Difference between revisions of "Sexual Abuse: Educating Yourself"

Revision as of 20:53, 21 October 2014

This information was taken directly from Child Welfare Information Gateway

Parenting a Child Who Has Been Sexually Abused: A Guide for Foster and Adoptive Parents

You may be a current or prospective foster or adoptive parent of a child with a known or suspected history of child sexual abuse. In some cases, you may not be certain that abuse has occurred, but you may have suspicions based on information you received or because of the child’s behavior. You may feel confused, concerned, and unsure of the impact of prior child maltreatment, including sexual abuse.

It is important to understand that the term sexual abuse describes a wide range of experiences. Many factors affect how children react to abusive or neglectful experiences and how they recover. Most children who have been abused do not go on to abuse others, and many go on to live happy, healthy, successful lives. As parents, you will play an important role in your child’s recovery from childhood sexual abuse. 1

This factsheet discusses how you can help children in your care by educating yourself about child sexual abuse, establishing guidelines for safety and privacy in your family, and understanding when and how to seek help if you need it. Reading this factsheet alone will not guarantee that you will know what to do in every circumstance, but you can use it as a resource for some of the potential challenges and rewards that lay ahead.

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 This factsheet discusses how you can help children in your care by educating yourself about child [[Sexual Abuse|sexual abuse]], establishing guidelines for safety and privacy in your family, and understanding when and how to seek help if you need it. Reading this factsheet alone will not guarantee that you will know what to do in every circumstance, but you can use it as a resource for some of the potential challenges and rewards that lay ahead.
-==Educating Yourself==
-One of the most useful actions that kinship caregivers and foster and [[Adoptive Parents|adoptive parents]] can take is equipping themselves with information. Parents of children who may have been sexually abused can learn about the definitions of child [[Sexual Abuse|sexual abuse]], behaviors associated with prior [[Sexual Abuse|sexual abuse]], and how [[Sexual Abuse|sexual abuse]] affects children’s trust of others. With this information in hand, it will be easier to recognize possible behaviors associated with past [[abuse]] and avoid taking them personally or feeling alarmed or uncertain if your child exhibits uncommon sexual behaviors. Most importantly, you will feel capable of responding to these behaviors in sensitive and informed ways that help both you and your child.
-====What is Child Sexual Abuse====
-The National Child Traumatic Stress Network (NCTSN) defines child [[Sexual Abuse|sexual abuse]] '''2''' as
-''“…any interaction between a child and an adult (or another child) in which the child is used for the sexual stimulation of the perpetrator or an observer. [[Sexual Abuse|Sexual abuse]] can include both touching and nontouching behaviors. Touching behaviors may involve touching of the vagina, penis, breasts or buttocks, oral-genital contact, or sexual intercourse. Nontouching behaviors can include voyeurism (trying to look at a child’s naked body), exhibitionism, or exposing the child to pornography. Abusers often do not use physical force but may use play, deception, threats, or other forms of coercion to engage children and maintain their silence. Abusers frequently employ persuasive and manipulative tactics to keep the child engaged. These tactics—referred to as ‘grooming’—may include buying gifts or arranging special activities, which can further confuse the victim.”''
-Child [[Sexual Abuse|sexual abuse]] is defined in Federal law by the Child [[Abuse]] Prevention and Treatment Act (42 U.S.C. sec. 5106g(4)) as
-''“…the employment, use, persuasion, inducement, enticement, or coercion of any child to engage in, or assist any other person to engage in, or assist any other person to engage in, any sexually explicit conduct or simulation of such conduct for the purpose of producing a visual depiction of such conduct; or the rape, and in cases of caretaker or interfamilial relationships, statutory rape, molestation, prostitution, or other form of sexual exploitation of children, or incest with children.”''
-Within this Federal guideline, each State is responsible for establishing its own legal definition of child [[Sexual Abuse|sexual abuse]]. For more information, see the Identification of Child [[Sexual Abuse]] webpage on the Child Welfare Information Gateway website at https://www.childwelfare.gov/can/identifying/sex_abuse.cfm.
-For legal definitions in each State, see Child Welfare Information Gateway’s Definitions of Child [[Abuse]] and [[Neglect]]: https://www.childwelfare.gov/systemwide/laws_policies/statutes/define.cfm
-====Signs of Sexual Abuse====
-If you are parenting a child who has been removed from his or her family, you may not know for sure whether or not the child in your care has been sexually abused. Child welfare agencies usually share all known information about your child’s history with you; however, there may be no prior record of [[abuse]], and many children do not disclose past [[abuse]] until they feel safe. For this reason, kinship caregivers or foster or [[Adoptive Parents|adoptive parents]] are sometimes the first to learn that [[Sexual Abuse|sexual abuse]] has occurred. Even when there is no documentation of prior [[abuse]], you may suspect something happened because of your child’s behavior.
-There are no hard and fast rules about what constitutes normal sexual development and what behaviors might signal [[Sexual Abuse|sexual abuse]]. Children show a range of sexual behaviors and sexual curiosity at each developmental level, and their curiosity, interest, and experimentation may occur gradually, based on their development. (See table on the following page.) However, children who have been sexually abused may demonstrate behaviors that are unusual, excessive, aggressive, or explicit. There is no one specific sign or behavior that can be considered proof that [[Sexual Abuse|sexual abuse]] has definitively occurred, but there are a number of signs that are suggestive of [[abuse]]. The following signs or symptoms may suggest the possibility of child [[Sexual Abuse|sexual abuse]]:
-'''Explicit sexual knowledge beyond the child’s developmental stage'''
-'''Sexual preoccupation indicated by language, drawings, or behaviors'''
-'''Inserting toys or other objects in genital openings'''
-'''Sexual behaviors with other children that seem unusual, aggressive, or unresponsive to limits or redirection'''
-'''Excessive masturbation, sometimes in public, not responsive to redirection or limits'''
-'''Pain, itching, redness, or bleeding in the genital areas'''
-'''Nightmares, trouble sleeping, or fear of the dark'''
-'''Sudden or extreme mood swings: rage, fear, anger, excessive crying, or withdrawal'''
-'''“Spacing out” or appearing to be in trance'''
-'''[[Loss]] of appetite, or difficulty eating or swallowing'''
-'''Cutting, burning, or other self-mutilating behaviors'''
-'''Unexplained avoidance of certain people, places, or activities'''
-'''An older child behaving like a much younger child: wetting the bed or sucking a thumb, for example'''
-'''Talking about a new, older friend'''
-'''Suddenly having money''''
-This list of signs and symptoms is simply that: red flags designed to alert you to the fact that the child’s behaviors may reflect an underlying problem. There are other possible explanations for some of these signs, and they need to be evaluated by a trained professional who specializes in child [[Sexual Abuse|sexual abuse]]. The following [[organizations]] offer more information about behavioral signs of [[Sexual Abuse|sexual abuse]] on their websites:
-'''Stop It Now!''' http://www.stopitnow.org/warning_signs_child_behavior
-'''The National Child Traumatic Stress Network:'''
-http://www.nctsnet.org/sites/default/files/assets/pdfs/ChildSexualAbuseFactSheetFINAL_10_2_07.pdf
-'''Mayo Clinic:''' http://www.mayoclinic.com/health/child-abuse/DS01099/DSECTION=symptoms
-'''American Academy of Child and Adolescent Psychiatry:''' http://www.aacap.org/AACAP/Families_ and_Youth/Facts_for_Families/Facts_for_ Families_Pages/Child_Sexual_Abuse_09.aspx
-====Healthy Sexual Development in Children====
-Children’s sexual interest, curiosity, and behaviors develop gradually over time
-and may be influenced by many factors, including what children see and experience and the guidance they receive from parents and caretakers. The presence of sexual behavior is not in and of itself a conclusive sign that [[abuse]] has occurred. The table on the next page lists some of the sexual behaviors common among children of different age groups, as well as some behaviors that might be considered less common or unhealthy:'''3'''
-====Preschool (0-5 years)====
-{| class="wikitable" style="text-align: center; font-size: 95%;"
-|-
-! scope="row" colspan=“2"| Common
-! scope="row" colspan="2"| Uncommon
-|-
-! scope=“col”| Sexual language relating to differences in body parts, bathroom talk, [[pregnancy]], and birth
-! scope="col"| Discussion of sexual acts
-|-
-! scope=“col”| Self-fondling at home and in public
-! scope=“col”| Sexual contact experiences with other children
-|-
-! scope=“col”| Showing and looking at private body parts
-! scope=“col”| Masturbation unresponsive to redirection or limits
-|-
-! scope=“col”|
-! scope=“col”| Inserting objects in genital openings
-|}
-====School Age (6 to 12 years)====
-{| class="wikitable" style="text-align: center; font-size: 95%;"
-|-
-! scope="row" colspan=“2"| Common
-! scope="row" colspan="2"| Uncommon
-|-
-! scope=“col”| Questions about menstruation, [[pregnancy]], sexual behavior
-! scope="col"| Discussion of explicit sexual acts
-|-
-! scope=“col”| “Experimenting” with same-age children, including kissing, fondling, exhibitionism, and role-playing
-! scope=“col”| Asking adults or peers to participate in explicit sexual acts
-|-
-! scope=“col”| Masturbation at home or other private places
-! scope=“col”| Masturbating in public or excessively to bleeding
-|-
-! scope=“col”|
-! scope=“col”| Inserting objects in genital openings
-|}
-====Adolescence (13 to 16 years)====
-{| class="wikitable" style="text-align: center; font-size: 95%;"
-|-
-! scope="row" colspan=“2"| Common
-! scope="row" colspan="2"| Uncommon
-|-
-! scope=“col”| Questions about decision-making, social relationships, and sexual customs
-! scope="col"| Sexual interest in much younger children
-|-
-! scope=“col”| Masturbation in private
-! scope=“col”| Aggression in touching others’ genitals
-|-
-! scope=“col”| Experimenting between adolescents of the same age, including open-mouth kissing, fondling, and body rubbing
-! scope=“col”| Asking adults to participate in explicit sexual acts
-|-
-! scope=“col”| Voyeuristic behaviors
-! scope=“col”| The use of force, aggression, or drugs to obtain compliance
-|-
-! scope="col"| Sexual intercourse (more than half of 11th graders )
-! scope="col"|
-|-
-! scope="col"| Oral sex (approximately one-third of 15-17 year olds) '''5''', '''4'''
-! scope="col"|
-|-
-|}
-For a more complete list, or if you have any questions or concerns about your child’s sexual behaviors, call the Stop It Now! toll-free helpline at 1.888.PREVENT (1.888.773.8368).
-====Factors Affecting the Impact of Sexual Abuse====
-If a professional has determined that a child in your care has been a victim of [[Sexual Abuse|sexual abuse]], or if you continue to suspect that the child in your care has been abused, it is important to understand how abusive experiences may affect children’s behavior.
-All children who have been sexually abused have had their physical and emotional boundaries violated or crossed in some way. Because of this, children may feel a lack of trust and safety with others. Children who have been abused may come to view the world as unsafe, and adults as manipulative and untrustworthy. As with other types of [[abuse]] or trauma, many factors influence how children think and feel about the [[abuse]], how the [[abuse]] affects them, and how their recovery progresses. Some factors that can affect the impact of [[abuse]] or trauma include:
-'''The relationship of the abuser to the child and how much the [[abuse]] caused a betrayal of trust within an important interpersonal relationship'''
-'''How long the [[abuse]] occurred''' (chronicity)
-'''Whether the [[Sexual Abuse|sexual abuse]] was extensive and there was penetration of some kind'''
-'''The age of the child''' (younger children are more vulnerable and less capable of facing these challenges alone)
-'''The abuser’s use of “friendliness” or seduction and efforts to make the child a compliant participant'''
-'''The abuser’s use of threats of harm or violence, including threats to pets, siblings, or parents'''
-'''The abuser’s use of secrecy and threats to do harm or withdraw love and affection'''
-'''Gender of the abuser being the same as or different from the child''' (some children are less likely to report sexual activity with same gender after the fact, and those observing or assessing for [[abuse]] may have a stronger reaction to same-sex [[abuse]] than to [[abuse]] that is male-female)
-'''The child’s emotional and social development at the time of the [[abuse]]'''
-'''The child’s ability to cope with his or her emotional and physical responses to the [[abuse]]''' (for example, fear and arousal)
-'''How much responsibility the child feels for the [[abuse]]''' (and, for example, not telling right away, not stopping it somehow, etc.)
-It is very important for children to understand that they are not to blame for the [[abuse]] they experienced. Your family’s immediate response to learning about the [[Sexual Abuse|sexual abuse]] and ongoing acceptance of what the child has told you will play a critical role in your child’s ability to recover and lead a healthy life. (See the last section of this factsheet, Seeking Help, for more information about healing from [[abuse]].)
-Some parents may feel grave concern when children act out sexually with peers or younger children and may question why a child who has been abused, and suffered from that experience, could repeat it with someone else. Children who have experienced [[Sexual Abuse|sexual abuse]] need an  opportunity to process their own [[abuse]] in therapy or with a trusted trained adult to understand their thoughts and feelings and to have a chance to ask questions and achieve some kind of closure. Acting- out behaviors usually indicate that some traumatic impact of their [[abuse]] is still active and signals a need for additional attention. Responding in calm, informed ways while seeking appropriate professional help for children whose acting out persists will be important to resolving children’s sexual behavior problems. The most important lesson is learning not to over- or under- respond to problem situations and finding just the right balance of guidance and empathic care.
-If your child has a history of prior [[abuse]], it’s important to know that he or she may be vulnerable to acting out victim or victimizing behaviors. Some children may be more likely to be bullied or exploited, and others may be angry and aggressive towards others. You may need to pay special attention to protecting some children while setting firm limits on others. In addition, some children act out when memories of their own [[abuse]] are triggered. Triggers can happen unexpectedly, for example, by seeing someone who looks like the abuser or in a situation such as being alone in a public restroom, or by a variety of circumstances that occur in daily life. Other triggers might include the scent of a particular cologne or shampoo or the texture of a particular piece of clothing or blanket.
-In addition, there are cultural differences among children with regard to their comfort level with physical proximity, physical affection, bathing and nudity practices, hygiene, and other factors that can lead to  problem situations. There are many cultures in which parents never discuss sexuality directly with their children, or in which any type of sexual activity (for example, children touching themselves) can be viewed as unacceptable or punishable. Children may thus carry shame and guilt about their bodies.
-Continue to [[Sexual Abuse: Establishing Family Guidelines for Safety and Privacy]]
-Return to [[Special Needs]]
-==Acknowledgment==
-Child Welfare Information Gateway would like to acknowledge the contributions of Eliana Gil, Ph.D., Gil Institute for Trauma Recovery and Education, LLC, in Fairfax, VA, and a nationally known lecturer, author, and clinician specializing in working with children and families in which child [[Sexual Abuse|sexual abuse]] has occurred as well as children with sexual behavior problems and their families. This is an update to an original publication written in partnership with Susan A. Rich, Ph.D.
-==Reference==
-Child Welfare Information Gateway. (2013). Parenting a child who has been sexually abused: A guide for foster and [[Adoptive Parents|adoptive parents]]. [[Washington]], DC: U.S. Department of Health and Human Services, Children’s Bureau.
-==Citations==
-'''1''' Although the term “parents” is used throughout this factsheet, the information and strategies provided may be equally helpful for kinship care providers, guardians, and other caregivers.
-'''2''' (2009). See http://www.nctsnet.org/sites/default/files/assets/pdfs/ChildSexualAbuseFactSheetFINAL_10_2_07.pdf
-'''3''' The list is adapted from the Stop It Now! publication Prevent Child [[Sexual Abuse]]: Facts About Those Who Might Commit It (2005) available at http://www.stopitnow.org/files/Prevent_Child_Sexual_Abuse.pdf. Additional information was provided by Eliana Gil, Ph.D., RPT-S, ATR, specialist, trainer, and consultant in working with children who have been abused and their families. See http://www.elianagil.com.
-'''4''' According to a 2011 poll by the Centers for Disease Control and Prevention (CDC) at http://apps.nccd.cdc.gov/youthonline/App/QuestionsOrLocations.aspx?CategoryId=4
-'''5''' According to a 2012 CDC report at http://www.cdc.gov/nchs/data/nhsr/nhsr056.pdf