By Joan Tabachnick and David Prescott

In the past, most studies examining the sexual abuse of children were conducted through cases known to professionals -- coming to the attention of child protection services, police/medical forensic examinations, schools, clinical samples -- or from adults recalling the abuse retrospectively. This National Survey of Children’s Exposure to Violence (NatSCEV) interviewed 13,052 older adolescents and parents of younger children to provide information over the full course of childhood (0-17).  It therefore provides a snapshot of cases of sexual abuse that were not known to authorities and for the 10-17 year old adolescents, may not be known to parents. 

The study’s key finding is that most sexual abuse and assault of children and adolescents are at the hands of other children and adolescents (76.7% for males and 70.1% for females). This is far higher than the juvenile proportion (35.6%) found in most police or child protection samples (Finkelhor, Ormrod & Chaffin, 2009). Females were mostly abused by males (88.5%) and males were equally abused by males (45.6%) and females (54.4%). Over half (66.3%) of the 10-17-year-old adolescents did not disclose the abuse to a parent or any other adult and only 19.1% reported to the police. This information could not be determined for the younger cohort since the information is collected through their parents. It should be noted that the study found low prevalence rates of 5.6% for girls and 1.9% for boys overall. However, these lower numbers are a result of the fact that most of the children in this sample had not yet completed childhood. 

The analyses also indicated that sexually abused children were more likely to be female, black (non-Hispanic), of low socioeconomic status and living in a large city. Sexual abuse was most like to occur inside or near a child’s house and/or somewhere else and least likely to occur in after-school or early education and care programs.

Finally, the findings from this study found that only a third (37.5%) of the cases reported high levels of fear. Female survivors reported feeling significantly more fear than the male survivors during the abuse. The authors suggest that the low levels of fear overall may be explained by the small number of cases that included physical injury, harm or requiring medication treatment. 

One of the most important studies of the past several years, these results highlight the diversity of experiences among young people who are sexually abused. This article points out the wide differences in experience, the expression of fear, the impact of sexual abuse when the person causing the harm is another child or teen. It is not the case that sexual abuse results in predictable outcomes, especially over long periods of time. It is critical that professionals entering the field first understand the most common effects of sexual abuse. Then, with experience, professionals can work to understand the effects of sexual abuse one client at a time and one family at a time. 

Of note, the authors discuss how the findings underscore the complexity of boys’ experiences facing both the stigma of same-sex behavior behavior and the lack of recognition that boys can be victimized by girls. Likewise, it can be difficult for many professionals to imagine or understand that females can and do sexually abuse others, even though known incidents are fewer in number. 

This study points to the fact that there is much we do and don’t know about sexual abuse. One point that the authors make regards the importance of language. They suggest using language such as “sexual abuse” and “sexual assault” because the term “child sexual abuse” can too easily imply that an adult perpetrated the abuse. The authors introduce the term CSAA (child sexual abuse and assault). While terminology can offer peril as well as promise (correct descriptive language is vital to understanding complex ideas but can sometimes be used in an overly prescriptive or rigid manner), the authors’ suggestion fits well with recent thinking in the field of abuse prevention and trauma treatment. Whether you adopt this term or not, this article suggests a seismic change in how people need to consider the common responses, the treatment and the policies of child sexual abuse and assault and its impact on children or teen who cause the harm. 

All professionals have an obligation to remain current in their knowledge. This important paper is one of the most comprehensive summaries of our knowledge to date. 

Gewirtz-Meydan, M & Finkelhor, D. (2019). Sexual abuse and assault in a large national sample of children ad adolescents. Child Maltreatment. DOI: 10.1177/10775595/9873975

The present study sought to examine features of sexual abuse cases among a U.S. nationally representative sample of 13,052 children and adolescents, ages 0–17 years. The National Survey of Children’s Exposure to Violence was collected in three different years (2008, 2011, and 2014) via telephone interviews. Information about sexual abuse and assault was obtained from youth themselves (ages 10–17) or caregivers (for children ages 0–9) using the Juvenile Victimization Questionnaire. Results indicate most offenses are at the hands of other juveniles (76.7% for males and 70.1% for females), primarily acquaintances, and occurring more frequently for adolescents aged 14–17. Whereas girls are mostly abused by males (88.4%), boys are abused by both males (45.6%) and females (54.4%). In 15% of cases, penetration is part of the abuse. Victims report being very afraid in 37.5% of episodes but not at all afraid in 19.8%. Among 10- to 17-year-olds, 66.3% of episodes are not reported to parents or any adult. Police reports occur for 19.1% of all cases. The results in the present study indicate that children and youth are exposed to sexual abuse and assault in varied ways, which require moving beyond conventional stereotypes of the problem. 

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