National Center on Sexual Behavior of Youth Fact Sheet

April 18, 2011

National Center on Sexual Behavior of Youth Fact Sheet

Sexual Development and Sexual Behavior Problems in Children Ages 2-12
This Fact Sheet provides basic information about sexual development and problematic sexual behavior in children ages 2-12. This information is important for parents and professionals who work with or provide services to children such as teachers, physicians, child welfare personnel, daycare providers, and mental health professionals. Understanding children’s typical sexual development, knowledge, and behavior is necessary to accurately identify sexual behavior problems in children. Guidelines to distinguish typical sexual behaviors from problematic sexual behaviors are described below.

Research on sexual behavior of children ages 2 to 12 has documented that:

sexual responses are present from birth; 1
a wide range of sexual behaviors for this age range are normal and non-problematic;^{1, 2}
increasing numbers of school age children are being identified with inappropriate or aggressive sexual behavior;³ it is not clear if this increase reflects an increase in the actual number of cases or an increase in identification and reporting;
several treatment interventions have been found to be effective in reducing problematic sexual behavior in children, such as cognitive behavioral group treatment;^{4, 5} and
sexual development and behavior are influenced by social, familial, and cultural factors, as well as genetics and biology.⁷

Typical sexual knowledge of children age 2 to 6 years old:

understand that boys and girls have different private parts;
know labels for sexual body parts, but use slang words such as weenie for penis; and
have limited information about pregnancy and childbirth.

Typical sexual knowledge of children ages 7 to 12 years old:

learn the correct names for the genitals but use slang terms;
have increased knowledge about masturbation, intercourse, and pregnancy; and
understand the physical aspects of puberty by age 10.

Common vs. Infrequent Sexual Behaviors in Children

In the last decade, research has described typical sexual behaviors in boys and girls ages 2-12.² The table below lists sexual behaviors that are commonly observed or reported by parents of pre-school and school age children.

COMMON SEXUAL BEHAVIORS
AGES 2-6

Do not have a strong sense of modesty, enjoys own nudity
Use elimination words with peers
May explore body differences between girls and boys
Curious about sexual and genital parts
Touch their private parts, even in public
Exhibit sex play with peers and siblings; playing “doctor”
Experience pleasure from touching their genitals

COMMON SEXUAL BEHAVIORS
AGES 7-12

Sexual play with children they know, such as playing “doctor”
Interested in sexual content in media (TV, movies, radio)
Touch own genitals at home, in private
Look at nude pictures
Interested in the opposite sex
Shy about undressing
Shy around strange men

Research has also described infrequent and uncommon sexual behaviors in boys and girls ages 2-12. ²

The table below lists sexual behaviors that are reported by parents of pre-school and school age children to be infrequent or highly unusual.

INFREQUENT SEXUAL BEHAVIORS AGES 2 – 12
Puts mouth on sex parts
Asks to engage in sex acts
Puts objects in rectum or vagina
Imitates intercourse
Masturbates with objects
Undresses other people
Touches others’ sex parts after being told not to
Asks to watch sexually explicit television
Touches adults’ sex parts
Makes sexual sounds

Sexual Play vs. Problematic Sexual Behavior

Professionals in the field have developed a continuum of sexual behaviors that range from common sexual play to problematic sexual behavior.¹⁰ These are described below.

Sexual play

is exploratory and spontaneous;
occurs intermittently and by mutual agreement;
occurs with children of similar age, size, or developmental level, such as siblings, cousins, or peers;
is not associated with high levels of fear, anger, or anxiety;
decreases when told by caregivers to stop; and
can be controlled by increased supervision.

Problematic sexual behavior

is a frequent, repeated behavior, such as compulsive masturbation;

Example: A six-year-old repeatedly masturbates at school or in other public places.

occurs between children who do not know each other well;

Example: An eight-year-old girl shows her private parts to a new child during an after school program.

occurs with high frequency and interferes with normal childhood activities;

Example: A seven-year-old girl has been removed from the soccer team because she continues to touch other children’s private parts.

is between children of different ages, size, and development level;

Example: An eleven-year-old boy is “playing doctor” with a three-year-old girl.

is aggressive, forced, or coerced;

Example: A ten-year-old threatens his six-year-old cousin and makes him touch his penis.

does not decrease after the child is told to stop the behavior;

Example: A nine-year-old child continues to engage other children in mutual touching after being told the behavior is not allowed and having consequences, such as being grounded.

causes harm to the child or others.

Example: A child causes physical injury, such as bruising, redness, or abrasions on themselves or another child, or causes another child to be highly upset or fearful.⁹

Children With Sexual Behavior Problems

Children with sexual behavior problems (SBPs) are children 12 years and under who demonstrate developmentally inappropriate or aggressive sexual behavior. This definition includes self-focused sexual behavior, such as frequent public masturbation, and intrusive or aggressive sexual behavior towards others that may include coercion or force. Although the term “sexual” is used, the children’s intentions and motivations for these behaviors may be unrelated to sexual gratification.

Some children who have been sexually abused have inappropriate sexual behaviors and others have aggressive or highly problematic sexual behavior.⁸ However, it should be noted that the majority of children who have been sexually abused do not have subsequent inappropriate or aggressive sexual behaviors.

Although only a small number of children develop problematic sexual behavior, professionals and parents may have concerns about (1) whether the behavior is problematic, (2) whether a child should be referred for mental health services, and (3) when an incident should be reported to the proper authorities.

Suggestions for professionals and parents are listed below:

Do not overreact as most sexual behaviors in children are within the typical or expected range.
Inappropriate or problematic sexual behavior in children is not a clear indicator that a child has been sexually abused.
Most children will stop the behavior if they are told the rules, mildly restricted, well supervised, and praised for appropriate behavior.
If the sexual behavior is problematic as defined above, referral for mental health services is recommended.
It is important to remember that children with problematic sexual behavior are significantly different from adolescent and adult sex offenders.
A report to Child Protective Services (CPS) and/or law enforcement may be required by law for certain behaviors such as aggressive or forced sexual behavior.

Additional information about adolescent sex offenders and children with sexual behavior problems is available from the National Center on Sexual Behavior of Youth, http://www.ncsby.org.

Reference:
1. Gordon, B. N., & Schroeder, C. S. (1995). Sexuality: A developmental approach to problems. New York: Plenum Press.
2. Friedrich, W. N., Grambsch, P., Broughton, D., Kuiper, J., & Beilke, R. L. (1991). Normative sexual behavior in children. Pediatrics, 88, 456-464.
3. Araji, S. K. (1997). Sexually aggressive children: Coming to understand them. Thousand Oaks, CA: Sage.
4. Bonner, B. L., Walker, C. E., & Berliner, L. (1999). Children with sexual behavior problems: Assessment and treatment (Final Report, Grant No. 90-CA-1469). Washington, DC: Administration of Children, Youth, and Families, Department of Health and Human Services.
5. Pithers, W. D., Gray, A., Busconi, A., & Houchens, P. (1998). Children with sexual behavior problems: Identification of five distinct child type and related treatment considerations. Child Maltreatment, 3, 384-406.
6. DeLamater, J., & Friedrich, W. N. (2002). Human sexual development. The Journal of Sex Research, 39, 10-14.
7. Silovsky, J. F., & Bonner, B. L. (2003). Children with sexual behavior problems. In T.H. Ollendick, & C.S. Schroeder (Eds.), Encyclopedia of Clinical Child and Pediatric Psychology (pp.589-591). New York: Kluwer Press.
8. Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164-180.
9. Hall, D. H., Matthews, F., Pearce, J., Sarlo-McGarvey, N., & Gavin, D. (1996). The development of sexual behavior problems in children and youth. Ontario, Canada: Central Toronto Youth Services.
10. Johnson, T. C. (1998). Understanding children’s sexual behaviors: What is natural and healthy. Order information http://www.TcavJohn.com.

The University of Oklahoma is an equal opportunity institution.

Opinions in this document are those of the authors and do not necessarily represent the official positions or policies of the US. Department of Justice/Office of Juvenile Justice and Delinquency Prevention.

This Fact Sheet was prepared through the National Center on Sexual Behavior of Youth at the Center on Child Abuse and Neglect, University of Oklahoma Health Sciences Center and was authored by Jane F. Silovsky, PhD and Barbara L. Bonner, PhD. This project is funded by grant number 01-JR-BX-K002 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), US Department of Justice.

Filed under Children Tagged with Child abuse, Child Protective Services, Child sexual abuse, Fear, Sexual abuse, Sexual violence, Survivors

Possible Life Span Signs and Symptoms Associated with Victims of Childhood Sexual Abuse

March 30, 2011

Infancy and Early Childhood Under 4 Years
• Fearful
• Night terrors Loneliness
• Shame
• Clinging behavior
• Developmental delay
• Suspicious physical findings
• Staring blankly
• Mood swings
• Cruelty to others
• Whining
• Withdrawn
• Secretive
• Daydreaming
• Sexual preoccupation

Middle and Late Childhood 5 – 10 Years
• Sudden onset of anxiety
• Depression
• Insomnia
• Conversion hysteria
• Weight gain/loss
• Sudden school failure
• Truancy
• Run-away
• Sudden irritability
• Excessive bathing
• Psychosomatic problems
• Suspicious physical findings
• Staring blankly
• Cruelty to others
• Mood swings
• Withdrawn
• Lying
• Cheating
• Secretive
• Daydreaming
• Sexual preoccupation
• Seductiveness

Early Adolescence 11 – 14 Years
• Guilt
• Low self-esteem
• Isolation
• Poor body image
• Staring blankly
• Cruelty to others
• Mood swings
• Withdrawn
• Lying
• Cheating
• Aggression
• Secretive
• Daydreaming
• Sexual preoccupation
• Low sexual self-esteem
• Fear of homosexuality
• Sexual abuse of younger children

Late Adolescence 15 – 17 Years
• Self-depreciation
• Prostitution
• Promiscuity
• Depression
• Social isolation
• High rebellion
• Pregnancy
• Venereal disease
• Drug abuse
• Acting out
• Anorexia
• Aggression
• Seductiveness
• Sexual preoccupation
• Low sexual self-esteem
• Sexual abuse of younger children

Adult 18 Years +
• Figidity
• Conversion hysteria
• Promiscuity
• Prostitution
• Phobias
• Suicide attempt
• Psychotic behavior
• Low self-confidence
• Low self-esteem
• Guilty feelings of defenselessness
• Feelings of worthlessness
• Seductiveness
• Sexual preoccupation
• Sexual abuse of others

Remember that lists such as these should be carefully regarded. You will note that many of the behaviors might be associated with many other causes and in some instances can be associated with “normal” behavior. It is critical to carefully consider the full range of information about any case.

From: Dr. Pamela Langelier, Vermont Family Forensic Institute, 1989

Filed under Children Tagged with Child abuse, Child sexual abuse, Self-esteem, Sexual abuse, Support Groups, Survivors

Sexually Abused Child Trauma Response by Age Group

March 30, 2011

Sexually Abused Child Trauma Response by Age Group

It can often be very difficult to recognize whether or not a child is being abused, both for parents and for professionals.

Children respond to sexual assault in many different ways according to their age, gender, personality and family circumstances. Their behavior will always reflect how they feel as children tend to communicate through their behavior. Children frequently find it extremely hard to talk about what is happening to them, especially when they’ve been told to keep it a secret or have been subjected to coercion, bribery or threats. Children very rarely lie about sexual abuse. They may underplay the effects of the abuse or change the identity of the perpetrator in an attempt to protect the family, but they have not been found to lie about the occurrence of the abuse itself.

Generally speaking there are two main behavioral indicators of trauma following sexual abuse. Regression to an earlier developmental stage or loss of developmental tasks previously achieved and failure to learn or distortion of new developmental tasks.

Signs of Trauma Responses in Preschoolers (age 2-5)

They may become anxious and clingy, not wanting to separate from their parents at day care or the baby-sitter’s house.
They may seem to take a backward step in development (regression), sucking their thumbs, wetting their beds, refusing to go to sleep, or waking at night when they passed those stages long ago.
They may become aggressive in their play with other children, with their parents, or with their own toys.
They may play the same game over and over, like piling blocks and knocking them down, dropping toys behind furniture and retrieving them, or crashing the same two cars over and over again.
They may express ‘magical’ ideas about what happened to them which alters their behavior (ex: “Bad things happen when I get too happy”).
Though they say they are having fun in an activity they may look sullen, angry, or intense in a way that to an adult it doesn’t look like they are having fun.

Signs of Trauma Responses in School Age Children (age 5-13)

They may revert to developmentally earlier coping mechanisms, such as an ego-centered view (i.e. thinking that someone died because they had bad thoughts about the person).
They may compensate for feeling helpless during the crisis of the abuse by blaming themselves for what happened. Thinking that thtey caused the event gives children a sense of power and control while helplessness painfully reminds them of being young and totally dependent.
Their lack of control over the abuse may make them feel that their future is unsure, which can lead some children to act recklessly.
They may experience a significant change in school performance. It’s not uncommon for children to have great difficulty concentrating and performing in school following trauma. On the other hand, they may become intensely focused on schoolwork to the exclusion of other activities in an effort to cope.
They may test out rules about bedtime, homework, or chores. School age children believe in rules. When something bad happens, even if they obeyed the rules, they become oppositional and testy.
They may have interruptions in their friendships.
They may experience sleep disturbances, nightmares, and difficulty falling asleep.
They may engage in reckless play. Where the preschool child will crash their truck a hundred times, the school age child might physically engage in dangerous games as a way of exhibiting a sense of control that was lost during the abuse.

Signs of Trauma Responses in Teenagers (age 13-18)

They often feel that no one can understand what they are going through and there is a marked shift in relationships with parents and peers.
They may get involved in risky behaviors, such as experimenting with drugs, sexual activity, or refusing to go to school as a way of handling anxiety and countering feelings of helplessness. They feel their future is limited and may believe they are damaged for good by the abuse so planning for the future is pointless.
They develop a negative self image because they were not able to avoid or alter what happened to them.
They are likely to engage in revenge fantasies against the person or people responsible for the abuse and then feel guilty about their vengeful feelings.
They may experience a shift (either an intensification or withdrawal) in the normal developmental tasks of their age, such as dating, friendships, or sense of autonomy. They may isolate themselves, be depressed and at risk of suicide.

Some More Specific Behaviors Of Children Following Sexual Assault.

Wetting/soiling

Many young children lose bladder/bowel control following sexual assault. It can be frustrating for parents and cause extra work. It can be humiliating and embarrassing for children. It is easy for adults and children to focus on the consequences of wetting and soiling e.g. changing sheets/clothes, washing, rather than the reasons why it happens.

All children bed wet from time to time when they are sick, stressed or anxious. Children who have been sexually assaulted will often bed wet every night and sometimes more than once a night. Bedwetting can be linked to feelings and may be a result of nightmares. Extreme fear can cause loss of bladder control and may serve the purpose of waking a child from a terrifying dream.

Bedwetting can also result from feelings of helplessness when children feel a loss of ownership and power over their body when it has been used by someone more powerful than they are. Bedwetting can be a reflection of children regressing in many ways, following sexual assault, when they lose a number of skills they previously had. Children may regress to a younger state to try and get their needs met. Bedwetting and soiling may also occur because a child separates from their genital/urinary/anal areas. They may lose the ability to respond to their body cues and therefore become less able to regulate their toilet habits. Sometimes children may be scared to actually go to the toilet. They may have experienced sexual assault in a bathroom or their fears may focus on the toilet itself.

Nightmares

All children have bad dreams from time to time but children who have experienced sexual assault often have nightmares every night sometimes more than once. They may have recurring dreams which are all the more frightening because they know what is coming. Nightmares can make children terrified of the dark and bed time.

Their dreams are likely to reflect their fears and their sense of lack of control. Looking at the content of their dreams can help them to talk about what has happened.

Persistent Pains

Lots of children develop aches and pains that have no physical cause. These will often have a connection to an aspect of the assault. Sometimes if a child has experienced physical pain during the assault, their body can retain the memory of this pain. Children may also think that something is broken inside of them. Repeated pain can also be a way for children to gain the extra love and attention they need at the time. Sometimes emotions manifest themselves physically for children because they do not have the ability to put it in to words.

Clinginess

A clingy child can test the patience of a saint! This behavior which is so common after sexual assault is a communication of a real need to be reassured of being lovable and of being secure. Children are attempting to rebuild a sense of safety and trust through their relationships with close adults. They are trying to restore a sense of good touch by demanding affection and cuddles. In essence, they are trying to heal their wounds. Constant physical and verbal demands can be difficult for parents but can be modified by identifying what the child needs and putting limits on when and how they are met. Clinginess can also reflect fears which can be reduced by talking about them.

Aggression

Aggression in children after sexual assault tends to be related to fear and anger. It can be a direct communication that states “I am never going to be hurt again”. Anger is a healthy response and a necessary part of the recovery process from any trauma. It needs to be expressed in a safe and constructive way with firm limits against hurting yourself or others. To do this, anger needs to be acknowledged and recognized by the child and the adult. A child needs opportunities to discharge their anger. If this, for whatever reason, does not happen then anger is likely to come out through aggression. This causes the child more problems as their aggression prevents other people seeing or understanding the child’s needs.

Aggression also stems from fear and a need to protect themselves from further hurt.

Being aggressive can also cause a child to punish themselves and confirm their low self esteem because they have no friends and are always in trouble.

Sexualized Behavior

When children are sexually assaulted their sense of what is right and wrong becomes distorted. What they had previously learned about bodies and sexual activity becomes invalid. If a child was shown how to light a fire, for example, it is likely that the child will attempt to repeat what they saw. If children have learned that they get attention by being sexual with one person they may well repeat the behavior with another person. If children have experienced sexual feelings, which are common in children who have been sexually assaulted, they are likely to try and recreate those reactions. They may begin to sexually act out with other children to try and make sense of what has happened to them. Their curiosity about sexual matters may have been activated years before they develop the intellectual ability to understand. Children may want to sexually act out on other children to make them feel less vulnerable in the same way they may be aggressive. The trouble they may get into as a result of this behavior then confirms their view of themselves as dirty and bad.

Sexual acting out by children needs to be distinct from what is natural curiosity. Sexual acting out usually involves a difference in power between the children and may involve coercion/force or blackmail and a repetition of an adult sexual activity.

Normal sexual activity between children is about exploration not gratification (Martinson 1991 in Hunter 1996). Up to the age of 5, children are interested in touching their private parts and looking and touching the private parts of others if they have the opportunity. From 6 to 10 children have learned that sexual activity should be hidden and will masturbate secretly. They may create situations with their peers that involve looking and possibly touching. (Attempted or actual penetration and activities using force are not normal). They are likely to be curious about adult bodies. Early adolescents will masturbate and begin to develop relationships that involve a range of touching.

Sexual acting out in children who have been assaulted will involve either the child repeating what has been done to them on other children or getting other children to do to them what the offender did. It can also involve children approaching adults in a sexual way. It does not mean that the child automatically becomes an offender but it is an indication that professional help is needed.

Triggers & Recovery

Everyone who has suffered a trauma will react when they are reminded of it. The things that remind us can be called ‘triggers’ and they cause similar feelings to those experienced during the trauma. Very often these ‘triggers’ are not known to the adult because they relate to an aspect of the assault the parent may not know about. Some examples include the smell of beer or smoke; the feel of a beard; the color of a car; someone resembling the offender; a song or a game. Some are obvious, others are not. Often children can be triggered by unrelated things going wrong because that triggers their feelings of helplessness.

When children are triggered then their behavior tends to reflect the fact that they are experiencing similar feelings to the ones they felt during the assaults. Parents should be encouraged to discuss with the child what sort of things trigger them, so they are all aware of situations when it may occur.

The behaviors that children exhibit after sexual assault do tend to pass in time as children regain a sense of safety and self control. When the feelings that drive the behavior are explored, they become less powerful and the behavior becomes more manageable. Establishing a link between the feeling and the behavior is important as it gives you an understanding of what is happening.

Children can and do recover from sexual assault. The long term effects of sexual assault are often caused by secrecy, fear and denial of feelings. The more open and honest you can be about what happened the easier it is for children to be the same and the quicker the recovery.

From: http://www.secasa.com.au/index.php/family/13/44

Psychological Effects of Child Sexual Assault

Child sexual assault can have a number of effects both physical and psychological that last both in the short term and the long term. Outline below are some common effects which can occur as a result of childhood sexual assault.

Psychological Effects:

Fear. The offender may swear the child to secrecy and say something bad will happen if they tell. Coercion, bribery, or threats usually accompany sexual abuse. Overwhelmingly, the child is afraid to tell be cause of what the consequences might be, such as punishment, blame, not being believed, and ultimate rejection or abandonment.
Helplessness/Powerlessness. Children in this situation often feel that they have no control over their own lives or even over their own bodies. They feel that they have no choices available to them.
Guilt and Shame. The child knows something is wrong, but blames him or herself, not others. The offender will often encourage the child to feel that the abuse is his or her fault and as a consequence, is a “bad” person.
Responsibility. The offender coerces the child to feel responsible for concealing the abuse. The child then believes they are responsible for preserving the secret in order to keep their family together and to maintain appearances at all costs. The burden of this responsibility interferes with all normal childhood development and experiences.
Isolation. Incest victims feel different from other children. They must usually be secretive. This further isolates them from non-offending parents and brothers and sisters. This isolation often leads to the child being labeled as “different,” “a problem,” or in some way different from their siblings.
Betrayal. Children feel betrayed because they are dependent upon adults for nurturing and protection and the offender is someone who they should be able to love and trust. They may also feel betrayed by a non-offending parent who they believe has failed to protect them.
Anger. Children most often direct their feelings of anger in several ways.

1. They may direct it outward at perceived “little things.”

2. They may direct it inward, affirming their feelings of low self worth/value.

3. Almost never direct their anger towards the abuser while still in a relationship with them. Anger is most often dealt with as an adult.

Sadness. Children may feel grief due to a sense of loss, especially if the perpetrator was loved and trusted by the child.
Flashbacks. These can be like nightmares which happen while the child is awake. They are a re-experience of the sexual assault as it occurred at that time. As an adult, a survivor may experience the same type of omnipotent fear that they experienced as a child. Flashbacks can be triggered by many things. By a smell, a mannerism, a phrase, a place, or a wealth of other environmental factors that may have significance.

From: http://www.secasa.com.au/index.php/survivors/5/145

Adult Survivors of Childhood Sexual Assault

There are many reactions that survivors of rape and sexual assault can have. But for adult survivors of childhood abuse there are reactions that may either be different or stronger than for other survivors. These include:

Setting Limits/Boundaries

Because your personal boundaries were invaded when you were young by someone you trusted and depended on, you may have trouble understanding that you have the right to control what happens to you.

Memories/Flashbacks

Like many survivors, you may experience flashbacks.

Anger

This is often the most difficult emotion for an adult survivor of childhood sexual abuse to get in touch with.
As a child your anger was powerless and had little to no effect on the actions of your abuser. For this reason you may not feel confident that your anger will be useful or helpful.

Grieving/Mourning

Being abused as a child means the loss of many things- childhood experiences, trust, innocence, normal relationship with family members
- You must be allowed to name those losses, grieve, and then bury them.

Guilt, Shame, and Blame

You may carry a lot of guilt because you may have experienced pleasure or because you did not try to stop the abuse.
There may have been silence surrounding the abuse that led to feelings of shame.
It is important for you to understand that it was the adult who abused his/her position of authority and should be held accountable, not you.

Trust

Learning to trust again may be very difficult for you.
You may go from one extreme to the other, not trusting at all to trusting too much.

Coping Skills

You have undoubtedly developed skills in order to cope with the trauma.
- Some of these are healthy (possibly separating yourself from family members, seeking out counseling, etc.)
- Some are not (drinking or drug abuse, promiscuous sexual activity, etc.)

Self-esteem/Isolation

Low self-esteem is a result of all of the negative messages you received and internalized from your abusers.

Because entering into an intimate relationship involves trust, respect, love, and the ability to share, you may flee from intimacy or hold on too tightly for fear of losing the relationship.

Sexuality

Your first initiation into sex may have been nonconsensual.
You may experience the return of body memories while engaging in a sexual activity with another person. Such memories may interfere in your ability to engage in sexual relationships which may leave you feeling frightened, frustrated, or ashamed.

http://www.rainn.org/get-information/effects-of-sexual-assault/adult-survivors-of-childhood-sexual-abuse

Filed under Children Tagged with Abuse, Child abuse, Child sexual abuse, Rape, Sexual abuse, Sexual assault, Support Groups, Violence and Abuse

Signs of Child Sexual Abuse

March 30, 2011

Signs of Child Sexual Abuse

Child sexual abuse is the exploitation of a child for the gratification or profit of an adult. Sexual abuse can range from exhibitionism and fondling to intercourse or use of a child in the production of pornographic materials. Sexual abuse also may result in physical injury or be accompanied by other signs of abuse or neglect. Sexual abuse generally is perpetrated by someone known to the child and frequently continues over a prolonged period of time. Often it does not involve sexual intercourse or physical force. The incidence is estimated at 100,000 to 250,000 cases per year; however this type of abuse is difficult to detect and confirm.

PHYSICAL SIGNS

Any of the following physical signs may indicate abuse:

Difficulty in walking or sitting
Thickening and/or hyperpigmentation of the labial skin (especially when it resolves during out-of-home placement)
Horizontal diameter of vaginal opening that exceeds 4mm in prepubescent girls
Torn, stained, or bloody underclothing
Bruises or bleeding of the genitalia, perineum, or perianal area
Vaginal discharge and/or pruritus
Recurrent urinary tract infections
Gonococcal infection – Pharynx, Urethra, Rectum, Vagina
Syphilis
Genital herpes
Trichomonas
Chlamydial infection when resent beyond first six months of life (may be present at birth up to 6 months)
Lymphogranuloma venereum
Nonspecific vaginitis
Candidiasis
Pregnancy
Sperm or acid phosphatase on body or clothes; sperm in the urine of a female child
Lax rectal tone

BEHAVIORAL SIGNS

Children may display a wide range of psychological reactions to sexual abuse. Reactions depend on the age of the child, emotional maturity, nature of the incident, duration of sexual abuse, and the child’s relationship to the offender. The child may:

Confide in a relative, friend, or teacher; the disclosure may either be overt or subtle and indirect
Become withdrawn and daydream excessively
Evidence poor peer relationships
Experience poor self-esteem
Seem frightened or phobic, especially of adults
Experience distortion of body image
Express general feelings of shame or guilt
Exhibit a sudden deterioration in academic performance
Show pseudomature personality development
Attempt suicide
Exhibit a positive relationship toward the offender
Display regressive behavior
Display enuresis (wetting self) and/or encopresis (soiling self)
Engage in excessive masturbation
Engage in highly sexualized play
Become sexually promiscuous
Have a sexually abused sibling.

Filed under Children Tagged with Child abuse, Child sexual abuse, Crime, Rape, Sexual abuse, Sexual assault, Sexual intercourse, Support Groups

Working with Children Living with Domestic Violence

March 30, 2011

An image of a child being spanked by a man while in the background a woman is being hit by another man with a stick. Image via Wikipedia

The published research on children’s exposure to domestic violence focuses largely on two aspects of their experience: the trauma of witnessing physical assaults against their mothers, and the tension produced by living with a high level of conflict between their parents (e.g. Rossman, Hughes, & Rosenberg, 2000). As important as these factors are, they are in fact only two aspects of many complex problems that typically pervade the children’s daily life. The bulk of these difficulties have their roots in the fact that the children are living with a batterer present in their home. The parenting characteristics commonly observed in batterers have implications for the children’s emotional and physical well-being, their relationships with their mothers and siblings, and the development of their belief systems.

The Batterer’s Parenting Style

Authoritarian
Under involved
Undermining of mother’s authority
Undermining of mother’s parenting in multiple ways
Limited sense of age-appropriateness
Use the children as weapons
Good under observation
Tend to see children as personal possessions
Rarely improve post-separation (typically get worse)
High risk of child abuse

Batterers’ Risk to Abuse Children

Physical Abuse

50-70% of batterers abuse children
7 times more likely than an non-batterer
Correlated with level of physical abuse of partner
Other indicators: level of control, substance abuse, rigid belief-system, abused as a child

Sexual Abuse

2-5% of batterers will sexually abuse children
6 times more likely than a non-batterer
Correlated with presence of violence towards partner but not with severity
Other indicators: high entitlement, self-centered, use of children to meet his own needs, manipulative, seeing the children as personal possessions, substance abuse

Psychological Abuse

Generally present to some degree

From: MCADSV New Service Provider Training Manual and Resource Guide who cites:

The Parenting of Men Who Batter, and The batterer as Parent: Addressing the Impact of Domestic Violence on Family Dynamics by Lundy Bancroft, © 2002. Published in Court Review, Vol. 36, No. 2, 44-39.

Filed under Children Tagged with Abuse, Child abuse, Domestic violence, Physical abuse, Psychological abuse, Sexual abuse, Violence, Violence and Abuse

Sexual Assault: Coping Mechanisms

March 15, 2011

Survivors of sexual assault, childhood sexual assault, and domestic violence often will incorporate any number of coping mechanisms to deal with the pain, anger, sadness, and confusion. Coping mechanisms serve to protect the individual from the overwhelming emotions, which naturally occur after being hurt in this way. Here is a list of some of these coping mechanisms:

Minimizing
Rationalizing
Denying
Forgetting
Splitting
Dissociation (leaving the body)
Chaos
Spacing out
Hyper-vigilance
Humor
Busyness
Self-destructive behaviors
Addiction
Isolation
Eating disorders
Lying
Stealing
Gambling
Avoiding intimacy
Sexual compulsion or avoidance

Fear: Responses vs. Coping Mechanisms from Exchange of Realities (exchangeofrealities.com)

Filed under SexualAssault Tagged with Coping, DomesticViolence, Rape, Sexual abuse, Sexual assault, Support Groups, Violence and Abuse

(Sexual Assault/Domestic Violence) Survival Strategies of Children and Teenagers

March 15, 2011

Survival Strategies of Children & Teenagers

from http://www.lfcc.on.ca/HCT_SWASM_18.html

When faced with a difficult situation, children “cope” by coming to an understanding (possibly distorted) about what is happening and dealing with the flood of hurtful emotions. Their strategies can involve feelings (emotional), thoughts (cognitive), or actions (behavioural).

Some strategies are helpful

examples are seeking peers or supportive adults to talk about the feelings
young children cannot easily engage in healthy strategies and need adults to buffer them from the harmful consequences of family adversities such as violence

Some strategies are helpful but costly

strategies may be helpful during a crisis but not healthy in the long run, such as emotional numbing, self-injury, substance use, having a baby to escape the family, or being an emotional caretaker for a parent
these strategies can be a response to a variety of family adversities, including violence and maltreatment
an objectively helpful strategy may not “work” while some objectively unhealthy strategies did do
they help a child get through a time of stress or crisis, such as when there is violence in the home
however, if used after the crisis is over, or in other circumstances, these strategies may create problems
the longer a strategy is used, or the more effective it is in shielding a youth from overwhelming emotions and hurt, the harder it may be to extinguish

Once the family is safe, gradually extinguishing strategies with negative effects and replacing them with healthier strategies may be the key to helping children who have lived with family adversities such as violence.

These are some coping strategies commonly observed in children and teenagers who have lived with violence and maltreatment. Remember that coping styles vary with age.

Mental Blocking or Disconnecting Emotionally

numbing emotions or blocking thoughts
tuning out the noise, learning not to hear it, being oblivious
concentrating hard to believe they are somewhere else
drinking alcohol or using drugs

Making it Better Through Fantasy

planning revenge on abuser, fantasizing about killing him
fantasizing about a happier life, living with a different family
fantasizing about life after a divorce or after the abuser leaves
fantasizing about abuser being “hit by a bus”
hoping to be rescued, by super heroes or police or “Prince Charming”

Physical Avoidance

going into another room, leaving the house during a violent episode
finding excuses to avoid going home
running away from home

Looking for Love (and Acceptance) in all the Wrong Places

falling in with bad friends
having sex for the intimacy and closeness
trying to have a baby as a teenager or getting pregnant as a teen to have someone to love you

Taking Charge Through Caretaking

protecting brothers and sisters from danger
nurturing brothers and Sisters like a surrogate mother / taking the “parent” role
nurturing his or her mother

Reaching out for Help

telling a teacher, neighbour, or friend’s mother
calling the police
talking to siblings, friends, or supportive adults

Crying out for Help

suicidal gestures
self-injury
lashing out in anger / being aggressive with others / getting into fights

Re-Directing Emotions into Positive Activities

sports, running, fitness
writing, journalling, drawing, acting, being creative
excelling academically

Trying to Predict, Explain, Prevent or Control the Behaviour of an Abuser

thinking “Mommy has been bad” or “I have been bad” or “Daddy is under stress at work”
thinking “I can stop the violence by changing my behaviour” or “I can predict the violence”
trying to be the perfect child
lying to cover up bad things (e.g., a bad grade) to avoid criticism and worse

Handout for Women

How my Child or Teen Copes (pdf link to off-site page)

Help women use this sheet to identify coping strategies of each of her children (this exercise will not be helpful for babies, toddlers, or most pre-schoolers). Distinguish between those used in response to violence in the past and those still used today. The group can brainstorm specific ways to encourage healthy strategies.

Want to know more?

Alison Cunningham & Linda Baker (2004). What About Me! Seeking to Understand the Child’s View of Violence in the Family. London ON: Centre for Children & Families in the Justice System.

Filed under Children, SexualAssault Tagged with Abuse, Behavior, Child abuse, Children, DomesticViolence, Family, Rape, Relationships, Sexual abuse, Sexual assault, Violence, Violence and Abuse, Women

What you might be feeling after sexual assault

March 15, 2011

What You May Be Feeling
Survivors of sexual assault experience a wide range of reactions. Some have said that after the assault their emotions go up and down from one extreme to another. It is important for you to know that what you are feeling and thinking right now is okay. Your reactions are your own way of coping with the crime that has been committed against you. There is no standard response to sexual assault. You may experience a few, none or all of the following emotions.

SHOCK AND NUMBNESS: Feelings of spaciness, confusion, being easily overwhelmed, not knowing how to feel or what to do. You may react in a way that is similar to your reactions during other crises in your life, for example, with tears, irritability, nervous laughter or withdrawing.
WHAT YOU CAN DO: Be aware that these are normal reactions to trauma. Each person handles crisis differently, so think of things that helped you get through crises in the past. Get help to sort out what you would like to do and how you may want to organize you time, thoughts and decisions. Be compassionate toward yourself; give yourself time to heal.

LOSS OF CONTROL: Feeling like your whole life has been turned upside down and that you will never have control of your life again. Your thoughts and feelings seem out of control.
WHAT YOU CAN DO: Try to get as much control over your life as soon as you possibly can, even on small things. Ask for information that may help you sort out your thoughts and feelings. Use outside resources, such as counselors and legal professionals. Ask how other people have handled similar situations. Try to make as many of your own decisions as possible. This may gradually help you regain a sense of control over your own life.

FEAR: Fear that you assailant may return; fear for your general physical safety; fear of being alone; fear of other people or situations that may remind you of the assault.
WHAT YOU CAN DO: If you want company, do not hesitate to ask people who you trust to be with you day and night. You may want to make your physical environment feel more safe such as moving, making your home more secure or getting to know your neighbors better.

GUILT AND SELF-BLAME: Feeling like you could have or should have done something to avoid or prevent the assault; doubts regarding your ability to make judgments.
WHAT YOU CAN DO: No matter what the situation was, you did not ask to be hurt or violated. Blaming yourself is sometimes another way to feel control over the situation, thinking that if you avoid similar circumstances, it will not happen to you again.

ISOLATION: Feeling that this experience has set you apart from other people; feeling that other people can tell you have been sexually assaulted just by looking at you; or not wanting to burden other people with your experience.
WHAT YOU CAN DO: Recovering from an assault can be a very lonely experience. However, you are not alone in what you are feeling. You may find it reassuring to talk to others who have been assaulted, or to a counselor at you local Rape Crisis Center who has worked with other sexual assault survivors.

VULNERABILITY, DISTRUST: Feeling that you are at the mercy of your own emotions or the actions of others; not knowing who to trust or how to trust yourself; or feelings of suspicion and caution.
WHAT YOU CAN DO: Trust your instincts about who you want to talk with about what happened with you. Try to talk with people whom you have found to be the most dependable in the past; select those who have been good listeners or are non-judgmental. Feelings of general suspicion may subside as you begin to find people you can trust.

SEXUAL FEARS: Feeling that you do not want to have sexual relations; wondering whether you will ever want or enjoy sexual relationships again; fears that being sexually intimate may remind you of the assault.
WHAT YOU CAN DO: Try to tell your partner what your limits are. Let your partner know if the situation reminds you of the assault and may bring up painful memories. Let your partner know that is the situation — not him/her — that is bringing up the painful memories. You may feel more comfortable with gentle physical affection. Let your partner know what level of intimacy feels comfortable for you.

ANGER: Feeling angry at the assailant. You may find yourself thinking about retaliation. You may be angry at the world since you no longer feel safe. You may be angry that your faith did not prevent this.
WHAT YOU CAN DO: Although these are common reactions, they can be quite disturbing. Take things very slowly. Some people find it helpful to keep a notebook at hand to write down feelings, thoughts, ideas, or details of the assault; keeping the thoughts and feelings in one place makes them feel more manageable.

An excerpt this information from the publication, “A Handbook For Survivors Of Sexual Assault.”

Filed under SexualAssault Tagged with Sexual abuse, Sexual Abuse and Assault, Sexual assault, Survivors, Violence and Abuse

Adult Survivors of Childhood Sexual Assault

March 15, 2011

Adult Survivors of Childhood Sexual Assault

CAVEAT: The following descriptions are meant to serve as a general guideline for how a victim of sexual assault might react in a time of pain or crisis. It is important to recognize, however, that each victim of sexual assault will have his or her own life experiences and personality that will influence how he or she react to the assault.

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