Time to abandon prevalence studies of childhood sexual abuse?

CRFR Associate Researcher Dr Sarah Nelson reflects on the problematic issues around prevalence studies of childhood sexual abuse.

The wealth of prevalence studies of childhood sexual abuse (CSA) continue to display wildly differing results. Yet the impetus to carry out more studies continues, nationally and internationally. These studies are driven by the demands of commissioners and funders to ‘prove’ need before services are provided or expanded, but also by professional ambition among researchers to be the ones producing a definitive study.

Neither of these is a child-centred approach, especially when basic services – as for instance an NSPCC Scotland report recently demonstrated - remain inadequate for the minority of sexually abused children we do know about. I suggest that conventional prevalence studies are largely fruitless, and that greater accuracy about prevalence will come about as a by-product of ethical, child-centred practice against sexual abuse.

First of all, while factors like safety and confidentiality, follow-up, inclusion of stigmatised subgroups, and description of acts rather than terms like ‘abuse’ or ‘rape’ will produce more accurate survey findings, we will never approach anything like total accuracy about a secretive, often organised crime overlaid with coercion, shame and silencing.

Crucially, recent revelations, such as professional footballers in their 40s reporting abuse for the first time, support research findings that a majority of children do not tell, and sometimes never will. Officially recorded cases always understate: Stoltenborgh’s examination of hundreds of prevalence studies, for instance, found self-report rates 30 times higher than authorities’ reports. Another problem is that CSA and child sexual exploitation (CSE) overlap in their characteristics, and increasingly now in their official definitions. Do we count them together, or separately?

Even more to the point, there has never been any evidence that studies suggesting higher prevalence rates have led to any increase in services, nor to greater action against abuse. Unpalatable as this may be, public scandals exposing shameful practice have been far more likely to do so, just as they have been in other public services. For example, action against child sexual exploitation in Rotherham, Rochdale or Greater Manchester did not belatedly take place because someone conducted a prevalence study of CSE, but through exposure of disgraceful practice towards young victims.

Commissioners and funders are better directed to the results of good practice in investigation as a demonstration of significant prevalence figures. Many ‘searchlight’ or ‘snapshot’ investigations have uncovered that over decades. Back in 1984 for instance a single, active police investigation unit uncovered ten sex rings and 175 victims in one area of Leeds alone. Peter McKelvie’s proactive social work/police investigations between 1988 and 1995 closed several abusive schools and convicted dozens of perpetrators while Professor Alexis Jay’s Rotherham investigation, reported in 2014, found at least 1400 girls had been sexually exploited over 16 years.

However, ethical good practice in enabling abused children and young people to speak out may in future have the single greatest impact in uncovering a greater accuracy of prevalence. Again, it will do so as a by-product of that good practice.

 For example, the Barnahus Children’s Houses, now spreading across Europe from Scandinavia, provide a reassuring child-centred ‘one stop shop’ for enabling children to tell, for interviewing, for preparing court cases and for therapeutic work. They are being actively considered by the Scottish Government for adoption here. The Confidential Space model being piloted in several Scottish local authorities at present aims to slow the investigation process to an abused child’s pace, increase their support, and build knowledge and confidence among staff who work with young people.

There is another alternative way to persuade commissioners and funders to increase CSA/ CSE services and prevention work - to show them that while results of prevalence studies vary greatly and will continue doing so, a substantial, more consistent body of research on negative effects of abuse has demonstrated over decades that survivors are at higher risks than others of mental and physical ill health, addictions, homelessness, very young pregnancy, suicide, self-harm, offending, and distressed acting-out behaviour by young people.

 As a result of this, current costs and ‘revolving door’ usage continue to be high in many hard-pressed services - including mental and physical health, prisons, social work, addiction services and homelessness projects. Future resource savings, through investment in support and prevention projects, can thus be emphasised to funders and commissioners.

...And of course these negative effects, most of all the suffering survivors face, in themselves suggest the importance of a major investment in prevention.


This is a summary of Sarah Nelson’s presentation to the Connect 2018 conference in Cardiff, 3/5/18 (available on request). Prevalence and disclosure issues, and official statistics, are analysed in detail in Nelson, below:
Nelson (2016) Tackling Child Sexual Abuse: Radical approaches to prevention, protection & support Bristol: Policy Press, Chapter 1

Stoltenborgh M, van Ijzendoorn MH, Euser EM, Bakermans-Kranenburg MJ. (2011) ‘A global perspective on child sexual abuse: meta-analysis of prevalence around the world’, Child Maltreat. 16(2):79-101.

NSPCC (2017) The right to recover: Provision of therapeutic services in the West of Scotland for children and young people following sexual abuse  https://www.nspcc.org.uk/services-and-resources/research-and-resources/2017/right-to-recover-sexual-abuse-west-scotland/

 

 

The strange disappearance of child sexual abuse: New book charts decline

Sarah Nelson, CRFR Associate

Has child sexual abuse been steadily falling off the child protection ‘radar’? That sounds a very strange question, given the current - almost daily - publicity and concern about ‘celebrity’ perpetrators, about clergy abuse, child sexual exploitation, and historic abuse in care.

Yet statistics and professional feedback paint a different, worrying picture, as my new book details. ‘Tackling child sexual abuse: radical approaches to prevention, protection and support’ is launched on Monday 13 June at the CRFR International Conference: Unequal Families & Relationships.

Throughout the UK, a continuing fall in officially known sexual abuse cases and concerns has occurred alongside considerable growth in those about emotional abuse, neglect and parental substance misuse. That suggests not genuine declines or increases in these social problems, but altered priorities among policymakers and practitioners.

For example highly-publicised child deaths, such as that of ‘Baby Peter’ Connelly in 2007, brought large increases in UK care orders involving young children, where there were concerns about neglect or physical abuse. Thus, after the case, numbers in England subject to a child protection plan increased by 47% between 2008 and 2012; numbers on child protection registers increased in Scotland by 23%. In 2007–08, registrations in Scotland for sexual abuse were down by 33% on the previous year alone. From 2012 onwards in Scotland, multiple concerns could be recorded at each case conference. Most common were parental substance misuse (39%), emotional abuse (39%) and domestic abuse (37%). Sexual abuse was ninth in a list of 11 concerns, at just over 3%.

Overall, only 5% of all the children on child protection registers or subject to child protection plans in the UK were under a category that included sexual abuse in 2013.

Accepting that child protection registers and child protection plans only form one way of addressing sexual abuse, such figures do not even begin to reflect the most conservative estimates of child sexual abuse (CSA) prevalence. Police figures themselves hint at greater problems. In Scotland in 2013–14 there were 3,742 recorded sexual offences against children under 18. A major study by the Children’s Commissioner for England (2015) estimated that only one in eight sexually abused children is identified by professionals. This was largely, they found, because protective services were geared to children self-reporting, yet children rarely do this. An analysis of more than 200 international studies of prevalence, from 1980 to 2008, with a total of nearly 10 million participants, revealed wider disparities still: prevalence figures of self-reported sexual assault (18.0% of women, 7.6% of men), 30 times higher than the prevalence rates reported by authorities (Stoltenborgh et al, 2011).

Again, when in 2014 Professor Alexis Jay, after extensive study of records, calculated that at least 1,400 children, some as young as 11, had been sexually exploited in Rotherham over 16 years, it became clear that these cases had been neither classified nor recorded as sexual abuse. This was because the stigmatised girls were viewed by most authorities as freely choosing prostitution. Thus, only now will these cases count in official records as ‘substantiated’.

Researchers and trainers in the CSA field have been told in conferences, seminars and discussions with child protection professionals (including social workers, children’s panel members and safeguarding board members) that the priority for CSA has gradually diminished. Some gave feedback that it was regarded as “yesterday’s issue”. Concern was such that in 2013 Scottish specialists working with CSA wrote to the media and met the Association of Directors of Social Work about their deep concern that “sexual abuse is being allowed to disappear off the statutory radar”. They said different types of abuse “should not be in competition with each other for resources, but approached on the basis of need”.

Could the shocking abuse and killing of the toddler Liam Fee further skew child protection priority towards physical harm to very young children, at the expense of vulnerable older children and teenagers, especially with reference to CSA and CSE (child sexual exploitation)?

We cannot hope to meet today’s multiple online and offline challenges from sexual violence against children and young people - and at times by young people themselves upon others -without honestly and carefully examining why this decline in priority has been happening. Many committed professionals believe the situation must change, and currently four Scottish local authorities are pioneering the Stop to Listen project, a Children 1st initiative overseen by a senior multidisciplinary, statutory/voluntary steering group. This and other imaginative initiatives, designed to help abused young people tell without fear and to ensure whole communities are genuinely involved in protecting children in their neighbourhood, are described in my book.

It also includes chapters on major issues which adult survivors face, including mental health and – for some - involvement in the penal system, after offending born from anger and despair. I hope the book will enable the findings of those research projects, carried out at CRFR, to reach an even wider and more diverse audience.  

==============

Delegates of CRFR's International Conference are invited to attend the launch of Sarah Nelson's new book Tackling Child Sexual Abuse: Radical Approaches to Prevention, Protection and Support, Bristol: Policy Press at the conference drinks reception on Monday 13 June, 5.30pm.

You can follow live tweets from the conference using the hashtag #CRFR2016 on Twitter.


References

Dempster, H., Henry, M., Houston, A., Matthew, L., McCrae, R., Nelson, S., Rennie, J. and Stark, R. (2013) ‘Listening Watch’, Letters, Scotsman, 24 January.

Haringey Local Children Safeguarding Board (LCSB) (2010) Serious Case Review: Baby Peter, 2nd Review. London: Haringey LSCB, October

HM Government (2014) The Fifth Periodic Report to the UN Committee on the Rights of the Child: United Kingdom, May, www.equalityhumanrights.com/sites/default/files/upload/Pdfs/The%20UK’s%20Fifth%20Periodic%20Review%20Report%20on%20the%20UNCRC.pdf

Jay, A. (2014) Independent Inquiry into Child Sexual Exploitation in Rotherham (1997–2013), Rotherham Metropolitan Borough Council.

McLeod, S., Hart, R., Jeffes, J. and Wilkin, A. (2010) The Impact of the Baby Peter Case on Applications for Care Orders, Slough: National Foundation for Educational Research.

Norfolk, A. (2012) ‘Police files reveal vast child protection scandal – Confidential papers show a decade of abuse in south Yorkshire’, The Times, 24 September.

NSPCC (2015) How safe are our children? 2015, Indicator 4, London: NSPCC.

Stoltenborgh, M., van Ijzendoorn, M., Euser, E. and Bakermans-Kranenburg, M. (2011) ‘A Global Perspective on Child Sexual Abuse: Meta-Analysis of Prevalence Around the World’, Child Maltreatment, 16(2): 79–101.

Scottish Government (2014a) Children’s social work statistics Scotland, 2013–14, Chart 8.

Scottish Government (2014b) Child protection key trends: Last update, March 2014, www.scotland.gov.uk/Topics/Statistics/Browse/Children/TrendChildProtection

Lessons of the Rotherham report

What can Scotland learn from Rotherham? Sarah Nelson draws very clear conclusions from the Rotherham report - in what it tells us about the  attitudes held by authority figures towards vulnerable young people and why guidance to identify victims of child sexual abuse has been ignored.

Since last week’s publication of Alexis Jay’s explosive report, which found that at least 1400 children had been sexually exploited in Rotherham over 16 years, there have been repeated claims that “political correctness” caused failure to prosecute the perpetrators, mainly men of Pakistani heritage. Alleged fears of being thought racist or of stirring racial conflict have been seized upon by some politicians and commentators, to suggest this proves a wider failure of multicultural policies in Britain.

But while such fears were one factor for some staff and councillors in the prolonged inaction, were they the key issue? The police after all prosecute Asian suspects over other offences, such as drugs or suspected terrorism. Hugh Muir in the Guardian, highlighting that minority ethnic people are over-represented in prisons and the courts, concluded sarcastically: “if authorities didn’t use their powers against minorities for fear of giving offence... it would be a first.

“If a backlash was feared, where would it have come from? There is no minority lobby for criminals and paedophiles. So long as communities knew the issue was one of law enforcement rather than an assault on those communities themselves, they would have supported tough action by the authorities” (as they did in London over gun crime).

Thus in attempting to learn lessons from these distressing events, we need to ask what was different about this particular crime, and whether the principal answer lay not in the perpetrators but the victims. Were they not considered worth protecting, nor worth risking community tensions?

Many in the police and social care, even the public witnessing grooming “in plain sight”, seemed to share the abusers’ derogatory view of these vulnerable girls, who were often already in care, under supervision through previous abuse or neglect, or otherwise vulnerable. Some were “difficult”, reacting to harm with chaotic or desperate acting-out behaviours. But they were also just children.

Despite Professor Jay describing brutality, callousness and exceptional violence towards girls as young as 11, she found “the police gave no priority to child sex exploitation, regarding many child victims with contempt”......Hilary Willmer, colleague of a Home Office researcher whose 2002 report on CSE was suppressed, said the authorities responded that the "girls had chosen this lifestyle to feed their drug habit...the perception (was) that these were errant teenagers who were just a nuisance...(that) they are going out with these men, and have almost got what they asked for.”

Such attitudes were unearthed in every recent child sexual exploitation scandal. Sara Rowbotham of the NHS crisis intervention team in Rochdale, who had fruitlessly referred more than 100 girls to social services, told MPs “It was attitudes towards teenagers. It was absolute disrespect that vulnerable young people did not have a voice. They were overlooked. They were discriminated against. They were treated appallingly by protective services."

Why did authorities continue for more than a decade to flout laws and guidance which clearly stated that children involved in “prostitution” should be treated as victims, as children in need, and their coercers prosecuted? Why, as Alexis Jay revealed in Rotherham, did they also continue to ignore worrying local reports, years of training and publicity on the issue?

Feminist columnist Suzanne Moore saw links with wider treatment of women in her harsh conclusion: “The macho environment in which the girls were not listened to, or even seen as children, is part of a continuum of thought in which girls, once deemed sexually active, even if it is against their will, are seen as damaged goods. Thus they can be bought and sold in a market that has made it apparent it no longer considers them worth protecting”.

Also influential, given that boys who become involved in child sexual exploitation also face dismissal as “delinquent”, is the persistent failure by authorities and communities to recognise behaviours which many of these young people exhibit as the consequence of past abuse, or present sexual exploitation: not as an invitation to it. Running away, school truancy and exclusions, apparent “promiscuity” through confused sexual boundaries and a sense of debasement, substance misuse to blot out the trauma (or through abusers creating addiction); anger and rage, extreme distrust of authority following betrayal: these have been listed for decades in child protection guidelines and training, and discovered time and again through research.

A massive awareness-raising programme for professionals and communities focussing on this very point, and using direct testimony from young people, may need to be instigated if these derogatory attitudes are finally to be uprooted and further child sexual exploitation scandals prevented. For professionals, that programme needs to include painful reflective work on why they ignored information about children’s reactions to abuse, which was widely available for decades.

Finally, given that these scandals so far have been English, can we be complacent about child sexual exploitation here in Scotland? The Scottish Parliament’s Public Petitions Committee carried out an Inquiry into child sexual exploitation in 2013. It heard from the National Working Group that estimates by Scottish agencies of likely child sexual exploitation victims ranged from 64 to 300 for each agency. The NWG found much concern about under-recognition of the issue, particularly in rural areas.

Strathclyde University’s CELCIS team concluded from its case study research that provisionally, “a prevalence of child sexual exploitation at least approaching 25% (one in four) would seem likely for children in the care population. ... we expect this to be considerably higher for older age groups, for girls and for children placed in residential care.”

In February 2013 Scottish police established Operation Dash to scope the extent of child sexual exploitation in the 12 local authorities of the (then) Strathclyde Police force area, working closely with Barnardo’s, and its work continues.

Everyone concerned with the welfare of vulnerable young people in Scotland will hope that in their attitudes to our most troubled teenagers, the authorities will now choose respect and understanding above contempt.



REFERENCES

Independent Inquiry into Child Sexual Exploitation in Rotherham 1997 – 2013. Alexis Jay OBE. Rotherham Metropolitan Borough Council, 2014.

The Scottish Parliament, Public Petitions Committee. The 1st Report, 2014 (Session 4): Report on tackling child sexual exploitation in Scotland: SP Paper 449; PU/S4/14/R1.