2.1. Definition and classification
Child sexual abuse is a form of child abuse in which an adult or older adolescent uses a child for sexual stimulation. It is generally defined as contacts between a child and an adult or other person significantly older or in a position of power or control over the child, where the child is being used for sexual stimulation of the adult or other person. The World Health Organization has deﬁned child sexual abuse and exploitation as the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society.
The United Nations Convention on the Rights of the Child (CRC) is an international treaty that legally obliges states to protect children's rights. Articles 34 and 35 of the CRC require states to protect children from all forms of sexual exploitation and sexual abuse. This includes outlawing the coercion of a child to perform sexual activity, the prostitution of children, and the exploitation of children in creating pornography. States are also required to prevent the abduction, sale, or trafficking of children (United Nations, 1989).
Forms of child sexual abuse include asking or pressuring a child to engage in sexual activities (regardless of the outcome), indecent exposure of the genitals to a child, displaying pornography to a child, actual sexual contact against a child, physical contact with the child's genitals (except in certain non-sexual contexts such as a medical exam), viewing of the child's genitalia without physical contact (except in nonsexual contexts such as a medical exam), or using a child to produce child pornography.
Child sexual abuse can be classified as:
Sexual assault – a term defining offenses in which an adult touches a minor for the purpose of sexual gratification; for example, rape (including sodomy), and sexual penetration with an object. Most U.S. states include, in their definitions of sexual assault, any penetrative contact of a minor’s body, however slight, if the contact is performed for the purpose of sexual gratification.
Sexual exploitation – a term defining offenses in which an adult victimizes a minor for advancement, sexual gratification, or profit; for example, prostituting a child, and creating or trafficking in child pornography.
Sexual grooming - defines the social conduct of a potential child sex offender who seeks to make a minor more accepting of their advances, for example in an online chat room. (APA Board of Professional Affairs, 1999; Child Welfare Information Gateway, 2009; Finkelhor & Ormrod, 2001; WHO, 1999)
2.2. Incidance and prevelance
Sexual assault is a sociological problem affecting individuals in all age groups. According to the Convention on the Rights of the Child, a child means every human being below the age of eighteen years unless under the law applicable to the child, majority is attained earlier (Office of the United Nations High Commissioner for Human Rights,1989).
Different studies reports different percentages of child and adolescent sexual assault. For example it’s reported that % 43 of 766 cases of sexual assault were under 18 age in a study of Michigan State University (Jones et al., 2003). It’s mentioned that 178 of 405 victims were adolescent in another research. Teenagers 16-19 are reported to be victims of rape or sexual assault more than twice as likely as any other age group in USA. Children and especially adolescent females are sexually assaulted more frequent comparatively to adults according to many studies (Navratil, 2003; Jones et al., 2003; Peipert & Domagalski, 1994). In author series most of the sexual assault victims (%87.65) were less than 18 years of age.
Estimates of child sexual abuse rates vary for many reasons. Less than 10 percent of set abuse is reported to the policed (Finkelhor et al,1988). Even in self-reporting surveys, abuse may be underreported because many people are afraid or ashamed to reveal victimization, have repressed memories of abuse, refuse to participate in studies or deny that what happened was "real" abuse.
Definitions of both abuse and the age of maturity affect frequency rates. Some researchers have estimated that over 50% of the female child population will experience some form of sexual abuse before the age of 18 (Russell, 1984; Wyatt, 1985), while others have reported rates of 11% and lower (Fritz et al., 1981; Kercher & McShane, 1984). Similarly, while a meta-analytic study by Rind and Tromovitch, (1998) reported mean prevalence rates of 17% and 28% for males and females respectively, the range for males was 3% to 37%, and for females 8% to 71%. The results of the systematic review of 11 studies on the prevalence of child sexual assault in Switzerland shows that the percentage of participants that ever experienced any form of child sexual assault, prevalence rates assessed by a single general item are considerably lower (up to 18.1% for girls and 3.0% for boys) than when rates were calculated on the basis of several items assessing specific forms of child sexual assault (up to 39.8% for girls and 10.9% for boys) (Schönbucher et al., 2011). Such wide variation in the prevalence rate is due to differences in the definition of child sexual abuse, the type of sample used, design, and measurement techniques.
Sarafino (1979) estimated the national incidence of reported and unreported child sexual abuse to be over 336,000 cases per year. Sarafino arrived at this figure by calculating the rates of reported sexual offences per 100,000 children in each of the four locales, and then applying this rate to the national total of 61 million children. This led to an estimated 74,725 cases of child sexual abuse in a one-year period. The rate of unreported cases was calculated by multiplying 74,725 by 3.5 (assuming that the number of unreported cases is at least 3 or 4 times higher than the reported cases as believed by several experts in the field). The number of reported cases was added to the estimated number of unreported cases. Consequently, it was estimated that approximately 336,200 sexual offences are committed against children every year in the United States.
In this respect, the prevalence of sexual assaults, especially among children and adolescent, is thought to be extremely higher than in literature.
2.3. Characteristic features of child sexual assault
Few people are aware of the true state of the science on child abuse. Instead, most people's beliefs have been shaped by common misconceptions and popular myths about this hidden crime. Societal acceptance of these myths assists sex offenders by silencing victims and encouraging public denial about the true nature of sexual assaults against children. Common Myths about Child Sexual Abuse:
Child sexual abuse is a rare experience.
Children make up stories or lie about sexual abuse.
A child is most likely to be sexually abused by a stranger
Child sexual abuse is always perpetrated by adults.
Normal-appearing, well educated, middle-class people don't molest children
Children who are being abused would immediately tell their parents.
Boys can't be sexually abused.
Sexual abuse of a child is usually an isolated, one-time incident.
Child molesters are all, 'Dirty old men.
Boys abused by males are or will become homosexual
Boys are less traumatized as victims of sexual abuse than girls
Children will naturally outgrow the effects of sexual abuse or incest
People are too quick to believe an abuser is guilty, even if there is no supporting evidence.
Children who are being abused will show physical evidence of abuse.
Acts like fondling, kissing, or touching, for example, are not really sexually abusive, and don't really harm the young person
Children and youth are sexually abused because their parents/caregivers neglected to care for, or supervise them properly.
Preschoolers do not need to know about child sexual abuse and would be frightened if educated about it.
However children of all ages, races, ethnicities, and economic backgrounds are vulnerable to sexual abuse. Child sexual abuse affects both girls and boys in all kinds of neighborhoods and communities, and in countries around the world.
Even the mean age of child sexual assault varies in different studies, most authors agree upon the reality of “children are sexually assaulted in every ages of childhood and adolescence”. Many researches represent data about the age of child sexual assault between infancy and 18 years of age (De Jong et al., 1982; Mian et al., 1986; Riggs et al., 2000). Even sexual assault of girls especially adolescents are more frequent; boys are also at significant risk of sexual abuse, often at younger ages than girls. (De Jong et al., 1982)
Female dominancy of the victims is described in many descriptive researches which focused on child and adolescence sexual assault (Peipert & Domagalski, 1994; Jones et al.; 2003, Navratil, 2003). It was found 254 female (86%) and 40 male (14%) children in South Africa, 85.5% of the victims were female and 14.5% were male in Canada, 113 girls and 17 boys in Minessota, USA and 77% of girls and 23% of boys in England (Bentovim, 1987; Dubé& Hébert, 1988; Cox et al., 2007; Tilelli et al., 1980).
Most often, sexual assault victims are assaulted by an acquaintance not stranger. A number of studies revealed the percentages of acquaintance assailants as changing from 56% to 78% (Christian et al., 2000; Csorba et al., 2005; Dube&Hebert, 1988; Grossin et al., 2003; Lauritsen&Meldgaard, 2000; Muram et al., 1995; Peipert & Domagalski, 1994; Sahu et al., 2005). Most children are abused by someone they know and trust, although boys are more likely than girls to be abused outside of the family (American Medical Association, 1992; Courtois, 1988 A study in three states found 96 percent of reported rape survivors under age 12 knew the attacker. Four percent of the offenders were strangers, 20 percent were fathers 16 percent were relatives and 50 percent were acquaintances or friends. Among women 18 or older, 12 percent were raped by a family member, 33 percent by a stranger and 55 percent by an acquaintance. (Langan & Harlow, 1994) In another study it was found that fifty-nine percent (398) of the children were sexually abused by an acquaintance, 21% (145) of the children were sexually abused by a relative, and 5% (33) of the children were sexually abused by a stranger. (Murphy et al., 2010) Abuse typically occurs within a long-term, on-going relationship between the offender and victim, escalates over time and lasts an average of four years. Offenders often develop a relationship with a targeted victim for months before beginning the abused (Courtois, 1988) In author’s series 73 cases were acquaintance sexual assault, stranger assault were only in 4 cases. (Table 1)
|Types of acquaintanceship / Age , sex||Relative||Neighbor||Non Relative acquain-tance||Adjunct||Fiancé||Husband religiously but not registry married||Friend or beloved||Stranger||Step father||Total|
Relationship between victims and perpetrators with respect to sex and age groups
This finding might be connected with characteristics of these age groups such as physically weakness, low comprehension about the abusive acts.The place of sexual assault are indoor especially victims own home and outdoor sexual assault is rare in most studies. The location of assault are reported as Own home inside 25%, other home inside 19%, own home outside 9%, other home outside 5%, other 11%, public place 6%, school 4%, unknown 21% in a study performed in South Africa. (Cox et al. 2007) The incidents most often took place in the victim’s or assailant’s home (76.7%). A total of 11.9% of the incidents occurred in another closed place, while 8.8% occurred in an open public place in another study (Dube & Hebert, 1988). The place of sexual assault was perpetrators’ home in 39.74 % of the cases, followed by outdoor in only 23.08 % of the cases in authors’ series.
Children are mostly assaulted during the day rather than night. In a study 60% of the cases were seen during the day, 34.9% between 18:00 and midnight, and 5.1% between midnight and 6:00 (Dube & Hebert, 1988). Another author mentioned that 49% of sexually assaults occur in broad daylight (Firsten, 1990).
Child abuser is young rather than an old person in generally. Adolescent sexual offenders report having approximately two paraphilias with onsetbetween ages 15 to 18 years of age (Abel et al., 1987). It is typical that they act upon these deviant impulses in adolescence. Nearly half of adult convicted rapists and child molesters committed their ﬁrst offense between 8 and 18 years of age, with model age being 16 (Groth et al., 1982). The disparity between the age of victims’ and perpetrators’ was detected to be 1-2 years in 14.29% of the cases, 3-5 years in 25.97%, 6-10 years in 32.47%, and 11 years and over in 27.27% cases in authors’ series.
More offenders are male than female, though the percentage varies between studies. The percentage of incidents of sexual abuse by female perpetrators that come to the attention of the legal system is usually reported to be between 1% and 4% (Denov, 2003). Other studies shows that women commit 14% to 40% of offenses reported against boys and 6% of offenses reported against girls (Dube et al., 2005; Finkelhor, 1994).
A number of studies have stated that, victims of child sexual assault are generally do not disclose the assault. However, most of victims applied to legal authorities disclose the assault because of secondary psychiatric problems and fear, and 55.6% of these had noticed to be assaulted many years before reporting (Safran, 1998; Jones et al., 2003). There are many factors that may have inﬂuenced the rate at which children were referred for medical care following the sexual abuse, including delayed disclosures. However, abuse by strangers is often treated with more seriousness by other disciplines than abuse by family members or others known to the child. Similarly, 76.92% of cases referred to sexual assault evaluation unit later than three days after assault, in authors’ study. The main cause of delay in 19.23% of the cases explained the cause of delay as, they were anxious about being accused or punished, which support the idea of “victims might conceal the assault because of the fear of being accused, punished or injured by perpetrators”.
The American Academy of Pediatrics Committee on Child Abuse and Neglect recommends forensic evidence collection when sexual abuse has occurred within 72 hours of the examination (Kellogg, 2005). Adams recommends evidence collection within 24 hours for prepubertal children (Adams, 2008; Christian et al., 2000) suggest that the best evidentiary material obtained from children post-abuse is found in the ﬁrst 24 hours.