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Monday, January 6, 2014

THE TRAUMA OF CHILD SEXUAL ABUSE


The impact of child sexual abuse, signs, symptoms and prevention tips...

Sex is hard enough to talk to our innocent children about, much less the horrifying possibility that someone could potentially overpower and violate them in an evil and violating act.   We adults have lived in a fog of denial and have inadvertently done a poor job in discussing sex and child sexual abuse with our kids.  We model what we have learned and rarely do we receive accurate education from our own parents on sex or sexual abuse, so we are left to maneuver through this fog with no headlights.  Our discomfort with the issue of sexual abuse, combined with our lack of understanding the risk and complexities of the issue, has left our kids completely vulnerable.  Our lack of offensive prevention training has produced the horrifying statistics of 1 in 4 girls and 1 in 6 boys being sexually abused by the age of 18, with only 1 in every 10 ever telling anyone about the abuse.  The trauma of abuse is a heavy burden for a child to bear alone.  Victims of child sexual abuse are often shamed into silence and afraid of the repercussions of disclosure, so parents are unfortunately the last to know. 

We trust those closest to us; our family, our friends, our tutors, our coaches and our teachers, so it is most difficult to accept that 93% are abused by someone close, yes someone our child knows, loves and trusts; someone we know, love and trust.  Often, someone we have introduced into their life, who we would least suspect as a danger, violates our children.

So how can this possibly happen?   We are going to look at the issue and glean a clear definition of child sexual abuse, situations that make your child most vulnerable and the devastating impact on our children’s emotional, spiritual and physical health.  Sexual trauma can happen in a number of ways and cause self-destructive patterns that set your child up for a lifetime of suffering without intervention and healing.

The Center for Disease Control defines child sexual abuse:

“Child sexual abuse involves any sexual activity with a child where consent is not or cannot be given.  This includes sexual contact that is accompanied by force or threat, regardless of age to participants, and all sexual contact between an adult and a child, regardless of whether or not there is deception or the child understands the sexual nature of the activity.  Sexual contact between an older and younger child can also be abusive if there is significant disparity in age, development, or size, rendering the younger child incapable of giving informed consent.  The sexual abuse acts may include sexual penetration, sexual touching, or non-contact sexual acts such as voyeurism or exhibitionism.”[1]

So now that we have a clear definition of what sexual abuse encompasses, let’s describe how it happens.  Perpetrators are cunning, manipulative and very patient to target their prey.  Grooming is the process of testing the vulnerability of a child, progressing slowly to take sexual power over the child.  Grooming happens in a number of ways.  They may show the child extra attention or affirmation.  The abuser make tickle, they may cuddle, wrestle, kiss or find other ways to make physical contact with the child.  The inappropriate touch or action may appear as an accident.  If the child says nothing, the second try may be followed by, “You liked it when I did that yesterday, let me try it again and show you how good it feels,” leaving the child confused, embarrassed and ashamed.  Children are most vulnerable when they are going through transition, (family illness, death in the family, move, divorce) when they need affirmation, attention and when they are ill prepared to respond to the risk of sexual abuse.  Some children are made to feel consensual in the act, paralyzed with fear and immediately lose their voice.  The perpetrator convinces the child this is their secret, never to be told.  Children are groomed by fear and intimidation and hear phrases like:  “No one will believe you.  If you tell I’ll hurt you, your mother, your sister.  If you tell I’ll put these pictures out on the Internet for everyone to see.  If you tell you will be in a lot of trouble for what you have done.”  If the picture of a completely powerless and wounded child is forming in your mind you are opening your mind to the reality of sexual abuse.

You may be thinking, “My child is smarter than that, they would not fall prey to a grooming.”  Or even more common, “My child would tell me if someone makes them feel uncomfortable or touches them inappropriately.”  And that is the exact impression that fills your head with the fog of denial.

Signs?

What are some signs that your child has been sexually abused?  First and foremost know that there may be no signs at all.  What you want to pay close attention to is a drastic change in behavior that you cannot explain.  Recognize unhealthy behavior.
Signs a child is being abused
·      Touching genitals of others or inducing fear or threats of force.
·      Sexually explicit conversations with significant age difference.
·      Repeated peeping, exposing, obscenities, or pornographic interest.
·      Oral, vaginal, anal penetration of dolls, other children, or animals.
·      Any genital injury or bleeding not explained by accidental cause.
·      Children should not sexualize relationships or be preoccupied with sexual play.
·      Masturbation is constant.

Inappropriate Sexual Exposure
·      All forms of sexual activity with adolescents and adults.
·      Viewing pornography or other sexually explicit material.
·      Witnessing sexual behaviors between adults.
·      Sexual play with another child that is 2 years younger or 2 years
    older, or a child who has more sophisticated sexual knowledge.
·       A child who forces any sexual activity whatsoever.

Inappropriate Sexual Behaviors
·      Preoccupation with sexual themes or showing sexually aggressive 
    behaviors
·      Sexually explicit conversations
·      Precocious sexual knowledge
·      Preoccupation with masturbation
·      Simulating foreplay with dolls or peers with clothing on
·      Engaging in sexual behaviors in public, such as sexual exposure, rubbing, or masturbation

Checklist to Identify Children with Possible Sex-Specific Problems
·      Any child using sexual language beyond his or her age group.  This suggests that the child has been looking at sexual material or engaging in sexual behavior beyond his or her age group.
·      Any child who acts out sexually at school.
·      Any child who continues to engage in chronic sexually harassing behavior after an adult has told the child to stop.
·      Any child who others report as having excessively sexually provocative behavior.
·      Any child attempting to get another child or adult nude, especially at school or outside of home.
·      Any child who is overly attentive to younger children (three or more years younger).
·      Any child suspected of having a sexually transmitted disease.
(The checklist above is taken from The Child Molestation Research and Prevention Institute/Copyright © 2007)

Do not dismiss your child’s isolation or withdrawal with puberty or hormonal surges.  One or more of these signs prevalent is cause for concern.  If you witness a change in behavior you might want to pay close attention to your child’s interactions with older youth or adults.  Does your child seem uncomfortable around certain people, even frightened or embarrassed? You may be shocked when you piece the puzzle of abuse together and you immediately may want to go into the fog of denial but you must know that your child is looking to you to protect them and your intervention actions will promote justice, hope and healing for your child.  Intervention takes courage; great courage to believe your child, act on the crime of child sexual abuse by doing the right thing:  call 911 and report.

Prevention Anyone?

The sooner you can give your kids a VOICE the better.  You must help them understand the power of their VOICE and that no-one can take that power away from them.  We have to take responsibility to teach our children healthy childhood sexual development and learn how to talk to children about sex and sexual abuse.  More importantly, we much teach them to respect their bodies and the bodies of others.

Normal Sexual Development

Infancy - Birth to Age 2

Much of an infant’s learning is body (sensory) related, focused on touch and smell. One of the first things they learn is their own body, where boys discover their penis around 7 months and girls discover their vulva around 9 months.  Infant boys will have erections regularly and infant girls will lubricate, but this is not a response to erotic stimulation.  These are natural responses to touch, friction, or the need to urinate.  Children at this age:
·      Learn about love and trust through relationships with caregivers.
·      Focus on developing a sense of trust.
·      Learn and explore their bodies through sense of touch including their genitals.
·      May have spontaneous reactions that appear sexual (e.g., erection or lubrication), but are not.
·      Have no inhibitions about nudity.
·      Begin to learn distinction between male and female and learn expected behaviors.

Adults can facilitate healthy sexual development by:
·      Using correct terms for body parts.
·      Modeling “comfortable” touch (e.g., hugs that are not forced upon the child).
·      Talking to child about boundaries as the opportunity arises (e.g., during diapering, bath tell child that genitals are off limits).

Toddler and Preschool Years - Ages 2 to 5
By the age of 3, children will have a clear sense of whether they are a boy or a girl and they will become very curious about the opposite sex.  Because genitals are usually covered, interest in these areas may be heightened.  This is a great opportunity to introduce the concept of privacy for themselves and others.  Teach and encourage the child to use correct terminology to describe genitalia, this means penis and vagina.  Children at this age:
·      Develop language to describe genitalia.
·      Should clearly know the differences between males and females and begin to understand male/female roles.
·      May know basics of human reproduction (e.g., babies grow inside mother’s tummy).
·      May show curiosity about adult genitalia (e.g., may try to see Mommy nude)
·      Have no inhibitions about nudity.
·      May play house, or doctor or engage in consensual genital exploration with same age peers.
·      May masturbate often.

Adults can facilitate healthy sexual development by:
·      Teaching child the difference between comfortable/appropriate touch and uncomfortable/unacceptable touch.
·      Modeling comfortable touch by not forcing child to have physical contact (e.g., no forced hugs or kisses, no wrestling if child protests).
·      Modeling the importance of privacy during bathing and toileting.
·      Giving child permission to be private about his/her own nudity.
·      Using everyday opportunities to teach child fundamentals of sexuality (e.g., if child asks questions about sex, give simple and direct answers).
·      Teaching child that touching oneself feels good, is okay and is done in private
·      Teaching child to respect other people’s boundaries and privacy.

Middle Childhood - Ages 5 to 8
The process of gender role socialization is heightened during this period and they tend to show a strong preference for gender typed clothing and activity.  Some children in this age range will masturbate but only a minority, it will increase again during adolescence. Children at this age:
·      Begin to have more stable friendships with children of the same sex.
·      Will want to be like their peers and start to feel peer pressure.
·      May be affected by stories they hear in media about violence, sex or drugs.
·      Understand physical, behavioral and emotional distinctions between males and females (gender identity solidifies and stabilizes).
·      Should have a basic understanding of puberty (some children, especially girls, will show early signs of puberty).
·      Should have a basic understanding of human reproduction.
·      May understand differences in sexual orientation.
·      Will begin to become modest about nudity.
·      May masturbate or engage in consensual genital exploration with the same age (and often same sex) peers.

Adults can facilitate healthy sexual development by:
·      Respecting child’s need for privacy.
·      Being clear with child about respect for people’s boundaries and need for privacy.
·      Talking with child about bodily responses, especially those that are precursors to sexual response (e.g., “it feels good to touch one’s genitals), and about what is and is not appropriate during peer interaction.
·      Modeling healthy, intimate adult relationships characterized by effective communication.
·      Teaching child about male and female puberty (by 7-8 years old).
·      Using everyday opportunities to teach child about sexuality and reproduction.  Children should know the “birds and bees” by no later than 9 years old.  It is important to know research shows that children whose parents talk with them about sexuality are less likely to become sexually active at an early age.

Pre-Adolescents – Ages 9 to 12
Pre-adolescents are navigating puberty, comparing themselves to others, and wondering if their bodies are “normal.”  Children at this age:
·      Begin to have more secretive behaviors with their peers, such as telling “dirty jokes” and gossiping about relationships.
·      Need more privacy.
·      May begin to masturbate to orgasm; however, these behaviors are more discreet.
·      Have an increase in emotional ups and downs.
·      May begin menstruating (girls); may experience nocturnal emissions (boys).
·      Become more strongly influenced by peers.
·      Develop romantic crushes on older teens, teachers, coaches, celebrities.
Adults can facilitate healthy sexual development by:
·      Continuing to be supportive and express that support.
·      Respecting privacy and boundaries, as you’ve taught since infancy.
·      Continuing to stay involved and sensitive to changes in behavior.
·      Recognizing healthy behavior and having conversations with pre-adolescents about good decision-making.

Adolescents – Ages 13 to 17
Adolescents may struggle with their own entrance into adulthood and with peer pressures.  They also may be exploring their sexuality and have difficulty talking to adults and even other peers about this.  Children at this age:
·      May have questions about decision-making, social relationships and sexual customs.
·      Masturbate in private.
·      May experiment with adolescents of the same age, including open-mouth kissing, fondling and body rubbing.
·      May engage in oral sex and sexual intercourse which occurs in approximately one-third of this age group.  Oral sex has been found to occur in 50 percent of teens ages 15 and older.

Adults can facilitate healthy sexual development by:
·      Setting boundaries around internet use similar to other types of house rules.
·      Encouraging independence, but providing support.
·      Talking to adolescents about choices regarding sex, including oral sex, despite what their friends say.
·      Modeling appropriate behavior and good decision-making.
·      Continuing to encourage them to talk to your identified trusted person.

How to Talk to a Child about Sex and Sexual Abuse

Start Early
·      Children are already hearing about sex through the media and through other children.
·      It is best to start talking with children about sexuality in early childhood.
·      Always be open and available and listen carefully to what your child asks.
·      Keep the language simple but always use correct terms.
·      Do not try to cover everything at once.

Is There Such a Thing as Giving Too Much Information
·      No.  Information does not encourage a child to be sexually active.
·      Most parents are uncomfortable talking about sex, so be open about this and do not cover up your feelings or avoid the issue.
·      Children just want to know that they are normal, so teach them that it is “normal” for everyone to be different.
·      Answer honestly and if you do not know an answer look it up together.

Share your Family Values
·      Set good examples for children.
·      Be clear about your values and let them know other families may have different values.
·      Do not use scare tactics.
·      Let children know what you expect of them and help them to understand consequences.
·      Be encouraging; allow them to explore their thoughts and feelings about sexuality.

Helpful Tips for Parents: When a Young Child Asks…..

“Where did I come from?”  Give them a nice, straightforward answer like “You were made in Mommy’s tummy, and that’s where you grew until you were ready to be born” or “ A seed from Daddy and an egg from Mommy mixed together and formed a new baby - you.”

“What is sex?” – “Sex is a kind of cuddling Mommy and Daddy do to show how much they love each other” or “Sex is a way grownups who love each other can be as close as possible, to cuddle and kiss in a special way.”

“How is the new baby going to get out of your tummy?”  Do not give too many details for younger children.  Say something like “After a long time, the baby grows too big for Mommy’s tummy, so it has to be born” or “After the baby gets too big, Daddy will take Mommy to the hospital, where the doctors can help the baby to be born.”

Talk to your Children about Sexual Abuse
·      Plan a specific time for you and your child to sit down and discuss this topic.
·      Explain to your child which parts of the body are private and should never be touched by another adult or child.
·      Let your child know that if anyone touches them in these private areas they must come and tell you, no matter who it is.

Fog Horn

Though it is easier to live in the fog of denial, we must blow the foghorn and find our way out of the fog into the light of truth about the issue of child sexual abuse by talking about the risks openly and honestly.  The truth is that every child is at risk of sexual abuse at any age and we have to communicate with our children and have these conversations often.  Please note, I say conversations because it is not one conversation at puberty, but a lifetime of layered conversations increasing in content and intensity.

You may want to breathe a sigh of relief when your child reaches dating age, but the conversation must continue beyond into the risk of date rape.  There is a serious risk of date rape that lurks involving force or even drugs.  We have to make sure they are always in control and do not put themselves in risky situations.  Even the most vigilant child can be tricked.  We have even heard stories of young girls being drugged with Nyquil and taken advantage of while sleeping.

The most powerful tool you can give your child is education, clear personal boundaries and personal power.  These are a lifetime of lessons, often practiced in the most risky of situations.  Most importantly your child needs to know that you love them and that you will always believe them and support them in case of sexual abuse.  They also need to know that you will fight for justice and no matter the identity of the abuser.  Child sexual abuse is a crime that takes great courage to face and greater courage to report.  Be a parent of great courage.  This will speak volumes into the next generation in being able to break not only the silence of child sexual abuse but the cycle.  For more information and resources on child sexual abuse awareness, prevention and healing, please visit VOICE Today, Inc. at www.voicetoday.org



[1] Saul, Ph.D., Janet, and Natalie Audage, Ph.D. United States Department of Health & Human Services. Centers for Disease Control and Prevention. Preventing Child Sexual Abuse Within Youth Serving Organizations: Getting Started on Policies and Procedures. Atlanta: National Center for Injury Prevention Control, 2007. Print.

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