Legal and Social Service Responses to Child Sexual Abuse: A Primer and Discussion of Relevant Research

This paper provides a broad overview of legal and social service responses to child sexual abuse, the overarching legal framework provided by federal legislation, and funding mandates and the unique and shared investigative concerns of law enforcement and child protective service entities. Relevant psychological research is highlighted throughout, including research on investigator training, forensic interviewing techniques, children's suggestibility, jurors' perceptions of child witnesses, and courtroom accommodations for child witnesses.     

Study of Cases of Child Sexual Abuse Referred for Medico-Legal Examination in Cairo and Giza,Egypt,2007–2011

ABSTRACT

Child sexual abuse is a complex problem that results in detrimental effects on its victims. This study aimed to investigate the pattern of child sexual abuse in cases referred for medico-legal examination in Cairo and Giza governorates in the period between 2007–2011. The study included 813 cases of child sexual abuse. Female gender was more predominant than male gender (52.8%, 4.29 cases), and adolescents were the most frequent age group identified as victims of sexual abuse (43.8%, 356 cases). All perpetrators were male and most of them were persons outside the victims’ families (89.9%, 731 cases). It was recommended to teach and encourage children to tell their caregivers if they have been assaulted and to educate parents and caregivers on how to respond when the child discloses sexual abuse.     

Child Sexual Abuse: Community Concerns in Urban Tanzania

The aim of this study was to explore community perceptions about child sexual abuse in Tanzania. Thirteen focus group discussions were conducted with adult community members. The core category, children's rights challenged by lack of agency, was supported by eight categories. Aware but distressed portrayed feelings of hopelessness, lack of trust in the healthcare and legal systems reflected perceived malpractice, decreased respect for children's rights referred to poor parental care and substance abuse, myths justifying CSA illustrated cultural beliefs to rationalize child sexual abuse, disclosure threatened by fear of stigma and discriminationaligned the manifestations that prevent disclosure, actions driven by economic circumstances described the economical dependence of victims, urging a change in procedures reflected informants' wish to ally with local governance and pressure groups, and willingness to act indicated the community's role in supporting victims. The study showed how lack of agency calls for efforts to increase children's human rights at all levels.     

Male victims of sexual abuse: a case review within a child protective team.

A retrospective review of 77 cases of sexual abuse of boys seen for assessment by a multidisciplinary child protection team in Florida collected data on age at time of referral, findings of medical examinations, sex of offender, relationship of offender to child, and type of abuse. The history of abuse was categorized as (1) short-term, (2) intermediate, or (3) long-term. An examination was made of the relationship of length of abuse to (a) suicidal ideation reported by or of the boy, (b) threats by the offender directed at the victim, and (c) a history of recapitulation of sexual abuse. The findings of the review, as reported here, further the momentum of research on male victims of sexual abuse, a category of abuse that is seeing an increasing rate of referrals.     

Child witness support and preparation: are parents/caregivers ignored?

Over recent decades research has confirmed the sensible belief that to participate in criminal proceedings (that were designed for adults) child witnesses may benefit from support and preparation. This is so even in countries where special measures have been introduced to make it less arduous for children to give their testimony (e.g. closed circuit television to allow children to testify away from the actual courtroom; video recorded evidence‐in‐chief). Indeed, it could be argued that as more and more children provide testimony (e.g. as alleged victims or witnesses), the more comprehensive should be preparation and support programmes for them. However, while in some countries preparation and support programmes are now offered to such children, the needs of these children's (non‐offending) parents/caregivers seem to be ignored. This paper contends not only that these adults need preparation and support but also that the provision of this is likely to benefit child witnesses. Copyright © 2006 John Wiley & Sons, Ltd.     

Reclaiming the Mother-daughter Relationship after Sexual Abuse

This paper seeks to provide direction to therapists working with mothers and daughters after a disclosure of father-daughter sexual abuse. The importance of the mother's belief in and support for the child's recovery is highlighted, as are some of the cultural assumptions about mothers and daughters which negatively impact on the relationship. Despite paying lip service to offender responsibility, there continues to be a culture of mother blaming in the child sexual abuse and family therapy literature on incest. Current research findings challenge some of the prevalent myths about mothers’ responses to their children's disclosures. Few clinical sources have addressed this issue, and therapists who reject the mother blaming literature are therefore left with little guidance as to how to work more effectively with mothers and daughters. Consequently they may unwittingly further undermine the relationship. Work with mothers and daughters as they recover from intrafamilial sexual abuse is discussed, and key therapeutic themes and guidelines for practice presented. We explore the significant theme of the rebuilding of trust between mothers and daughters and facilitate a process whereby the woman is able to bear witness to and acknowledge the trauma experienced by her daughter.     

Family Responses to Young People Who have Sexually Abused: Anger,Ambivalence and Acceptance

Data on 117 British young people who had sexually abused others were examined in order to investigate the nature and impact of family responses on the management of young sexual abusers. Parental responses were varied, ranging from being entirely supportive of the child, through to ambivalence and uncertainty and, at the other end of the continuum, to outright rejection. Parents were more likely to be supportive when their child's victims were extra‐familial and condemnatory when the victims were intra‐familial. Sibling responses were complex and strongly influenced by whether that sibling was the victim of the young person's abuse or not. Policy and practice implications are discussed.     

The Relationship between Knowledge and Child and Caregiver Distress during the Medical Examination for Child Sexual Abuse

When child sexual abuse is suspected, a child sexual abuse–related medical examination is recommended to ensure the child's well-being. While the extant research has sought to identify factors influencing child distress during this examination, only recently have studies began examining variables that may be directly associated with the child or with the medical setting. Knowledge of the child sexual abuse–related medical examination is one medical-related variable that has been implicated in child and caregiver distress during the examination. The current study contributes to the existing literature by investigating associations among examination knowledge in relation to caregiver and child anxiety at the time of a child sexual abuse–related medical examination, taking into account ethnicity, past child abuse, injury to child as result of abuse, and caregiver response to disclosure. Sixty-eight children and their nonoffending caregiver were assessed. Results indicated that understanding of the examination and caregiver response to disclosure were significantly associated with caregiver and child anxiety.     

Male victims of child sexual abuse

Despite the increased attention the subject of child sexual abuse has received in recent years, rarely has much consideration been given to the boys and adolescent males who are the victims of such abuse. That young girls are consistently the clear majority of sexual abuse victims is not disputed, however the extent to which they are the majority is in question. A review of existing literature has indicated that one of the leading factors for this inadvertent negligence in presenting a truer picture of the magnitude of the problem for male victims concerns the area of under-reporting of the incidence of abuse of young males. Under-reporting has served to give a false sense of the scope of child sexual abuse, particularly for male children. Many societal and methodological factors contribute to under-reporting. Reasons for the discrepancy in reporting abuse will be presented and implications for practice will be discussed.     

Parent-Child Relationships of Victims and Siblings in Incest Families

Clinical accounts suggest that families in which sexual abuse occurs are characterized by poor parent-child relationships. However, there have been no empirical studies utilizing standardized measures to assess the quality of such relationships. In this study, information on parent-child relationships was obtained for 36 child victims and 41 nonabused siblings in families in which father-child sexual abuse had been acknowledged by the father/perpetrator. Results indicated that child victims reported greater relationship problems with father/perpetrators than with mothers. In addition, victims reported greater relationship difficulties with father/perpetrators than did siblings. There were no differences between father/perpetrator and mother reports of relationship quality for victims and siblings. Victims' self-reported depression and anxiety were associated with father/perpetrators' views of father-child relationships, whereas nonabused siblings' self-reported depression and anxiety were associated with father/perpetrators' views of father-child relationships, whereas nonabused siblings' self-reported depression and anxiety were associated with mothers' views of mother-child relationships.     

Sexual abuse: giving help to the children: A practical guide for concerned proiessionals

SUMMARY. This paper has been written for those professional workers who may have to deal with situations involving child sexual abuse, while having only limited knowledge and training. There are two sections. The first examines some of the key issues needed to increase understanding, and includes a preliminary discussion on the emotional impact of sexual abuse on Professional workers. Following a clarification of definitions, family aspects and incidence, this section focuses first on the child victims and then on the perpetrator. Finally, there is an examination of the consequences of child sexual abuse. The second section gives guidance on how a professional worker might respond if confronted with a case—from recognising the signs to facilitating disclosure. Suggestions are made about supporting the child during the investigation and heaving the child afterwards.     

Interviewing child witnesses within Memorandum guidelines. A survey of police officers in England and Wales

Since 1991, the evidence‐in‐chief of child witnesses in United Kingdom (UK) criminal proceedings can be an initial video‐recorded interview between a police officer/social worker and the child witness. This paper reports on the results of a survey of the attitudes and opinions of police officers who conduct video interviews with child witnesses in 18 police forces in England and Wales. Notably, officers' views were sought on the conduct of interviews. This builds on previous surveys which have focused on general views of videotaping children's evidence (for example, Davies and others 1995) and training issues (for example, Davies, Marshall and Robertson, 1998). Our findings support previous reports in that police officers view current provisions for child witnesses as a step in the right direction (Davies and others, 1995) but there are some reported limitations for example, gaps in training (Davies, Marshall and Robertson, 1998). In addition, we highlight the difficulties that can arise in relation to language use and some differences of opinion amongst officers (for example, with respect to the use of props in interviewing). Copyright © 2000 John Wiley & Sons, Ltd.     

Children as Witnesses: Understanding Their Capacities,Needs, and Experiences

Historically the law regarded children as inherently unreliable and made it difficult for them to testify. Since 1975 awareness of child abuse has increased and research has established that children can be reliable witnesses. Governments began to recognize the needs and capacities of children and enacted legal reforms to facilitate prosecutions for child abuse. This paper reports on a survey of victim witness workers and other justice system professionals which reveals some of the continuedfailings of that system in dealing with children. Althoughrelatively rare, there are cases of false allegations of abuse, usually a result of investigations by poorly trained professionals. Further legal reforms and better human supports are required to ensure that the needs of children are met and their capacities as witnesses are fully appreciated.     

Medical advances in child sexual abuse

This volume is the first of a two-part special issue detailing state of the art practice in medical issues around child sexual abuse. The six articles in this issue explore methods for medical history evaluation, the rationale for when sexual examinations should take place, specific hymenal findings that suggest a child has been sexually abused, the healing of genital injuries, approaches to interpretation of medical findings, and the neurological harm of sexual abuse. From the initial history to the process of the medical examination, the mechanics of what a genital examination might show, and the neurobiological consequences, it is demonstrated that the harm of sexual abuse is has more effect on the brain than the genital area.     

Parents’ Experiences of Reporting Child Sexual Abuse in Urban Tanzania

This article reports parental experiences of legally reporting child sexual abuse in Tanzania. Based on in-depth interviews, four types of sexual abuse incidents are portrayed. Each evokes different reactions from parents and the community. An incident characterized as the innocent child was associated with a determination to seek justice. The forced-sex youth elicited feelings of parental betrayal of their child. The consenting curious youth resulted in uncertainty of how to proceed, while the transactional-sex youth evoked a sense of parental powerlessness to control the child because of low economic status. Differentiating between types of sexual abuse incidents may increase awareness of the complexities of child sexual abuse reporting. Education on laws regulating sexual offenses and a functional national child protection system are needed to address child sexual abuse complexities and safeguard the rights of children in Tanzania.     

Children as Witnesses: Understanding Their Capacities, Needs, and Experiences

Historically the law regarded children as inherently unreliable and made it difficult for them to testify. Since 1975 awareness of child abuse has increased and research has established that children can be reliable witnesses. Governments began to recognize the needs and capacities of children and enacted legal reforms to facilitate prosecutions for child abuse. This paper reports on a survey of victim witness workers and other justice system professionals which reveals some of the continued failings of that system in dealing with children. Although relatively rare, there are cases of false allegations of abuse, usually a result of investigations by poorly trained professionals. Further legal reforms and better human supports are required to ensure that the needs of children are met and their capacities as witnesses are fully appreciated.     

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.     

Incest,paedophilia, pornography and prostitution: making familial males more visible as the abusers

In this paper I return to the survivor case study and sex offender data I used in my paper on conceptual models of the relationship between pornography and child sexual abuse in Child Abuse Review in 1997. Here I use them to show how paedophile typologies and sex offender classifications contribute to constructing the invisibility of the normal, ordinary, heterosexual family men who sexually abuse their own and other people's children on a very substantial scale. I also use it as the basis for developing a typology which constructs the connections between incest, paedophilia, pornography and prostitution in the form of a ‘Continuum typology of child sexual abuse and the characteristics of child sexual abusers’, and captures the crossover of victims and perpetrators and the overlap of intrafamilial and extrafamilial child sexual abuse and exploitation. This, in turn, becomes the basis for constructing a ‘Nosology of child sexual abuse classification’ which genders the abusers and takes account of both the overlap and the dominant discourse currently of policing and policy, in which ‘paedophilia’ and ‘child sex offending’ have become synonymous, and incest abusers are invisible. Copyright © 2001 John Wiley & Sons, Ltd.     

Child sexual abuse: community concerns in urban Tanzania

The aim of this study was to explore community perceptions about child sexual abuse in Tanzania. Thirteen focus group discussions were conducted with adult community members. The core category, children's rights challenged by lack of agency, was supported by eight categories. Aware but distressed portrayed feelings of hopelessness, lack of trust in the healthcare and legal systems reflected perceived malpractice, decreased respect for children's rights referred to poor parental care and substance abuse, myths justifying CSA illustrated cultural beliefs to rationalize child sexual abuse, disclosure threatened by fear of stigma and discrimination aligned the manifestations that prevent disclosure, actions driven by economic circumstances described the economical dependence of victims, urging a change in procedures reflected informants' wish to ally with local governance and pressure groups, and willingness to act indicated the community's role in supporting victims. The study showed how lack of agency calls for efforts to increase children's human rights at all levels.     

Child Sexual Abuse Intervention: An Exploratory Study of Policy Concerns and Implications for Program Development

ABSTRACT

This exploratory study was designed to determine public opinion regarding intervention options for intrafamilial child sexual abuse offenders, victims, and families. The study investigated the public's willingness to support strategies of victim protection, offender control, and treatment services in various types of child sexual abuse intervention strategies. The respondents to the statewide survey generally supported established, adversarial intervention strategies, and had mixed reactions lo several of the diversion program strategies. The findings suggest that policy makers may have to compromise lo obtain public support when designing and implementing intervention programs for intrafamilial child sexual abuse. The article addresses policy issues and concludes with implications for program development.