BLOG PODS #18 - Child Sexual Abuse: Prevalence & Practice Tips
INTRODUCTION
Lately I’ve been working on a book chapter with a colleague - it’s about kids and why their age and stage of development is especially important when it comes to assessing sexually reactive and/or harmful behaviour.
The research for the chapter has sent me back to some of the basics of child development in general and the emergence of children as sexual beings in particular.
No-one wants to talk about child sexual abuse (CSA) and sexual offending - why would they? The whole thing is pretty grim and all the more so because children are involved.
But such is the nature of the problem that it is always there. It never goes away or fades or ceases to be relevant for the children themselves or for those who work with them.
So here’s a short overview to refresh your memory and (hopefully!) energise your practice if you’re helping kids where this might be an issue…
Lots of the data & other info for this post is borrowed from the CSA Centre’s ‘Scale and Nature’ report - see their excellent website here.
Prevalence
Establishing good prevalence data is tricky. Surveys, questionnaires and research studies all ask different questions of different sample groups for different reasons.
For example:
* The NSPCC child maltreatment study* asked adults about CSA experiences up to being 18 years old.
* 24.1% responded positively for some form of CSA
* The Crime Survey for England & Wales asked about childhood abuse
* 7.5% reported experiences of CSA
So it’s tricky.
The Centre of Expertise on Child Sexual Abuse has done extensive work on all aspects of CSA since they were established in 2017. Here is their latest aggregation of the broad prevalence data:
Taking into account the variations in prevalence studies for England and Wales, the data suggests that at least 15% of girls/young women and 5% of boys/young men experience some form of sexual abuse before the age of 16, including abuse by adults and under-18s. Source**
In raw numbers that looks like this:
The nature of CSA - the ‘what’
The challenges with obtaining sound prevalence data are mirrored in efforts to categorise the amount of each kind of child sexual abuse. Suffice to say that these are numerous!
From a practice perspective, having a good grasp of the wide range of factors contributing to an abusive scenario is important.
Factors include (not an exhaustive list):
* Intra or extra-familial abuse
* Abuse by adults, teenagers or other children
* Contact or non-contact abuse
* Penetrative or non-penetrative acts
* Abuse by females, males, young , old, related or unrelated
* By friends, family, professionals, community members…
* Online abuse or exposing children to sexual material
* Hearing, seeing or experiencing the abuse of others
* One-off or serial abusive experiences
* Exploitative/transactional abuse (there’s an ‘exchange’)
* Known or unknown (stranger) perpetrators
For children, of course, all of these are horrific and can be life-changing in their impact. Many children experience numerous forms of abuse from a number of different people; abuse can happen singularly, over a short period or serially over years.
💡 Practice tip: being mindful of the vast range of potential abusive scenarios keeps us from being blinkered in our investigations and assessments; being suspicious of our own confirmation bias is critical.
The victims of CSA - the ‘who’
The other key domain in looking at CSA is the ‘who’ of it - who does it and who do they do it to. Again, these are tricky to tease out from the data but here are some information points to inform our thinking.
- Groups of kids who seem to be at higher risk for child sexual abuse:
* Girls - 3 times as likely as boys to describe experiences of CSA
* Children with disabilities - twice as likely to describe experiences of sexual abuse as non-disabled peers
* Kids living in care homes - 4 times as likely to have experienced CSA
* Neglected kids - 5 times as likely to have experienced CSA than non-neglected children
- Perpetrators of CSA by victim group, include:
* Penetrative behaviours tend to be committed by people known to the victim***
* For boys, these people are often authority figures
* For girls and young women, they are family members
* For women, they are fathers, stepfathers or other family members
The pattern here (for contact/in-person abuse, at least) is that children are much more likely to know their abuser than not know them.
💡 Practice tip: Stranger danger is not really a big thing in the offline field of CSA perpetration. Looking closer to home and the community - to the context of the child’s life generally - is a more likely source of the abuse. (Check out the Contextual Safeguarding Network for more info on this and what can be done about it)
- Telling someone about what happened
We’ve known that most children and young people don’t tell anyone about what happened at or near the time of the abuse. Many wait until they become adults before disclosing their experiences; a majority never speak of it.
* 5 out of 6 people who said they’d been abused by another child didn’t tell anyone
* One third of people who said they were abused by an adult didn’t tell anyone
* One in five adults responding to the Crime Survey*** had never told anyone
* Children and young people who do tell someone, tend to tell a family member or a friend, rather than a professional
* Agencies estimate that they are told at the time of the abuse in less than 10% of cases…
* …and they were told later in only about 25% of cases.
According to the same survey, the following are the most common reasons for not telling anyone about the abuse they experienced
* Embarrassment
* Fear
* Not being believed
* Fear of humiliation (no surprises there)
Practice implications
We could go on all day with summarising the data on this - but who’d want to do that? (Read a brilliant summary of it all - here - that’s where I nicked most of this from!)
The point, though, is that we use this knowledge to do a better job for the kids we serve at work.
Here are a few ideas:
- Beware confirmation bias
Being mindful of the vast range of potential abusive scenarios guards us from being distracted, blinkered or accepting the most obvious explanation in our investigations and assessments; being suspicious of our own confirmation bias is critical. The easy tropes, habitual heuristics and stereotypes in our thinking must be resisted and overcome if we are to to really see the child and what might be going on.
- Screening in till there’s a reason to screen it out
This is a practice ideal I come back to time and time again.
The more we know about a problem-in this case child sexual abuse-the less likely we are to miss something important when responding to children. Using the information we know from research, the literature and our pervious professional experiences, can safeguard us against this. I prefer to think that all possibilities may be present, until I have a reason to believe they’re not. That way my thinking is driven by what I know rather than by what I assume to be true.
The more I know, the less I assume.
- Work with families
Given the above data about the prevalence of abuse within families and by known others, we must tread carefully. The child’s family may well be the most likely source of their abuse, but it’s also the place they are most likely to find someone they can talk to about it, feel safe with and recover.
We, the professionals, are rarely the person the child will tell. So thinking about how we can get to know the family and understand its functioning and the child’s relationships within it, will help us to lend support to the people and processes best suited to helping the child disclose and begin to move on.
- Avoid taking the easy route
When resources are stretched and colleagues are stressed it’s so easy to fall into the trap - as agencies/teams and as individuals - of batting things away. This might be through increasingly high thresholds, such that accessing services gets harder and harder. It might be a team culture that prides itself in batting away referrals that aren’t very obviously urgent or high risk. It might be we succumb to the temptation to believe what we’re told straight away and avoid digging deeper. Tiredness, an endless glut of cases, low staffing levels, limited budgets and exhaustion can all fuel this stuff…
But there might just be a child who needs our help, a non-abusing parent looking for hope or a situation ripe for disruption and resolution - I, for one, don’t want to miss that.
FINAL THOUGHTS
None of this is easy. In fact, it can be overwhelmingly grim, at times. But I’m always struck by what an immense privilege it is to be working in a field that includes the imperative to keep kids safe.
Having a clear sense of what might be going wrong for a child - in this case sexual abuse - can help us to do the best we can, to work at our optimum and, hopefully, to do some good in the world and help put the beast that is child sexual abuse to death once and for all.
Let me know your thoughts…
See you in the next one.
More information:
* WEB ARTICLE: See this short read on confirmation bias by my good mate, Alex Clapson (link)
* PAPER: * Radford, L. et al. (2011) Child abuse and neglect in the UK today. London: NSPCC (link)
* PAPER: ** CSA Centre: Scale & Nature of Child Sexual Abuse: A Review of the Evidence (link)
* STATS: *** Office for National Statistics: Child Abuse Extent & Nature (report link) (appendix tables link)
* WEBSITE: Contextual Safeguarding Network (link)
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©️ Jonny Matthew 2024
