'A kindergarten teacher must have 100 eyes and 100 ears!': Kindergarten teachers' experiences coping with child sexual abuse and problematic sexual behavior

BACKGROUND

Child sexual abuse (CSA) and problematic sexual behavior (PSB) are worldwide phenomena that occur across all ages. Kindergarten teachers' proactive involvement can be crucial to the prevention, disclosure and intervention of CSA and PSB. However, research on their experiences of contending with CSA and PSB remains limited.

OBJECTIVE

This study examines kindergarten teachers' experiences in Israel with the CSA and PSB of their students.

PARTICIPANTS AND SETTING

Semi-structured interviews were conducted with 31 teachers: 11 secular Jewish, seven religious Jewish, nine Druze Arab, and four Muslim Arab.

METHODS

A qualitative analysis was conducted using the interview transcripts as data.

RESULTS

The analysis revealed three themes illustrating teachers' professional transformations regarding their knowledge of these phenomena: 1) initial shock, uncertainty and sense of responsibility when exposed to CSA and PSB due to missing knowledge, 2) implementation of prevention and intervention strategies regarding CSA and PSB, and 3) embracing a social role to disseminate CSA and PSB knowledge. The findings indicated that the majority of the teachers went from overwhelming shock and fear due to a lack of knowledge in coping with CSA and PSB to a sense of responsibility as a community leader.

CONCLUSIONS

The fragmentation of the Israeli education system isolates kindergartens, and the lack of training and education for the teachers left them alone when contending with the CSA and PSB of their students. Nevertheless, the participants exhibited remarkable agency and resourcefulness, gaining the necessary knowledge and acting as knowledge agents within their communities.

Sexual Abuse of Children With Disabilities: Key Lessons and Future Directions Based on a Scoping Review

In recent years there has been a growing public and professional interest in situations of risk, abuse, and exploitation of children with disabilities (CWDs). Despite the increasing awareness of CWDs experiencing child sexual abuse (CSA) at high rates, research in this area is still in its infancy. The current study seeks to identify, map, and thoroughly analyze the existing knowledge to better inform future research, policy, and practice. A scoping review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, identifying 35 articles addressing CSA among CWDs based on self-report surveys, official report data, and qualitative interviews. The findings addressed the phenomenon's epidemiology, disclosure, identification patterns, and consequences. Studies showed that CWDs experience CSA two to four times more often than children without disabilities and that they suffer longer and harsher abuse due to factors that complicate the identification of CSA of CWDs. This review highlights the diverse methodologies, producing a high variance in phenomenon rates, as well as unique methodological strategies for addressing challenges in CSA and disability research. Future research should focus on qualitative-retrospective studies of the perceptions of survivors and significant others in their lives (e.g., parents). Moreover, an intersectionality paradigm must be adopted in future studies to address the diverse contexts that construct the phenomenon (including sociocultural contexts). There is also a need to develop integrative interventions to allow higher accessibility of services, adaptive identification mechanisms, and more effective collaboration between professionals and CWDs.

What Enables Child Sexual Abuse in Sport? A Systematic Review

Sporting environments provide opportunities for perpetrators to commit child sexual abuse (CSA). While awareness of CSA in sport and preventative interventions are increasing, CSA in sport still occurs at alarming rates. A systematic review was conducted to identify and synthesize the extant literature on the enabling factors for CSA in sport. The 34 included articles were peer-reviewed and were primary sources; had full-text versions in English; included the individual, situational, environmental, or systemic antecedent factors and characteristics which enable CSA in organized sport (clubs, schools, universities, and representative teams); and focused on abuse in children (0-18 years old), and included retrospective incidents. The enabling factors from across the broader sports system were identified and mapped using a systems thinking-based approach, the Risk Management Framework (RMF) and the associated AcciMap method. The results indicated that enabling factors for CSA in sport were identified at multiple levels of the sporting system hierarchy. The results show that 24.1% (n = 46) of the enabling factors identified in the literature relate to the hierarchical level of the Athlete, teammates, opponents, and fans levels, and 52.9% (n = 101) of the enabling factors relate to the level of Direct supervisors, management, medical, and performance personnel level. However, only 13% (n = 25) of enabling factors to CSA in sport were identified at the combined top four hierarchical levels. Results indicate that the problem of CSA in sport is a systems issue, and future research is required to explore how these factors interact to enable CSA in sport.

Perpetration-Focused Prevention: The Perceptions of Victim-Survivors

Policymakers are increasingly calling on victim-survivors of child sexual abuse to consult on prevention initiatives, including perpetration-focused prevention efforts like Stop it Now! However, very little is known about the perspectives of victim-survivors on perpetration-focused prevention and whether they support such initiatives. This study was informed by the research question: How do victim-survivors of child sexual abuse perceive perpetration-focused prevention, including the Stop it Now! program? Sixteen Australian victim-survivors participated in an individual, one-hour interview and the data were analysed according to thematic analysis. Four themes emerged through the data analysis: Core of repulsion; Doubt and dismissal; Conditions for congruence; and Arriving at acceptability. These themes are represented as a spiral from the first theme at the centre to the last at the outer edge, reflecting a process of rationalisation. Their initial reaction was a sense of revulsion to perpetration-focused prevention, but their final position was one of conditional support.

Exploring Screening Practices for Child Sexual Abuse in School Settings: An Integrative Review

Child sexual abuse (CSA) is a pervasive public health problem. If left undetected, CSA can result in immediate and long-term health problems, which can be mitigated through early identification. Schools are an ideal environment to implement screening measures, and school nurses (SN) are uniquely poised to intervene and respond early. The aim of this review was to systematically examine and synthesize the international evidence related to screening for early identification of CSA in schools. Themes emerging from the analysis were SN behaviors relative to screening, potential instruments or approaches for screening, and SN and school professionals' beliefs about CSA screening practices. This review found little evidence that CSA screening is occurring in schools. However, SNs are aware that screening falls within their scope of practice and many SNs feel they should be screening for it. A constant proactive approach by SNs is necessary to improve early identification and subsequent intervention.

Responsible Behavior With Younger Children: Results From a Pilot Randomized Evaluation of a School-Based Child Sexual Abuse Perpetration Prevention Program

Many efforts to prevent child sexual abuse (CSA) aim to teach children strategies for recognizing, resisting, and reporting victimization. There is limited evidence that victimization-focused efforts actually prevent CSA. Moreover, these efforts often overlook the fact that many children and adolescents engage in problem sexual behavior against younger children. Responsible Behavior with Younger Children (RBYC) is a novel universal school-based perpetration-focused intervention that aims to prevent the onset of inappropriate, harmful, or illegal sexual behavior by adolescents against younger children.1 Responsible behavior with younger children was designed to provide adolescents and their parents with the knowledge and tools to help adolescents interact appropriately with younger children and avoid CSA behaviors. In this paper we describe intervention development, summarize lessons learned from implementing RBYC in four urban schools, and report results from our pilot randomized waitlist-controlled trial (RCT) with 160 6th and 7th grade students. Results indicate RBYC was associated with increased accuracy in youth knowledge about CSA and CSA-related laws, and with increased behavioral intention to avoid or prevent CSA with younger children and peer sexual harassment. Although the sample was small and the effects were relatively modest, the findings do suggest that RBYC holds promise for preventing the onset of problem sexual behavior.

Piloting an Alternative Implementation Modality for a School-Based Child Sexual Abuse Prevention Curriculum

BACKGROUND

In the U.S., the most pervasive child sexual abuse (CSA) prevention strategy involves school-based prevention programs; however, the reach of these programs is limited due to implementation constraints, such as budgets or turnover. This is notable as standard delivery of often requires two facilitators in the classroom. Leveraging a natural experiment in the implementation of Safe Touches, the current study sought to explore the feasibility of implementation with a single facilitator using pre-recorded videos compared to the standard in-person delivery.

METHODS

A six-item CSA-related knowledge questionnaire was delivered to (N = 1480) second-graders post-workshop. An independent-samples t-test was used to compare the mean of CSA-related knowledge item responses for each delivery modality. Student-level data were paired with teacher evaluations and an interview with the facilitator.

RESULTS

Across workshops delivered in 25 schools, there was no significant difference in knowledge based on CSA-related questions by workshop modality. Teachers indicated the facilitators responded effectively to the children's questions and comments in both delivery modalities. Input from the facilitator was positive.

CONCLUSIONS

Triangulation of student knowledge, teacher input, and facilitator experience indicates the viability and feasibility of this implementation strategy for Safe Touches, and potentially other school-based CSA prevention programs. To ensure equitable access to the CSA prevention program, the empirical examination of, and investment in, alternative implementation options for school-based CSA preventive programs is encouraged.

Enhancing Child Sexual Abuse Prevention Knowledge With an Educational Toolkit -Evaluation of the Chinese Doll Program

Objective: In countries with conservative attitudes towards sex and limited resources to prevent child sexual abuse, culturally adapted CSA prevention programs are essential. This study outlines a randomized controlled trial evaluating the effectiveness of the Doll program for preventing CSA in the specific context of China. Method: 181 children were pre-tested and post-tested (5 weeks later) for knowledge of sexual abuse prevention. Children were assigned to one of three groups; 1) child only (n = 60); 2) child and parent (n = 60); and 3) control (n = 61). Results: Children in groups 1 and 2 showed significant increases (p < 0.001) in scores on the Appropriate Touch Scale (ATS) and the Inappropriate Touch Scale (ITS), whereas those in the control group did not show a significant increase in ATS scores, but their scores on ITS significantly increased (p < 0.001). Children in group 2 showed significantly increased ITS scores compared to group 1 (p = 0.016). Conclusion: Doll program effectively enhances children's CSA prevention knowledge, with parental engagement demonstrating a positive impact on the program.

Child Sexual Abuse in Pakistan: A Phenomenological Study on Parental Understanding and Prevention Strategies for Child Protection

Child Sexual Abuse (CSA) is widespread and pervasive in Pakistan, presenting a significant threat to a child's physical health, psychological well-being, and overall development. This study aimed to empirically substantiate the understanding of parents regarding CSA and their utilized preventive strategies. The study utilized Social Ecological Theory to gain a deeper comprehension of the phenomenon. Data was collected through in-depth semi-structured interviews with 18 parents from Islamabad capital city, using a qualitative phenomenological research approach along with thematic analysis. Results reveal that most of the parents were highly aware of the most common aspects of sexual assault and molestation, but they were unaware of the more manipulative subtle forms such as "grooming." Additionally, they had a limited understanding of the long-term consequences of sexual abuse. While many parents knew about the option of involving the police in cases of abuse, they were unaware of helpline services and the availability of psychological support. In terms of prevention, most parents employed an integrated approach involving various preventive measures, such as educating their children about appropriate and inappropriate touch. These findings underscore the importance of implementing public-focused initiatives and community-based programs to enhance parental awareness, knowledge, and capabilities in preventing CSA in Pakistan.

Parental Involvement in Programs to Prevent Child Sexual Abuse: A Systematic Review of Four Decades of Research

This systematic review is the first to synthesize knowledge of parental involvement in child sexual abuse (CSA) prevention programs. Guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, 24 intervention evaluations met the inclusion criteria of aiming to change parental knowledge, attitudes, behaviors, behavioral intentions, self-efficacy, response-efficacy, or capabilities for prevention of CSA. Included papers were identified via a combination of electronic database searches (PsycINFO, Web of Science, Scopus, Google Scholar, Cochrane Library, World Health Organization's International Clinical Trials Registry Platform, google.com.au, open.grey.eu, Global ETD, Open Access Theses & Dissertations, EThOS, and Trove) and direct communication with researchers. Improvement post intervention was found most commonly for parental behavioral intentions and response-efficacy, closely followed by parental behaviors, then capabilities, self-efficacy, knowledge, and lastly, parental attitudes. Improvements in behaviors, intentions, and response-efficacy occurred in 88 to 100% of the studies in which they were addressed, improvements in self-efficacy and capabilities occurred in 67 to 75%, and improvements in knowledge and attitudes occurred in only 50 to 56%. Many of the included evaluation studies suffered from methodological and reporting flaws, such as high participant attrition, lack of control group, lack of statistical tests, missed testing time points, and a lack of (or short) follow-up. Future parent-focused CSA prevention evaluations must address these concerns by conducting rigorous empirical research with sound methodologies and comprehensive reporting. Furthermore, study designs should consider measuring the real-world impact of increases in assessed parent variables, including their ability to prevent sexual victimization of children.

It's More Than a Matter of Trust: What Parents and Young Children Need to Know to Prevent Intrafamilial Child Sexual Abuse

Programs aimed at preventing child sexual abuse typically focus on skilling up young children and, to a lesser extent, parents by imparting a range of protective messages. Many sexual abuse prevention programs include a focus on identifying or vetting "safe" or "trustworthy" people. The authors qualitatively analyzed the content of narratives from individuals with childhood experience of intrafamilial sexual abuse, an under-represented voice in the development of child sexual abuse prevention programs. The analysis of impediments to protection indicated that, within the family context, reductionistic judgments of familiar individuals' perceived safety or trustworthiness impaired child safety. In addition to adults and children being unable to recognize sexually abusive behavior and warning signs, child-victim survivor narratives highlighted the barriers for prevention in family environments characterized by maltreatment, a lack of child rights or that were unsupported by external authorities. Implications for the content of messages young children and their parents need to prevent child sexual victimization in the context of everyday family life are discussed.

Non-offending caregivers reflections on the use of a film encompassing child sexual abuse perpetrator's testimonies for potential child protection initiatives in South Africa

BACKGROUND

Child sexual abuse (CSA) remains a challenge in South Africa, despite various legislative developments to address child abuse. Despite non-offending caregivers (NOC) playing a critical role in child safeguarding, and supporting disclosure and recovery, very little research has focused on understanding what works in assisting them in supporting child victims in South Africa.

OBJECTIVES

The study examines the exposure of NOC who watched a short film based on the testimonies of four CSA perpetrators in therapy, with a view to exploring whether this film could be useful for CSA prevention, disclosure and support initiatives.

PARTICIPANTS AND SETTING

A convenience sample of eight NOC attending a community support service in KwaZulu-Natal, South Africa.

METHODS

After viewing the film, the NOC completed a questionnaire, and were asked to discuss usefulness of film content based on perpetrator testimonials in sensitizing NOC around disclosure of sexual abuse and support of the child. Thematic data analysis combined their perceptions of sexual abuse experienced by their children/grandchildren and the effect that content of the film had on their perceptions.

RESULTS

Five themes emerged; Awareness of CSA and available child protection programs; Views toward CSA disclosure; Emotive responses; Lessons learnt for identification of CSA and child protection; and Recommendations for future programs.

CONCLUSIONS

The process of viewing and discussing the film stimulated a shift for NOC to identify risk, facilitate disclosure of CSA, and become more supportive toward child victims. The study highlights the potential of using film to guide NOC targeted child protection and safeguarding initiatives.

Sexual grooming processes carried out by offending rabbis toward religious men and their families

BACKGROUND

Research regarding sexual grooming in cases of sexual abuse by religious authorities (SARA) is limited, despite the assumption that many SARA cases go unreported. To the best of our knowledge there is no research regarding sexual grooming committed by rabbis who sexually abused Israeli Jewish religious men.

OBJECTIVE

The present study examined how Israeli religious SARA victims and their family members experienced sexual grooming carried out by offending rabbis.

METHODS

Based on a constructivist-phenomenological paradigm, semi-structured in-depth interviews were conducted with 16 formerly and/or currently still religious men who had been sexually abused by rabbis in their adolescence, and 14 of their family members.

RESULTS

In comparison to the Sexual Grooming Model (SGM), findings showcased that unlike other kinds of sex offenders, offending rabbis incorporated religious elements throughout the grooming process. Additionally, offending rabbis used different grooming tactics than did Catholic priests (e.g., offering joint religious studies with victims' family members; using religion to justify sexual discourse and contact).

CONCLUSIONS

The findings expand the SGM, enable a more complex understanding of the grooming processes in SARA, and emphasize the importance of further research focused on increasing the ability to use the SGM for detecting and preventing grooming behaviors.

The public's knowledge about child sexual abuse influences its perceptions of prevention and associated policies

BACKGROUND

Child sexual abuse (CSA) prevention requires efforts from all members of society.

OBJECTIVE

The current study aimed to examine factors associated with (1) perceptions of CSA as unpreventable and (2) support for policies to prevent CSA and to punish people who perpetrated CSA. We focused on the roles of knowledge and misperceptions about child sexual abuse.

PARTICIPANTS AND SETTING

We collected survey data online from a large (N = 5068), nationally representative sample of adults in the United States.

RESULTS

Analyses revealed factors promoting perceptions of CSA as unpreventable. Support for or against policies that aim to prevent CSA or to punish perpetrators of CSA were associated with individual factors such as older age (B = 0.08, -0.13), Republican political affiliation (B = 0.10, 0.07), and misperceptions about CSA (B = 0.15, 0.06).

CONCLUSIONS

Findings highlight malleable factors that could be targeted to collectivize calls for CSA prevention and to promote support for effective policies to prevent CSA. In particular, ensuring accurate knowledge about CSA, and collective responsibility and government efficacy specific to CSA prevention, were identified as helping shape views of CSA as preventable.

"I was alone. No one offered me a real intervention": Israeli child protection services as experienced by adults who underwent child sexual abuse

BACKGROUND

Many children worldwide come into contact with child protection social workers (CPSW) following child sexual abuse (CSA). Surprisingly, little is known concerning how they experience and perceive these encounters.

OBJECTIVE

The current study was designed to examine the way adults who underwent CSA experienced and perceived child protection services (CPS) in Israel as conveyed in their written testimonies.

METHOD

The current sample included 83 written testimonies sent to the Israeli Independent Public Inquiry on CSA, analyzed using inductive thematic analysis.

RESULTS

The participants' testimonies uncovered two main themes: 1) experiences with CPSW interventions, including being disregarded, abandoned and disbelieved; and 2) constructions of the CPSW practice as poor, maladapted and abusive. Some participants described their active efforts to change the system from within.

CONCLUSIONS

The participants' testimonies, which reflected the negative manifestations of neoliberal policy in the CPS, will be broached in the discussion section, alongside two other significant concepts: child participation and a context-informed perspective of child risk and protection. The ramifications for policy and practice will be expanded while acknowledging the complex role of social workers in CPS.

Effectiveness of child sexual abuse prevention programs on knowledge acquisition: A meta-analytical study

BACKGROUND

Child sexual abuse (CSA) is a type of maltreatment considered a global health problem. CSA is a traumatic experience with important consequences for the victim's health. It is essential to report the effectiveness of CSA prevention programs to offer society useful tools to combat this abuse.

OBJECTIVE

We aimed to study the effectiveness of CSA prevention programs on the knowledge acquisition based on comparing pre- and post-treatment changes, and also if their effectiveness is related to program-related and methodological variables.

PARTICIPANTS AND SETTINGS

Standardised mean change (with studies that report pre-post program measures) of the effectiveness of CSA prevention programs published between 2014 and 2021 was carried out.

METHODS

The general effectiveness of these programs and whether the results were influenced by program-related variables (the duration, the target population, participants' age, or the type of intervention) or by methodology-related factors (the agent who taught them, the geographical area where they were carried out or the way the programs were evaluated) were analysed. A total of 43 samples analysing knowledge about CSA as a dependent variable were included.

RESULTS

The results reported a combined effect size considered large (dMR = -0.96, 95 % CI [-1.10, -0.82], p < .001). High inter-study heterogeneity was observed in the meta-analysis, although only the geographic area where the studies were conducted appears as a significant moderator.

CONCLUSIONS

In conclusion, the prevention programs included in this analysis significantly improved the participants' knowledge acquisition.

Caring for Domestic Minor Sex Trafficking Patients: Recommendations for Identification, Interventions, and Resources

Domestic minor sex trafficking has increasingly gained awareness as a social phenomenon that affects adolescent health and safety. Healthcare providers are uniquely positioned to identify and facilitate supportive interventions for adolescents at high risk or involved in trafficking. A growing literature base and clinical experience provide recommendations on how to identify, engage trafficked youth, and provide beneficial linkages with community resources. A coordinated, multidisciplinary, and trauma-informed response that fosters therapeutic alliances promoting agency, safety, and trust are key components of successful care for this vulnerable adolescent population.

"It's a preventable type of harm": Evidence-based strategies to prevent sexual abuse in schools

The last two decades have seen global public recognition of the scale and impact of adult-perpetrated institutional child sexual abuse. A sizeable body of knowledge about generalized safeguarding measures has since been generated to inform organizations' prevention efforts. Apparent in the extant literature, however, is a notable lack of evidence-based and context-specific prevention strategies targeting perpetration in distinct institutional environments. This absence extends to educational settings where most reported contemporary cases occur or originate. The recommendations outlined in this article contribute to this gap. Derived from empirical findings establishing the role of context-specific rather than person-specific factors, a range of prevention strategies framed by Situational Crime Prevention are proposed for secondary educational settings. These recommendations are supplemented by the unique insights of interviewed experts with specialist professional knowledge. Recommendations center around targeting features of the environment such as high-risk locations, available guardians, and intimacy-promoting situations available in educational contexts. Taken together, this robust prevention and control agenda can create conditions for safer educational environments.

Prevention of child sexual abuse in the USA: a scoping review protocol of US legislative policies

INTRODUCTION

Child sexual abuse (CSA) poses a significant threat to the health and well-being of children in the USA and globally. Many states have introduced or implemented policies to address and prevent CSA, but little research has linked the effects of this legislation on the reduction of adult-perpetrated CSA. The objective of this scoping review is to identify US policies which aim to prevent CSA, explain the components of these types of legislation, review evidence of effectiveness, describe the populations included in the literature, and identify barriers and facilitators to the implementation of said policies.

METHODS AND ANALYSIS

This scoping review will follow Joanna Briggs Institute methodology for scoping reviews and will use the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews Checklist. Sources of peer-reviewed evidence from January 2000 to July 2023 will be included. Relevant publications will first be searched in PubMed/MEDLINE database, then 25 other databases. The reference lists of included studies and high-yield journals will be hand searched. Articles which focus on the types of CSA prevention policies and their effects will be included. Studies must clearly demonstrate a connection between policies and CSA outcomes. Title, abstract, full-text screening and extraction will be completed by a team of three researchers. Critical appraisal of the included studies will be performed. Extracted data will be displayed in tabular form and a narrative summary will describe the results of the review.

ETHICS AND DISSEMINATION

This scoping review will provide an extensive overview of legislative policies which aim to prevent CSA in the USA. Results of this review will inform future CSA prevention policies in the USA, particularly regarding policy development, evaluation and implementation. Results will be disseminated through a peer-reviewed publication.

Unpacking School-Based Child Sexual Abuse Prevention Programs: A Realist Review

Background: Existing efforts to understand school-based child sexual abuse (CSA) prevention programs mainly focus on the effectiveness of these programs in increasing participants' CSA knowledge and self-protective skills. There are currently no reviews addressing the underpinning pathways leading to these outcomes. In order to increase our understanding about the underpinning causal and contextual factors and inform the further development of school-based CSA prevention programs, a realist review was conducted to synthesize existing evidence from a broad range of data. Methods: An iterative search of electronic databases and grey literature was conducted, supplemented with citation tracking to locate relevant literature. For quantitative evidence, we considered evaluation studies that focused on students aged 5-18 years, who were enrolled in primary or secondary schools; for other types/formats of studies/documents, no population restrictions were applied. We included school-based CSA prevention programs that focused on improving knowledge of CSA or self-protective skills. Outcomes of interest included knowledge of CSA or self-protective skills. We did not apply methodological filters in terms of the types of studies to be included. Thematic content analysis was conducted to synthesize data. Results: Sixty-two studies were included. Five themes and five overarching Context-Strategy-Mechanism-Outcome configurations (CSMOs) that contributed to the success of school-based CSA interventions were identified, including tailoring programs to participants' cognitive developmental levels, repeated exposure of key concepts and skills, utilization of interactive delivery methods and positive feedback, delivery of positive information and application of the 'train-the-trainer' model. Implications: Findings from this realist review provide insights into the underlying program theory of school-based CSA prevention programs, which can aid in the development and implementation of these programs in the future.

"One Day It Will Be Over, and You Will See Other Landscapes. . . You Are Not Alone": Adult Survivors' Messages to Children Undergoing Child Sexual Abuse

Child sexual abuse (CSA) has received considerable attention from scholars, contributing to policy, intervention, and prevention efforts worldwide. However, survivors' involvement in this research is limited. This study was designed to delve into the messages of adult CSA survivors to abused children. In all, 371 written testimonies were provided to the Israeli Independent Public Inquiry on CSA by survivors from diverse communities in Israel. The Inquiry aimed to promote change in policies related to CSA. The testimonies were analyzed using the qualitative thematic analysis method. The results revealed five main messages emphasized by survivors to children experiencing CSA: (a) transferring the responsibility and guilt from children to perpetrators and society; (b) turning toward the light and continuing on; (c) disclosure is essential; (d) a happy life is possible; and (e) together we can survive. The discussion emphasizes how various systems in survivors' lives have profound impacts following the abuse. Although survivors were from diverse backgrounds, their messages to abused children were consistent. Through their messages to the children, the survivors emphasized their wish to transfer responsibility and guilt from children experiencing abuse to the society that is supposed to see, listen, protect, and validate. Implications for practice are discussed, focusing on the importance of making room for survivors' voices and experiences in the processes of shaping policies in the area of CSA. Moreover, the survivors' desire to be there for the children emphasized the urgent need to promote the perception of survivors as key stakeholders in the field of child abuse and to integrate their experiences and perceptions into the formal and informal systems for children.

Child Witnesses Productively Respond to "How" Questions About Evaluations but Struggle With Other "How" Questions

Child interviewers are often advised to avoid asking "How" questions, particularly with young children. However, children tend to answer "How" evaluative questions productively (e.g., "How did you feel?"). "How" evaluative questions are phrased as a "How" followed by an auxiliary verb (e.g., "did" or "was"), but so are "How" questions requesting information about method or manner (e.g., "How did he touch you?"), and "How" method/manner questions might be more difficult for children to answer. We examined 458 5- to 17-year-old children questioned about sexual abuse, identified 2485 "How" questions with an auxiliary verb, and classified them as "How" evaluative (n = 886) or "How" method/manner (n = 1599). Across age, children gave more productive answers to "How" evaluative questions than "How" method/manner questions. Although even young children responded appropriately to "How" method/manner questions over 80% of the time, specific types of "How" method/manner questions were particularly difficult, including questions regarding clothing, body positioning, and the nature of touch. Children's difficulties lie in specific combinations of "How" questions and topics, rather than "How" questions in general.

Implementation of a Universal School-Based Child Sexual Abuse Prevention Program: A Longitudinal Cohort Study

Child sexual abuse (CSA) is a public health problem of considerable magnitude. The prevailing primary prevention strategies are universal, school-based CSA prevention programs, some of which have been designated as evidence-based, such as Safe Touches. However, to reach their public health impact potential, effective universal school-based CSA prevention programs require effective and efficient dissemination and implementation strategies. The purpose of this study was to demonstrate the reach and effectiveness of a school-based CSA prevention curriculum, Safe Touches, when implemented on a wide scale. Using a longitudinal cohort design, children in second grade classrooms in public elementary schools in five counties received the Safe Touches workshop and completed surveys designed to assess gains in knowledge at four timepoints (one week prior, immediately post-workshop, 6- and 12-months post-workshop). In total, the Safe Touches workshop was delivered in 718 classrooms in 92% of school districts, reaching ~14,235 second graders. Multilevel models (n = 3,673) revealed that Safe Touches significantly increased CSA-related knowledge, and that these gains were maintained 12-months post-workshop (ps < .001). There were some small but significant time-varying effects among participants in schools with a greater percentage of low income and minority students, but these effects largely disappeared 12-months post workshop. This study demonstrates that a single-session, universal school-based CSA prevention program can effectively increase children's knowledge when implemented and disseminated on a wide scale and knowledge gains can be retained 12-months post intervention.

Cohort analysis of child abuse and neglect cases treated during the initial 2 years of a programme to support hospital-based child protection work in Austria

OBJECTIVE

To describe characteristics of suspected child abuse and neglect (CAN) cases associated with the decision of paediatric departments (PDs) in Vienna, Austria, to involve services of a regional tertiary child protection service programme (Forensische Kinder- und JugendUntersuchungsStelle, FOKUS).

DESIGN

Retrospective cohort analysis of a regional data collection of CAN cases over the first 2 years of FOKUS's operational period (1 July 2015-30 June 2017).

SETTING

All CAN cases reported to the PDs of six public hospitals in Vienna. Five of these public hospitals were secondary heath care centres and one was a tertiary healthcare centre.

RESULTS

Overall, 231 cases (59.1%) were treated without and 160 (40.9%) with additional involvement of the FOKUS service programme. The odds of a case to be treated without FOKUS involvement were higher if neglect was suspected (OR 3.233, 95% CI 2.024 to 5.279). In contrast, when sexual abuse was suspected, the odds for involvement with FOKUS were significantly higher (OR 7.577, 95% CI 4.580 to 12.879). The odds of being managed with FOKUS services nearly doubled when multiple forms of abuse were suspected (OR 1.926, 95% CI 1.136 to 3.285). The odds for additional FOKUS involvement were significantly lower for patients treated as inpatients (OR 0.239, 95% CI 0.151 to 0.373). CAN patients managed with FOKUS involvement were significantly more often reported to law enforcement (LE) (OR 3.234, 95% CI 2.078 to 5.002). Concurrently, suspected sexual abuse cases and cases reported to LE were more frequently treated in the PD of the tertiary centre than in other PDs (χ2 p<0.001).

CONCLUSION

CAN case characteristics significantly influenced if PDs involved a tertiary child protection programme. Suspected sexual abuse, if more than one form of CAN was suspected and cases reported to LE required additional specialist expertise. For suspected neglect involvement of tertiary services seemed less important.

Culturally Competent Interventions for Child Sexual Abuse: A Scoping Review of the Literature and the Implications for American Samoa

Significant stigma regarding child sexual abuse exists in American Samoa. Although cultural interventions may help prevent child sexual abuse, very little is known about such interventions. Therefore, through a scoping review process, this study aimed to gain a broad understanding of past and current culturally tailored interventions to prevent child sexual abuse. Because no studies examine interventions to prevent child sexual abuse in American Samoa specifically, the reviewed literature investigates interventions in different cultures. The literature search initially identified 180 relevant articles. After applying inclusion and exclusion criteria, nine studies met the eligibility criteria for review. Extracted data from these articles included the country or population, sample, study methods, children's age, intervention type, and details about the intervention. Results suggest that culturally tailored interventions for preventing child sexual abuse exist in various countries and cultural contexts. Results highlight that child sexual abuse prevention interventions are effective if translated into the native language. Findings from this study highlight the importance of using a culturally tailored approach to addressing child sexual abuse and can help guide the development of new interventions. Although more research on the prevention of child sexual abuse in American Samoa is needed, the results of this study might inform the development of culturally tailored interventions for the region.

Knowledge Gains from the Implementation of a Child Sexual Abuse Prevention Program and the Future of School-Based Prevention Education

School-based child sexual abuse (CSA) programs effectively increase students' CSA-related knowledge. This study focuses on an implementation trial of Safe Touches, an empirically supported, school-based CSA prevention program, that was disrupted by the COVID-19 pandemic. We sought to demonstrate gains in CSA-related knowledge following Safe Touches but were limited to a pre-post design. A total of 2,210 students across five counties in a Mid-Atlantic state received the Safe Touches workshop between September 2019 and March 2020. McNemar's chi-square test was used to assess changes in the proportion of correct responses pre-workshop (Time 1) and one-week post-workshop (Time 2). Students' CSA-related knowledge increased significantly based on changes in mean CSA knowledge scores and the number of correct item-level responses assessed at Time 1 and Time 2 (p < .000). Leveraging the experience of the facilitators' who delivered these workshops prior to the disruption of implementation, we gathered facilitators' perspectives to explore the viability of offering Safe Touches virtually. In July 2020, 16 facilitators completed an electronic survey designed to understand the viability of a virtual Safe Touches workshop. Three themes emerged from facilitator feedback on virtual programming: student engagement concerns, handling disclosures, and technology access to a virtual program. The findings of this study indicate that the Safe Touches workshop significantly increased CSA-related knowledge and, overall, facilitators supported further exploration and development of a virtual Safe Touches workshop. The transition of empirically supported school-based CSA prevention programs to a virtual delivery modality is necessary to maintain an effective means of primary prevention and opportunity for disclosure.

Preventive Education Outreach on Social Media: The Quest to Enroll Community Members in a Child Sexual Prevention Workshop

Social media is a frequently used tool in health promotion efforts although less so for the prevention of child sexual abuse (CSA). This is due, in part, to the lack of standardized branding guides for community-based efforts in how to craft messages related to CSA prevention. This study examined the use of Twitter (now "X") as a means of promoting participation in the adult-focused Stewards of Children CSA prevention workshop, prior to and following the implementation of a standardized branding guide. The exposure, reach, and engagement of the top tweets and top media tweets were examined over 24-months pre- and post-implementation of a five-point branding guide. Engagement was descriptively compared to the number of adults who enrolled in the Stewards of Children workshop. As evidenced by the increase in tweet impressions and the number of adults trained, it is likely the implementation of the branding guide was beneficial in promoting participation in the Stewards of Children workshop. Though participation in a program does not inherently suggest behavior change, getting participants to enroll is a crucial first step. The findings emphasize the potential of using social media to ultimately promote behavior change in the field of CSA prevention and beyond.

Evaluating the Effectiveness of a Live Musical Theater-Based Approach to Child Sexual Abuse Prevention in Elementary Schools

Hugs and Kisses is a theater-based child sexual abuse (CSA) prevention program designed for children in kindergarten through fifth grades. The purpose of this cross-sectional case study is to evaluate how a comprehensive live musical theater program can prepare teachers to discuss and identify the signs of CSA, help children increase their knowledge, and learn prevention strategies to stop CSA in the future. A total of 154 teachers and 2,700 children from 31 schools participated in this program during 2016. Findings show this program increases children's awareness of touch and action knowledge through five primary safety lessons taught during the program and reinforced by a teacher led in-person discussion after the play. Nearly 85% of the students across all grade levels in this sample understood the lessons taught in the play, and students whose teachers held an in-class discussion after the play scored better than those students whose teachers did not hold a discussion. Teachers who were prepared with training resources also held longer in-class discussions compared to those who were not prepared. The Hugs play has the potential to be a national model for evidence-based CSA programs.

How Do Survivor and Mandatory Reporter Status Correlate with Program Outcomes for an Adult-Focused Child Sexual Abuse Prevention Program?

This exploratory study investigated group differences and pre-post changes in knowledge, beliefs, and behavior by mandatory reporters and Child Sexual Abuse (CSA) survivor status for a CSA prevention training designed for the general public. Of the 8,114 study participants, 32% identified as having experienced CSA, and 77% indicated they were mandatory reporters for child abuse and neglect. Mandatory reporters had higher baseline knowledge about CSA than those who were not mandatory reporters and reported more CSA preventative behaviors. Mandatory reporters continued to have higher levels of knowledge following the training. Survivors of CSA also had higher baseline knowledge about CSA and preventative behavior scores than individuals who are not survivors of CSA. Unlike mandatory reporters, they experienced fewer increases in knowledge. At posttest, there was no evidence of a difference in knowledge between CSA survivors and non-CSA survivors. For items related to beliefs, mandatory reporters had higher baseline scores than other participants. However, they had smaller gains, so mandatory reporters and non-mandatory reporters had more similar beliefs related to CSA after the training. There were few differences between CSA survivors and non-survivors on baseline beliefs related to CSA, though CSA survivors reported greater increases in beliefs that CSA prevention is their responsibility and in the idea that they know what to do to prevent CSA. These results have significant results for the development and evaluation of trauma-informed prevention programming.

The Knowledge, Perceptions and Training Needs About Online Sexual Grooming of Children and Adolescents in a Sample of Professionals Who Work in Portugal

Online sexual grooming occurs when adults or adolescents contact children and adolescents using online media intending to establish sexual contact with the victims. Professionals who work with children and adolescents can be crucial in the prevention and intervention in this phenomenon. The main goal of this research was to evaluate the knowledge, the perceptions, and the training needs regarding online sexual grooming perpetrated by adults in a sample of professionals who work with children and adolescents in Portugal. A total of 161 professionals participated in the study, of which 72 (45%) were teachers, 52 (32%) were child protection professionals and 37 (23%) were psychologists. A new questionnaire was developed for this study, which was distributed online. All the participants reported having heard the term "online sexual grooming" before. The data show that most participants have some training regarding violence against children and adolescents but that only a minority of participants have training regarding online sexual grooming. Participants reported confidence in their ability to support victims of grooming and considered training regarding this phenomenon as a beneficial tool for professionals. The main conclusion from this research is that professionals are motivated to prevent online sexual grooming, and that, if they receive adequate evidence-based training, they may be essential first responders in sexual abuse cases.

A Global Outlook on Child Sexual Abuse and Sexually Explicit Material Online During COVID-19: Trends and Interdisciplinary Prevention Methods

This scoping review investigates the impact of COVID-19 on global and national trends in online child sexually explicit material (CSEM) trafficking and production in addition to online child sexual abuse (OCSA). Globally, CSEM consumption increased dramatically during the pandemic, as well as trafficking of self-generated material. The hypothesized reasons for the increase in OCSA and CSEM that guided this review included stay-at-home orders, COVID-19-related precautions, technology use increase, economic instability, and lack of available victim and legal resources. Current global and national law enforcement procedures to prevent the proliferation of online sexual abuse are reviewed with suggestions for preventing further increases in CSEM production, distribution, and consumption at the micro and macro levels.

Cultural Determinants and Parent-Child Communication as an Effective Tool to Prevent Child Sexual Abuse: A Quick Qualitative Study

The current study's sole specific goal was to use a qualitative approach, from the parents' emic perspective, to investigate the cultural determinants that influence using parent-child communication as an instrument to protect children from sexual abuse in the six electoral wards of Ife-East Local Government that covered the rural settlement of Ile-Ife. The study adopted a simple random sampling method to select a village from each ward and a convenient sampling method to select six parents from each village, making a total sample size of 36. The study utilized in-depth face-to-face interviews to garner the primary data and content analysis for data analysis. This study found and concluded that parents' economic activities, religious beliefs, fear of stigmatization or mockery, belief that giving a child sex education via parent-child communication promotes waywardness in the behavior of such a child, belief that sex education should be best confined to formal education, and overconfidence of the parents in their wards were among the cultural determinants influencing the efficacy of parent-child communication as a device to shield young ones from being victims of sexual abuse in the study location. The study recommended public enlightenment via various social institutions on dealing with these cultural determinants.

Knowledge, Skills, and Self-Disclosure Following a Sexual Abuse Prevention Program Among Iranian Preschoolers: A Cluster Quasi-Experimental Controlled Study

Standard empirical studies are needed despite three decades of research on child sexual abuse prevention programs (CSAPPs). This study aimed to investigate the effects of CSAPP on the child's sexual safety. A multicenter, random cluster, quasi-experimental controlled survey was conducted in a 1:1 ratio in Tehran, Iran, from May to December 2019 in seventy 5- to 6-years-old children from 10 kindergartens. In groups of 7 to 8, the intervention group participated in four sessions of 45 minutes of face-to-face sexual self-care training, 3 to 4 days apart. The control groups received one session on accident safety. Knowledge, self-protective skills, fear, and self-disclosure were assessed respectively by the "Personal Safety Questionnaire (PSQ)," "What If Situation Test (WIST)," "Fear Assessment Thermometer Scale (FATS)," and researcher-made questions before and 8 weeks after the intervention. At the baseline, children obtained 70% of knowledge and 45% of protective skills scores. After the intervention, knowledge, protective skills, and detection of "appropriate requests" were significantly promoted (p < .001). Detecting "inappropriate requests" did not differ; however, all quadruple skills (Say, Do, Tell, and Report) improved significantly. "Girl sex" and "parents' education" were related factors promoting children's protective skills. Sexual abuse self-disclosure was 4.2% (n = 3), and one child reported child sexual abuse (CSA) only after the intervention. Despite the lack of formal education, children's basic knowledge reflects the importance of parents in preventing CSA. However, the CSAPP significantly improved children's skills and revealed one CSA case. CSAPP should not focus solely on risky scenarios because if children cannot distinguish between safe and unsafe situations, they will experience unnecessary anxiety. Even after recognizing the dangerous conditions, CSA prevention will practically fail without appropriate reactions such as escaping and reporting. CSAPP should emphasize individual rights such as body ownership and assertiveness skills and explain the "danger of known people" with detailed scenarios, especially in collectivistic and traditional societies.

Provider Attitudes and Self-Efficacy When Delivering a Child Sexual Abuse Prevention Module: An Exploratory Study

BACKGROUND

As constant figures in children's lives, parents are key in protecting children from sexual abuse. One barrier to reaching parents is that the topic can be difficult to broach and is sensitive in nature. Such barriers can interfere with implementation and fidelity of evidence-based prevention strategies that are focused on reducing rates of childhood sexual abuse (CSA).

AIMS

In this exploratory study, we examine provider attitudes about delivering CSA-specific content in an evidence-based prevention module and their self-efficacy.

METHOD

Thirty-three providers participated in three surveys: prior to a skills-oriented training on how to deliver the CSA prevention module (pretraining), immediately posttraining, and 6 months posttraining. Changes in self-reported willingness to deliver content, beliefs about parents' role in CSA prevention, and confidence about their ability to deliver content were assessed over time. Open-ended questions were coded thematically to reinforce quantitative findings.

RESULTS

Prior to training, providers were worried that parents would respond negatively to CSA content and were concerned about their comfort level discussing victimization and sexual development. Findings suggest that skill-oriented training and provision scripts effectively supported providers and improved confidence in delivering CSA prevention content.

DISCUSSION

Provider self-efficacy is an important element of implementation fidelity. This exploratory study demonstrated that, though providers may approach CSA content with wariness and trepidation, adequate skills-oriented training can reduce negative attitudes and increase perceived efficacy in the actual delivery of CSA content that persists through implementation.

CONCLUSION

Skills-based training can significantly enhance fidelity in the delivery of difficult content included in parent-focused preventative interventions.

What Can We Learn About the Others Present During Incidents of Child Abuse?: Key Lessons and Future Directions Based on a Scoping Review

Child abuse (CA) is a global problem that has received attention from policymakers, researchers, and practitioners. The majority of studies have focused on the phenomenon's epidemiology and consequences, alongside groundbreaking writing on victims and perpetrators. The concept of others who are present during the abuse is understudied and underdeveloped, despite its vital importance in better understanding children's experiences as well as their disclosure. The current study was designed to spotlight the phenomenon of others' presence, beyond the victims and perpetrators, during child abuse incidents. The current literature review was guided by a scoping review strategy. The results revealed scant empirical data, with only 15 studies meeting the inclusion criteria of the study. The articles that met the inclusion criteria addressed other people's presence during CA incidents, were published in peer-reviewed journals, and were written in the English language. These articles' analyses addressed the relations of the survivors with these others, pointing mainly to two identities: accidental bystanders who are not familiar with the child and family members of the child. The results provided a glance into the process that accidental bystanders go through during the abuse and the meaning of their presence for those who are family members. The perceptions and experiences of the children themselves with respect to the presence of the others during the abuse are noticeably lacking. The key conclusion from the current scoping review pinpoints the urgent need to advance the empirical knowledge on the presence of others during incidents of child abuse, especially others who are familiar to the children and are a significant part of their lives. The conceptualization of this phenomenon has the potential to better adapt prevention and intervention efforts in the field of child abuse.

Assessing Impact of Health Education in Improving Knowledge of Children on Child Sexual Abuse

BACKGROUND

Every year, millions of children around the world face sexual abuse and exploitation. Sexual and reproductive health education is an important form of health promotion action against it. This study aims to assess the impact of health education program in improving knowledge of the children on child sexual abuse.

METHODS

A school based pre-experimental study was done among 120 lower secondary level students of a private school in Bharatpur municipality of Chitwan District, Nepal during March 2021. An interventional health education program imparting knowledge on child sexual abuse and its preventive measures was given to the children. Their knowledge was assessed and compared before and after intervention using paired t-test. Data analysis was done using SPSS version 17 software.

RESULTS

The mean age of children was 13.77±0.65 years with 1:1.18 girls to boys ratio. The level of knowledge of the children on child sexual abuse and its preventive measures increased significantly post-intervention as compared to pre-intervention. The mean scores of post-test (29.80±4.53) was higher than pre-test (17.04±6.96). The intervention was proved effective with statistically significant t-test values (t=20.996, p=<0.001). About 6.7% children disclosed an experience of child abuse post-intervention.

CONCLUSIONS

The school based health education program effectively increased the knowledge of the children on child sexual abuse, thus helping in preventing and protecting them from child sexual abuse and its harmful effects.

The Nature and Scope of Educator Misconduct in K-12

Educator sexual misconduct is a serious problem in the United States (U.S.), with a 2004 Department of Education report estimating that 9.6% of K-12 students in the U.S. had experienced either verbal, visual, or physical educator misconduct at some point during their school career. However, since that report almost 20 years ago, there have been few large-scale studies examining the extent of the problem. As such, the current study, which uses a large sample from recent high school graduates in four U.S. states, offers updated data on the nature and scope of sexual misconduct in educational settings. Overall, 11.7% of the 6632 participants reported having experienced at least one form of educator sexual misconduct during Grades K-12, with 11% reporting sexual comments and less than 1% reporting other forms of sexual misconduct (e.g., receiving sexual photos/messages, being kissed, touched sexually, or engaging in sexual intercourse/oral sex). Those who reported misconduct showed significantly more difficulties in current psychosocial functioning than those who did not report educator misconduct. Academic teachers most often perpetrated the abuse (63%), followed by coaches and gym teachers (20%). Educators who engaged in sexual misconduct were primarily male (85%), whereas students who reported experiencing educator misconduct were primarily female (72%). Rates of disclosure to authorities were very low (4%) and some sexual grooming behaviors like gift giving (12%) and showing special attention (29%) were reported. These findings will be discussed as they pertain to the prevention of sexual misconduct within educational settings.

Improving professional practice in the investigation and management of intrafamilial child sexual abuse: Qualitative analysis of serious child protection reviews

BACKGROUND

Local multi-agency case reviews are regularly held in England when children have suffered significant harm from abuse or neglect, including from child sexual abuse (CSA). Most CSA takes place within families, is common but under-reported and can cause long-term harm.

OBJECTIVE

The aim was to analyse English child protection reviews relating to intrafamilial CSA to identify improvements for professional practice.

PARTICIPANTS AND SETTING

Local Child Safeguarding Practice Reviews (LCSPRs) and Serious Case Reviews (SCRs) relating to serious incidents of intrafamilial CSA occurring between 01 April 2017 and 31 March 2020.

METHODS

LCSPRs and SCRs were obtained from the National Case Review Repository and thematically analysed.

RESULTS

There were 243 reviews, of which 25 featured intrafamilial CSA. The main themes related to perpetrators, vulnerable families, and professional practice. Half of perpetrators were known by services to have previously abused children, but issues with professional practice enabled them to continue. Most children did not disclose CSA verbally showing challenging or sexualised behaviour; but professionals lacked knowledge and confidence on how to intervene without verbal disclosure, which limited safeguarding actions. Non-engagement by families with services was common, with some non-abusing parents complicit in abuse and deception. Significant neglect occurred in half the families, which diverted professional attention away from CSA.

CONCLUSION

CSA is deliberate abuse of children involving considerable deception by perpetrators in contrast to some other types of child abuse. This difference in abuser behaviour makes child protection more difficult, particularly when professionals do not recognise and respond to children's non-verbal disclosures.

Knowledge Transmission and Skills Building Relating to Child Sexual Abuse in China

Parents play a key role in child CSA prevention, but the mechanisms underlying the intergenerational knowledge transmission are not fully understood. This study explores the role of two parenting practices - parent-child communication and parent's protective behavior - as mediating factors in the relation between parents' knowledge and their children's knowledge and skills. Four hundred and ten dyads of early adolescents and their mother or father from rural China participated in the study. Parents were surveyed on their knowledge, protective behaviors, and parent-child communication regarding CSA, while children answered questions on relevant knowledge and skills. Results revealed that parental knowledge was positively and significantly related to communication and protective behavior, protective behavior was positively related to children's knowledge and skills, but the coefficient between communication and children's knowledge and skills was insignificant. The findings highlight direct parental protection as one of the most important mechanism for intergenerational knowledge transmission.

Identification of red flag child sexual grooming behaviors

BACKGROUND

Sexual Grooming is the deceptive process wherein a would-be perpetrator prepares a child for sexual abuse (CSA) and prevents disclosure and detection. It is often difficult to detect sexual grooming because some grooming behaviors resemble normal adult-child interactions. To prevent CSA, it is vital to identify sexual grooming behaviors that can be considered "red flag" behaviors.

OBJECTIVE

This study compared reported sexual grooming behaviors between adults who experienced CSA and those with no CSA history to identify which behaviors differed between the two groups. Further we explored whether the relationship to the adult male in the Non-CSA group impacted reported behaviors.

PARTICIPANTS AND SETTING

Participants were recruited online through Prolific and included adults who experienced CSA (n = 411) and those with no CSA history (n = 502).

METHODS

Participants who reported CSA completed the Sexual Grooming Scale - Victim Version (SGS-V) about their CSA experience. Those with no CSA history were randomly assigned to one of three conditions (family member/non-family member/community member) and completed a modified version of the SGS-V about an adult male with whom they had the most interpersonal contact before age 18.

RESULTS

Numerous sexual grooming behaviors that differentiated the behaviors of adults who engaged in CSA and those who did not were identified. The relationship to the adult was an important consideration.

CONCLUSIONS

Red flag sexual grooming behaviors, specifically those related to desensitizing the child to physical contact and sexual content, can be identified in cases of CSA and have an important role in prevention.

"It was in Control of Me": Notions of Addiction and Online Child Sexual Exploitation Material Offending

This paper focuses on notions of "addiction" among users of online child sexual exploitation material (CSEM) through a comparative analysis of two qualitative studies. The first is a 17-month anthropological ethnography (participant observation, interviews, and focus groups) in UK group programs for CSEM users, and the second is based on interviews with individuals in sexual offense treatment units of a US prison. We thematically analyze the narratives of 103 CSEM users at different timepoints and settings from pre-trial to incarceration. Those citing "addiction" focused on three areas. First was pornography progression. Second were perceived indicators of "addiction" and alignment/analogy to other addictions, including ideas about losing control; ignoring detrimental consequences and continuing; physiological signs similar to withdrawal; likening to substances; and progression from "softer" to "harder" material. Third, less common was rejecting the "addiction" label, citing choice and responsibility. We situate these results within debates and literature regarding pornography and Internet "addiction"; implications of the label; societal conceptions of sexual offending; harms of CSEM; and treatment/prevention considerations. Lastly, highlighting the merit of interdisciplinary comparative qualitative analysis, we demonstrate similarities in narratives despite differences in location, timeframe, setting, conviction status, intervention programming, and research methods.

No Check We Won't Write: A Report on the High Cost of Sex Offender Incarceration

Child sexual abuse is a preventable public health problem that is addressed primarily via reactive criminal justice efforts. In this report, we focus on the cost of incarcerating adults convicted of sex crimes against children in the United States. Specifically, we summarize publicly available information on U.S. state and federal prison and sex offender civil commitment costs. Wherever possible, we used government data sources to inform cost estimates. Results indicate the annual cost to incarcerate adults convicted of sex crimes against children in the United States approaches $5.4 billion. This estimate does not include any costs incurred prior to incarceration (e.g., related to detection and prosecution) or post-release (e.g., related to supervision or registration). Nor does this estimate capture administrative and judicial costs associated with appeals, or administrative costs that cannot be extricated from other budgets, as is the case when costs per-prisoner are shared between prisons and civil commitment facilities. We believe information on the substantial funding dedicated to incarceration will be useful to U.S. federal, state, and local lawmakers and to international policymakers as they consider allocating resources to the development, evaluation and dissemination of effective prevention strategies aimed at keeping children safe from sexual abuse in the first place.

Incorporating Quaternary Prevention: Understanding the Full Scope of Public Health Practices in Sexual Abuse Prevention

This discussion piece argues for a refinement in our understanding of prevention in sexual abuse, suggesting that we include quaternary prevention on the grounds that this concept from medical literature has potential and helpful application to criminal justice and particularly to work with those who cause sexual harm. Located within the paradigm of Epidemiological Criminology (EpiCrim), quaternary prevention extends the prevention spectrum to enable a stronger distinction between tertiary level responses and long-term safe, sustainable reintegration into communities, particularly of those who sexually abuse others. The key principles of quaternary prevention are adapted and refined from current medical literature, and the potential usefulness of quaternary prevention to crime and sex abuse prevention is explored.

Child Sexual Grooming of Catholic Clergy: A Comparison between Victims Allegedly Abused by Clergy with Single versus Multiple Victims

There is evidence that clergy who commit child sexual abuse (CSA) may utilize sexual grooming behaviors in the offense process consistent with a content-validated model (Sexual Grooming Model; SGM). Although research has examined differences in characteristics between clergy with single versus multiple CSA victims, little is known about how sexual grooming behaviors may vary between these groups. The present study utilized a large sample of alleged clergy sexual abuse incidents (n = 10,667) to examine the differences in reported sexual grooming behaviors for victims who experienced abuse by an individual who had a single (V-SVOs) or multiple (V-MVOs) victims. As part of a larger study, files of victim reports of CSA were reviewed from 195 dioceses/eparchies and 140 religious institutes in the United States; these data were analyzed based on behaviors in the SGM for the present study. Overall, the findings showed that the two groups (V-SVOs and V-MVOs) experienced similar tactics throughout the sexual grooming process outlined by the SGM. However, there were some differences for certain tactics within the gaining access and isolation, trust development, and desensitization to sexual contact and physical touch stages of sexual grooming. The implications for prevention, policy, and treatment, as well as future directions of research, are discussed.

What Messages Are Communicated to Children in Maltreatment Prevention Programs? Conclusions of a Scoping Review

There is a worldwide consensus that the prevention of child maltreatment (CM) is critical in promoting children's safety. Furthermore, a significant part of the prevention efforts targets the children themselves. This scoping review aimed to map the characteristics of CM prevention programs that targeted children by examining studies that described the relevant implemented programs, published in peer-reviewed journals over the last decade. Thirty-one relevant manuscripts were identified from the online databases. The analysis, guided by scoping review guidelines, examined these programs in terms of content, context of delivery, and practitioners involved. A thematic analysis identified the key messages conveyed to the children. The findings showed that the vast majority of programs are school-based and focused on preventing child sexual abuse (CSA) with considerably less attention given to other forms of maltreatment. In addition, most programs did not promote active parental participation. The content descriptions of the CSA prevention programs revealed several common key messages that focused on children's individual safety skills, specifically recognition, refusal strategies, and disclosure. The discussion addresses the concepts of blame and guilt as crucial to rethinking the CM prevention messages conveyed to children. Key conclusions that were drawn from the current scoping review highlight the need to better align prevention efforts and recent CM research. Additionally, ceiling effects in several studies indicated that children's participation, as information sources and partners in program development, should be promoted, so that prevention efforts will meet their needs within their various relevant life contexts.

The Longitudinal Effects of Second Step Child Protection Unit on Children: Gender as a Moderator

We investigated the longitudinal effects of the Second Step Child Protection Unit (CPU; Committee for Children) on student outcomes through a randomized controlled trial. Eight schools with a total sample including 2,031 students were assigned randomly to the CPU intervention or the wait-list control condition. We employed a multi-process latent growth model using a structural equation modeling framework which simultaneously analyzed student outcome growth via the effects of the intervention. The moderating effect of gender was also included. Over four data collection waves (pretest, posttest, follow-up [6 months] and follow-up [12-months]), the intervention group students were better able to recognize appropriate requests in CSA scenarios than control group students over time. Teacher-student relations improved for the students in the intervention schools but worsened for the students in the control schools over time. Despite concerns that CSA prevention programs may result in the unintended consequence of making children more fearful, children in both conditions did not show increased fears over time. The longitudinal effect on CSA recognition was more pronounced among girls, who suffer from higher CSA prevalence, compared with boys. Implications for prevention, policy, and directions for future research are discussed.

Recruitment and Entrapment Pathways of Minors into Sex Trafficking in Canada and the United States: A Systematic Review

The domestic sex trafficking of minors is occurring across Canada and the United States. Understanding the routes into sex trafficking, including the way traffickers target, recruit and enmesh youth in the sex trade is invaluable information for service providers and law makers developing prevention and intervention initiatives. This review synthesized research on the exploitation processes and tactics employed by traffickers in the sex trafficking of domestic minors in Canada and the US. The authors comprehensively and systematically searched five electronic databases and obtained additional publications and grey literature through a backward search of the references cited in articles reviewed for inclusion.  Inclusionary criteria included: Studies published in the English language between January 1990 and June 2020 containing original research with quantitative or qualitative data on the recruitment or pathways into sex trafficking for minors trafficked within the US and Canada. The search yielded 23 eligible studies. The synthesis of the studies in the review converged on the notion of sexual exploitation occurring on a continuum comprising of three components; the recruitment context, entrapment strategies utilized by traffickers, and enmeshment tactics used to prolong exploitation. Findings highlight the significant physical, psychological and emotional hurdles faced by youth victims of sex trafficking and point to the importance of comprehensive and holistic approaches to prevention and intervention practices.

Child abuse prevention education policies increase reports of child sexual abuse

BACKGROUND

It is well supported that engaging in prevention education increases a child's awareness of child sexual abuse. However, due to methodological limitations, prior research has yet to determine whether this knowledge leads to increases in reporting or substantiation of child sexual abuse.

OBJECTIVE

We examined whether state mandates for school-based prevention education correlate to changes in reports of child sexual abuse.

METHODS

We used a quasi-experimental design to investigate the association between child sexual abuse report rates from 2005 to 2019 and presence of state legislation mandating school-based child sexual abuse prevention curricula. Child sexual abuse report data were obtained from the National Child Abuse and Neglect Data System child files. We focused on reports for school-aged children ages 5-17. Data on state laws on prevention curricula were extracted from enoughabuse.org, Prevent Child Abuse America, ErinsLaw.org, and directly from published legislation.

RESULTS

State education mandates were associated with an increase in the incidence of child sexual abuse reports made by education personnel (IRR = 1.22, 95 % CI, 1.01-1.48). Policies were not associated with increases in incidence of child sexual abuse reports made by non-education personnel (IRR = 1.08, 95 % CI, 0.95-1.22) or decreases in likelihood that any given report was confirmed (OR = 1.00; 95 % CI, 0.90-1.12).

CONCLUSIONS

There is moderate evidence that adopting state mandates for child sexual abuse prevention education may increase disclosures and reporting of child sexual abuse by school-based sources. There is no evidence that mandates decrease the validity of child sexual abuse reporting by school-based sources.

Child Sexual Abuse Prevention: Parental Discussion, Protective Practices and Attitudes

Understanding parental practices and attitudes regarding child sexual abuse (CSA) prevention could be used to improve CSA prevention, but little information is available. In this study, we summarise survey data collected from 248 Australian and UK parents (87% female) with at least one child aged 6-11 years (M = 8.6, SD = 1.8). This is the first study to quantify parental use of protective practices, other than prevention education, which may guard against CSA. Parental media mediation, which may safeguard against online dangers, was another unique focus of this study. Participants reported their discussion of sensitive topics with their children including CSA; behaviors that may reduce the incidence of CSA (e.g., monitoring, supervision, delegation of care and checking-in with the child); mediation of their child's media use; and attitudes towards CSA prevention education. Parents reported discussing sexual abuse less than other sensitive topics such as abduction dangers, drugs, and death but more than issues surrounding puberty, sex and pornography. Parents reported using high levels of protective behaviours, however some areas of concern were revealed. Of concern was the low-moderate level of parental media mediation, with substantial numbers of children potentially exposed to online risks such as using devices unsupervised in bedrooms or chatting to individuals unknown to their parents and not having their devices checked for concerning content. Almost all parents were supportive of CSA prevention education and felt they should provide this education. However, two-thirds of parents thought CSA education may be associated with harms for the child and two-thirds of parents believed children could prevent their own abuse. Reported results will aid in our understanding of which areas of parenting could be strengthened to create safer environments for children. This research has particularly highlighted the need for parents to be more protective around their children's access to online devices.

A Q Methodology Investigation of School Counselors' Beliefs and Feelings in Reporting Suspected Child Sexual Abuse

School counselors can be influenced by a wide variety of beliefs and emotions when reporting suspected child sexual abuse (CSA) including worry, fear, sadness, depression, helplessness, anger, and distrust of child protective services. These beliefs and emotions can keep school counselors from reporting suspected CSA despite their duties as mandated reporters. We sought to uncover patterns of school counselors' (N = 85) shared beliefs and emotions that can impact their decision making in reporting suspected CSA. Q methodology allowed us to reveal common profiles of school counselors' viewpoints on reporting CSA to inform school counseling practice and training. Our data analysis revealed two profiles representing distinct patterns of school counselor viewpoints: worry about consequences and knowledge gap. School counselors in the worry about consequences factor felt that the potential negative consequences of their reports for the child and themselves impacted their reporting process. School counselors in the knowledge gap factor believed their lack of knowledge of signs of CSA, school procedures, and school counseling ethical codes influenced their reporting of CSA. School counselors should reflect on their beliefs and emotions that may prevent reporting, communicate and collaborate with child protective services, and seek support and mentorship as necessary.