Shining a Light to Improve How We Respond to Sexually Abused Children

By Shelley A. Kester, Esq.

It is horrible to consider child sexual abuse—yet it is a social ill we read about every day. The fact that we read about it, in some sense, is good news. A dear friend of mine often reminds me that it is not impossible for darkness to exist in the light. Children’s Advocacy Centers (CACs) strive to bring light to the darkness that is child sexual abuse, a crime that is perpetuated in secrecy, manipulation, and shame. Arguably, we cannot say we are a civilized society when we tolerate the abuse of our children. CACs attempt to shine the light on child sexual abuse and brighten the path for survivors.

What constitutes sexual abuse of a child? The National Center on Child Abuse and Neglect defines child sexual assault as “contacts or interactions between a child and an adult when the child is being used for sexual stimulation of the perpetrator or another person, when the perpetrator or another person is in a position of power or control over the victim.” Sexual abuse is any time that a child is engaged in a sexual situation with an older person. It can include actual physical contact, such as fondling or rape, but it also includes making a child watch sexual acts or pornography, using a child in any aspect of the production of pornography, or making a child look at an adult’s genitals. Horrible.

Tragic still is the fact that sexual abuse of children has lasting effects on victims and society. The social and economic costs of child sexual abuse are significant. Costs directly related to the crime include medical treatment for injuries sustained from abuse as well as foster care costs to remove children who cannot safely remain with their families. Indirect costs to victims include lower academic achievement, adult criminality, and lifelong mental health problems, including problems with interpersonal relationships throughout life.

The legal system has been engaged in the battle to protect children from abuse through the various agencies tasked with the different aspects of combating the problem—police, prosecutors, child protection service workers, and mental health professionals. Our experience has seen that these cases are often difficult to prove, in part because of the age of the victims.

CACs were developed to consider and incorporate the experience of the child victim. In doing so, the method for helping victims of child sexual abuse has been improved.

Challenges of the Traditional Response to Child Abuse. When an adult suspected that a child may have been a sexual abuse victim, the traditional response was far too often to ask a child victim to repeatedly tell what had occurred through multiple interviews by each agency charged with a role to help. Not all interviews were conducted by forensically trained interviewers, sometimes beginning with a well-meaning teacher or responding police officer who had not had forensic training, risking the integrity of how the information was obtained, either through inadvertent suggestion or leading questions. The environment children were in when asked to recount what had occurred was often less than child friendly, such as the back of a police car or in a sterile office building. It is little wonder that some child victims might have considered that the reason they were asked to repeat the ordeal of what had happened so often had something to do with how they were telling it. Inconsistent descriptions of what had occurred, made by children re-traumatized by the intervention systems in place to help them, not surprisingly, were used by defense attorneys representing alleged child perpetrators.

Confronted with the nightmare of learning that their child had been victimized, parents were expected to enter an unfamiliar legal system, while at the same time taking their child to multiple appointments in different locations in order to get the necessary help. At the same time, these parents were confronted with many unanswered questions. Where do I take my child next for help? What will happen in court? How do I help my child recover from what has happened? What does it mean for our family? The process for getting help, all too often, was more than the child or their families could endure at the time. Communications between agencies had its limitations depending upon the agency culture and interagency relationships and resources.

A New Approach. There are now over 900 CACs in the U.S. and at least 12 in different countries around the world. The National Children’s Advocacy Center (NCAC), the nation’s first CAC, celebrated 27 years of services in May 2012. CACs begin with a child-focused, multidisciplinary team response to child abuse. The team, made up of the entire collective agencies that respond to abuse, works with the objective of preventing re-victimization of sexually abused children by how the system responds to their cases. CACs serve children under the age of 19, as well as the developmentally disabled community, for free.

A Multidisciplinary Approach. The “multidisciplinary team approach” pulls together, into one coordinated team, law enforcement, prosecutors, child protective service workers, and medical and mental health workers as well as family/victim advocates and other resources. The collaboration of the multidisciplinary team recognizes that no one agency, by itself, can assure the protection of children but, by working together, better outcomes for young victims and families were achieved. CACs are designed to be child (and teenager) friendly, often decorated in child-friendly colors with toys and/or other amenities geared to putting children at ease. This is the site where a forensic interview is conducted via closed-circut television by a trained interviewer, monitored by the multidisciplinary team, which is located in another part of the CAC. Interviews are preserved by recording or CD, thereby preserving the chain of evidence. Some CACs have a medical professional on site when a medical exam is deemed appropriate.

Forensic Interview. All of the professionals who serve on the multidisciplinary team are sensitive to the difficult and confusing time that parents and their child may be experiencing. Through a forensic interview, the safety and protection of each child is assessed. An interview specialist will ask the child questions and is part of the team discussion following the interview, which is monitored by the other team members on closed-circuit television. During the interview, team members may communicate with the forensic interviewer to relay observed nonverbal cues the interviewer may have missed, bringing the talents of the entire team to one interview of the child.

Team Members and Support Services. Medical examinations by professionals trained to identify medical signs of child sexual abuse address any medical concerns. A medical exam is available to every child, as deemed appropriate to the circumstances. The police officer from the location where the alleged incident occurred, along with the prosecuting attorney for the area, will determine if a crime has been committed and what other investigative steps must be taken to obtain the facts. A victim’s advocate will link the family to the court system, if and when criminal action is taken, and will provide support services to the family throughout the process and with continuity and regular contact. Mental health services are provided at no cost to the victim and to the family as needed. The multidisciplinary team’s overall goal is to complete the investigation in a child friendly, timely, and professional manner, and to help the child and family recover as effectively as possible to minimize the long-term effects of abuse.

The various institutions that join a CAC are asked to make unaccustomed systemic changes in the delivery of their services. This transition presents challenges, but the various agencies quickly experience the value, efficiency, and impact of the multidisciplinary model.

CACs served more than 270,000 children during 2009, and this model has now been implemented in more than 12 countries throughout the world. The American Bar Association has endorsed CACs as the preferred model for responding to child sexual abuse.

Who We Serve. Diverse communities are impacted by abuse. CACs equally serve children and families from a wide range of socioeconomic and ethnic groups. No group is denied services because of an inability to pay since there is no charge for services. All children who qualify for and need services receive them regardless of race, ethnicity, religious background, and socioeconomic status.

CACs are also often involved in the education and delivery of prevention programs in their communities. For more information on CACs, see thenationalcac.org and nationalchildrensalliance.org.”

Image credit: Flickr/Pink Sherbet Photography