Introduction

Do you look after a child who has been sexually abused in the past? Or do you teach someone at school or Sunday club who has been through this experience? If you know a child abuse 'survivor' then maybe there will be something in this article that will help you to help them. The article does not cover what to do when a child initially discloses details of the abuse, but is about how to help them in the longer term.

What is sexual abuse?

Sexual abuse is not just about sex, it is also about power. It is normal for young children of similar ages to explore each other's bodies and this very natural behaviour should not be thought of as abuse. When there is a wider age difference and the older or more powerful child has forced or encouraged the younger or less powerful child, this is more likely to be abusive. Whenever there is sexual activity by an adult which involves a child under sixteen years of age, then this is defined as sexual abuse of the child. Although 16 years is the legal age of consent used for defining child sexual abuse, Home Office guidance regarding abuse of trust states that it is unacceptable for anyone in a position of trust over a young person under 18 to engage in behaviour which might allow a sexual relationship to develop.

The sexual activity that can be considered as abuse is not just sexual intercourse. The definition of abuse includes petting and touching of sexual areas. The abuser may expose him or herself inappropriately or show the child inappropriate sexual material, perhaps pictures or videos. 'Grooming' may take place, which, in this context, describes the way a person wishing to abuse prepares his or her victim. At first the abuser makes the child feel very special, perhaps spoiling them or choosing them above other children for little treats and 'special times'. It is then the special times which may become the times for abusing the child or young person. Some of the abuse may not take place face-to-face, but could be over the internet.
Effects of abuse

Children who have themselves been abused are likely to lose sight of sexual boundaries. This means that they may demonstrate inappropriate sexual behaviour themselves. For example, an abused child may undress other children against their will, or engage in sexual play with younger children, or use inappropriate sexual language. If the abuser has been someone the child loves or has loved, then it is likely she or he will have confusion between affection and sexual behaviour. They will find it difficult to cope with adults, maybe developing a lack of trust or becoming over-trusting. They may not respect authority.

The child who has been abused often develops coping strategies during the abuse which cause them problems in other situations. For example, they may mentally and emotionally cut themselves off (dissociate) from what is happening. If this coping strategy carries on through the rest of their daily lives, it will cause them problems in schoolwork, making friends etc.

Many children who are being sexually abused are so good at cutting themselves off from their feelings and bodily sensations that they develop eating problems and/or soiling or wetting problems. They may also lose the sensations of feeling hot and cold, so, for example become careless about keeping warm. They may stop feeling pain or have a distorted or exaggerated response to pain.

Anxiety is also very common. The anxious child may become over-controlling of others in their environment, or may find it difficult to make decisions, not recognize their own rights, focus on their faults, be self-blaming and feel powerless. Often they have sleep problems and problems concentrating in school.

Add to all the above the commonly experienced post-traumatic stress reactions (nightmares, flashbacks and intrusive thoughts etc.) and it is easy to see that most children who have been sexually abused often need help.

Hopefully the child in question will have access to professional help, a clinical psychologist or specialist counsellor perhaps, but if there is a delay in receiving that help or it is not readily forthcoming, the following ways to help may be useful.

Ways to help

1. Encourage your child to talk

......but not too much! I once saw a child who had been abused. She met
with a counsellor every week and was encouraged to talk over the details of the abuse again and again. This had the effect of re-traumatising her once a week, and she never had the chance to move on. The child you are helping will need time to talk about the feelings around the abuse. Only when he or she talks about them will you be able to help her to realise that some adults can be trusted even if she has had experience of one she loved who cannot.

Do not force the child to talk about the abuse if he or she does not want to. Instead, make sure you have a good enough relationship to talk about anything. If possible, reserve special times of the day just to talk or when the child knows you will be available. If the child cannot easily talk to you, then spend this time in age-appropriate play, drawing or painting. While that relaxed time together may encourage sharing, it is also possible to sometimes emphasise an area you think might help the child. For example, you might both enjoy painting 'feelings' pictures together then use the pictures as a way of talking about things. Don't try to interpret the paintings unless you are trained in that area!

2. Take the guilt away

Maybe this should have come first. It is certainly the most important. Many children have enjoyed the sexual experience, or the feeling of being special. This does not make it their fault. The child needs to understand that they are not the ones who have done wrong, it is the abusers. The abuser may have blamed them, calling them dirty or a tramp. Help them to realise that the adult did wrong, not them.

If the child has a simple Christian faith, help him or her to understand that God loves them completely and wants them to feel safe and loved.

3. Help the child feel cared for

Try not to replicate the way the abuser treated the child when he or she was being 'groomed'. However, do give the child plenty of time and care. Give them the message that they are important, but also that they have the right to be listened to, understood and kept safe. If you are their carer, try to give them such a positive experience of everyday life that gradually they are able to lose some of their no-longer-needed defence mechanisms. For example, help them want to stay focused in the present because it is so good and help them build their confidence so that anxiety becomes a thing of the past.

Build their self-esteem by encouraging them at things they are good at or enjoy. If they are wetting or soiling, praise them for the days or even hours when they have managed to gain control over these difficulties. Celebrate with them any small achievements.

4. Be sure of your own boundaries

It is very easy to let a persistent child with inappropriate boundaries erode your own. Not that you would abuse a child, but if the child is physically clinging too tight or snuggling up too close, be sure enough of yourself to risk encouraging her or him to back off a little. If you are fostering a child, be sure to have the sort of boundaries that will keep you safe from any accusations by the child. For example, if you are of the opposite sex to the child, do not undress or bathe them. If they are of an age to do these things themselves, then let them as far as you can. Have strict rules about not running around the house in undies. Have a rule about wearing dressing gowns and one about keeping out of each other's bedrooms.

5. Teach the child to keep safe

If the abused child has poor sexual boundaries, he or she is likely to be an easy target for other abusers. The care system can make a child very used to going off with strangers, usually social workers or new foster carers, which does not help the abused child know how to protect themselves and discriminate between those who are caring for them and those who will do them harm. Michelle Elliot has produced the 'Kidscape' set of materials, which include useful booklets as well as posters to complete and talk about with a child. If you do not have access to these materials, then teach the child that no-one must touch them in the areas that their swimsuit covers until they are all grown up and ready to decide that this is what they want for themselves. Help them to gain ownership over their body, and to understand that they will make these decisions and will probably choose someone of about their own age who they know very well and they think is very special. Obviously, how you explain all this to them will depend on their age and understanding of sexual matters - which brings us to our next point.

6. Education

All children will need to learn about sex, but gradually at different ages. Children who have been sexually abused may already know a fair amount, but will have a distorted understanding. They may think of sexual intercourse as dirty or disgusting, or even frightening. You may wish to use a general children's book about the body as a starting point for moving on to answer questions about sex. Two useful books are 'Human Body' and 'Flip-flap Body Book". If any mention of sex or private parts of the body is too difficult for them or seems to upset them, concentrate on the 'keeping safe' side of sex. Add in the gentle reminder that sex is for having babies as well as showing love, and if you are able, introduce your own morals while you are talking about it. However, do be careful not to make the child feel guilty.

7. Keep the child's confidentiality

......as far as possible. However, you will not be able to keep it to yourself if the child talks to you about abuse that she or he has not disclosed before. Otherwise, try to keep the conversation between yourselves ensuring, of course, that you are operating within the guidelines laid down by the Agency and Social Services if you are a foster carer. If the child is having trouble trusting others s/he is unlikely to be able to trust you if you are always chatting about what happened. Just accept what the child says in a non-shocked manner. Always accept what the child has said, even if you are unsure the child's memory is absolutely accurate. Sometimes what they say may be more about the feelings that were around at the time, not the actual incident. Keep a careful note of what the child says and what you say, explaining the context, eg “I was putting the child to bed and she suddenly said….. ”Information which may appear to be of little consequence in itself might be quite significant taken with other facts known to Social Services.

Try to help the child understand that it may be important for some people to know what he or she has told you. Explain why, and reassure the child that you will not tell just anyone. Name the people who have to know, to keep the child or other children safe. If you are a foster carer it might be important to keep the child's social worker (and/or agency) informed of what the child is saying. Apart from anything else, a carer should not have to carry the responsibility of deciding what might or might not be relevant and it is vital that you feel supported and protected too. Others may also be able to see notes and information, for example a Children's Guardian, if the child's case is before a court. On the other hand, there are occasions, say in a case conference, when it will be possible to say that a child is now talking about the abuse and you are helping him or her work through some of the issues. It will be important to try and help the child understand your position so that you do not offer false reassurances and hopefully the child will accept this and what you might need to do.

If the child does disclose ongoing abuse, then your first duty is to keep the child safe. This means that you will have in the first instance, to tell the person in your organisation who is responsible for child protection and then speak to the child's social worker or the local Social Services social worker on duty. If you work with children or young people in your Church, make sure you know who is the child protection person in your Church. Again, try to gain the child's permission first and explain to the child your reasons for telling someone else.

A final word

Finally, seek support. Find other people in your Church, family or community who you know are safe and preferably police-checked (foster carers will need to ensure that such arrangements are agreed with Social Services). They can maybe give the child some time, letting you re-charge your batteries. They can perhaps also be your mentor, helping you to stand back from the situations you are likely to encounter with the child, to discuss and pray around them. If you do not feet the child is moving forward, then push hard to find the professional help he or she needs, sooner rather than later.

References:

Elliot, M. (1994) Keeping Safe, Hodder & Stoughton, London.

Elliot, M. (1995) Teenscape. Health Education Authority, London.

Parker, S. (1994) Human Body from the Explorers Series, Dorling Kindersley, London.

Smith, A. (1999) Flip-flap Body Book, Usborne Publishing.

Useful book:
Adopting or Fostering a Sexually Abused Child, by Catherine Macaskill (BAAF)
£17.99 (inc p&p) from CCPAS

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