this isn't a possibility for everyone, but in case it is, I cared to share.
It's basically what I'm going to have to do to protect my children since we got flat out disbelieved. My divorce settlement is me paying for a live in nanny to go wherever the children are.

I'm sorry but I wasn't clear - a LCSW social worker who is trained in dealing w sex abuse victims.

I'm planning on advertising at masters is social work colleges...

Oops and I should rephrase
LCSWs (Licensed Certified Social Workers) are professionals at least in our area who are not highly compensated.