Social Work 550 UKY
Only adolescent males commit sex offenses.
Females under the age of 18 account for 1% of forcible rapes committed by juveniles and 7% of all juvenile arrests for sex offenses, excluding the category of prostitution.
Higher ACE scores
can result in higher uses of substance abuse, smoking, and depression make it easier to develop diseases
The most common circumstance of sexual abuse is a dyadic relationship, which means:
situations involving one victim and one offender
Which of the following are examples of non-sexual behavioral indicators of possible sexual abuse?
sleep disturbances enuresis
When considering if sexual behavior of children and young people is normal, concerning, or harmful, it is important to consider all of the following
context in which occurs age, ability and development location, frequency and nature of behavior
Short‑Term and Long‑Term Reactions
depression, anxiety, behavioral problems, and PTSD risky sexual behavior
Child trauma
refers to a scary, dangerous, violent, or life threatening event that happens to a child (0-18 years of age)
Critical to determining if a sexual behavior is appropriate or considered harmful involves the following:
Correct! power, consent and coercion
Emotional Indicators
Nightmares Depression Guilt Fearful Aggressive actions Anger Tantrums Suicidal ideations or attempts Low self-esteem Phobias Obsessions Anxiety Tics PTSD (Post-Traumatic Stress Disorder)
Intervention with the Parents
Parents should be given permission to express a range of emotions in front of their children. As long as they provide an explanation. Providing parents with information about how children grieve is another important intervention strategy.
Sibling Behaviors of Concern, Continued
Persistent sexual activity(even when parents or other adults have told the children to stop) ●When one sibling states there have been sexual activity and the other strongly denies it ●Sexual activity when one or both of the siblings is an adolescent (usually by this time, kids have internalized norms that would dictate that sibling activity is not OK) ●Sexual behaviors which include ongoing fondling of the breasts and/or genitals; insertion of objects in the vagina or anus, oral sex; vaginal or anal intercourse; ongoing exposure of the genitals; self-stimulation in front of the other child; repeated sexual discussions, or other similar behavior ●When there is significant sexual activity and the relationship is generally characterized by a degree of bossiness/bullying or manipulation that seems more serious than typical sibling rivalry—the use of bribery; coercion, intimidation, threats, intense teasing or force to gain the participation of the other child in sexual behavior ●Siblings who are very secretive about the time they spend together
The original ACEs study included the following 10 adverse childhood experiences
Physical abuse Sexual abuse Emotional abuse Physical neglect Emotional neglect Mother treated violently Household substance abuse Household mental illness Parental separation or divorce Incarcerated household member
Juvenile perpetrators should have which of the following:
clear boundaries explicit planning for safety behavior monitoring
Which of the following is not a phase in the sex abuse cycle?
impression
How to reduce impact of ACEs in children
- access to supportive adult
Adolescent Sex Offenders: Common Misconceptions vs. Current Evidence
...
Children's behavioral reactions to sexual abuse may include all but the following:
stigmitization
Moral Factors
Demands of culture majority/minority Reconciling social and religious beliefs with peer pressure
Short term effects of Child Abuse
Helplessness—Assault on body privacy and the psychic self. Sexual abuse does not occur in a vacuum. Vulnerability to Abuse—Pre-existing conditions of neglect, parental, inferior self-image and lack of nurturing may make potential victims vulnerable to perpetrators. Prior to Life Experience The degree to which the abuse impacts the child's view of the world may affect the level of trauma as well as the method of coping. The victim who has experienced the world as a safe, empathic place may be more traumatized. Betrayal—Often, abuse is perpetrated by someone the victim trusts. The betrayal of that confidence is paramount. The basic development of trust vs. distrust in infancy contributes to the quality of all relationships. The victims level of trust affects the perception of betrayal. The offenders lack of regard for the victim will be perceived in the contact of earlier experience of trust or distrust. Relationships—It is the victim's perception of trust and dependency in the relationship that must be considered when the impact of the abuse. A father who has been emotionally absent has a different relationship with the child than of an older cousin who dotes on the child. Developmental stages—The experience of victimization on trauma creates a developmental crisis that may affect future development of trigger regression to an earlier developmental stage. Development of interpersonal relationships is almost certain to be adversely affected and future development may be distorted. Sexuality—Concepts of sexuality relate to genitalia, arousal and relationship. Children often believe their bodies are different from other children. This "damaged goods" syndrome may lower self-esteem, devalue the sense of self, and future, the experience of sexual arousal or pleasure in the physical closeness may lead the victim to conclude that they are guilty and stigmatized. Gender Issues—For the male who is sexually abused by a male, the issue of homosexuality arises. The male victim may conclude that the experience causes or defines him to be homosexual. The opposite conclusion may also result in extreme homophobia that impairs all future same-sex relationships. The male victim may deny his arousal in the abuse, or translate himself into the role of aggressor. When males are sexually abused by a female, they are likely to convince themselves they are not really a victim. The Female Victim's Sexuality—may be perceived as tarnished or perverted. Her acceptance of guilt and responsibility may lead her to interpret the abuse as deserved. Secrecy Accommodation—or the Child Sexual Abuse Accommodation Syndrome—The victim's experience of sexual abuse must be reconciled with their view of themselves and of the world. Roland Summitt addresses the child victim's dilemma in the "The Child Sexual Abuse Accommodation Syndrome." Summits' concept bridges the span from experience through disclosure. Victims may "test" the reality of the outside world and find that the immediate response is much like the perpetrator said. When disclosure triggers a sequence of embarrassment, disbelief or "trouble," victims sometimes retract statements in order to escape the impact and stigma of the systems response.
A 2 year old girl touches her genital area while bathing. This is a sign of sexual abuse?
false
There is a high probability that a 14 year old prostitute was sexually abused as a child.
true
4 years
• Extremely conscious of navel • Under social stress may grasp genitals and may need to urinate • May play game of 'show' by showing genitals or urinating before another child • Interest in other people's bathrooms • Demands privacy for self, but extremely interested in bathroom/ toilet activities of others • Verbally expressive about elimination
9-12 months
• Handles genitals when clothes are off • May be beginnings of masturbation (manipulation is the preferred term) • Wants to be changed when in wet/soiled nappy • Girls look at main caregiver and smile when urinating
2 years
• Kisses at bedtime May find it hard to go to toilet in unfamiliar places • Aware of own genitals, may handle when unclothed • Beginnings of interest in physical differences between sexes • Shows interest in different postures for urinating and watching others in bathroom/going to toilet/undressing
Summary of atypical and concerning sexual behaviors in adolescents/teenagers 13-16 years old
• Masturbating in public. • Having sexual contact with much younger children. • Taking younger children to 'secret' places or hideaways. • Showing sexual material to younger children. • Exposing his or her genitals to younger children. • Forcing sex on another adolescent or child. • Threatening or bullying children to keep the 'secret'.
9 years old
• May talk about sex information with friends of same sex. Seeks out pictures in books, sex swearing, sex poems • Interest in details of own organs and function
15 years old
• Need for increasing independence • Same sex friends very important • Homosexuals understand their sexuality • The management of partner sex is very important
3 years
• Talks about physical differences between sexes and different postures for urinating • Girls may try to urinate standing up • Interest in own genitals, showing and touching them • Wants to look at and touch adult • Wants to look at and touch mother's breasts
Children should be given the following messages:
(1) "You will not be alone at death or after death"; (2) "You have done all you could do with your life"; (3) "Death will not hurt"; (4) "Your parents and others will always remember you and the happy times"; (5) "You can say goodbye to friends and family members if you want to"; (6) "We don't understand why children die, and we cry because we are sad about it"; (7) "It's OK to cry and feel sad and angry, and it's OK not to want to talk about it, too"
Benefits of informing children about medical procedures
(1) increasing the child's trust, (2) reducing uncertainty (3) increasing the child's ability to cope with the potential procedure, (4) minimizing distress, (5) increasing the effectiveness of treatment out-comes, and (6) lessening pain intensity. It also may help the parents by lessening their anxiety levels and empowering them to support their child.
Focus on ill children
(1) understanding how children with life- threatening illnesses perceive death and (2) finding ways to help them cope with the invasive, lengthy, and often painful medical treatment necessitated by their dis-ease and with the possibility of death
Etiology of Sexual Offending - Adolescents
* Physical/Medical •Developmental and Environmental •Five Precursors Early sexualization Poor social skills Intimacy issues Poor impulse control Lack of accountability in all areas of a youth's life •Addictive Systems Model
Evironmental factors
- Family (Separation and divorce Domestic violence racial differences) - Educational (Homework Sexual Education) - Community (Peer groups, social groups) - Work (managing money, behaviors) - Relationship (awareness, flexibility) - Social (gender demands, risks of STDs)
The Role of CPS
- Local authority, housed in public social services agencies, responsible for investigation of and intervention in cases of suspected sexual abuse. -Mandate to protect children can be found in Federal and State legislation. -CPS is only responsible for intervening in those situations in which the offender is in a caretaking role for the child. -CPS conducts an investigation, within a specified time frame (typically within 24 or 48hours or up to 5 days, depending on the State).
Precipitating Phase
- Some event/trigger (physical abuse, sexual victimization, rejection, humiliation, loss, alienation, loss of control, embarrassment, and/or betrayal. -Can be slow phase. -Once this occurs the youth begins to avoid others and isolate themselves.
Factors to consider in risk assessment
- types of sexual abuse -characteristics of the abuse situation -victim age -relationship between victim and offender -number of victims -number of offenders -Reactions and functioning of the non-offending parent -Reaction of the offender -The presence of other problems in family functioning
adolescents 11-18
-Adolescents may or may not have acquired adult narrative skills. Adolescents are often confused by linguistic ambiguity such as is found in newspaper headlines, some ads, metaphors, idioms, proverbs, and jokes. -Adolescents are likely to lose track of long, complex questions. -Adolescents are reluctant to ask for clarification of a question(s) or acknowledge that they don't understand.
Things to do
-Choose easy words -Use several short questions to replace long overloaded questions. -In trying to establish time lines and dates you can use holidays, school days, night/day. -"What do you remember seeing or hearing?" -We remember first and last and this is no different with children, they remember first and last -Avoid leading questions Talk about what children understand Help children deal with questions they don't understand Be objective. You are A Neutral Fact-Finder. Understand children's emotional reactions. Never think if a child did not react a certain way that the child is not telling the truth. We all react differently to things and abuse can impact a child's affect in many different ways. Ask the child, What would I have seen (heard, etc.) if I had been there. Ask questions such as; "What did you smell, hear, see, etc. can help jog memories many times and can be good questions to ask a child. Always remember to ask if anyone took pictures of them. Ask about computers in the house (who uses them, etc.).
Compensatory Phase
-Externalizing distortion- blaming others; becoming angry. ("It's their fault I am feeling this way") -Power and control- attempts to dominate; control seeking; retaliation, must win; -Fantasy- retaliation fantasies, sexual fantasies, mentally rehearse. -Offense setup- planning victim selection, grooming, and stalking. -Sexual abuse- the act of abuse occurs.
Integration Phase
-Reinforcing distortion- celebration; affirm adequacy. "I pulled it off". -Fugitive thinking- fear of getting caught; fear of consequences. -Control distortion- the youth's thinking has reverted to them not getting caught. -Reframing- ambivalence; self-concern. -Suppression distortion- thinking they don't have a problem and will never do it again
School Age 7-10 years old
-School age children may still have difficulty in handling abstract concepts. -School age children may still have problems processing complex questions
Interventions and Strategies for Children Who Have Been Sexually Abused
-Separating the child from the behavior. You have to know they are behaving inappropriately because they have been hurt and have not gotten the modeling, guidance and limits they need—not because they are bad.
CHILDREN'S ADJUSTMENT TO DEATH Short‑Term Effects
-Uncomplicated grief -depression(24% of children) -reduced financial resources
elementary children
-become anxious or fearful -full guilty -easily startled -difficulty sleeping
Preschool Children
-cry/scream a lot -nightmares -asks questions about death -change in behavior -eat poorly
interviewing preschoolers
-do not handle abstractions well -Preschoolers aren't good at collecting things into adult-like categories. -Preschoolers use words for time, distance, kinship, size and so on, long before they understand their meaning.-Preschoolers have difficulty with pronoun reference. Keeping track of your"He's," "We," "they's", "that's" and whatever it is that these pronouns refer to is not something they are good at.
The Interview With the Alleged Offender
-for law enforcement to take the lead role in order to obtain a legally admissible confession. -the law enforcement officer can obtain a warrant to search the premises and seize relevant physical evidence and has the capacity to "preserve the chain of evidence," so that the physical evidence will be admissible in court. Police officers are also the only professionals who can make arrests
Middle/high school
-sexually active -take too many risks -feel as if they are going crazy -feel depressed and alone
Interventions and Strategies for Children Who Have Been Sexually Abused
.In praising the child it is important to remember that there should be at least 6praises for every correction.
10 step investigative interview
1. DON'T KNOW instruction 2. DON'T UNDERSTAND instruction 3. YOU'RE WRONG instruction 4. IGNORANT INTERVIEWER instruction 5. PROMISE TO TELL THE TRUTH instruction 6. PRACTICE NARRATIVES a. FRIENDS b. LAST BIRTHDAY 7. DISCLOSURE 8. DISCLOSURE FOLLOWUP 9. MULTIPLE INCIDENTS 10. Ask OPEN-ENDED Questions
Common Threads of Sibling Incest
1. Parent-child incest or other sexual abuse 2. Physical Abuse 3. Children in the family who feel angry, anxious, confused and /or depressed and do not know positive ways to express the emotions 4. Children who have difficulty trusting and who do not feel cared about by others 5. Intense rivalry between the siblings that the parents are fostering, sometimes without being aware of it 6. A sibling victim who is a "favorite" of the family 7. A sibling victim who has developmental or cognitive deficits 8. An abusive sibling who is disliked by the parent(s) for reasons which are not always related to the child but sometimes related to people, places or occasions which hold negative memories for the parent(s) 9. The environment in the home is sexually charged 10. The home has poor emotional, sexual and physical boundaries 11. Children who rely on each other to be soothed rather than their parents or other adults 12. Children who are so confused and overwhelmed by the atmosphere in their home that they act out their sexual confusion with each other 13. Parents who have had sexual partners outside of their marriage of which the family is consciously aware 14. Parents who are emotionally distant from each other and their children and who do not provide a nurturing environment in which the siblings can find support 15. Adults in the family who have had a great deal of difficulty in their own interpersonal relationships, including excessive physically and verbally aggressive behaviors within the family 16. Children who have been exposed to adult sexual behavior, which they have not understood 17. Lax or no supervision 18. Children who have been influenced by exposure to sexually explicit magazines, films, videos, internet and television 19. Siblings who have been sexually abused together by another person, or exposed to pornography together and continue to engage in sexual behaviors with one another 20. Significant disruptions in the family home including separation, divorce, death,
stages of interviewing
1. Policy states we should, per SOP 2.11 A.The alleged victim(s) B.All other children in the home C.The non-offending parent/caretaker D.All adults living in the home E.Collaterals, as necessary F.The alleged perpetrator/caretaker
Sex Abuse Cycle
1. Precipitating Phase: Trigger, Negative Anticipation, Avoidance. 2. Compensatory Phase: Power, Fantasy, and Inappropriate Sexual Behaviors, 3. Integration Phase: Transitory Guilt and Reframing.
PTSD
1. witnessing an event involving threatened or actual death or injury to self or others; (2) intrusive symptoms related to event (e.g., nightmares, trauma- specific reenactment in play); (3) avoiding stimuli associated with the trauma (e.g., not talking about the event or refusing to go to the place where the trauma occurred); (4) problematic changes in thoughts or mood (5)hyperarousal (i.e., startle responses, hypervigilance, inattentiveness, irritability or anger, and/or trouble sleep-ing).
Few sex crimes are committed by adolescents.
ASOs commit a substantial number of sex crimes, including17% of all arrests for sex crimes1 and approximately 1/3 of all sex offenses against children.
Disclosure Phase
Accidental disclosure Observation by third party Physical injury to the child Sexually transmitted infection Pregnancy Display of precocious sexual knowledge Purposeful disclosure Young adult may tell the secret Adolescents may tell the secret to escape Victim may tell the secret due to fear of pregnancy Victim may tell to protect others
Emotional Factors
Acting on impulse Development history Regulation
ASOs
Adolescent sexual offender
Sibling Behaviors of Concern
Adult like sexual activity ●Behaving like boyfriend and girlfriend ●Siblings who appear embarrassed when found alone together. Threats: ●A child who fears being left alone with a sibling, especially if one is more dominant, aggressive, manipulative or controlling sibling. ●One sibling antagonizing the other but the other not retaliating (through fear, or fear of exposing the secret), or in some cases the threat of blackmail. A large age difference between the siblings: ●Generally 2 years differential—remember some sexual behaviors between siblings even if they are the same age or similar ages can be a problem—younger siblings can be the initiators of harmful sexual interactions with older siblings
ACEs
Adverse Childhood Experiences- difficult or scary experiences.
10+ years Formal operational
All components of death understood, abstract religious ideas -may come to under-stand death from religious doctrine and rituals, worship services, and ceremonies
ASSESSMENT OF TRAUMATIC EVENTS
Assessment of children exposed to trauma is challenging due to the different types of experiences and outcomes for children. it is very important to clarify the purpose of the assessment.
5 years
Aware of genitals and boy/girl differences but lessening of interest in anatomical differences • Masturbation/genital manipulation • Less 'sex play' and games of show, lessening interest in unfamiliar bathrooms • More modest, less exposing of self
TREATMENT OF TRAUMATIC EVENTS
Because children who have experienced traumatic events are a heterogeneous group, no single treatment protocol is appropriate for all of them. Developmental factors influence all aspects of treatment, including the effects of trauma and prognosis for treatment, treatment issues and approaches, possible placement and protection decisions, and expectations for a child as a witness in legal proceedings.
physical indicators
Bruises Genital pain, bleeding, itching, discharge and/or odors Gait disturbance Eating disturbance Enuresis Stomach aches Pregnancy STI's (sexually transmitted infections) Trauma to rectum Dysuria Foreign bodies in vagina, urethra or rectum
Addictive Systems Model
Carnes developed an addictive systems model of sexual deviancy. He theorized that sexual deviancy is the result of a set of core beliefs developed by the offender during childhood and adolescence. The common beliefs are as follows: (Only bad things happen to me... Sex is my most important need)
Comprehensive Assessment- to- Intervention System (CAIS)
Child Interview:The purpose of this first session with the child is to foster engagement, express sympathy about the loss, and to gather information about the child's perceptions of the death and current worries or concerns. It is also important to gather information about other aspects of the child's life (school, friends, activities).
Kentucky stats
Children 25.8% have experienced 2 or more aces Kentucky is 42 in the nation for ACE
Expected sexual behaviors at each age range: Birth-4 years
Comfort in being nude Body touching and holding own genitals Unselfconscious masturbation Interest in body parts and functions Wanting to touch familiar children's genitals during play, toilet or bath times Participation in make believe games involving looking at and/or touching the bodies of familiar children, e.g. 'show me yours and I'll show you mine', playing 'family' Asking about or wanting to touch the breasts, bottoms or genitals of familiar adults, e.g. when in the bath)
Worst concerns sexual behaviours at each age range: Birth- 4 years
Compulsive masturbation which may be self injurious, of a persistent nature or duration Persistent explicit sexual themes in talk, art or play Disclosure of sexual abuse Simulation of sexual touch or sexual activity Persistently touching the genitals/private parts of others Forcing other children to engage in sexual activity Sexual behaviour between young children involving penetration with objects, masturbation of others, oral sex Presence of a sexually transmitted infection
Worst concerns sexual behaviours at each age range: 14-17 years
Compulsive masturbation, e.g. self-harming, in public, seeking an audience Preoccupation with sexually aggressive and/or illegal pornography Sexual contact with others of significant age and/ or developmental difference Engaging others in a process to gain sexual activity by using grooming techniques, e.g. gifts, manipulation, lies Deliberately sending and/or publishing sexual images of another person without consent Arranging a meeting with an online acquaintance without the knowledge of a peer or known adult Sexual contact with animals Sexual activity in exchange for money, goods, accommodation, drugs or alcohol Forcing or manipulating others into sexual activity Possessing, accessing or sending child exploitation materials
Worst concerns sexual behaviours at each age range: 10-13 years
Compulsive masturbation, e.g. selfharming, seeking an audience Engaging vulnerable others in a process to gain sexual activity by using grooming techniques, e.g. gifts, lies, flattery Forcing or coercing others into sexual activity Oral sex and/or intercourse with a person of different age, developmental ability and/or peer grouping Presence of sexually transmitted infection or pregnancy Deliberately sending and/or publishing sexual images of self or another person Arranging a face to face meeting with an online acquaintance Sexual contact with animals Sexual activity in exchange for money or goods Possessing, accessing or sending child exploitation materials, e.g. photos or videos of children naked or doing sexual activities
Worst concerns sexual behaviours at each age range: 5-9 years
Compulsive masturbation, e.g. selfinjuring, self-harming, seeking an audience Disclosure of sexual abuse Persistent bullying involving sexual aggression eg pulling/ lifting/removing other children's clothing, sexually threatening notes, drawing, text messages Sexual behaviour with significantly younger or less able children Accessing the rooms of sleeping children to touch or engage in sexual activity Simulation of, or participation in, sexual activities, e.g. oral sex, sexual intercourse Presence of a sexually transmitted infection Persistent sexual activity with animals Using mobile phones and internet which includes giving out identifying details or sexual images
ASOs will become adult sexual offenders.
Current research shows that the sexual re-offense rate for ASOs who receive treatment is low in most US settings. Studies suggest that the rates of sexual re-offense (5 - 14%) are substantially lower than the rates for other delinquent behavior (8 - 58%).10,11 The assumption that the majority of ASOs will become adult sex offenders is not supported by the current literature.
Interventions and Strategies for Children Who Have Been Sexually Abused
Define the behavior. Describe specifically and clearly what the child is doing that is not okay. The more specific and clear, the better opportunity the child has to change or relearn his behavior
Interventions and Strategies for Children Who Have Been Sexually Abused
Develop cues and signals to help the child remember the "new" behavior.You and the child/youth might pick a certain word that you say when you see an identified behavior. When you say that word, it will remind the child to proceed to the new appropriate behavior.
Cognitive indicators
Difficulty learning and/or concentrating Poor school performance Inability to pay attention and focus
Interventions and Strategies for Children Who Have Been Sexually Abused
Education-It is important that children be given correct information and education about normative sexuality as well as safe versus unsafe touching (appropriate vs. inappropriate, etc. touching).
Puberty to Adolescence
During adolescence 'normal' sexual experiences are open to wide interpretations dependent on values, background, gender, culture, etc. • Early writers described differences between boys and girls which were mainly felt to be biological. Current thought on sex differences in behavior favors more the effects of social factors, sex-role expectations, and conditioning from an early age
13-15 years old
Early adolescence is marked by the early onset of puberty • There may be rapid growth spurts, secondary social characteristics develop, and there is an increased awareness of the physical self and its impact on others • The young person can become concerned with their psychosocial identity. Such questioning can lead to misunderstandings that others are preoccupied with his or her appearance and behaviour. Such self-consciousness can lead to a desire for greater privacy and independence • At this time, there can be increasingly stronger connections made with peers and a corresponding separation from family. At the same time, there may be increasingly stronger sexual attractions. Sexual behaviour can become very strong and as with other adolescent behaviour can show poor social judgment, high risk and lack of discrimination
5 phases of sexual abuse
Engagement Phase Sexual Interaction Phase Secrecy Phase Disclosure Phase Suppression Phase
3 E's of Trauma
Event-refers to the threat or actual experience of harm which may occur once or multiple times to your child. Experience-refers to your child's unique perception of the event described above Effect-refers to the impact the event and experience has upon your child. The impact can be short-term or long-term and it may come on immediately or show up late
Cognitive factors
Executive functioning Verbal ability Speech & language • Logical reasoning ability Non-verbal reasoning
What are some Sexualized Behaviors?
Extreme/excessive masturbation A child being overly clingy to an adult A child inserting objects into their genitals A child asking to touch or touching other's genitals A child attempting to engage in a sexual act with others A child acting out sexual acts with their toys or dolls
All sexual behavior that takes place between children is a sign of abuse.
False
The 5 phases of sexual abuse always occur in a sequential order.
False
2-6 years Preoperational
Focus on self, hard to take perspective of others, more concrete, focus on the present; incomplete understanding of death, death seen in terms of sleep, separation, and injury; language skills less developed
2 months
Genital erection common in boys (from birth)
Expected sexual behaviors at each age range: 10-13 years
Growing need for privacy Masturbation in private Curiosity and seeking information about sexuality Use of sexual language Interest and/ or participation in girlfriend or boyfriend relationships Hugging, kissing, touching with known peers Exhibitionism amongst same age peers within the context of play, e.g. occasional flashing or mooning Use of mobile phones and internet in relationships with known peers
Adolescent women sex offender characteristics
High prevalence of sexual victimization; • Instability and dysfunction within the family and home; • Co-occurring psychiatric disorders, including Post-Traumatic Stress Disorder; • Victimizing young children within the family or with whom they are familiar; • Targeting victims of either gender; and • Acting alone, often offending within the context of care-giving activities.
Interventions and Strategies for Children Who Have Been Sexually Abused
Identify and establish standards of behavior that the child can understand and fulfill. This simply means as we stated earlier to make sure it is developmentally appropriate for the age of the child as well as emotionally appropriate and that the child is capable of achieving the standards. This also means you have to remember that sometimes when children have been abused their emotional age is different than their numerical age.
Risk Assessment
If it is determined by CPS or law enforcement that a child has been sexually abused, the case is one of interfamilial abuse, and the child is at home, then it is necessary to make a determination of risk to the child ifshe/he stays in that environment. Following are three types of potential risk: Risk of additional sexual abuse? Risk of physical abuse?Risk of emotional maltreatment?
Expected sexual behaviors at each age range: 5-9 years
Increased sense of privacy about bodies Body touching and holding own genitals Masturbation, usually with awareness of privacy Curiosity about other children's genitals involving looking at and/or touching the bodies of familiar children, e.g. 'show me yours and I'll show you mine', playing 'family' Curiosity about sexuality, e.g. questions about babies, gender, relationships, sexual activity Telling stories or asking questions, using swear words, 'toilet' words or names for private parts Use of mobile phones and internet in relationships with
Individual Child Factors
Individual factors before, during, and after the event have been shown to play a role in children's experience of trauma. anxiety or depression, have been shown to exacerbate trauma reactions, with depression being the most predictive of PTSD symptoms.
Children who have been sexually abuse usually have a mistrust in others. What theory and cycle help to understand this mistrust?
Maslow's Heirarchy of Needs and the Cycle of Need
Statistics
It is estimated that there are somewhere between 250,000 and 300,000 cases of child sexual abuse each year in theU.S. The estimated number of sex abuse survivors in the U.S. is over 60 million
DSM-5; American Psychiatric Association [APA]
It suggests that those who grieve continue to enjoy pleasurable activities from time to time, whereas those who are depressed typically do not. Furthermore, those who are depressed often express feel-ings of worthlessness, whereas lack of self- esteem is not usually seen in those under-going typical bereavement.
8 years old
Know more about physiology and how the body works • Interest in sex rather high but exploration and play less than at six years • Interest in smutty jokes, giggling • Children whisper or write 'elimination' words or 'sex words'
Shared Purpose
Law enforcement and child protective services workers have some of the same purposes, such as determining: •If abuse occurred, and as much detail as possible regarding what happened, where and who else might know •Who is responsible for the abuse •What action is necessary to ensure safety of the child(ren)
7-8 years old
Less interest in sex - some mutual exploration, experimentation and sex play, but less than earlier • Know about social relations, sexual intercourse, sperm and egg but generally not combined to make a whole picture
0-1 years Infancy
Little understanding of death, death related to separation from caregiver
Interventions and Strategies for Children Who Have Been Sexually Abused
Make sure the adults/caretakers model appropriate behavior. They may need to actually model appropriate ways to give affection, to get attention when you need it, and to identify emotions.
ASOs need long-term (3-5 years) intensive therapy (2-5 sessions per week).
Many ASOs are successfully treated in shorter, less intensive treatment programs. Many ASOs are seen in outpatient group treatment programs that meet once a week for 8 to 28 months.
. ASOs should not attend public schools.
Many ASOs can safely attend public schools and participate in school activities such as sports programs, the band, or the school newspaper.
ASOs have other serious psychological disorders.
Many ASOs do not have other major psychological problems. Some ASOS have serious psychological problems, including conduct disorders, depression, and learning disabilities that need to be addressed during treatment.
ASOs were molested as children.
Many ASOs were not sexually victimized as children. The self reported rates of sexual victimization of ASOs range from 20%8 to 55%.4 Several studies have shown higher rates of self-reported physical abuse than sexual abuse.
6 years
Marked awareness of interest in differences between sexes in body structure - boys ask factual questions about their testicles • Mild sex play or exhibitionism, 'doctors and nurses' • Some children are subjected to sex play by older children; the age and power differences between the children are critical factors in defining
concern sexual behaviours at each age range: birth-4 years
Masturbation in preference to other activities Preoccupation with sexual behaviours Persistently watching others in sexual activity, toileting or when nude Explicit sexual talk, art or play Following others into private spaces, e.g. toilets, bathrooms to look at them or touch them Pulling other children's pants down or skirts up against their will touching the genitals/ private parts of other children in preference to other activities Attempting to touch or touching adults on the breasts, bottom, or genitals in ways that are persistent and/or invasive Touching the genitals/ private parts of animals after redirection
concern sexual behaviours at each age range: 10-13 years
Masturbation in preference to other activities, in public and/ or causing self injury Persistent explicit talk, art or play which is sexual or sexually intimidating Accessing age restricted materials, e.g. movies, games, internet with sexually explicit content Persistent expression of fear of sexually transmitted infection or pregnancy Marked changes to behaviour e.g. older or adult flirting behaviours, seeking relationships with older children or adults in preference to peers Engaging in sexual activities with an unknown peer, e.g. deep kissing, mutual masturbation Oral sex and/or intercourse with a known partner of similar age and developmental ability Using mobile phones and internet with unknown people which may include giving out identifying details
concern sexual behaviours at each age range: 5-9 years
Masturbation in preference to other activities, in public, with others and/or causing self injury Explicit talk, art or play of sexual nature Persistent questions about sexuality despite being answered Persistent nudity and/ or exposing private parts in public places Persistently watching or following others to look at or touch them Pulling other children's pants down or skirts up against their will Persistently mimicking sexual flirting behaviour too advanced for age, with other children or adults Touching genitals/ private parts of animals after redirection Use of mobile phone and internet with known and unknown people which may include giving out identifying details
characteristics of women sex offenders
Mental health symptoms, personality disorders, and substance abuse problems; • Difficulties in intimate relationships, or an absence of intimate relationships; • A propensity to primarily victimize children and adolescents (rarely adults); • A tendency to commit offenses against persons who are related or otherwise well known to them; and • An increased likelihood of perpetrating sex offenses in concert with a male intimate partner.
Interventions and Strategies for Children Who Have Been Sexually Abused
Messages received through the media are important for children who have been sexually abused. You cannot allow them to watch or listen to any media which promotes sexually behavior or might give confused messages about the behavior you are trying to correct.
13-14 years old
More critical of adults • Sensitive to criticism • Preoccupation with personal appearance • Girls can be child/woman in appearance • More rapid growth spurt in boys so the voice deepens • Erection and ejaculation more frequent • Strong peer group identification • Girls physically mature and more likely to masturbate • Sometimes more stable pairing between boys and girls • Boys continue growth spurt
ASOs should be placed in secure, residential treatment facilities.
Most ASOs can safely remain in the community during treatment. Some ASOs need residential placement; however, there is some professional consensus that most ASOs can be treated on an outpatient basis. Decisions about placement in residential or incarcerated settings should depend on community safety and treatment issues. The possible negative effects of out-of-home placement, such as increased risk of socialization into a delinquent lifestyle, negative peer influences, weakening of family ties, absence of parental involvement in treatment, and disruption of normal adolescent social development, should be considered.
ASOs are similar in most ways to adult sex offenders
Most ASOs differ from adult sex offenders in several ways. ASOs are different from adult sex offenders in that they have lower recidivism rates, engage in fewer abusive behaviors over shorter periods of time, and have less aggressive sexual behavior.
Expected sexual behaviors at each age range: 14-17 years
Need for privacy Masturbation in private Accessing information about sexuality Viewing materials for sexual arousal, e.g. music videos, magazines, movies Sexually explicit mutual conversations and/or use of humour and obscenities with peers Interest and/or participation in a one on one relationship with someone of the same or other sex Sexual activity with a partner of similar age and developmental ability (ability to consent must be considered) Use of mobile phones and internet in relationships with peers
Maslow's Hierarchy of Needs
Psychological Safety Social Esteem Self- Actualization
Five Precursors
Rasmussen, Burton, and Christpherson suggested that five precursors lead to a vulnerability to act out sexually in young sexually reactive or aggressive children. 1)Early sexualization- child was exposed to sexual material or conversation; possibly sexually abused 2)Poor social skills- child did not develop typical communication skills or was not exposed to social settings 3)Intimacy Issues- child has lack of ability to connect with someone else 4)Poor impulse control- child unable to resist temptation or urges 5)Lack of accountability in all areas of a youth's life- child was never held accountable
Module3: Behavioral Indicators:
Regression Withdrawal Advanced sexual knowledge Excessive masturbation Preoccupation with sex Victimizing others Conflicts with friends/family Hyperactivity Problems separating Secretive behavior Delinquency behaviors Poor relationships with peers Self-injuring behaviors Promiscuity Prostitution Early marriage Substance abuse Dropping out of school Manipulative behavior Seductive behavior
Social factors
Sense of identity and group belonging Self esteem with abandonment Managing dangers Engaging in risky behavior Bullying Child sexual exploitation Coping and managing with power and authority
Interventions and Strategies for Children Who Have Been Sexually Abused
Set the child up to succeed. This means you must make sure the rules are achievable and developmentally appropriate and also to make sure you practice catching the child being good.
Long term effects of Child Abuse
Sexual Dysfunction-While the outcome of sexually abusing others is a primary concern, many other sexual dysfunctions may also result from the traumatic sexual abuse. Hypersexual dysfunction may include promiscuity, sexual addictions, compulsive masturbation, and/or elevated or deviant arousal patterns. Sadistic or masochistic characteristics may be present in either consensual or exploitive relationships and are frequently present in the dynamics of prostitution and marital difficulties. Hypo-sexual dysfunctions may include inhibited desire or arousal and result in frigidity, impotence, or sexual aversions. Victimless fetishes such as cross-dressing may also related to impacts of childhood sexual abuse Somatic Complaints-The fears and helplessness inherent in the experience of abuse may be present. The "damaged goods" perception may lead to somatic complaints and nonspecific anxiety. Anxiety Affective Disorders & Suicide Risk-The chronic feeling of fear, helplessness and "damaged goods: may contribute to feelings of depression and a profound sense of hopelessness. In childhood these may appear as sadness and worry or in hyperactivity and attention deficits. With maturity, depressive disorders increase the risk of self-destructive behaviors and suicidal ideation. Self-destruction may related to a control-seeking cycle with suicide representing the ultimate control. Substance Use and Abuse-The thinking patterns present in the abuse of alcohol or drugs may relate to either a self-medication of somatic or depressive conditions or an escape from hyper-vigilance and anxiety. Eating Disorders Communication, Learning and Relationships
Child Sexual Exploitation (CSE)
Sexual exploitation of children and young people under 18 involves exploitative situations, contexts and relationships where young people receive 'something' (e.g. food, accommodation, drugs, alcohol, cigarettes, affection, gifts, money) as a result of them performing, and/or another or others performing on them, sexual activities.
concern sexual behaviours at each age range: 14-17 years
Sexual preoccupation which interferes with daily function Intentional spying on others while they are engaged in sexual activity or nudity Explicit communications, art or actions which are obscene or sexually intimidating Repeated exposure of private parts in a public place with peers, e.g. flashing Unsafe sexual behaviour, including unprotected sex, sexual activity while intoxicated, multiple partners and/or frequent change of partner Presence of sexually transmitted infection or unplanned pregnancy Oral sex and/or intercourse with known partner of more than two years age difference or with significant difference in development Arranging a meeting with an online acquaintance accompanied by a peer or known adult Using mobile phones and internet to send or receive sexually explicit photos of another person with their consent
Biological & physiological factors
Staying in charge of body weight Keeping healthy Underlying neurological difficulties Attachment and bonding
Interventions and Strategies for Children Who Have Been Sexually Abused
State the rule or expectations about the behavior. Don't lecture, statematter-of-factly with as few words as possible. "In this house..." "The rule is..." or "We expect everyone in our family to..." Also when stating the rules make sure you explain the rules around privacy and boundaries.
traumatic experiences and interpret this within the CAIS
Step 1: Initial Contact The Referral- parents, CPS workers, police, physicians, insurance companies, attorneys, and judges.it is most important to clarify the referral question(s), so that the clinician and the referring person(s) are in agreement about the focus of the assessment.
Comprehensive Assessment- to- Intervention System (CAIS)
Step 1: Initial Contact- should be completed prior to their first appointment. The PSI-4 gives information about sources of stress for the family apart from the death, as well as indications of parental depression. The CBCL or BASC-3 alert the clinician to child behavior prob-lems that may be unrelated to the death
Comprehensive Assessment- to- Intervention System (CAIS)
Step 2: Initial Intake Parent Interview: We typically begin the parent interview with the parents alone. During this time, facts about the death are obtained, and the parents' specific concerns are clarified. 1. How is each parent handling the death? 2. What questions about the death have the children asked? 3. What have the children been told regarding the death? 4. What was the relationship between each of the children and the deceased? 5. What unusual behaviors have the children exhibited?
traumatic experiences and interpret this within the CAIS
Step 2: Initial Intake Interview Child Interview: ESTABLISHING RAPPORT It is important that the child be informed of the reason for the interview, what will happen during the session(s),
traumatic experiences and interpret this within the CAIS
Step 2: Initial Intake Interview Parent Interview: we usually interview the parents with the child present. In order to decrease the pressure on the child, we ask the parents to tell us the details of the trauma, while checking periodically with the child to verify the information. This informs the child that it is OK to talk about the trauma.
Comprehensive Assessment- to- Intervention System (CAIS)
Step 3: Observation of Behavior observing the parent-child relationship outside the clinic. In the case of a terminally ill child, observation of the child in school may lead to suggested interventions to address problems in that setting
Comprehensive Assessment- to- Intervention System (CAIS)
Step 4: Further Evaluation although further evaluation may be indicated for children with problems that existed prior to the death,
Comprehensive Assessment- to- Intervention System (CAIS)
Step 5: Collaboration with Other Health Care Professionals Parents who are experiencing significant depression should be referred to a mental health professional for counseling and/or medication. The clinician should be aware that other family members may also need to be seen.
Comprehensive Assessment- to- Intervention System (CAIS)
Step 6: Communication of Findings and Treatment Recommendations the clinician should provide the parents with general information about children's understanding of death and how this applies to each child. Parents may also have specific questions about the children, such as attending the funeral (including open and closed casket), the resumption of regular routine, and behavior management.
Interventions and Strategies for Children Who Have Been Sexually Abused
Stop the behavior. Tell the child to stop, remove child's hand (if touching self in an inappropriate manner/place or touching another child, etc.),
Interventions and Strategies for Children Who Have Been Sexually Abused
Strive to teach, not to punish or shame. Use words that describe behavior such as "not O.K." or "against the rules" instead of words that judge the person such as"bad" or "misbehaving" or "nasty".
Interventions and Strategies for Children Who Have Been Sexually Abused
Supervision—some children may require one on one supervision and may not be able to play with other children without adult supervision. You also have to consider sleeping arrangements, supervision during school and hygiene (can they bath with other children, go to the bathroom with other children, etc.).
Trauma- focused cognitive- behavioral therapy (TF-CBT)
TF-CBT combines aspects of CBT to build skills, so that children are then able to work on the main trauma component, the trauma narrative. -TF-CBT has shown the strongest empirical evidence for treatment across different traumatic experiences, (1) psycho education about the treatment approach and the particular trauma; (2) parenting component for parents to learn skills on how to deal with difficult behavior; (3) relaxation skills; (4) affective expression and modulation skills; (5) cognitive coping skills; (6) the trauma narrative and cognitive processing of the trauma experience; (7) in vivo mastery of trauma reminders; (8) conjoint child- parent sessions; (9) enhancement of future safety and development.
Types of Emotional Risk
The child may be disbelieved by her/his mother, siblings, and/or extended family.? The child may be blamed for the sexual abuse. She/he may be told she/he was seductive. The child may believe she/he allowed it because she/he got special favors from the offender.? The child may be rejected by her/his family. Mother is angry at her/him. The child's siblings are angry because she/he has caused them embarrassment and loss of their father.
Suppression Phase
The child recants of suppresses the disclosure The following are reasons they may do so: If the perpetrator is outside the family, the family may try to suppress the information and intervention so that it will not become public information. If the perpetrator is within the family circle, intense pressure may be put on the victim to re-cant by the perpetrator or other family members. Feelings of guilt may be placed on the child Child may be isolated or ostracized Attempts from the child's family to undermine the child's credibility
engagement phase
The engagement phase consists of grooming behaviors such as: Special activities/games Giving gifts Spending excessive time with the child Making excuses to touch the child Creating situations to touch the child
16/17 years old
The growth rate slows, so that by the end of this stage, most teenagers will have completed puberty and physical transitions from childhood to adulthood • Hormonal balance is achieved and social behaviour is likely to develop within the context of a relationship • Although adolescents continue to be influenced by their peers, the power of peer pressure tends to be less and there is a greater tendency to become self-sufficient, more self-assured and pairing more stable
TRAUMA- AND STRESSOR-RELATED DISORDERS
The most common of these disorders in children are post traumatic stress disorder (PTSD), acute stress disorder, and adjustment disorder.
Sexual Interaction Phase
The sexual interaction phase usually consists of sexual implications that progress over time. The following are examples of actions that can occur. Nudity Disrobing Genital Exposure Observation of the child Kissing Fondling Masturbation Dry intercourse Fellatio (oral stimulation of a man's penis) Cunnilingus (stimulation of the female genitals using the tongue or lips) Digital penetration Penile penetration
traumatic grief
The traumatic death of a relative or friend
The Child Interview
There are several issues related to the child interview that should be determined before it takes place. These include where it should occur, who should be present, how information from the interview will be recorded, and how many interviews are needed. The interview should occur in a location the child perceives as a "safe place." In most instances, this will not be the child's home, but it may be the child's school, a therapist's office, a child interview room at the CPS office or police station, or a Children's Advocacy Center.
There are instruments that can determine whether or not an adolescent is at high risk to re-offend.
There is currently no test or scientifically validated instrument that can reliably determine if an adolescent will commit a subsequent sex offense. There are instruments (J-SOAP-II, ERASOR-2) under development to assess, with reliability and validity, the risk for future sex offenses by adolescents.
ASOs come from highly dysfunctional families.
There is no specific family profile for ASOs. No unique family pattern has been identified for ASOs.4The characteristics of ASO families are diverse and may or may not be considered dysfunctional.5
Factors Influencing Long‑Term Adjustment
These include accepting the reality of the loss, experiencing the pain or emotional aspects of the loss, adjusting to life without the deceased, and finding ways to memorialize the person and place the relationship in a new perspective for ongoing adjustment. denial, anger, bargaining, depression, and acceptance.
Phase 7: Disclosure
This is the phase in which you gather details about the abuse. You want to find out everything possible in the most organized way as possible.
Phase 3: Rapport Building
This phase is an ice breaker for the person you are talking with and the situation. It is designed to get to know the person and begin to build a trust with them.
Phase 5: Testing
This phase is designed to help you test around developmental skills to show that an individual understands the concepts thus adding credence to their story.
Phase 4: Rules
This phase is designed to set up ground rules for your interview. You want the person you are interviewing to feel comfortable in letting you know how they are feeling.
Phase 2: Introduction
This phase is to help normalize the situation and put people at ease. Not only will your introduce yourself, but also your profession.
Phase 8: Closure
This phase is used to wind up the interview and help the child transition back to their daily life. You want to begin backing away from the topic of concern once you have all of your details.
Phase 6: Topic of Concern
This phase is when you go from rapport building, testing and rules into the topic at hand. It can be intimidating and awkward to shift to such a personal and difficult topic. Your goal is to collect a clean story from them without asking leading questions.
Phase 1: Pre-Interview Preparation
This phase occurs before the forensic interview takes place. Anything and everything you can do to prepare prior to going out to see the child, you should do!
medical examination
Thus, the child should receive a medical examination at some point during the investigation. Generally, physicians only see the necessity of an immediate exam when the abuse is quite recent and/or there is concern about injury or disease. Otherwise the exam can be postponed for a few hours until there is an experienced health care professional available with sufficient time available to conduct the genital exam and necessary tests in the context of a general physical exam.
The Interview With the Non offending Parent
To gather additional information about the likelihood of the sexual abuse; To determine whether the mother is protective and supportive of the victim; In some instances, to ascertain if the mother has had a role in prompting the child to make or recant an allegation; and To understand the causes or dynamics leading to the sexual abuse.
Cycle of Need
Top: Need (hungry) Next: Need is expressed (cries) Bottom: Need is met (Parent feeds) Last: Trust Build/positive reinforcement (child stops crying and is content)
Factors which may influence how sexual abuse impacts an individual include age of victim, sex of the offender, extent of the sexual abuse and relationship between the offender and the victim.
True
Pre-adolescence is usually the age when kissing games may first become common at mixed parties.
True
The enormity of sexual abuse is likely to engender one of two opposing responses, disbelief or belief accompanied by an intense desire for retribution; this is considered part of the universal emotional reactions
True
7-10 years Concrete operational
Understand permanence of death but not for self; only older people die, death is the result of external situations; able to see cause-and-effect relationships
effects ^
When this happens it can cause emotions such as fear, loss, or distress.
ASOs are curious about sexuality and do not commit serious sex offenses.
While some illegal sexual behavior by ASOs is limited, such as touching a child over the clothes, other ASOs have extensive, aggressive sexual behavior including forced anal or vaginal intercourse.
Secrecy Phase
Why is secrecy important? Eliminates accountability for the perpetrator Enables the perpetrator to continue repeating the behavior Allows the perpetrator to continue to meet their needs (whatever they may be) through sexual abuse Children keep the secret for many reasons: Rewards and/or enjoyment of the activity Feeling close or important to the perpetrator Threats and fears for self Threats and fears for family or others
Can Sexual Behavior among siblings be "Normal"?
Yes. 1. similar ages 2. similar physical size 3. equal developmental levels 4. both are in agreement to the behavior 5. happens for a short period of time and in limited instances
Things to avoid
You want to avoid long complex questions or instructions. -Avoid these types of questions; it makes it difficult for the child to answer. -Avoid three or four Syllable words. Use one or two syllable words . Avoid Double negatives. Avoid hierarchical/categorical terms such as weapons; use concrete terms such as gun, knife, etc . Avoid jargon or uncommon usage of language we use such as: legal terms, of parties, strike, etc. Use common meanings of terms. Avoid pronouns (such as him, her, they, he/she) Use proper names, so there will be no misunderstanding of what is meant. -Avoid unclear references (those things, this, it, etc.) Repeat the name of whatever you are talking about -Avoid words whose meaning varies with time or place, such as here, there, yesterday, tomorrow). -Avoid relational terms (more, less). -Avoid questions that list several previously established facts -Avoid using the words pretend or story as this can imply make believe or fiction and end up being an issue in court. Never lie to a child, as you will lose your credibility. If they ask if someone is going to be arrested, never say yes. Do not make promises to children, as we are not sure what will happen.The child will possibly perceive it as a lie.
Child PTSD Symptom Scale
a child version of a trauma scale developed for adults, has a parent- report form for children ages 8-18 years. This scale asks about symptoms, gives severity scores, has been translated into several languages, and has suggested cutoffs of severity scores for a diagnosis of PTSD
Children's behavioral reactions to sexual abuse may
aggression toward people and animals criminal activity, running away, and suicidal behavior excessive masturbation
burnout
associated with fatigue and insensitivity that results from long continuous exposure to work that requires significant amounts of time and energy.
Physical symptoms of stress
backache, body ache, blurred vision, digestive problems, fatigue, headaches, changes in heart rate, muscular tension, skin rashes, sleeping problems, and sweating.
Which of the following is important and considered essential when working in the field of child sexual abuse?
being familiar and comfortable with all aspects of sexuality
Child Traumatic Stress
child has reactions that impact his/her daily life after a traumatic event, these responses. These reactions may show up in different ways, such as changes in your child's behavior, difficulties in interactions with others, problems or changes in sleeping or eating patterns, or school performance
Developmental and Environmental
development of sexual deviance can stem from developmental and environmental factors that have their beginnings. Such factors include: Lack of empathetic care and physical nurturing in infancy and early childhood Chaotic living conditions with multiple caregivers and/or multiple residences Physical abuse Sexual abuse Neglect
Adolescent sex offenders exhibit the following:
difficulties with impulse control and judgement
Which of the following is not a common factor that impacts the short and long term effects of a child sexual abuse victim?
disclosure of victim to a friend
psychological /emotional symptoms
disturbed eating patterns, feeling distressed, decreased motivation, loneliness, helplessness, feeling pressure, difficulty concentration, inability to perform duties, irritability and mood swings.
Nightmares are considered what type of indicator of a victim of child sexual abuse?
emotional
Interventions and Strategies for Children Who Have Been Sexually Abused
enforce the consequence—for younger children you can re-direct the child to amore appropriate behavior/activity. Always make sure you have several activities available that the child likes to do.
Specific Trauma Event Characteristics
evidenced by children who have been sexually abused when additional factors are present, including: 1) a close relationship with the perpetrator; 2) high frequency and long duration of sexual encounters; 3) physical evidence of oral, anal, or vaginal penetration; and 4) use of force
A five year old who does not want to sleep alone through the night, has nightmares, fears darkness and abandonment is clearly:
experiencing normal behavior and development for a 5 year old
A four year old child has begun having nightmares and is afraid to sleep alone. This is a clear indicator of the emotional effects of child sexual abuse.
false
Five year olds should be punished for use of tension reducing behaviors such as sucking their thumb or rubbing their genitals.
false
Sex offender treatment programs for female perpetrators are just as prevalent as those of male perpetrators?
false
Sexual knowledge, when demonstrated by younger children, should be evaluated the same as sexual knowledge demonstrated by older children.
false
Which of the following are common effects of sexual abuse for the victim?
feelings of powerlessness feeling betrayed
What can social workers do that law enforcement cannot during an investigation?
gain access to many pertinent records during the course of the investigation without a warrant (i.e. mental health records, medical records, school records, etc.)
Secondary Trauma
generate feelings of helplessness and despair as a result of the professional's perceived inability to make positive and helpful changes for a client who has been affected by a traumatic experience.
The Child Sexual Behavior Inventory
has been shown to be useful in documenting unusual sexual behaviors. It consists of questions about specific types and frequencies of sexual behavior exhibited by children. This instrument has been standardized and validated by comparing responses of parents of sexually abused children (ages 3-12) with those of parents of non-abused children of the same ages.
Which of the following are atypical/concerning behaviors in adolescents/teenagers 13-16 years old?
having sexual contact with much younger children taking younger children to "secret" places or hideaways
Power Differential can include which of the following?
implies that one party (the perpetrator/offender) controls the other (victim) the sexual encounter is not mutually conceived and undertaken the perpetrator/offender is physically stronger than the victim
Sensory information
includes a description of the sensations (noises, smells, physical sensations)
Physical/ Medical
individuals expression of sexual urges in a deviant way to be due to physical or medical factors/conditions. ◦Neurological Impairment ◦Head Trauma ◦Hormonal Imbalances
An adolescent perpetrator whom thinks to themselves, "I pulled it off", is in what phase of the sexual abuse cycle?
integration
procedural information
involves explaining the steps of the procedure
UCLA PTSD
is a revised version of a widely used and researched measure that screens for the presence of a traumatic event and associated PTSD symptoms. This measure, which has been used with the National Child Traumatic Stress Network database, has shown good internal and convergent validity
A traumatic event
is a scary, dangerous, or violent event. An event can be traumatic when we face or witness an immediate threat to ourselves or to a loved one, and it is often followed by serious injury or harm
Understanding normal sexual development is important because:
it provides an understanding of how different age groups are vulnerable to an offender it helps the worker more affectively access the abuse and educate the parents about protection from potential abuse
Helping Children Cope
parents often feel that their child will not understand the concept of death or medical procedures, so they decide not to talk with their child about these things Some seek out information while other avoid it.
What factors are useful in clinically differentiating abusive from non-abusive sexual acts?
power differential, knowledge differential, and gratification differential
The General Parent Questionnaire (see Appendix B)
provides information about the family constellation and the parents' perceptions of the problem. In addition, there are specific questions about types of trauma the child may have experienced that can be followed up in the parent interview if the parent indicates that the child has experienced.
Intervention Strategies Intervention with the Child
providing children with factual, honest information about death that is appropriate for their developmental level. For a young child, this means crafting the message in terms that are concrete and related to the child's experience. (1) The person has died; (2) this is very sad, and it is OK for children to talk about how they feel
Factors affecting the recognition of female-perpetrated sex offenses include all of the following except?
sexism
The under-reporting of child sexual abuse is influenced by:
societal taboos not readily believing males as victims the factor of power differential Correct! all of the above
Acute Stress Disorder and Adjustment Disorder
that the symptoms start 3 days after the trauma and remit after 1 month. Does not meet the severity level of PTSD
A child who has been sexually abused lacks the power and knowledge to give informed consent to the abuser.
true
An adolescent perpetrator may begin avoiding others in the precipitating phase of the sexual abuse cycle.
true
Gender Identification can result in either greater empathy or greater rejection of the persona of the same sex in child sexual abuse cases.
true
In order to act ethically according to SOP 1.1 Ethical Practice, one must ensure that their clients have the opportunity to make self-determined choices from among the options available to them free from external coercion.
true
Per Standards of Practice (SOP) 2.3, Acceptance Criteria, children ages 12-17 can be identified as a perpetrator if the report is substantiated?
true
Stigmatization and the associated feelings of guilt can be reflected in a child's self-destructive behavior.
true
We all come from different backgrounds, value systems, and cultures which influence our comfort level in talking about sex, sexual abuse and sexuality?
true
Psychological first aid (PFA)
was developed as an immediate response service to chil-dren, adults, and families, after a disaster or terrorist event (1) promoting a sense of safety, (2) promoting calmness, (3) promoting a sense of self and community efficacy, (4) promoting connectedness, and (5) instilling hope.
The Pediatric Emotional Distress Scale
was devised to detect symptoms after a traumatic event for children as young as 2 years to those that are 10 years old. It is a shorter screen that discriminates between those who have experienced a trauma and those who have not.
When considering if sexual behavior of children and young people is normal, concerning, or harmful, it is important to consider all of the following except:
whether they are remorseful or not
1 year
• Affectionate towards main caregiver when tired, wet or troubled; hugs and shows affection towards dolls and teddies
10 years old
• Considerable interest in 'smutty' jokes
11/12 years old
• Peer group very important • Girls can be anti-boy and vice-versa • Girls have very rapid growth. Breasts fill out. Menstruation starts. Body odour develops • New awareness of self. Gender specific anatomical differentiation. Emotional swings. More mature boys like to tease girls about their bra size • Boys interested in sexual jokes and sexually graphic material • Boys show some physical changes in the penis and pubic hair • Masturbation increases • Kissing, frequent change of boy/girlfriend • Boys tell others about their sexual experiences. • Girls gossip about the sexual experiences of others. • Homosexual young people become more aware of not being interested sexually in their opposite sex peers.
Differences in male vs. female sex offenders
• Sexual victimization histories are exceedingly more common among adult and adolescent female sex offenders than with male sex offenders, and their maltreatment experiences are often more longstanding, extensive, and severe; • Adult women are more likely than men to commit sex offenses with a co-offending male, either in concert with the male or as a result of coercion by the male; • Offending by adult and adolescent females is more likely to occur within the context of caregiving situations; • Acts of rape are less common among female sex offenders, but when they occur, the victims tend to be the same gender, unlike the victims of male-perpetrated rapes; • The victims of adolescent female perpetrators more often than adolescent male offenders tend to be young children; and • When child victims are involved, adolescent female offenders are more likely than adolescent males to target both genders, whereas adolescent males more commonly target children of the opposite sex.
Dynamics of Siblings in CSA cases
●They may be jealous—the victim is getting a great deal of attention ●They may be scared—not knowing what is going to happen to the family, maybe they are a victim also and afraid it will be found out ●Embarrassed that their friends and others will know what has occurred in their family ●Angry—they may blame the victim for tearing the family apart and it will have direct implications on them—emotional and possibly economic ●Confused now that sexual abuse has been disclosed ●Sad or worried about the victim ●Believe it is wrong to turn to outsiders and be angry that the victim brought these outsiders into the home
