Child Sexual Abuse Flashcards
Cultural Context
In terms of this, what do we need to know?
What is one boundary to knowledge?
Need to know what is culturally acceptable sexual behaviour.
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Few studies focus on normal patterns of touching and physical contact in families.
Common (1) and extremely rare (2) sexual behaviour in non-abused children
common
Touching their own genitals or sexual parts.
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extremely rare
Inserting objects into the vagina or anus.
Oral – genital contact.
Conceptual issues * Components essential to defining sexual abuse: * Definitions are typically... They often include... Emphasis is placed on? They address?
- broad enough to include intra-familial and extra-familial abuse
- sexual experiences with children involving both physical contact and noncontact activities
- the adult’s exploitation of his or her authority and power to achieve sexual ends
- age or maturational advantage of the perpetrator over the victim
Conceptual Issues
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Concerns related to definitions: (3)
WIN
What specific behaviours should be deemed abuse?
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intent of the abuser (Need to evaluate …intended for the sexual stimulation?)
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Need to take into account the perpetrator’s size, age, sex and/or status as well.
Contextual Issues.
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There is an implicit assumption that children cannot give informed consent.
2 reasons why.
Developmentally cannot understand what they are consenting to and what the consequences of their consent might be
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Might not be in a position to decline involvement because of the adult’s authority and power
Legal Issues * The Criminal Code of Canada prohibits the following behaviours * Under 14 (3)
- Any sexual activity b/w adult and child under 14 with the exception of consensual “peer sex.”
- Direct/indirect touch anywhere on person under 14 for sexual purpose.
- Inviting, counselling, inciting direct/indirect touch from person under 14 for sexual purpose.
Consensual “peer sex” is not an offence in the following situation:
one child is between 12 and 14
the other is
– 12 years or more but under the age of 16
– less than two years older
– not in a position of trust or authority towards the other child
– nor in a relationship of dependency
Legal Issues * The Criminal Code of Canada prohibits the following behaviours * Adult in position of trust (2)
- Any sexual activity between an adult in a position of trust or authority towards a child 14-18.
- Sexual intercourse between an adult and someone within blood family (child, grandchild, brother, sister)
Legal Issues * The Criminal Code of Canada prohibits the following behaviours * Technology (2)
- Child pornography
* Luring a child by computer to facilitate prohibited sexual offences.
Legal Issues * The Criminal Code of Canada prohibits the following behaviours * Under 18 (3)
- Living on the avails of prostitution of a person under the age of 18
- Aiding, abetting, counselling or compelling a person under 18 to engage in prostitution; using, threatening to use, or attempting to use violence, intimidation or coercion in relation to the person under that age.
- Obtaining for consideration or communicating with anyone to obtain for consideration, the sexual services of a person under the age of 18.
Incidence of child sexual abuse
From which two sources do numbers come from?
Official estimates
Self-report Surveys
Incidence of child sexual abuse
From which two sources do numbers come from?
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Official estimates – numbers usually come from?
Problem with this? (2)
Child Protection Agency reports
under-reporting and of undisclosed cases
Self-report Surveys – potentially a clearer picture, but problems include…(3)
samples
under-estimates of actual rate
problems with memory
Canadian picture – Statistics Canada
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Children and youth accounted for what percentage of sexual assault victims reported to the police?
What percentage were female?
60%
80% of victims were female
Canadian picture – Statistics Canada
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Prior to age 12, female victims were more likely to…
What percentage knew the assailant?
be sexually assaulted than to be victims of other types of crimes
85% knew the assailant
Canadian picture – Statistics Canada
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85% knew the assailant. Break it down in terms of accused in family-related sexual assaults against children and youth.
30% fathers
30% brothers
30% extended male relatives
2% by a female relative
Police reported incidents for victims under 13 occurred most often when?
between 3pm and 7pm
Characteristics of the Child Victim
Gender – number of male victims may be under reported. Why?
Societal norms
– support not reporting
– should be dominant and self-reliant
– shouldn’t express helplessness or vulnerability
– early sexual experiences normal for boys
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Fears about homosexuality
Family Factors (5)
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Living situation
- Living w/o bio parents for extended time
- Stepfather
- Working mother
Family Factors
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Relationships (3)
- Domestic violence
- Strained parental relationship
- Poor relationship with one or both parents
Family Factors
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Parent problems (3)
- Disabled (physical or mental) mother
- Drug, alcohol or emotional problems
- Parent’s hx of sexual abuse
Family Factors
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Social factors (2)
- Few close friends
* Family isolation
Characteristics of those who sexually abuse children
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Age (2)
Develop deviant sexual interests prior to age 18.
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Adolescent offenders – most are male and represent all cultural and socioeconomic groups.
Characteristics of those who sexually abuse children
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Gender
Most offenders are male.
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Women do offend but we have limited data. Women are
– accomplices to men
– lonely and isolated single parents
– adolescent babysitters
– adult women who develop a romantic attachment to adolescent boy
Characteristics of those who sexually abuse children
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Relationship to child victim
Describe intra and extra
Intrafamilial (within the family) – more common with men being more often the perpetrators
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Extrafamilial – reported far less but more common.
4 preconditions that must exist before abuse can occur
Perpetrator must:
Perpetrator must:
• have some motivation to sexually abuse a child
• overcome internal inhibitions against acting on the motivation
• overcome external barriers to acting on that motivation
• overcome the child’s resistance to sexual abuse
Initiation of abuse
3 stages
Careful selection
Grooming
Maintenance of the abuse – keeping the secret
What is grooming?
purposeful and focused on preparing the child for the abuse
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desensitizing the child using a progression from nonsexual to sexual touch in the context of a gradually developing relationship.
What are some grooming tactics?
MMMST
Misrepresent moral standards Misuse authority Money or other bribes Separate from parents and peers Threats of harm to people or pets
Perpetrators justify their behaviour.
You came on to me. You wanted it. You seduced me.
Maintenance of the abuse – keeping the secret (3)
bribes, threats, physical agression
Organized Exploitation refers to?
3 examples?
sexual maltreatment of groups of children for – the sexual stimulation of one or more perpetrators – commercial gain – both * Sex rings Pornography Prostitution
Child Sex Rings
What do they do first?
In order to be accepted, what must the child do?
Core element?
• Interest children in joining the group
• Require children to fulfill sexual demands in order to be accepted.
• Core element – pornographic activities
Children are often photographed or videotaped
Child Pornography definition
a visual depiction of any kind * whether made or produced by electronic, mechanical, or other means * of sexually explicit conduct involving a minor. – drawing – cartoon – sculpture – painting – photography – film – video – computer-generated image or picture
Child Prostitution
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Where are youth most often found working?
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Age of entry – difficult to assess as it is a process.
Studies have varied by region – anywhere from
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Gender?
• on the street • non-regulated off-street work – gang houses – trick pads – drug houses * 12 to 17 years * More girls than boys involved
Signs of Child Sexual Abuse
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Physical
- Unexplained pain, bleeding, or swelling of mouth, genitals or rectal area
- UTIs
- STIs
- Bed wetting
- Sleep disturbances
- Eating disorders
- Physical complaints including headaches and/or stomach aches
Signs of Child Sexual Abuse
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Psychological
- Anxiety and/or depression including suicide attempts
* Substance abuse problems
Signs of Child Sexual Abuse
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Behaviour
- Persistent sexual play with self, toys, other kids
- Excessive bathing or poor hygiene
- Early sexual activity
- Early pregnancy
- School problems
- Discipline problems including running away
- Aggressive or self-destructive behaviour
Long term effects
PTSD Depression and anxiety Substance abuse Eating disorders * Relationship issues Sexuality issues Sexualized behaviour
Why are some children affected severely by the abuse and others not at all?
TIER
- Threats, force and violence are linked to increased problems
- Intense emotional relationship with the abuser
- Exposure to other forms of abuse
- Response of adults to the disclosure
When a child is exposed to sexual abuse in addition to physical and psychological abuse, the effect is often…?
cumulative and therefore, more severe
Factors Affecting Adjustment after the Disclosure Duration x 2 Degree x 3 Difference Age/Development
• Duration/nature of r’ship of victim to offender
• Duration of the sexual abuse activities
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• Degree of aggression or severity of force the child endured
• Degree of the victim’s participation
• Degree of support from the family and professionals on disclosure of the sexual abuse
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• Difference in age b/w victim/offender
• Victim’s developmental state or maturity at onset of the sexual abuse
• Sophistication of the child about sexual abuse
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• Type of sexual abuse activities
• Environment or context of the sexual abuse
• Gender of victim and perpetrator
How does the non-abusive family member react and respond to the child? If supportive =
more positive outcome.
The greater the age difference between victim and offender…
the greater the trauma
Treatment Interventions
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Must take into account (2)
- Diverse backgrounds of victims and perpetrators
* Attend to countertransference (seek supervision always!) for therapist (this could be my child..my husband)
Treatment Interventions * Goals of tx (2) * Common method?
• Alleviate sx
• Teach the appropriate expression of anger
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• Specialized play therapy for children
Treatment Interventions
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Rules of tx (2)
- One size does not fit all. Must tailor interventions to the individual whenever possible.
- Treatment requires specialize training and skills. Therapy is long and intensive and costly when done well.
Treatment Interventions
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Offender Treatment Goal
• Reduce the likelihood of reoffending
Treatment Interventions
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Offender tx approaches
• Psychotherapy
• Usu group therapy as result of conviction
• Medical Approaches
– rarely used in Manitoba and Canada
Med for medical tx?
– Depo-Provera
Depo-Provera is used to?
It does not?
Depo-Provera is used to reduce the testosterone levels. Does not prevent the behaviour.
Why is it so difficult to disclose sexual abuse?
Child feels threatened ashamed unsafe doesn't have language to articulate worried about what it will do to family
Why is it difficult to acknowledge that women can be perpetrators of sexual abuse?
all the stereotypes we have: women naturally viewed as victim and nurturers of children men viewed as more powerful reports not taken seriously males always want/won't say not to sex men can't be forced
What are the factors that make sexual abuse by the clergy difficult to acknowledge?
clergy always right – ppl don’t say no to
the person is a role model
ppl can’t wrap mind around breach of role
affects the whole community
What role might an RPN play?
recognize/refer
connecting w/ resources
working w/ ppl dealing w/ LT effects of abuse on daily basis
PTSD, BPD
