Child Sexual Abuse (CSA)

What is CSA?
Who sexually abuses children?
Who is abused?
What is Sexualised Behaviour?
What is normal sexual exploration?
What is abuse reactive behaviour?
What is sexually obsessive behaviour?
How do you determine abusive behaviour by adolescents and young people?
What are the effects of CSA?
What are the signs and symptoms of CSA?
How might an abused child feel?
Why don't children tell that they have been abused?
Why do children tell that they have been abused?
As a parent or guardian, how do I cope with the disclosure of abuse?
What should I do if I suspect a child is being sexually abused?
What makes it difficult for children to tell about abuse?
Do children lie about sexual abuse?

1.What is CSA?

 Child sexual abuse occurs when an adult uses his or her power and authority to force or persuade a child to take part in sexual activities for his/her gratification or sexual arousal, or for that of others. A child is never in a position to make a valid choice about appropriate sexual acts. Incest refers to sexual abuse by a family member.

Examples of child sexual abuse include:

Exposure of the sexual organs or any sexual act intentionally performed in the presence of the child;
Intentional touching or molesting of the body of a child whether by a person or object for the purpose of sexual arousal or gratification;
Masturbation in the presence of the child or the involvement of the child in an act of masturbation;
Sexual intercourse with the child, whether oral, vaginal or anal;
Sexual exploitation of a child, which includes inciting, encouraging, propositioning, requiring or permitting a child to solicit for, or to engage in, prostitution or other sexual acts.
Sexual exploitation also occurs when a child is involved in the exhibition, modelling or posing for the purpose of sexual arousal, gratification or sexual act, including it's recording (on film, video tape or other media) or the manipulation, for those purposes, of the image by computer or other means.

CSA may also include;

Showing sexually explicit material to children, which is often a feature of the ‘grooming’ process by perpetrators of abuse;
Consensual sexual activity involving an adult and an underage person. In relation to child sexual abuse, it should be noted that, for the purposes of the criminal law, in Ireland the age of consent to sexual intercourse is 17 years for both boys and girls.

(Please note: An Garda Síochána will deal with the criminal aspects of the case under the relevant legislation. It should be noted that the definition of child sexual abuse presented in this section is not a legal definition and is not intended to be a description of the criminal offence of sexual assault.)

2. Who sexually abuses children?

 Men and women sexually abuse children. Children are usually abused by someone they know, for example, a family member, babysitter, neighbour or authority figure. Sexual offenders often appear to be ordinary, trustworthy people. Child abusers are from every type of background.  The majority of sexual abusers are men, although some perpetrators are women.

Sexual offenders often appear to be ordinary, trustworthy people. People who abuse children are from every type of background.

3. Who is abused?

CSA can happen to any boy or girl. The HSE receives approximately 2,300 new reports of CSA every year but only approximately 520 of these cases are notified to a HSE Child Care Manager every year following some degree of initial assessment. The most recent research shows that 1 in 5 children in Ireland have experienced sexual abuse (SAVI).   Children who are affected by sexual abuse come from many different family backgrounds. The impact of this trauma upon them may be affected also by social problems such as marital difficulties, poor parenting, lack of finance, addiction or domestic violence.  Boys and girls are sexually abused and this can happen within every strata of society. Research indicates that one in eight girls and one in twelve boys are sexually abused before they are sixteen.

4. What is Sexualised Behaviour?

In some cases of child abuse, the alleged perpetrator will be another child. In such situations, it is particularly important to consider how the HSE Children and Family Services and other agencies can provide care for both the child victim and the other child.

5. What is normal sexual exploration?

Normal sexual exploration should consist of naive play between two children that involves the exploration of their sexuality. This type of behaviour may be prompted by exchanges between children, such as ‘You show me yours and I’ll show you mine’. One of the key aspects of this behaviour is it's tone: there should not be any coercive or dominating aspects to this behaviour. Usually, there is no need for child protection intervention of any kind in this type of situation.

6. What is abuse reactive behaviour?

In abuse reactive behaviour, one child who has previous experience of sexual abuse acts out the same/similar behaviour on another child. This is serious behaviour and needs to be treated as such. In addition to responding to the needs of the abused child, the needs of the child perpetrator in this situation must also be addressed.

7. What is sexually obsessive behaviour?

In sexually obsessive behaviour, the children may engage in sexually compulsive behaviour. An example of this would be excessive masturbation, which may well be meeting some other emotional need. Most children masturbate at some point in their lives. However, in families where care and attention is missing, they may have extreme comfort needs that are not being met and may move from masturbation to excessive interest or curiosity in sex, which takes on excessive or compulsive aspects. These children may not have been sexually abused, but they may be extremely needy and may require very specific help in addressing those needs.

8. How do you determine abusive behaviour by adolescents and young people?

Behaviour that is abusive will have elements of domination, coercion or bribery, and certainly secrecy. The fact that the behaviour is carried out by an adolescent, for example, does not, in itself, make it ‘experimentation’. However, if there is no age difference between the two children or no difference in status, power or intellect, then one could argue that this is indeed experimentation. On the other hand, if, for example, the adolescent is aged 13 and the child is aged 3, this gap in itself creates an abusive quality that should be taken seriously.

9. What are the effects of CSA? 

The extent of the trauma caused by sexual abuse varies and depends on the nature and extent of the abuse. The relationship of the abuser to the child plays a significant part in the extent of the trauma experienced by the child.

There are some general themes found in children who have been sexually abused:

Loss of trust
Poor self esteem
Emotional deadness
Feeling responsible for the abuse
Guilt

As the child develops into an adolescent and adult, s/he may find it difficult to form close relationships and may choose to distance him/herself from people, feeling worthless and unlovable. S/he may become involved in violent or abusive relationships in adulthood.  The person may experience sexual difficulties, either being unable to engage in a sexual relationship or behaving promiscuously. Some people resort to alcohol, drugs or food to numb the deep emotional pain and to build up 'protective' barriers from engaging with other people. It is important to be aware that with skilled therapeutic intervention a person who has experienced child sexual abuse can recover fully and can progress in their life to have healthy relationships.

It is important to be aware that with skilled therapeutic intervention a person who has experienced child sexual abuse can recover fully and can progress in their life to have healthy relationships.

10. What are the signs and symptoms of CSA?

Pregnancy
Poor performance suddenly in school
Injuries to the genital/anal area
Fear of changing clothing/undressing in public places
Sexually transmitted infection e.g. thrush/cystitis etc.
Sexualised drawings/play/behaviour
Regressive patterns – soiling/wetting
Psychosomatic symptoms – headaches/frequent stomach pains
Having unexplained sums of money or gifts
Anorexia/bulimia
Sleep disturbances – nightmares
Hyper-alertness
Aggressive/withdrawn
Fear of certain people/places
Running away
Self- mutilation/suicide attempts
Social isolation/no friends

*Whilst these are all causes for concern, they should not be looked at in isolation. It is important to remember that there could be some other explanation. It is always important to check any concerns you may have with a professional.

11. How might an Abused Child Feel?

Confusion:

Keeping secrets can cut off the normal routes for children to find answers
Inappropriate abuse confuses children, can become unsure of how to act with other people.

Fear:

Fear of physical pain.
Fear where/how it will happen next.
Fear of punishment for themselves and for the abuser.
Fear of reverting to childhood behaviour.

Guilt and Shame:

In order to live with recurrent abuse victim believes they are to blame. They feel guilty for being involved, “It must be something about me”, etc.
Guilt because they find the abuse pleasurable and accept rewards given.
Guilt of family break up.
Shame of abuser’s denial.
Guilt towards mother/sister/brother.

Anger:

Towards abuser, mother and siblings.
Repressed anger because of powerlessness, this can lead to depression and withdrawal.
Aggressive attacks on themselves/other.

Feeling Different:

Isolate themselves usually out of choice.
Feeling dirty, worthless, contaminated.
Concern that they will mature differently to others and become like abuser.
Feel whole body image to adults is different to others

Worthlessness & Loss of Self Esteem:

Feel like damaged goods.
Feel that they don’t deserve anything good from anybody.
“I’m fat”, “I’m ugly”, “I’m unattractive”, that’s why it happens.

Sadness, Depression & Loss:

Loss of love/people that are important (interfamilial abuse).
Loss of companionship/friends through isolation.
Loss of childhood.

Powerlessness

Takes on a victim identity.
Sees the world and people in it as unsafe.
Lacks trust in their own judgement.
Survivor can often see themselves as defined by their abuse.

Impact on Sexuality

Depending on the age at which the abuse takes place, natural developmental stages can be impacted and the person can present for therapy/support with issues around sexuality and a distortion in their understanding of themselves as a sexual being.

12. Why don’t Children tell that they have been abused?

Obedience – abuser tells you not to tell.
Fear and/or threats of violence.
Family breakup and turmoil.
Loss of family status within the community.
Publicity – neighbours, relations knowing.
Fear of not been believed.
Lack of appropriate vocabulary.
Don’t have adult permission to talk about sex.
Taught to obey adults.
Intrusion of external agencies – social workers/Gardai calling to the family home.
Loss of privileges.
Reluctant to betray abuser.
Guilt, self blame the child feels responsible for his/her experiences.
Fear of rejection, loss of affection from the abuser and others.
Learned helplessness, the child believes that they have no control over the situation and so learns to behave helplessly even if the opportunity to escape presents itself.

13. Why do children tell that they have been abused?

Pregnancy or fear of becoming pregnant.
Changes in family circumstances, e.g. abuser moves away.
To protect younger siblings.
New boyfriend or girlfriend, change in understanding of sexual norms.
Appearance of trusted adult.
Sex education at school (e.g. Stay Safe programme)
Media coverage of sexual abuse issues.
Increasing age and maturity.
Venereal Disease – STD, kidney infections, UTI’s.
Self harming and suicidal behaviours
Fear of death. Sex = Rape = Death (sometimes a child’s fear of abuse can lead them to disclose.
If children attend therapy for other reasons, disclosure can happen.

14. As a parent or guardian, how do I cope with the disclosure of Abuse?

It is not possible to write down what to do when a child tells us about abuse. The points below are offered as guidelines, and to aid discussion.

Stay calm and don’t overreact
Look at the child directly
Try to drop your eye level equal to or lower than the child’s
Tell the truth
Let them know when and why you are going to tell anyone else
Assume that the child has been threatened
Help the child to trust their feelings
Try to find out what they are afraid of so that you will know how best to help
Don’t pressure the child to talk or avoid talking about what has happened
Allow the child to talk at his or her own pace. Forcing information can be harmful. Silencing the child will not help him/her to forget.
Make notes as soon as possible. Try to write exactly what the child said.
Do not confront the offender. This is a job for the authorities.

15. What should I do if I suspect a child is being sexually abused?

Any person reporting child abuse or neglect concern should do so without delay to the HSE Children and Family Services. A report can be made in person, by telephone or in writing. Before deciding whether or not to make a formal report, you may wish to discuss your concerns with a health professional or directly with the HSE Children and Family Services.

Under no circumstances should a child be left in a situation that exposes him/her to harm or to risk of harm. In the event of an emergency where you think a child is in immediate danger and you cannot get in contact with the HSE, you should contact the Gardaí. This may be done through any Garda station. If you have a concern about a child it is now a legal requirement that you inform the relevant authority.

16. What makes it difficult for children to tell about abuse?

Being a child
Simply because of age, children may lack the knowledge, maturity and sometimes even the language to describe traumatic experiences.

Child’s view of the world
The world of a child is by nature self-centred, causing them to feel responsible for their experiences.

Fear of consequences
A child who is being abused may believe that by telling they will make their situation worse.

Protecting the family
Children often try to protect other family members both from abuse and information they feel will upset them.

Attachment to the abuser
Children need to form attachments in order to survive. They may become attached to, and care about, a person who may hurt or abuse them.

Fear of rejection
Children can fear losing the affection of both the abuser and others.

Learned helplessness
When children believe that they have no control over a situation they learn to behave helplessly. They may continue to behave helplessly even if an opportunity for escape or change presents itself.

Fear of the abuser and the abuser’s threats
Believing the abuser’s threats can be enough to silence a child.

Obedience
Children are taught to obey adults and they may have been told by their abuser not to tell.

Not knowing who or how to tell
Fear of getting themselves into trouble and the fear of not being believed can be very real for a child.

17. Do children lie about sexual abuse?

Sexually abused children have been known to deny, minimize, "forget", and confuse, but rarely do they lie. Research by Lucy Berliner and colleagues in Seattle has matched children's statements and later admissions by sexual offenders and found that not only were the children's statements accurate, but often they were found to be understated accounts of the abuse suffered.

The reporting of sexual abuse is a developmental phenomenon. Children do not automatically report the way adults do. Their reports vary at different ages. For example, a very young child might not have the vocabulary or concept to express an abusive act correctly. The manner in which children remember and recall material also changes as they grow. For example, a child who is recalling details from incidents that occurred when he was four is attempting recall from a very different cognitive arrangement - and even more different from an adult's way of thinking. These differences and inconsistencies might initially appear as "lies" but they are not.

There is no way a child can depict explicitly the details of sexual acts performed on him/her unless the child has experienced it or been exposed to it; his/her life does not typically involve exposure to such material.