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Understanding indicators of child sexual abuse and barriers to disclosure

Indicators of child sexual abuse

Child sexual abuse often occurs in the context of other forms of child abuse or neglect, including households where domestic and family violence is present (Howe, 2005; Hume, 2003). Hence, indicators may be subtle and attributed to other concerns or problems that the child may be experiencing.

Attention

Many children and young people do not disclose child sexual abuse they have experienced until they are in adulthood. Some children never disclose. Findings from the Child Abuse Royal Commission (2017) found that on average, it took survivors of child sexual abuse 23.9 years to tell someone about the abuse.

Aside from a child’s verbal disclosure of child sexual abuse, indicators of sexual abuse can include:

  • general trauma symptoms
  • sexual behaviours that are inappropriate for a child’s age or developmental level
  • a pattern of events, environment or behaviours that appears focused on keeping secrets.

More specifically, indicators can be grouped into physical, behavioural (sexual and general) and emotional indicators (Mangilio, 2009; Righthand, Kerr & Drach, 2003; Sanderson, 2004; Sgroi, 1982).

Physical indicators Emotional indicators Behavioural indicators - Sexual Behavioural indicators - General
  • bruising, bleeding, swelling, tears or cuts on genitals or anus
  • an unusual vaginal odour or discharge
  • torn, stained, or bloody clothing, especially underwear
  • pain or itching in genital area, difficulty going to the bathroom, walking or sitting
  • sexually transmitted diseases or infections, especially in a preadolescent child
  • pregnancy.

Sudden changes such as:

  • anxiety
  • arousal (easily startled, overly fearful or overly watchful)
  • change in mood
  • depression
  • emotionless
  • fear of particular situations, persons or things
  • hopelessness/helplessness
  • hyper-activity
  • intense fear
  • lack of concentration
  • lethargy, listless
  • memory problems;
  • nightmares, difficulty sleeping, fear of the dark.
  • self-injury
  • has or involves many sexual partners
  • sexual pre-maturity
  • sexual behaviour that is unexpected/ developmentally inappropriate
  • hiding intimate items such as used underwear, bras, used tampons or pads
  • suicide attempt or fire lighting incident at location where sexual abuse is alleged to have taken place
  • placing objects in genitals
  • smearing of faeces or blood in alleged physical location of sexual abuse.

Children may engage in any of these behaviours by themselves, with other children, adolescents or adults, or in groups.

 

  • aggressiveness
  • avoidance of people or places
  • bed-wetting
  • detachment
  • drug/alcohol or inhalant use
  • vagueness
  • eating problems – difficulty swallowing, loss of or increase in eating
  • oppositional and defiant behaviour
  • physical pain (for example, body aches, frequent tummy aches, genital discomfort)
  • re-experiences vivid flashbacks, dreams
  • school refusal, truancy or school related problems
  • self-defeating statements
  • self-harm
  • sleeping problems
  • social problems
  • isolating
  • withdrawing
  • conflict with peers
  • stealing
  • suicidal ideation
  • running away from residence
  • tantrum behaviour
  • toilet training problems.

 

Attention

Always take a child’s verbal disclosure of sexual abuse seriously. A child does not need to exhibit any of the above indicators of child sexual abuse for their disclosure to be believed.

The presence of any indicators – except disclosure which is highly reliable in its own right - should not be considered in isolation. There may be a number of explanations aside from child sexual abuse to account for some behavioural presentations such as developmental delay and disability, a medical issue, other types of abuse or trauma and cultural considerations.  Attempts should be made to gather as much ‘pre-abuse’ functioning information in order to accurately consider the child’s presenting behaviour.

Pre-abuse functioning includes consideration of the child’s:

  • temperament
  • attachment
  • cognitive development
  • emotional development
  • mental health history
  • psychological development
  • psycho-social development.

Barriers to disclosure

There are a range of reasons why children and young people do not disclose, even when there is physical evidence or an admission of offending by an alleged abuser or offender. These include but are not restricted to:

  • the person who has experienced sexual abuse, or other family member, feeling guilty, fearful, embarrassed, or ashamed
  • a lack of language skills to communicate the abuse
  • a fear of not being believed
  • coercion –  being afraid of threats made by the alleged abuser or offender or a significant other
  • trauma – the severity of the abuse, being unable to remember the details of the abuse
  • dissociation, which can occur:
    • during the interview or engagement with the child, thereby restricting the practitioner’s ability to obtain information
    • during the abuse, which impacts the child’s ability to remember or articulate the memory of the abuse
  • inability to recognise the activity as abusive
  • cultural considerations (further outlined below)
  • not wanting to talk to strangers
  • the gender of the interviewer
  • system/community responses, such as fear of what will happen following the disclosure
  • lack of parental support, either explicitly voiced or implied.

(DeVoe & Faller, 1999; Faller, 2003; London, Bruck, Wright & Ceci, 2008; Paine & Hansen, 2002).

Children who have experienced sexual abuse need practitioners to:

  • notice their distress
  • recognise when they are conveying that abuse has occurred
  • show children that they are interested, concerned and capable of listening to the child’s story.

Note

Children also need practitioners to build the capacity of the people who have a relationship with the child. These people were in the child’s life before Child Safety became involved and will be in their life long after Child Safety are gone. They are instrumental in helping the child to tell their story.

The below diagram has been adapted from Allnock and Miller’s (2013) article ‘No-one Noticed, No-one Heard’ which explored 60 children’s experiences of abuse in the United Kingdom. The diagram is a summary of their findings around why the sexual abuse of children does not stop sooner. It highlights common professional pitfalls in working with child sexual abuse, including instances where a committed offender has contact with children and families.

Note

The information in the diagram highlights the importance of working with children, parents and the community to identify the abuse, recognise that a child is trying to talk about the abuse, and removing barriers to disclosure.

It is acknowledged that the diagram contains the word ‘grooming’ which is commonly referred to as ‘manipulation and coercion’ by Child Safety in current practice.

Recantation

Children who disclose sexual abuse may at a later stage retract or recant their statements. Recantation rates vary from 4% to 27% (London, Bruck, Wright & Ceci, 2008). This may be because of the significant contextual variants which impact recantation. There are several reasons why children recant their disclosures and their recantation should be considered in the context of all information gathered during the investigation and assessment.

A child’s recantation may be as a result of:

  • the upheaval created since the investigation and assessment commenced or since they first disclosed (i.e. they may have seen the alleged abuser or offender leave home or the child may have been removed from the home themselves)
  • observing how others have been affected (i.e. the child’s parent may have had to rejoin the workforce or leave the workforce, they see their parent upset)
  • fear that others will (or have) blamed them or had other negative reactions to them (including siblings, grandparents, parents)
  • an ongoing concern for the alleged abuser or offender which may be due to the child’s relationship with the abuser (who could be the child’s parent or family friend).

These factors can influence a child to recant their disclosure. Their impact may be subtle in how they influence a child making such factors difficult to detect and manage.

Note

The level of support provided to the child by the parent/carer is of paramount importance in reducing the likelihood that a child may recant. Ensure that a parent/ carer has appropriate education and support for a child in their care who has disclosed sexual abuse.

Further reading

Read the New South Wales Office of the Senior Practitioner Child Sexual Abuse and Disclosure Literature Review to understand more about what children need to help them to disclose.

Royal Commission into Institutional Responses to Child Sexual Abuse: Final Report (volume four: identifying and disclosing child sexual abuse).

Aboriginal and Torres Strait Islander children – additional considerations

In addition to the barriers to disclosure identified above, there are further barriers identified in the literature relating to Aboriginal and Torres Strait Islander children disclosing sexual abuse:

  • isolation from service providers in remote communities
  • a lack of community understanding about child sexual abuse and how to address it, and a lack of culturally specific sex education for children in schools
  • shame experienced by children and their families
  • fear of reprisals from the alleged offender / abuser and their families due to how disclosure will impact family and community networks (Aboriginal Child Sexual Assault Taskforce, 2006; Gordon et al., 2002; Mullighan, 2008; Wild & Anderson, 2007, as cited in Anderson et al., 2017).

The intergenerational impact of trauma caused by historic government policies continues to have implications for Aboriginal and Torres Strait Islander families today. A significant impact of intergenerational trauma is mistrust and fear of statutory authorities. Historically, the sexual abuse of Aboriginal and Torres Strait Islander children was widespread under ‘protectionism’ and assimilation (Human Rights and Equal Opportunity Commission as cited in Anderson et al., 2017). The implication for practice is that Aboriginal and Torres Strait Islander children are less likely than non-Indigenous children to disclose to police or child protection practitioners in formal interviews. If an Aboriginal or Torres Strait Islander child does not disclose sexual abuse during a formal interview, do not assume that the abuse has not occurred. All children, including Aboriginal and Torres Strait Islander children, are more likely to disclose sexual abuse if they have access to adults who they feel safe with, who they know believe them, and who they trust to protect them.

Culturally appropriate care promotes a child’s wellbeing. For Aboriginal and Torres Strait Islander families and communities, the sharing of parenting roles, nurturing and socialising responsibilities is the cultural norm. At the heart of a collectivist approach is the safety and wellbeing of all children belonging to the community. Having access to a wide range of support when they experience difficulties increases the protective factors for Aboriginal and Torres Strait Islander children by increasing the number of secure attachment relationships that they have in their extended kinship network (Lohoar et al, 2014). If a child discloses sexual abuse, ensure the child’s connections to secure attachments and important relationships continue wherever possible.

As practitioners, develop and respect cultural and community norms regarding who is appropriate for a child to speak to about sensitive topics, and the timing and context of these conversations. Make arrangements for such people to support the child during interviews and to support the child in response to the child’s disclosure.

Positive cultural connections have been suggested to indirectly increase protective factors for Aboriginal and Torres Strait Islander children by supporting the social and community conditions required for adults to heal their own trauma, foster strong attachments to children in the community, and in turn, create safer more connected communities (Anderson et al, 2017).

Further reading

Further reading

Aboriginal and Torres Strait Islander children and child sexual abuse in institutional settings.

Royal Commission into Institutional Responses to Child Sexual Abuse: Final Report (volume three, p. 130-133).

Read further about 'Women’s business and men’s business' and 'Understanding the concept of shame' in the Working with Aboriginal and Torres Strait Islander peoples part of the Practice kit Safe Care and Connection

Children who are culturally and linguistically diverse – additional considerations

For families from Cultural and Linguistically Diverse (CALD) backgrounds, there may be additional considerations regarding a child’s disclosure of sexual abuse. For migrant and refugee children and families, the journey from their country of origin to Australia can vary from a planned trip to a journey that was unforeseen, sudden, dangerous and exhausting.

Women and children of CALD backgrounds face a range of additional barriers to reporting violence and sexual abuse, which are further outlined below. This may lead to women and children being hurt and sexually abused over a longer period of time and the violence or abuse becoming more severe, and the family system may appear more closed and protective of the person responsible for the abuse due to broader cultural or community isolation, rejection, fear or stigmatisation.

While culture cannot and should not be used as an excuse for the abuse of children, some newly arrived migrants and some members of established communities may be unfamiliar with aspects of Australian legislation, including legislation relating to child protection. For some CALD people, there may also be different views about what constitutes child abuse and neglect in their country of origin. This does not mean that the welfare and interests of the child should not be paramount in all decisions but rather, differing approaches to parenting and a lack of understanding or appreciation of norms expected in Australia could be factors that are encountered during assessment and case work and need to be responded to.

Factors that can impact on a culturally and linguistically diverse family’s engagement and response to child sexual abuse

Many factors for a CALD child and their family can impact how they engage with Child Safety and other services in relation to child sexual abuse, which are outlined below.

Compromised visa status

If child sexual abuse allegations lead to charges and conviction, visas for the individual or family may be impacted. There are financial and emotional impacts resulting from a decision to leave a partner who has sexually abused a child, and a parent may be less likely to adhere to any safety plan for a child which means an alleged abuser or offender must leave the family unit.

Social isolation

An absence of a support network compounded by lack of CALD specific services may lead to a family becoming a ‘closed network’, with limited ability for children to disclose abuse. A lack of knowledge about support services, or a mistrust of services due to past experiences, may prevent a parent from seeking help for their child. Due to this isolation and invisibility, children from CALD families are under-represented in child protection notifications.

Note

CALD children are at higher risk in rural and remote areas due to further isolation and a lack of culturally appropriate services. Opportunities to identify or establish a support network are impacted when a CALD family is located in a rural or remote area.

Limited understanding of Australian laws around harmful cultural practices

The family may have a limited understanding of Australia’s laws around cultural practices such as Female Genital Mutilation and forced marriage.

Female Genital Mutilation refers to all procedures involving partial or total removal of the external female genitalia, or other injury to female organs (such as stitching of the labia majora or pricking of the clitoris) for non-medical reasons. Globally, there is a link between female genital mutilation and other harmful practices such as early and forced marriage.  Female genital mutilation is comprehensively criminalised under the laws of Australia’s States and Territories. A girl at immediate risk of female genital mutilation may not know what's going to happen. But she might talk about the following or you may become aware of:

  • a long holiday abroad or going 'home' to visit family
  • relative or ‘cutter’ visiting from abroad
  • a special occasion or ceremony to 'become a woman' or get ready for marriage
  • a female relative being ‘cut’ – a sister, cousin, or an older female relative such as a mother or aunt. 

A forced marriage is when a person is married without freely and fully consenting. Children may have been coerced, threatened or deceived, emotionally pressured by their family, been physically harmed or threatened with harm or tricked into marrying someone. A person under 16 years of age at the time of the marriage is not usually considered to be capable of understanding the nature and effect of a marriage ceremony.

Note

It is a crime in Australia to cause a person to enter into a forced marriage or to be a party to the forced marriage (unless you are the victim). The law is included in Division 270 of the Commonwealth Criminal Code Act 1995.

In Australia, a range of factors may indicate that a child is at risk of a forced marriage, including if the child:

  • suddenly announces they are engaged
  • suddenly leave school or are away from school for a long time with no reason
  • indicates they will or actually does run away from home
  • has older brothers or sisters who stopped going to school or who were married early
  • is never allowed out or always has someone else from the family with them
  • shows signs of depression, self-harming, or drug or alcohol abuse
  • seems scared or nervous about an upcoming family holiday overseas
  • exhibits indicators that they are experiencing family violence or abuse.

Gender roles

Gender roles and attitudes to family roles and responsibilities, domestic and family violence, sexual assault and children may be influenced by the belief that men are superior to women. Families may be unaware of how violence and sexual abuse is defined in Australia, and this impacts on the disclosure of child sexual abuse and actions to keep children safe. When assessing a child’s safety, focus on whether power and control are misused within the family, resulting in an alleged abuser or offender having access and opportunity to sexually abuse a child.   

Community reputation of an alleged abuser or offender

Patriarchal cultures where men’s voices are valued over the voices of women and children can create barriers to disclosure. These barriers may include fear of reprimand, fear of not being believed or of being discredited, and being disowned and isolated. These worries can have significant implications on a child’s disclosure, family’s response, and the child and family’s engagement with the criminal justice and child protection systems. 

Language barriers

The alleged abuser or offender may be the only person who speaks English in the home, which significantly impacts on:

  • a child’s ability to disclose to someone who they trust and who understands them
  • a parent’s ability to act independently in relation to keeping a child safe.

When considering the use of an interpreter, seek information about cultural factors and gender roles that impact on the choice of interpreter. Due to the sensitive nature of child sexual abuse, determine if the interpreter is willing to translate the content of child sexual abuse in a way that their beliefs and values do not influence the translation.

Attention

At no time should a child act as an interpreter for a parent. At no time should a person who is an alleged abuser or offender act as an interpreter for the child.

Be aware that connection to cultural community will vary from family to family and some people have multiple cultural influences, customs and languages. Children who have parents from multiple cultures or countries require practice to be culturally responsive to both cultures (Aronson, Fontes & Plummer, 2010).

Culture as protection and strength

Do not stereotype or make assumptions about a family’s functioning based on their cultural or linguistic background. The family are the experts of their culture, so start with the family to ask questions to understand and acknowledge cultural differences and norms. This is a good way to engage with and empower the family.

Culture can be a protective factor. Cultural communities and networks may provide support and refuge for women and children hurt by violence. Practitioners may be able to draw on community or religious leaders to challenge a man’s sexual abuse of a child, remaining mindful of community attitudes towards the victim around the disclosure. Cultural practices or faith may be a form of resilience that the mother or child may draw on to survive the sexual abuse and give them hope.

Being connected to extended family and culture is also a protective factor for children. A strong sense of culture can strengthen a child’s self-esteem, sense of identity and belonging. Children who are not connected to family and are not visible in or supported by their communities are more vulnerable to harm.

Further reading

Report by the Australian Institute of Health and Welfare (2019): Towards estimating the prevalence of female genital mutilation/cutting in Australia.

Webpage on Female genital mutilation by the National society for the prevention of cruelty to children (2019).

Factsheet on Forced and early marriage fact sheet (2015), Department of social services.

Website by Anti Slavery Australia: About forced marriage (2015).

Website: Immigrant women’s support service.

The ways in which sexual abuse is discovered

Child sexual abuse can become known about in four main ways:

  • a voluntary, complete disclosure from the child
  • a voluntary, incomplete or partial disclosure from the child
  • the sexual abuse is discovered
  • the sexual abuse is suspected

(adapted from Lanning, 2002, p.333).

A voluntary complete disclosure is when disclosure occurs voluntarily by the child or young person. They have told another person of the abuse they have experienced and are able to relay the details, with varying degrees of complexity and completeness (dependent upon their age and other barriers that may exist). This child or young person can generally be supported to provide detail with little intervention required by the departmental officer or the police. While these children or young people provide a lot of detail, it is still important to conduct the interview in such a way that enough detail is generated to assess risk and protective factors.

Note

Some of the barriers to disclosure may become apparent once other people are aware of the child sexual abuse allegations. In some cases, other people becoming aware of the abuse can lead to recantations later on.

A voluntary but incomplete or partial disclosure occurs when the child or young person may be unable to or chooses not to reveal the full details of the abuse (Faller, 2003). Information about the abuse is either not recalled or not provided completely due to the barriers to disclosure (identified in the part above) . It may also be that a child has told once and will not tell again because the response they got from the original disclosure was not positive, or there was no change to the abusive behaviour after disclosure.

When sexual abuse is discovered, the sexual abuse becomes known to others. This occurs when either the alleged abuser or the child is observed by another person, either through medical examinations (due to specific or non-specific complaints of symptoms) or when physical evidence such as pictures, videos or blood on underwear are discovered.

Sexual abuse that is suspected presents the greatest challenge for practitioners, as the issues requiring investigation and assessment are difficult and complex, and require sensitive, skilled interviews. Practitioners must balance the child’s reluctance to talk about sexual abuse with the possibility that they were not abused. Consideration should also be given to the embarrassment and confusion a child may be experiencing about the sexual abuse and being asked personal questions about their body and abuse by strangers in formal settings (Faller, 2003).

To further understand the ways in which children disclose or convey their abuse including help-seeking behaviour, telling without words, partially telling, telling others and telling in detail, refer to 'Notice and respond to a child's disclosure' in the part Recognise disclosures and respond to children.

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