Disclosure

Child Sexual Abuse


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Has our knowledge base shifted over past 20 years? 

Some evidence incidence rates falling

Reporting rates improving

Much clearer understanding of tactics used

More precise knowledge of long term impact currently framed within trauma theory

Can construct clearer safety strategies


What has not changed?

Children still struggle to disclose and be believed

In familial CSA mothers are in difficult situations

Boys find it harder to disclose and generally do not follow up with counselling*

Pressure for CP workers to assess and implement long term solutions quickly


Definition Child Sexual Abuse

Different definitions over time have been used, which in turn are reflected in research.

Older definitions were quite static.

Preferred  Dynamic Definition    Ryan 2000

Lack of Consent

Lack of Equality 

Coercion

Population estimates

‘Unwanted’ sexual incidents before 16yo

Girls 17%     Boys 7%    

(Moore et al 2010)

National Phone survey U.S.A. 2003/2008/2011 Compared girls and boys at ages 15 and 17yrs

Girls  15yrs   16.8%  17yrs    26.6%

Boys 15yrs     4.3%   17yrs    5.1%

(Finkelhor et al 2014)


Types of Child Sexual Abuse

Various ways to categorise

Best done by relationship

Sometimes done by means of abuse        e.g. online sexual abuse

Trying to categorise by severity is problematic (but may be significant in relation to responding to the abuser)


“Grooming”

Position of advantage and/or trust

Develop close relationship with the child

Emotionally separate child from others

Gradual violation adult-child boundaries (often on context of intimate care)

Entrapping child:

-  Secrecy       -Shame

 -  Blame          -Sense of responsibility

-  Fear             -Isolation


(Grooming) Conditioning

Ploys: seemingly accidental touching / confusion

Covert warning of silence

Non-verbal cueing of abuse

Words to place responsibility on victim

Coercion / physical force 

Instilling fear

Conditioning (grooming) child’s carers/ family/ people at work


Disclosure

Understanding conditioning (grooming) an important frame of reference for disclosure

A child who has been well ‘conditioned’ to abuse will be restrained from disclosing by the elements of this

Safety or anticipating safety is significant. What may prevent this?

Disclosure is a process and in relation to initial disclosure, is often measured


Disclosure

Disclosure in context of investigative interviews not as measured by children

Only 7% of children mentioned expectation of belief

An interview with open-ended questions in a facilitative manner with active listening results generally in an expansive narrative of the abuse  (Malloy et al 2013)


Impact

Short and long term impact are well known

Duration, dependence, relationship, frequency are key elements of severity of impact

Long-term are higher rates of self-harm, suicide, accidental death by O.D. and serious mental illness  (Cutajar 2010)


Impact

Re-victimisation is high

Relates to underlying vulnerabilities and highlights complexities of the trauma  (Wall & Quadara 2014)

 Particular issues for boys abused from age 12 years (Ogloff et al 2012)


Vulnerable Populations

Children previously harmed

Siblings

Young People in OOHC

Girls


OOHC

Risky sexual behaviours in adolescence. Includes early onset of ‘consensual’ sexual activity, unprotected sexual intercourse, multiple sexual partners and teenage pregnancy (Arriola 2005)

Higher rates of sexual victimisation in OOHC, particularly resi-care 

(58:3.5/1000)

(Euser et al 2013)


Mediators of harm

Family Support and Strong Peer relationships  (Cashmore & Shackel 2013)

What may prevent this?

What does ‘family support’ look like?


Family Support

Who

Belief   (Vs Denial)

Clarity re process

Understanding the experience 

‘What it was like’

Communicating all of the above, listening and attunement


Tactics Targeting Context and Relationships

Gas lighting (Rush.1977: “… an attempt to destroy others’ perception of reality and, ultimately, their sanity.”, p.31)

Subverting relationships around the child

Ensuring position of control and influence (structural, strategic, emotional)

Promoting a positive image of self

Promoting a negative image of others around the child (possibly staff/ carers/ family)


Location to Both Access Victims and Commit Offences  

Queensland, 323 Convicted Child Sex Offenders (including 79 Intrafamilial) (Smallbone & Wortley, 2000)

Perpetrator’s own home     68.9%

Going for a car ride      27.4%

Isolated or out of the way places     25.6%

Out of the way place in the child's home     19.5%

A friends’ or relative's home     17.1%

The bush     15.5%

Others: park (9.5%), public toilet (7.1%), swimming pool and taking child for walks (5.4%), playground (3.0%), movie theatre (2.4%)


Strategies for getting access to children for sexual contact (extrafamilial offending)

Spent time with the child while parent/caretaker was present   46.2 %

Made friends with the parent/caretaker   44.9%

Helped parent/caretaker around the house   35.9%

Offered to baby-sit victim   23.1%

Asked neighbours or friends of family to join in family activities   21.5%

Offered to drive/walk victim to or from school  19.2%

Volunteered for child or teen organisation     8.0%

Romantic relationship with a single parent     7.0%

Ref. Smallbone & Wortley 2000


Pornography

1/3 of child sex offenders had viewed pornography immediately prior to offending (Marshall, 1988, cited in Wortley & Smallbone, Situational Prevention of Child Sexual Abuse, 2006)

Online and other technology based points of access, with this currently merging into adolescent sexual development     

Ref. ‘Love and Sex in an Age of Pornography’


Tactics After Disclosure

Denial (various levels)

Minimisation

Isolation / denigration of victim

Maintaining central role around the child

Boundary violations (physical / emotional)

Deception (e.g. lying to professionals, family members, friends, employer, etc)

Courtship


Tactics After Disclosure

Selective disclosure /  non-disclosure

Holding position of control and influence

 Promoting a positive image of self / inviting sympathy / pity (‘hard-done-by’ story)

Promoting a negative image of child’s carers / family/ staff

Distorting information re: investigation, professionals, etc

Suicidality


After Disclosure

Boundary Violations

Seeking information on child / child’s carers/ family/ place of employment (note possibility to use informal information networks)

Out of hours visits to other family

Intimidation / harassment

Breaching AVOs

The tactics used after disclosure are the same as, or closely mirror, the tactics used in setting up, perpetrating, and maintaining, the sexual abuse


Assessing Risk

Past behaviour best predictor of future

Risk assessment is an estimate

Recommend CP workers have thorough understanding of risk assessment

Past dynamics of CSA (or report of CSA) critically important to safety planning


Engage carers in safety planning

Target key areas of risk such as:

Intimate care

Isolation of child from key family members or peers

Sexualisation/ denigration

Unsupervised time with child


Be alert to being conditioned (groomed)

Working alone is a risk

Debrief regularly including impressions of each carer

‘red flag’ any splitting

When evidence is being presented re ‘unreliability’ of a child leave room to conceptualise child’s behaviour as having a trauma base so have an alternate point of reference to a ‘compelling’ explanation

Join around commitment to care for child


References 

Arriola, K., Loude, T., Doldren, M., Fortenberry, R. (2005) A meta-analysis of the relationship of child sexual abuse to HIV risk behaviour among women. Child Abuse & neglect p. 725-746. 

Cashmore,  J, and Shackel, R. (2013) The long term effects of child sexual abuse. CFCA paper No. 11

Cutajar, M., Mullen, P., Ogloff, J., Thomas, S., Wells, D, and Spataro (2010) Suicide and fatal drug overdoes in child sexual abuse victims: a historical cohort study, Medical Journal of America 192 (4) p.184

Euser, S., Alnik, L., Tharner, A.,, van I Jzendoorn, H., Bakermans-Kranenburg, M. (2013) the prevalence of child sexual abuse  in out-of-home care: A comparison between abuse in residential and in foster care. Child Maltreatment 18 p. 221.

Finkelhor, D., Shattuck, A., Turner, A., Hamby, S, (2013). The lifetime prevalence of child sexual abuse and sexual assault assessed in late adolescence. Adolescent Health  2014 in press. 

Malloy, C., Brubacher, S and lamb, M. 2013. ‘because she’s one who listens”: Children discuss disclosure recipients in forensic interviews. Child maltreatment 18:p. 245.

Moore, E.., Romaniuk, H., Olsen, C., Jayasignh, Y., Carlin,J. Patton, G. (2010) The prevalence of childhood sexual abuse and adolescent unwanted sexual contact among boys and girls living in Victoria, Australia. Child Abuse and Neglect 34p.379-385.

Ogloff, J., Cutajar, M., Mann, E., Mullen, P. (2012) Child sexual abuse and subsequent offending: A 45 year follow –up study. Trends & Issues paper No 440 Australian Institute of Criminology 

Smallbone, S  and Wortley R. Child sexual abuse offender characteristics and modus operandi. Trends and Issues Paper No. 193 Australian Institute of Criminology 

Wall< l. and Quadara a. (2014) Acknowledging complexity in the impacts of sexual victimisation trauma. ACSSA issues No 16 Australian Centre for the Study of Sexual assault. 

Wall, G. and McArthur M. 2006. Being ‘child centred” in child protection . What does it mean?  Children Australia 31 (4)  p. 13

Key note address Child Sexual Abuse 

dale.tolliday@health.nsw.gov.au