Creating a Safe Place for Children
New research reminds us of the need to listen to children about sexual abuse.
Posted Nov 05, 2019
Recent research conducted by Helton et al. (2019) suggests that over the past several years, there has been a 70% increase in child sexual abuse cases treated in emergency departments. More specifically, the findings indicate that the number of child sexual abuse admissions increased from 5,138 in 2010 to 8,818 in 2016.
Although the findings demonstrate an increase in ER admissions, the research does not explain why this increase is occurring. Perhaps it is because of an increase in child sex trafficking or exploitation, limited options in rural locations to obtain sexual abuse support (Helton et al., 2019), or perhaps it is because of an increase in children disclosing over the past several years. The causal factors are not yet known; but what these findings do tell us, is that we need to listen to children about sexual abuse.
Sexual abuse in children is an immense problem. Although some sources suggest that child sexual abuse rates may be decreasing, other estimates suggest that as many as 1 in 10 children (Townsend & Rheingold, 2013) or as many as 1 in 4 girls and 1 in 6 boys may experience sexual abuse (Finkelhor, 2014). Making matters more complicated, childhood sexual abuse is vastly under-reported; making accurate statistics a challenge. As such, we do not know the precise level of impact it has on our society.
What we do know is that sexual abuse is an issue that affects everyone and has a devastating impact on individuals, families, and communities. In particular, sexual abuse can have especially heinous impacts on the child survivor including increased rates of depression, shame, self-blame, decreased self-esteem, eating disorders, somatic concerns, anxiety, dissociative patterns, substance abuse, Post-Traumatic Stress Disorder and traumatic stress, relationship problems, and more (Ferguson et al., 2013; Hall & Hall, 2011).
Understandably then, the recent research conducted by Helton et al. (2019) reveals a need for continued prevention efforts against childhood sexual abuse. Additionally, these findings remind us that there are many children who experience sexual abuse and need a safe place to disclose their traumatic experiences and obtain support. Although this research demonstrates that a number of children do disclose and obtain help, the reality remains that this is not true for many others.
According to the World Health Organization Guidelines for Medico-Legal Care for Victims of Sexual Violence, a large barrier in obtaining support for children is that children are often reluctant to share about their abuse. This can be because of feelings of helplessness, fear of repercussion, fear of not being believed, or even fear of getting the perpetrator in trouble (particularly if the perpetrator is a caregiver or known to the child). Further, if a child discloses the assault and is not believed or supported adequately, this can lead to increased distress for the child (World Health Organization).
Therefore, these new findings remind us that creating a safe place for children to disclose their adverse experiences is essential. Creating this safe place starts with educating ourselves around the issue and on what steps we can take in supporting children if they disclose abuse. An important aspect to consider is that disclosures from children may come in different forms than expected. For example, the disclosure may be purposeful or accidental, they may involve direct disclosures or indirect disclosures, and often can come in coded or disguised words (especially in younger children as the child tries to use their limited vocabulary or understanding to share what happened to them).
Whether we are parents or concerned citizens, there are some steps we can all take to create a safe space for the children in our lives:
- Develop an understanding of child abuse and neglect.
- Educate children about their body parts and which parts are theirs and should not be touched by others.
- Educate children on their body parts teaching them the correct anatomical words for body parts (e.g. vagina and penis) versus other covert words that may be more challenging to understand if disclosures occur.
- Educate children on their ability to say “no” and set boundaries (with everyone).
- Take what children share with you seriously and do not dismiss them (regarding all matters). This will set a precedent for children to know that you are someone who listens to them.
- If you see something (e.g. wounds that look mysterious, a child acting differently, etc.), say something. Do not wait to report issues or get seek support for a child until you are "sure" that something happened.
If a child does disclose abuse:
- Be supportive and tell them that you believe them.
- Reassure the child that they did nothing wrong and that you are there for them.
- Listen and do not ask leading questions. This can distort the child’s story and make them uncomfortable or feel interrogated. It is not your job to get all of the details.
- Breathe. Do not panic. This is a terrifying and distressing experience, but the child needs a calming and supportive presence. Panicking can lead them to retract their disclosure or feel unsafe to share further.
- Document the exact words of the child.
- Report the abuse and contact agencies that are there to support you (in addition to police and child welfare agencies, there are sexual assault centers and child advocacy centers that will provide support for survivors and their families). Communicate what the child shared clearly to supporting agencies so that they can best support the child.
- Take care of yourself. Hearing about the abuse of a child can lead to your own distress or vicarious traumatization. We must take care of ourselves first if we want to adequately support the children we care about.
Some additional information on how to better support children through their disclosures can be found at Childhelp and The National Child Traumatic Stress Network. Let’s create a safer place for children together.
Copyright 2020 Danielle Render Turmaud, MS, NCC. All Rights Reserved. No part of this article may be reproduced or utilized without permission of the author.
Fergusson, D. M., Mcleod, G. F. ., & Horwood, L. J. (2013). Childhood sexual abuse and adult developmental outcomes: Findings from a 30-year longitudinal study in New Zealand. Child Abuse & Neglect, 37(9), 664–674. https://doi.org/10.1016/j.chiabu.2013.03.01
Finkelhor, D., Shattuck, A., Turner, H. A., & Hamby, S. L. (2014). The Lifetime Prevalence of Child Sexual Abuse and Sexual Assault Assessed in Late Adolescence. Journal of Adolescent Health, 55(3), 329–333. https://doi.org/10.1016/j.jadohealth.2013.12.026
Hall, M., & Hall, J. (2011). The long-term effects of childhood sexual abuse: Counseling implications. Retrieved from http://counselingoutfitters.com/vistas/vistas11/Article_19.pdf
Handling child abuse disclosures. (n.d.). Retrieved from Childhelp website: https://www.childhelp.org/story-resource-center/handling-child-abuse-disclosures/
Helton JJ, Carbone JT, Vaughn MG, Cross TP, (2019). Emergency Department Admissions for Child Sexual Abuse in the United States from 2010 to 2016. JAMA Pediatrics. Published online November 04, 2019. doi:10.1001/jamapediatrics.2019.3988
Townsend, C. & Rheingold, A.A. (2013). Estimating a child sexual abuse prevalence rate for practitioners: A review of child sexual abuse prevalence studies. Charleston, S.C., Darkness to Light. Retrieved from www.D2L.org/1in10.
What to do if your child discloses sexual abuse: A guide for parents and caregivers. (n.d.). Retrieved from The National Child Traumatic Stress Network website: https://www.nctsn.org/resources/what-do-if-your-child-discloses-sexual-abuse-guide-parents-and-caregivers
World Health Organization Guidelines for Medico-Legal Care for Victims of Sexual Violence (n.d.). Retrieved from World Health Organization website: https://www.who.int/violence_injury_prevention/resources/publications/en/guidelines_chap7.pdf