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2.29 Sexual abuse
- Definition(Jump to)
- Risks and Indicators(Jump to)
- Disclosure(Jump to)
- Protection and action to be taken(Jump to)
- Support for the child(Jump to)
- Non-offending carers(Jump to)
- Safety planning(Jump to)
- The need for good record keeping, information sharing & professional challenge(Jump to)
- Avoid delay (Jump to)
- Contacts(Jump to)
- Further Information(Jump to)
Sexual abuse Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse. Sexual abuse can take place online, and technology can be used to facilitate offline abuse. Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.
(Definition provided by Working Together 2018)
Child sexual abuse is complex, illegal, harmful and has lasting impacts on children. It is important to remember that Child Sexual Exploitation (CSE) is Child Sexual Abuse (CSA). Child sexual abuse can be perpetrated by males and females. Work carried out by the Centre of Expertise on Child Sexual Abuse has identified a wide range of sexual abuse offending:
Child sexual abuse through trusted relationships outside the family environment: sexual abuse of a child or young person by someone who holds a position of authority over them as a result of a professional or vocational role.
Child sexual abuse through an intermediary: sexual abuse of a child or young person which is carried out by more than one perpetrator; the perpetrator who initiates the abuse (the initiating perpetrator) seeks to gain access to the child, or to images of the child, through another perpetrator (the intermediary perpetrator).
Child sexual abuse through online interaction: abuse where a perpetrator, operating online, encourages/deceives/ coerces a child or young person to take part in online sexualised conversations or sexual acts, and/or to produce images (photos or videos) of themselves that they share with the perpetrator online.
Child sexual abuse through viewing, sharing or possessing images: the viewing of images of CSA that have already been created. This can include viewing, possessing and sharing images (photos or videos) with others, generally (but not exclusively) online.
Child sexual abuse through groups and networks: sexual abuse committed by perpetrators who are part of a group or network. This may be a social group, gang or network that meets in person, or a group or network in which members interact online and remain anonymous.
Child sexual abuse arranged and perpetrated for payment: sexual abuse of a child or young person by one or more perpetrators where, in return for payment (either financial or other), a perpetrator (‘the seller’) offers other perpetrators (‘buyers’) access to the child or young person for contact abuse and/or creates and sells images (photos or videos) of abuse, e.g. via live-streaming.
Child sexual abuse through attack by an unknown person: abuse where a perpetrator, who is unknown to the child or young person, attacks and sexually assaults them. Further information is provided in the full report into how sexual abuse is perpetrated:
Recognising the many ways that child sexual abuse can be perpetrated means that these procedures may need to be considered concurrently with others:
Many children and young people who are experiencing sexual abuse may come to professionals attention because of other types of abuse, (Physical Abuse, Emotional Abuse or Neglect, for example) so professionals should always remember that a child can be experiencing many types of abuse at any time.
Contact abuse is where an abuser subjects a child to physical contact, this includes;
- Sexual touching or any part of the child’s body, whether they’re clothed or not
- Using a body part or object to rape or penetrate a child
- Forcing a child to take part in sexual activities
- Making a child undress and touch someone else
- It includes touching, kissing and oral sex- sexual abuse isn’t just penetrative
- Exposing or flashing
- Showing pornography
- Exposing a child to sexual acts
- Making them masturbate
- Forcing a child to make, view or share child abuse images or videos
- Making, viewing or distributing child abuse images or videos
- Forcing a child to take part in sexual activities or conversations online or through smartphones
Research has recognised that the impacts of any sexual abuse can be complex, harmful, lifelong and far reaching; online abuse has added difficulties in identifying and bringing abusers to account; the speed of occurrence, the use of technology to initiate, escalate and maintain the abuse (“24/7”), the control of images, permanence, re-victimisation, lack of resolution, and the perception by the child and others that they may be to blame for the abuse or have in some way agreed to taking an “active” role themselves. To deal with such a pervasive and destructive issue, everyone must work together. Many different professionals play a role in preventing, identifying, and responding to sexual abuse, and in supporting children.
Risks and Indicators
Knowing the signs of sexual abuse can help give a voice to children. Sometimes children won’t understand what is happening is wrong, or they may be scared to speak out. Some of the signs professionals may notice in children include:
- Avoiding being alone or frightened of people or a person they know
- Language or sexual behaviour you wouldn’t expect them to know/ is not age appropriate
- Having nightmares
- Bed wetting and or smearing faeces
- Alcohol or drug misuse
- Changes in eating habits or developing an eating problem
- Changes in mood, feeling irritable and angry, or anything out of the ordinary
- Bleeding, discharge, pains or soreness in genital or anal area
- Sexually transmitted infections
If a child is being sexually abused online, they may:
- Spend a lot more or a lot less time than usual, texting, gaming or using social media
- Seem distant, upset or angry after using the internet or texting
- Be secretive about who they’re talking to and what they’re doing online or on their mobile phone
- Have lots of new phone numbers, texts, email addresses on their devices
- Make travel arrangements - to meet someone- go missing from where they should normally be
Any child is at risk of being sexually abused however girls are disproportionately more likely to be victims of sexual abuse, but it is important to remember that both boys and girls can be sexually abused. Most children who have been sexually abused were abused by someone they know. Children with disabilities are more likely to be subjected to sexual abuse, especially those who are unable to tell someone what is happening or don’t understand what is happening to them. Some abusers target children who are isolated or will seek to isolate the person they wish to abuse to groom them. Both males and females can groom & perpetrate sexual abuse.
Grooming is when someone builds a relationship, trust and emotional connection with a child so they can manipulate, exploit and abuse them. Anybody can groom a child before sexually abusing them, no matter their age, gender or race. Grooming can take place over a short or long period of time- from weeks to years. Groomers may also target family members or friends and build relationships making them appear trustworthy, so they can groom the child before subjecting them to sexual abuse.
(This section takes information from Protecting Children From Harm; a critical assessment of child sexual abuse in the family network in England The Childrens Commissioner 2015)
The term ‘disclosure’ is open to different interpretations across professional contexts. Here, disclosure is broadly defined as ‘one person conveying what they have been subjected to, to another’. Children convey these experiences in many different ways. Most children who have been subjected to child sexual abuse feel unable to report or tell anyone during childhood.
Rates of verbal disclosure are low at the time that the abuse occurs. However, children are trying to disclose the abuse when they show signs or act in ways that they hope adults will notice and react to, as behaviour is a form of communication. This is particularly important for disabled children.
While some children communicate the abuse directly through verbal means, others do so indirectly (e.g. “I don’t want to go to grandpa’s house any more”), or they may use terminology that the perpetrator has used (e.g. talking about ‘secrets’ or ‘games’) or adult language that is not appropriate for their stage of development.
Non-verbal means of expression include letter-writing, drawing pictures or playing with dolls. Younger children may appear clingy or display temper tantrums, while older children and adolescents may withdraw, self-harm, exhibit anger, avoidance and run away. Even positive behaviours such as ‘being good’ can be a sign that children are trying to communicate abuse.
Disabled children may be more likely than others to exhibit behaviours as signs, particularly where they are unable to communicate verbally with adults. It is important that these behaviours are understood, and not simply attributed to the child’s impairment.
Professionals need to keep in mind that a child could be attempting to disclose, but certain children may face additional barriers to disclosure because of disability, sex & gender, ethnicity and/ or sexual orientation. A range of complex interacting individual, relational and social barriers may prevent children disclosing abuse, to professionals or anyone else. Research suggests that boys are less likely to disclose sexual abuse because of the fear of being seen as a homosexual and feelings of stigmatization or isolation because of the belief that boys are rarely victimised, and Black, Asian and minority ethnic groups (and other groups, in particular disabled children) are less likely to come to the attention of authorities, face additional barriers to accessing statutory services and receive a poorer quality of support.
Disclosure is therefore best understood as a process which is influenced by safe & supportive relationships and interactions with others and may extend over a considerable period of time.
The act of disclosing sexual abuse can heighten shame & guilt, as it is common for children to feel they are to blame for the abuse. Negative reactions to disclosure may compound these impacts. This should not stop professionals from providing opportunities to children to disclose. It is essential that children and their families receive appropriate support following disclosure.
Further information about disclosure from the Centre of Expertise on Child Sexual Abuse is within this guide Communicating with Children- a guide for those working with children who have or may have been sexually abused.
They have also designed a guide support professionals in all organisations and agencies in systematically observing, recording and communicating their concerns about possible child sexual abuse.
Some children will not recognise they are being sexually abused, but for those who do, there are a number of reasons for them to retract or delay disclosing, including:
- pressure or threats from the perpetrator;
- relationship to the perpetrator;
- expected consequences of telling (e.g., physical injury/death, family separation, parental distress);
- pressure from their wider family/ community;
- fear of negative reactions from parents or family;
- fear of not being believed;
- feelings of embarrassment, shame and self-blame; and/or
- for males specifically: fears of stigmatisation, being labelled a victim or being labelled homosexual.
Protection and action to be taken
When a child discloses that he or she has been subjected to sexual abuse it is an opportunity for an adult to provide immediate support and comfort and to assist in protecting the child from the abuse. It is also a chance to help the child connect to professional services that can keep them safe, provide support and facilitate their healing from trauma. Disclosure is about seeking support and your response can have a great impact on the child or young person's ability to seek further help and recover from the trauma.
If a child discloses abuse it’s important to;
- If possible, move to a suitable environment free from distractions, only if doing so will not disrupt the child
- Be calm & patient – allow them time to express themselves
- Let the child use their own words; avoid leading questions or ‘quizzing’ them about specific details (Research has shown that children and young people prefer to be asked sensitive questions in professional but conversational manner. Staff may need to rephrase questions to suit individuals, and avoid using language that may be unfamiliar to young people, such as medical jargon (BASH 2014))
- Listen carefully to what they are saying and give them your full attention
- Maintain a calm appearance and let them know they’ve done the right thing by telling you
- Reassure them it is not their fault and recognise the courage they are showing in speaking out
- Let them know you are taking them seriously
- Explain what you will do next and don’t make promises you cannot keep*
- Report what the child has disclosed as soon as possible and explain to them that you have to do this to get the help & support they will need*
- As soon as possible record what happened using the child’s words, distinguish between fact & opinion & limit any jargon
- Do not confront the perpetrator
Because sexual abuse is not openly spoken about, it may be necessary to ask clarification questions to understand what this child is communicating.
These should only be used if needed and should be open questions to clarify things the child has raised, they should be open ended and non-leading, and will often start with who, what, when or where, for example: Who was there? What happened? How do you feel? The child must not be pressed for information, led, or cross-examined.
More information is available from The Children’s Society.
*It is vital that children are not promised confidentiality in the disclosure of child sexual abuse. They may say that they will not speak with statutory agencies and they do not want any action taken, this view may change when they receive the right support, but there may also be other children at risk from the same perpetrator, so it is imperative that information is shared as soon as possible.
Strategy Discussion / Meeting – if a strategy discussion/ meeting takes place the core agencies involved with the child should participate, as a minimum this should include representation from children’s services, police & health- (Working Together 2018). Health representatives and the dedicated SARC Safeguarding & Strategy Manager should be invited to attend(to ascertain if an holistic medical, aftercare or other support is needed & indicate time frames for evidence collection if applicable). A clear plan should be agreed and circulated to each agency participant. Wherever possible these should be face to face meetings (in person or virtually) rather than telephone discussions to allow better analysis of the available information.
At the conclusion of the investigation, if the case does not proceed to an Initial Child Protection Conference a second de-briefing strategy meeting should be held to ensure that any ongoing risks are understood, and protective action can be undertaken.
Child sexual assault medical assessment – this must be planned timely & carefully in order to secure any forensic evidence, if it is judged to be appropriate. However, the examination should not be undertaken purely for forensic reasons. Outside the forensic window, an examination can identify significant findings, and a normal examination can be therapeutic and reassuring for the child and family. A SARC medical will also address emergency contraception needs, STI screening and access to counselling, so even if the child/YP declines examination, a SARC assessment may still be warranted. If the child declines this, thought will need to be given to accessing medical and therapeutic support.
Visually recorded interviews must be planned and conducted jointly by trained police officers and social workers in accordance with the Achieving Best Evidence in Criminal Proceedings: Guidance on Interviewing Victims and Witnesses, and Guidance on Using Special Measures, Department of Justice 2022. All events up to the time of the video interview must be fully recorded. Consideration of the use of video recorded evidence should take into account situations where the child has been subject to abuse using recording equipment.
Visually recorded interviews serve two primary purposes:
- Evidence gathering for criminal proceedings;
- Examination in chief of a child witness.
Relevant information from this process can also be used to inform Section 47 Enquiries, subsequent civil childcare proceedings or disciplinary proceedings against adults, where allegations have been made.
Are there any other Children that need to be considered?
While it is important to focus on the child identified as being at risk and keeping that child safe, wider consideration must be given to brothers and sisters, other children who were potential victims, or children with connections who have displayed harmful sexual behaviour, in risk plans. The opportunity to assess and intervene earlier for brothers and sisters, other connected children, suspects and the wider public must be considered to prevent risks to some children being overlooked or not responded to in a timely way.
Initial Child Protection Conference- where an Initial Child Protection Conference takes place great care should be taken beforehand if the child / young person wishes to participate. The child should not be put in the position of meeting the alleged perpetrator or of attending the meeting at the same time.
The single and most important consideration is the safety and well-being of the child or children.
In reconciling the difference between the standard of evidence required for child protection purposes and the standard required for criminal proceedings, emphasis must be given to the protection of the children as the prime consideration. This means that enquiries, investigations and responses should have a co-ordinated multi-agency response, with all agencies involved having equal weighting and a victim support strategy and service being established at the outset.
It should be recognised that the beyond reasonable doubt threshold required for a case to go to court may not be met with the evidence available, however this does not mean that there is not a requirement for safeguarding & support. If cases do proceed to court, support will be required, especially in pre-trial, trial and post-trial periods. Minimum periods for contact should be established.
It is clear from research around sexual abuse investigations that many victims and families feel strongly that it is important that they remain in contact with the same practitioners throughout the investigative process.
The investigation and enquiries must also address the religious, cultural, language, sexual orientation and gender needs of the child, together with any special needs of the child arising from illness or disability.
While there may be a number of risks identified, it is important that the plan developed is identified under the category of sexual abuse to ensure the child is receiving the correct response and support for their needs.
Support for the child
Assistance for children recovering from both contact and non-contact sexual abuse should include:
- Being safe- feeling safe- keeping safe
- Telling- time and security
- Placing responsibility with the abuser
- The “family” relationships
- Help with the legal process; police- court- compensation
- How it happened
- Why it happened
- Understanding gender myths and oppression
- Memories, flashbacks, fears
- Anger and feelings
- Sex & sexuality education & knowledge
- Physical pleasure
- Fears of abusing others
- Friends & peer relations
- General support
These headings are explained in more detail here.
How others respond to disclosures is central, particularly non-offending carer’s, especially if the sexual abuse has taken place in the familial environment, in relation to mediating the psychological impact of the abuse and long-term mental health outcomes (Lovett, 2004).
Retraction of an allegation is likely to be a result of the child’s lack of support from the non-offending caregiver’s, and a desire to protect the perpetrator; especially where they are a family member.
Inappropriate adult responses will serve to reinforce any sense of guilt, shame and powerlessness the child already feels.
Parental support has been correlated with a positive outcome for sexually abused children, parental distress and disbelief can have a negative impact
This document provides information for consideration in the assessment of non-offending carer’s of a child who has been sexually abused.
This guide provides information for supporting parents & carers.
If the sexual abuse has happened in the familial environment consideration should be given to the development of a safety plan that should include;
- The minimum requirements for risk management, in terms of house rules and supervision.
- A clear identification of actions that are “risky” i.e. those behaviours or interests that could lead to sexual abuse.
- Details of house rules – bedroom use; bathroom use etc.
- Agreements about supervision.
- Agreements about meeting as a family to discuss the working of the plan.
- Details about each child or young person’s opportunities to speak about the plan in private.
- Details of professional support to be provided to the family in managing the plan.
The need for good record keeping, information sharing & professional challenge
Good record keeping is a vital component of professional practice that supports continuity of care, risk assessment & management, documents thinking, decision making, and actions taken, it is a professional aid to planning & analysis. It is therefore important that all records in all settings are full, accurate, dated and timed and distinguish between factual information (for example, clinical findings), opinion and information provided by others.
The importance of detailed and timely information-sharing between agencies is a major factor in the protection of children.
This requires attendance by all relevant agencies at multi-agency decision-making forums, so that all relevant information can be shared. The absence of safeguarding partners can mean that assessments are not always taking account of the continuing risk of harm, and therefore incorrectly assess the risk to children. This could mean that decisions are made to conclude child protection plans when actually other agencies hold important information that could have a critical impact on these decisions.
An effective multi-agency response requires professionals to establish a collaborative and co-ordinated approach. This should remove any hierarchies of standing, recognising that good practice includes the expectation that constructive challenge amongst colleagues, within agencies and between agencies, will happen and is in the best interests of children.
Research and analysis from Multi-agency response to child sexual abuse in the family environment: joint targeted area inspections (JTAIs) emphasised the need for effective challenge@
“This was most apparent in relation to the police’s decision-making, which was not challenged by other agencies:
Delays in arresting or questioning suspects of sexual abuse, the use of the voluntary attendance of a potential perpetrator at a police station, or delays in the forensic examination of digital equipment, which can take up to a year to do, can mean that investigations take too long and impact on children’s well-being. In addition, in some cases, this also led to a delay in children receiving the therapeutic support they needed, which was further exacerbated by the misunderstanding by some professionals about children not being able to access support during investigations. There was a lack of communication between the police and children’s social care services and consequently a lack of challenge by the latter about the police’s delays and decision-making. Children and their families were not always updated on the progress of investigations.
Strategy discussions in most cases we saw did not involve health agencies or the appropriate health professional and did not involve the sexual assault referral centre (SARC). This led to inadequate decision-making and agencies working in silos. It also led to health professionals not being able to challenge decisions by the police, exacerbated by the lack of challenge by children’s social care professionals. For example, in several cases, police stated that a medical examination was not required for a child because it was outside the forensic window – the period during which evidence from an examination would be of value. However, these assessments are necessary to identify and treat children for sexually transmitted diseases or other harm they may have come to, as well as for assessing the child’s emotional well-being. Although the evidence may not be permissible in a criminal court, local partnerships were missing opportunities to protect the children in question and to meet their emotional and physical health needs.
The lack of effective challenge between agencies and professionals resulted in decisions to carry out single-agency child protection enquiries when a joint agency enquiry by police and children’s social care was required. This means that investigations have not routinely had the benefit of the expertise and knowledge of all partners from an early stage, and in some cases, this meant that valuable evidence for prosecutions was not collected at the outset.”
There is an expectation that practitioners will challenge each other and raise concerns directly and immediately when they disagree with each other and that they will always retain a focus on the welfare of the child. An agency or individual who does not agree with a decision must feel able to, and know how to, use the local escalation process for professional disagreements.
- West Midlands Children and Young Person’s Service (SARC) 0808 196 2340
- Access to children & young people’s SARC services
The following 4 centres are all adult acute clinics. The Children & Young People’s Service do run historic clinics once a week from these sites, however the contact should always be made with the Children & Young People’s Service to access these clinics 0800 196 2340
Horizon Birmingham & Walsall 08009700375
Blue Sky Centre Nuneaton 08009700370
The Glade West Mercia 08009700377
Grange Park Stoke 08009700372
The Survivors Trust National helpline 08088010818
Birmingham & Solihull Rape & Sexual Violence Project RSVP 0121 643 0301
Black Country Rape and Sexual Violence Support Service BCWA 0121 553 0090
- The Centre of Expertise on Child Sexual Abuse
- HM Government Child Sexual Abuse Strategy
- The Home Office has published guidance for local partnerships on the Child House multi agency service model of support for children and young people affected by sexual abuse
- Research and analysis of Multi-agency response to child sexual abuse in the family environment: joint targeted area inspections (JTAIs) Published 4 February 2020