Is There a Place for Extended Assessments in Addressing Child Sexual Abuse Allegations? How Sensitivity and Specificity Impact Professional Perspectives

Using data from a survey of perceptions of 932 child welfare professionals about the utility of extended assessments, the researchers constructed a scale to measure respondents' views about sensitivity (ensuring sexually abused children are correctly identified) and specificity (ensuring nonabused children are correctly identified) in child sexual abuse evaluations. On average, respondents scored high (valuing sensitivity) on the sensitivity versus specificity scale. Next, the researchers undertook bivariate analyses to identify independent variables significantly associated with the sensitivity versus specificity scale. Then those variables were entered into a multiple regression. Four independent variables were significantly related to higher sensitivity scores: encountering cases requiring extended assessments, valuing extended assessments among scarce resources, less concern about proving cases in court, and viewing the goal of extended assessments as understanding needs of child and family (adjusted R2 = .34).     

Forensic, cultural, and systems issues in child sexual abuse cases--part 2: research and practitioner issues

This article introduces the second issue of the special double issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. We briefly review the articles, which include a discussion of child sexual abuse myths, an empirical analysis of extended child sexual abuse evaluations, an article on the role of the medical provider in child sexual abuse evaluations, a study of satisfaction levels with multidisciplinary teams in child advocacy centers, and a commentary advocating for the credentialing of forensic interviewers. We call for further empirical examination of media related to child sexual abuse risk, research on appropriate models for extended sexual abuse interviews and evaluations, and optimal practices relevant to each member of multidisciplinary teams in a child advocacy center.     

What Poole and Wolfe (2009) actually said: a comment on Everson and Faller (2012)

Everson and Faller's (2012) article on the significance of sexualized behavior in child sexual abuse assessments critiques a chapter by Poole and Wolfe (2009), but their objections assumed conclusions and practice implications that were not contained in that chapter. In this comment, I reiterate the value of educating adults about normative sexual and nonsexual behavior that could be misconstrued as symptoms of sexual abuse in some children, review key points from the chapter, and point out that Everson and Faller's critique supports the chapter's take-home messages (i.e., the importance of gathering information from multiple sources and the need to test alternative hypotheses for concerning behavior, consider the overall context of individual cases, and obtain independent verification of evidence).     

Assessment and intervention in cases of suspected ritual child sexual abuse

Agency workers have been heavily criticized over their handling of alleged ritual child sexual abuse cases, particularly in respect of their assessments and interventions. However, a study of referrals to police and social service departments revealed that agency workers raised suspicions of ritual abuse in respect of both child ‘victims’ and adult ‘survivors’ very rarely. Furthermore, they did this only after an assessment which showed the cases to possess a number of ‘troubling’ features. While agency workers believed that all the child ‘victims’ had been subject to serious sexual abuse, virtually all of them were circumspect as to whether this had occurred in a ‘ritual’ context. Initially, agency workers were generally open-minded as to the experiences of adult ‘survivors’, but by the end of their assessments, they tended to be more concerned about their mental health and less concerned about issues of ritual abuse. Finally, agency workers appeared to act appropriately in terms of the types of intervention they used and the way in which they applied these. These results suggest that there should be more confidence in the ability of agency workers to respond to cases of alleged ritual abuse. Copyright © 2001 John Wiley & Sons, Ltd.     

Evaluation of an Innovative Tool for Child Sexual Abuse Education

Child sexual abuse poses a serious threat to public health and is often unreported, unrecognized, and untreated. Prevention, early recognition, and treatment are critically important to reduce long-term effects. Little data are available on effective methods of preventing child sexual abuse. The current research demonstrates a unique approach to promoting awareness and stimulating discussion about child sexual abuse. Qualitative methods have rarely been used to study child sexual abuse prevention. Qualitative inductive analyses of interviews from 20 key informants identified both positive and negative assessments with six emergent themes. The themes revealed inherent tensions in using narrative accounts to represent the complex cultural context within which child sexual abuse occurs. More research is needed, but the program shows potential as a methodology to raise awareness of child sexual abuse.     

From behind the shadows: a profile of the sexual abuse of older men residing in nursing homes

Previous research on the sexual abuse of older adults has revealed few cases of the sexual abuse of older men. The first national study of the sexual abuse of vulnerable adults in facilities, reported in this article, collected data on alleged, investigated, and substantiated cases of sexual abuse. This study revealed 26 cases reported and screened in for investigation concerning the alleged sexual abuse of older men (aged 50 and older) residing in nursing homes. Cases occurred in five states within a six month time period. Of these cases, six were confirmed upon investigation by Adult Protective Services or other regulatory agencies. Victims tended to be predominantly white males with cognitive and physical deficits that limited their ability for self care. The most typical sexual abuse alleged and substantiated was fondling. Residents were more often substantiated as the abuser than other perpetrators. Sexual abuse of older men in nursing homes crosses traditional gender, cultural, and role boundaries for both victims and perpetrators.     

What makes sex offenders confess? An exploratory study

This study examines correlates of offender confession in criminal sexual conduct cases involving children. The cases consist of all closed court files (N=318), spanning the last 10 years from a single jurisdiction. This jurisdiction has a community-wide protocol for handling child sexual abuse cases, a high rate of charging (69%), a high rate of confession (64%), and high rates of pleas to sex crimes (77%). To determine what factors were associated with suspect confession before adjudication, we examined characteristics of the suspect, the child, the abuse, and the system using bi-variate and multi-variate analysis. The following four variables are associated with suspect confession: (1) having the state police conducting the law enforcement part of the investigation, (2) more serious abuse, (3) younger age of the suspect, and (4) having a court appointed (as opposed to a retained) attorney.     

Child Sexual Abuse Cases: Implementing a Specialist Judicial List

The damage done to children who are subjected to sexual abuse and the often lengthy delays in the resolution of these matters by the child welfare and legal systems is well documented. With this in mind, the Children's Court in Victoria established for 12 months in 2013 a pilot specialised judicial list (the “D” List) as an intensive case-management approach to more effectively respond to child sexual abuse concerns. The evaluation of the pilot aimed both to review the effectiveness of the list in terms of court functioning, and to provide information about the nature of such cases coming to court, the ages and family circumstances of subject children, decisions made and factors associated with these decisions, and the challenges related to management of and decision-making about such cases. The success of the specialist list has seen it extended to regional courts, because it is a more effective approach to managing and deciding this complex class of cases.     

Child Sexual Abuse News: A Systematic Review of Content Analysis Studies

Public knowledge and attitudes toward child sexual abuse are shaped through media depictions and coverage. Since the media are the main source of information about child sexual abuse, studies of child sexual abuse news can help us understand how news is created, how child sexual abuse is presented to the public, and what is the possible impact of such presentation and coverage on the audience. A systematic review of content analysis research is conducted using predefined criteria in order to identify quality studies, main findings, research gaps and to develop recommendations for future studies. International databases were systematically searched using keywords in September 2017. A total of 24 original quantitative content analysis studies published in the English language were included in the review and evaluated according to research methodology. The framework of child sexual abuse news media studies is developed and main findings are highlighted: (1) presentation and coverage of child sexual abuse (n = 7); (2) prevalence of coverage of CSA cases reported to the authorities (n = 2); (3) presentation and coverage of child abuse and sexual crimes where child sexual abuse is only a subtopic (n = 9); (4) presentation and coverage of specific child sexual abuse cases or issues (n = 6). Although studies represent valuable contribution, most did not meet content analysis design and reporting standards or both (e.g., calculating intercoder reliability), which seriously compromises validity and replicability requirements. Recommendation for future studies and most common errors in conducting content analysis are emphasized.     

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.     

Factors Related to Prosecution of Child Sexual Abuse Cases

ABSTRACT

This study explored how various factors regarding the victim, offender, abuse situation, and case evidence were related to prosecution decisions in child sexual abuse cases. Data were collected from records of 200 closed child sexual abuse cases served at a southwestern United States agency during 1989–1990. Results indicated that cases involving recently reported abuse and offenders who were charged with abusing multiple child victims were significantly more likely to be prosecuted than cases involving less recently reported abuse and offenders charged with abusing only one victim, respectively. In terms of the victim-offender relationship, prosecution was most likely for cases with offenders who were strangers, next most likely for acquaintances and step and extended family members, and least likely for biological nuclear family members. Also, cases with medical evidence of abuse were more likely to be prosecuted than cases without medical evidence only when serious abuse was involved. In addition, prosecution was significantly less likely for cases with younger victims than for cases with older victims. Seriousness of abuse, the presence of medical evidence, and recency of abuse did not account for this victim age-prosecution status relationship. Furthermore, no cases involving possible custody disputes were prosecuted. Implications are discussed concerning the need for focused and integrated efforts in responding to allegations of child sexual abuse.     

What Poole and Wolfe (2009) Actually Said: A Comment on Everson and Faller (2012)

Everson and Faller's (2012) article on the significance of sexualized behavior in child sexual abuse assessments critiques a chapter by Poole and Wolfe (2009), but their objections assumed conclusions and practice implications that were not contained in that chapter. In this comment, I reiterate the value of educating adults about normative sexual and nonsexual behavior that could be misconstrued as symptoms of sexual abuse in some children, review key points from the chapter, and point out that Everson and Faller's critique supports the chapter's take-home messages (i.e., the importance of gathering information from multiple sources and the need to test alternative hypotheses for concerning behavior, consider the overall context of individual cases, and obtain independent verification of evidence).     

Patterns of abuse in male same-sex relationships

Previous studies of abuse in male same-sex relationships have been limited by convenience samples and/or by incomplete assessments of partner abuse. We examined patterns of same-sex partner abuse in a random sample of 284 gay and bisexual men. Respondents reported on perpetration and receipt of physical, psychological, and sexual abuse over multiple time frames, as well as injuries resulting from abuse. Almost all respondents reported psychological abuse, more than one-third reported physical abuse, and 10% reported having engaged in unwanted sexual activity because of partner force or threats of force. More than half of recipients of partner violence reported sustaining injury. We found strong associations between different forms of abuse, and between severity of abuse receipt and perpetration.     

Conceptualization of the complex outcomes of sexual abuse: a signal detection analysis

Eighty-five New Zealand based practitioners experienced in treating adults with a history of child sexual abuse participated in an online judgment study of child sexual abuse outcomes using signal detection theory methodology. Participants' level of sensitivity was assessed independent of their degree of response bias when discriminating (a) known child sexual abuse outcomes from behaviors thought to be unrelated to child sexual abuse and (b) direct child sexual abuse effects from subsequent coping strategies. Results demonstrated good sensitivity (accuracy) when identifying child sexual abuse effects from noneffects. When asked to discriminate direct child sexual abuse effects from ways of coping with distress, practitioners' accuracy was reduced, revealing a tendency to identify all effects as coping. Although treatment approaches highlight the pivotal role of identifying coping strategies, practitioners did not perceive maladaptive coping as a distinct clinical feature. Complex abuse cases may benefit from replacing maladaptive coping strategies (e.g., self-harm) with constructive coping (e.g., social support) in order to deliver efficacious practice.     

Base rates, multiple indicators, and comprehensive forensic evaluations: why sexualized behavior still counts in assessments of child sexual abuse allegations

Developmentally inappropriate sexual behavior has long been viewed as a possible indicator of child sexual abuse. In recent years, however, the utility of sexualized behavior in forensic assessments of alleged child sexual abuse has been seriously challenged. This article addresses a number of the concerns that have been raised about the diagnostic value of sexualized behavior, including the claim that when population base rates for abuse are properly taken into account, the diagnostic value of sexualized behavior is insignificant. This article also identifies a best practice comprehensive evaluation model with a methodology that is effective in mitigating such concerns.     

What Makes Sex Offenders Confess? An Exploratory Study

ABSTRACT

This study examines correlates of offender confession in criminal sexual conduct cases involving children. The cases consist of all closed court files (N = 318), spanning the last 10 years from a single jurisdiction. This jurisdiction has a community-wide protocol for handling child sexual abuse cases, a high rate of charging (69%), a high rate of confession (64%), and high rates of pleas to sex crimes (77%). To determine what factors were associated with suspect confession before adjudication, we examined characteristics of the suspect, the child, the abuse, and the system using bi-variate and multi-variate analysis.

The following four variables are associated with suspect confession: (1) having the state police conducting the law enforcement part of the investigation, (2) more serious abuse, (3) younger age of the suspect, and (4) having a court appointed (as opposed to a retained) attorney.     

Healing from childhood sexual abuse: a theoretical model

Childhood sexual abuse is a prevalent social and health care problem. The processes by which individuals heal from childhood sexual abuse are not clearly understood. The purpose of this study was to develop a theoretical model to describe how adults heal from childhood sexual abuse. Community recruitment for an ongoing broader project on sexual violence throughout the lifespan, referred to as the Sexual Violence Study, yielded a subsample of 48 women and 47 men who had experienced childhood sexual abuse. During semistructured, open-ended interviews, they were asked to describe their experiences with healing from childhood sexual abuse and other victimization throughout their lives. Constructivist grounded theory methods were used with these data to develop constructs and hypotheses about healing. For the Sexual Violence Study, frameworks were developed to describe the participants' life patterns, parenting experiences, disclosures about sexual violence, spirituality, and altruism. Several analytic techniques were used to synthesize the findings of these frameworks to develop an overarching theoretical model that describes healing from childhood sexual abuse. The model includes four stages of healing, five domains of functioning, and six enabling factors that facilitate movement from one stage to the next. The findings indicate that healing is a complex and dynamic trajectory. The model can be used to alert clinicians to a variety of processes and enabling factors that facilitate healing in several domains and to guide discussions on important issues related to healing from childhood sexual abuse.     

Forensic, cultural, and systems issues in child sexual abuse cases--part 1: an introduction

This article introduces the first in a two-part special issue focusing on forensic, cultural, and systems issues in child sexual abuse cases. The five articles contained in this issue include a diversity of perspectives on approaches to extended interviews and evaluations of child sexual abuse suspicions, an exploration of the ways culture affects child sexual abuse disclosure and reporting, considerations relevant to the management of a child's mental health needs while forensic process are ongoing, and the use of anatomical dolls in forensic interviews. We call for attention to several practice areas, including (a) prioritizing a child's mental health needs while minimizing disruption of forensic processes, (b) developing best practices and models of child sexual abuse assessment and evaluation when a one-session forensic interview is insufficient, (c) appropriately evaluating child sexual abuse concerns when they occur without a disclosure and/or in children with communication limitations, and (d) the integration of cultural sensitivity into interviews and evaluations.     

Exploring the link between sexualized behaviour and sexual abuse in a clinical setting

This study examined the issue of sexualized behaviour in children as an indicator of sexual abuse. The purpose was to develop alternative explanations for sexualized behaviour if sexual abuse was not confirmed or suspected. Other possible explanations explored were the presence of frequent disruptions to family life, previous unresolved exposure to sexual abuse or contact with a sexualized child. Data were collected on 81 cases of sexualized behaviour referred to a specialist child protection assessment unit over a 7‐year period. It was found that in very few cases was sexual abuse considered an explanation for the sexualized behaviour. Of the remaining cases, a substantial number showed evidence of family disruption, which could lead to sexualized behaviour developing as a comforting response for the child. Furthermore, a number of children also had experienced sexual abuse in the past, which might have been unresolved for the child, or had contact with another sexualized child, and this might have accounted for their behaviour. It would appear that many of the children were facing difficulties in their lives and might require therapeutic intervention, even if concerns about recent sexual abuse had been allayed. Copyright © 1999 John Wiley & Sons, Ltd.     

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.