Child Sexual Abuse Prevention The purpose of this literature review is to evaluate the information that has been collected in the area of child sexual abuse prevention. From the research studies critically examined, a decision will be made as to what areas improvements need to be made in, in order to adequately outfit children, teachers and child care workers with the skills and knowledge to help prevent child sexual abuse. An exploratory study entitled "Child Sexual Abuse Prevention" was conducted by Michele Elliott of Kids cape Charity for Children's Safety, London England and also by Kevin Browne and Jennifer Kilcoyne of the School of Medicine, University of Birmingham, Birmingham England. The Nuffield Foundation sponsored the research. The aim of this study was to interview child sex offenders about the methods they used to target their victims with the hope of using this information to improve child abuse prevention programs. The researchers chose ninety-one men who had been convicted and incarcerated for committing sexual offenses against children.
Fifteen of these men were attending community based sex offender treatment programs, twenty two of the participants were in special hospitals and thirty-nine of these men were at the time of the first interview still incarcerated in prisons, with sentences ranging from nine months to life. No sexual offenders with mental illnesses were used for this study. "All of the participants were convicted of "hands-on" assaults, including indecent assault, unlawful intercourse, rape and buggery against children under the age of 18 and were receiving some form of therapy." (Elliott, Browne and Kilcoyne 1995, page 580) "Participants were given no special consideration in either reducing their sentences or treatment programs." (Elliott, et al, 1995, page 580) Each participant was interviewed a total of three times, the firs was to inform the men of the purpose of the study and to invite them to join. The second interview asked the men a total of seventy-two questions and was conducted by a female research psychologist. Some of the questions were; the age and range of their victims, how they selected children, how they maintained them as victims and what suggestions they had for preventing child sexual abuse.
The third interview was conducted six months after the second and the answers received were compared to those in the second interview to test for consistency. The offenders displayed a 90 percent consistency in the way they responded throughout the interviews. The study concluded that in order for prevention programs to become more affective and successful they need to include information about the specific ways that child molester operate. "It also stated that it is potentially dangerous for children to tell the abuser "no" once the abuse as started and that Child Safety Programs needed to be re-evaluated and information reassessed in light of the information that offenders have revealed." (Elliott et al, 1995, page 593) The next research study that will be examined is entitled "Positive and Negative Effects of a Child Sexual Abuse Prevention Program." The aim of this research is to study the intended and unintended affects of the "Right to Security" child sexual abuse prevention program. "The aim of the prevention program is to enhance self-protective skills of children that are thought to contribute to safety in potential abuse situations." (Taal & Edelaar, 1997, page 400) The program aims to outfit children to deal with their first encounter with persons who intend to sexually offend them. "The "Right to Security" program was adapted from the American "Feeling Yes, Feeling No" program and the "Child Assault Prevention Project", to Dutch society." (Taal & Edelaar, 1997, page 407) "The program consisted of eight sessions, three of which were given by actors and the others by teachers trained to administer the program." (Taal & Edelaar, 1997, page 402) The duration of the program was six weeks.
This was a quasi-experiment research study. Both the experimental and control group was chosen from the Dutch elementary-school system and the participants ranged in age from eight to twelve years old. There were 161 participants in the experiment group, these subjects were participants in "Right to Security", and thus they were non-randomly selected to participate in the study. Children who were on the waiting lists to attend the program and were assigned to the control group. Both the experimental and control groups were instructed to complete six questioners. Each questioner addressed a specific question, there was; control in sexual conflicts, choice of safety strategy, feasibility, touch, relationship with teacher and relationship with classmates.
The treatment group was tested three times, there was a pretest, posttest and they were tested six weeks later. The control group completed all the tests, however they did not complete the follow up test. The program illustrated the different affects that the program had on the participants. The results varied with the different age groups of the participants. "Shortly after the program only the oldest children thought it easier to refuse unwanted sexual advances and they became more optimistic in the long run." (Taal & Edelaar, 1997, page 408) The results were also the same for the younger children, but this affect did not last long. One of the negative affects of the program was that the older children experienced negative feelings about physical touches of any find in the long run.
The next study evaluated was entitled "Evaluation of the effectiveness of project trust: An elementary school-based victimization prevention strategy." The aim was to find out children's knowledge of general prevention concepts, knowledge of difficult-to-acquire prevention concepts, anxiety, and reporting of abuse. This study evaluated a play called Touch, sponsored by Project TRUST, an acronym for Teaching Reaching Using Students and Theater. This study consisted of 1, 269 children (658 in the experimental group and 611 in the control group). These children were enrolled in grades 1-6 in four public schools in a Midwestern city during the 1994-1995 academic years. There were 598 males and 671 females. The numbers of children at each level ranged from 184 - 252.
Trained high school students performed the play for the elementary students. "The presentation lasted approximately 30 minutes and followed by a 15 minute student question and response period." (Oldfield. , Hays. , and Megel, 1996, page 822) The study design was a posttest only control group to assess the effects of observing the play.
Classrooms of student in grades 1-6 at the four public schools were randomly assigned to either treatment or control groups. The instruments used in this study were; the Children's Knowledge of Abuse Questionnaire -Revised (CMAQ), the Revised Children's Manifest Anxiety Scale (RCM AS), State-Trait Anxiety Inventory for Children (STATIC) and Maltreatment Disclosure Report Form (M DRF). The project TRUST intervention was used during the first quarter of the school year prior to the students receiving any other school-based personal safety instruction. Parents and guardians were contacted for their permission for the research, 63 percent of students participated and classrooms at each grade level were randomly assigned to the treatment or control condition. Data was collected by assigned evaluators from the subjects in both groups on the same day. Data was collected within 2 days for the experimental group and the data was collected after the play for the control group.
Data was collected with a blind assessment format. Instruments were given and testing lasted approximately 50 minutes. Abuse disclosure data was sent directly to Child Protective Services (CPS). Investigators collected the disclosure data without names, 3 months after the play. Students exposed to Project TRUST demonstrated significantly greater knowledge of maltreatment prevention information, as well as difficult-to acquire concepts, than control group students. A 3 month delay reassessment of the experimental and subgroup showed loss in acquired prevention information.
No differences in anxiety scores existed between the groups. First time student abuse disclosures were greater in the experimental than control group. Overall, project TRUST was a strategy to increase prevention knowledge and generate abuse disclosures without creating student anxiety. This next study was entitled, "A longitudinal analysis of risk factors or child maltreatment: findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect." The primary aim of this longitudinal study was to identify the demographic, family, parent and child factors that increased the risk for child physical abuse, sexual abuse and neglect. Surveys were conducted on 644 families in upstate New York on four separate occasions between 1975 and 1992. New York State records were used to collect data on child abuse and neglect in the families studied.
A retrospective self-report was also administered when the children were 18 years or older. "The participants were selected from a larger sample of families with children between the ages of 1 and 10 in 1975 who were randomly sampled on the basis of residence in one of two upstate New York counties." (Brown, Cohen, Johnson and Salzinger, 1998, page 1067) The participants act as the representatives of the demographic compilation of the population in the northeastern region of the United States. At the time of the second study in 1983 there was only 79 percent participation. The study reported that there were 18 cases of sexual abuse reported. "It also found that sexual abuse was associated with two demographic risk factors (maternal youth and parental death), four familial risk factors (harsh punishment, maternal sociopathy, negative life events and presence of a stepfather), one parenting risk factor (unwanted pregnancy) and two child risk factors (child gender and handicap)." (Brown, et al, 1998 page 1070) "It also concludes that daughters more than sons, handicapped children with a deceased parent, and children living with a stepfather were at risk for sexual abuse." (Brown, et al, 1998 page 1073) "The researchers identified one of the limitations of the study as: because data on risk factors were obtained through parent and child interviews, the occurrence of some risk factors may have been over or under reported." (Brown, et al, 1998 page 1075) Also the relatively small number or cases made definitive comparisons of the effects of self-verses official identification. From these finding social workers and others in contact with children can identify the children with the risk factors for sexual abuse, physical abuse, neglect and maltreatment and then preventative measures can be implemented.
The next article that was reviewed was entitled "Prior childhood sexual abuse in mothers of sexually abused children." The objective of the research was "to see if mothers who were sexually abused in their own childhood are at increased risk of their children being sexually abused and to see if prior sexual abuse in mothers affects their parenting abilities." (Oates, Tebbutt, Swanston. , Lynch and O'Toole, 1998 page 1113) The study followed the quasi-experimental design. There were "67 mothers whose children had been sexually abused by others and 65 control mothers," (Oates, et al, 1998 page 1113) if they had experienced sexual abuse in their childhood. The researchers conducted three interviews on the participants: at the time of disclosure, after 18 months and after 5 years. These assessments measured self-esteem, depression and behavior.
The study concluded, "mothers of sexually abused children are more likely to have been sexually abused in their childhood" (Oates, et al, 1998 page 1116) than the control mothers. The study also found that adult females who were sexually abused had difficulty sustaining a reasonable balance of affection and discipline, they have more mental health problems and are less skillful in their maternal functioning's. Another study exploring the potential risk factors for childhood sexual abuse was examined in to order to compare the findings. This other study was entitled "A Study of potential risk factors for sexual abuse in childhood." The study found that "the variables significantly associated with childhood sexual abuse (CSA) were physical abuse, having a mother who was mentally ill, not having someone to confide in, and being socially isolated. This study had some similarities and confirmed some of the findings in the research article titled "Prior childhood sexual abuse in mother of sexually abused children." However, one of the main limitations with the two studies is that their experimental and control groups excluded men in their studies. They both highlighted the risk factors that can be seen in mothers and not in the fathers if they were present in the family.
These studies also including the study entitled "Longitudinal analysis of risk factors for child maltreatment" failed to secure experimental and control groups that included participants from various socioeconomic groups and demographics. Before affective prevention programs can be designed to effectively protect children in this country and worldwide, we must understand: why offenders offend, how and why they target their victims, and what factors cause children to be targeted. This will enable child care workers and others to teach parents: how they can equip their children with the skills necessary to defend themselves against potential offenders, how to make their children less vulnerable to offenders and what factors in the parents parenting techniques can contribute to childhood sexual abuse. From this information childcare workers can also identify those families that demonstrate the risk factors that may possibly contribute to child sexual abuse. Prevention programs should also not cause anxiety in the participants. Programs following the example of Project TRUST appear to be very effective in equipping children with the knowledge and skills needed to protect themselves from offenders and with no anxiety unlike the Dutch program "Right to Security." Future studies also need to include father and male guardians in their studies instead of only mothers in order to include the portion of the population that is headed by single fathers.
My study will include fathers, participants from all socioeconomic classes and provide additional information on the effectiveness of the different prevention programs. Bibliography References Brown, Jocelyn. , P. , Cohen, J. G. , Johnson, and S.
Salzinger. (1995). A longitudinal analysis of risk factors for child maltreatment: findings of a 17-year prospective study of officially recorded self-reported child abuse and neglect. Child Abuse & Neglect, 22 (11), 1065-1078. Elliott, Michele, K. , Browne, and J.
, Kilcoyne. (1995). Child sexual abuse prevention: what offenders tell us. Child Abuse & Neglect, 19 (5), 579-594.
Fleming, Jillian. , P. Mullen. , and G. Bummer. (1197).
A study of potential risk factors for sexual abuse in childhood. Child Abuse & Neglect, 21 (1), 49-58. Taal, Margot and Monique Edelaar. (1997). Positive and Negative Effect of a child sexual abuse prevention program.
Child Abuse & Neglect, 21 (4), 399-410. Oates, R, Kim. , J. Tebbutt, H. Swanston. , D.
Lynch and B. O'Toole. (1998). Prior childhood sexual abuse in mothers of sexually abused children.
Child Abuse & Neglect, 22 (11), 1113-1118. Oldfield, Dick. , B. Hays, and M.
Megel. (1996). Evaluation of the effectiveness of project trust: and elementary school-based victimization prevention strategy. Child Abuse & Neglect, 20 (9), 821-832.