Update on child sexual abuse
Update on child sexual abuse
Adam M. Tomison
- What is Child Sexual Abuse?
- The Backlash
- Causes of Child Sexual Assault
- Suspected Child Sexual Abuse and Occurrence of Domestic Violence
- Ritual Abuse: The 'New' Sexual Abuse
Child sexual abuse is an old phenomenon (Plummer 1993). The sexual exploitation of children - males and females - has occurred throughout history (Tower 1989), yet it was not until the 16th century that legislation was enacted in England that began the process of protecting children from sexual abuse: boys were protected from forced sodomy, and girls under the age of ten years from forcible rape. By the time of the settlement of the United States, sexual prohibitions were becoming more stringent (Oates 1990). Illick (1974 as cited in Oates 1990) reported that in Conneticut in 1672, a father was found guilty of incestuous acts with his daughter and executed. The case also exemplified an attitude still encountered today: victim blaming. In the Conneticut case this resulted in the child being sentenced to a whipping for her part in the crime.
In the 1700s some educators began warning parents to supervise their children at all times, and to ensure they were never nude in front of other adults, in order to protect them from sexual abuse. This constituted one of the first indications that society at large recognised the potential for children to be sexually abused (Conte and Shore 1982). By the late 1900s welfare groups were familiar with child sexual abuse, and that its most common form was intrafamilial assault (Wurtele and Miller- Perrin 1992). However, by the 1920s sexual abuse had become characterised as extrafamilial assault, committed by 'strangers', with the victim perceived as being a 'temptress' rather than an innocent child (Gordon 1990, as cited in Wurtele and Miller-Perrin 1992).
Societies continued to turn a 'blind eye' to child sexual abuse until after the 're-discovery' of child maltreatment in the early 1960s by Kempe and his colleagues in the United States (Kempe, Silverman, Steele, Droegemuller and Silver 1962). Kempe's construction of the 'battered child syndrome' has been expanded extensively over the past three decades to encompass sexual abuse, emotional abuse and neglect. The continuing growth of concern about child sexual abuse is frequently attributed to child advocates and the feminist movement (Reppucci and Haugaard 1993). This greater awareness grew particularly out of the latter's work as advocates for adult victims/survivors of rape and other sexual assault.
Why wasn't child sexual abuse widely identified prior to the 1960s? As Oates (1990) states, while society could cope with 'stranger danger' and the threat of the stereotypical child molester assaulting children, it was much more threatening to acknowledge that sexual abuse was commonly occurring within the family, committed by family members upon whom children were dependent and should have been able to trust. The acknowledgement of sexual abuse was therefore a threat to the structure of the family. It has been contended that some researchers, for example Kinsey and associates (1953, as cited in Goddard and Carew 1993) 'minimised' or played down the sexual abuse of children because they felt society had not reached a point where it was able to acknowledge intrafamilial sexual abuse.
In any discussion of child sexual abuse it should be recognised that there may be interest groups that believe that there are benefits for children in having sexual relationships with adults (Tower 1989; Korbin 1990). Enmore (1986, as cited by Goddard and Carew 1993) asserted that arguments used by such groups to gain rights for those who engage in, or wish to engage in sexual relationships with children are similar to those used to assist the gay rights movement. That is, they claim that their activities are normal, human and valuable experiences. The proponents of 'child love' assert that children are not always traumatised by a sexual relationship which may enable them to 'satisfy instinctual drives . . . [or] to test in reality an infantile fantasy . . . [where the child's] emotional balance is . . . in favour of contentment' (Bender and Blau 1937, as cited in DeYoung 1982:46).
One of the more convincing arguments against this view has been presented by Finkelhor (1984) who asserted that modern society is based upon the idea of free will and the ability to consent: true consent is only possible if one has knowledge and authority, and Finkelhor contended that children lack both.
Occupying a position of less personal power and control in comparison with adults (Korbin 1990), children have no authority in a legal or psychological sense. Moreover, they lack 'knowledge of the meanings of sexuality, information to enable them to anticipate the direction of the sexual relationship, or any idea of how others will react to their sexual involvement' (Tower 1989:103).
This paper discusses some of the current issues of child sexual abuse, including perpetrator characteristics, the 'backlash' against child sexual abuse, ritual abuse and sexual abuse prevention initiatives.
What is child sexual abuse?
As was indicated in the last National Child Protection Clearing House Issues paper (Tomison 1995a), there are problems in arriving at concrete definitions of child abuse and neglect, and child sexual abuse is no exception.
Kempe and Kempe's (1978) definition, based on Schechter and Roberge's (1976) work, has been widely used. They defined child sexual abuse as: 'The involvement of dependent, developmentally immature children and adolescents in sexual activities which they do not fully comprehend, are unable to give informed consent to and that violate social taboos of family roles'. (1978:60)
The importance of the definition lies in the acknowledgment of the limitations of children to give truly informed consent. The Australian Institute of Health and Welfare provides a useful national definition of child sexual abuse: 'Sexual abuse is any act which exposes a child to, or involves a child in, sexual processes beyond his or her understanding or contrary to accepted community standards' (Angus and Woodward 1995:46).
As Goddard and Carew (1993) note, child sexual abuse commonly refers to the abuse of children by the extended family (or non-family members); often this abuse stops short of actual intercourse. Incest on the other hand has become progressively more constrained, to the extent that it refers specifically to the societal taboo of intercourse between immediate family members.
In this paper child sexual abuse will be used as a term to describe all types of sexually abusive behaviour, regardless of whether that abuse involves incestuous acts.
Put simply, child sexual abuse is the use of a child for sexual gratification by an adult or significantly older child/adolescent (Tower 1989). It may involve activities ranging from exposing the child to sexually explicit materials or behaviours, taking visual images of the child for pornographic purposes, touching, fondling and/or masturbation of the child, having the child touch, fondle or masturbate the abuser, oral sex performed by the child, or on the child by the abuser, and anal or vaginal penetration of the child. Sexual abuse has been documented as occurring on children of all ages and both sexes, and is committed predominantly by men, who are commonly members of the child's family, family friends or other trusted adults in positions of authority.
Child sexual abuse has been further classified by some academics and practitioners as sexual exploitation, which involves touching the child and/or compelling the child to observe, or be involved in other sexual activity (for example, watching pornographic videos); sexual assault, molestation, victimisation, and child rape. Finkelhor (1979) argued against the term sexual assault and sexual abuse because he felt they implied physical violence which, it was contended, was often not the case (see the discussion on sexual abuse and domestic violence below). Finkelhor favoured the term sexual victimisation in order to underscore that children become victims of sexual abuse as a result of their age, naivete and relationship with the abusive adult.
In contrast, a recent Victorian Parliamentary Crime Prevention Committee report on child sexual abuse (1995) recommended that child sexual abuse be referred to as 'child sexual assault' rather than by terms such as 'harm', 'injury', or 'abuse'. The term 'child sexual assault' would highlight the true nature of the offence, avoid minimisation of the abusive acts, and compel or force the 'abuse' to be considered as a criminal assault and treated as such from the beginning of any investigation of the abusive concerns. For these reasons the term 'child sexual assault' will be used throughout this paper.
Finkelhor (1984) estimated the proportion of children in the United States that were exposed to some form of sexual abuse was between 9 and 52 per cent for females and between 3 and 9 per cent for males (depending on the definition of sexual abuse and methodology used). It is also clear that the majority of perpetrators of sexual abuse are men, and that the victims are predominantly female (Finkelhor 1979). In the latest Australian national statistics of the prevalence of child sexual abuse, 19 per cent of 28,711 substantiated cases were labelled as sexual abuse (Angus and Woodward 1995); 74 per cent of cases involved female victims.
Aboriginal and Torres Strait Islander families were significantly over- represented in the national sample. However, within the Aboriginal and Torres Strait Islander sample, a significantly lower proportion of cases were classified as sexual abuse (11 per cent) in comparison with the national sample. Based on substantiated cases reported by the various state child protection services, the rate of sexual abuse for the nation was 1.1 per 1000 children aged 0-16 years. Despite the comparatively low number of sexual abuse cases in the Aboriginal and Torres Strait Islander population the rate of sexual abuse for Aboriginal and Torres Strait Islander families was 2.0 per 1000 children aged 0-16 years, an indication of the over-representation of Aboriginal and Torres Strait Islander families in the national child abuse statistics.
There has been a significant increase in the recognition of child sexual assault (Leventhal 1990), which has been reflected by a substantial increase in the number of reports made to child protection services across Australia and overseas, particularly in the last five years. However, until 1995, the substantiation rate of cases had not increased proportionately. Thus more cases were being reported, but higher numbers of cases were not being substantiated. In 1995, only 44 per cent of all finalised child maltreatment cases were substantiated (Angus and Woodward 1995). The increase in child maltreatment reports is attributed to the introduction of mandatory reporting of child sexual abuse across most states and territories, and the much greater public awareness of the problem (Clark 1995).
The substantial increases in sexual abuse reports and investigations across the western world (Myers 1994), have been accompanied by the formation of an 'opposition' to child sexual assault investigations and the child protection system. In 1988 Hechler published an account of efforts designed to raise community awareness of the child sexual abuse problem, and focused on a counter-movement which he termed the 'backlash' ' said to be comprised mainly of aggrieved parents or professionals who have been investigated as possible offenders and feel unfairly treated or stigmatised (Finkelhor 1994).
The backlash counter-movement focused on what was perceived as the overzealous investigation of alleged sexual abuse, criticising inadequacies in the current child protection services. Put simply, backlash supporters believe there has been an epidemic of sexual abuse accusations rather than an epidemic of actual sexual abuse. The backlash has gained some credence as a result of well-publicised, controversial, multiple victim child sexual abuse cases, such as Cleveland or the Orkneys in the United Kingdom, which have affected the public perception of child protection services' competency (Myers 1994). Some of their more constructive recommendations have been better training for child protection workers, and the adequate provision of services to marginally dysfunctional families rather than an overly intrusive protective intervention (Wimberly 1990, as cited in Myers 1994).
Traditionally, studies have indicated that almost all sexual abusers have been men (Leventhal 1990). However a consistent profile of child sex abusers has not emerged (Oates 1990). To date work with perpetrators and research studies have failed to typify offenders by class, profession, wealth or family status (Willis 1993). Similarly, there has been no clear delineation between perpetrators and non-perpetrators in terms of race or religion (Wurtele and Miller-Perrin 1993); neither has a psychological profile of a typical offender been able to be constructed - perpetrators of child sex assault 'constitute a markedly heterogeneous group' (Wurtele and Miller-Perrin 1993:16).
Because of this heterogeneity, typological frameworks have been constructed in order to provide homogenous sub-groups of offenders (Wurtele and Miller-Perrin 1993), the intention being to elucidate why offenders abuse by focusing on who abuses. Offenders have been divided into a number of overlapping categories - one of the most- frequently used being exclusive versus non-exclusive attraction to children.
This is also known as 'fixated' versus 'regressed' paedophilia respectively (Groth, Hobson and Gary 1982, as cited in Wurtele and Miller-Perrin 1993), and is allied with Howells' (1991, as cited in Willis 1993) typology of the 'preferential' sex offender versus the 'situational' offender, where the former refers to offenders predisposed to seek sexual gratification from children, while the latter is more closely allied with family-based offenders, many of whom are not primarily sexually aroused by children.
Other typologies have been: extrafamilial versus familial victims; violent versus non-violent assaults; pre-pubertal versus post-pubertal victims; same-sex versus opposite-sex victims, commonly referred to as homosexual and heterosexual sexual assault (Friedman 1991); multiple victims versus single victim. The most resistant to changing his behaviour would be an offender predisposed to the first of each paired factors. That is, offenders exclusively attracted to violent sexual acts with children, particularly extrafamilial, pre-pubertal, same-sex victims (Hobson and Bunk 1987, as cited in Friedman 1991). These offenders can be classified as what the general public would define stereotypically as 'paedophiles'.
Research has shown that each of these crude categories is unreliable because of the extensive overlap of various behaviours by offenders (Willis 1993). Willis (1993) proposed a more accurate model based on previous categorisations such that offenders are classified according to their preferences on three scales: fixated versus regressed paedophilia, preferential versus situational offending, and homosexual versus heterosexual offending. In this model those more strongly associated with the first term of each factor would more closely resemble a 'paedophile' profile, while those regressed, situational, heterosexual offenders would be more likely to be intrafamilial offenders, and may be more accessible to changing his abusive behaviour (Willis 1993).
Overall, Wurtele and Miller-Perrin (1993) note that: '[Given] that the vast majority of typological studies are conducted with samples of offenders who are convicted, hospitalised, or receiving psychotherapy, the obtained findings may be seriously affected by reporting and judicial biases (Howells 1981) . . . The only common denominators appear to be an offender's lack of sensitivity to the child's wishes and needs, along with a willingness to exploit the child's trust for the abuser's own gratification, profit, or selfish purposes.' (1993:20)
Despite the fact that children are significantly more likely to be abused by a family member or friend of the family, the general public perception of sexual abusers is that of the 'dirty old man' and the so- called 'stranger-danger'. The following sections outline some non- stereotypic offender sub-groups which are currently generating interest in the child abuse community.
As mentioned above, most child sex offenders are male. However some studies have indicated females sexually abuse also. For example, Leventhal (1990) noted that in the 1986 United States national yearly report of child sexual abuse only 82 per cent of offenders were male. Leventhal posited that this may be because women who failed to protect their child from sexual abuse were included with those who actually committed sexually abusive acts. In a review of the evidence for female sex abusers, Finkelhor and Russell (1984) concluded that females do abuse in a small proportion of cases: approximately 5 per cent of cases with female victims, and 20 per cent in cases involving males.
Often women who do sexually abuse children do so at the instigation or encouragement of male abusers (Adams-Tucker 1982, as cited by Wurtele and Miller-Perrin 1993; Faller 1987). Others argue that the prevalence of female sexual abusers is an under-estimation because of a general unwillingness to believe that women also commit sexually abusive acts (Banning 1989, as cited in Wurtele and Miller-Perrin 1993).
Estimating the true incidence of female abusers is further hampered by the failure of most child abuse statistical reports to provide a gender breakdown of sexual abuse perpetrators. The majority of such reports classify abusers according to their relationship to the victim - 'parent', 'blood relative', 'family friend' (Angus and Woodward, 1995; Tomison, 1994).
Irrespective of the difficulty in obtaining a clear picture of the incidence of female abusers, research to date has failed to demonstrate that large numbers of women sexually abuse children (Wurtele and Miller-Perrin 1993) - with two notable exceptions: perpetrators of sexual abuse in day care centres, and abusers who form part of a child sex ring or group involved in the ritual or organised sexual abuse of children.
With regard to the former, women make up the vast proportion of workers who staff day care centres, enhancing the potential to detect women engaging in sexually abusive behaviour independent of male involvement. Kelley (1994) reviewed the literature and reported that in three major United States studies, women were identified as perpetrators of sexual abuse in 40-55 per cent of sexual abuse cases.
In the latter case, Lanning (1991) reported that in an analysis of several hundred 'mulitdimensional sex rings' approximately 40-50 per cent of perpetrators were identified as women (see ritual abuse section).
These findings contrast with the feminist theory of child sexual assault (see cause of child sexual assault section), which is based on the assumption that sexual assault occurs as a result of gender inequality in society, with sexual abuse existing as one part of a range of violence perpetrated by males (O'Hagan 1989). Identification of female abusers may support an argument that sexual assault occurs as a result of a general power imbalance, rather than as a result of a purely gender- based dominance pattern.
Child and adolescent sex offenders
That children and adolescents may commit acts of sexual abuse is a relatively recent discovery, occurring years after identification of adult perpetrators (Vizard, Monck and Misch 1995). The recent Victorian Parliamentary Crime Prevention Committee report (1995) noted that practitioners had reported that adolescents displaying the early signs of sex offending tended to grow up and commit sex offences unless they were provided with treatment. The need to break the cycle of offending at an early stage was echoed by many professionals and highlights the targeting of young sex offenders as a special population. According to the Children's Protection Society (1995), the literature on adolescent sex offenders has unanimously concluded that the professional community must 'work to identify and treat child (and adolescent) perpetrators and not deny the potential risks to themselves and the community' (Johnson 1988, as cited in Children's Protection Society 1995:14).
Like adult perpetrators, young offenders comprise a heterogeneous group (Vizard, Monck and Misch 1995) with few broad characteristics. Perhaps one of the most widely reported is a history of sexual abuse and/or other maltreatment. While the 'majority of male children who are sexually assaulted do not become sexual offenders' (Becker 1988:195), the rate of sexual victimisation for young offenders is estimated to be between 30 and 70 per cent (Watkins and Bentovim 1992).
Published studies of the incidence or prevalence of child and adolescent sex offenders are rare, and they suffer from the same definitional and methodological issues that plague child abuse and neglect studies as a whole. The National Children's Home (1992, as cited in Masson 1995) reported that it is estimated that between one-quarter to one-third of sexual abuse cases in England are perpetrated by a young sexual offender. Overall, 1 per cent of sex offences in Britain are currently attributed to adolescent females - the ratio of male to female perpetrators is given as 100:1 for offenders aged 14-20 years and over 20 years (Vizard, Monck and Misch 1995).
The stereotypic 'paedophile' can be classified as being more likely to be an extrafamilial, preferential offender who indulges in same-sex or 'homosexual' offending (Willis 1993). The basic societal assumption is that paedophiles who sexually abuse same-sex children are members of the homosexual community (King 1994). That is, there is no qualitative difference between a homosexual man who engages in sexual behaviour with another adult male, and a male who engages in sexual behaviour with a boy. As recently as 1995 this perception has resulted in moves by the Victorian Government to enact a special clause in the new Victorian Equal Opportunity Act 1995 allowing employers to discriminate against homosexuals (gay men and lesbians) who apply for jobs which involve the supervision, care or instruction of children (Stewart 1995). Yet the supposed link between homosexuality and paedophilia, and the assumption that paedophiles have come from the gay community is not backed up by evidence.
An offender's sexual orientation, whether he perceives himself to be homosexual, bisexual or heterosexual, is not mentioned as a risk factor, indicator, or characteristic in typologies of child sex offenders (Finkelhor, Williams, Burns and Kalinowski 1988; Wurtele and Miller-Perrin 1993). Offender typologies account for same-sex sexual abuse purely on the biological sex of the victim and offender, regardless of self-reported sexual orientation.
Willis noted that the attempt to classify offenders as 'homosexual' and 'heterosexual' involved 'crude categories [that were] very unreliable given the extensive overlap of the [offender's] behaviour' (1993:20). Willis also reported that 'substantial numbers of non-familial child molesters do not display or report deviant sexual preferences' (1993:22). That is, many offenders offend against both male and female children, defying strict classification on the basis of sexual orientation. In addition, Willis indicated that many offenders do not have any outward signs of so- called 'deviant' sexual behaviour, such as homosexuality.
Summit (1990) stated that male child molesters tend to cultivate adult female partners regardless of whether they engage in same-sex or opposite-sex offending behaviour. Despite a lack of references to support this claim, it is one of the few statements specifically referring to 'homosexual' offending and the link to heterosexual (adult-adult) sexual behaviour.
In a national study of child sexual assault in day care centres in the United States, Finkelhor, Williams, Burns and Kalinowski (1988) found that males were disproportionately represented as sexual abusers despite accounting for only 5 per cent of staff. Yet Finkelhor's group found no offender characteristics which would distinguish the abusers from other staff or people generally. It was specifically reported that stereotypic paedophile characteristics were notably absent. Finkelhor and colleagues made recommendations for the screening of all applicants for day care positions, but did not specify an individual's sexual orientation as a risk factor. A more recent review of studies of sexual abuse in day care also made no reference to offender's sexual orientation as a risk factor (Kelley 1994).
In a discussion paper focused on men's role in primary education, King (1994) found that there was no evidence of a relationship between homosexual male teachers and paedophile activity. Newton (1978) found that homosexual teachers were no more likely to engage in same-sex sexual abuse than were heterosexual teachers. In a study of child sexual abuse by clergy, Camargo and Loftus (1992) found that there was a clear distinction in terms of masculinity and femininity factors between clergy who were active homosexuals (adult-adult), and those engaged in same- sex paedophile activity.
In their classic study aimed at determining sexual behaviour and orientation in the community, Kinsey and colleagues (1948, as cited in DiLapi 1989), found that crimes such as child sexual assault had been historically incorrectly attributed to homosexuals and that, if anything, heterosexual males were more likely to be involved in sexual abuse. Despite methodological flaws, and what has been charitably described as a 'minimisation' of the negative effects that sexual abuse has on child victims (Finkelhor 1979), this study was one of the few to attempt to define the prevalence of homosexuals as offenders in cases of child sexual abuse (Freund and Watson 1992).
Finally, studies of offender arousal patterns have indicated that paedophiles and homosexuals have different patterns of response (Freund and Watson 1992), with paedophiles not surprisingly being more aroused by images of children. Overall, what little evidence there is, although flawed, appears to indicate that sexual orientation does not play a part in child sexual assault typologies, and that the assumption that paedophiles who engage in same-sex sexual abuse are homosexuals is more a societal myth than a reality.
Causes of Child Sexual Assault
Why then, does child sexual assault occur? O'Hagan (1989) has summarised the two major theoretical perspectives for what has been one of the more significant controversies in the child maltreatment field (Goddard and Hiller 1993). The family therapy view posits that child sexual abuse occurs as a result of 'family dysfunction'. Also known as a family dysfunction model, the emphasis is on the role of sexual abuse as a means of maintaining equilibrium within the family system. Thus each family member would be seen as having an interest in the continuation of the abuse (O'Hagan 1989).
In contrast, feminist theorists view child sexual abuse from a sociological rather than a familial perspective (Tower 1989), considering the sexual assault of children as an outcome of societal values. According to this view, women and children have inferior social status under the current patriarchal social structure and are subject to male dominance. Using such a 'social power' framework, sexual abuse is seen merely as one part of the range of violence perpetrated by men against women and children (O'Hagan 1989).
Finkelhor (1984) has contributed to an understanding of why sexual abuse may occur by proposing a four-part model - all of which, it is posited, must occur for abuse of a child by an adult to eventuate:
- A potential offender must have some motivation to sexually abuse a child. The potential offender must feel some form of emotional congruence with the child, sexual arousal with the child must be a potential source of gratification, and alternative sources of gratification must be unavailable or less satisfying.
- Any internal inhibitions against acting on the motivation to engage in sexual assault must be overcome. For example, alcohol or drugs may be used in order to lower inhibitions against sexual offending. This may be combined with the knowledge that society often shows greater tolerance towards those who commit crimes while under the influence of substances (Goddard and Carew 1993).
- Any external impediments to acting on the impulse to abuse must be overcome. Inadequate care or supervision by a parent or guardian can provide an opportunity for an offender to act.
- Avoidance or resistance by the child must be overcome. This may involve enticing an emotionally deprived child into accepting inappropriate attention, or overt coercion to achieve domination of the relatively powerless child.
Finkelhor noted a number of risk factors which may increase the likelihood of sexual offending, specifically by overcoming internal inhibitions or external impediments to offending. These included: maternal illness or absence (providing greater opportunity for father-daughter incest); overcrowding and the concomitant lack of privacy which may lead to less inhibitions; unemployment and family stress; or emotional deprivation in the child who may then be more open to accepting inappropriate 'affection' from an adult. Adults suffering from sexual role confusion, sexual frustration, and/or the need to dominate a child as a means of self-assurance/power, may also have an increased potential to offend against children. Finally, as previously mentioned, would-be abusers may use alcohol or drugs in order to overcome inhibitions towards sexual offending.
To date there is a paucity of hard evidence to support either Finkelhor's model or the risk factors (Oates 1990). Oates believes that this can be used as an indication that child sexual abuse is a complicated phenomenon, with no simple solutions. Goddard and Carew (1993) contended that Finkelhor's model indicated more about how sexual abuse occurs rather than why it occurs. They argued that in order to understand sexual abuse, like other forms of child maltreatment, it is necessary to categorise and separate the various types of sexually abusive behaviour, given that different causative factors may be operating for each 'type' of abuse.
Suspected child sexual abuse and occurance of domestic violence
In the late 1980s research began to be produced which provided support for the feminist assertion of a link between sexual and physical assault. There is a growing body of evidence to suggest that different types of violence may occur simultaneously within a family (Stanley and Goddard 1993; McKay 1994), but until relatively recently the link between violence in a family and child sexual abuse was not widely investigated. Two Australian studies, Goddard and Hiller (1993) and Tomison (1994) examined the possibility of a relationship between child sexual abuse and domestic violence.
Using data from a hospital-based child abuse case tracking study (Hiller, Goddard and Diemer 1989), Goddard and Hiller (1993) reported that 40 per cent of identified sexual abuse cases and 55 per cent of identified physical abuse cases were occurring in families where domestic violence was also evident. Tomison (1994) reported on the results of a large-scale tracking of suspected child abuse and neglect cases within a Victorian regional child protection network. In Tomison's study approximately 16 per cent of cases identified as sexual abuse reportedly occurred in families where one or both of the child's caregivers was verbally and/or physically violent to each other, compared with approximately 28 per cent of physical abuse cases. While the relative proportion of sexual and physical abuse cases reported to be occurring in families where domestic violence was a factor was higher in the Goddard and Hiller study, the overall trend was similar. Both studies indicated that domestic violence was a factor in a sizeable proportion of both child sexual and physical abuse cases.
Taking domestic violence as an overt expression of male domination and/or male power in the family unit, it can be argued that the abuse of children has occurred within a coercive environment. Yet the extent of such coercive forces impacting on children is possibly far greater than what would be expected from taking only the overt signs of domestic violence into account.
First, many child protection workers failed to determine whether even overt verbal and physical domestic violence was occurring in the family (Tomison 1994). Second, the measure of the extent of coercion and/or male domination in the family that Tomison and Goddard and Hiller (1993) employed does not take into account the effects of the less overt forms of aggression that can exist (Goddard and Hiller 1993), nor does it specifically incorporate the actual physical violence that can be used as a coercive force against children.
For example, in Tomison's (1994) study, 19.4 per cent of child sexual abuse cases (24 of 124) also involved the child being physically abused; 17 per cent of these cases (4 of 24) were reported to be occurring in families not identified by professionals as violent. This would seem to provide support for the contention that workers were taking a conservative approach to identifying family violence, and that the measure of coercion used in this paper is both conservative and an underestimate of the true level of coercion operating in these families.
The data from this study, and from that of Hiller, Goddard and Diemer (1989 as cited by Goddard and Hiller 1993), suggests that a violent, coercive environment may be almost as likely for sexual abuse cases as it is for physical abuse cases, particularly with the more severe cases of physical and sexual abuse. Child sexual abuse may, like child physical abuse, occur as a function of the misuse of personal power, and is another example of male attempts to control others through the use of violence. As Goddard and Hiller (1993:27) note: 'The point, crudely stated, is this: children having witnessed the beating of their mothers need no further reminder of the possible consequences of their resistance to the wishes of their fathers (or, indeed, of older males in general).'
The research reported here did not allow for a test of the 'family dysfunction' theory of child sexual abuse. However, the results do provide at least some support for the feminist contention that child sexual abuse exists as a function of the gender imbalance of power in family structures. It would also appear to provide further support for the view that workers professionally involved in this area should give greater consideration to the implications of domestic violence, and the implications for child abuse.
Rital abuse: the 'new' sexual abuse
In the 1980s reports began to appear in the literature of a new form of sexual abuse: ritual abuse - a dimension that has created significant confusion and controversy. Since its 'discovery' serious questions have been raised as to whether ritual abuse exists at all (Lanning 1991; LaFontaine 1994). Lanning concluded that: '[after] all the hype and hysteria is put aside, the realisation sets in that most satanic or occult activity involves the commission of no crimes, and that which does, usually involves the commission of relatively minor crimes' (1991:144).
Such arguments are based predominantly on the lack of physical evidence associated with alleged cases of ritual abuse, and come mainly from those involved in the criminal justice system. The possibility of ritual abuse remains open, with many professionals involved in child protection or welfare services maintaining a belief in the existence of ritual abuse, despite a lack of consensus among professionals as to what actually constitutes such maltreatment. This paper will proceed on the basis that there is a possibility of ritual abuse.
Ritual abuse has been described in a number of ways (Lewandowski 1995): some link ritual abuse with satanic practices (Young 1991), while others differentiate between satanic rituals and other forms of rituals (Lanning 1991). To add to the confusion, the terms 'satanic', 'occult' and 'ritualistic' abuse are often used interchangeably (Lanning 1991).
Finkelhor, Williams and Burns (1988:59) defined ritual abuse as 'abuse that occurs in the context linked to some symbols or group activities that have a magical or supernatural connotation, and where the invocation of these symbols or activities are repeated over time and are used to frighten and intimidate the children'. They suggested three sub-types of ritual abuse: 'true cult based', where sexual abuse is merely one component of the child's involvement in a religious cult's activities; 'pseudo-ritualistic', where sexual abuse is the primary aim and rituals or cult activities are secondary; and 'psychopathological ritualism', where mentally disturbed adults employ idiosyncratic rituals while abusing their children.
Investigators in the criminal justice system (Lanning 1991; Hopley 1994) and some academics/practitioners (Goddard 1994a) choose to encompass ritual or satanic abuse under the more general category 'organised' abuse or 'multidimensional child sex ring'. Law enforcement officers appear to favour the term 'multidimensional child sex ring' because not all ritualistic activity is spiritually motivated, nor is all ritualistic activity satanic in nature (Lanning 1991).
Organised abuse can be defined as 'sexual abuse where there [is] more than a single abuser and the adults concerned appear to have acted in concert to abuse the children and/or where an adult has used an institutional framework or position of authority to recruit children for sexual abuse' (LaFontaine 1994:3)
A common occurrence in cases of alleged ritual abuse has been a lack of physical evidence to substantiate charges of such maltreatment. This has reportedly affected the public's trust in law enforcement and child protection services to adequately manage/investigate allegations; it has also made it difficult to substantiate allegations of ritual abuse (Myers 1994; Lewandowski 1995). In addition, well-publicised cases of alleged ritual abuse which have been perceived as being mishandled, such as the Orkney Islands case in the United Kingdom, or the Oude Pekela cases in Norway (Myers 1994) have certainly proved useful material for the backlash movement (Lanning 1991).
Lanning (1991) believes that the lack of physical evidence may be due to a number of factors. 'Pathological distortion' by the victims may occur as a result of mental disorder or attention-seeking (for example, Munchausen's syndrome). 'Traumatic memory' may result where fear and severe trauma have distorted reality and led to some confusion as to what happened, in severe cases this may be represented by a dissociative disorder (previously known as multiple personality disorder).
According to Lanning (1991) the most popular explanation for the lack of evidence pertaining to ritual abuse cases is the perpetrator's use of 'misperception, confusion or trickery'. Some perpetrators may deliberately introduce satanic or occult activity into sexual offending in order to obfuscate what has occurred, which may be achieved through the use of drugs, magic, or costumes. In addition, investigators of ritual abuse often unreasonably expect a child to accurately describe sexual behaviours for which they have little frame of reference. Thus the child's inability to comprehend what has happened may also hinder the gathering of physical evidence. Lanning also noted that 'overzealous interveners' may inadvertently contaminate a child's disclosure.
LaFontaine (1994) presented another possible explanation for the disclosures of ritual abuse by some children. She assessed a number of ritual abuse cases as part of her evaluation of the extent of ritual and organised abuse in the United Kingdom. She contended that the caregivers of some difficult children, or professionals that were involved with the children, may have sought 'ritualistic' or 'bizarre' explanations with which to justify the children's behaviour. That is, the caregivers and social workers may have assumed that a child's 'acting out' was due to some horrendous experience, rather than to some other, mundane factor. LaFontaine posited that some caregivers may also have inadvertently coached or recorded information disclosed by the child in a biased fashion, highlighting the more bizarre aspects.
It has been claimed that some ritual abuse/multidimensional child sex ring cases have not been successfully prosecuted because there has not been a vigorous investigation of the ritualised aspects of the case (Lanning 1991). Goddard (1994b) reported that a United Kingdom social service department dealt with ritual abuse cases in a manner similar to other sexual abuse cases - that is, the case was defined as sexual abuse, albeit with ritualised aspects.
The investigation and subsequent legal action taken were handled on this basis, with the case being run purely on the direct evidence of sexual abuse that could be gathered. Lanning (1991) advocates such an approach. Also in support of this approach, Goddard noted the potential to lose sight of abusive concerns if inaccurate labels are applied to abuse. Using the sexual and physical abuse of children by teachers as an example, he stated that '[such cases] should not be described as 'educational' abuse because it is perpetrated by a teacher, or because it took place in a classroom' (1994a:38). Under this argument, alleged ritualised or satanic sexual abuse should not be defined as ritual abuse, but rather as sexual abuse with ritualised aspects and dealt with accordingly.
Child sexual assault prevention programs must target victimisation, sexually abusive behaviour and the changing of community attitudes which allow the sexual abuse of children to occur' (Crime Prevention Committee 1995:265). The following sections detail some of the currently operating prevention programs and some possible future directions.
Wurtele and Miller-Perrin (1992) contended that child sexual assault is ultimately the responsibility of every citizen. In order to encourage society as a whole to acknowledge the problem and to educate them about it, community education has been undertaken in most countries. In the past decade it has been argued that the western world has achieved a much greater recognition of the problem of child sexual assault. The significant increase in the number of cases reported to child protection services has been taken as some support for this contention (Clark 1995). Media campaigns (radio, print media and television) have attempted to enhance public awareness. Media presentations have helped to 'demystify and reduce the secrecy surrounding child sexual abuse' (Wurtele and Miller-Perrin 1992:200).
While the general public is aware of the child sexual assault problem, Oates (1990) contended that the public does not have a balanced view of the area, and that there is a need for a community education campaign to enhance people's knowledge.
Following a similar argument, Wurtele and Miller-Perrin (1992) contended that in the future media should be better used, targeting perpetrators, victims, and parents with more detailed information about seeking help, where to obtain assistance. They also suggest the use of actors to role-play realistic scenarios on television.
This suggestion was recently advocated in Australia by McGurk (1995). He referred to the success of hard-hitting advertising campaigns to discourage drunk driving and driving without seatbelts. The advertisements illustrate the unacceptable and undesirable nature of such behaviour and present the consequences of such behaviour very explicitly (graphic car accidents). McGurk believes that such an approach would be useful for the secondary and tertiary prevention of family violence. He advocated a trial media campaign explicitly portraying family violence, with the intention of confronting 'perpetrators with the grossness, grotesqueness and total unacceptability of their behaviour. For victims, the campaign would be directed at encouraging them to come out of the cupboard' (McGurk 1995: 11).
It is contended that such an approach could also be adapted for a child sexual assault campaign, and may represent a way forward as a means to combat child sexual assault.
Currently the major school-based primary prevention initiatives are personal safety and protective behaviours programs. Personal safety programs have the aim of educating school-age children to protect themselves from sexual abuse. Protective behaviour programs focus on teaching children to avoid a wide range of potentially unsafe situations, only some of which involve child maltreatment. The programs attempt to involve the children's parents in the program in order to raise community awareness of sexual abuse and to teach parenting skills related to protecting their children and detecting signs of abuse (Plummer 1993).
School-based prevention programs are designed to reduce the incidence of sexual abuse by preventing the occurrence of some of Finkelhor's (1984) four preconditions for sexual offending. The aim of the programs is to educate children about what constitutes inappropriate sexual advances or behaviour and how to deal with such advances (Plummer 1993).
The intention of protective behaviour/personal safety programs is to educate children, not to make them solely responsible for their own safety (Plummer 1993). The most common and consistent positive outcomes of such programs have been children's heightened knowledge of sexual abuse, increased child disclosures of abuse (Plummer 1993; Reppucci and Haugaard 1993), and an improvement in parental awareness and ability to protect their children (Plummer 1993).
Plummer (1993) contended that by 1990, as a result of the child sexual abuse backlash, child abuse prevention initiatives began to be judged more harshly. Major criticisms of school-based programs have been that they may not be tailored for the specific ages of the target children (especially younger children), that they are methodologically problematic, ineffectively evaluated, and emphasise the child protecting her/himself, with a reliance on an overly complex method of repelling an advance (Plummer 1993; Reppucci and Haugaard 1993).
In her first audit of the National Child Protection Clearing House prevention programs and research databases, James (1994) found that despite a general acceptance that rigorous evaluation was an essential part of all prevention programs, very few effective evaluations had been done in Australia. A 'rigorous' evaluation was defined as one designed as a 'true experiment' (Fink and McCloskey 1990), involving pre- and post-test models, and/or matched control and experimental samples. The overall intention was to evaluate programs with large sample sizes over time, enhancing the potential for future replication.
James (1994) concluded that, with a few exceptions, no systematic research had preceded the implementation of many primary and secondary prevention programs (including personal safety/protective behaviours programs); and that often overseas programs had been adapted for use in Australia without any investigation into the needs of the community for which the program was intended.
However, Tomison's (1995b) audit of the National Child Protection Clearing House databases indicated a greater implementation of rigorous evaluations of prevention programs. Approximately 25 per cent of personal safety/protective behaviour programs on the databases were identified as attempting to conduct 'rigorous' evaluations. It was concluded that professionals and organisations working in the child abuse prevention field had to some extent acted to rectify the lack of quality evaluations in Australia outlined by James (1994) in the first audit of the NCH Prevention Programs and Research databases.
Despite attempts to effectively evaluate protective behaviours and personal safety programs, few would be able to fulfil the methodological requirements of James (1994). If program success is measured in terms of an increase in the reporting of sexual abuse by children, and enhanced knowledge of sexual abuse and preventative actions, then personal safety and protective behaviours programs can be described as successful. If however, strict evaluation criteria are employed which require evidence of the prevention of child sexual abuse, then current programs fail to meet the set standards. Overall, such programs were not designed to place responsibility on children to protect themselves, merely to aid them in identifying potentially abusive situations (Plummer 1993). Under such an assumption school-based prevention programs have achieved some positive results.
A future role for schools in prevention
In support of personal safety/protective behaviour programs, a major thrust of the Victorian Crime Prevention Committee's (1995) approach to child sexual assault prevention was the enhancement of current educational programs running in primary and secondary schools. It was the Committee's view that the education system should take more responsibility for the production of capable, functioning members of society. This responsibility would involve running compulsory protective behaviours programs in schools (as occurs in South Australia) and the uniform teaching of life skills. According to the Committee, the latter should address the following issues: criminal law, victim empathy, gender and socialisation, sexual education, sexual assault, child abuse, violence, domestic violence, and alcohol/drug use.
Such an approach is currently advocated by a number of professional and community groups across the nation, and reflects a growing perception that education should not be limited to purely academic subjects (Cohn 1990, as cited in Oates 1990). Under this approach, education is strongly involved in preparing young people to function in society, rather than working to educate on a purely academic agenda.
Offender treatment programs
'The community must accept that incarceration in, and of itself, will not achieve a single thing, other than the protection of the community for that time which an offender is incarcerated' (Crime Prevention Committee 1995:230). The small proportion of offenders who are convicted and sentenced to imprisonment will be returned to society, while the majority of offenders are never imprisoned (Crime Prevention Committee 1995). The prevention of child sexual assault is discussed in terms of an ideal model for managing child sexual assault proposed by Victoria's Crime Prevention Committee (1995).
Assessments of sex offender recidivism indicate that, without treatment, approximately 60-70 per cent of sex offenders will re-offend, while less than half of sex offenders who undergo a treatment program reportedly re-offend (Crime Prevention Committee 1995). Cost/benefit analysis has indicated that the treatment of offenders is a cost-effective approach to the problem of child sexual assault, given that it appears to lead to much lower recidivism rates, while the costs of treatment are far outweighed by the costs of incarcerating recidivists in addition to the social and human cost of the assaults themselves (Prentky and Burgess 1990).
Based on national and international evidence, the Crime Prevention Committee (1995) proposed a model of offender treatment which would involve a mandatory assessment of all convicted sex offenders sentenced to a custodial or non-custodial sentence. Following assessment, offenders would commence an extensive treatment program which would continue on until the offender's parole period has expired. It was acknowledged in the report that an offender's progress through the treatment program could be used as an assessment tool by parole boards who may have concerns about granting parole to a sex offender who has refused treatment, or who has made unsatisfactory progress through the treatment system.
Adolescent offender programs
As mentioned previously, the professional child maltreatment community recognises the need to intervene with young sex offenders, or potential offenders (Children's Protection Society 1995). Studies of adult sex offenders in the United States indicated that many begin sexually deviant behaviour from the age of eight upwards (Groth, Longo and McFadin 1982, as cited in Children's Protection Society 1995). Honey Knopp (1982) reported that early intervention is paramount in order to more easily disrupt deviant behavioural patterns; young people are still experimenting with a variety of sexual patterns, thus providing alternatives to offending behaviour; distorted or inappropriate cognitive patterns are less deeply entrenched and can be re-directed; and young people are better candidates to learn new, acceptable social skills. In summary, it is easier to prevent further abusive behaviour in offenders where the behaviour has not become a deeply ingrained pattern.
The Victorian Crime Prevention Committee (1995) recommended that all adjudicated adolescent sex offenders undergo assessment and appropriate treatment. Rather than using the criminal justice system as a means to ensure that young offenders receive mandatory assessment and treatment, the Committee proposed extending the grounds under which a protection application may be made under state legislation. The new grounds would allow applications to be taken out for children displaying the 'early signs of sexually offending behaviour', and would enable an appropriate assessment and treatment program to be instituted under the supervision of specialist child protection staff.
In the Committee's view, the potential benefits of such a system would be the adequate treatment and prevention of sexual assaults by young offenders. The proposed model also provides an answer to an ongoing debate within the professional community as to whether diversion (from the criminal justice system) or prosecution should be the preferred option for young offenders (Masson 1995). The Committee's proposal allows for mandated treatment, but avoids the necessity of having to go through the criminal courts by widening the criteria for protection applications.
An additional positive side-effect of the program may be an adequate investigation as to why a child had begun acting out in such a way - that is, a determination of who, if anyone, may have been sexually assaulting the child victim/offender.
The enormity of the child sexual abuse problem has been described as 'one of the most discouraging discoveries of our era' (Finkelhor 1990:394). Despite society's reluctance to acknowledge what can be a major source of suffering for young people (Tower 1989), there has been progress, particularly in the last decade, in the identification, treatment and prevention of child sexual abuse.
This paper has been an attempt to describe some of the current issues in child sexual abuse research and practice. It is by no means an exhaustive review of the area, but highlights aspects of sexual assault which appear to have successfully penetrated society's attempts to keep sexual abuse at arm's length. The intention has been to redress some of the stereotypic assumptions characteristic of child sexual assault and sexual assault perpetrators, while offering some possible solutions for the decade to come.
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An overview of conceptual definitions of abusive and neglectful behaviours, and legislative definitions of "a child in need of protection"
In this paper, we look at the issues facing those responsible for ensuring the safety and wellbeing of children in the context of parental separati
Describes Fabricated or Induced Illness by Carers (FIIC) and explore some implications for practitioners working to protect children from harm.
Child abuse is associated with an increased risk of gambling problems in adulthood, according to a recent systematic review.