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/

 

 

How resilient do we want our children and young people to be?

In a follow-up post, CRFR Associate PhD student Ariane Critchley provides her thoughts on resilience in response to the recent CRFR Seminar ‘The Troubling Concept of Resilience’ given by Eric Carlin and Emma Davidson.


As a social worker I was fortunate to meet a number of children and young people who I would describe as ‘resilient’. The work of Gilligan (2001) was highly influential on my practice and I considered ways in which I might foster resilience in the children I worked with, particularly those children to whom we owed corporate parenting responsibilities, by virtue of their status as ‘looked after’. In my view, it makes sense to talk of ‘resilience’ in the context of frontline social work, where practitioners encounter young people who have suffered 'extraordinary vulnerability’ (Brownlie, 2014: 195) through their experiences of early trauma, their separation from family of origin, and experiences of an imperfect care system with multiple moves of home and school. Should young people flourish through such extremes of early adversity, aren’t we right to think of them as resilient?

I would argue that in this context, ‘resilient’ is exactly how we should describe the ongoing achievement that individual children make by not only surviving serious challenges, but somehow finding a way to grow and to thrive. And the ‘somehow’ here is crucial. Acknowledging Carlin & Davidson’s challenge, that resilience risks that we ‘prioritise external and normative judgements about individuals’ characteristics and behaviours and the adversities they are deemed to have overcome’ (Ungar, 2005), I wish to suggest that resilience as properly understood is an ecological and ‘relational’ quality (Bondi et al. 2007). We can only be resilient to the challenges we face through interaction with the internal and external factors that make up our life world. For example, our health, the people who surround us, the socio-economic context we live in, and the resources to which we have access. Resilience then, is not a ‘characteristic’ so much as a process.

Which is why, as social workers, we feel we can contribute to an individual child or young person’s overall ‘resilience’. However, this does not translate into a policy aspiration that all children and young people should be resilient. Listening to the seminar last week, what struck me was the way that the universal application of concepts such as ‘resilience’ can be dangerous. When youth policy suggests through GIRFEC that all Scottish children should be encouraged to be resilient we risk a backwards misapplication, which seems to demand that children and young people do their best with the cards they are dealt rather than our society finding them a better hand.

In their study of the operationalisation of resilience in practice, Daniel et al. cautioned that, ‘policy documents are increasingly referring to the promotion of resilience as an aim – it is important that such documents set out their operational definitions (Daniel et al., 2009)’. Viewing resilience ‘as an aim’ introduces the great danger that this seminar warned of; we might expect that children and young people encountering significant difficulty should simply become more resilient, flipping resilience on its head in a way that demands individual overcoming, not structural equalising. If resilience is understood as a dynamic process that occurs in conditions of adversity, the aim of public policy should surely be to challenge and reduce the social and material conditions in which children can truly be described as ‘resilient’, to decrease the very circumstances in which resilience can flourish.

Ariane Critchley is a qualified social worker and researcher with a range of interests across social work and public health. Ariane is based at the University of Edinburgh where she is writing up her ESRC funded PhD on pre-birth child protection, examining the complexities of applying child protection processes to unborn children and the experiences of practitioners and of expectant families. Ariane has contributed to Scottish Government publications on maternity care and is currently working with Social Work Scotland on finding evidence of good practice in the implementation of self-directed support in Scotland.


References


Bondi, L., Davidson, J. and Smith, M. (2007), ‘Geography’s ‘Emotional Turn’’, Chapter 1 in Davidson, J. Bondi, L. and Smith, M. (2007), Emotional Geographies, Aldershot, Hampshire: Ashgate.

Brownlie, J. (2014), Ordinary Relationships. A Sociological Study of Emotions, Reflexivity and Culture, Hampshire: Palgrave Macmillan.

 Daniel, B, Vincent, S, Farrell, E & Amey, F (2009), 'How is the concept of resilience operationalised in practice with vulnerable children?' International Journal of Child and Family Welfare, vol. 12 (1): 2-21.

Gilligan, R. (2001), Promoting resilience : a resource guide on working with children in the care system, London: British Agencies for Adoption & Fostering (BAAF).

Ungar, M. (2005) ‘Introduction: Resilience across cultures and contexts’, in Handbook for working with children and youth. London: Sage.

Supporting children and families in early childhood: When does community action let the Government off the hook?

CRFR Associate Researcher, Dr Kate McAlpine works in Tanzania at the intersection between good governance, technology and children’s rights. In this post she reflects on the key findings from a qualitative study that evaluated the impacts of Children in Crossfire’s[i] programme of integrated child development interventions for children in the early years.


In Tanzania too many people live hand to mouth, as deep and shallow poverty exist side by side. The prevailing belief is that children unite a family, but that they should defer to adults. Until recently young children have been considered by the Government to be the responsibility of the family and not a group that warrants any services beyond health care. 

The main concern of the programme we evaluated was to mitigate the effects of poverty on children’s developmental outcomes, and to do so by increasing young children’s access to early years education. The programme did this by equipping community volunteers to run community based early years centres; and establishing micro-finance funds for women to help finance the centres.

Using a narrative approach that sought out people’s stories; we inquired about parents’ and early years educators’ internal capacities to protect and nurture children. We also investigated the attitudes and behaviours of the Local Government Authorities with regards to investing in services for young children; and sought out changes in familial and community relationships. The interviews were coded and analysed using the classic grounded theory method. 

We discovered that individuals who have been touched by the programme are now ready to parent. But, punitive parenting continues to be prevalent in the communities. Parents and local leaders who were interviewed believe that the early years educators are “true teachers” even though they have learnt on the job. Parents hear that the early years services are good; their children want to attend; and then parents see their child thrive.

Notably, community members are self-organizing to undertake development initiatives that benefit children. Unexpectedly, social capital has been strengthened as a result of the establishment of community managed micro funds that were initially intended to provide funding to the early years centres.

The success of the programme raises wider questions about the planning and financing of social services when communities have initiated their own services. The programme had a working assumption that the early years centres would be legitimized via a process of Government supervision, regulation, and resourcing. However, the minimum standards for centres that were developed by the Government are not fit for purpose. This is because they frame quality in terms of infrastructure and processes, and ignore standards around safety. Nor, is the Government fully invested in resourcing the regulation of early years centres.

Many community members see the value of contributing to early years education, and ward officials recognise that early years and child protection services need financing. But, this does not translate into revenue. Planning to resource services is a completely different thing from delivering services, and children’s services continue to be treated as a matter of charity.

Long-standing systemic impact for young children can only be achieved if neighbourhood leaders (both public servants and elected officials) self-identify as agents of change; if a social consensus emerges that services for children need to be resourced by the government; and finally if citizens and leaders learn how to navigate the Government mechanisms for participatory planning and budgeting, and consistently put pressure on the government to resource children’s services. 


The full research report can be downloaded at http://www.doingtherightthing.co/publications/

 [i] Children in Crossfire is an Irish International NGO that furthers early years education and development in Tanzania. https://www.childrenincrossfire.org/


References


Glaser, B., & Strauss, A. (1967). Discovery of grounded theory: Strategies for qualitative research. Chicago: Aldine de Gruyter.


McAlpine, K & Omesa, Njeri (2017) A Qualitative Evaluation of the Impacts of a Programme of Integrated Child Development in Tanzania. Dar es Salaam, Tanzania. Children in Crossfire.

The brain, the family and the state

Does it help if parents receive advice on how to raise their children?

Or does it make them more confused, trying to find their way through all the information?

These are some of the questions being asked in a CRFR project looking at how ideas from brain sciences are being used in policies relating to parenting and family life. The child’s brain has come to be a hot topic, and whether or not parents are aware of the origins of the advice they receive, brain science is being increasingly used to shape professional practice: from the content of parenting courses, to initiatives to encourage singing and reading with your baby, through to legislation targeting children and families.

Many parents may be able to recall, for example, advice given on the importance of cuddling their children – which stems from evidence that affection aids the development of infant’s brains. What once were perhaps seen as ‘soft’ topics are now being backed up by what is often seen as ‘hard’ science. Brain science is, today, playing an important role in reshaping the relationship between parents and the state.

We have almost completed the first part of our project, looking at how brain science is used in policy and how this relates to any changes in policy priorities and aims. We have also interviewed a number of very engaged and enthused policy-makers, who are involved in different ways in making ‘Scotland the best place to grow up’. One finding is that, whilst the brain sciences seem to have clearly played a role in policies for parenting and care, they are at the same time talked about very tentatively – policymakers are keen to highlight what they don’t know (yet), as well as what they feel certain of.

But what about parents? We are now interested in hearing what advice parents receive on parenting, and what they think about the role of brain science in this advice. Do they value it, do they use it, or do they ignore it? Upcoming interviews with families will help to shed light on how parents view these policy-backed messages, and the impact this type of advice has on their own parenting approaches.

If you are interested in learning more about this project please contact Tineke Broer (tineke.broer@ed.ac.uk). If you are a parent/carer of a child from 0-3 and would like to be interviewed for this project, please also get in touch.

Integrating children’s services: exploring practice through comparison

A new project, affiliated with What Works Scotland, to explore how local authorities integrate children's services will be the focus of an CRFR informal seminar on 21 January. In this blog Stefanie Schmachtel-Maxfield introduces the project and extends an invitation to two WWS local authority learning partners and others to participate.

How do local authorities implement integrated children’s services? Who is involved? What governance structures and processes are needed to help with the implementation? And what challenges and dilemmas does the implementation pose to local authority professionals? These questions are at the core of a new project affiliated with What Works Scotland (WWS) to explore the governance practices and challenges in local authorities of implementing integrated children’s services.

Existing studies of local partnership repeatedly stress the crucial yet complex role of local authority leadership in implementing partnership-based policies. Leadership in this context involves the difficult and paradoxical juggle between taking authority, acting as moderator and engaging in egalitarian participation. On one hand, leaders have to ensure the implementation of integrated policies, account for it, and provide sufficient guidance and structure so, for instance, everyone has an opportunity to participate. One the other they also have to moderate partnerships whilst also acting as just one stakeholder amongst several. Local authorities also occupy an intermediate position between the central government and diverse localities, which means they face direct pressures from both ‘above’ and ‘below’. Despite these findings about the complexity of leadership in this context, little research has been done on the local authority level investigating the implementation of integrated children’s services. Such research can serve the dual role of exploring the issues whilst also providing valuable opportunity and space for local authority professionals to collectively and in situ reflect on these challenges.

This WWS affiliated project will take a comparative approach to address these issues. Comparison, if conducted in a collaborative situated way, offers considerable underexplored potential as a form of learning for local authority professionals. Traditional comparative policy research is often done solely by researchers ‘from above’, and is often located at the macro level, comparing how whole states differ in their policies and ways of governing. This makes it difficult for comparative policy research to connect with the specific situations on the local level. Yet, if we change how we think about comparison and build it around concrete problems and dilemmas of local authority professionals, we can make it much more relevant locally and transform it into learning possibilities. But how exactly can such a comparison ‘from within’ look like and how does it work?

The idea is relatively simple. It needs (for starters) two partnering teams from different Scottish local authorities who are already engaging in the strategic leadership of integrated children’s services and who are open for a ‘dilemma swap’. This ‘dilemma swap’ is embedded in a three-step procedure which is conducted as a series of three workshops in each locality: in the first meeting, each team decides upon a core dilemma in implementing integrated children’s services for the other team to work upon. In the second workshop, the teams work on each other’s dilemma. The third workshop is dedicated to reflect on the leaning that took place through working on the other team’s dilemma and through receiving their responses to the own dilemma.

When working on a solution of someone else’s problem, our own issues and perspectives inevitably come into play. In putting ourselves into the shoes of others, we are comparing ourselves with others – and in doing so, we can become aware of own ways of thinking about and dealing with problems. We might be surprised about certain aspects which might then provoke us to rethink our own problem focus. Comparison helps to reveal tacit assumptions that become accessible only through taking the issue out of the context. But we might also find out what we value and like to retain and build upon (Hetherington, 2002). More generally, leadership and more specifically, developing leadership in the way described, becomes a collective endeavour. This offers an alternative to the still prevalent approach of developing the ‘heroic individual local authority leader’: one that might contribute to the wellbeing of local authority professionals.

I am looking for two local authority partners to participate in this project from the WWS learning partners. However, if you are interested but are not a learning partner or if you have further questions or comments on this project, please get in touch (stefanie.schmachtel@ed.ac.uk).

I am hosting a free informal seminar on 21 January 2015 (12.30-1.30pm, CRFR, University of Edinburgh) to discuss and develop this project further. To book please email: Brenda.saetta@ed.ac.uk.


References
Freeman, Richard; Mangez, Eric (2013): For a (self-)critical comparison. Critical Policy Studies, 7(2), 198-206.

Hetherington, Rachel (2002): Learning from Difference. Comparing Child Welfare Systems. Partnerships for Children and Families Project. Social Work, Wilfried Laurier University. Waterloo, Ontario, Canada.