Intro to Child Maltreatment and Child Sexual Abuse

What is Child Maltreatment?

• Any recent act or failure to act on the part of the parent which results in death, serious physical or emotional harm, sexual abuse or exploitation

Victims of Maltreatment Stats (2020)

• 3.9M referrals

• 54% investigated

• 681K unique victims

Of the 681K unique victims…

• 76% were neglected

• 16% were physically abused

• 9% were sexually abused

• 0.2% were sex trafficked

Victims of Maltreatment stats continued…

• Higher age = lower risk of victimization

• Highest rates were infants younger than a year

• Approx. 27% victims were under 3 y/o

• Girls are more likely to be victimized than boys but boys have a higher rate of fatality than girls

• African American child fatalities is 3x higher than for White Children but Natives have the highest victimization rates (15 per 1k children)

Perpetrator stats (definition, age, gender, ethnicity, contributing factors)

• Most states define them as a parent or other caretaker who has maltreated a child

• 83% of perps were between 18-44

• 52% were female while 47% were male

• Whites lead at 48% with 20% being African American and Hispanic

• 77% of perps are parents of the child victim

• Highest risk factors for perpetration was drug abuse and DV

What is Child Sexual Abuse?

• A type of maltreatment that refers to the involvement of the child in sexual activity to provide gratification or financial benefit to the perpetrator

  • This includes molesting, statutory rape, prostitution, pornography, incest, exposure, etc

What is Child Sex Trafficking?

• A type of maltreatment that refers to the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act

States have the option to report to NCANDS any sex trafficking victim who is younger than…

• 24 years old

Child Sexual Abuse (Gender)

• Girls are 2.5-3x more likely than boys to experience child SA; however, boys may be less easily identified as victims d/t embarrassment

• Child SA perpetrators are almost always male

Children with disabilities (Child Sexual Abuse)

• 30% more likely than other children to be sexually abused

• Receive less prevention info

• Have less access to trusted adults

• Less likely to receive services d/t

  • Physical, Communication, Beliefs, Attitudes, Systemic/structural

There are definition issues to child sexual abuse, why?

• Definitions vary/are broad

• Child sexual abuse is viewed as a continuum

• Certain acts and events have varying interpretations

What are some of the statistical challenges that arise?

• Delay of CSA disclosure/non-disclosure is common

• It’s not always reported to authorities

• Definition problems

• National stats are significantly lower than estimated rates

• Over-reporting

• Bad reporting

• Memory issues

List the terms of the ACE pyramid

• Adverse Childhood Experience

• Social, Emotional, & Cognitive Impairment

• Adoption of Health-risk behaviors

• Disease, Disability, and Social Problems

• Early Death

What are some possible indicators of Sexual Abuse?

• Sleep Disorders

• Eating Changes

• Increased Anxiety/Aggression

• Avoidance of Specific Stimuli

• Concerning Sexual Statements and Behaviors

Are there general signs of child sexual abuse?

• No single profile of a sexually abused child

• Responses can vary among children and may change over time

• Medical findings are relatively rare for sexual abuse

Cultural Considerations for Sexual Abuse

• Child sexual abuse is found is most cultures

• Cultural norms can affect likelihood of identification and disclosure to authorities

Relevant factors when it comes to disclosure in a cultural context

• Shame

• Virginity

• Status of females

• Religious values

What are some structural barriers that prevent disclosure in a cultural context?

• Mistrust of system/fears of bias

• Language obstacles

• Lack of understanding of systems and laws

• Undocumented status

According to David Finkelhor, what are the four preconditions

• Motivation to sexually abuse (i.e. arousal)

• Overcoming Internal Inhibitors

• Overcoming External Inhibitors

• Overcoming Child’s Resistance

What are some of the risk factors for sexual abuse from a child and parent perspective?

• Child

  • Psych vulnerabilities (need for attention, low self-esteem, trust/dependence of perp)

  • developmental disabilities

• Parent

  • Disbelieving, Emotionally distant, Poor supervision of child, Substance abuse, Trauma/Abuse history

What are some of the risk factors for sexual abuse from a family and community perspective?

• Family

  • DV, unsupervised environment, isolation, single/step parent family

• Community

  • Limited resources, cultural context, legal issues, limited prevention and awareness

Possible causes to Disclosure

• Developmental changes

• Exposure to educational/prevention material

• Probing by others

• Wish to protect another child or children

What factors causes concern from a medical standpoint?

• Disclosures by child or others

• Sexual behaviors (masturbation, object insertion, etc)

• Medical findings

• Nonspecific bodily and/or genital pain

Psychological barriers to disclosure?

• Shame

• Embarrassment

• Guilt

• Self-blame

• Fear

Social/Environmental barriers to disclosure?

• Lack of access to trusted individual

• Dependence on perpetrator

• Fear of retribution from family members/peers

• Protection of perpetrator from consequences (e.g criminal charges)

Developmental barriers to disclosure?

• Memory limitations

• Inadequate verbal/communication skills

• Confusion or misunderstanding regarding sexual acts

When screening a child for disclosure of sexual abuse, you should…

• Listen, be supportive, calm and non-confrontational

• Document verbatim statements as much/soon as possible

• Reassure them

• Within 72hrs provide medical exam

When screening a child for disclosure of sexual abuse, you should NOT…

• Accidentally or purposely influence the child’s statements

• Pressure them to answer questions

• Repeat the same questions

• Use leading questions

What are some of the common parental reactions when learning about their child’s sexual abuse?

• Self-blame and guilt

• Vicarious trauma

• Anger at alleged perpetrator(s) and/or therapist

• Denial

What are the different types of professionals and systems that CSA is involved with?

• Psychology (DCF)

• Medicine (SANE/Pediatric Medical Eval)

• Forensic (Police)

• Social Work

What are the potential avenues of legal involvement for sexually-abused children?

• Probate: Divorce, Custody, Visitation, Termination of Parental Rights

• Juvenile: Child abuse/neglect, CHINS, delinquency

• Criminal: Victim, Witness, Perpetrator

• Other: Education, civil suits

In cases of CSA, Police do what?

• First responders

• Investigate cases

• Decide whether or not to arrest the alleged perp

• Involve DCF if not already

• Contact the SAIN coordinator to arrange interviews

In cases of CSA, DCF does what?

• Determine whether or not a child is in need of protection

A case tracks optimally when the DCF investigator schedules what type of interview?

SAIN

What is SAIN?

• SAIN stands for Sexual Abuse Investigation Network

• They grew out of the efforts of advocacy movements and abused child agencies

• A child is interview by a specialist behind a one-way mirror

What’s the goal of a SAIN interview?

• To collect facts/obtain essential info

• Determine whether or not there’s sufficient data to continue with a criminal prosecution

• Determine whether or not the child is a competent witness

• Determine whether or not prosecution is in the child’s best interest

What is Suggestibility?

• The degree to which children’s memory and reporting of events can be influence by a range of external and internal factors

True or False? Young preschoolers can provide highly accurate reports

True; however, adults tend to recall better than children by generating more details and chronological events

What are the two ways for a child’s statement to be unreliable?

• False beliefs

• Lies

How is a false belief created?

• The child’s original memory has been changed before, during, or after the event

• Source Misattribution: event can be familiar b/c it’s imagined or observed