THE DISCLOSURE PROCESS AMONG VICTIMS OF CHILD SEXUAL ABUSE

1. THE DISCLOSURE PROCESS AMONG VICTIMS OF CHILD SEXUAL ABUSE Disclosure, Delay and Denial

2. Questions about the Disclosure Process Among Victims of CSA • What proportion of CSA victims disclose their sexual abuse? What proportion do not? • Among those who do disclose, when do they disclose, e.g., during childhood, during adulthood? • Which CSA victims are least/most likely to disclose? • Why are some victims of CSA reluctant or unwilling to disclose their abuse?

3. Information about the Disclosure Process Is Drawn From Two Sources • Retrospective studies of adults who report that they were sexually abused as children • CSA cases that were reported to the authorities and were “substantiated” (e.g., by child protective services, law enforcement, the courts, etc.)

4. There are Major Limitations in our Knowledge About the Disclosure of CSA Due to ‘Sampling Bias’ • Our information about the disclosure process is limited to samples of identified victims only • Many unidentified victims are excluded: • Children who did not disclose their abuse during childhood • Children who disclosed to ‘someone’ during childhood but whose abuse was never reported to the authorities • Reported cases that were erroneously classified as “unsubstantiated” • Adults who participated in retrospective studies but denied their CSA

5. All Sexually Abused Children Those who, as adults, disclosed to researchers Those who disclosed to ‘someone’ during childhood Those whose abuse was reported to the authorities Those who disclosed during forensic interviews Those whose abuse was ‘substantiated’ Those whose abuser was criminally prosecuted

6. Because many victims of CSA are never identified as victims, the actual rates for disclosure and non-disclosure cannot be determined

7. DISCLOSURE DATA FROM ADULT SAMPLES(Retrospective Studies)

8. Retrospective studies have found that NON-DISCLOSURE of CSAduring childhood is very common • Approximately 60-70% of adults who report they were molested as children do not recall disclosing their abuse to anyoneduring childhood (e.g., not even to a peer or a parent) • Only a small fraction (10-18%) of CSA victims who did disclose their abuse to ‘someone’ during childhood recalled their abuse being reported to the authorities London, et al (2007)

9. Even ‘severe’ child sexual abuse is rarely reported to the authorities during childhood • In a nationally representative retrospective survey of over 4000 American women, only 12% of childhood “rapes” were reported to the authorities • “Rapes” were defined as nonconsensual sexual penetration of the victim’s vagina, anus or mouth by the perpetrator’s penis, finger, tongue or an object that involved the use of force or the threat of force or coercion. Rochelle F. Hanson et al., Factors Related to the Reporting of Childhood Rape, 23 Child Abuse & Neglect 559- 569 (1999)

10. Even When There Is Diagnostic Medical Evidence of Sexual Abuse, Some Children Still Fail To Disclose Their Abuse • Across 21 studies examining gonorrhea in children, the average disclosure rate was only 43% Lyon, 2007

11. Which children were most likely to disclose their abuse to “someone” during childhood? • Retrospective studies have found that adults who experienced CSA during adolescence were more likely to have disclosed their abuse to someone than those who were abused at a younger age. • They most commonly disclosed to a peer. (Bruck, et al, 2007)

12. DISCLOSURE DATA FROM CHILD SAMPLES(Forensic Interviews)

13. Two Types of Sampling Bias Artificially Inflate Disclosure Rates and Suppress Denial Rates • “Suspicion bias” - occurs when the child’s disclosure is the reason abuse is suspected in the first place. If the child does not disclose to anyone, it is unlikely that an abuse report will be made. Therefore, only those who disclose are typically included in studies of ‘suspected’ victims. • “Substantiation bias” – occurs because disclosure increases the likelihood that abuse will be substantiated. Lyons, 2007

14. When children do not disclose to anyone, their cases are quite unlikely to be reported—let alone “substantiated” • Therefore, disclosing victims are over-represented in studies of sexually abused children; and non-disclosing victims are under-represented. • Children who are ‘suspected’ of being sexually abused are unrepresentative of abused children in general, given that retrospective surveys of adults indicate that most abuse is never disclosed during childhood (Lyon, 2007)

15. Rates of CSA Disclosure and Non-Disclosure (Denials) in Forensic Interviews with Children Suspected of Being Sexually Abused • Across 17 studies published since 1990, the mean disclosure rate during forensic interviews was about two-thirds; about 1/3 on average denied abuse (London, et al, 2007) • In a very large sample of suspected victims of CSA, 71% disclosed sexual abuse; interview quality (NICHD) was likely a factor (Hershkowitz, et al, 2007) • However, these studies exclude sexually abused children who were never considered by the authorities to be ‘suspected victims’ (“suspicion bias”)

16. What do children’s denials of abuse mean about the likelihood of abuse? • “As long as non-abused children are more likely to deny abuse than abuse children, denial of abuse is some evidence that abuse did not occur. But to the extent that denial rates are surprisingly high, an expert can justifiably testify that that denial are surprisingly weak evidence against abuse.” Lyon, 2007

17. Although many children are reluctant to disclose abuse initially, many do so after a period of time, or after repeated questioning • Delayed disclosure was common in retrospective studies and in child samples • Multiple interviews may be necessary with some children; however, this also increases the risk of leading some non-abused children to make false allegations

18. Which children are most likely to disclose their abuse during “forensic interviews”? • The most significant predictor of disclosure during forensic interviews is whether the child had disclosed before, e.g., to a parent, a teacher, a therapist. (London, et al, 2007)

19. Older Children are more likely than younger children to disclose their abuse during forensic interviews • Younger children are more likely to make ‘accidental’ or spontaneous disclosures, without realizing the significance of their abuse Example: 4 year-old being bathed by mom spontaneously says, “Uncle Joey likes to lick my pee-pee.”

20. Age-related Trends in Disclosure During Forensic Interviews in Israel(Hershkowitz, et al, 2007) • Sample: All child abuse investigations conducted in Israel from 1998 – 2002;N = 26,325 3- to 14 year old alleged victims of sexual and/or physical abuse • Percent making no abuse allegations: • More than half of 3-6 year olds • One-third of 7-10 year olds • One-fourth of 11-14 year olds

21. Cognitive Factors and Sexual Naiveté Are Likely to Contribute to Lower Disclosure Rates Among 3 – 6 year-olds(Hershkowitz, et al 2007) • Very young children may not understand that what they experienced was sexual abuse • Very young children are disproportionately likely to misunderstand the purpose of the forensic interview; they might be willing to disclose the abuse if they understood that this was the purpose of the interview

22. Children were much more likely to disclose abuse by a non-relative than a relative(Hershkowitz, et al, 2007) • This was true for children of all ages; however, the 3- to 6-year olds were especially reluctant to implicate a close family member

23. Some Studies Have Found that Children with “Supportive Parents” Were More Willing to Disclose Their Abuse • Children with STDs (e.g., gonorrhea) were questioned about possible abuse during a forensic interview • When their parents rejected the possibility that they were sexually abused, only 17% disclosed; • 67% of children whose parents were open to the possibility that their child had been sexually abused disclosed their sexual abuse Lawson, L. & Chaffin, M. (1992).

24. Many CSA Victims Do Not Disclose Their Abuse Until Adulthood • Non-disclosure rates for women molested a children range from 33% to 92%. (Lyon, 2002) • Non-disclosure rates for men molested as children range from 42% to 85% (Lyon, 2002)

25. The Significance of Inconsistent Statements Among Suspected Victims • Disclosure of sexual abuse is often a “dynamic process” not a “one-time event.” • Victims may initially deny their abuse; then provide a minimized account; they disclose more abuse over time—especially if they are responded to supportively • Consequently, confirmed victims often make inconsistent statements

26. Why Are Many Victims of Child Sexual Abuse Reluctant to Disclose their Abuse?

27. NAIVETE -Youngand sexually naïve children may not even realize that they have been abused. Molesters who target younger children often misrepresent the abuse as something innocent: Game or playful activity, i.e., tickling, wrestling display of affection hygiene practice massage Educational, i.e., swimming lesson, sex education

28. MODESTY Children receive “modesty training” about sexual topics early on. “Private” Parts

29. NON-ABUSED CHILDREN’S REPORTS OF VAGINAL AND ANAL TOUCHING DURING A MEDICAL EXAM5 and 7 year old girls(Saywitz, Goodman, Nicholas & Moan, 1991)

30. SampleN = 72 females5 & 7 year-olds Half (36) of the children received a routine medical exam, including a vaginal and anal exam. The other half received a routine medical exam, but with a scoliosis (spinal) exam instead of a vaginal and anal exam.

31. STAGE 1OPEN-ENDED QUESTIONINGNO ANATOMICAL DOLLS“Tell me everything you remember about your visit to the doctor.” • 22% Disclosed Vaginal touching • 11% Disclosed Anal touching

32. STAGE 2OPEN-ENDED QUESTIONING WITH ANATOMICAL DOLLS“Show and tell me what happened when you went to the doctor’s” (using anatomical dolls and medical props) • 17% Disclosed Vaginal touching • 11% Disclosed Anal touching • Note: Lower rate of disclosure of vaginal touching when anatomical dolls were used (22% vs. 17%)

33. STAGE 3SUGGESTIVE QUESTIONING WITH ANATOMICAL DOLLS“Did the doctor touch you there?” (pointing to various body parts on anatomical dolls) • 86% Disclosed Vaginal touching • 69% Disclosed Anal touching

34. False Reports of Genital and Anal Touching by 5 & 7 year olds(Scoliosis Condition) Anatomical dolls + option-posing questions • One of the 36 children (< 3%) erroneously answered “yes” when asked if doctor touched vaginal area. • Two (< 6%) erroneously answered “yes” when asked if doctor touched anal area. • Only one of these three children were able to provide anydetail about the alleged touching.

35. MISPLACED SENSE OF GUILT • Many sexually abused children feel at least partially responsible for their own abuse • “It was my fault” (e.g., It was because I dressed that way; It was because I didn’t lock my door; It was because I was too pretty) • “I should have stopped him/her” • “I should have told the very first time” • Many sexually abused children feel guilty for having become sexually aroused during their abuse

36. For many sexually abused children, disclosing their abuse feels more like confessing a sin, than reporting a crime Their misplaced sense of guilt and shame are strong motivators for keeping the abuse a secret

37. STIGMA and SHAMEPre-teen and teenaged BOYS are often extremely reluctant to disclose abuse by a MALE • “Homophobia” is rampant among boys this age • This sense of shame can be reinforced by the victim experiencing an erection during the abuse • Male molesters who target boys are also masterful at befriending their victims and ensuring that they remain ‘loyal’

38. FEARS OF SEPARATION AND REJECTION CAN INHIBIT DISCLOSURE • Separation from loved ones (including the Perpetrator!) • Loved ones are angry and blame the child for : • not telling earlier • “seducing” the perpetrator • causing family hardships by disclosing the abuse

39. SOME VICTIMS DON’T DISCLOSE DUE TO THREATS OF PHYSICAL HARM • To the victim • To the victim’s loved ones, i.e., parents, siblings, pets • BUT, threats of physical harm are rarely needed to maintain secrecy

40. Secrecy Pact • Children are often quite compliant when asked by influential adults to keep secrets

41. Some Victims Don’t Disclose Because They Are Protecting Their Perpetrator • Sometimes the molester is also a beloved relative or adult friend • The ‘grooming process’ used by many molesters serves to inhibit disclosure (i.e., showering the child with attention, gifts, etc) • Victims often have ‘mixed feelings.’ They may be uncomfortable, confused or even repulsed by the sexual activity but nevertheless love the offender and don’t want to get him/her in trouble

42. Risky Assumptions about Sexually Abused Children • All sexually abused children: • View the abuse as “noxious” and “harmful” • Were “forced” or “made” to tolerate and participate in the sexual activity • Fear their abuser • Were “threatened” by the abuser not to disclose the abuse • Want the abuser to be punished

43. Compliant Teenaged Victims • Teens are naturally interested in sex and often seek out sexual experiences • Teens often want to engage in ‘adult’ behaviors and may feel flattered and more ‘mature’ when an adult shows a sexual interest in them • The burgeoning independence of teens creates opportunities for those who would molest them, i.e., unsupervised activities, chat rooms, etc.

44. Dissociation and PTSD-related Amnesia This is far more likely when the abuse is terrifying, painful, repetitive and emotionally or physically intolerable for the child. “Whenever he did that, I went to the pink forest.” “I left my body and hid in a crack in the wall.” “I watched Mickey Mouse cartoons in my head when it started to hurt real bad.” “I think I was sleeping. PTSD and Dissociative amnesia can give rise to delayed memories and flashbacks

45. Some Sexually Abused Children Do Disclose Their Abuse But Later RECANT Their Valid Allegations

46. Why Do Sexually Abused Children Sometimes Recant Their Valid Allegations of Abuse? • For the same reasons that children fail to reveal their sexual abuse in the first place • Negative reactions to the disclosure • Parent appears overwhelmed, hysterical, angry and “out of control” -- this is especially upsetting for younger children • Parent blames victim for ‘seducing’ the abuser or for not disclosing the abuse earlier • Family members are angry at victim for creating hardships for the family

47. Why Do Sexually Abused Children Sometimes Recant Their Valid Allegations of Abuse? • The child is separated from the family • Threats/enticements by perpetrator or others to recant • To protect or ‘rescue’ the perpetrator • Stress associated with involvement in the legal system

48. Recantation Rates Vary Widely Among “Confirmed” Victims of Child Sexual Abuse

49. Recantation Rates for ”Confirmed” Victims • 4% recanted (Bradley & Wood,1996) • 9% recanted (Jones & McGraw, 1987) • 11% recanted (Bybee & Mowbray, 1993) • 14% recanted (Keary & Fitzpatrick, 1994) • 17% recanted (Gordon & Jaudes, 1996) • 22% recanted (Sorenson & snow, 1991) • 30% recanted during initial investigative interview (Devoe & Faller, 1999)

50. Recantation Rates Among ‘Confirmed’ Victims Are Affected by the Criteria Used to ‘Confirm’ Abuse • Abuse is unlikely to be ‘confirmed’ when victims recant