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1.
The purpose of this study was to ascertain the factors which influence custody change in cases of children who have been sexually abused. Of 180 children admitted to La Rabida Children's Hospital and Research center with a suspicion of having been sexually abused, 138 met the state's criteria for proven sexual abuse, and 30% of those children had a sexually transmitted disease. One-third of the children with proven abuse were under 4 years of age. Of the children with proven abuse, ultimately 40% had a custody change. Only an initial outcry of abuse was associated with an increased probability of a change in custody. A change in custody was not found to be related to the patient's age, sex, the perpetrator's relation to the child or access to the home, the presence of sexually transmitted disease, whether the child was also physically abused, or whether the child had had developmental delay. These data suggest an absence of any discernible guidelines in the juvenile court's decision concerning custody change of a sexually abused child. 相似文献
2.
OBJECTIVES: The two aims of this study were to: (1). describe the prevalence and characteristics of domestic adult and child physical violence in the homes of children and adolescents evaluated in a specialized sexual abuse clinic and (2). describe parent or caretaker responses to domestic adult and child violence and child sexual abuse, including tendencies to report or seek medical care. METHOD: A consecutive sample of 164 subjects (ages 7-19) were interviewed in a sexual abuse clinic regarding in-home violent or abusive experiences among family members that had occurred at any time during their childhood. RESULTS: Fifty-two percent of these children and teenagers reported spousal violence in their home. Fifty-eight percent of child sexual offenders who were in-home males also physically abused their adult female partner. Half of in-home males who were physically violent to children also sexually abused them. In 86% of homes with partner violence, the children were also physically assaulted. There was no difference in sexual abuse disclosure rates or patterns for children living with or without adult violence. CONCLUSIONS: Sexually abused children should be questioned about physical abuse and the presence of violence among adults in their home. Safety plans for sexually abused children should incorporate screening for family violence and safety plans for parents and siblings of child victims, when appropriate. 相似文献
3.
Swanston HY Parkinson PN Oates RK O'Toole BI Plunkett AM Shrimpton S 《Child abuse & neglect》2002,26(2):115-127
OBJECTIVE: To determine the incidence of re-abuse in children known to have been sexually abused and to find factors that increase the risk of re-abuse. METHOD: The study group consisted of 183 children with substantiated sexual abuse who presented to two children's hospitals' Child Protection Units in Sydney, Australia during 1988 through 1990. At intake, when the children were aged between 5 years and 15 years, data about the child, the family, and the nature of the index sexual abuse were collected. Six years after presentation for the abuse, records of the Department of Community Services were checked to see if any of the young people had been the subject of substantiated notifications for abuse/neglect before and after intake to the study. Predictors of notifications for abuse/neglect after presentation for the index sexual abuse were identified. RESULTS: Of the sexually abused young people, nearly one in three were the subject of subsequent substantiated notifications to the Department of Community Services for some form of child abuse and neglect or behavior which placed them at risk of harm. Later notifications for abuse/neglect were predicted by notifications for emotional abuse before the index sexual abuse (adjusted RR = 4.88, CI: 1.43 to 16.65), severity of the index sexual abuse (p = .03), and the number of changes in the child's primary caregivers before intake (p = .03). Approximately one in six of the sexually abused young people were notified for sexual abuse after intake to the study. One in 10 also had prior notifications for sexual abuse. Sexual abuse notifications after study intake were predicted by caregiver changes before intake (p = .01) and whether or not there were notifications for emotional abuse before the index sexual abuse (adjusted RR = 3.40, CI: 1.05 to 11.02). CONCLUSIONS: Revictimization of children appears to be a marker of ongoing family dysfunction. Intervention in child sexual abuse needs to consider a range of risk factors associated with re-abuse and, in particular, should focus on family functioning if further abuse is to be prevented. 相似文献
4.
OBJECTIVE: The purpose of this study was to explore how mothers' developmental history and current functioning affects their sexually abused children's functioning and recovery. METHOD: A sample of 67 African-American mothers and their sexually abused children participated in this study. Interviews and a range of adult and child measures were administered in order to assess maternal developmental history and current functioning, and child functioning. RESULTS: Mothers' past experiences as children were associated with their children's behavior and general functioning following the sexual abuse. Mothers who experienced more discontinuity of childhood care, who were sexually abused as children, and/or had more problems in their family of origin had children who showed poorer functioning and more behavioral symptomatology. In addition, mothers who currently were experiencing more trauma symptomatology, reported substance abuse, and/or were less able to provide support to their children, had children with more behavior problems and poorer functioning. CONCLUSIONS: The findings from this study point to the impact of mothers' developmental history and current functioning upon the symptomatology of their sexually abused children. 相似文献
5.
The behaviors of two groups of children were observed and recorded in their play with anatomically correct dolls. One group had been determined to have been sexually abused and the other group had not been determined to have been sexually abused. The findings show that significantly more children who had been sexually abused demonstrated sexual behavior(s) with the anatomically correct dolls than did the group of children who had not been sexually abused. These findings suggest that anatomically correct dolls are a useful instrument in sexual abuse investigations. 相似文献
6.
Mandell DS Walrath CM Manteuffel B Sgro G Pinto-Martin JA 《Child abuse & neglect》2005,29(12):1359-1372
OBJECTIVE: To determine the demographic and psychosocial correlates of physical and sexual abuse among children with autism. METHODS: Data collected from 1997 to 2000 through the national evaluation of the Comprehensive Community Mental Health Services for Children and their Families Program on 156 children with autism were used. Data included a baseline assessment of child and family psychosocial experiences and presenting problems associated with referral into system-of-care service, demographic information, and a clinical record review to obtain psychiatric diagnosis. Binary and multinomial logistic regression was used to determine the association of different characteristics of children who were abused compared with those who were not abused. RESULTS: Caregivers reported that 18.5% of children with autism had been physically abused and 16.6% had been sexually abused. Physically abused children more likely had engaged in sexual acting out or abusive behavior, had made a suicide attempt, or had conduct-related or academic problems. Sexually abused children more likely had engaged in sexual acting out or abusive behavior, suicidal or other self-injurious behavior, had run away from home, or had a psychiatric hospitalization. In adjusted multivariate models, the relationship between sexual abuse and sexual acting out, running away from home and suicidal attempts persisted. CONCLUSION: Based on the prevalence of abuse and its association with various behaviors, clinicians should be as attuned to the psychosocial histories of children with autism as they are for other children, and consider the potential of abuse when these behaviors are observed. 相似文献
7.
OBJECTIVE: This study compares abnormal genital examination findings made by pediatric emergency medicine (PEM) physicians to examinations by physicians with training in child sexual abuse in the evaluation of prepubertal girls for suspected sexual abuse. METHOD: A prospective study was performed following the genital examination by a PEM physician of prepubertal girls suspected of being sexually abused. A physician with training in child sexual abuse re-examined those girls whose examinations were interpreted as abnormal by the PEM physicians. The findings and interpretations of the PEM physician were then compared to those by the physicians with training in child abuse. RESULTS: Between October 1994 and October 1998, 46 patients diagnosed by PEM physicians with nonacute genital findings indicative of sexual abuse were re-examined by a physician with training in child abuse. The follow-up examinations were done 2 days-16 weeks (mean 2.1 weeks) after the emergency department visit. The physicians with training in child abuse concluded that only eight of these children (17%) showed clear evidence of abuse. Normal findings were noted in 32 children (70%), nonspecific changes were noted in 4 children (9%), and 2 children (4%) had findings that are more commonly seen in abused children than nonabused children but are not diagnostic for abuse (concerning for abuse). CONCLUSIONS: There was poor agreement between the pediatric emergency medicine physicians and the physicians with training in child sexual abuse. This study suggests that emergency medicine physicians should consider additional training in this area. In addition, all children with abnormal ED examinations should have follow-up examinations by a child abuse trained physician. 相似文献
8.
T C Johnson 《Child abuse & neglect》1988,12(2):219-229
While the seriousness of sexual abuse by adolescents is finally beginning to receive adequate attention from the professional community, the existence of child perpetrators is largely dismissed and denied. Forty-seven boys between the ages of 4 and 13 are described who have molested children younger than themselves. Coercion was involved in all of the cases included in this study. These children had been treated in a program especially designed for child perpetrators at Children's Institute International in Los Angeles. Prior to their own sexually abusive behaviors, 49% of these boys had been sexually abused and 19% physically abused. The children all knew the people who victimized them. These male child perpetrators all knew the children they molested. In 47% of the cases the sexual abuse was of a sibling. The average number of victims of these children was 2.1 with a range of 1 to 7. The mean age at the time of perpetration was 8 years, 9 months. The mean age of the victims of these children was 6 years, 9 months. There was a history of sexual and physical abuse in the majority of the families of these children, as well as a history of substance abuse. This population is compared to adolescent perpetrators. 相似文献
9.
OBJECTIVE: There have recently been many debates in the UK about how to provide good care for children placed away from home. Professionals have realized that the level of child abuse in foster care and children's homes is high. This research examines the characteristics of physical and sexual abuse of children in foster and residential care in a city in England. The number of cases of abuse reported by pediatricians in this group was compared to the number reported by the same pediatricians for the population of Leeds as a whole. METHOD: This is a retrospective study of 158 children, fostered or in residential care who were involved in 191 episodes of alleged physical and/or sexual abuse assessed and reported by pediatricians over a 6 year period from 1990 to 1995 in Leeds, England. Details of the child including the reason for placement in care, their physical and mental health, abuse characteristics, including perpetrator and case management were studied. RESULTS (see Table 1): 158 incidents of abuse in 133 children in foster/residential care are described. In foster care, 42 children were physically abused, 76 were sexually abused, and 15 experienced both forms of abuse. In residential care, 12 children were physically abused, 6 were sexually abused, and 6 experienced both forms of abuse. In foster care 60% of sexual abuse involved girls and 60% of physical abuse involved boys. In residential care almost twice as many boys as girls were reported to be abused. Foster carers perpetrated the abuse for 41%, natural parents on contact for 23%, and children 20% of incidents. A significant proportion of abuse was severe with 1 death, 8 children with burns, 18 with genital, and 34 with anal penetration. Long-standing emotional, behavioral and learning difficulties were common. Most children (80%) had been abused prior to entry into care. Foster children were 7-8 times and children in residential care 6 times more likely to be assessed by a pediatrician for abuse than a child in the general population. CONCLUSIONS: Children in foster or residential care form an at risk group for maltreatment. Their special needs include additional measures to protect them from abuse. 相似文献
10.
Child psychiatric examination of the sexually abused child is strongly indicated as more than two-thirds of these children have concomitant emotional problems. Special considerations which are important in approaching these children but would not be a part of the routine child psychiatric evaluation are highlighted. The approach to the child who has been sexually assaulted by someone outside the family is contrasted with the evaluation of an incestuous family.Five specific expectations of the child psychiatric examination are as follows: 1. The nature of any emotional problem must be defined and an appropriate treatment plan established. 2. An immediate proposal must be made for the care of the child which will provide protection from future abuse while minimizing emotional stress. 3. Long-term planning for the family should be initiated based on an assessment of the likelihood of future recurrence of sexual abuse. 4. The child's reality testing should be evaluated if there is a question regarding the occurrence of the sexual abuse. 5. Psychological characteristics of the child which might influence the success of long-term care proposals should be documented. 相似文献
11.
A retrospective record survey was performed using all child clients aged less than 7 years seen at a community mental health center during the period 1982-1984. The total number of 202 children fell into three groups: sexually abused (n = 37), physically abused (n = 35), and nonabused clinical children (n = 130). These groups were compared in order to learn more about sexual abuse in young children. Family background of both abused groups were similar to each other but differed from the nonabused group in having more factors related to family stress than the nonabused group. Clinical presentations of all the children overlapped a great deal symptomatically; however, the sexually abused children had a statistically significant higher frequency of inappropriate sexual behavior than the other two groups. Several characteristics of the abusive patterns suffered by the two abuse groups differed at or near statistical significance: sexually abused children were more often victimized in single acts by nonrelated child perpetrators than were physically abused children. 相似文献
12.
Objective
The goal of the current study was to examine the extent to which child sexual abuse (CSA) and particular characteristics of CSA are associated with pedophilic interest and sexual recidivism.Methods
Subjects were 462 adult male sexual offenders who had been incarcerated in Canadian federal prisons.Results
Compared to sexual offenders who had not been sexually abused, those who had been sexually abused before age 16 sexually offended against significantly younger victims and had significantly more indicators of pedophilic interest. This was the case whether we examined self-reported or officially documented CSA. Offenders who had been sexually abused exclusively by a male had significantly more indicators of pedophilic interest than those who had been sexually abused exclusively by a female. These findings are consistent with past research and theory suggesting that CSA may play a role in pedophilia and sexual offending against children. CSA exclusively by a female abuser predicted higher rates of sexual recidivism than abuse by a male or both a male and female abuser. Among offenders with victims 15 years old or younger, a closer relationship between offender and abuser predicted higher rates of sexual recidivism. The relationship between CSA and sexual recidivism was significantly moderated by actuarial risk. More specifically, CSA predicted higher rates of sexual recidivism among higher risk offenders, but CSA did not predict sexual recidivism among lower risk offenders. This novel finding raises the possibility that CSA may play a role in sexual recidivism for some offenders.Conclusion
If future research replicates this CSA by risk interaction and identifies the constructs and processes involved, CSA may be worth considering in risk assessment and treatment. 相似文献13.
Forty-five children who had been sexually abused were psychologically evaluated. Parents or guardians of the children completed symptom checklists. Results indicated that the majority of children (71%) were abused 4 or fewer times. In addition, genital manipulation and/or fondling was the most common form of abuse. In 82% of the cases, there were no marital separations or family breakups of any kind within six months before or six months after the abuse. Many children (69%) displayed psychological symptoms. The most frequent were nightmares, bedwetting, clinging behavior, inappropriate sexual behavior, anxiety and sadness. Results of this study are largely inconsistent with popular notions about the nature of child sexual abuse. The major methodological shortcoming of the investigation was the lack of a systematic control group. 相似文献
14.
Carol Kleemeier Ph.D. Carol Webb Ph.D. Ann Hazzard Ph.D. Judith Pohl M.A. 《Child abuse & neglect》1988,12(4)
Teachers are potentially helpful resource persons for large numbers of sexually abused children who may have difficulty disclosing abuse, particularly to family members. In the present study, the effectiveness of a 6-hour teacher training workshop on child sexual abuse prevention was evaluated. Responses of 26 female elementary teachers who participated in the workshop were compared to responses of 19 control teachers on several pre-, post-, and follow-up measures. Relative to controls, trained teachers demonstrated significant increases from pre- to post-testing in knowledge about child sexual abuse and pro-prevention opinions. On a post-only vignettes measure, trained teachers were better able than control teachers to identify behavioral indicators of abuse and suggest appropriate interventions for hypothetical sexually abused children. Over a 6-week follow-up period, trained teachers read more about child abuse than control teachers but did not differ on other behavioral dimensions such as reporting suspected abuse cases. Further research will examine the effects of additional teacher training over an extended follow-up period. 相似文献
15.
Personality development following sexual abuse 总被引：1，自引：0，他引：1
Thirty-seven girls and twelve boys who had been sexually abused at an average of 2.6 years previously were traced and reviewed. The nonoffending parents participated in a structured interview and the children were assessed using the Piers-Harris Self-Concept Scale and the Achenbach Child Behavior Checklist. Each child was matched with a child not known to have been sexually abused and these control children underwent a similar psychological assessment. Interviews with the nonoffending parents found that 76% of the children were thought to be less confident than before, 30% had fewer friends, and 20% were more aggressive. Increased sexual awareness was noted in 24%. School teachers reported that 28% still had behavior problems, 17% had repeated a year at school, and a further 17% had deteriorated in their school work. The sexually abused girls had significantly lower self-esteem than the control girls. There was no difference in self-esteem between the control and the sexually abused boys. There was a higher incidence of stranger assault in the boys compared with the girls. The Child Behavior Checklist completed by the parents, the Teacher Report Form, and the Youth Self-Report of the Child Behavior Checklist showed that a highly significant proportion of sexually abused children fell into the clinical range. Sexual abuse appears to have long-term adverse consequences for many of the victims. This may have implications for their ability to relate to others, for the adult friendships they will make, and eventually for the way they will relate to their own children. 相似文献
16.
The diagnostic utility of sexual behavior problems in diagnosing sexual abuse in a forensic child abuse evaluation clinic 总被引：2，自引：0，他引：2
OBJECTIVE: This study examined the utility of sexual behavior problems as a diagnostic indicator of sexual abuse. The hypothesis was that sexual behavior problems are multiply determined and consequently are variably related to sexual abuse in a clinical sample. METHOD: A sample of 247 children evaluated for sexual abuse at a multidisciplinary forensic child abuse evaluation clinic were included. Results from the Child Behavior Checklist (CBCL) and the Child Sexual Behavior Inventory (CSBI) were analyzed and compared to the results of a structured abuse assessment performed independent of these scores. RESULTS: The forensic team assessment found evidence of sexual abuse in 25% of cases, and no evidence in 61%. Children in this sample exhibited an elevated level of both sexual and nonsexual behavior problems. However, considerable variability was noted in sexual behavior problem scores. Thus, in this study a high score or a low score had no relationship to the diagnosis of sexual abuse. Indeed, nonsexually abused children were just as likely to have high CSBI scores as sexually abused children. CONCLUSIONS: This study found no significant relationship between a diagnosis of sexual abuse and the presence or absence of sexual behavior problems in a sample of children referred for sexual abuse evaluation. The finding suggests that community professionals should use caution in relying on sexual behavior problems as a diagnostic indicator of abuse. 相似文献
17.
Previous studies have shown that most abusing parents have a history of physical abuse or neglect in their own childhoods. There is little data on the frequency of prior sexual abuse among parents who physically or sexually abuse their children. Many case reports describe the uncovering of a prior incest experience in a parent during the investigation of the child's current incest accusation, but it is unclear how frequently this occurs. One hundred mothers of abused children were asked about sexual incidents that occurred before age 18; the control group consisted of 500 normal women from the same community who were surveyed during meetings of various voluntary organizations. Age and ethnicity did not differ in the two groups. Of the mothers of abused children, 24% reported a prior incest experience, whereas only 3% of the control women reported prior incest. This eightfold difference was highly significant. The 34 mothers from families where sexual abuse was occurring were no more likely to report prior incest than were the 66 mothers from families where physical abuse occurred. The one case of genital mutilation of a child occurred in a family where both parents had been incest victims. Case studies indicate that the parent who has been an incest victim has inhibitions and fears about tenderness, traceable to the childhood incest experience, which are important in the development of either physical abuse or sexual abuse in the family. 相似文献
18.
OBJECTIVES: To explore the knowledge and attitudes of the general public about child sexual abuse (CSA) through a population-based survey. METHOD: A survey was completed by 246 respondents living in Klamath Falls, a small city in rural eastern Oregon. Specific areas of inquiry included who respondents believed were likely perpetrators of CSA, when a child was most likely to disclose sexual abuse, whether respondents believed that children would be truthful, reasons a child might not acknowledge that they had been sexually abused, what respondents knew about how CSA could be diagnosed, and what attitudes respondents thought that a sexually abused child might have towards the perpetrators of their abuse. Finally, respondents were asked how they would report a suspected case of CSA and about their receptivity to personal safety training to prevent CSA. RESULTS: While significant proportions of respondents were fairly knowledgeable about CSA, gaps in knowledge were found in all age groups and ethnic groups. Groups with the most significant knowledge deficits about CSA included men, unmarried respondents, respondents who had not had children, respondents in younger age groups, respondents of Latino descent, and respondents with low incomes or low education. Respondents were most likely to report CSA to their physician or the police. There is community interest in training about CSA and its prevention. CONCLUSION: These data indicate that significant deficits as well as strengths in knowledge about CSA exist in this rural community, and identify populations to which community education about CSA could be directed. 相似文献
19.
20.
A total of 295 child protection workers, law enforcement officers, mental health practitioners, and physicians were surveyed to ascertain their uses of the anatomical dolls in child sexual abuse evaluations and their interpretations of young children's interactions with the dolls. The dolls enjoy fairly wide use among all four professional groups although most professionals employing the dolls have had little specific training in their use. Law enforcement officers were significantly less likely than the other professionals to view children's demonstrations of sexual acts with the dolls as convincing evidence of sexual abuse. There was no behavior (e.g., undressing the dolls, touching the dolls' genitals) which all professional groups unanimously agreed would be normal play behavior by young children ages 2-5, who had not been sexually abused. Results highlight the need for training resources and normative research. 相似文献