Presentation on theme: "California Common Core Training Version 1.25"— Presentation transcript:
1California Common Core Training Version 1.25 CHILD MALTREATMENT IDENTIFICATION, PART II: Sexual Abuse and ExploitationCalifornia Common Core TrainingVersion 1.25
2Learning Objectives/Overview Present the historical background, legal definitions and dynamics of child sexual abuse;Discuss characteristics of perpetrator, victim, and non-offending caretaker;Identify physical, behavioral, and emotional indicators of child sexual abuse;Examine the dynamics involved in sexual abuse and sexual exploitation;Practice identifying child sexual abuse when allegations occur.
3History: Current U. S. “Discovery” Cycle Some publications for specific disciplines began to appear in the early 1980’s.“Stranger-Danger” was believed to be the most common form of child sexual molestation.During this same time period, the McMartin/Manhattan Beach, Country Walk, and Jordon, MN multiple victim cases involving pre-schoolers were publicized.
4History: System Responses Mandatory ReportingSpecialized Investigative Units FormedGovernment Sponsored Trainings DevelopedJoint Investigations Between CPS & LE BegunIncreased Criminalization of IncestChild Advocacy Center Concept BeginsState and Federal Laws Enhanced or DevelopedResearch on Child Sexual Abuse BeginsChild Interviewing Protocols Developed
5And Now For You…Possible personal difficulties in working cases with sexual aspects:Emotional reactions are expected and normalMatters dealing with sexualized behaviors are very personal and value ladenSexual abuse victimization historyParenthoodPersonal feelings concerning sexuality, sexually motivated behaviors, and children and sexuality
6Questions For You…Where and under what conditions you were taught or learned about sex, sexuality, and what is appropriate or inappropriate sexual behaviors?Who informed you?What were your emotions and what caused them?Girls were told by? Boys were told by?Cultural Differences?
7Question for you. . .What are some ways that your own views of sexuality may impact your handling of situations involving the sexual abuse of children?
8Exercise: Body Part Identification All terms or phrases are consideredClinical/ “proper”Slang/ EuphemismsCulturalWrite on post-its and place on appropriate body partMost post-its up wins for the team
9General Definition Components Sexual contact that is accomplished by threats or threat of force, regardless of the ages of participants;All sexual contact between an adult and a child regardless of whether there is deception or the child understands the sexual nature of the activity;Sexual contact between a teenager and a younger child can also be abusive if there is a significant disparity in age, development, or size, rendering the child victim incapable of giving informed consent. (Ryan, 1991)See California Penal Code (a,b,c,)
10Continuum of Behaviors Non-contact sexual acts such as exposure, voyeurism, showing or producing pornography, masturbation or other sexual acts in front of the child;Touching of the sexual or erogenous zones or touching designed for the sexual gratification of the perpetrator or for the furtherance of sexual activity;Penetration of vagina, anus, mouth
11Legal Definitions for Sexual Assault and Sexual Exploitation California Welfare & Institutions Code (WIC) Section 300(d)California Penal Code (PC) Sections
12Informed Consent The dimensions of informed consent: 1. Know what is being requested2. Have a thorough understanding of the consequences of the behavior3. Have an equal power base in the relationship4. Be able to say no without repercussionsAbel, G.G., Becker, J.V., & Cunningham-Rathner. (1984). Complications, consent, and cognitions in sexbetween children and adults. International Journal of Law and Psychiatry, 7,
13Prevalence 9.7% of maltreatment reports involve sexual abuse (2004) % of American females who are sexually abused or exploited in some manner before 18:1 in 3-4% of American males who are sexually abused or exploited in some manner before 18:1 in 7-10 (underreporting a major issue)90-95% of sexual abuse is perpetrated by someone the child knows. *Child abuse reporting systems and clinical programs tend to over represent intrafamilial cases. Based on general population surveys, abuse by parent figures constitutes between 6 and 16% of all cases, and abuse by any relative comprises more than 1/3 of cases.
14Prevalence The challenge of the numbers… All are estimates and have limitations:Different studies use different definitions.Child abuse reporting and clinical programs tend to over-represent intrafamilial cases.Cases reported by official agencies meet a particular standard, many cases never get reported so these data sources underestimate the number of victims.Numbers are reported for different time periods.
15Key Questions: Child Welfare Does the allegation involve intra-familial abuse?Is the child safe?Did abuse occur, per WIC Section 300?* Also refer to Trainee Content re: When Consensual Sexual Intercourse is Deemed Child Abuse in CaliforniaIs the caregiver able/willing to protect the child?Is there a viable safety plan to allow the child to stay in the home?
16Key Questions: Law Enforcement Is the child safe?Did a crime occur, per the Penal Code?Is the alleged perpetrator safe in the community?
17Sexual BehaviorsResearch has also demonstrated a consistent relationship between sexual abuse and sexual behaviors in pre-adolescent children.HOWEVER, a broad range of sexual behaviors has been observed in children who do not have a history of sexual abuse.Important to be aware of what is normal sexual development, including related behaviors, interactions, and feelings for the growing child!
18Exercise: Sexual Behavior Cards What do you think is:NATURAL/HEALTHY,PROBLEMATIC/ OF CONCERN,or ABUSIVE/ SEEK PROFESSIONAL HELP?
19When do sexual behaviors need to be addressed? Is the behavior putting the child at risk for physical harm, disease or exploitation?Is the behavior interfering with the child’s development, learning, social or family relationships?Is the behavior violating a rule?Is the behavior causing the child to feel confused, embarrassed, or bad?Is the behavior causing others to feel uncomfortable?Is the behavior abusive because it involves lack of informed consent, some type of coercion or lack of equality?
20Importance of ContextObservers of children’s normal sexual behaviors note:It is curious in nature;Children involved in normal sex play are generally of similar age, size, and developmental status;Children participate on a voluntary basis;It is balanced by curiosity about other aspects of their lives;Does not usually leave children with deep feelings of anger, shame, fear, or anxiety;The affect of children regarding their sexual behavior is generally light-hearted and spontaneous.
21Adolescent Sexual Experience Quiz What do you know?Are these statements TRUE or FALSE?
22Child Sexual Abuse in a Cultural Context Acceptance and manifestation of sex and sexuality within culturesAppropriate and inappropriate sexual behaviors and participantsSanctionsSexual orientation, gender identificationAssignment of responsibility and/or “blame”
23Cultural Aspects of Shame in Child Sexual Abuse Responsibility for the abuseFailure to protectFateDamaged goodsVirginityPredictions of a shameful futurePromiscuity, homosexuality, sexual offendingRe-victimizationLayers of shame
24Gender & Sexual Orientation Issues Double standard for males and femalesSexual orientation
25Elements to consider in Identifying Child Sexual Abuse Commonly referred to as “indicators”Four broad areas:Reporting (including aspects of the allegation and disclosure);Physical (including medical indicators);Behavioral (including emotional indicators for the victim); andFamilial (including family and caregiver dynamics)
26Presence of Indicators ≠ Abuse Remember. . .Presence of Indicators ≠ Abuse
27Reporting Elements Credibility of the report (and the reporter) Type and credibility of the child’s disclosureCorroboration of disclosure/reportStatements about prior unreported sexual abuseHistory of CWS involvement
28Physical Elements Presence of illness or injury (ies) Report of past illness or injury (ies)Explanation of illness or injury (ies)Developmental abilities of alleged victimDevelopmental abilities of alleged perpetratorMedical assessment findings
29Physical Elements: Medical Assessments When?In all cases in which the most recent episode of abuse/assault occurred within the last 72 hoursWhen penetration is disclosed, regardless of timeTo assess any injury/pain/physical complaints of the childWhen the child would benefit from a medical opinionKnow your county’s protocols!
30Behavioral ElementsHistory of sexually abusive behavior by someone in the home or with access to the childDevelopmentally or socially inappropriate sexual knowledge and/or sexual behavior by alleged victimSelf-protective behavior by alleged victimIndicators of emotional distress by alleged victimCoaching or grooming behaviors
31Behavioral Elements: Emotional Distress Trauma-related indicators:Physiological reactivity/Hyperarousal (hypervigilance, panic and startle responses, etc.)Retelling and replaying of trauma and post-traumatic playIntrusive, unwanted images and thoughts and activities intended to reduce or dispel themSleeping disorders with fear of the dark and nightmaresDissociative behaviors (forgetting the abuse, placing self in dangerous situations related to the abuse, inability to concentrate, etc.)
32Behavioral Elements: Emotional Distress Anxiety-related indicatorsObsessive cleanlinessSelf-mutilating or self-stimulating behaviorsChanged eating habits (anorexia, overeating, avoiding certain foods)
33Behavioral Elements: Emotional Distress Depression-related indicators:Lack of interest in participating in normal physical activities, loss of pleasure in enjoyable activitiesSocial withdrawal and the inability to form or to maintain meaningful peer relationsProfound grief in response to losses of innocence, childhood, and trust in oneself, trust in adultsSuicide attemptsLow self-esteem, poor body image, negative self-perception, distorted sense of one’s own body
34Behavioral Elements: Emotional Distress Other indicators:Personality changesTemper tantrumsRunning away from homePremature participation in sexual relationshipsAggressive behaviorsRegressive behaviors in young children (thumb sucking or bedwetting)Poor school attendance and performanceSomatic complaintsAccident proneness and recklessness
35Familial ElementsIsolation of the child (inhibits reporting and makes child more vulnerable)Coercion/threats made to the child to prevent disclosureCurrent caregiver’s substance abuseOpportunity for the abuse to occur
36Myths and Facts about the Forensic Medical Examination The medical examination will confirm if there was sexual abuse.If sexual abuse occurred, there will be findings.Exams can confirm if a girl is a virgin or not.The examination will likely be traumatic for the child.The exam mimics an adult gynecologic exam.If a child’s pediatrician did an exam, that is sufficient.
37Myths and Facts about the Forensic Medical Examination The medical examination will confirm if there was sexual abuse.MythIf sexual abuse occurred, there will be findings.Exams can confirm if a girl is a virgin or not.The examination will likely be traumatic for the child.The exam mimics an adult gynecologic exam.If a child’s pediatrician did an exam, that is sufficient.
39Sgroi’s Five Stages in CSA EngagementSexual interactionSecrecyDisclosureSuppression
40Summit's Child Sexual Abuse Accommodation Syndrome SecrecyHopelessnessEntrapment and accommodationDelayed, conflicting, and unconvincing disclosureRetraction
41in Johnny’s disclosure? How do we see Sgroi’s Stages and Summit’s Child Sexual Abuse Accommodation Syndromein Johnny’s disclosure?
42What Is the Evidence? Child Disclosures of Sexual Abuse Summary of Research Findings:(Olafson & Lederman, 2006)Majority of CSA victims do not disclose their abuse during childhood;
43Olafson & Lederman (2006), cont’d 2. When children do disclose sexual abuse during childhood, it is often after long delays.3. Prior disclosure predicts disclosure during formal interviews.4. Gradual or incremental disclosure of child sexual abuse occurs in many cases, so that more than one interview may become necessary.5. Experts disagree about whether children will disclose sexual abuse when they are interviewed. However, when both suspicion bias and substantiation bias are factored out of studies, studies show that 42% to 50% of children do not disclose sexual abuse when asked during formal interviews.
44Olafson & Lederman (2006), cont’d 6. School-age children who do disclose are most likely to first tell a caregiver about what happened to them.7. Children first abused as adolescents are most likely to disclose than are younger children, and they are more likely to confide first in another adolescent than to a caregiver.8. When children are asked why they did not tell about the sexual abuse, the most common answer is fear. Recantation rates range from 4% to 22%.Lack of maternal or paternal support is a strong predictor of children’s denial of abuse during formal questioning.Many unanswered questions about children’s disclosure patterns remain, and further multivariate research is warranted.
45Olafson & Lederman (2006), cont’d Additional factors that affect children’s disclosure of sexual abuse:Abuse by a family member may inhibit disclosure;Dissociative and post-traumatic symptoms may contribute to non-disclosure;Modesty, embarrassment, and stigmatization may contribute to non-disclosure; and
46Non-Offending Parent/Caregiver Reactions Reactions you may see:DenialAngerBargainingDepressionResolutionBUT- Change and movement between the reactions can happen and will!
47Why don’t moms believe? Anger Disbelief Denial Shame Guilt Self-blame HurtBetrayalConfusion and doubtOwn abuse historyJealousySexual inadequacy or rejectionMinimizationRevengeFinancial or other fearsReligious concernsProtect perpetratorHatredRepulsion
48Why don’t moms protect? Behaviors can be viewed on a continuum: Knows nothingHas knowledge and does nothingRecognizes potentially abusive behaviors, ineffectual or no protectionMay “sense” something isn’t right, but doesn’t askRecognizes potentially abusive behaviors, acts to reduce risk or intervene
49Why don’t moms protect?Growing evidence shows when mothers are incapacitated in some way children are more vulnerable to abuse. This may take a variety of forms:Absent due to divorce, sickness, or death;Emotional disturbances, psychologically absent;Their own intimidation, fear, or abuse;Large power imbalance with perpetrator undercuts her ability to be an ally for her children.
50Perpetrator DynamicsRule 1: They don’t look or act the way you’d expect-No profile of offender-Have a public self vs. private selfRule 2: The rules of logic do not apply- Need-based cognitive distortions- They come to believe their own distortions
51Perpetrator Continuum Situational:Do not have a true preference for childrenMay molest for a wide variety of reasonsMore likely to be aroused by adult pornographyFrequently molest readily available children that they have easy access toVictims young, vulnerable, accessible, less likely to be believed, easy to manipulate or threaten
52Perpetrator Continuum Preferential:Primary sexual orientation is toward childrenOver represented in the higher SES groupsBehavior tends to be scripted, compulsive, and primarily fantasy-driven.More specific sexual preferences as to age, gender, body typePornography usually focuses on the themes of their sexual preference (children)Refer to Behavioral Analysis of Sex Offenders Handout
54Finklehor’s Four Pre-Conditions to CSA Motivation of the perpetrator to sexually abuse.Internal inhibitors against acting out abuse.External inhibitions against acting out abuse.Resistance of the child to the attempted abuse.
55Information Gathering (Tab 3, pages 61 – 63) GoalsMethodsTrainingDocumentationChildWelfareInformation gathering; safety and risk assessment; protective capacity; case management; court proceedingsEngagement, empathic, strength-basedSocial workWritten summaryForensicObjective fact-finding for legal proceedings and for all members of MDITChild: Research-based protocols;Adults: Varies from empathetic to confrontationalSpecializedDetailed written,Signed statements, audiotape or videotapedClinicalInformation gathering for psychosocial assessment & treatmentEmpathic, strength-based, subjective, unstructured, supportiveBrief notes, confidential5555
56Information Gathering with a Child (Child Welfare Perspective) WhoWhere (body parts, geographical)WhatHowDocumentationClarificationClosureExplanation of next steps5656
57What is a Forensic Interview? A forensic interview is conducted with the expectation that it will become part of a court proceeding.It is intended for a judicial audience and governed by rules of evidence.Its goal is to obtain facts for a court trial or hearing.The forensic interviewer strives to:maintain a neutral and objective stance, to facilitate the child’s recall of previous events they witnessed or experienced.To ascertain the child’s competence to give accurate and truthful information.
58Examples of General Questions Which is better?Do you know why you’re here today?orTell me why you’re here today.Do you know why we’re talking today?Tell me why we’re talking today.
59Avoid These Questions!Leading (The answer to the questions is quite clear in the question itself)Your mother rubs your private parts, doesn’t she?Coercive Statements (Interviewer offers the child something in return for an appropriate response)You can’t go home until you tell me who did this.If you tell me who did this to you, I’ll buy you some ice cream.
60Information Gathering: Child Victims (also refers to section on Impact of Abuse) Guilt“Damaged Goods” beliefBlurred physical boundariesSexualized behaviorsAbility to say “NO”Difficulty in talking about ‘taboo’ materialEmbarrassment, shame, anger, fearLocation of interviewDegree of privacyRapport with interviewerPrevious decision to discloseQuestioning style of the interviewerPresence of a witness (supportive or otherwise)Response of other adults to previous disclosures of maltreatment
61Information Gathering: Non-Offending Parent Expect denial, disbelief, minimization, projection of blame and possibly hostility toward you;Choose interview location where perpetrator has little or no power;Explore observations, time frames, relationships, mental health issues (depression), use of medications, sexual abuse/activity history; possibility of DV/ emotional abuse, support system, etc.;Prepare for it to take some time before attitude or belief changes.
62Information Gathering: Non-Offending Parent Assess dependency issues; drug/alcohol useAssess ability to emotionally support child or children;Anything you tell them, you need to provide in writing;Assess ability to carry through safety plan and investigative requirements (willingness and/or cognitive or logistical ability);Be prepared to allow ventilation time;Always leave the door open for further conversations;Really LISTEN to what their primary concerns are.
63Issues With Non-Abused Siblings May be angry with victim for telling (decisional balance) and the consequences of disclosure;May develop negative behaviors or withdrawal as they cope with situation;Parent/s may develop and enforce rules to reduce the risk of sibs being victimized, causing resentment and rebellion;Need to be included in any treatment plan.
64Information Gathering: Perpetrator Law enforcement involvement;Who, where, what are you interviewing for?Denial 1st responseMinimization of behaviorsJustificationBlame onto victim or spouse“Sick and sympathy”
65Welcome Back! Questions, Comments, Clarifications… Day TwoWelcome Back!Questions, Comments, Clarifications…
66Assessment Physical and Behavioral Indicators Child’s Disclosure Evidence DiscoveryCollateral InformationChild/ Family/ Perpetrator HistoryAlternative Hypotheses/ Confirmatory BiasSource MonitoringPerpetrator Admission or Confession
67Cultural Considerations What is the general cultural perception of the act/s?How best to structure approach to child and familyRelationship with authority/government entitiesShame for the child, parent/s, communityLanguage proficiency, taboo topics or words
68Analyzing the Child’s Statement Multiple events/elements of progression;Explicit sexual knowledgeRichness of details/idiosyncratic detailsInternal logic/feasibilitySecrecyPresence of pressure, coercion, enticementChild’s perspective of events*
69Alternative Hypotheses Reasonable alternative explanations for what the child is describing or other elements uncovered through the investigative process.
70Validation of the Referral Looking at the totality of the information gathered from all sources, does it:Fit professional knowledge of dynamics of child sexual abuse?Is there a secondary gain for one of the principals?Is there medical validation/ support?Is there physical evidence to support allegation?Is there prior history?
72Information Gathering: Child Victims (also refers to section on Impact of Abuse) Guilt“Damaged Goods” beliefBlurred physical boundariesSexualized behaviorsAbility to say “NO”Difficulty in talking about ‘taboo’ materialEmbarrassment, shame, anger, fearLocation of interviewDegree of privacyRapport with interviewerPrevious decision to discloseQuestioning style of the interviewerPresence of a witness (supportive or otherwise)Response of other adults to previous disclosures of maltreatment
73Case Management Considerations Separating the FamilyPerpetrator from familyChild/children from familyCollaboration and MonitoringMultidisciplinary team functioningDeveloping and monitoring treatment plan/sVisitation/ ReunificationIf, when, and how
74Treatment Considerations for Victims Treatment ApproachesSupportiveSymptom-focusedAbuse focusedVisit this website for Evidence Based Practice:Treatment IssuesFoster healthy expression of feelings related to abuseReframe/correct distorted thinking about the abuseAssist the child in understanding nature and impact of abuseReduce behavioral symptoms and emotional distressSex education; assertiveness; self-esteem; empowerment; personal safety
75Treatment Issues for the NOP Treatment ApproachesSupportivePsychoeducationalAbuse-focusedTreatment IssuesEnhance Safety/Reduce Risk!Believe abuse occurredHold perpetrator responsibleEmpathy/ support for childIdentification of their own role in abuseResolution of own abuse/victimization issuesFoster independence
76Treatment Issues for Perpetrator Treatment ApproachesCognitiveBehavioralRelapse preventionOffense-specificTreatment IssuesAccept responsibility for behaviorsDevelop/demonstrate empathy for victims and othersModification of thinking errors/cognitive distortionsIdentify and reduce/control deviant sexual arousalResolution of own childhood abuse/victimization
77Time to see what you have learned so far! Embedded EvaluationTime to see what you have learned so far!
78ClosureTHANK YOU AND GOOD LUCK TO YOU IN YOUR CHILD WELFARE WORK WITH CHILDREN AND THEIR FAMILIES.