Twenty-nine percent of female rape victims in America were younger than eleven when they were raped (National Center for Victims of Crime & Crime Victims Research and Treatment Center, 1992).
According to the National Committee to Prevent Child Abuse's annual survey, state child protective agencies received 218,820 reports of child sexual abuse in 1996 (Wang & Daro, 1997). (Calculated by multiplying the estimated number of reported child victims (3,126,000) by the percentage of sexual abuse cases (7%).)
In the United States, at least 20% of women and 5% to 10% of men were sexually abused as children (Finkelhor, 1994).
Child sexual abuse has been at the center of unprecedented public attention during the last decade. All fifty states and the District of Columbia have enacted statutes identifying child sexual abuse as criminal behavior (Whitcomb, 1986).
This crime encompasses different types of sexual activity, including voyeurism, sexual dialogue, fondling, improper touching of private areas and forcing children to participate in pornography or prostitution.
Child Sexual Abusers
Perpetrators of child sexual abuse come from different age groups, genders, races and socio- economic backgrounds. Women sexually abuse children, although not as frequently as men, and juvenile perpetrators comprise as many as one-third of the offenders (Finkelhor, 1994).
One common denominator is that victims frequently know and trust their abusers. Child abusers coerce children by offering attention or gifts, manipulating or threatening their victims, using aggression or employing a combination of these tactics.
"[D]ata indicate that child molesters are frequently aggressive. Of 250 child victims studied by DeFrancis, 50% experienced physical force, such as being held down, struck, or shaken violently" (Becker, 1994).
Child Sexual Abuse Victims Studies have not found differences in the prevalence of child sexual abuse among different social classes or races. However, parental inadequacy, unavailability, conflict and a poor parent-child relationship are among the characteristics that distinguish children at risk of being sexually abused (Finkelhor, 1994).
According to the Third National Incidence Study, girls are sexually abused three times more often than boys, whereas boys are more likely to die or be seriously injured from their abuse (Sedlak & Broadhurst, 1996). Both boys and girls are most vulnerable to abuse between the ages of 7 and 13 (Finkelhor, 1994).
Incest traditionally describes sexual abuse in which the perpetrator and victim are related by blood. However, incest can also refer to cases where the perpetrator and victim are emotionally connected (Crnich & Crnich, 1992).
"[I]ntrafamily perpetrators constitute from one-third to one-half of all perpetrators against girls and only about one-tenth to one-fifth of all perpetrators against boys. There is no question that intrafamily abuse is more likely to go on over a longer period of time and in some of its forms, particularly parent-child abuse, has been shown to have more serious consequences" (Finkelhor, 1994).
Symptoms of Child Sexual Abuse
Many sexually abused children exhibit physical, behavioral and emotional symptoms. Some physical signs are pain or irritation to the genital area, private area discharge and difficulty with urination. Victims of known assailants may experience less physical trauma because such injuries might attract suspicion (Hammerschlag, 1996).
Behavioral changes often precede physical symptoms as the first indicators of sexual abuse (American Humane Association Children's Division, 1993). Behavioral signs include nervous or aggressive behavior toward adults, sexual provocativeness before an appropriate age and the use of alcohol and other drugs.
Boys "are more likely than girls to act out in aggressive and antisocial ways as a result of abuse" (Finkelhor, 1994). Children may say such things as, "My mother's boyfriend does things to me when she's not there," or "I'm afraid to go home tonight."
Consequences of Child Sexual Abuse
Consequences of child sexual abuse range "from chronic depression to low self-esteem to sexual dysfunction to multiple personalities. A fifth of all victims develop serious long-term psychological problems, according to the American Medical Association.
These may include dissociative responses and other signs of post-traumatic-stress syndrome [sic], chronic states of arousal, nightmares, flashbacks, venereal disease and anxiety over sex or exposure of the body during medical exams" ("Child Sexual Abuse . . .," 1993).
Cycle of Violence
Children who are abused or neglected are more likely to become criminal offenders as adults. A National Institute of Justice study found "that childhood abuse increased the odds of future delinquency and adult criminality overall by 40 percent" (Widom, 1992).
Child sexual abuse victims are also at risk of becoming ensnared in this cycle of violence. One expert estimates that forty percent of sexual abusers were sexually abused as children (Vanderbilt, 1992). In addition, victims of child sexual abuse are 27.7 times more likely to be arrested for prostitution as adults than non-victims. (Widom, 1995).
Some victims become sexual abusers or prostitutes because they have a difficult time relating to others except on sexual terms.
Stopping the Cycle of Violence
With early detection and appropriate treatment, society can prevent some victimized children from becoming adult perpetrators. In order to intervene early in abuse, parents should educate their children about appropriate sexual behavior and how to feel comfortable saying no (American Humane Association Children's Division, 1993).
Although about 40% of untreated nonincest offenders recidivate, studies have found that treatment can successfully decrease recidivism rates (Becker, 1994). Depo-Provera and other pharmacological treatments can decrease sexual thoughts, urges or drives by lowering male sexual offenders' testosterone levels. This method is sometimes referred to as chemical castration.
Offenders' inappropriate attraction to children can be diminished by behavioral modification techniques, such as aversive conditioning and other procedures. Psychological treatment such as psychotherapy and counseling can help offenders understand their behavior and identify its origins (Groth & Oliveri, 1989).
Steps must be taken to ensure that perpetrators do not attack again once the criminal justice system's punitive measures have taken their course. All states and the federal government have enacted versions of Megan's Law that require community notification and sex offender registration. Under these laws, authorities are required to notify communities when sex offenders move in.
In some cases, law enforcement agencies make the notification while the offender is responsible in others. Registration laws require offenders to provide information such as name and address to a law enforcement agency. The FBI maintains a nationwide sex offender registry (Walsh, 1997).
Child Sexual Abuse Reporting
Children may resist reporting sexual abuse because they are afraid of angering the offender, blame themselves for the abuse or feel guilty and ashamed. In order to increase reporting, parents and adults who interact with children, such as school personnel, teachers, counselors, child care workers, Boy and Girl Scout troop leaders and coaches, should be educated about the behavioral and physical symptoms of child sexual abuse (American Humane Association Children's Division, 1995).
Children are more likely to reveal sexual abuse when talking to someone who appears to 'already know' and is not judgmental, critical or threatening. They also tend to disclose when they believe continuation of the abuse will be unbearable; they are physically injured; or they receive sexual abuse prevention information. Other reasons may be to protect another child or if pregnancy is a threat ("Child Sexual Abuse . . .", 1993).
Recovery from Child Sexual Abuse
Once a child discloses the abuse, an appropriate response is extremely important to the child's healing process. The adult being confided in should encourage the victim to talk freely, reassure the child that he or she is not to blame and seek medical and psychological assistance.
Family members may also benefit from mental health services (American Academy of Child and Adolescent Psychiatry, 1992).
Suspicions of child sexual abuse should be reported to a child protective services agency or law enforcement agency. Local child protection agencies investigate intrafamilial abuse and the police investigate extrafamilial abuse. The law requires professionals who work with children to report suspected neglect or abuse. In addition to reporting child sexual abuse to the authorities, victims can sue their abusers in civil court to recover monetary damages or win other remedies (Crnich & Crnich, 1992).
Many states have extended their criminal and civil statutes of limitation for child sexual abuse cases (National Center for Victims of Crime, 1995). In addition, the delayed discovery rule suspends the statutes of limitation if the victim had repressed all memory of the abuse or was unaware that the abuse caused current problems (Crnich & Crnich, 1992).
Adult Survivors of Child Sexual Abuse
Survivors of child sexual abuse use coping mechanisms to deal with the horror of the abuse. One such mechanism, protective denial, entails repressing some or all of the abuse. This may cause significant memory gaps that can last months or even years.
Victims also use dissociative coping mechanisms, such as becoming numb, to distance themselves from the psychological and physiological responses to the abuse. They may also turn to substance abuse, self-mutilation and eating disorders. In order to recover, adult survivors must adopt positive coping behaviors, forgive themselves, and relinquish their identities as survivors (Sgroi, 1989).
The healing process can begin when the survivor acknowledges the abuse. When working with adult survivors of child sexual abuse, therapists should consider the survivor's feeling of security and the personal and professional ramifications of disclosure. Societal influences play a big role in the recovery process. Although males are raised to shoulder responsibility for what happens to them, male victims need to understand that the victimization was not their fault. Only then can they begin to accept that they were not responsible for the abuse (Male Survivors of Childhood Sexual Abuse, 1990).
American Academy of Child and Adolescent Psychiatry. (1992). Child Sexual Abuse. Washington, D.C.: American Academy of Child and Adolescent Psychiatry.
American Humane Association Children's Division. (1993). Child Sexual Abuse: AHA Fact Sheet #4. Englewood, CO: American Humane Association.
American Humane Association Children's Division. (1995). Guidelines to Help Children Who Have Been Reported for Suspected Abuse or Neglect: AHA Fact Sheet #14. Englewood, CO: American Humane Association.
Becker, Judith. (1994). "Offenders: Characteristics and Treatment." The Future of Children, 4(2): 179, 186. "Child Sexual Abuse: Does the Nation Face an Epidemic - or a Wave of Hysteria?" (1993). CQ Researcher, 3(2): 27-28.
Crnich, Joseph & Crnich, Kimberly. (1992). Shifting the Burden of Truth: Suing Child Sexual Abusers - A Legal Guide for Survivors and Their Supporters. Lake Oswego, OR: Recollex Publishing.
Finkelhor, David. (1994). "Current Information on the Scope and Nature of Child Sexual Abuse." The Future of Children, 4(2): 31, 46-48.
Groth, Nicholas & Oliveri, Frank. (1989). "Understanding Sexual Offense Behavior and Differentiating among Sexual Abusers: Basic Conceptual Issues."
Vulnerable Populations: Sexual Abuse Treatment for Children, Adult Survivors, Offenders, and Persons with Mental Retardation Volume 2, Suzanne Sgroi, Ed. Lexington, MA: Lexington Books.
Hammerschlag, Margaret. (1996). Sexually Transmitted Diseases and Child Sexual Abuse. Washington, D.C.: Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice.
Male Survivors of Childhood Sexual Abuse. (1990). Virginia Child Protection Newsletter, 31: 1-12.
National Center for Victims of Crime. (1995). "Extensions of the Criminal and Civil Statutes of Limitation in Child Sexual Abuse Cases." FYI, No.57. Arlington, VA: National Victim Center.
National Center for Victims of Crime and Crime Victims Research and Treatment Center. (1992). Rape in America: A Report to the Nation. Arlington, VA: National Center for Victims of Crime and Crime Victims Research and Treatment Center.
Sedlak, Andrea & Broadhurst, Diane. (1996). Executive Summary of the Third National Incidence Study of Child Abuse and Neglect. Washington, D.C.: National Center on Child Abuse and Neglect, U.S. Department of Health and Human Services.
Sgroi, Suzanne. (1989). "Stages of Recovery for Adult Survivors of Child Sexual Abuse." Vulnerable Populations: Sexual Abuse Treatment for Children, Adult Survivors, Offenders, and Persons with Mental Retardation Volume 2, Suzanne Sgroi, Ed. Lexington, MA: Lexington Books.
Walsh, Elizabeth Rahmberg. (1997). "Megan's Laws - Sex Offender Registration and Notification Statutes and Constitutional Challenges." The Sex Offender: New Insights, Treatment Innovations and Legal Developments, Barbara Schwartz and Henry Cellini, Eds. Kingston, NJ: Civic Research Institute.
Wang, Ching-Tung & Daro, Deborah. (1997). Current Trends in Child Abuse: The Results of the 1996 Annual Fifty State Survey. Chicago, IL: The National Center on Child Abuse Prevention Research, The National Committee to Prevent Child Abuse.
Whitcomb, Debra. (1986). Prosecuting Child Sexual Abuse: New Approaches. Washington, D.C.: National Institute of Justice, U.S. Department of Justice.
Widom, Cathy Spatz. (1992). The Cycle of Violence. Washington, D.C.: National Institute of Justice, U.S. Department of Justice.
Widom, Cathy Spatz. (1995). Victims of Childhood Sexual Abuse - Later Criminal Consequences. Washington, D.C.: National Institute of Justice, U.S. Department of Justice.
For additional information, please contact:
American Humane Association Children's Division
63 Inverness Drive East
Englewood, CO 80112-5117
Family Violence and Sexual Assault Institute
1121 East Southeast Loop
323 Suite 130 Tyler, TX 75701
Big Brothers/Big Sisters of America
230 North 13th Street
Philadelphia, PA 19107
National Clearinghouse on Child Abuse and Neglect Information
P.O. Box 1182
Washington, DC 20013
Rape, Abuse & Incest National Network
252 10th Street NE
Washington, DC 20002