"Sexual abuse doesn't happen in silence," said Karen Duncan, a clinical therapist. "Things are said to the child before, during and after. Offenders say things in a purposeful way -- to convince the child what they're doing is OK and acceptable. The children do not know the laws. They really don't know this is something that's not supposed to happen."
In sexual assault cases, adults threaten or lie to get children under their control.
"We don't know if she was told her parents didn't want her anymore, or that if she tried to escape, they would kill her parents," said Dr. Sharon Cooper, a developmental and forensic pediatrician, who also is a consultant for the National Center for Missing & Exploited Children. "There are many threats to compliance in these kinds of situations."
Because Dugard remained at the Garridos' compound for 18 years, she could have identified with her captives, experts said. Dugard may actually miss her captors now because they have been the center of her world for so long, forensic psychiatrist Helen Morrison told CNN.
"That was her life," Morrison said. "That's what she knew. That's the only thing she had. It's a little variant of what we call the Stockholm syndrome where you become identified with your kidnappers and in many ways, you become attached to them."
The pivotal step for Dugard is to get connected with a mental health professional, Landry said. It's essential to reinforce to survivors that what happened is not their fault.
On Thursday, she [formally kidnapped Elizabeth Smart] told CNN's Anderson Cooper that after the reunion she spent lots of time with her family and advised survivors to not let "this horrible event take over and consume the rest of your life. Because we only have one life and it's a beautiful world out there."
"I would just encourage her to find different passions in life and continually push forward ... [and] not to look behind, because there's a lot out there," Smart said.