2022 California Council of Community Behavioral Health Agencies (CBHA) Conference

Championing a Hidden Health Crisis: Childhood Sexual Trauma

The contemporary English writer, Julian Barnes once wrote “Memories of childhood were the dreams that stayed with you after you woke.” Sadly so, for many children those memories of childhood are not laced with adjectives such as happy, trusting, innocent, precocious, fresh, sensitive, fanciful, gentle, joyous, and imaginative. Some memories are so traumatic and pervasive that their life experience changes them both emotionally and biologically through their lifespan if no intervention is sought. Childhood sexual abuse occurs at rates so high as to liken it to an epidemic.

  • Nearly 70% of all reported sexual assaults in the United States occur to children ages 17 and under. (National Crime Victimization Survey, 2002)
  • Youths have higher rates of sexual assault victimization than do adults. In 2000, the rate for youths aged 12 to 17 was 2.3 times higher than for adults. (Sedlak et.al., 2010)
  • Child Sexual Assault is widespread, affecting 1 in 5 girls and 1 in 7 boys (Domestic Violence National Hotline, 2018)

The Domestic Violence Hotline reports that in 2018 every 98 seconds, an American is sexually assaulted . . . and every 8 minutes, that victim is a child.

Research (Finlehor, 2012) supports that about 90% of children who are victims of sexual abuse know their abuser. Only 10% of sexually abused children are abused by a stranger. It has been reported that 60% of the children who are victims were abused by people the family trusted.

We know that childhood sexual trauma begins gradually. Months may be spent by the perpetrator ‘grooming’ their victim with nonsexual hugging and touching, behavior that appears perfectly normal and acceptable. Among many factors, perpetrators may provide the attention or the help children are missing, or they recognize and chose the child who is lonely or has little confidence.

Children are trusting and innocent; they believe that everybody loves them. The Stranger Danger and Good Touch, Bad Touch campaigns are not enough.

Elizabeth Jeglic, Ph.D, a professor of psychology at the City University of New York Graduate Center, supports that we are targeting the wrong individuals when we teach our children about stranger danger. Teaching our children about consent and that no one should be touching them without their permission is essential. Perpetrators are more likely to be known to the child –meaning family, friends and those they know in their environment, like teachers, clergy and coaches.

Consent is key – children need to understand that they control who can and cannot touch their bodies, and they can leave when a situation feels wrong. Children at different developmental ages communicate their concerns and needs, meaning when bad things happen to them, in different ways. Hence, educating all caregivers, not just parents to be more clearly aware and able to provide a simple message to children that it is okay to talk and there are safe people to talk to is essential. Parents and caregivers will benefit from support in helping to teach children to trust their instincts and how to handle situations that make them feel uncomfortable–like what you do if you are at a friend’s house and someone there tries to touch you, or show you inappropriate material. Open communication allowing for roleplay of these types of situations with a child helps to build a comfort and resiliency.

Communicate, communicate; the collective ‘we’ (parents, caregivers and professionals) need to listen and permit the expression of ideas and feelings even when the child’s ideas differ from yours. Listen first and acknowledge the expressed opinions and thoughts. Viewpoints can change, but, mutual respect entitles each to their own. Give undivided attention; let children see that the focus is solely on what they are staying. Keep communication open ended on any subject. Avoid making judgments. To be seen as a confident we need remember, respect brings respect. It is not necessary to approve of all behavior, but it is important to understand the feelings involved. Back our children up – when a child decides they don’t want to be touched, either in a tickle fight or when they meet an Aunt, ‘we’ need to respect that.

Impact of Sexual Abuse Surfacing Later in Life

Research supports that disclosure is extremely challenging emotionally and intellectually for a multitude of reasons, one of which is the manipulation and threats of varying degrees by the abuser. The emotional experience of disclosure is mixed, with a percentage of the victims expressing guilt related to the disclosure. In an overview, The Center for Disease Control and Prevention looks at the potential lifetime view of the impact of childhood sexual abuse in these categories; social, emotional and cognitive impairment, adoption of health risk behaviors, disease, disability and social problems and early death.

Childhood sexual abuse, physical abuse, emotional abuse and neglect are associated with adolescent suicidal ideation across community, clinical and high-risk samples, (Miller, A.B., et. Al. 2013.) It is a strong predictor of suicidal ideation into adulthood.

The biological impact, the stronger and more intense an experience of stress from many sources for a child, impacts their brain development. Trauma experiences have a powerfully significant and detrimental impact on the developing brain: they override the impact of normal developmental experiences. Stress when prolonged, severe or recurrent, impairs coping abilities and if too great a child becomes vulnerable to future stress and less capable of benefitting from healthy nurturing supports that might help buffer future stressors or trauma. There is a body of research that supports that changes do occur in the brain and our response to stress. In addition, the study of gene expression, known as epigenetics, is uncovering changes that may affect stress response in the DNA.

We need public education as well as evidenced based treatments for traumatic childhood experiences. Victims’ voices, research, clinical studies and practice have helped to develop a more comprehensive understanding of the childhood sexual abuse trauma experience and its effect across an individual’s lifespan. How to more effectively address the needs of children in a preventative, nurturing, open manner and approaches in treatment that are effective and successful continues to evolve. We need to champion this health crisis in our homes, communities, schools, etc. so that the dreams and hopes seeded in childhood can be realized by all.

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