Presentation on theme: "Child Sexual Abuse: Prevention, Identification and Action"— Presentation transcript:
1Child Sexual Abuse: Prevention, Identification and Action
2Agenda What is child sexual abuse (CSA) Dynamics of CSA How children experience CSAPerpetrator risks and dynamicsCultural considerationsResponding
3What is CSA?Any interaction when the child is being used for sexual stimulation of the child or the perpetrator or observer.Contact sexual abuseNon-contact sexual abuseCare and/or custody of the child (CPS)
4Sexual Assault/Statutory Rape 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.
6Sexual TraffickingChild sex trafficking includes any child involved in commercial sex (Polaris Project)Florida, Illinois, Connecticut and MarylandState regulations governing Social Services Departments to provide services to victims of Human Sex TraffickingCheck with your local jurisdictions about mandated reporting.
7CSA History Exploded into awareness in the 1980s. 322% increase in reports (National Center on Child Abuse and Neglect, 1988).Credibility of reports questioned.Complaints of false allegations and brain-washing.Nationwide agencies develop methods and protocols for investigating CSA allegations.
8Dynamics of CSA Unique crime with unique behaviors and dynamics Rarely third-party witness or medical evidenceOnly 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.
9Dynamics of CSA: Myths Denials of the extent of CSA Perpetrator stereotypesMinimizations or exaggerations of the extent of harm CSA poses on the childDiffusions of perpetrator blame
10Extent of CSA: How common is it? High incidence and prevalence1 in 4 girls1 in 6 to 7 boys…Will be sexually abused before theage of 18.Elevated risk for younger children and children with disabilities.
11Extent of CSA: How common is it? 300,000 cases reported in United StatesOnly reported cases; unknown how many cases actually existOnly 10% of children report their abuse
12Extent of CSA: How common is it? Myth:Only happens in poor, uneducated communities…Fact:Inconsistent and scarce findings that race or socioeconomic status are risksUnlike physical abuse
13Perpetrator Stereotypes MythsStranger dangerMedia focusAll CSA perpetrators are maleDirty, perverted menMen who sexual abuse boys are homosexual
14Perpetrator Stereotypes 70-90% of alleged abusers are people the child knows and trusts90% of alleged offenders are male; however, there are documented cases of female perpetratorsHighly under-reported and not recognizedCSA alleged offenders tend to be married, employed and heterosexual
15How Children Experience Abuse Child Sexual Abuse Accommodation Syndrome (CSAAS)Roland C. Summit, M.D. (1983)Widely known theory for understanding dynamics of child sexual victimizationHowever, merely a clinical opinion, not scientific instrumentAnecdotal, not backed by research
16Child Sexual Abuse Accommodation Syndrome (CSAAS) Five categories:SecrecyHelplessnessEntrapment and AccommodationDelayed, unconvincing disclosureRetraction and Recantation
17Secrecy 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.
18Helplessness 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 awayAlmost every child fails.Fight, flight, freeze.Difficult for courts and law-enforcement to understandDisbelief and rejection by non-offending caregiver = self-blame, self-hate, guilt for allowing the acts to occur.
19Entrapment and Accommodation Abuse is not usually a one-time occurrence.Multiple incidentsGroomingAccommodating 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.
20How Children Experience Abuse Usually happens under the disguise of love or attention:Bath timeBedtimeWhile watching TV on the couchWresting and ticklingGamesAbusers use these and physical contact opportunities to sexually touch children.
21Natural 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.
22How 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.
23How Children Experience Abuse This must be loveGrooming – abuse is concealed by love and attentionKids 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.
24How Children Experience Abuse “It felt good to me and I wanted it.”15y/o abused by older brother“It was my mom’s boyfriend and he treated me like his girlfriend – holding my hand when we went to the mall, telling me I was so good-looking. I felt special.”14y/o abused by mother’s boyfriend“I liked it in a way. I kind of felt loved. He’d always be there for me.”16y/o abused by biological father
25How Children Experience Abuse I deserve this.Perpetrator tell you, “you seduced me.”Adults are never do wrong.
26How Children Experience Abuse: Disclosure and Discovery Accidental vs. Purposeful DisclosureMajority of cases are accidental discovery (74%)More likely in pre-schoolersSexualized behavior or inappropriate statementsExposure to an alleged suspectShare with a friend who did not keep the secretChild has Sexually Transmitted InfectionChild is pregnant
27How Children Experience Abuse: Disclosure and Discovery Purposeful disclosure:Educational awareness (school prevention programs)Influence of peers (predominantly young teens)Proximity to perpetratorDeparture of perpetrator or threat of return of perpetratorTimely disclosureAnger (adolescent group)
28How 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 childhood55-69% of adults never toldTreated, reported or investigated cases are the exception, not the norm.
29How Children Experience Abuse: Disclosure and Discovery “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.”
30How Children Experience Abuse: Disclosure and Discovery 116 confirmed cases (Sorenson & Snow, 1991)Denial3/4th of children denied having been sexually abusedActive Disclosure - Personal admission by the childOnly 7% that initially denied, then moved into active disclosure.Only 11% were able to provide a disclosure without denying or demonstrating tentative features.Tentative Disclosure - Partial, vague or vacillating78% - common middle step from denial to active disclosure“I forgot”“It happened a long time ago”“He tried to touch me, but I hit him and ran away”
31How Children Experience Abuse: Disclosure and Discovery Delayed disclosure risks:Some data indicate that males are more reluctant to disclose than femalesYounger children may not have linguistic or cognitive abilitiesRelationship to perpetrator: longer delays among familialSupport from non-offending caregiver (protective factor)
32How 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 caregiversDelinquent/acting-out childWell-adjusted childChild does well in school and all other social aspects – not showing any kind of distress; how could the allegations be true?
33How Children Experience Abuse: Recantation Retraction of a previous allegation of abuse that was formally made and maintained.Pressure/threats from perpetratorPressure from family, coachingDisbeliefFragmentation of family (child bears responsibility)Negative personal consequencesInvestigative process
34How Children Experience Abuse: Recantation Percentage rates vary across studies from high to low numbers:23.1% recantation rate (Malloy, L.S., Lyon, T.D., & Quas, J.A; 2007)Abuse victims more vulnerable to familial adult influencesYoung childrenAbuse by parent figureLack of support by non-offending caregiverMaternal reactions are protective factor
35How Children Experience Abuse: Reaffirmation Reassertion of the validity of a previous statement of CSA.Of those recanted, 92% reaffirmed their abuse over time.Disclosure is a process.
36False 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.
37False 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 negativesNeed researched-based investigative protocols
38Emotional 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.
39Emotional Coping Techniques Splitting/Dissociation:Out of body experience“I was about nine or ten; my father and I were driving in the car. I can’t remember what he said to me or did to me, but I was definitely not in my body. I mean, my whole visual memory is of the back of his head, the back of my head, the back of the front seat of the car and that’s because I was literally on the ceiling at the back of the car. So all I can remember is how things looked from the back seat – but my body was in the front seat!”- Richie, 15y/o abused by biological father
40Emotional Coping Techniques Olga Trujillo: The Sum of My PartsDissociation“Dissociating is like watching your life from 50 feet off the ground” – Olga Trujillo“The problem was, I dissociated automatically and had been doing so for decades. It seemed like I couldn’t stop and I wasn’t sure I wanted to. I liked feeling numb and calm. The fuzziness in my head felt addictive.” – Olga Trujillo“DID, or Dissociative Identity Disorder, is a separated sense of consciousness. Consider it like a spectrum, with normal dissociation one on end. On the other end is a fractured consciousness with distinct personality states that are not aware of each other: a condition formerly known as multiple personality disorder, or MPD.”
42Psychological 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.
43Sexual 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.Kaufman and Zigler (1987) – 70% of abused children did not offend in adulthoodWidom and Ames (1994) – childhood sexual abuse did not account for increased risks for violent sex crimes.
44Sexual Behavior Problems Do all sexual behavior problems in children indicate that the child has been sexually abused?Myth in 1980s and 1990sThere 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.
45Sexual Behavior Problems Sexual exploration and sexual play are a natural component of children’s development.Similar age, size and developmental statusVoluntary basisLight-hearted and spontaneousEmbarrassment, but no shame, guilt or fearChild’s interest in sex and sexuality is balanced by curiosity about other aspects of his or her life.
46Sexual Behavior Problems Continuum:Natural/healthy → Molestation of other childrenSexual Behavior Problems:Sexually ReactiveConfusion about sex – trying to work through their confusion by enacting behaviorsExtensive, Mutual Sexual BehaviorSexual behaviors as a way of coping with feelings of abandonment, loss and fearMolestation of Other ChildrenUse some type of coercion.
47Sexual Behavior Problems How should we react?Remain non-judgmental and non-punitiveCaregiver’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”
48Sexual 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.
49Sexual Behavior Problems: Sibling Sexual Offending Most common form of familial sexual abusePervasive underreportingApproximately half of all adolescent-perpetrated offenses involve a sibling.Correlated with family violence and dysfunction historiesSexual abuse, domestic violence history and exposure to pornographyImplications for juvenile justice and mental health.Family-based interventions
50Creating 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 adultsOver-stimulating for childChild who molests should not sleep in the same room with any other children.Motion detectorsShould 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 behaviorOther 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 meetingClinician’s roleWork with molesting childAsk other children, in private, on a regular basis if other child has tried to touch them (older children only).
51Sexual Abuse Offenders Does not excuse the abuser. Abuser is fully responsible for the abuse.Fixated OffendersSexual attraction toward children (pedophilia)Regressed OffendersAbuses children within easy reach – stressorsTurns to child in misguided attempt to copeChildren give affection freely, idolize parents, taught they cannot say no to a parent.
52Sexual Abuse Offenders: Why do they abuse? Abused themselves as childrenLack abilities to relate to people, express love and affection, express anger and disappointment.Trying to feel loved and importantFeeling intimate with children makes them feel secure.Looking for power and controlNot looking for love or sexual pleasure, but satisfaction of being in control of another.Think love and sex are synonymousWhen child shows affection, think child is looking for sex. In turn, they think they are showing affection by being sexual.Acting out their rageTake pleasure in seeing children hurt and in pain.Was a victim, but instead of becoming a survivor, became an abuser.
53Cultural 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.
54Cultural and Ethnic Considerations Correlation between acculturation level and reporting.Knowledge of legal systemsImmigration fearsShamePredictor of post-abuse adjustmentHonor, respect and patriarchyAsian culturesFamilism (family harmony and stoicism)Filial piety (honoring older male relatives)Taboos and ModestySexual discussion and education taboosReligiousSexual ScriptsMale-female interactionGender struggle modelVirginityLess valuable bridesLoss of prestige for the family or disgrace (Honor Killings)Virginity testsObligatory violenceRetaliation by family members (child may delay disclosing to protect family)
55RespondingAcceptance 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.
56Responding MINIMAL FACTS 8Children are at risk of experiencing secondary trauma in the process of discovery.MINIMAL FACTS
57Reporting: Minimal Facts Suspicion is sufficient for reporting!List of basic information needed for reporting.Name and DOB/age of childName of mother/caregiverWhere child resides/contact informationWhere incident occurred (jurisdiction)What happened?Child stated that their private part was hurting because Uncle Tony touched him there.
58ReportingContact local Child Protective Services and/or law enforcement (911)Sexual Trafficking – FBI involvementCheck jurisdiction for mandated reporting to protective services.Even if you are not sure if CPS should be involved (care/custody)14y/o X went to a party with another 14y/o Y. They left the party with the Y’s uncle and went to another person’s home. Y’s uncle raped X. CPS took the case because established that the uncle was in a position of care and custody at the time of the incident.
59Responding Child Advocacy Centers One Stop Family Focused BCACChild Advocacy CentersOne StopFamily FocusedReducing TraumaNeutralMDTForensic Interviews
60How 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?
61Court – Risks for Recantation Can the case be prosecuted?Child’s age – not a reliable witnessProminence of alleged suspect in communityInconsistencies in evidenceMust prove beyond a reasonable doubtPreliminary or Grand Jury Hearing – should criminal trial be held?Child required to testifyAccommodations available depend on jurisdiction.Closed-circuit television
62National Children’s Advocacy Center National Children’s Alliance
63ReferencesAhern, E.C., Lyon, T.D., & Quas, J.A. (2011). Young children’s emerging ability to make false statements. Developmental Psychology, 47,Cavanagh Johnson, Toni (2009). Helping Children With Sexual Behavioral Problems: A Guidebook for Professionals and Caregivers. Institute on Violence, Abuse and Trauma. San Diego, CA.Cromer, L. D, & Goldsmith, R.E. (2010). Child Sexual Abuse Myths: Attitudes, Beliefs and Individual Differences. Journal of Child Sexual Abuse. 19,Finklehor, D. (1994). Current Information on the Scope and Nature of Child Sexual Abuse. Sexual Abuse of Children, 4(2), 31-53Fontes, L.A., & Plummer, C. (2010). Cultural Issues in Disclosures of Child Sexual Abuse. Journal of Child Sexual Abuse, 19,Lipian, M.S., Mills, M.J., & Brantman, A. (2004). Assessing the verity of children’s allegations of abuse: A psychiatric overview. International Journal of Law and Psychiatry, 27(3),London, K., Bruck, M., Wright, D.B, Ceci, S.J. (2008). Review of the contemporary literature on how children report sexual abuse to others: Finding, methodological issues, and implication for forensic interviewers. Memory, 16(1),Malloy, L.C., Lyon, T.D., & Quas, J.A. (2007). Filial dependency and recantation of child sexual abuse allegations. Journal of the Academy of Child and Adolescent Psychiatry, 46(2),Malloy, L.C., & Lyon, T.D. (2006). Caregiver support and child sexual abuse: Why does it matter? Journal of Child Sexual Abuse, 15(4),Mather, Cynthia L., & Debye, Kristina E. (1994). How Long Does it Hurt? A guide to recovering from incest and sexual abuse for teenagers, their friends and their families. Jossey-Bass. San Francisco, CA.Sorensen, T., Snow, B. (1991). How Children Tell: The Process of Disclosure in Child Sexual Abuse. Child Welfare League of America, 3-15.Summit, R.C. (1983). The child sexual abuse accommodation syndrome. Child Abuse and Neglect, 7,
64THANK YOU! Maria del Socorro Vernetti Bi-lingual Forensic Interviewer Baltimore Child Abuse Center