The State of the Debate About Children's Disclosure Patterns in Child Sexual Abuse Cases

In current research studies about the disclosure patterns of sexually abused children, experts agree that most victims delay disclosure for years, often until adulthood. Researchers disagree about disclosure rates and recantation rates among children during formal interviews. Studies of children who had not previously disclosed but are known through corroborative evidence to have been sexually abused show lower rates of disclosure than do studies of children who had disclosed prior to the formal interview. Gradual disclosures among children are common, and more than a single interview may be necessary in some cases. Prior disclosure, level of support by non‐offending parents, developmental level, and relationship to perpetrator affect children's rates of disclosure and their disclosure patterns. More research is necessary to clarify children's post‐disclosure recantation rates and predictors.     

Do parents blame or doubt their child more when sexually abused by adolescents versus adults?

Although the importance of parental support for child sexual abuse victims is well documented, the nature of parental support for victims sexually abused by adolescents is less understood. In this exploratory study, we examine whether parents differ in their levels of blame or doubt for their child when sexually abused by adolescents versus adults. Data included 161 reports of child sexual abuse. Parental blame toward their child was higher when sexually abused by an adolescent versus an adult suspect. In the bivariate and multivariate analysis, parental blame was significantly higher as victim age increased, for Black, non-Hispanic children, and when there was an adolescent suspect. Practitioners need to recognize that high levels of blame and doubt could exist for adolescent victims of sexual abuse and when children are sexually abused by adolescents.     

Measuring the Difference Between Parental Alienation and Parental Estrangement: The PARQ-Gap

Parental alienation (rejection of a parent without legitimate justification) and realistic estrangement (rejection of a parent for a good reason) are generally accepted concepts among mental health and legal professionals. Alienated children, who were not abused, tend to engage in splitting and lack ambivalence with respect to their parents; estranged children, who were maltreated, usually perceive their parents in an ambivalent manner. The hypothesis of this study was that a psychological test—the Parental Acceptance–Rejection Questionnaire (PARQ)—will help to distinguish severely alienated from nonalienated children. The PARQ, which was used to identify and quantify the degree of splitting for each participant, was administered to 45 severely alienated children and 71 nonalienated children. The PARQ-Gap score—the difference between each child's PARQ: Father score and PARQ: Mother score—was introduced and defined in this research. Using a PARQ-Gap score of 90 as a cut point, this test was 99% accurate in distinguishing severely alienated from nonalienated children. This research presents a way to distinguish parental alienation from other reasons for contact refusal. The PARQ-Gap may be useful for both clinicians and forensic practitioners in evaluating children of separating and divorced parents when there is a concern about the possible diagnosis of parental alienation.     

An Objective Measure of Splitting in Parental Alienation: The Parental Acceptance–Rejection Questionnaire

Both clinicians and forensic practitioners should distinguish parental alienation (rejection of a parent without legitimate justification) from other reasons for contact refusal. Alienated children—who were not abused—often engage in splitting and lack ambivalence with respect to the rejected parent; children who were maltreated usually perceive the abusive parent in an ambivalent manner. The purpose of this study was to assess the usefulness of the Parental Acceptance–Rejection Questionnaire (PARQ) in identifying and quantifying the degree of splitting, which may assist in diagnosing parental alienation. Results showed that severely alienated children engaged in a high level of splitting, by perceiving the preferred parent in extremely positive terms and the rejected parent in extremely negative terms. Splitting was not manifested by the children in other family groups. The PARQ may be useful for both clinicians and forensic practitioners in evaluating children of divorced parents when there is a concern about the possible diagnosis of parental alienation.     

Differences in trauma symptoms and family functioning in intra-and extrafamilial sexually abused adolescents

This study investigated to what extent abuse-related symptoms and family functioning are related to intra- or extrafamilial sexual abuse. One hundred adolescents (12 to 18 years old) were recruited shortly after disclosure of the abuse. Information from the participants was obtained through self-report questionnaires and a semistructured interview. Fifty-three percent of the adolescents reported clinically significant symptoms. Data did not support the idea that intrafamilial sexually abused adolescents report more symptoms than extrafamilial sexually abused adolescents. Type of abuse did not account for the differences and variety of reported symptoms or for differences in family functioning. Family functioning-in particular, lack of cohesion- was an independent contributor to internalizing trauma-related problems.     

Predictors of trauma symptomatology in sexually abused adolescents: a 6-month follow-up study

This study examines the natural course of trauma-specific symptoms 6 months after disclosure. Furthermore, this study investigates whether severity and type of abuse (intrafamilial or extrafamilial sexual abuse), negative appraisals, coping strategies, and crisis support measured at time of disclosure can be predictive of trauma symptoms 6 months later. Sixty-five sexually abused Flemish adolescents are reassessed 6 months after disclosure. Information from the participants is obtained through self-report questionnaires. Forty-six percent of the adolescents report clinically significant trauma symptoms. Although internalizing symptoms significantly decreases after 6 months, externalizing symptoms persist. Type or severity of the abuse does not account for differences in symptomatology. Two predictors of ongoing trauma symptomatology are identified: postdisclosure trauma symptomatology and a lack of initial crisis support. Information on the victims' postdisclosure symptomatology as well as information on the initial received social support is critical in understanding which abused adolescents are most at risk for poor outcomes in the long term.     

The Effect of Childhood Sexual Abuse on Psychosexual Functioning During Adulthood

The study examined whether and how characteristics of childhood sexual abuse and disclosure influenced three dimensions of psychosexual functioning—emotional, behavioral and evaluative—during adulthood. The sample included 165 adults who were sexually abused as children. The General Estimating Equation was used to test the relationship among the predictors, moderators and five binary outcomes: fear of sex and guilt during sex (emotional dimension), problems with touch and problems with sexual arousal (behavioral), and sexual satisfaction (evaluative). Respondents who were older when they were first abused, injured, had more than one abuser, said the abuse was incest, and told someone about the abuse were more likely to experience problems in at least one area of psychosexual functioning. Older children who told were more likely than younger children who told to fear sex and have problems with touch during adulthood. Researchers and practitioners should consider examining multiple dimensions of psychosexual functioning and potential moderators, such as response to disclosure.     

The spectrum of sexual abuse in daycare: An exploratory study

Findings from an exploratory study of 48 children sexually abused in daycare centers and daycare homes are presented. About two thirds were female and one third male. Approximately half of victims were maltreated by a single perpetrator and about half by more than one perpetrator, in the latter instance almost always by both men and women. On average, the children were subjected to 5.3 types of sexual abuse, experienced 2.1 different sorts of threats to obtain their cooperation or prevent disclosure of their victimization, and suffered from 3.7 symptoms regarded as sequelae of sexual abuse. Differences in the characteristics of offenders, victims, the sexual abuse, threats, and sequelae were found based upon the daycare context, that is, whether children were victimized in a center with multiple perpetrators, a center with a single perpetrator, or a daycare home.     

Limits of guardian treatment refusal: a reasonableness standard

The debate concerning the legal and ethical bases of guardian refusal of medical treatment on behalf of incompetent patients often ignores critical distinctions among types of patients and guardians. For example, patients who have expressed preferences regarding treatment while competent are distinguishable from patients who have always lacked the competency requisite to expressing a treatment preference. "Bonded guardians," whose relationship with the patient preexisted guardianship, should have a different role in the decision-making process than "non-bonded guardians," who were strangers to the patient prior to the guardian-ward relationship. This Article proposes criteria for guardian treatment refusal on behalf of incompetent patients. Under the model for guardian decision making presented here, bonded guardians should be preferred over non-bonded guardians, and bonded guardians should be allowed discretion to make treatment choices, limited only by a standard of reasonableness policed by the courts. The Author presents legal and ethical justifications for the bonded guardian's heightened role. Finally, he considers the proper roles of health professionals, hospital ethics committees, and judges in the decision-making process.     

Men and intimate partner rape: characteristics of men who sexually abuse their partner

This article explores men's use of sexual violence against their intimate partner. Although there is a growing body of information about men's use of physical violence, there is less data about men's sexual violence in intimate partnerships. Data were collected from 229 men who were enrolled in an intervention program for men who abuse. Of men in this study, 53% had sexually assaulted their partner at least one time. This article will address the ways in which this sample of men sexually abused their partner and the connection between physical and sexual abuse within their relationships.     

Differences in Family Functioning of Sexually Abused vs. Nonabused Enuretics

The present study examined self-reported maternal depression, children's somatic complaints, and perception of family functioning in sexually abused and nonabused enuretics. Forty children with primary nocturnal enuresis served as subjects. Half had documented histories of sexual abuse while the other half did not report a history of victimization. Results indicated that those children with a history of sexual abuse perceived and rated their families as significantly more conflictual and rigid than their nonabused counterparts. Variables such as type of abuse (intrafamilial vs. extrafamilial) and perpetrator did not affect the outcome. However, there were no significant differences in child somatic complaints or maternal depression between the two groups. These results suggest that primary nocturnal enuresis may manifest itself differently in families of sexually abused children than nonabused children. Implications of these findings with respect to intervention are discussed.     

Disclosure of children's free and reduced price meals and free milk eligibility information in the child nutrition programs. Final rule

This final rule establishes requirements for the disclosure of children's free and reduced price meals or free milk eligibility information under the Child Nutrition Programs. The Child Nutrition Programs include the National School Lunch Program, School Breakfast Program, Special Milk Program, Summer Food Service Program, and Child and Adult Care Food Program. Within certain limitations, children's free and reduced price meal or free milk eligibility information may be disclosed, without parental/guardian consent, to persons directly connected to certain education programs, health programs, means-tested nutrition programs, the Comptroller General of the United States, and some law enforcement officials. Additionally, officials also may disclose children's free and reduced price meal or free milk eligibility information to persons directly connected with State Medicaid (Medicaid) and the State Children's Health Insurance Program (SCHIP) when parents/guardians do not decline to have their information disclosed. These regulations affect State agencies and local program operators that administer the Child Nutrition Programs and households which apply for and/or are approved for free and reduced price meals or free milk. The final rule reflects the disclosure provisions of the Healthy Meals for Healthy Americans Act of 1994 and comments received on the proposed rule published in anticipation of implementing those provisions. Additionally, this final rule includes the regulatory disclosure provisions implementing the Agricultural Risk Protection Act of 2000 and comments received on the interim rule issued to implement those provisions. This final rule also implements nondiscretionary provisions of the Child Nutrition and WIC Reauthorization Act of 2004, allowing certain third party contractors access to children's eligibility status and will allow school officials to communicate with Medicaid and SCHIP officials to verify that children are eligible for free and reduced price school meals or free milk. The disclosure provisions are intended to reduce paperwork for administrators of certain programs that target low-income households and for low-income households which may benefit from those programs by allowing some sharing of household's free and reduced price meal eligibility information. This rule also includes several technical amendments.     

Detection

Sexually abused children who are not treated will likely commit violent crimes and will probably abuse or condone the abuse of their own children. But the best of treatment programs are of no use if the abused children are not found. Reporting laws adopted in recent years, even though of somewhat limited scope, have greatly increased the number of children found and brought to treatment, and each child treated not only improves that child's pursuit of happiness, it also breaks a cycle of abuse to his children. Reporting laws can be strengthened. They can help more children. They can cast a broader net of those who must report abuse and of those who are protected when they report. They can clarify the procedures to be taken and the agencies responsible when reports are made. They can provide for confidentiality and protective orders to save the family a second trauma during judicial and administrative procedures. They can identify public policy as to when to treat and when to punish if both cannot be done. They can encourage research for determining the truth of reports and for improving treatment methods. There is resistance to reporting laws. Physicians are well aware that if they report an abuse they may well lose not merely that family as patients but also their friends and relatives which can be a severe economic hardship. Lawyers and physicians resist intrusions into the confidentiality of their relations with their clients and patients. Foster homes and residential care facilities know that even a hint of impropriety may end their arrangements for payment by the public and insurance carriers. Families often resist reporting because of its embarrassment and potential impact on their jobs and on their relationships with friends. Children resist because of guilt feelings or for fear of losing a parent. Mothers resist because they fear the breakup of their homes and loss of a breadwinner. Compulsory reporting laws may be the best means of helping sexually abused children and of breaking the cycle of sexual abuse by those who were sexually abused and even of reducing violent crime. It is not a simple solution. But just as we can do nothing about child abuse unless it is reported, neither can we do anything about abuse unless the reports are managed efficiently, with prompt investigation and prompt action when appropriate. A report allowed to gather dust may have cost a physician a part of his practice without protecting or helping the child.     

Severity of intimate partner violence and occurrence and frequency of police calls

This article evaluates whether female victims of severe physical, psychological, or sexual intimate partner violence (IPV) call police more often than other abused women. Abused women (431) reported frequency of contacting police (dependent variable), nature and severity of IPV experienced, and characteristics of themselves and their perpetrator (explanatory variables). A two-part regression model estimated likelihood of police contact among all participants and rate of contact among callers. Women with severe physical or psychological IPV or injury were more likely to call police than were other abused women. Among callers, women made 96% more calls if a weapon was involved, 58% more if they were severely sexually abused, and 40% more if they were severely physically abused. Women with children at home made 32% more calls. These results delineate the level and types of IPV and other characteristics of homes that make single and repeat calls to police.     

Behavior Problems in Sexually Abused Children of Depressed Versus Nondepressed Mothers

Children's psychological adjustment following stressors, such as sexual abuse, is impacted by environmental variables. One such factor is parental support, which can be hampered when a caregiver suffers from psychopathology. The purpose of this study was to determine whether maternal depression would impact the children's adjustment to sexual abuse. It was hypothesized that depressed mothers would report more behavior difficulties for their sexually abused children than nondepressed mothers. Participants were 58 children (and their mothers) who were referred for trauma symptoms related to sexual abuse. Mothers completed the Beck Depression Inventory as a measure of their depression and rated their children's behaviors on the Revised Behavior Problem Checklist. The children completed the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale. Results revealed that depressed mothers reported more conduct problems, inattention/immaturity, and psychotic behavior than nondepressed mothers. Differences were not observed for mothers' report of depressive or anxious behaviors across groups. The children of depressed mothers reported increased levels of depression, but not anxiety, when compared to children of nondepressed mothers. Although both groups of mothers reported symptoms to be clinically significant, the children did not endorse their symptoms in clinically significant ranges.     

ASSESSING AND MANAGING ALLEGATIONS OF CHILD SEXUAL ABUSE

This article examines the procedures involved in the assessment and management of allegations of child sexual abuse in courts exercising custody and access jurisdictions. The author discusses the various options available to the court when confronted with such allegations, noting that, in the contex: of access disputes, the issue for the court is not whether a parent has sexually abused a child but whether, in all the circumstances of the case, access should take place or custody should change. In all matters involving access between parents and children, the overriding principle is the paramountcy of the welfare of the child. It is also argued that supervised access, although an increasingly popular alternative for the court when faced with allegations of abuse, is problematic and may not be in the best interests of the child. The author suggests that the emphasis must be on children's rights find parental responsibilities.     

CROSSOVER KIDS

This article considers the plight of the child found both abused and delinquent in the American legal system. Discussed in detail are the difficulties attorneys representing these children face, including ethical issues of confidentiality and attorney-client privilege, maintaining a permanent placement for an abused child found delinquent and the paramount importance of determining appropriate jurisdiction. These difficulties are presented through interviews with three children's attorneys who represent abused children and/or delinquent children in Wisconsin, Maryland and Pennsylvania. The article finds that the needs of abused delinquents are not being adequately addressed for a number of reasons. Lack of communication between the two systems and lack of statutory guidelines are both considered and improvements for these issues suggested. Although not directly addressed, the question of whether there is a causal connection between abuse and delinquency is considered in analyzing the techniques and theories of the three interviewed attorneys.     

Medical examination of sexually abused children: medico-legal value

The Department of Forensic Medicine (forensic pathology and clinical forensic medicine), Aarhus, Jutland, Denmark, performs examinations of children suspected to have been sexually abused when reported to and requested by the police in Jutland, Denmark. Jutland covers an area of 210,000 km2 with about 300,000 inhabitants in Aarhus. A colposcope initially equipped with an Olympus camera, but now with a video camera attached has been used since 1994. Since 1994 the department has performed more than 100 examinations of children suspected of having been sexually abused. A preliminary study was taken to evaluate all cases from 1995 including the legal outcome. RESULTS: The material included 34 cases with three boys, mean age 11 years, and 31 girls, mean age 8 years, at the time of the examination. The sexual abuse events were fondling including penetration of the vagina, vaginal (14), anal (7), and oral (5) intercourse as well as cunnilingus and nontouching abuses. The medical examination was most often performed more than a week after the abuse. The examination revealed normal findings in 23 cases, nonspecific findings including erytherma in 13 cases, and in only one child was a traumatic lesion with rupture of the hymen seen. The perpetrators were above 25 years of ane and were family members or someone known to the child. Nine perpetrators were convicted at court, of whom three admitted having abused the child. CONCLUSION: A medical examination in cases of sexual child abuse seldom provides a legal proof of sexual abuse. The most important is the story told by the child. Therefore, the examination is a supplement which may support or remain neutral to the story told by the child.     

Prevalence of sexual abuse in organised competitive sport in Australia

Abstract

This article reports the first phase of a three-phase research programme investigating the prevalence and long-term sequelae associated with sexual abuse in a non-psychiatric sample of male and female Australian athletes. A cross-sectional, retrospective design, using a mailed survey, provided a quantitative assessment of sexual abuse prevalence in a national sample of elite athletes and a regional sample of club athletes. Results from the total sample (n = 370) revealed that 31% of female and 21% of male athletes reported experiencing sexual abuse at some time in their lives. Of these, 41% of females, and 29% of males had been sexually abused within the sports environment. It was also found that almost half, 46.4%, of the elite group reporting sexual abuse had been sexually abused by sports personnel. For the club group, this figure was 25.6%. Implications of these results and current initiatives for the prevention of sexual abuse of athletes in Australia are discussed.     

Children Fleeing Domestic Violence to Emergency Accommodations: Education Rights and Experiences

Domestic violence forces many families to flee to emergency accommodations. This article focuses on children’s experiences of schooling and life at confidential addresses, and to what extent their legal right to education in the face of domestic violence is safeguarded in practice. Data were collected from interviews with 20 children aged 6–16 with multiple relocations at Norwegian refuges for abused women. Interviews were coded using the constructive approach to grounded theory. Data were analyzed using Antonovsky's theory and interpreted within the context of Norwegian and international law, examining the rights of children to education versus the legal rights of abusers. The findings indicate that children’s rights to education and a life without violence may be sacrificed in favor of due process for abusers. The article suggests concrete protective measures to help safeguard these rights, and calls on policymakers and support agencies worldwide to rethink their policies and practice.