What Is Sexual Abuse?

1
What Is Sexual Abuse?

• Sexually abusive behavior is defined as
• any sexual interaction between person(s)
• of any age that is perpetrated (1) against
• the victims will (2) without consent or
• (3) in an aggressive, exploitative,
• manipulative, or threatening manner.
• (G. Ryan, 1997)

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Normative Sexual Behaviors

• Finkelhor et.al., Study
• TC Johnson Stoplight

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Green Light Behavior

• GREEN LIGHT BEHAVIOR (Expected, Normal Behavior)
  Most sexual behavior considered normal in
  childhood involves either periodic solitary
  activity or similar age peers or siblings, with
  no coercion, occurring within the cultural norms
  of society. These behaviors may still need limits
  or intervention by the foster parent but are not
  consider pathological.
• ?? Playing doctor or house
• ?? Occasional masturbation, no penetration
• ?? Imitating adult seduction such as flirting or
  kissing
• ?? Dirty works or jokes within cultural or peer
  group norm
• ?? Mutual showing of body parts by peers
• ?? Conversations with peers about reproduction
  and genitals

4
Yellow Light Behavior

• YELLOW LIGHT BEHAVIOR (Cause for Concern/Possible
  Intervention Needed)
• ?? Preoccupation with sexual themes (especially
  sexually aggression)
• ?? Sexually explicit conversation with peers
• ?? Sexual innuendo/teasing/harassment/embarrassmen
  t of other
• ?? Attempting to expose others genitals (e.g.
  pulling up skirts, pulling down pants)
• ?? Sexual graffiti (especially chronic and or
  impacting others)
• ?? Precocious sexual knowledge and/or activity
• ?? Single occurrences of peeping, exposing,
  obscenities, pornographic interest.
• ?? Preoccupation with masturbation
• ?? Mutual masturbation/group masturbation
• ?? Simulating foreplay with dolls, toys, peer
  with clothing on (petting, French
• kissing)

5
Red Light Behavior

• RED LIGHT BEHAVIOR. (Requires adult supervision,
  confrontation, and possible
• therapeutic intervention)
• ?? Touching of genitals of others
• ?? Using force to expose others genitals or body
  parts
• ?? Sexually explicit conversations with
  significant age difference chronic
• obscenities
• ?? Inducing fear/threats of force to coerce
  sexual activity
• ?? Sexually explicit proposals/threats including
  written notes
• ?? Repeated or chronic peeing/exposing/pornographi
  c interest
• ?? Compulsive masturbation/interrupting tasks to
  masturbate
• ?? Masturbation by girls that includes
  penetration
• ?? Simulating intercourse with dolls, peers,
  animals
• ?? Oral, vaginal, anal penetration of children
  adults, animals dolls
• ?? Force touching of genitals, genital injury or
  bleeding without accidental cause
• ?? Simulating intercourse with peers with
  clothing off

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Continuum of Sexual Behaviors in Children

• Toni Cavanaugh Johnson

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GROUP ONE Normal Sexual Exploration

• Characteristics Children of all ages show
  normal, sexual behavior based on the discovery
  and development of their physical and sexual
  selves. This may include exploring feelings and
  genitals, interest in language related to sex,
  and giggling about bathroom related functions.
  Children involved in normal sexual exploration
  may do it solitarily or with friends of similar
  age and size. They more often explore with
  friends rather than siblings. These encounters
  are voluntarily, and often light-hearted, fun and
  silly. They do not often include feelings of deep
  shame, fear or anxiety. For teens, this often
  involves intense feelings for the opposite sex
  and sexual exploration in relationships. These
  behaviors may need limits, guidance or education,
  but are not considered abnormal or pathological.

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GROUP TWO Sexually Reactive Behaviors

• Characteristics Group Two exhibits more sexual
  behaviors than Group One and has a preoccupation
  with sexuality. Many of these children have been
  abused or exposed to pornography and sexual
  stimulation. These children have trouble
  integrating and understanding such stimulation
  and express this confusion in increased sexual
  behavior. Sexually reactive children often feel
  deep shame guilt and anxiety about sexuality.
  Their behavior focuses mostly on themselves. When
  they involve other children, the difference in
  age in usually not great and force is not usually
  involved. These children respond well to therapy
  and education. When the anxiety is reduced or
  more age appropriate and less sexually
  stimulating environments are encouraged, the
  level of sexual behavior tends to decrease.

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GROUP THREE Extensive Mutual Sexual Behaviors

• Characteristics These children often approach
  sexuality as just the way they play and are often
  more resistant to treatment than Group Two. These
  children use coercion and manipulation but rarely
  resort to violence. They are characteristically
  without emotional affect, meaning they neither
  have the lighthearted spontaneity of normal
  children nor the shame and guilt of the sexually
  reactive children. These children often have a
  history of severe abuse and abandonment. Sex is a
  way to relate to their peers. These children need
  an intensive and rigorous relearning of social
  skills and peer relationships. These children
  will also need intensive supervision in the home
  setting and around other children.

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GROUP FOUR Children Who Molest

• Characteristics The children in this category go
  far beyond developmentally appropriate play. They
  are obsessed with sexual thoughts and engage in a
  full range of sexual behavior that becomes a
  pattern, rather than solitary incidents. These
  children need intensive and specialized
  treatment. These children often link sexual
  acting out to feelings of anger, rage,
  loneliness, or fear. Children with severe
  offending behaviors choose vulnerable and younger
  victims. They lack compassion with their victims
  and feel regret in getting caught, not with
  hurting another child. Most of these children
  have severe behavior problems at home and school
  and have few friends. For some of these children,
  their behavior borders on compulsive behavior.
  Compulsive behavior means the child has lost
  control over it and has a very difficult time not
  repeating actions, even when punished or when
  trying to stop. These children need therapy,
  strong intervention, combined at times with
  medication to control these impulses.

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Five Sub-Types of Children with Problem Sexual
Behaviors

• Pithers, et al., 1998b

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Non-Disordered

• Females over-represented
• Fewest number of psychiatric disorders
• ADHD diagnosed in 24
• Mixed history of maltreatment
• Acknowledge their own sexual abuse
• Physical Abuse relatively rare
• Children have fewest number of victims
• Sex acts rarely involve use of force
• Penetration relatively rare

13
Abuse Reactive

• Males over-represented
• High number of psychiatric diagnoses
• ADHD diagnoses far more common as well as conduct
  disorder diagnosis
• High level of maltreatment
• High number of sexual abusers (theirs)
• Moderate physical abuse
• Shortest time from own abuse to abusing others
• Child may penetrate victims
• Highest number of victims
• Aggression rarely used during abusive acts

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Highly Traumatized

• Genders proportionately represented
• Highest number of psychiatric diagnoses
• Highest number of PTSD diagnoses
• ADHD diagnoses highly prevalent
• Extensive history of maltreatment
• Highest number of sexual abusers
• Highest number of physical abusers
• Highest total number of abusers
• Relatively young at first victimization
• Do not penetrate their victims

15
Rule Breakers

• Females over-represented
• Mixed psychiatric diagnoses
• Mixed history of maltreatment
• Acknowledge own sexual abuse
• Moderate physical abuse
• Longest time from abuse to abusing
• Aggression used to gain victim submission
• Penetration relatively rare

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Sexually Aggressive

• Males over-represented
• Highest percentage of conduct-disorder diagnoses
• ADHD diagnoses also prevalent
• Seldom acknowledge own maltreatment
• Fewest sexual abusers
• Oldest children at time of onset
• Greatest percentage who penetrate victim
• Highest average number of penetrative acts
• Aggression used to gain victim submission

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Juveniles (Adolescents) with Problem Sexual
Behavior
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Arrests for Forcible RapeAdults vs.
Juveniles(FBI, 2001)
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Arrests for Other Sex OffensesAdults vs.
Juveniles (FBI, 2001)
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The Underestimate Problem

• Sexual abuse is significantly underreported
• Research indicates that the majority of victims
  do not report their victimization
• Arrest data alone is misleading
• Additional discrepancies may exist due to
  different definitions of sexual abuse
• Research design
• State statutes
• Victims perceptions
• Statistics can be based on
• Arrests
• Adjudications/convictions
• Offender disclosures
• Victim reports/disclosures

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Perpetrators of RapeAdults vs.
Juveniles(Inclusive Estimates)
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Perpetrators of Child Sexual AbuseAdults vs.
Juveniles(Inclusive Estimates)
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How Do We Know if a Juveniles Sexual Behavior is
Problematic?

• Age, power, size differential
• Secrecy vs. public displays
• Manipulation, bribery, trickery
• Level of intrusiveness
• Range of sexual behaviors
• Frequency and chronicity
• Use of force or violence
• Victims account

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Adult vs. Juvenile Sex Offenders Similarities
and Differences
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Adult vs. Juvenile Offenders

• There are three useful typologies for adult
  offenders the Knight-Prentky, The Groth
  Typology, and the FBI Typology. The
  Knight-Prentky typology, based on Groths work,
  has been statistically validated.
• There are no statistically valid typologies for
  juvenile sex offenders.

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Adult vs. Juvenile Offenders

• It appears that most adult sex offenders have
  issues with on-going deviant fantasies with
  varying degrees of severity and that sexual
  deviance plays a major role in adult sexual
  offending behavior.
• Sexual deviance appears to exist within a
  minority of adolescents who sexually abuse.

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Adult vs. Juvenile Offenders

• Other criminal behaviors are more likely in
  adults than juveniles, but in either indicate an
  increased likelihood of future relapse behavior.
• A moderate number of adult offenders have a
  history of childhood sexual abuse.
• A high number of juveniles have a history of
  childhood sexual abuse .

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Adult vs. Juvenile Offenders

• Recent studies by Burton, Miller and Shill (2000)
  found empirical support that adolescent sexual
  abusers generally have a higher rate of having
  been sexually abused than non-sexually abusive
  youth.
• A youth was found to be 23 times more likely to
  be in the sexually abusive group if he had been
  sexually abused by both men and woman, his
  perpetrator was related to him, a forceful MO was
  used, if the abuse occurred over several years,
  and if penetration occurred.

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Adult vs. Juvenile Offenders

• Veneziano, Veneziano and LeGrand (2000) that a
  high number of adolescent abusers repeat the
  abuse that was done to them. Findings indicated
  that sexually abusive youth tend to learn from
  and repeat the characteristics of their own
  abuse.
• Burton (2001) found youths were likely to abuse
  the same type of person who abused them (e.g., a
  youth sexually abused by a relative was almost 3
  times more likely to abuse a relative than a
  youth who was not sexually abused by a relative
  and 4.5 times more likely to sexually abuse a
  neighbor if they had been sexually abused by a
  friend or neighbor, twice a likely to abuse a
  male if abused by a male, etc.

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Adult vs. Juvenile Offenders

• Knight (2001), following up on a Knight/Prentky
  study (1993) found that a lower general level of
  social competency, a higher frequency of
  anti-social behavior, more pervasive anger and a
  higher frequency of childhood sexual abuse appear
  to suggest a greater likelihood of continued
  offending behavior into adulthood.
• Limitations among other problems, studies are
  on incarcerated or placed offenders so we do not
  know the degree to which they can be generalized.

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Adult vs. Juvenile Offenders

• Adult offenders clearly benefit from
  cognitive-behavioral interventions such as
  Relapse Prevention. While it is desirable that a
  treatment program offer additional treatment
  options, just utilizing R.P. will have an effect.
• Juveniles require a multi-systemic treatment
  response that may focus less on Relapse
  Prevention and more on other treatment areas.

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Adult vs. Juvenile Offenders

• We now have a variety of valid methods to
  reasonably determine the risk and dangerousness
  of adult offenders, including use of actuarial
  devices, phallometry, the Abel Screen,
  polygraphy, and the Hare PCL-R.
• We have no actuarial devices for juveniles.
  Phallometry and polygraphy are usually not
  recommended except in very specific and
  controlled circumstances. The Abel Screen has not
  been shown to be effective, and the Hare should
  not be used with juveniles under 16.

33
Adult vs. Juvenile Offenders

• Adults require a treatment intervention that
  lasts about three years on average.
• Juveniles appear to benefit from a briefer period
  of treatment intervention one to two years.

34
Exclusive focus on the problematic sexual
behaviors or Labeling can be problematic given
the lack of solid research
35
Labeling

• It is fairly rare that we categorize or label
  other types of juveniles and force them to
  maintain the label
• juvenile physical assaulter, juvenile truant,
  juvenile carjacker, juvenile drug dealer
• However, there is a tendency to label these youth
  as juvenile sex offenders
• This produces a limited and narrow view of the
  juvenile and subsequently defines the juvenile
• (He did, therefore he isand thats all he is)

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It is more appropriate to utilize a response that
is comprehensive, multisystemic, and holistic in
nature.
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A Multisystemic Response

• Sexual offending behaviors need to be addressed,
  but
• A multitude of other areas (that can either
  increase or reduce risk) need to be addressed as
  well
• The focus should be holistic and comprehensive
• individual
• family
• peers
• school

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Etiology of Juvenile Offending
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How Adolescent Problem Sexual Behavior Has Been
Explained The Swing of the Pendulum...

• Failed to attend to juvenile offenders
• Boys will be boys
• Its just a phase
• Teenage boys hormones are raging
• It was only experimentation
• Over-labeling, over pathologizing of juveniles
  with sexual behavior problems
• The young pedophile
• The budding sexual predator
• Perception of juveniles as mini-adult offenders
  who are destined to continue offending as adults
• Based on retrospective studies of adult offenders

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Etiological Considerations in Juvenile Sexual
Offending

• Child maltreatment
• Exposure to pornography
• Poor impulse control
• Exposure to violence, aggressive role models
• Substance abuse
• Esteem deficits
• Attachment difficulties
• Social competency deficits
• Empathy deficits
• Emotional regulation difficulties
• Sexual victimization

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Sexual Victimization to Perpetration

• Younger at time of victimization
• Were victimized more frequently
• Waited a longer period of time to disclose
• Perceived their families as having been less
  supportive of them
• (Hunter Figueredo, 2000)
• Suggests attachment and environmental issues may
  be etiologically significant

42
Juvenile Sexual Abuser Typologies(Hunter et
al.)
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Peer/Adult Victims
Child Victims
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Abusers of Peers/Adults

• Generally victimize females
• Most victims tend to be strangers or casual
  acquaintances, rather than family members
• Offense often occurs in conjunction with other
  crime
• More likely to commit offense in public areas
• More likely to use force, violence, or weapon and
  subsequently cause injury
• Appear more delinquent or conduct disordered

45
Abusers of Children

• Higher proportion of male victims
• Intra-familial victims more common
• Less violent or forceful, more manipulative and
  opportunistic
• Less emotionally indifferent/less antisocial
• Self-esteem and social competency deficits are
  common

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Both Types

• High levels of academic difficulties, learning
  disabilities
• Mental health/behavioral health difficulties
• Impaired judgement and impulse control