Child Sexual Abuse: Prevention, Identification and Action

1. Child Sexual Abuse: Prevention, Identification and Action

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

3. 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) http://www.arpan.org.in/

4. 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. http://www.arpan.org.in/

5. 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. http://www.arpan.org.in/

6. 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 http://www.arpan.org.in/

7. 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 http://www.arpan.org.in/

8. 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 http://www.arpan.org.in/

9. Secrecy Helpessnes  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. http://www.arpan.org.in/

10. 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. http://www.arpan.org.in/

11. How Children Experience Abuse  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. http://www.arpan.org.in/

12. 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. http://www.arpan.org.in/

13. How Children Experience Abuse 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. http://www.arpan.org.in/

14. 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) http://www.arpan.org.in/

15. How Children Experience Abuse: Disclosure and Discovery  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.” http://www.arpan.org.in/

16. How Children Experience Abuse: Disclosure and Discovery  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) http://www.arpan.org.in/

17. How Children Experience Abuse: Disclosure and Discovery  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? http://www.arpan.org.in/

18. How Children Experience Abuse: 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   http://www.arpan.org.in/

19. How Children Experience Abuse: 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. http://www.arpan.org.in/

20. 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. http://www.arpan.org.in/

21. 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 http://www.arpan.org.in/

22. 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. http://www.arpan.org.in/

23. Physical Coping Techniques  Eating Disorders  Drugs and Alcohol  Self-Mutilation  Sexual promiscuity (self abuse)  Suicide  Being Perfect http://www.arpan.org.in/

24. 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. http://www.arpan.org.in/

25. 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. http://www.arpan.org.in/

26. Sexual Behavior Problems  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. http://www.arpan.org.in/

27. Sexual Behavior Problems  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. http://www.arpan.org.in/

28. Sexual Behavior Problems  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” http://www.arpan.org.in/

29. Sexual Behavior Problems  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. http://www.arpan.org.in/

30. 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).         http://www.arpan.org.in/

31. 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. http://www.arpan.org.in/

32. 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. http://www.arpan.org.in/

33. 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. http://www.arpan.org.in/

34. Responding Children are at risk of experiencing secondary trauma in the process of discovery.  8 http://www.arpan.org.in/

35. Responding  Child Advocacy Centers  One Stop  Family Focused  Reducing Trauma  Neutral  MDT  Forensic Interviews BCAC BCAC http://www.arpan.org.in/

36. 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? http://www.arpan.org.in/