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Reframing Child Sex Abuse as a Preventable Public Health Issue

Strategies depend on wider awareness that prevention works.

Key points

  • Fixed narratives about child sexual abuse may draw focus away from the opportunity to prevent harm before it occurs.
  • Limited public understanding may impede healthy public policy and effective prevention.
  • A new three-step approach can help reframe child sexual abuse as a preventable public health problem.
Raphael Schaller/Unsplash
Photo by Raphael Schaller on Unsplash
Source: Raphael Schaller/Unsplash

Child sexual abuse can assume its rightful place as a preventable public health priority if practitioners take three steps to reframe the issue with the general public, according to research led by the Moore Center for the Prevention of Child Sexual Abuse.

The “public narrative of CSA as unpreventable flies in the face of available evidence,” writes a team of four authors led by Moore Center faculty affiliate Rebecca L. Fix, Ph.D., in the journal Child Abuse & Neglect. As many as three-quarters of sexual offenses against children under 18 are caused by other children, and sexual recidivism rates are vastly lower than most people think: 95 percent of children adjudicated and 80 percent of adults convicted of sex crimes never go on to commit another sex crime.

These low rates, startling though they may be for many, “indicate that problematic sexual behaviors can be controlled and managed, and therefore that initial first-time sex crimes might also be avoided,” the study team writes. Continuing research has identified several factors associated with sexual offending—beginning with adolescents’ limited understanding of what constitutes appropriate sexual behavior—that “appear to be good targets for universal prevention efforts.”

But not if child sexual abuse messaging is silent on the pathways to prevention.

In North America, child sexual abuse communication has “emphasized alarming statistics and vivid imagery to draw attention to the scale and impact of the problem,” with early efforts presuming “the absolute culpability of those who engaged in illegal sexual behavior,” the authors say. “Sensationalist media portrayals of particularly horrific cases have also heightened the emotionality associated with CSA.”

Those storylines, and the heightened public awareness that resulted, have driven and sustained an overreliance on punitive judicial responses like incarceration and sex-offender registration and notification. The strategies all have two serious flaws in common: They begin after the harm has occurred, and they do nothing to prevent future instances of CSA.

Now, after years of a narrative that treats people who have engaged in sexually abusive behavior as monsters, “the public’s current understanding of CSA impedes efforts to influence public policy” to embrace effective prevention strategies, the new paper argues. “New ways of translating this evidence base are needed to improve the public’s understanding of CSA—why it happens, why it matters, and how it can be prevented. Armed with more accurate understanding, the public will be better equipped to value and support programmatic and policy solutions to preventing CSA.”

The Three Steps

Rebecca Fix—along with colleagues Daniel S. Busso, Ed.D., formerly of the FrameWorks Institute, Tamar Mendelson, Ph.D., director of the Center for Adolescent Health, and myself—present a three-step approach to framing child sexual abuse as a preventable public health problem:

Step 1: Map gaps in knowledge and understanding, among experts and the general public, using interviews with thought leaders to uncover the “untranslated expert story on CSA” and semi-structured interviews to get at public attitudes and assumptions. “The expert and public consensus ‘stories’ are then compared to identify areas of consensus and divergence between expert and public understandings of CSA,” we explain. “The areas of divergence, or ‘gaps’ in understanding, represent core areas likely to create challenges for experts when communicating with the public about CSA.”

Step 2: Develop and test new communication frames to address the most important gaps between perception and reality. Communicators create “explanatory metaphors” to break down and clarify complex concepts, making them “easily understood and highly communicable."

Step 3: Share new strategies through an extended, diverse network of expert colleagues and partners. “Through broad expertise, communication strategies developed can be effective not only with the public but also acceptable to front-line practitioners, journalists, policymakers, and advocates.”

The paper stresses how urgent it is to raise awareness that child sexual abuse is preventable, not inevitable—that the harms that have to date led to a tough judicial response and a steady drumbeat of public alarm were never required in the first place.

“Despite concerted efforts by experts in the field, this understanding is not broadly shared by the public and policymakers, which leaves experts unable to support and mobilize around policies that can effectively prevent CSA,” the authors conclude. That makes prevention awareness “a necessary prerequisite to building public and policymaker support for incorporating CSA within national violence prevention efforts.”


Fix et. al. (2021). Child Abuse & Neglect. Science Direct.

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