Sexual Abuse of Children: Selected Readings.

191 Pages·2007·3.45 MB·English

DOCUMENT RESUME
CG 015 840
ED 215 237
AUTHOR
Jones, Barbara McComb, Ed.; And Others
Sexual Abuse of Children: Selected Readings.
TITLE
National Center on Child Abuse and Neglect
INSTITUTION
(DHHS/OHDS), Washington, D.C.
Administration for Children, Youth, and Families
SPONS AGENCY
(DHHS), Washington, D.C.
REPORT NO
DHHS-OHDS-78-30161
Nov 80
PUB DATE
NOTE
191p.
Superintendent of Documents, U.S. Government Printing
AVAILABLE FROM
nficiL,___Washington, DC 20402; or LSDS, Department 76,
Washington, DC 20401.
MF01/PC08 Plus Postage.
EDRS PRICE
Anthologies; *Child Abuse; Child Advocacy; Children;
DESCRIPTORS
*Crisis Intervention; *Family Problems; Fathers;
*Parent Child Relationship; Sexuality; Therapy;
*Victims of Crime; Violence
Incest; *Sexual Abuse
IDENTIFIERS
ABSTRACT
This volume of selected readings contains a wide
range of materials on the subject of child sexual abuse. The eight
chapters in Part I, written by the staff of the Child Protection
Center, Children's Hospital National Medical Center, Washington,
D.C., discuss the etiology and short-term management of child sexual
abuse, describe an approach to crisis intervention services, and
provide an outline of suggested case management procedures to be
implementdd upon intake and throughout the crisis phase of treatment.
Materials in Part II deal specifically with incest, treatment and
interviewing techniques, and sexual exploitation cf children for
commercial purposes. Several of the chapters focus on the problem of
father-daughter incest and the issues associated with the long-term
treatment that is often required in such cases. Many different
perspectives concerning various theoretical and clinical aspects of
child sexual abuse are presented. A collection of writings by adult
and teenage victim; of child sexual abuse is also included. The
appendices contain several different hospital protocols developed to
aid medical personnel in the physical examination and diagnosis of
child sexual abusa cases, and a list of child abuse and neglect
treatment programs that are equipped to treat child sexual abuse.
(Author/NRB)
***********************************************************************
*
*
Reproductions supplied by EDRS are the best that can be made
*
from the original document.
*
***********************************************************************
SEXUAL ABUSE OF
CHILDREN:
SELECTED READINGS
Editors:
Kee MacFarlane, M.S.W.
Barbara McComb Jones
Linda L. Jenstrom
National Center on
Children's Hospital
Child Abuse and Neglect
National Medical Center
Children's Bureau
U.S. DEPARTMENT OF EDUCATION
NATIONAL INSTITUTE OF EDUCATION
EDUCATIONAL RESOURCES INFORMATION
IERICI
CENTER
reproduced as
The document has
been
received from the person or organization
originating it
'Minor changes
made to improve
have be
reproduction qua, ty
view or opinions stated in this docu
Points of
ment do not necessarily represent official NIE
position or policy
National Center on Child Abuse and Neglect
Children's Bureau
Administration for Children, Youth and Families
Office of Human Development Services
Co
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
...7
CO
UN
DHHS Publication No. (OHDS) 78.30161
e- ti
0
Issued November 1980
CD
C-)
The editors would like to express their appreciation to the many people who contribute0 to the publication of this book. Our special thanks
go to the staff of the Child Protection Center of Children's Hospital National Medical Center and their director, Mary Holman; to Douglas
Besharov for his continuing support; and to Dr. Frederick C. Green for his patience and assistance throughout. We are particularly grateful to
those women who were willing to share their own feelings and experiences with us.
2
Cover drawings are by victims of incest.
Children, Youth
Opinions of contributors are their own and do not necessarily reflect the views of the Administration for
by the U.S.
and Families, nor does the mention of trade names, commercial products, or organizations imply endorsement
Government. Single copies of this publication are available from: LSDS, Department 76, Washington, D. C. 20401.
For male by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402
3
This book is dedicated to Clara Jo Stember: artist, teacher, therapist, and friend to children. Clara Jo died in her sleep just
before the book went to press. Her contributions to this book are only a small example of her pioneering work in the use of art
therapy with sexually abused children and her fervent belief in the importance of creative, non-verbal expression. Her love and
undaunted enthusiasm will be remembered not only by her young clients, but by the field as a whole.
Editors:
Kee MacFarlane, M.S.W.
Barbara McComb Jones
Linda L. Jenstrom
National Center on
Child Abuse and Neglect
Children's Hospital
Children's Bureau
National Medical Center
FOREWORD
This book marks a depanure from previous publications
in full in order to share the medical techniques that have
by the National Center on Child Abuse and Neglect. Rather
been developed independently by professionals in various
than commissioning the efforts of one author or reprinting
parts of the country.
the collected works of others, we have attempted to draw
Also contained in the appendices is a list of child abuse
together in this volume of select xl readings a wide range of
and neglect treatment programs that were either developed
materials on the subject of child sexual abuse. To the book's
exclusively to treat child sexual abuse or that incorporate
core section on the etiology and short-term management of
special components and resources to deal with this problem.
sexual abuse (Part I), written by staff of the Child Protec-
The list is far from exhaustive; it contains only those pro-
tion Center, Children's Hospital National Medical Center,
grams that are known to the National Center or that have
Washington, D.C., we have added materials that deal spe-
responded to requests for information by the National Cen-
cifically with incest, treatment and interviewing techniques,
ter's Clearinghouse. Child sexual abuse programs that are not
and sexual exploitation of children for commercial purposes.
included in this list are encouraged to write to the N
In keeping with the limited state of knowledge concerning
Center.
the dynamics and effective prevention and treatment of child
It is our hope that this book of selected readings no only
sexual abuse, this book does not espouse a single point of
will provide useful information for those who wish to learn
view or a "correct" way of handling the problem. Rather, it
more about the subject of child sexual abuse, but will serve
presents a number of different perspectives from profes-
as a resource for professionals and concerned citizens who
sionals who represent a variety of disciplines. It also con-
seek to develop better treatment programs in their com-
tains a collection of writings by adult and teenage victims of
munities. Such resources are badly needed to prevent, iden-
child sexual abuse who have allowed us to print their stories
tify, and treat this most insidious, emotionally laden and hid-
and feelings in the hope that their experiences will enable
den form of child maltreatment. Unlike child battering or
professionals to better understand and help others like them.
physical neglect, the physical and emotional effects of sexual
The appendices contain several different hospital prow-
abuse often are not immediately evident and, therefore, may
cols developed in recent years to aid medical personnel in
be minimized or overlooked. In doing so, we not only leave
the physical examination and diagnosis of child sexual abuse
children vulnerable to continuing abuse, but we fail to pro-
cases. Although some of the procedures contained in the
vide them with the necessary support to deal with what has
various protocols are duplicative, and many are not neces-
been appropriately referred to as a "psychological time
sary for every type of case, we have chosen to reprint them
bomb;" the long-term effects of sexual exploitation.
CONTENTS
XII. Art Therapy: A New Use ill the Diagnosis and
59
PART I
Treatment of Sexually Abused Children
Clara Jo Stember, A.T.R.
Introduction
1
XIII. Father-Daughter Incest
65
Sexual Abuse of Children: An Overview of the
I.
3
Judith Herman, M.D., and
Problem
Lisa Hir.schmanALA,. M.Ed.
-Ray lene A. De Vine, M.D.
)(Iv. Child Prostitution and Child Pornography:
77
II. Developmental Sexuality
7
Medical, Legal, and Societal Aspects of the Sexual
Karen M. Leaman, R.N., M.S.N., aid
Exploitation of Children
Anne Lowe Knasel, M.D.
Judianne Densen-Gerber, J.D., M.D.,
III. The Sexually Abused Child in the Emergency
11
F.C.L.M.
Room
XV. Family and Couple Interactional Patterns in
83
Raylene A. De Vine, M.D.
Cases of Father-D
.ghter Incest
IV. Venereal Disease in Children
17
Maddi-Jane Stern, A.C.S.W., and
Anne Lowe Knasel, M.D.
Linda C. Meyer, M.A.
V. Sexual Abuse: The Reactions rA Child and
21
XVI. Adult Sexual Orientation and Attraction to
87
Family
Underage Persons
Karen M. Leaman, R.N., M.S.N.
A. Nicholas Groth, Ph.D., and
Incest: A Review of the Literature
25
VI.
H. Jean Birnbaum, B.A.
Raylene A. De Vine, M.D.
XVII, Sexual Misuse and the Family
91
VII. The Nature and Treatment of Male Sex
29
Alvin A. Rosenfeld, M.D.
Offenders
97
XVIII. Voices of Victims
Ronald M. Costell, M.D.
A collection of writings by victims of incest
VIII. Sexual Acts Against Children: Medical-Legal
31
XIX. Conclusion: Aspects of Prevention and
123
Aspects
Protection
Karen M.Leaman, R.N., M.S.N.
Kee MacFarlane, M.S.W.,
in consultation with Nan R. Huhn, J.D.
Linda L. Jenstrom, and
Barbara McComb Jones
PART II
35
APPENDICES
Introduction
37
IX. Humanistic Treatment of Father-Daughter Incest 39
Hospital Protocols for the
APPENDIX A:
129
Henry Giarretto, Ph.D.
Diagnosis and Treatment of Child
47
X. Advocating for Sexually Abused Children
Sexual Abuse
in the Criminal Justice System
APPENDIX :
Guides for Parents Concerning the
Lucy Berliner, M.S.W., and
173
Sexual Abuse of Children
Doris Stevens, M.A., A.C.S.W.
APPENDIX C:
Child Sexual Abuse Treatment
XI. Sexual Abuse of Children: A Clinical Spectrum
181
51
Programs
Roland Summit, M.D., and
Contributing Authors
APPENDIX D:
Jo Ann Kryso, M.S.W.
191
b
PART I
Introduction
The eight chapters that.compriseFart_Lotshisboohivere-
__seseaschess and many frnnt-line service :wen/
written by staff members from the Child Protection Center
tory and mythology give ample evidence that sexual abuse is
(CPC), Children's Hospital National Medical Center, Wash-
not new, the nature and extent of this phenomenon are only
ington, D.C. In 1975, the CPC was funded by the National
now receiving recognition and investigation. One of the
Center on Child Abuse and Neglect to work with abused
basic problems encountered in preparing these chapters was
and neglected children and their families. Shortly after the
defining specifically what is meant by the term child sexual
CPC opened, the hospital's emergency room and outpatient
abuse. In the search for a concrete, inclusive definition, a
clinics began referring all children in cases in which sexual
review of the relevant literature and laws was undertaken.
abuse was suspected. It soon became apparent that these
While this effort was invaluable in many ways, it failed to
cases demanded a special approach and that they were dif-
unearth a generic definition sufficiently broad to encompass
ferent from cases of child battering. The more we tried to
the problem as a whole but sufficiently specific to ward off
define the problem and the services needed, the more inter-
vagueness and ambiguity. Child sexual abuse is defined in
ested we became in working with these children. Conse-
various ways depending on the source, context, and purpose
quently, we undertook to systematize and apply current
of the definition.
knowledge about the diagnosis and treatment of sexual
Some of the ambiguity in terms can be attributed to re-
abuse. The information presented in Part 1 is a synthesis of
searchers who have based their definitions on the laws of
our research and clinical experience and the case manage-
sack jurisdictions. Unfortunately, laws vary considerably
ment techniques we have found most useful.
from state to state, and most jurisdictions have both civil
One of the dilemmas which immediately confronted us
and criminal laws related to sex offenses involving children.
relates to case identification and diagnosis. As the only pedi-
Because child protection and therapeutic intervention are the
atric hospital in a major metropolitan area, we receive a
primary objectives of the civil laws, while the criminal laws
wide range of cases. Some are self-identified cases of incest
are designed to apprehend, try, and punish offenders, defi-
or other sexual abuse; others present with more ambiguous
nitions may vary widely between the two codes.
symptoms or complaints. We have found that it is usually
In our own efforts to define child sexual abuse, we began
necessary to initiate services before there is a clear determi-
with a broad concept of childhood sexual trauma, which we
nation of all the facts. A four-year-old with venereal disease
define as any childhood sexual experience tha: interferes
may or may not be sexually abused. An accusation of rape
with or has potential for interfering with a child's normal
against an unsavory neighbor may or may not prove true.
healthy development. This definition could include every-
Denial of an incestuous relationship between father and
thing from an accidental genital injury to forcible rape. Cer-
daughter is one of the most common reactions of the
tainly, any trauma to a child that has sexual implications
mother, the father, and often, the daughter. In short, it was
rap:re: especially sensitive management by service pro-
necessary to devise a service delivery system which would
viders. However, as clinicians specifically charged with
provide the child with adequate protection and support
responsibility for identification and treatment of sexually
while permitting us time to assess the situation and develop
abused children, we have found it useful to adopt a more
a case management plan.
explicit definition of the problem we confront. To clarify
For assistance, we turned to traditional crisis theory. The
our thinking, we focused on the word abuse. For abuse to
crisis model enables the provision of immediate care and
occur, a person must be acted upon in a way that is inap-
support in all casts of sexual abuse, including those in which
propriate or harmful. In this context, child sexual abuse can
the parents neither perpetrated the incident nor contributed
be defined as contacts or interactions between a child and an
to it through neglect. The model has the added advantage of
adult when the child is being used as an object of gratifica-
providing a stabilizing and supportive entry point to more
tion for adult sexual needs or desires.
extensive services for those children and families who are
In keeping with our child-centered point of view, it would
found to want or need them. In our experience, such ser-
be most elegant if we could define the various types of sex-
vices are usually required in cases in which neglect of the
ual abuse accordihg to the nature of the child's reactions to
child contributes to the abuse or in which the incident is
the experience. Unfortunately, little is known about the spe-
perpetrated by a parent, guardian, or other close family
cific effects of sexual abuse on children. Existing studies and
member.
case reports in the psychiatric literature have produced con-
Child sexual abuse is a relatively unexplored area for
flicting opinions about the seriousness of such experiences.
1
7
Familial
It is commonly agreed, however, that the child's age and
developmental status, the relationship of the abuser to the
those
The second category of relationships consists of
member other than a
child, and the violence associated with the abuse are impor-
cases in which the abuser is a family
definition of incest
tant variables in determining the child's reaction. In general,
parent or parent figure. The broadest
the closer the relationship and more violent the incident, the
includes these cases, and the incest statutes of most states
experi-
more difficult it will be for the child to cope with the
prohibit sexual relations between siblings, grandparents and
ence. In addition, the reactions of the child's parents and of
grandchildren, and uncles or aunts and nieces or nephews.
professionals who become involved in the case can contrib-
Sexual relations between siblings are thought by some to be
ute substantiallyfor better or for worseto the
child's
incest.
the most common, though least reported, form of
ability to resolve the situation.
Certainly, very little is known about these relationships and
Given the range of variables and the lack of any reliable
their effects on the children involved. More commonly re-
means of categorizing incidents of sexual abuse by the reac-
ported are cases of sexual abuse involving members of the
tions of the children who experience them, we have found it
child's extended family. In these cases, the quality of the
relationship between the child and the adult may be or
moo![" usefurtcr-dass-ify-tiel se-raserfronrthe-point of-view of
the relationships existing among those involved. In so doing,
of -,,lated-
greater or lesser significance than the mere fact
is,
adult as a powerful
we have maintained our child-centered orientation; that
ness. The child may see the abusing
we are interested in knowing the role or status the abuser
figure in the family and as a source of support, approval,
has in the eyes of the child. We have found that a thorough
and nurturance, or the relationship between the two may be
understanding of this relationship is crucial to the develop-
needs
remote and involve little trust or regard. Treatment
ment of an appropriate treatment plan. By necessary ex-
must be defined accordingly.
tension, this usually means we must also discover the rela-
Trusted Adult
tionship of the abuser within or to the child's family. In
developing plans for therapeutic intervention, we have found
The third category includes those cases in which the
it unwise to rely on preconceptions about family roles and
abuser is not a relative but is a significant person in the
structure. Rather, careful assessment of the unique charac-
child's life. Because children do not limit their important
in-
teristics of each family is needed. Within this framework, it
attachments to family members, cases of sexual abuse
is possible to differentiate four broad categories of child sex-
volving persons outside the family require the same care in
ual abuse that reflect the relationship between the abuser
admired neigh-
assessment as those involving relatives. An
ob-
bor, a favorite teacher, a babysitter may be chosen as an
and the
ject of the child's affection. At times, the child's trust
is
misplaced. When a child is sexually abused by a well-known
Farewell
relative or
and highly esteemed adult, whether the adult is a
The first category is comprised of those cases in which a
not, trauma may result.
child is sexually abused by a parent or true parent figure.
Sexual abuse of a child by a natural parent is commonly
Strasser
referred to as incest and is thought by many to have the
Cases in which a child is sexually abused by a stranger or
The histori-
most serious personal and social consequences.
remote acquaintance comprise the fourth and final category.
cal and social taboos against sexual relationships between
in
While children are less likely to be abused by a "stranger
blood-relations, especially parents and children, are strong.
do, of
the park" than by people they know, such incidents
However, the term incest raises some troublesome issues.
exists between
course, occur. Because no close relationship
The natural parent may or may not be a significant figure ir
such
the abuser and the child in these cases, other variables,
the child's life. The natural parent may never have accepted
with the incident and
as the degree of violence associated
the role of parent to the child. On the other hand, someone
in
the reaction of the family, assume increased importance
related or unrelated, may have assumed this role.
else,
determining the impact on the child.
Unfortunately, we may be tempted to minimize the implica-
providing
The following chapters describe an approach to
tions of a sexual relationship between a child and a father
victims of all
crisis intervention services to children who are
figure who is not recognized by the law or our social cus-
suggested
forms of sexual abuse. They provide an outline of
of the
toms as a "real father." This may be true regardless
implemented upon in-
case management procedures to he
duration or stability of the parent-child relationship and
take and throughout the initial or crisis phase of treatment.
'stment in the man as
regardless of the child's emotional ir
The purpose of the intervention is to support and protect
.ed, the extent of the
a father. If the sexual abuse is disco
primary care-
the child and to improve the parent's or other
nd, as a result, the
child's needs may not be recognizt._
child's
giver's capacity to respond appropriately to the
service intervention may be inadequate. In forming clinically
children
needs. The model is based on the premise that most
useful definitions, therefore, a diagnosis of incest involving
when
will recover from an experience with sexual abuse
consideration the
parents or parent figures must take into
by pro-
given optimal support, protection, and nurturance
emotional and psychological relationship between the adult
fessionals and family members.
and the child, as well as social norms and legal definitions.
2
CHAPTER I
Sexual Abuse of Children:
An Overview of the Problem
Rayline A. De Vine, M.D.
are naturally interested in everything. They are
the source of her infection. It was later found, however,
curious, courageous, willing to learn, constantly striv-
that her mother's boyfriend was actually responsible.
ing to understand adult secrets, to grow upto be-
A nine-year-old girl who had to be examined by several
come part of the adult world. Yet sexual matters persistently
physicians under court order because her mother claimed her
evade their grasp. If children are curious about accessible
father had been molesting her. The parents were involved in
matters, they are twice as curious about matters that are
a custody suit.
hidden from them. Sexual curiosity, sexual fantasies, sex play,
Two fourteen-year-old, run-away girls who had been
masturbation, and adolescent sexual experimentation are
beaten and raped after they were picked up while hitch-
considered normal parts of a child's development. In fact,
hiking. They refused to obtain medical treatment out of fear
children have been described as "polymorphous perverse,"
of police involvement. They knew their physically abusive
meaning that they can be led into a variety of sexual activities.'
parents would be notified, and they would be forced to
Occasionally, these sexual activities involve an adult, often an
return home.
adult the child knows, trusts, and views as a dominant figure.
A two-year-old girl who, according to her father, had
This sexual involvement between child and adult has a
been involved in homosexual activity with her mother. This
harmful potential that far outweighs what may have been
later proved to be another custody suit.
innocent, playful beginnings.
A fourteen-year-old girl who went to the local police sta-
Sexual abuse of children is not a 1 ew problem or a rare
tion to ask for protection from her father. She had been
occurrence. It is not easily identified or diagnosed; it rarely
involved in an incestuous relationship with him for the past
in physical injury; and often goes unreported to
results
five years; her mother refused to believe her; her relatives
authorities. Many of the common beliefs regarding sexual
refused to help her.
abuse are based on misinformation and hearsay. In order to
It is clear that sexual abuse is not easy to define. Permissi-
understand and prevent sexual abuse, such myths must be
ble childhood sexual behavior varies in accordance with cul-
dispelled. Warnings such as "Don't take candy from a
turil taboos and family and social tolerances. Yet, to work
stranger!" and "Don't accept rides from people you don't
with sexually abused children and their families, some defi-
know!" are given to children in hopes of protecting them
nition of the problem is needed. As discussed in the Intro-
from sexual assault. Yet, most children are sexually abused
cl.,ction, sexual abuse can be defined as contacts or interac-
by people they know and trust. Children who are sexually
tions between a child and an adult when the child is being
abused me not special children with special characteristics;
used as an object of gratification for adult sexual needs or
they are not of one age, one sex, one race, or one social
desires. It is an experience that interferes with or has poten-
class. They are not victims of any particular offense. Their
tial for interfering with a child's normal, healthy develop-
role in the offense, their disclosure of the incident, and their
ment. It is an experience with which the child may not be
reactior to the assault all differ. In the last few months we
able to cope physically, intellectually, or emotionally. Phys-
have treated:
ically, the child may find the experience highly sexually stim-
A six-year-old boy who had gone to use the bathroom in
ulating but rarely satisfying. ' Intellectually, the child's stage
a supermarket while his mother waited in the check-out line.
of cognitive development may not be sufficiently advanced
While in the bathroom, he was subjected to anal sodomy by
to permit comprehension of the experience. Emotionally, the
as older boy.
child may not be mature enough to isolate his or her own
A four-year-old girl who had a positive vaginal culture
feelings from the feelings of others. Thus, a sexually abused
for gonorrhea. Initially, her older brother was believed to be
child may suffer anxiety from excessive, unfulfilled physical
3
9
Crimes against children also account for a large propor-
stimulation,' distortions and misconceptions due to intellec-
tion of all reported sex offenses. From 1965 to 1969 in
tual limitations, and emotional disturbances from his own
Washington, D.C., a third of all reported rape cases in-
and his incorporated feelings of guilt and shame.'
13 percent were under age
volved a victim under age 15;
We are becoming mor.. aware of the needs of sexually
nine.' In a similar study of reported rapes in Philadelphia
abused children as a result of recent efforts to address the
conducted during 1973, I? percent of all victims were ten or
needs of battered and neglected children. There are, of
younger and 40 percent 15 or younger.'° Though these fig-
sexual
course, similarities in these cases, particularly when
of child-
ures are alarming, it is believed that reported cases
abuse is perpetrated by a parent or guardian. However, as
hood sexual abuse represent only a small proportion of the
it be-
more information is gathered about these problems,
actual incidence of this problem."
comes increasingly evident that there are substantial differ-
National estimates generated in 1969 by the American Hu-
ences between most cases of child sexual abuse and most
mane Association indicate that each year there may be at
reflected in
cases of child battering. These differences are
least 4,000 cases of sexual abuse in every large city.' A retro-
handling, and the
case idenfification and diagnosis, judicial
spective study conducted by Landis in 1956 indicates that
treatmem needs- nf -child and family. For example, battered
some form of childhood or adolescent sexual abuse may
children often have multiple old and new injuries which can-
this sur-
occur in as much as one-third of the population. In
not be adequately explained by their paretits. In such cases,
vey of 1,800 middle-class college students, 35 percent of the
the diagnosis of abuse can often be made on the basis of
females and 30 percent of the males reported a prior experi-
physical findings. Sexually abused children, however, rarely
ence with sexual abuse. Of the 360 females who had such an
sustain physical injury; the diagnosis of sexual abuse may
experience, only half disclosed the abuse to their parents,
rest entirely on the history as given by the child.
and only a tenth of the incidents were reported to the po-
Many battered children, because they are injured directly
lice. Of the males in the study, only one in six even reported
or indirectly by their caretakers, must be removed from their
the incident to their parents.'
homes, at least temporarily. Sexually abused children are
Children may keep an assault secret from their families
often returned home following initial treatment unless a par-
for many reasons. They may fear rejection, blame, punish-
ent or guardian is clearly responsible for the abuse or is
ment, or abandonment; they may feel their parents will not
unable or unwilling to protect the child from a recurrence of
believe them.' Boys are less likely to disclose abuse than
the abuse. Children who have been sexually abused by a
girls.' Children in general are most likely to report a single
parent or guardian may be removed from their homes until
assault by a stranger." The closer the relationship of tht
such time as the parent-offender is removed through legal
offender to the child or family, the less likely it is that the
proceedings. In cases of sexual abuse that are adjudicated
child will ref -in the incident." Thus, delay in reporting a
under criminal law, the child victim is subjected to a com-
sexual assault is common in childhood, as is the incidence of
plex and often lengthy legal process which includes giving
repeated assault.
testimony against the offender, often in an open courtroom.
Even when the abuse is disclosed, parents may be reluc-
Battered children and their families may require long-term
tant to report the incident to the police " or social
service
in
assistance. Crisis intervention is often sufficient treatment
agencies. This reluctance may stem from cultural taboos;
stranger
cases of forcible or non-forcible sexual assault by a
fears of social censure, blame, or punishment; lack of physi-
known
art:1 in cases of non-forcible sexual abuse by a person
cal injury to the child; or apprehension about involving the
is protect-
to the family when the parent's primary concern
child in legal proceedings. The identity of the offender may
Willingness to
ing the child and meeting his or her needs.
also affect the parents' decision to report. They may fear
services are often
accept help and high motivation to seek
retaliation by the offender, or they may feel a need to pro-
characteristics of these families. Parent-child incest usually
tect an offender who is a family member or friend, espe-
cially if reporting the offense could precipitate the loss of
requires longer and more intensive therapeutic intervention.
More intensive intervention also may be required in cases in
economic or emotional support.
which the parent of a sexually abused child seeks to protect
According to the 1969 study conducted by De Francis in
the offender or is for some other reason unable to focus on
two boroughs of New York City, up to a third of the cases
the child's needs. Clearly, then, only certain kinds of sexual
that are reported to the police may be dropped before they
abuse lend themselves to the diagnosis and treatment plans
withdraw the
come to trial, either because parents decide to
used in cases of child battering. A new focus and new
complaint or the offender cannot be positively identified. In
approach are needed in the management of many types of
this study, up to 44 percent of the cases taken to court were
dismissed for lack of evidence.' In the study coaducted by
cases of sexual abuse of children.
Peters in Philadelphia, among the group of 121 adolescents
It is difficult to determine the actual number of sexually
who reported being raped, 28 percent were urged to drop
abused children in the United States. The incidence of sex-
charges by the police. Of these, over half of the complain-
ual abuse may be greater than the incidence of physical
ants reported that the police did not believe them."
abuse.' For example, over a ter. year period in one county
High estimates of the incidence of sexual abuse raise
in Minnesota, there were 5,000 reports of suspected child
pressing questions about the nature of this phenomenon.
neglect, 660 cases of physical abuse, and 2,400 reports of child
Although generalizations are plagued with cYceptions, we
sexual abuse'
4