Child sexual abuse - prevention, identification and action

Child Sexual Abuse:
Prevention, Identification and
Action

http://www.arpan.org.in/
Agenda
 What is child sexual abuse (CSA)
 Dynamics of CSA
 How children experience CSA
 Perpetrator risks and dynamics
 Cultural considerations
 Responding

What is CSA?
 Any interaction when the child is being used
for sexual stimulation of the child or the
perpetrator or observer.
 Contact sexual abuse
 Non-contact sexual abuse
 Care and/or custody of the child (CPS)

Sexual Assault/Statutory Rape
 Sexual Assault:
 Assault of a sexual nature or sexual act without
consent.
 Statutory Rape:
 Sexual activity where the child is below the legal age of
consent.
 Different term, age differentials and particulars for
charging across states.

Dynamics of CSA
 Unique crime with unique behaviors and
dynamics
 Rarely third-party witness or medical
evidence
 Only 4-5% of children who give a credible
history of sexual abuse have a specific finding
on medical exam.
 94-95% of all children who give a history of
sexual abuse have a normal or nonspecific
medical exam.

Extent of CSA: How common is it?
 Myth:
 Only happens in poor, uneducated
communities…
 Fact:
 Inconsistent and scarce findings that race or
socioeconomic status are risks
 Unlike physical abuse

Perpetrator Stereotypes
 Myths
 Stranger danger
 Media focus
 All CSA perpetrators are
male
 Dirty, perverted men
 Men who sexual abuse
boys are homosexual
 Facts
 70-90% of alleged abusers
are people the child knows
and trusts
 90% of alleged offenders
are male; however, there
are documented cases of
female perpetrators
 Highly under-reported
and not recognized
 CSA alleged offenders tend
to be married, employed
and heterosexual

How Children Experience Abuse
 Child Sexual Abuse Accommodation Syndrome (CSAAS)
 Roland C. Summit, M.D. (1983)
 Widely known theory for understanding dynamics of child
sexual victimization
 However, merely a clinical opinion, not scientific instrument
 Anecdotal, not backed by research
 Five categories:
 Secrecy
 Helplessness
 Entrapment and Accommodation
 Delayed, unconvincing disclosure
 Retraction and Recantation

 Happens when child is
alone with their abuser.
 “This is our secret.”
 “Don’t tell anyone, or
else.”
 “Nobody will believe
you.”
Both the source of fear
and the promise of
safety.
 Authoritarian relationship
 No child has equal power to say no
to a parental figure or to anticipate
the consequences of sexual
involvement with an adult caretaker.
 Expectation for child to cry out and run
away
 Almost every child fails.
 Fight, flight, freeze.
 Difficult for courts and law-
enforcement to understand
 Disbelief and rejection by non-
offending caregiver = self-blame,
self-hate, guilt for allowing the acts
to occur.
Secrecy Helpessnes

Entrapment and Accommodation
 Abuse is not usually a one-time occurrence.
 Multiple incidents
 Grooming
 Accommodating to escalating sexual demands.
 Child faced with continued helpless victimization must learn to
somehow achieve a sense of power and control.
 Child prepares for the sexual act before it happens:
 Undresses and places themselves in a position for their
perpetrator.
 Child initiates the sexual act.

 Usually happens under the disguise of love or
attention:
 Bath time
 Bedtime
 While watching TV on the couch
 Wresting and tickling
 Games
 Abusers use these and physical contact
opportunities to sexually touch children.

Natural reactions of healthy child to profoundly
unnatural and unhealthy caregiver environment.
Coach on your soccer team always tells you what a great job you’re
doing on the field; he couldn’t get along without you; if he had
his way, you’d be voted most valuable player. Everyone loves
coach, so it makes you feel good that you have his attention.
Then while he’s driving you home, he starts saying things like how
during showers he noticed you were really developing into a
man. He begins commenting on the size of your penis and how
some day you’re going to make a girl really happy. All of a
sudden the good feeling goes away and you feel embarrassed,
confused, maybe frightened.

 Is this really abuse?
 Confusing emotions:
 Ordinary, non-sexual interactions when not being abused.
 Way the community views the abuser – good citizen.
 He didn’t mean it – It must have been an accident.
 Victim thinks he/she is weird for having a bad reaction to what happened.
 This must be love
 Grooming – abuse is concealed by love and attention
 Kids respond to loving attention. Like to have people spend time
with them, give them treats and make them feel loved.
 Some kids enjoy the physical closeness and physical feelings that
can happen in the abuse situation. They seek out the abuser for
attention.

How Children Experience Abuse:
Disclosure and Discovery
 Accidental vs. Purposeful
Disclosure
 Majority of cases are
accidental discovery (74%)
 More likely in pre-
schoolers
 Sexualized behavior or
inappropriate statements
 Exposure to an alleged
suspect
 Share with a friend who
did not keep the secret
 Child has Sexually
Transmitted Infection
 Child is pregnant
 Purposeful disclosure:
 Educational awareness
(school prevention
programs)
 Influence of peers
(predominantly young
teens)
 Proximity to perpetrator
 Departure of perpetrator
or threat of return of
perpetrator
 Timely disclosure
 Anger (adolescent group)

 Disclosure is a process not
and event.
 Most on-going sexual abuse is
never disclosed (retrospective
adult studies) or there is a
significant time lag between
abuse and disclosure.
 Most adults delayed
disclosure or failed to
disclose in childhood
 55-69% of adults never told
 Treated, reported or
investigated cases are the
exception, not the norm.
 “Nobody would believe
me.”
 “I would never tell. This
would kill my mother.”
 “Not a chance! They
would put me in some
foster home or take me
away from my family.”
 “If I tell, I’d have to go to
court and then everyone
would know about it.”

 Delayed disclosure risks:
 Some data indicate that males are more
reluctant to disclose than females
 Younger children may not have linguistic or
cognitive abilities
 Relationship to perpetrator: longer delays
among familial
 Support from non-offending caregiver
(protective factor)

 Disclosure does not always mean safety for the child.
 Majority of offenders have kinship and trusted
relationship; therefore, child is put on defensive for
attacking credibility of a trusted adult.
 Risks of family separation.
 Threats from the alleged offender for telling.
 Disbelief from authorities and non-offending caregivers
 Delinquent/acting-out child
 Well-adjusted child
 Child does well in school and all other social aspects – not
showing any kind of distress; how could the allegations be
true?

Recantation
 Retraction of a previous allegation of abuse that was formally made and
maintained.
 Pressure/threats from perpetrator
 Pressure from family, coaching
 Disbelief
 Fragmentation of family (child bears responsibility)
 Negative personal consequences
 Investigative process
 Percentage rates vary across studies from high to low numbers
 Abuse victims more vulnerable to familial adult influences
 Young children
 Abuse by parent figure
 Lack of support by non-offending caregiver
 Maternal reactions are protective factor

Reaffirmation
 Reaffirmation:
 Reassertion of the validity of a previous
statement of CSA.
 Of those recanted, 92% reaffirmed their abuse
over time.
 Disclosure is a process.

False Allegations
 “Why didn’t my child tell me sooner?”
 If child was really being harmed, would have spoken
up.
 When child is frozen in fear and does not fight back.
 Viewed as consensual.
 Child was angry for being punished.
 Child has delinquency and/or mental health issues.
 Promiscuous adolescent.
 Diffusion of blame from perpetrator to child.

False Allegations
 Majority of investigated accusations prove
valid.
 Based on review of studies, only 4-8% of
allegations were fabricated.
 Sloppy assessments could lead to false
positives or false negatives
 Need researched-based investigative
protocols

Emotional Coping Techniques
 Avoidance:
 “As soon as”…
 the abuse stops, I will be fine.
 I go to college, everything will be different.
 she finds a new husband, everything will be back to normal.
 Minimizing:
 “It’s not that bad”…
 Lots of kids have it worse.
 He didn’t mean it, he was drunk.
 Denial:
 “It happened, but I’m fine. No big deal.”
 Forgetting:
 Helps on surface, but deeper level impact.

Physical Coping Techniques
 Eating Disorders
 Drugs and Alcohol
 Self-Mutilation
 Sexual promiscuity (self abuse)
 Suicide
 Being Perfect

Psychological and Medical Impacts
 HOWEVER: Some survivors do not exhibit
any negative consequences associated with
the abuse.
 Positively correlated to satisfaction in current
social roles and one’s community.
 Negatively correlated to additional trauma
exposure.
 Myths on how a victim should react.

Sexual Behavior Problems
 Do all children that have been sexually abused act out sexually?
 Belief that all sexually abused children will have significant,
long-term problems is not supported by research.
 Do all sexual behavior problems in children indicate that the
child has been sexually abused?
 Myth in 1980s and 1990s
 There may be other psychosocial difficulties causing the
child to display sexualized behaviors.
 Physical abuse, neglect, family violence, etc.
 However, suspicion of exposure in children who display age-
inappropriate sexual behaviors.
 May be exposed to unhealthy sexual, emotional and
physical boundaries in the home environment.

 Sexual exploration and sexual play are a natural component of
children’s development.
 Similar age, size and developmental status
 Voluntary basis
 Light-hearted and spontaneous
 Embarrassment, but no shame, guilt or fear
 Child’s interest in sex and sexuality is balanced by curiosity about other
aspects of his or her life.

 Continuum:
 Natural/healthy → Molestation of other children
 Sexual Behavior Problems:
 Sexually Reactive
 Confusion about sex – trying to work through their
confusion by enacting behaviors
 Extensive, Mutual Sexual Behavior
 Sexual behaviors as a way of coping with feelings of
abandonment, loss and fear
 Molestation of Other Children
 Use some type of coercion.

 How should we react?
 Remain non-judgmental and non-punitive
 Caregiver’s reactions influence child’s sexual
self-esteem, sexual identity and sexual
judgment.
 Often becomes main focus for caregivers –
forget to look at child’s positive behaviors.
 Do not discuss act as “sexual” with children.
 Address the actual behavior
 “Touching your penis”

 Children who molest should not be compared
to adults who sexually offend.
 Adult sex offenders have established sexual
arousal problems.
 Pedophilic offenders’ primary sexual attraction
is to children.
 Most children who molest are acting out their
hurt and angry feelings in a disorganized and
chaotic manner using sex as a vehicle.
 Sexual behaviors in children do not represent
sexual gratification.

Creating Healthy Sexual Environment
 Children with sexual behavioral problems may need to be supervised while with
other children.
 Should not sleep in same bed with other children or adults
 Over-stimulating for child
 Child who molests should not sleep in the same room with any other children.
 Motion detectors
 Should not be left to care for other children, even for a short time.
 All bathroom activities should be done separately.
 Children and adults should not walk around without clothes on.
 Overwhelming memories or encourage unhealthy sexual behavior
 Other children in the home should know about the sexual behavioral problems
for the child with a history of molesting. Child with sexual problems should be
made aware that, for everyone’s safety, it is important for everyone to know.
 Family meeting
 Clinician’s role
 Work with molesting child
 Ask other children, in private, on a regular basis if other child has tried to touch
them (older children only).

Sexual Abuse Offenders
Does not excuse the abuser. Abuser is fully
responsible for the abuse.
 Fixated Offenders
 Sexual attraction toward children (pedophilia)
 Regressed Offenders
 Abuses children within easy reach – stressors
 Turns to child in misguided attempt to cope
 Children give affection freely, idolize parents,
taught they cannot say no to a parent.

Cultural and Ethnic Considerations
 No culture is defined solely by one value, nor
is any particular value held by one culture
exclusively.
 Be culturally competent, but avoid
stereotyping.
 Cultural background appear most associated
with psychological symptoms.

Responding
 Acceptance and validation are crucial to the
psychological survival of the victim.
 Mothers typically react to allegations with disbelief
and protective denial.
 How could I not have known?
 Why didn’t my child tell me sooner?
 How could my husband, who I’ve known for years, do
such a thing?
 Without professional intervention, most parents are
not prepared to believe their child in the face of
convincing denials from a responsible and trusted
adult.

Responding
 Children are at
risk of
experiencing
secondary
trauma in the
process of
discovery.
8

Responding
 Child Advocacy
Centers
 One Stop
 Family Focused
 Reducing Trauma
 Neutral
 MDT
 Forensic
Interviews
BCAC

How can we support the family
through the investigative process?
 CPS safety plan (contact with alleged
suspect)
 Encourage cooperation with law enforcement
and court processes.
 Is there a victim/family advocate available at
the local CAC or court?

Child sexual abuse - prevention, identification and action

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