# Presentation: 333834

## SEXUAL ABUSE

**It devastates the victim**
**It does not stop on its own**
**Silence allows the abuse to continue**

## WHAT IS SEXUAL ABUSE

- Sexual touching and fondling
- Having a child pose, undress, or perform in a sexual manner.
- Oral, anal, vaginal sex or attempted sex
- “Peeping” into bedrooms or bathrooms
- Exposing the child to pornographic material or sexual activity

- Any inappropriate sexual activity (emotional, verbal, physical,) between an adult and a child

## SEXUAL ABUSE INVOLVES

-  **FORCING**
** ****TRICKING**
** ****BRIBING**
** ****THREATENING**
** ****PRESSURING**
** ****BLACKMAILING**

**A CHILD INTO SEXUAL AWARENESS OR ACTIVITY**

## WHO IS A LIKELY ABUSER

**In 85% of the cases, the abuser is someone the child knows and trusts**
**In 50% of the cases it is a “parental figure”**

-  **Uncles or male cousins**
** ****Caregivers (aya/nanny, servants, maids)**
** ****Friends, and friends of older siblings**
** ****Shopkeepers (offering bribes)**
** ****One of the parents**

## CHIDREN AT RISK

**Sexual abuse is never a child’s fault.  It represents a sickness, perversity. **
**It is a  criminal activity on the part of the offender and it is a legal offense. **

-  _**OPPORTUNITY**_
-  Caretaker (aya/nanny, servants, domestic help)
-  A trusted and regular visitor (uncles, male or 		female cousin, family friend, friend of siblings)
-  neighbors or shopkeepers
-  Parent, step-parent

## Most Common Patterns

-  Maternal or paternal uncles
-  Older male/female cousin with younger girl/boy child
-  Neighbors or shopkeepers (“sugar daddy”)
-  Step-father/Father with girl child

- Watch out for an “older” person spending and wanting to spend unusually large amounts of time with the child, especially in private and possibly at “odd” hours.
- The child showing discomfort/sexuality in their presence

## Progression of Sexual Abuse

- With a known person it usually begins gradually as the offender “tests the limits” the child will accept.
- The abuse progresses through stages that may include exhibition, fondling, oral sex, attempts to enter, or actual penetration of the vagina or anus. Thus, many abused children have no physical indicators.

## SIGNS: PHYSICAL

- Difficulty in walking or sitting
- Torn, stained or bloody underclothing
- Pain, swelling, itching in genital/anal areas
- Bruises, bleeding, or lacerations of genitalia
- Pain on urination or urinary tract infections
- Vaginal/penile swelling or discharge
- Pregnancy
- Sexually transmitted diseases

## SIGNS: BEHAVIORAL

- Depression, anger, irritability
- Anxiety
- Headaches, physical complaints
- Change in personal hygiene habits, excessive cleanliness or lack of cleanliness
- Weight gain or loss, change in eating habits
- Sleep disturbances: bedwetting, nightmares

- These are highly variable and depend on child, age, type of abuse.  Trust your instincts -- something is “wrong”

## SIGNS: BEHAVIORAL

- Unusual interest in and/or knowledge of sexual activity, inappropriate for child’s age
- Promiscuity or seductive behavior
- Sexual drawings or stories
- Inappropriate dress: very tight revealing clothes or overdressing (too many layers of dress regardless of weather)
- Sexual activity or pregnancy at early age

## SIGNS: BEHAVIORAL

- Return to younger, babyish behavior
- Passive or overly pleasing behavior
- Reluctant to go home or to other places
- Avoids certain people and/or places
- Self-destructive behavior
- Hostility and/or aggression
- Running away
- Drug or alcohol problem
- Suicide attempt

## FEELINGS

**Children who have been abused often have very strong, overwhelming feelings**

-  **FEAR**
-  of the abuser
-  of causing trouble
-  of losing adult’s love/importance to them
-  of what others will think do
-  **ANGER**
-  at the abuser
-  at other adults around who did not protect them
-  at themselves (for not protecting themselves)

## FEELINGS

-  **CONFUSION**
-  because they still love the abuser
-  because their feelings change all the time
-  **GUILT**
-  for not being able to stop the abuse
-  for believing they “consented” to the abuse
-  for “reporting” -- if they told
-  for keeping it a secret -- if they did not tell
-  **SHAME**
-  about being involved in the experience
-  about their bodies response to the experience

## FEELINGS

-  CONCERN
-  for their parents and other relatives
-  ISOLATION
-  because something is “wrong” with me
-  because they feel alone in their experience
-  because they have trouble talking about their abuse
-  SADNESS
-  about having something taken from them
-  about losing a part of themselves
-  about growing up too fast
-  about being betrayed by someone they trusted

## DISCLOSURE

- Sibling
- Mother
- Friends
- Teacher

- Directly or indirectly through notes/drawings, actions, gestures, questions, examples, to

## DISCLOSURE

- KEEP CALM
- Make time available (if over committed ask if    you can do it later or if someone else can help)
- Find a quiet and private place
- Listen calmly, patiently.
- Believe the child. Do not question their integrity
- Support them & give positive feedback
- “How brave they are” & “How proud you are of them”
- reassure them of your concern & it is not their fault
- Explain to them that no one will get punished
- Do not suggest what was done to them - listen

**IT MAY HAPPEN AT A TIME YOU LEAST EXPECT. THE CHILD IS USUALLY VERY TROUBLED AND INSECURE**

## CONFRONTING

- A partnership between teacher, parents, and a professional in child abuse if the disclosure took place at school
- A partnership between the parents and a professional in child abuse if the disclosure took place at home
- A partnership between parent and family support system if it involves the other parent.

## CONFRONTING

- Calmly talk to your child first
- reassure them it is not their fault
- reassure them of your love and support
- do not express horror or make them feel “bad”
- do not doubt them or try to extract details
- reassure them you will deal with the offender
- confront the offender as soon as possible to gain trust of the child and to stop abuse
- DO NOT confront offender in presence of child
- Get professional help for the child and family

## CONFRONTING

- If offender is not part of immediate family (nuclear or extended) then both parents must
- confront the offender
*without making accusations or discussing the issue*, very directly tell the offender to not visit their house or spend any time with your child
- make sure the offender realizes that you will be monitoring your child and taking control.  Follow up on that with him and with your child.

## CONFRONTING

- If offender is an uncle of the child
- inform offender you know without accusing
- if the offender still persists, discuss the situation with your other “trusted” siblings to develop a course of action.
- make sure that the child and the offender are not left alone together

## CONFRONTING

- If offender is a cousin of the child
- inform offender you know without accusing
- if the cousin still persists, discuss the situation with his parents without throwing accusations. _*Jointly discuss course of action*_
- make sure that the child and the offender are not left alone together

## CONFRONTING

- If offender is a parent (father or step-father) then the mother has to stand up & face him
- inform offender you know without accusing. Suggest therapy. Hopefully the abuse will stop
- Carefully check and evaluate your support system: parents, brothers, friends
- If adequate support system exists, consider leaving along with the children. Marriage is dead.
- If no adequate support system exists: reassure and empower the child to not give in. Never leave any child alone with offender

## PREVENTION  & PROTECTION

- To feel good about themselves
- They are loved, valued, and need to be safe
- Proper names for all body parts -- helps communication
- Their body belongs to them -- nobody else has rights to it
- Difference between safe (good) and unsafe (bad) touches
- Say “NO” to any touch/situation that feels uncomfortable
- Build trust in you: to report if any adult asks them to keep a secret, has a problem, does something wrong
- To come to you without fear of being “bad” or punished
- Do not teach children blind obedience to adults: safety applies to all (even close relatives), not just strangers

- Without frightening the children we can provide appropriate safety information and support at all stages of development

## ACT AT ONCE

- Abuse does not stop on its own
- Take steps to stop abuse immediately
- Abuse is devastating for the child and the family
- Effects of repeated abuse accumulate
- Abused children have very severe emotional/behavioral problems in later life.
- Get professional help early