Online child protection is an important topic in modern policing and security and one of great significance to the public. This chapter discusses child sexual abuse material (CSAM) and the ongoing academic debate relating to its consequences, complexities and conflicting research findings. CSAM is discussed in the context of policing activity where it can be known as indecent images of children (IIOC), and the challenge of countering such material. One of the most significant ongoing discussions relates to the interrelationship between CSAM consumption and escalation to other forms of child abuse. Historically developments in technology have significantly changed how CSAM is generated and distributed. We now sit at a time of great development where artificial intelligence and haptic technology, among others, can be used in a child abuse context. The chapter considers how this may impact escalation and knowledge gaps in this area. The emergence of new technologies blurs the lines between established types of offending, in ways the criminal justice system will need to navigate to maintain public trust and confidence.