This document discusses symptoms and indicators of child sexual abuse. It lists 40 behavioral indicators, 20 physical/medical indicators, and 23 familial indicators of abuse. Some key signs include precocious or inappropriate sexual behavior, knowledge or dress; physical injuries; genital infections; pregnancy; and dysfunctional family dynamics like favoritism, role reversal, isolation, or substance abuse. The document also discusses characteristics of credible versus non-credible abuse allegations, noting that credible accounts are usually detailed, consistent internally and with known abuse patterns, while non-credible accounts often add inconsistent or improbable details over time.
This document discusses symptoms and indicators of child sexual abuse. It lists 40 behavioral indicators, 20 physical/medical indicators, and 23 familial indicators of abuse. Some key signs include precocious or inappropriate sexual behavior, knowledge or dress; physical injuries; genital infections; pregnancy; and dysfunctional family dynamics like favoritism, role reversal, isolation, or substance abuse. The document also discusses characteristics of credible versus non-credible abuse allegations, noting that credible accounts are usually detailed, consistent internally and with known abuse patterns, while non-credible accounts often add inconsistent or improbable details over time.
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This document discusses symptoms and indicators of child sexual abuse. It lists 40 behavioral indicators, 20 physical/medical indicators, and 23 familial indicators of abuse. Some key signs include precocious or inappropriate sexual behavior, knowledge or dress; physical injuries; genital infections; pregnancy; and dysfunctional family dynamics like favoritism, role reversal, isolation, or substance abuse. The document also discusses characteristics of credible versus non-credible abuse allegations, noting that credible accounts are usually detailed, consistent internally and with known abuse patterns, while non-credible accounts often add inconsistent or improbable details over time.
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Attribution Non-Commercial (BY-NC)
Доступные форматы
Скачайте в формате PDF, TXT или читайте онлайн в Scribd
Based on the Grant Martin’s Work, Critical Problems in Children and Youth.
Symptoms of Sexual Abuse
A. Behavioral Indicators 1. Indirect hints or open statements about abuse 2. Difficulty in peer relationships, i.e., violence against younger children 3. Withdrawn, less verbal, depressed, or apathetic 4. Abrupt and drastic personality changes 5. Self-mutilation 6. Preoccupation with death, guilt, heaven or hell 7. Retreat to fantasy world, dissociative reactions – loss of memory, imaginary playmates, child uses more than one name 8. Unexplained acquisition of toys, money, or clothes 9. Fear, clinging to parent, requires reassurance 10. Unwillingness to participate in physical / recreational activities 11. Refusal to undress for P.E. class at school 12. Sudden increase in modesty 13. Fear of bathrooms and showers 14. Self-conscious about use of bathroom, severe reaction if intruded upon 15. Anger, acting out, disobedience 16. Refusal to be let with potential offender or caretaker 17. Becoming uncomfortable around formerly trusted person[s] 18. Lack of trust 19. Active hostility and anger toward formerly trusted person 20. Runaway behavior 21. Refusal to go home or stated desire to live elsewhere 22. Extreme fear or repulsion when touched by an adult of wither sex 23. Touching to either extreme 24. Inappropriate dress, use of clothing to reverse roles – child looks like sophisticated adult, mother like teenager 25. Onset of poor personal hygiene, attempts to make self appear unattractive 26. Sophisticated sexual knowledge 27. Precocious, provocative sexual behavior 28. Seductive, indiscriminate display of affection 29. Pseudo-maturity, acts like small parent 30. Regression to earlier, infant behavior – bed wetting, thumb sucking 31. Sleep disturbances, nightmares 32. Sleep habits change, stays up late, or seems constantly tired 33. Continual, unexplained fear, anxiety, or panic 34. Inability to concentrate in school, hyperactive 35. Sudden drop in school performance 36. Overly compliant or almost compulsive in action 37. Arriving early at school and leaving late with few, if any, absences 38. Excessive masturbation 39. Combination of violence and sexuality in artwork, written schoolwork, language and play 40. Hysterical seizures 41. Attempts to establish boundaries, such as wearing clothing to bed 42. Total denial of problem with total lack of expression or feeling A. Physical and Medical Indicators 1. Passive during pelvic examination. A non-abused child is more agitated during first pelvic; a raped child will yell and scream, while a repeatedly abused child will quietly spread legs 2. Bruises and hickeys or both in the face or neck area or around the groin, buttocks and inner thighs 3. Torn, stained, or bloody underclothing 4. Bleeding from external genitalia, vagina, or anal regions 5. Swollen or red cervix, vulva, or perineum 6. Positive tests for gonococcus or spermatozoa 7. Pain or itching in genital areas 8. Difficulty in walking or sitting 9. Venereal disease or gonorrhea infections 10. Pregnancy 11. Unusual and / or offensive body orders 12. Abrasions and erythema of the vulva area, laceration of posterior fourchette 13. Amall perihymenal scars and scarring of posterior fouchette 14. Abrasions and laceration of hymen with tearing between three o’clock and nine o’clock 15. Scarred and thickened transected hymen and rounded redundant hymenal remnants with adhesions sometimes binding hymen laterally and distorting the opening 16. Complete or partial loss of sphincter control 17. Fan-shaped scarring extending out from anus in six o’clock position 18. Pain on urination 19. Penile swelling and penile discharge 20. Vaginal discharge and urethral or lymph gland inflammation B. Familial Indicators 1. Sibling Behavior a. A brother or sister behave like a girlfriend and boyfriend b. Child fears being left alone with sibling c. Children appear embarrassed when found alone together d. Child is teased or antagonized by sibling but does not retaliate e. Siblings report another child is favored by parent 2. Parent Behavior a. Stepfather present in home b. Parent, particularly the natural mother, absent from home by death, divorce, long-term work, or military c. Emotionally distant or sexually punitive mother d. Mother does not have high school education e. Little or no appropriate physical affection from father f. Strained marital relationship g. Dysfunctional family system, blurring of generational lines h. Parent often alone with one child; work or school schedules which cause one parent or caretaker, particularly the father or male family member, to spend a great deal of time with a child i. Favoritism by parent toward one child or an overly protective or jealous parent j. Reversal of roles between mother and daughter k. Parent severely restricts child’s outside contacts with peers l. Mother chronically ill or disabled m. Questionable sleeping arrangements, often sleeping with one parent or exposure to parental sexual behavior n. Domineering, inflexible father won’t allow wife to drive or interact with outsiders o. Father who either directs all family activities at church or school p. Parent or other family member has been sexually abused q. Social, physical, and geographic isolation of family r. Overcrowding or substandard living conditions s. Alcohol or substance abuse in family Credibility A. Reports of multiple incidents over time B. A progression from less intimate to more intimate sexual activity C. Revelation of direct or implied understanding between the child and offender that the activity should be kept secret, or the presence of elements of pressure and coercion D. Explicit details of sexual behavior E. Peripheral details as place of residence, or time of year Characteristics of Victim Statements in Intra-familial Sex Abuse Actual Sexual Abuse number of unique details, stereotypic in pattern; does not fit together into a 1. Statements internally and logically cohesive fabric, contains major consistent, large numbers of unique reversals, details tend to be self- details, flowing narrative pieces serving, may not be consistent with eventually all fitting together where Consistent with external data where such minor peripheral details may be added is available; includes non-self-serving or drop out, but no major reversals; details 2. Statements are rarely dramatic, Unreliable/Fictitious Allegations rarely seeking to make the perpetrator 1. Statements become increasingly appear in a totally negative light, but inconsistent over time, show diminished more ambivalent in tone; statements about details consistent with what is alleged multiple victims, and/or known about similar crimes, e.g., multiple perpetrators, orgies, describes perpetrator takes usual self-protective situations in which alleged perpetrator steps against being discovered, follows has not taken ordinary steps against expected patterns seen in chronic incest discovery of molestation 3. Rarely is force alleged, but usually 3. Statements almost invariably verbal manipulation, bribes, claims “we progress from relatively innocuous will both get in trouble if you tell.” The behaviors to increasingly intrusive, less adept perpetrator is more likely to abusive aggressive activities ultimately threaten or coerce the victim. In rare with threats to harm or kill child or cases where physical force is used in significant others if victim discloses; in intra-familial situations, it is usually some young children allegations of within the context of generalized family torture, killings are made of animals and violence, where the threat of force is the or humans most common mode of handling 4. Details may not be consistent with conflict or disputes between family what is known about sexual physiology, members response cycles except in areas where 4. Details provided are usually child has been questions extensively so consistent with what is known about that the right answers are learned sexual physiology and response cycles 5. Details provided are not consistent 5. Described changes in social and with what is known about sexual relationship across time are perpetrator/victim relationship patterns consistent with what is known about unless this is superimposed by perpetrator/victim long-term interviewers who are aware of what relationship patterns these patterns occurred at younger and 6. Rarely does the victim make issue of younger ages memory. There may be instances of not 6. Typically will not admit memory remembering known incidents, or not problems, but may claim not to remembering particular details at the remember when caught in height of stress. In the usual memory contradictions, or when feeling guilty loss, the report will be consistent with about making untrue statements; alleged what is known about memory memory losses do not fit what is known processes, e.g. recency effects, fading, about memory processes; may later loss of peripheral details first rather absolutely deny statements which were than loss of the major events; memory insisted upon earlier can usually be recalled by providing 7. Classical recantation is unlikely; non-leading cues. mother usually supports if not promotes 7. Recantation may occur for the entire the allegations; family pattern is incident or all alleged incidents when typically two family units following a external data where such is available; no pressure is applied within the family flowing narrative may have been given situation to relieve the legal/economic major details have been formed through ramifications of the accusation. Often interview technique of leading, the mother pushes for recantation pressuring, shaping overtly or covertly. This pattern is seen 2. Statements are often dramatic, in initially intact family units who are claims of being forced drugs or alcohol, now separated due to the legal case 8. Supportive parent has not allegations, has usually participated in participated in one or more formal child protective services or law- interviews of the child in regard to the enforcement interviews; parent makes allegations, nor observed the child allegations that child resists confirming, interviews followed by repeating part of what 9. Child may appear pseudomature, parent said later responsible, self-blaming, embarrassed 9. Child is often immature, dependent, and while reluctant to disclose, the manipulative, enmeshed with mother, statements are consistent across time. seen by both parents as naïve about Once or both parents may comment on sexual matters age-inappropriate sexual interests or behavior preceding or following the allegations coming to light prior separation or divorce 8. Supportive parent often highly involved in the emergence of the
Fabricated vs. Bona Fide Allegations of Abuse
Characteristics of Child Fabricated 2. Less variation because real experience exists 1. Welcomes chance to talk about 3. No parental dispute abuse 4. No manifestation of Parental 2. Contradictions and inconsistencies in Alienation Syndrome description 5. Can give exact details because 3. Presence of child custody dispute reality exists 4. Other evidence of Parental 6. Situation, description is probable Alienation Syndrome (PAR) 7. Realistic and appropriate description 5. Can’t describe as many details 8. Guilt, reluctant to tell, no vengeance. because there is no actual experience Guilt over problems allegations cause 6. Describes unlikely details or events to abuser 7. Simplistic, absurd, naïve description 9. Worries genitals have been damaged. 8. No guilt, even hostility. Seems glad Social as well as sexual damage to report perpetrator 10. Does not enjoy attention. Has been 9. Doesn’t feel genitals have been programmed for secrecy and shame damaged 11. Preoccupation with sexual behavior. 10. Seems to enjoy attention Will give litany and then go play. 11. No preoccupation with sex other abuser than fabricated incident 13. No fear of home. No desire to spend 12. No generalized fear of adults same excess time away from home. Willing sex as perpetrator. No fear of alleged to go to home of abuser Bona Fide 14. Not complaint in interview 1. Hesitant, fearful to talk. Disclosure 15. Not withdrawn. Outgoing and verbal requires several interviews 16. Not depressed 17. Sexual information comes from 13. Extremely fearful of being alone. fabricating adult, school, TV, or peers Stays away from being home. Won’t 18. Not prone to psychosomatic illness. go to offender’s house No regressive behavior 14. Compliant 19. Has a litany. Routine description 15. Withdrawn, nonverbal; may have 20. No reenactment of abuse in play fantasy world 21. Not likely to make physical contact 16. Depressed, even suicidal with therapist 17. Information comes from real 22. Uses adult terminology experience with abuser 23. No sleep disturbances 18. Prone to psychosomatic and 24. Reports only one or two events regressive behaviors and problems 25. In joint interview with abuser, not 19. No litany at outset. Although may likely to act seductive or fearful occur after several repetitions 26. If retraction is made, shows guilt 20. Reenactment of trauma in play is over problems caused likely. Need for desensitization 21. Likely to be seductive and physical with examiner 22. Uses terms used in home or by abuser 23. Sleep disturbances, particularly if abuse occurred in bed or at night 24. Often reports long history and progression of abuse Searching for gratification. Has been 25. Likely to act seductively to abuser, sexually excited or show high level of fear 12. Morbid fear of abuser, as well as of 26. If retraction is made, shows fear. other same-sex adults Result of threats made by abuser
Characteristics of Accusing Mother
Fabricated 3. Receptive to impartial evaluation and therapy to lessen future risk 1. Adversities to world. Not afraid of 4. In joint session with child, child does public disclosure not check with mother 2. Expands, exaggerates, fans every 5. Tries to avoid trauma spark 6. More open to eventual contact with 3. Wants hired gun evaluator against father abuser 4. In joint session with child. Child is importance of father/child relationship. often checking with mother Does not want father to see child 5. Does not appreciate legal process 7. Not likely to have been abused as trauma child 6. Do Does not acknowledge 8. Not passive; more aggressive, Bona Fide outspoken 1. Ashamed, withdraws, tends to 9. Presence of child custody dispute minimize 10. Inconsistencies in describing events 2. Would rather it be less, not more other than alleged abuse 7. Likely to have been abused 8. Passive, disabled, absent 9. No dispute 10. Lack f duplicity or inconsistencies
Characteristics of Alleged Abuser – Father
Fabricated Bona Fide 1. No instance of gifts, bribery by 1. Gifts are common abuser 2. Threats common 2. No threats involved in scenario 3. False indignation, passive silence, 3. Father is indignant, willing to take ambivalent about taking lie detector lie detector test 4. Child is not as affected by mother’s 4. Child is angry at father in mother’s presence presence, but out of mother’s presence, 5. Likely to have been abused child is not as hostile to father 6. Presence of sexual deviations. 5. Father is not likely to have been Sexual addiction symptoms abused as child 7. Negative past relationships. Poor 6. No associated sexual deviations self-esteem. Welcomes passive, 7. History of good equal heterosexual compliant, participation of child relationships. Adequate self-esteem. 8. Regression when stressed Can handle female rejection 9. Abusive of alcohol and drugs 8. Not prone to regression in situations 10. Isolated, few friends. Can be of stress controlling in home 9. Less likely to abuse drugs and 11. Choosing work opportunities that alcohol bring him into contact with children 10. Not likely to be social isolate 12. Stepfather more likely to be abuser 11. No special career choice relative to 13. Tends to be rigid, controlling, etc. family contact 14. No dispute 12. No difference in probability between 15. No inconsistencies father and stepfather 13. Not rigid, moralistic, or legalistic 14. Presence of custody dispute 15. Inconsistencies in details of events other than abuse
Treatment of Sexual Abuse
Damaged Goods Syndrome: The child feels physically, emotionally, and socially damaged Refer child for a physical exam to determine of there are any physical injuries that require medical attention Reassure child that physical injuries have been (or will be) treated Help child understand that he or she is not damaged physically or emotionally Help family members overcome distorted perceptions of the child and respond to the child in an appropriate manner Guilt: The child feels guilty about the sexual activity, about the closing, and/or about any family disruption that followed disclosure Help the child express guilty feelings Help the child and family members realize the child is not responsible for the sexual abuse Reassure the child he or she is not responsible for any disruption on the family that followed disclosure Reassure the child that he or she has a right to expect protection from the perpetrator Reinforce the child’s decision to disclose Help the child (if sufficiently mature) identify elements of his/her behavior for which he or she should be responsible (e.g., use of manipulative behaviors) Fear: The child is fearful of the consequences of his or her participation in the sexual activity and disclosure Help the child identify and express his or her fears Reinforce the child’s decision to disclose Refer to God’s protection, but remember victim’s experience to this point has been contrary Facilitate practical measures to keep child safe Depression: The child is depressed following the disclosure Observe the child for signs of depression or suicidal intent Help the child ventilate his or her feelings Believe, support, and love the child unconditionally Sometimes recommend hospitalization and/or medication If mother closely allied with offender, work toward reducing conflicting allegiances Low Self-Esteem: The child feels unwanted and undeserving and describes himself or herself in derogatory terms Help the child identify and express positive feelings about himself or herself Provide opportunities to develop a “claim to fame.” Needs areas of success Affirm identity as a child of God and a unique creation Communicate God’s unconditional love Use Christ’s suffering and anguish as a bridge for feelings of victim. Don’t rush too quickly to Christ the victor; give child time to identify with Christ the victim Emphasize God’s grace Poor Social Skills: Child has inadequate social skills as a result of parent’s pressure to limit outside relationships Provide child with opportunities to develop social skills (e.g., group therapy, anger management, self-control materials) Work with school personnel to facilitate social growth Anger and Hostility: Although sometimes outwardly passive, the child is inwardly hostile and angry Help child identify and ventilate angry and hostile feelings. Affirm that it is ok to be angry Help child to learn to express anger in assertive but non-destructive ways Provide opportunities to express anger in a safe environment such as a group Inability to Trust: The child is distrustful as a result of being abused by a trusted person Provide opportunities to develop satisfying, trusting relationships (e.g., with therapist “Big Brother”) Encourage child to try new relationships, but work to ensure they are safe Role Confusion: The sexual relationship with an adult has blurred boundaries and roles Help child and family members resolve role confusion. It is important to have family members confirm counselor’s statements about appropriate boundaries Modify communication patterns among family members so they are consistent with appropriate roles Work towards having a perpetrator explain to the child that the abuser is responsible for what happened, that the sexual activity was inappropriate, and that it will not happen again Approach the topic of forgiveness between the offender and victim, but not too soon If working toward reuniting family, work out detailed agreement on respect for Boundaries Failure to Complete Developmental Tasks: Preoccupation with sexual activity has interfered with child’s accomplishment of normal developmental tasks Help child assume more appropriate child role. Encourage child play Obtain family’s cooperation in helping child relinquish his or her inappropriate responsibilities. Entire system must change Lack of Self-Mastery and Control Help the child understand that he or she has a right to self-determination and privacy Provide opportunities for child to test his or her capacity for self-mastery and control (e.g., role-playing, learning about accountability) Teach family members how to reinforce the child’s appropriate independent and responsible behaviors Ambivalent Feeling Toward the Perpetrator: The child has negative and positive feelings towards the perpetrator Help the child sort out and express his or her negative and positive feelings Reassure the child that it is acceptable to have both types of feelings Teach the difference between physical contact and love Ambivalent Feelings Toward the Non-Offending Parent: The child has negative and positive feelings towards the non-abusive parent Help child to sort out and express negative and positive feelings Reassure child that it is acceptable to have both types of feelings Fears Concerning the Reaction of Others: Child is concerned about the responses of siblings, friends, etc. Identify how the child perceives the feelings and reactions of others Help the child express his or her disappointments, fears, and anger Help siblings identify and express their feelings about the abuse Provide child with opportunities to develop healthy relationships Inappropriate Boy-Girl Relationships: The child mistrusts others of the same sex as the perpetrator, displays inappropriate sexualized behaviors, etc. Provide the child with opportunities to develop positive relationships with individuals of the same sex as the perpetrator Provide instruction regarding appropriate behavior Provide information regarding appropriate boy-girl or dating behavior Negative Effects of the Legal System: The child has a negative response to the court system Prepare child for court proceedings by providing emotional support and information about the court process Reinforce child’s decision to disclose Lack of information about sex: The child’s knowledge about sex and birth control is limited and tainted Provide chills with age-appropriate sex education Work with family to reinforce values as well as knowledge information
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