Sir.—The article on incest by Weitzel et al (132:127-130, 1978) and the editorial comment by Weiner (132:123-124, 1978) in the February 1978 issue of the Journal are welcome additions to the scanty and perplexing literature on child sexual abuse. I agree that "knee jerk responses" may be detrimental, ie, immediate removal of the child. The symptom of incest warrants careful evaluation and planning. Both authors are clear to point out that the studies used to support allegations that sexual abuse of children is damaging are biased and select for children already identified as disturbed. However, the data used to support the contention that sexual abuse may not be harmful are equally misleading1.2; both deal with an inpatient psychiatric population. Those authors' perceptions of the severity of damage seem open to question.
At this point, we honestly don't know what the acute and long-term effects of child sexual