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Introduction to Sexual Abuse

Normal Child Sexual Development

Signs and Symptoms of Sexual Abuse

Impact of Child Sexual Abuse

Addressing Sexualized Behavior Problems

Treatment of Sexually Abused Children

Preventing Allegations

Sexual Abuse can be a difficult subject that might bring up your own emotions. Let's face it, this isn't an easy topic to discuss and it can leave us feeling sad or upset. If you find yourself feeling this way, please feel free to take breaks away from the group as needed.

Explicit words may be used and encouraged today, but our children need to learn the correct terms for sexual functions and body parts. We encourage you to develop some comfort level with the language so that you can better support the children in your care.

Discuss your thoughts on the following questions.

1. What is your comfort level when dealing with sexual issues and sexualized behaviors?

 

2. Which behaviors bother you more than others? (For example, a child masturbating in public, exposing him or herself to other children, touching your body or using sexual slang language)

 

3. Imagine yourself as child: What messages about sex and sexuality were you given? What were

Compare that to: What is healthy sexuality? Sex is pleasurable, fun and can be for the purposes of recreation, building intimacy or having children. Wide ranges of sexual activities exist and are considered healthy as long as the partners are consenting.

We bring our own history and biases to our discussions with children about sex and sexualized behavior. Our own experience and beliefs influence the way we deal with children's sexualized behavior

Group Discussion:

 1) What kind of behaviors do you think are sexually abusive? Does touching actually have to take place for a child to have been sexually abused?

 People enjoy a vast variety of sexual behaviors. We may have strong feelings about what constitutes healthy sexuality and what falls outside generally accepted norms. For our the purposes of our discussion, we consider the legal definition of sexual abuse to be:

• Unlawful sexual intercourse with a partner 10 years older. For example, a 17 year old with a 27 year old. Statutory rape charges can be brought against any adult involved in a sexual relationship with a youth under age 18.
• Unlawful sexual intercourse with a child under 16 years of age when the partner is over 21. For example, a 15-year-old boy and a 22-year-old woman.
• Penetration of the vagina or rectum by an object.
• Masturbation, sadomasochistic abuse or exhibition of genitals or rectal areas for the purposes of sexual stimulation.
• Lewd or lascivious acts upon a child under age 14, for example, showing child pornography or having them watch while adults engage in sexual activities. Includes taking pornographic pictures of a child.
• Can include any combination of contact among genital, mouth or anal areas.

The range of sexual behaviors in children is wide, and not all children will engage in the same behaviors. Differences may come from the amount of exposure the child has to adult sexuality (for example, TV shows, adult nudity, explicit videos).

Even sexually abused kids will exhibit some normal sexual behavior and play. It is important not to jump to conclusions about a child's sexual play, even when they have been abused. Always ask your social worker if you have concerns.

Preschool children: Aspects of sexuality in small children are related to curiosity and exploration. They are very curious about gender differences and will ask a lot of questions. They also don't have the concept of gender permanency. For example, girls will want to know what happened to their penis or boys will say they want to grow up and have a baby, just like mom.

Preschool children may not understand the concept of "private parts" and privacy. They are uninhibited and may do things like masturbating or fondling themselves in the living room. The response that you make will contribute to their attitudes about their own sexuality and comfort later. Teaching kids about their private parts, what they are called and appropriate touches are very important. You must decide as parents, how to respond to your child's sexual behaviors, but responses should be non-reactive and accepting. Examples are, "Your private parts are only touched by you and only in private." Shaming could cause them to identify sexuality, body parts, and their body image in a negative light.

Young school age children are also interested in the above, along with "dirty" words, books, dancing, touching and pictures. They like to say things like "poop" and have farting contests. They might engage in masturbation or in-group behaviors such as playing doctor or house with more sexual themes. Normal children engage in "sex play" as part of natural exploration and are generally silly and giggly during the activity.

Handout #1

Adapted from Child Behavior, Francis Ilg and Louise Ames.

Handout #2

A child focuses on sexuality to a greater extent than:

-Other areas of the child's environment

-Other developmentally matched peers

A child is admonished about certain behaviors, yet continues.

A child does not seem to understand that the overt display of sexual behaviors is uncommon.

Asks people to remove their clothes or tries to forcibly undress others.

Sexual knowledge too advanced for their age.

Smearing feces.

Puts objects in rectum or vagina of self or others after being told not to.

Humping other children with clothes simulated or real intercourse with another nude child.

There is secrecy, anger, anxiety/tension, fear, coercion, force, or compulsive interest in activity related to sex and sexuality.

A child's sexual behavior does not "go underground" as is normal when children learn that many adults are un-accepting of much of their overt exploration.

Sexual behaviors are engaged with between children of more than 3 year's age difference.

A child asks unfamiliar children or children who are uninterested to engage in sexual behavior.

A child consistently dominates and controls sexual interactions.

Other children complain about the child's sexual behavior.

 Adapted from Toni Cavanagh Johnson, Ph.D.

Handout #3

This is not a complete list but highlights common symptoms. Symptoms may differ depending on age and developmental level. Some children are symptom-free for long periods of time. Some symptoms more strongly indicate a history of sexual abuse, such as promiscuity. These "abuse-specific" indicators are starred. The other symptoms accompany many types of trauma, stress or other major problems. Having one or more symptoms does not necessarily prove that a child has been sexually abused, however, it is likely a combination of "abuse-specific" and other symptoms indicate that abuse has occurred.

The impact of sexual abuse on children may vary depending on many factors:

• Severity of abuse
• Duration
• Number of perpetrators
• Age of onset
• Relationship of child to perpetrator

Sexual abuse has a negative impact, even if it was "only one time". The impact may be greater if the perpetrator was a trusted adult such as a parent, relative or minister. Other factors contribute to the impact of trauma, like the child's own coping mechanisms or whether a trusted adult helped and believed in the child.

Child abuse in general can leave a scar that is carried out through life. Eighty-five percent of convicted felons were abused as children. Many victims grow up and continue the cycle by abusing their own or other children, or by allowing others to abuse their children.

Adults abused as children often develop a "blind spot" and become involved with people who abuse them and their children. Even though they don't like the behavior, it is what they know and they may unconsciously seek it out in partners.

Sexual abuse can destroy a person's ability to form healthy loving relationships. The majority of abused children knew and trusted their abuser. When someone who supposedly cared for him or her broke this trust, they learned not to trust.

Children are also torn between love and loyalty for a family member and the sense that the sexual activities are terribly wrong. If the child tries to break away from the sexual relationship, the abuser may threaten the child with violence or loss of love. Within a family, the child may fear the anger, jealousy or shame of other family members. Or they might fear breaking up the family or being rejected.

Sexually abused children may believe that their only value is in being a sexual object. They may become sexually promiscuous, seeking sexual relationships as a means to obtain "love".

Some children seek to experience the power of being an abuser or come to identify with them. As a result, they might become perpetrators themselves, which requires very close supervision of their activities with other children, especially younger children and perhaps even pets and animals.

Many children think that the non-abusive parent or other adults know about the abuse but choose to do nothing about it or don't care. For some of our foster children, this may have been true, which communicates to the child that the abuse is allowed, normal or that adults don't care about what happens to them. The non-abusive parent may have been afraid to confront the abuser for numerous reasons. They may include fear of financial hardship, loneliness, rejection or being abused themselves.

Handout #4A

Adapted from: A Source Book on Child Sexual Abuse

Finkelhor, D., Araji, S. Baron, L., Browne, A., Peters, S., Doyle, W., & Gail, E., 1986, Newberry Park, CA.

Sage Publications.

Handout #4B

Children often feel responsible for their own abuse. They think that everything revolves around them and that they should have control over it. Many children believe that they must have asked for the abuse, somehow.

When working with abused children, assure them that the perpetrator was solely responsible and they were not. Understand that the child may be experiencing intense feelings of guilt and shame over what happened. Help them to understand that these feelings are completely normal, but assure them that they did nothing to cause the abuse to occur and it is no way their fault.

Some children agreed to the abuse because of threats or the belief that other family members might be hurt as well. For example, they were told: I will kill your mommy if you don't do what I want. You'll go to jail if people find out. If you don't do this, I'll do it with your little sister instead.

Kids may have liked some of the attention, affection or gifts that came with the sexual abuse. It is normal for children to want to feel special or noticed. The abuser used this natural need within children to exploit them.

Children who feel "tricked" into sexual behavior with an adult may feel angry with themselves and with the adult. Therefore, they might have a hard time developing trusting relationships with other adults. Their strong sense of betrayal and outrage should be respected.

Handout # 5

Decide whether the following statements are true or false.

Sexually abused children are often extremely curious, confused and preoccupied with sexual matters. They often have an unhealthy sense of boundaries. They may express their sexual feelings inappropriately toward adults or other children. They may try to solicit sexual interactions with others. They might use "dirty" words to describe their abuse or to express their outrage and hurt feelings.

Boys who have been sexually abused by a male face the additional stigma of homophobia. Boys may begin to question their own sexuality or others may accuse them of being homosexual. If abused by an older female, he may not be taken seriously, given the "locker-room" mentality of friends who may respond by feeling the boy has "scored" with a woman. Boys often act out after having been sexually abused with behaviors such as fire setting, animal cruelty or becoming perpetrators themselves. Girls tend to act out sexual abuse by becoming promiscuous or scratching, burning or cutting themselves (i.e., self-mutilating behaviors).

As foster parents, it is your job to provide support, teach the children values, support them in therapy and maintain close supervision of their activities, especially those involving other children. Sexually abused children's behaviors may shock and disturb you, but you will help most by remaining calm and having insight into the underlying hurt, anguish and fear. Remember that the sexually acting out child demonstrates behaviors they have been taught, and those resulting from how they feel about themselves.

Handout #6

How would you handle the following scenarios? What would you say? Who would you need to contact, if anyone. What would you want the child to learn from you about this behavior?

1. Eleven-year-old Timmy masturbates in the living room in front of your four-year-old daughter.

 

 

 

 

 

2. Five year old Tanya hugs every new person she meets and tells them she loves them.

 

 

 

 

 

3. Your 7-year-old foster son keeps trying to touch your breasts and puts his hands up your shirt.

 

 

 

 

 

4. Your 3-year-old foster daughter climbs onto your lap and starts bouncing up and down. She tells you this is a special game her grandpa used to play with her.

 

 

 

 

 

5. You find your daughter and the neighbor girl under the covers in bed. When you ask them what they are doing, they look very startled and say, "We are just playing the game."

Therapeutic parenting means giving care and guidance to children in a way that promotes healing and recovery. When foster parents ignore or punish difficult behaviors, it only makes the problem worse. Therapeutic parenting increases a child's sense of personal safety and control. As a result, they become more capable of getting along with others. They need support in response to issues of fear, anxiety, anger and sexuality.

• Give children some control over events and activities that make them feel anxious and unsafe. Utilize clear house rules to keep everyone safe.
• Recognize that behavior problems may come from their history of sexual abuse.
• Understand that sexual abuse may cause children to express justifiable feelings in harmful ways.
• Affirm a child's feelings but not their expression when children behave inappropriately.
• Set and enforce firm limits on inappropriate sexualized behavior.
• Provide safe ways for children to express their feelings related to their history of sexual abuse.
• Praise children as they gain self-awareness, self-control, and skill in redirecting their feelings in healthier ways.

(Adapted from www.fosterparents.com, Sexual Abuse Training)

Patricia Ryan, PhD., has developed some simple techniques to use when confronting a child's sexual acting out behavior. (Write on the board or easel for group viewing).

1. Stop the behavior by telling them to stop, changing the environment, separating the children or redirecting their attention to another activity.
2. Define the behavior. "You are touching Sam's private parts" or "You are masturbating in front of other people".
3. State the house rule. "We don't allow children to touch each other's private parts" or "We masturbate only in private, in our bedrooms:"
4. Enforce Consequences or Redirect the child. "Come out of the bedroom so that I can be sure you're playing safely with each other," or "Why don't we go (do a project, go swimming, start dinner) together."

Handout #7

Use a calm, soothing approach. What happened is not as important as how you handle it.

Communicate your interest and concern in the child as a person. Don't respond in an overly shocked manner, or the child might stop talking and/or feel guilty.

Do express your feelings of sadness and empathy about what happened to them. Demonstrate caring and warmth.

Indicate your willingness to help them by providing support and reassurance.

Encourage them to talk and to share their feelings.

If the child becomes progressively more upset as they are talking about the incident(s), you can guide the conversation away. Assure the child that he or she can talk to you any time or that there are other adults who want to help and would also listen (for example, their social worker or a therapist).

Inquire gently and in a matter-of-fact way. Avoid overwhelming the child with your own anxiety. Do not interrogate.

Let the child express things in his or her own way. Try to use the same words that the child is using (mirror what they are saying).

Sometimes younger children can express themselves better by drawing pictures.

If a child starts by asking questions, keep responses brief. Be aware that the child might just be seeking reassurance or seeing if you are going to be supportive if they choose to confide in you.

Believe what you are hearing. Hear the child in a non-judgmental way.

Do not avoid subjects the child brings up, even if you find the subjects embarrassing. Let the child know that everything can be discussed.

Let the child tell their story without you making assumptions or jumping to conclusions.

Ask the child if he or she has told anyone else before. If so, find out what happened. File a child abuse report if appropriate. Be sure to tell your FamiliesFirst social worker, even if you think they must already know.

Find out what the child wants and openly explain any action you'll be taking. Never promise a child that what he or she tells you will stay between you. This is a promise you cannot keep.

(Adapted from www.fosterparents.com, Sexual Abuse Training)

Handout #8

Bedrooms: Bedrooms and nighttime may be an anxious time for children, especially if they were abused in their own bedrooms. Children should not share beds. Adults should knock before entering the bedroom. Care should be taken when "tucking in" a child to ensure that children are not misinterpreting your actions. Leave lights on and doors open if the child is fearful.

Privacy: Teach children the importance of privacy and allow everyone in the family some sense of privacy. Do not search drawers or read diaries without permission.

Around the house: Keep clothing on and avoid walking around nude or in underwear, which may be too stimulating or lead to mixed messages for children who are confused about their sexuality.

Horseplay: Reduce or eliminate horseplay and wrestling, which may lead to more coercive behaviors or intimate sexual touch between children or children and adults.

Sexual Talk: Monitor sexual talk between children in the home. Talk openly about sexuality, but ensure it is developmentally appropriate and respectful. Be aware that sexually stimulating television or reading materials can increase the tendency towards aggression in children.

Physical Punishment: Do not use corporal forms of punishment or other shaming or humiliating punishments in response to a child's misbehavior.

Supervision: You must provide intensive supervision at all times. Do not leave a child who sexually acts out alone with younger children.

Personal Touch: Ask permission to touch your foster child. Go slow, teaching them appropriate ways to touch family members and to gain positive attention. Never cajole children into unwanted hugs or physical affection with either yourself or others (i.e., grandparents, teachers or other adults).

Teach your children the house rules, and then stick to them!

Sexually abused children need therapy to deal with complex issues. Therapy can provide support not only to the child but also to the family. Therapy for children usually involves a lot of play, so it is confusing for adults who feel the child may not be really "working" toward healing. Kids often don't have the words to directly express themselves or their feelings. This may be particularly true if a child was abused before they had acquired the language to describe or label what was happening to them.

Children use play to communicate their feelings, thoughts and memories. They use toys such as puppets, art and games to act out feelings they can't explain or describe with words. The therapist interprets what they are doing and helps the child learn to use words to express their feelings in a constructive and healing way.

In play therapy, children often re-create the abusive events over and over until it doesn't hurt as much. In this way, they might also avoid "taking it out" on others at home or in the community. In play therapy, children work through disturbing material in the security of a quiet therapy room, with an objective and supportive witness who can help them label and process their very difficult feelings.

Therapy with abused kids can take years. The problems that develop from abuse are very complex, and since they involve fundamental issues such as trust, self-esteem and self-acceptance, there is no quick fix. As a foster parent, you can help by allowing a child to talk to you about their abuse and help them understand that it was not their fault.

It is important that siblings of child abuse victims also be treated, even if they weren't abused themselves. Why?

• They might also have been abused but have not yet revealed it.
• They may feel guilty for not protecting their sibling from abuse (survivor guilt).
• They might be angry with their sibling for telling on the perpetrator, especially if it breaks up the family.
• They might be jealous of the attention the victim is receiving.
• When all involved parties talk openly about the abuse that has occurred, it can no longer continue.

Abused children sometimes use false allegations as a way to punish their foster parents or to manipulate the foster care system. Sometimes they make allegations because they have misinterpreted your behavior toward them or another child in the home.

The best way to avoid false allegations is to utilize and stick to house rules. It is most important to keep good documentation and maintain a good, open relationship with your social worker. Lastly, it is important to support children in any kind of therapy and sex education in which they are participating.

Handout #9

• Utilize house rules consistently
• Ensure your behavior is above reproach.
• Get as much information about a child before placement in your home.
• Do not leave a child who sexually acts out alone with another child.
• Do not use physical punishment of any kind.
• Be clear about rules of privacy and touching.
• Record any sexually acting out in writing and report it to your social worker.
• Take care of yourself to reduce stress.
• Address issues immediately when they happen.
• Avoid behavior that can be misinterpreted such as tickling, horseplay, teasing, suggestive language or intrusive or unwelcome touch.