Child Abuse
What's Happening with Child Sexual Abuse Prevention?
Today the majority of child sexual abuse (CSA) prevention programs don't have the resources to do an effective job. According to prevention experts, most child-focused programs are so limited—usually comprised of a one-time presentation—that children retain little of what they learn. This is the only adult instruction many children will receive in sexual abuse prevention.
A recent study showed that only 63 percent of girls and 50 percent of boys reported that their parents had ever talked with them about sexual abuse prevention (Sexual Assault and Trauma Resource Center of Rhode Island, 1999). Some parents feel uncomfortable raising these issues and prefer that teachers cover them. Others may assume they need not address the subject themselves because it's being handled at school. Prevention experts suggest that too often parents and caregivers may think that as a result of child-focused prevention programs, their children are safe from sexual abuse.
What Kind of CSA Prevention Program Works?
A 1995 study defined a successful, comprehensive sexual abuse prevention program as one containing at least 9 of 12 key components. These components include abuse-specific information, skill-practice activities, parent involvement, and multiple sessions in which children learn skills and have concepts reinforced (Finkelhor and Dziuba-Leatherman, 1995). This study concluded that children who participated in less comprehensive programs had no more knowledge or skills than children who hadn't participated at all.
Research suggests that children of all ages can successfully make use of prevention skills if they are taught concrete concepts in a clear, developmentally appropriate way and are given adequate time for learning and follow-up. Yet only one third of all sexual abuse prevention programs appear to meet the criteria for a "comprehensive" approach (Plummer, 1999).
How Did We Get Here?
Sexual abuse prevention programs have proliferated since the late 1970s as parents, teachers, therapists, and the general public have become aware of the prevalence of sexual abuse and its risks to children. Although high-profile cases highlighted the issue in communities around the U.S., awareness of sexual abuse was generated primarily by adult survivors speaking out about their past abuse experiences. As a result of this increased awareness, school-based prevention programs became the norm.
Child-focused prevention in schools presents several advantages. First, schools allow access to large numbers of children, and teachers are trusted adults to whom children are likely to disclose abuse. Second, parents are often reluctant to provide the information themselves. Finally, children stand to benefit from learning assertiveness and self-protective skills.
A Variety of Programs
From the start, CSA prevention programs were guided by a wide variety of theories and perspectives. For example, some programs were modeled after rape prevention, using a feminist-empowerment model. Other programs came from a law enforcement framework and were more typically oriented toward "stranger danger," whereas some contained the issue within a generic "personal safety" curriculum.
There is also tremendous variety among programs in terms of content and program dosage. The amount of time allocated to discussing sexual abuse with children may vary from as little as a half-hour presentation to six weeks of daily presentations (Committee for Children, 1988; Cooper, 1991; Plummer, 1997).
The Michigan Study
A University of Michigan study (Plummer, 1999) surveyed 87 communities in the U.S. that are currently implementing CSA prevention programs. Program leaders were asked about their programs, goals, practices, target audiences, materials, funding, and problems. Some of the challenges program leaders face are described below.
Funding and Program Quality
Inadequate funding disables the vast majority of programs. Lack of money or resources was reported to affect 76 percent of programs, compromising delivery of adequate services. "We're having to cut back on our presentations and shorten our time in each school because every year we struggle to get enough money," said one respondent. "We're cutting back when we actually need to expand to reach more schools!"
Another troubling finding from the Michigan study concerns a poor fit between existing programs and current research on CSA. Learning specialists and researchers in prevention strongly recommend prevention approaches that provide repeated instruction to successfully deliver knowledge and skills to children. Even when money is available, too often program leaders ignore the well-established research finding that one-time presentations won't leave lasting messages with children. A full 63 percent of programs are still relying on one-time sessions to teach children safety skills.
Evaluations Are Critical
Parents could feel more assured about the quality of their children's prevention instruction if evaluations were done to assess the implementation and effects of programs. Evaluations are critical for practitioners to learn what type of instruction is really helpful to children and communities. But only 35 percent of program leaders surveyed have ever evaluated their programs (Plummer, 1999). Of the respondents that performed evaluations, only one suggested that assessment should be a required component of any prevention program.
Good programs and adequate evaluations both cost money. Communities need to provide greater and more varied funding for prevention efforts. The Michigan study showed a positive correlation between the number of funding sources and the number of approaches to prevention a community used. This finding indicates that a broad funding base may enhance comprehensiveness, or that good programs may attract more funding sources. The study also showed that programs with strong and stable funding are more likely to continue developing and expanding.
Community Education
Denial of the problem of CSA, especially in our own communities, is a persistent issue. In fact, 70 percent of the respondents in the University of Michigan study indicated that denial of sexual abuse as a major problem continues to provide challenges to prevention efforts.
But fortitude in community education can help break down resistance to prevention programs. A program leader who works on a Native American reservation said, "With a lot of awareness efforts, recognition that abuse even happens in Indian communities has changed immensely."
Parent Involvement
Program leaders herald parent education and involvement, as much as community education, as critical to program success. The Michigan study found that about half the prevention programs directly included parents in their efforts, either through parent meetings or by handing out materials for follow-up activities with children.
"Generally, parents feel more able to discuss safety skills with their children after attending a parent meeting about sexual abuse prevention," said one Michigan study respondent. Discomfort with the topic of CSA can silence many parents. Reinforcement of prevention messages at home is more likely to occur after parents take part in an education event. And when parents start talking about their children's sexual abuse prevention programs at community gatherings, such as soccer games and church, denial will likely decrease even further.
Experienced Advocates Keep the Vision
Many CSA prevention programs are supported by committed, experienced practitioners and advocates. Of the prevention specialists surveyed, 16 percent have been doing this work for more than 17 years, and an additional 67 percent have been involved between 3 and 17 years. Combined, these years add up to decades of practical knowledge and expertise.
The prevention programs these visionaries develop and administer are multifaceted and geared toward many different audiences. Most communities with successful programs simultaneously target youth, parents, teachers, the public, and professionals in their training efforts. Partnerships between schools, community groups, and faith communities also make for strong prevention programs.
Despite cutbacks in many parts of the country, some communities are managing to improve their program quality. "Sexual abuse prevention programs are improving in our community," says one Michigan leader. "As a state, we are becoming more organized and are setting standards for what we consider to be 'best practice.'”
Effecting Change
The Michigan study tells us that many elements must be in place to effectively support a community's abuse prevention efforts. These elements include:
- Offering the depth and breadth of information and skill practice necessary to adequately reach children, rather than one-shot presentations that do not adhere to research-based principles.
- Training teachers to respond appropriately to indicators of sexual abuse and children's disclosures of sexual abuse.
- Evaluating programs to provide ongoing feedback to practitioners for improvement.
- Making efforts to increase parent involvement. Innovative ways to involve parents could include workplace presentations, television spots, videos for loan to parents, and soliciting parents' help in volunteer efforts. If parents aren’t motivated to participate, practitioners need to figure out what dissuades them. However, parent components must always be supplemental to a school program. Relying solely on parents to educate their children will fail because some won't do the job, either because they are abusive themselves or are too uncomfortable to raise the subject.
- Using varied approaches to prevention work; ones that have been proven effective and are tailored to the unique needs of each community. Leaders from some rural communities spoke of the need for a paid position; one responsible for organizing prevention efforts in a multicounty area. In cities, creating culturally specific curricula for minority populations was a concern.
- Seeking a stable funding source, or better yet, numerous sources, so that one budget cutback won't destroy a program's existence.
We've had more than 20 years to build and expand prevention theories, research, and practice. Research shows that we must now raise the standard of CSA prevention programs. We must place our programs in alignment with what is known to be most helpful in keeping children safe from sexual abuse. And improved program quality will place our programs in better stead with critical community partners, such as schools.
Raising the bar generates a crying need for more funding; money must be forthcoming. If financial support doesn't materialize, program leaders will have to continue to choose between program quality and the number of children their programs can reach.
By Carol Plummer, M.S.W., A.C.S.W.
Carol Plummer has been a therapist in private practice since 1984, specializing in work with sexually abused children. She is a cofounder of the Association for Sexual Abuse Prevention and author of Preventing Sexual Abuse. She is currently a doctoral student in the Joint Program of Social Work and Psychology at the University of Michigan.
References
Committee for Children. (1988). Talking About Touching: Personal Safety for Preschoolers and Kindergartners. Seattle, WA: Committee for Children.
Cooper, S. (1991). New Strategies for Free Children: Child Abuse Prevention for Elementary School Children. Columbus, OH: National Assault Prevention Center.
Daro, D. A. (1994). "Prevention of Child Sexual Abuse." The Future of Children, 4, 198–223.
Finkelhor, D., and Dziuba-Leatherman, J. (1995). "Victimization Prevention Programs: A National Survey of Children's Exposure and Reactions." Child Abuse and Neglect, 19, 129–139.
Plummer, C. A. (1999). Child Sexual Abuse Prevention Programs: What Are They Doing? Unpublished report.
Plummer, C. A. (1997). Preventing Sexual Abuse (2nd ed.). Holmes Beach, FL: Learning Publications.
Sexual Assault and Trauma Resource Center of Rhode Island. (1999). Adolescent Dating Attitudes 1998 Survey Results. Unpublished report.
Wurtele, S. K., and Miller-Perrin, C. L. (1992). Preventing Child Sexual Abuse: Sharing the Responsibility. Lincoln, NE: University of Nebraska Press.