Child Sexual Abuse

Question 1

Cultural Context
In terms of this, what do we need to know?
What is one boundary to knowledge?

Answer 1

Need to know what is culturally acceptable sexual behaviour.
*
Few studies focus on normal patterns of touching and physical contact in families.

Question 2

Common (1) and extremely rare (2) sexual behaviour in non-abused children

Answer 2

common
Touching their own genitals or sexual parts.
*
extremely rare
Inserting objects into the vagina or anus.
Oral – genital contact.

Question 3

Conceptual issues
*
Components essential to defining sexual abuse:
*
Definitions are typically...
They often include...
Emphasis is placed on?
They address?

Answer 3

• 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

Question 4

Conceptual Issues
*
Concerns related to definitions: (3)
WIN

Answer 4

What specific behaviours should be deemed abuse?
*
intent of the abuser (Need to evaluate …intended for the sexual stimulation?)
*
Need to take into account the perpetrator’s size, age, sex and/or status as well.

Question 5

Contextual Issues.
*
There is an implicit assumption that children cannot give informed consent.
2 reasons why.

Answer 5

Developmentally cannot understand what they are consenting to and what the consequences of their consent might be
*
Might not be in a position to decline involvement because of the adult’s authority and power

Question 6

Legal Issues
*
The Criminal Code of Canada prohibits the following behaviours
*
Under 14 (3)

Answer 6

• 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.

Question 7

Consensual “peer sex” is not an offence in the following situation:

Answer 7

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

Question 8

Legal Issues
*
The Criminal Code of Canada prohibits the following behaviours
*
Adult in position of trust (2)

Answer 8

• 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)

Question 9

Legal Issues
*
The Criminal Code of Canada prohibits the following behaviours
*
Technology (2)

Answer 9

• Child pornography

* Luring a child by computer to facilitate prohibited sexual offences.

Question 10

Legal Issues
*
The Criminal Code of Canada prohibits the following behaviours
*
Under 18 (3)

Answer 10

• 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.

Question 11

Incidence of child sexual abuse

From which two sources do numbers come from?

Answer 11

Official estimates

Self-report Surveys

Question 12

Incidence of child sexual abuse
From which two sources do numbers come from?
*
Official estimates – numbers usually come from?
Problem with this? (2)

Answer 12

Child Protection Agency reports

under-reporting and of undisclosed cases

Question 13

Self-report Surveys – potentially a clearer picture, but problems include…(3)

Answer 13

samples
under-estimates of actual rate
problems with memory

Question 14

Canadian picture – Statistics Canada
*
Children and youth accounted for what percentage of sexual assault victims reported to the police?
What percentage were female?

Answer 14

60%

80% of victims were female

Question 15

Canadian picture – Statistics Canada
*
Prior to age 12, female victims were more likely to…
What percentage knew the assailant?

Answer 15

be sexually assaulted than to be victims of other types of crimes
85% knew the assailant

Question 16

Canadian picture – Statistics Canada
*
85% knew the assailant. Break it down in terms of accused in family-related sexual assaults against children and youth.

Answer 16

30% fathers
30% brothers
30% extended male relatives
2% by a female relative

Question 17

Police reported incidents for victims under 13 occurred most often when?

Answer 17

between 3pm and 7pm

Question 18

Characteristics of the Child Victim

Gender – number of male victims may be under reported. Why?

Answer 18

Societal norms
– support not reporting
– should be dominant and self-reliant
– shouldn’t express helplessness or vulnerability
– early sexual experiences normal for boys
*
Fears about homosexuality

Question 19

Family Factors (5)
*
Living situation

Answer 19

• Living w/o bio parents for extended time
• Stepfather
• Working mother

Question 20

Family Factors
*
Relationships (3)

Answer 20

• Domestic violence
• Strained parental relationship
• Poor relationship with one or both parents

Question 21

Family Factors
*
Parent problems (3)

Answer 21

• Disabled (physical or mental) mother
• Drug, alcohol or emotional problems
• Parent’s hx of sexual abuse

Question 22

Family Factors
*
Social factors (2)

Answer 22

• Few close friends

* Family isolation

Question 23

Characteristics of those who sexually abuse children
*
Age (2)

Answer 23

Develop deviant sexual interests prior to age 18.
*
Adolescent offenders – most are male and represent all cultural and socioeconomic groups.

Question 24

Characteristics of those who sexually abuse children
*
Gender

Answer 24

Most offenders are male.
*
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

Question 25

Characteristics of those who sexually abuse children * Relationship to child victim Describe intra and extra

Answer 25

Intrafamilial (within the family) – more common with men being more often the perpetrators * Extrafamilial – reported far less but more common.

Question 26

4 preconditions that must exist before abuse can occur | Perpetrator must:

Answer 26

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

Question 27

Initiation of abuse | 3 stages

Answer 27

Careful selection Grooming Maintenance of the abuse – keeping the secret

Question 28

What is grooming?

Answer 28

purposeful and focused on preparing the child for the abuse * desensitizing the child using a progression from nonsexual to sexual touch in the context of a gradually developing relationship.

Question 29

What are some grooming tactics? | MMMST

Answer 29

``` Misrepresent moral standards Misuse authority Money or other bribes Separate from parents and peers Threats of harm to people or pets ```

Question 30

Perpetrators justify their behaviour.

Answer 30

You came on to me. You wanted it. You seduced me.

Question 31

Maintenance of the abuse – keeping the secret (3)

Answer 31

bribes, threats, physical agression

Question 32

Organized Exploitation refers to? 3 examples?

Answer 32

``` sexual maltreatment of groups of children for – the sexual stimulation of one or more perpetrators – commercial gain – both * Sex rings Pornography Prostitution ```

Question 33

Child Sex Rings What do they do first? In order to be accepted, what must the child do? Core element?

Answer 33

• 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

Question 34

Child Pornography definition

Answer 34

``` 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 ```

Question 35

Child Prostitution * Where are youth most often found working? * Age of entry – difficult to assess as it is a process. Studies have varied by region – anywhere from * Gender?

Answer 35

``` • on the street • non-regulated off-street work – gang houses – trick pads – drug houses * 12 to 17 years * More girls than boys involved ```

Question 36

Signs of Child Sexual Abuse * Physical

Answer 36

* 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

Question 37

Signs of Child Sexual Abuse * Psychological

Answer 37

* Anxiety and/or depression including suicide attempts | * Substance abuse problems

Question 38

Signs of Child Sexual Abuse * Behaviour

Answer 38

* 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

Question 39

Long term effects

Answer 39

``` PTSD Depression and anxiety Substance abuse Eating disorders * Relationship issues Sexuality issues Sexualized behaviour ```

Question 40

Why are some children affected severely by the abuse and others not at all? TIER

Answer 40

* 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

Question 41

When a child is exposed to sexual abuse in addition to physical and psychological abuse, the effect is often...?

Answer 41

cumulative and therefore, more severe

Question 42

``` Factors Affecting Adjustment after the Disclosure Duration x 2 Degree x 3 Difference Age/Development ```

Answer 42

• Duration/nature of r'ship of victim to offender • Duration of the sexual abuse activities * • 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 * • 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 * • Type of sexual abuse activities • Environment or context of the sexual abuse • Gender of victim and perpetrator

Question 43

How does the non-abusive family member react and respond to the child? If supportive =

Answer 43

more positive outcome.

Question 44

The greater the age difference between victim and offender...

Answer 44

the greater the trauma

Question 45

Treatment Interventions * Must take into account (2)

Answer 45

* Diverse backgrounds of victims and perpetrators | * Attend to countertransference (seek supervision always!) for therapist (this could be my child..my husband)

Question 46

``` Treatment Interventions * Goals of tx (2) * Common method? ```

Answer 46

• Alleviate sx • Teach the appropriate expression of anger * • Specialized play therapy for children

Question 47

Treatment Interventions * Rules of tx (2)

Answer 47

* 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.

Question 48

Treatment Interventions * Offender Treatment Goal

Answer 48

• Reduce the likelihood of reoffending

Question 49

Treatment Interventions * Offender tx approaches

Answer 49

• Psychotherapy • Usu group therapy as result of conviction • Medical Approaches – rarely used in Manitoba and Canada

Question 50

Med for medical tx?

Answer 50

– Depo-Provera

Question 51

Depo-Provera is used to? | It does not?

Answer 51

Depo-Provera is used to reduce the testosterone levels. Does not prevent the behaviour.

Question 52

Why is it so difficult to disclose sexual abuse?

Answer 52

``` Child feels threatened ashamed unsafe doesn't have language to articulate worried about what it will do to family ```

Question 53

Why is it difficult to acknowledge that women can be perpetrators of sexual abuse?

Answer 53

``` 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 ```

Question 54

What are the factors that make sexual abuse by the clergy difficult to acknowledge?

Answer 54

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

Question 55

What role might an RPN play?

Answer 55

recognize/refer connecting w/ resources working w/ ppl dealing w/ LT effects of abuse on daily basis PTSD, BPD