Sexual Abuse Prevention Concept Knowledge: Low Income Children Are Learning but Still Lagging

School-based child sexual abuse (CSA) prevention programs have proliferated since beginning over 30 years ago. Research on program effectiveness has emphasized summative outcomes while under-reporting implementation and process fidelity, limiting reliable comparisons across programs and populations. External validity is further limited by racially and economically homogenous samples, or a failure to report such demographics. This article presents data from a CSA prevention program delivered to 2nd and 3rd grade public school children. A formative concept and item level analysis on the Children’s Knowledge of Abuse Questionnaire at baseline and four week follow-up, as well as fidelity and implementation data, are reported. Results show that children learn and retain certain concepts, but vary widely in knowledge across items. This sample of low-income, minority children also show lower baseline and “learned” abuse prevention knowledge compared to published norms, which is not attributed to implementation variability. These data give critical insight into workshop effectiveness that is masked in summative reporting, yet essential to adapting and strengthening school-based CSA programs. Knowing the long-term consequences of adverse childhood experiences and disparate health outcomes linked to race and socioeconomic status, it is imperative to adequately assess CSA prevention program impact across diverse populations.     

Families, orphans and children under stress in Zimbabwe

This paper evaluates a programme called FOCUS in Zimbabwe: Families, Orphans, and Children under Stress. The programme was initiated in 1993 and works with seven community groups, providing support to around 6500 children in 2000 households. The programme succeeds through committed community volunteers, who made over 93,000 visits to households in 1999. Communities are mobilised by building on existing practices, using natural entry points, and careful selection of local volunteers and supervisors. There is good community ownership, extremely low volunteer turnover, and reporting systems verify that aims and objectives are met. The programme maintains good ethics, addresses a range of children's rights, and is sustainable through a mixture of donor funds, FACT (sponsoring organisation) support and community support. Issues of concern include better recognition of psycho-social needs, prevention and protection from sexual abuse, reducing stigma and discrimination, increasing child-centred approaches and participation, and reducing gender imbalance among volunteers.     

Barriers to HIV Education and Prevention

Several researchers have identified a connection between unresolved childhood sexual trauma and the abuse survivor's increased risk for human immunodeficiency virus (HIV) infection. As a result of these studies, educators are encouraged to look at why the adult survivor population is not being affected by existing prevention efforts. The following discussion examines several prevention strategies based on cognitive, behavioral, or affective focus. Particular attention is given to describing how these programs do not adequately address the self-defeating behaviors and emotional distress of many sexual abuse survivors. The authors present a review of the emerging research delineating the connection between childhood sexual abuse and Acquired Immune Deficiency Syndrome (AIDS), and offer recommendations regarding the implications of these findings.     

Partnering with parents to prevent childhood sexual abuse

Although research demonstrates that child‐focused sexual abuse prevention programmes can teach children personal safety knowledge and skills, childhood sexual abuse (CSA) prevention programmes that involve parents have a number of distinct advantages. The more knowledge parents have about CSA, the greater likelihood they can create safer environments for their children and thus prevent the occurrence of sexual exploitation. Research has demonstrated that parents lack crucial information about CSA and can benefit from even brief educational efforts. This paper will identify potential barriers to participation and offer practical suggestions for enhancing both recruitment and retention rates. Recommendations for parent education programmes are offered, including improving parents' confidence and skills in educating their children about CSA, providing them with parent‐friendly materials to use and developing Internet applications. Copyright © 2010 John Wiley & Sons, Ltd.     

Introduction: Queering Later Life

Summary

The field of sexual trauma developed from the sociopolitical movements of the feminist, rape, and child protection movements. As thinking in the field developed, however, it has been difficult to integrate the perspective of the male survivor of sexual trauma into these perspectives. Gay men, in particular, have been notably absent from the literature, except when their abuse history is discussed as an etiology for their sexuality. It is clear that gay men suffer violence and oppression in the form of homophobia—an abuse with a sexual focus. Integrating the experience of gay men who have suffered trauma into perspectives regarding sexual trauma offers a possibility to enhance understanding about, as well as prevention efforts against, the sexual abuse of children. This includes expanding definitions and vocabulary regarding sexual trauma, as well as recognizing the impact on mental health professionals of working with survivors of sexual trauma.     

UK Paramedics Confidence in Identifying Child Sexual Abuse: A Mixed-Methods Investigation

United Kingdom (UK) paramedics are in a prime position to identify children and young people who are victims or at risk of sexual abuse. Paramedics have access, by phone, or in person, to unprepared homes and communities which other health professionals such as social workers may not. Little research exists however, investigating UK paramedic confidence in identifying child sexual abuse. This mixed-method explanatory sequential investigation used the self-reported confidence levels of 276 UK paramedics to inform the design of seven semi-structured focus groups with 25 UK paramedics from a large ambulance service with operating models similar to all UK services. Multiple factors contribute to a lack of confidence in identifying child sexual abuse, child sexual exploitation, and female genital mutilation, including a perceived lack of exposure to sexual abuse, the perceived hidden nature of sexual abuse, and the lack of physical symptoms and examination. An overarching lack of knowledge is the most significant contributor to a lack of confidence which in turn perpetuates misinformation surrounding prevalence, location, and the signs and symptoms of sexual abuse. These findings suggest a lack of sufficient training and a need for further research evaluating the content of current training and its method of delivery.     

An individual treatment programme for sexually abused adult males: description and preliminary findings

Growing recognition of male sexual abuse and its potentially debilitating effects has underscored the need to develop effective treatment interventions for this population. The present study describes an individual treatment programme that was developed for adult males who have experienced childhood sexual abuse. The treatment programme focused on three areas related to sexual abuse, specifically feelings of self‐blame, anger and anxiety. The study also presents preliminary findings on treatment effects, using self‐report measures that five participants completed prior to treatment and at various assessments following treatment termination. Overall findings indicated improvements in behavioural self‐blame, anger, state anxiety and trait anxiety. Treatment did not appear to have an effect on characterological self‐blame over the long term. The study's findings are limited by the reliance on self‐report data and the absence of a comparison group. As such, our findings should be viewed as an initial contribution to the currently limited empirical data on treatment effects for sexually abused adult males. Copyright © 2005 John Wiley & Sons, Ltd.     

Evolving Narratives About Childhood Sexual Abuse: Challenging the Dominance of the Victim and Survivor Paradigm

This research project explored the ongoing process of constructing a narrative, following childhood sexual abuse. Twenty‐two men and women aged 25–70 were interviewed about their childhood sexual experiences with adults using narrative inquiry methodology. These experiences occurred in different social and historical contexts, when the theoretical understandings and treatment of the issue of child sexual abuse were significantly different from the present. Many factors made disclosure even more difficult then than it is now including: respect for authority; rigid gender roles; the taboo surrounding sexual issues; lack of supportive adults; and lack of language to describe what was happening. Participants told four differing narratives about their experiences: narratives of silence; narratives of ongoing suffering; narratives of transformation; and narratives of transcendence. These narratives were examined in relation to the changing social and historical context and the current dominance of the victim and survivor paradigm in the child sexual abuse literature.     

The Child's Voice in Service Evaluation: Ethical and Methodological Issues

This paper examines the ethical issues which arose as part of a qualitative study with children who had experienced sexual abuse and the implications of these ethical issues for the methodology and conduct of the study. The ethical dimensions addressed include protection of the therapeutic relationship, anonymity, confidentiality, safeguarding (child protection), consideration of the sensitivity of the issue, informed consent, the right to withdraw and storage of data. The study formed one component of a service evaluation of a network of therapeutic projects provided by Action for Children, offering interventions for trauma following child sexual abuse. Children and young people's perspectives were collected using a child‐friendly activity book designed to elicit their views on the service. The paper highlights the importance of conducting research which adheres to ethical guidelines and reflects upon the process of designing a study which incorporates them. The research was funded by Action for Children and managed by a steering group comprising managers from the organisation. Copyright © 2010 John Wiley & Sons, Ltd.     

Prevention of child sexual abuse: implications of programme evaluation research

Thirty child abuse prevention programme evaluation studies were selected according to a set of methodological criteria following an extensive manual and computer literature search. Targets for intervention in 17 studies were children; in three parents; in four teachers; and in six studies multisystemic programmes were evaluated where some combination of children, parents and teachers was targeted for intervention. From a review of the 30 studies, it was concluded that child abuse prevention programmes can lead to significant gains in children's, parents' and teachers' safety knowledge and skills. Best practice guidelines arising from the review include the use of multisystemic programmes; child‐focused curricula which cover a wide range of safety skills and concepts; and the use of didactic instruction and discussion, video modelling and active behavioural skills training techniques in programme delivery. The curricula for parents' and teachers' programmes should cover child protection issues and local child protection procedures along with an overview of the children's programme lesson plans. Longer programmes conducted by trained staff are preferable and such staff may include teachers, parents, mental health professionals and law enforcement officers. Copyright © 2000 John Wiley & Sons, Ltd.     

Childhood sexual experience and adult offending: an exploratory comparison of three criminal groups

The study explored the links between adult offending and exploitative sexual experiences during childhood. A questionnaire was administered to three criminal groups (child molesters, rapists and non‐sexual offenders) with the aim of investigating the statistical relationships between the men's early childhood sexual experiences. The sample comprised a total of 125 males. Fifty‐eight were in prison for non‐sexual crimes, 23 were serving sentences for rape and the remaining 44 were undergoing therapeutic treatment for their child molestation crime at a special treatment programme within the prison. Significant differences were found across the groups with respect to family context: education, subsequent occupation, religious family background and levels of abuse experienced during childhood. The two sex offending groups reported higher levels of physical and sexual abuse. The rapists reported significantly higher levels of emotional abuse and neglect. The child molester group was more likely to report both consenting and non‐consenting activity with other children and there was significance across the range of sexual behaviours. Higher abuse reporting by the child molester and rapist groups suggests that early experience may influence developmental trajectories and offending pathways. Copyright © 2008 John Wiley & Sons, Ltd.     

Preventing child sexual abuse: parents' perceptions and practices in urban Nigeria

This study examined parents' perceptions of child sexual abuse as well as prevention practices in an urban community in southwest Nigeria. Questionnaires were collected from 387 parents and caregivers of children younger than 15 years of age. Results showed that many parents felt CSA was a common problem in the community, and most parents disagreed with common child sexual abuse myths. In addition, almost all parents ( >90%) reported communicating with their child(ren) about stranger danger. However, about 47% felt their children could not be abused, and over a quarter (27.1%) often left their children alone and unsupervised. There were no significant variations in the perceptions of child sexual abuse and communication practices. The implications of findings for child sexual abuse prevention are discussed.     

Knowledge and Skills of Sexual Abuse Prevention: A Study on School-Aged Children in Beijing,China

To examine the level of child sexual abuse prevention knowledge and skills in a sample of school-aged children, a total of 559 children from first to fifth grade were recruited from one primary school in Beijing, China. Participants were asked to finish a questionnaire surveying their knowledge and skills of child sexual abuse prevention. Results showed that accurate rate of knowledge on child sexual abuse prevention were between 44.0% and 80.0%. Percentage of participants having applied the self-protection skills of “saying ‘no,’” “going away,” and “telling adults” properly in hypothetical situations was 57.4%, 28.3%, and 48.3%, respectively. Third-to-fifth graders had a better performance than first-to-second graders, and girls performed better than boys. Findings suggest that Chinese school-aged children are in need of knowledge and skills related to child sexual abuse prevention, and education programs should be developed as soon as possible.     

“From that Moment on My Life Changed”: Turning Points in the Healing Process for Men Recovering from Child Sexual Abuse

Recent research indicates that child sexual abuse often undermines the health of boys and men across the lifespan. However, some male survivors experience a turning point marking a positive change in their health trajectories and healing process. Although frequently discussed in reference to physical health problems or addictions, very little is known about turning points with respect to child sexual abuse for men. The purpose of this secondary qualitative analysis was to describe the different types of turning points experienced by male survivors who completed the 2010 Health and Well-Being Survey (N = 250). Using conventional content analysis, researchers identified seven types of turning points that were classified into three broad categories: influential relationships (professional and group support, personal relationships), insights and new meanings (cognitive realizations, necessity to change, spiritual transformation), and action-oriented communication (disclosure of CSA, pursuit of justice). Implications for clinical practice and future research are discussed.     

Multi‐type maltreatment and the long‐term adjustment of adults

Multi‐type maltreatment refers to the experience of more than one form of child maltreatment (sexual abuse, physical abuse, psychological maltreatment, neglect and witnessing family violence). Researchers have largely ignored the presence of other types of child abuse and neglect when examining the adjustment problems associated with a particular form of maltreatment. The association between ‘multi‐type maltreatment’ and adjustment was explored in the current study. Retrospective data were obtained on (a) the degree to which maltreatment types co‐occurred, (b) childhood family characteristics and (c) adjustment problems in adulthood in an Australian self‐selected community sample (N=175). As hypothesized, a large degree of overlap was reported in the experience of the five types of maltreatment. Family characteristics—particularly family cohesion and adaptability—discriminated between respondents reporting single‐type and multi‐type maltreatment. Greater adjustment problems were associated with reports of a larger number of different maltreatment types. Multi‐type maltreatment should be recognized as a crucial aspect of the nature and impact of child maltreatment and considered in the development of programmes for the prevention and treatment of child abuse and neglect. Copyright © 2000 John Wiley & Sons, Ltd.     

Child sexual abuse: from prevention to self‐protection

There are a growing number of child abuse prevention and education programmes, including primarily group‐based parent and child education, which are taught by teachers within the school system. This article reviews some of the existing sexual abuse education and/or body safety programmes, as well as the research surrounding them. Advantages as well as criticisms of such programmes are reviewed. Issues such as target populations (i.e. children, teachers, parents), programme components and methodological limitations are addressed. Major findings include: children as young as three can be effectively taught self‐protection skills, parental and family involvement in training is important, and repeated exposure helps children maintain knowledge gains. The components of successful programmes include teaching children to identify and resist inappropriate touching, reassuring children that it is not their fault and learning the proper names of their genitals. Finally, future directions for programme development, research and policy are explored. Copyright © 2008 John Wiley & Sons, Ltd.     

‘Never mind the mechanics,what about the (sexual) ethics?’ Sex,sexuality and social work education in sexual violence prevention

ABSTRACT

This paper examines the efficacy of sexual violence prevention education (SVPE) in the USA and Australasia: areas, which have some of the worst rates for sexual violence prevalence, globally. Paradoxically, they are also at the forefront of innovations in sexual violence prevention, compared to some European countries where SVPE is virtually non-existent or at the embryonic stage, such as the UK. Drawing upon the Authors’ previous research on the delivery of SVPE in New Zealand secondary schools, and literature reviews into these innovations, the authors argue that social work education is ideally placed to develop SVPE, due to the ways that some of these innovations, coalesce with social work theory, critical andragogy, and social work values. These synergies have the potential for transnational application through the ways that they can inform SVPE in those countries where it is delivered by social workers in schools, and via the ways it can enhance the social work curriculum to improve post-qualifying practice in addressing sexual violence (SV).     

Mother-child communication about sexual abuse prevention

Two hundred and twelve Australian mothers completed an online survey examining features of mother-child communication about child sexual abuse prevention. Two-thirds (67.5%) of respondents had discussed child sexual abuse prevention with their children, with proportions varying according to age range (highest for mothers with children aged 5-12 years) and only-child status (lowest for mothers of only children). The number of topics discussed with their children differed according to child gender (greater number of topics discussed by mothers with both girls and boys) and age range (greater number of topics discussed by mothers with children aged 5-12 years). These findings provide new insights into mother-child communication about child sexual abuse prevention.     

Exploratory Evaluation of a School-Based Child Sexual Abuse Prevention Program

Internationally, efficacy studies of school-based child sexual abuse prevention programs display a series of methodological shortcomings. Few studies include adolescent participants, recording of disclosures has been inconsistent, and no studies to date have assessed presenter adherence to program protocols or summated the costs of program implementation. A pretest–posttest waitlist control design was used to evaluate the Tweenees program delivered to grade 6 (n?=?88) and grade 7/8 students (n?=?117) compared to a control (n?=?185). Outcome measures included a knowledge/skills questionnaire, systematic coding of disclosures, and video interaction analysis of lessons. Costs were calculated per student, class, and school. Adolescents made small knowledge and skills gains indicating a program ceiling effect. Implementation analysis suggests low levels of adult control facilitated disclosures. Program costs were relatively inexpensive. Recommendations are made for future research.