One thousand fifty-nine children with a chief complaint of sexual abuse

doi:10.1016/0145-2134(88)90023-3

Child Abuse & Neglect

Volume 12, Issue 2, 1988, Pages 151-162

https://doi.org/10.1016/0145-2134(88)90023-3 Get rights and content

Abstract

Sexual assault victims (1,059) under the age of 17 were evaluated over a period of 44 months in a teaching, metropolitan county emergency room. The cases were recorded and reviewed by use of a protocol. The children ranged in age from 3 months to 16 years of age. Most were female (89%). The average age for all children was 8.3 years. There was no mean age difference between male and female victims 12 and under. Victims were 1.58 times as likely to be black, 0.22 times as likely to be Latin, and 0.96 times as likely to be white than the general population. Perpetrators were strangers in 13.8% of cases and close family (incest) in 28.1% of cases. A major finding is that 58.1% of the perpetrators were known to the child but were not family members. These episodes were severe with penetration occurring in 754 (71%) of the assaults. Cultures were positive in 1.5% of all cases. The medical and social response to these children's needs is noted to be inadequate.

Résumé

L'étude a été faite aux Etats-Unis, 1,059 enfants âgés de 3 mois à 16 ans victimes de sévices sexuels ont été évalués pendant une période de 44 mois dans un service d'urgence métropolitain (teaching and county). Les cas ont été répertoriés puis revus selon un protocole. La plupart des enfants (89%) étaients des filles. La moyenne d'âge sur le total des enfants était de 8.3 ans. Il n'y avait pas de différence d'âge moyen entre les victimes garçons ou filles de 12 ans et moins. Le risque pour les victimes de race noire était 1.58 fois plus importante que la moyenne, pour les latino-américains de 0.22 et pour ceux de race blanche de 0.96. Les agresseurs étaient inconnus de l'enfant dans 13.8% des cas, et de famille proche (inceste) dans 28.1% des cas. La découverte principale a été que 58.1% des agresseurs étaient connus de l'enfant mais pas membres de la famille. Les actes de violence sexuels commis étaient sérieux avec dans le 71% des cas, pénétration (754 cas). Les cultures pour des organismes transmis sexuellement ont été positives dans le 1.5% de tous les cas. Les auteurs sont d'avis que la réponse médicale et sociale aux besoins de ces enfants n'est pas adéquate.

Resumen

1,059 víctimas de asalto sexual menores de 17 an̄os fueron evaluadas (por medio de un protocolo) sobre un període de 44 meses en el departamento de emergencia de un hospital universitario. Los niños tenían entre 3 meses y 16 anos de edad. La edad promedio era 8.3 an̄os. 42% de las víctimas eran menores de 7 años. La mayoria eran hembras (89%). Los perpetradores eran desconocidos en 13.8% de los casos, y familia cercana (incesto) en 28.1% de los casos. Un descubrimiento de gran importancia es que 51.8% de los perpetradores eran conocidos pero no miembros de la familia. 97.7% de los perpetradores eran varones. Los asaltos fueron severon con penetración (oral, anal, vaginal) en el 71% de los casos. Culturas para detectar enfermedades sexuales contagiosas fueron positivas en 1.5% de los casos.

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Cited by (57)

Young children's knowledge and skills related to sexual abuse prevention: A pilot study in Beijing, China
2013, Child Abuse and Neglect
Citation Excerpt :
Most children were not able to recognize that the sexual perpetrator included someone they trusted or liked (e.g., babysitter) in this study. Since most abusers are known to the victim and often to the family (Cupoli & Sewell, 1988; Elliott, Browne, & Kilcoyne, 1995; Tang, 2002), it is important for children to learn (in sexual abuse prevention programs) that someone they are familiar with can be a potential perpetrator. Furthermore, very few (16%) Chinese preschoolers knew that children should report the abusive incident even if the perpetrator tells them to keep it a secret, similar to other Chinese research with elementary school children (Chen, 2012; Chen, Du, et al., 2012), but much lower than western research with young children (about 40% in Wurtele & Owens, 1997; 54% in Kenny, 2010).
To examine the level of knowledge and skills related to prevention of child sexual abuse (CSA) in a sample of Chinese preschoolers in Beijing and to explore the associations between children's scores on the knowledge and skills and their parents’ reports on the knowledge and communication with children about CSA prevention. One hundred and thirty-six preschoolers were interviewed by researchers using the Chinese versions of Personal Safety Questionnaire and the “What If” Situation Test, and one parent of each child was invited to complete an anonymous questionnaire regarding parental knowledge and parent–child communication about CSA prevention. Less than half children knew that strangers were not the only perpetrators and only 16% thought that children should report secret touching. In 3 inappropriate touching requests, less than 30% of the children were aware of using verbal response to definitely refuse the inappropriate touching and less than 20% of the children were aware of definitely removing themselves from the abusive situations. Parent–child communication about CSA and parental educational level were the significant factors for children's self-protection skills. Preschool children lack CSA prevention knowledge and related self-protection skills. Culturally relevant primary CSA prevention programs in China need to be developed and parental education should be a part of CSA prevention. Parents need to be informed about CSA knowledge concepts and need to be encouraged to communicate with their children about sexual abuse prevention.
Child abuse in the eyes of the beholder: Lay perceptions of child sexual and physical abuse
2007, Child Abuse and Neglect
Citation Excerpt :
Because sexual abuse of females is considerably more common in the United States than sexual abuse of males (though overall, maltreatment of boys and girls is roughly evenly split; DHHS, 2006), we also predicted that it would be judged more likely to occur and to reoccur. Just as the literature emphasizes female victims, greater attention is paid to male perpetrators of sexual abuse, who appear to be more common (Cupoli & Sewell, 1988), than to female perpetrators (Lewis & Stanley, 2000). In contrast, overall abuse is perpetrated as much or more by mothers (40.8%) than by fathers (18.8%; McDonald, 2005).
The purpose was to explore the effects of victim and perpetrator gender, type of abuse, and victim-perpetrator relationship on university students’ and non-students’ perceptions of different kinds of child abuse.
One hundred and ninety-nine participants (including university students and non-student adults) evaluated each of 24 vignettes (within-subjects design) describing an abusive interaction between a child and an adult. The following four variables were manipulated: the victim's gender, the perpetrator's gender, the type of abuse (physical, relatively mild sexual, or relatively severe sexual), and the perpetrator's relationship to the victim (parent or babysitter). Participants rated each vignette on a number of dimensions: degree of trauma and severity, likelihood of general occurrence and reoccurrence, victim believability, and “repressibility” of the event.
Significant interactions emerged on each dimension. For example, sexual abuse (whether mild or severe) was rated as being more traumatic and severe if perpetrated by a parent, but relationship type did not affect perceptions of physical abuse. In addition, significant perpetrator gender by victim gender interactions indicated that homosexual abuse was perceived as more traumatic and repressible than heterosexual abuse, but as less likely to occur; and male participants tended to be more affected by the gender of the perpetrator and abuse type than female participants.
The results suggest that people have stereotypes about the circumstances and consequences of child abuse. These stereotypes are often, though not always, consistent with existing empirical findings.
Sexual knowledge and emotional reaction as indicators of sexual abuse in young children: Theory and research challenges
2004, Child Abuse and Neglect
Child abuse and neglect presentations to a pediatric emergency department
2002, Journal of Emergency Medicine
This study describes the epidemiology of reported abuse (physical, sexual, and neglect) in a teaching, metropolitan Pediatric Emergency Department (PED) with approximately 30,000 annual visits. A retrospective chart review was conducted of all cases from the PED that were referred to the Department of Social Work and reported to the Administration for Children’s Services (ACS), the New York children’s protective services, from May 1996 through December 1998. Demographic information about the victims as well as past medical history, number of previous PED visits, information about the perpetrator and the nature of the injuries were obtained. We identified 106 cases over this period of time that were reported for child abuse or neglect from the PED. Fifty-five percent of cases were reported for suspected physical abuse, 15% for sexual abuse, and 30% for neglect. The suspected perpetrator was the mother in 41% of cases and the father in 21% of cases. Bruises were the most frequent injury reported, seen in 25% of cases. The mean age of the patients was 6.4 years old. They averaged 4.6 previous PED visits. The majority of patients lived near the hospital. Sixty-nine percent of the patients presented for care between the hours of 5 PM and 9 AM. Most of the patients claimed their primary physician was located in a clinic near their home (44%). Only 12.7% were unsure of their primary physician. Significantly more victims (89%) had Medicaid or no insurance compared with other PED patients (71%). Victims did not live in zip codes with lower incomes compared with other PED patients. Upon complete investigation by ACS, 49 cases (46%) were deemed ‘indicated,’ 21 cases (20%) ‘unfounded,’ and for the remaining 36 cases (34%) follow-up information could not be determined. The incidence of reported abuse and neglect was lower than previous studies have shown. The majority of reported cases (especially those of sexual abuse) did not have any physical findings at the time of presentation, stressing the need of a careful search for both abuse and neglect.
The prevalence of a history of child sexual abuse among adults visiting family practitioners in Israel
2000, Child Abuse and Neglect
Objective: To determine the prevalence of a history of child sexual abuse (CSA) in a random sample of adult patients presenting for routine health care to family practice clinics in Israel.
Method: One thousand and five randomly selected patients aged 18 to 55, attending 48 clinics, participated in this questionnaire study.
Results: Twenty-five percent indicated that they had been sexually abused as children. More women reported CSA (p < .0001) than men, as did women originating from Western countries (p = .02) and those with more than 12 years of education (p = .01). There were no significant associations between CSA and the other socio-demographic variables examined. Fondling was the most common and intercourse the least common activity experienced. Forty-five percent of the perpetrators were previously known. The mean age at which the child sexual abuse began varied between 10 and 14. Only 45% of the subjects had ever told anyone about the experience.
Conclusions: Since no other prevalence study has been reported to date in Israel, these findings suggest that as in other Western countries CSA is a relatively common problem. Family physicians and other health professionals should be aware of this high prevalence and its known potential for initial and long-term deleterious outcomes.
Objectif: Déterminer la prévalence des antécédents d’abus sexuels dans un échantillon aléatoire de patients adultes recevant des soins courants dans une clinique de médecine familiale en Israël.
Méthode: Mille cinq patients dans 48 cliniques ont été choisis de façon aléatoire pour participer à cette étude en répondant à un questionnaire. Ils étaient âgés entre 18 et 55 ans.
Résultats: Vingt-cinq pour cent ont affirmé qu’ils avaient été abusés sexuellement durant leur enfance. Le nombre de femmes était plus considérable (p < .0001) que celui des hommes. Les femmes venant de pays occidentaux (= .02) et celles qui comptaient plus de 12 ans de scolarité étaient plus nombreuses. On a remarqué aucune association importante entre les abus sexuels et les autres variables socio-démographiques. Les attouchements sont le type d’abus le plus fréquent tandis que la relation sexuelle s’avère le type d’agression le moins fréquent. Quarante-cinq pour cent des agresseurs connaissaient leur victime. Le début des agressions varie entre 10 et 14 ans. Seulement 45 pour cent des victimes ont confié leur agression à quelqu’un.
Conclusions: Alors qu’on ne connaı̂t aucune autre étude en Israël sur la prévalence des abus sexuels en enfance, cette étude porte à croire que ces agressions sont chose courante tout comme dans les pays occidentaux. Les spécialistes en médecine familiale et les autres intervenants de la santé devraient reconnaı̂tre la prévalence importante de ces agressions et les graves conséquences qui peuvent en découler tant dans l’immédiat qu’à long terme.
Objetivo: Determinar la prevalencia de una historia de abuso sexual en la niñez (CSA) en una muestra aleatoria de pacientes adultos que se presentan para atención de salud rutinaria en clı́nicas de atención familiar en Israel.
Método: Participaron en este estudio de cuestionairo una muestra de un mil y cinco pacientes adultos seleccionados al azar de 18 a 55 años que asistı́an a 48 clı́nicas.
Resultados: El veinte y cinco por ciento indicaron que habı́an sido sexualmente abusados como niños. Más mujeres reportaron CSA (p < .0001) que los hombres, ası́ como las mujeres que venı́an de los paı́ses del Oeste (p = .01). No aparecieron asociaciones significativas entre el CSA y las otras variables socio-demográficas examinadas. Caricias (manoseos) fue la más común y coito la menos común de las actividades reportadas. El cuarenta y cinco por ciento de los perpetradores eran conocidos previamente. La edad en que el abuso sexual en la niñez comenzaba variaba entre los 10 y los 14 años. Solo el 45% de los sujetos le habı́an dicho a alguien de su experiencia.
Conclusiones: Como no habı́a otro estudio de prevalencia reportado en Israel hasta la fecha, estos hallazgos sugieren que como en otros paı́ses del Oeste, el CSA es un problema relatvamente común. Los médicos de familia y los demás profesionales de salud deben estar alerta de su alta prevalencia y su conocido potencial para producir resultados iniciales y a largo plazo adversos.
Characteristics of intrafamilial and extrafamilial child sexual abuse
1998, Child Abuse and Neglect
Objective: The precise nature of the differences between intrafamilial and extrafamilial child sexual abuse is not clear. The purpose of the present study is to provide clarification of these differences.
Method: Archival data containing 1,037 cases of child sexual abuse were obtained from police files in two western Canadian cities with populations of about 180,000. Two trained research assistants coded and transcribed the data.
Results: Results showed: (1) earlier onset, longer duration, higher level of intrusion, and greater physical and emotional injury for intrafamilial victims; (2) less use of physical/verbal force, or enticements, and greater use of instructions “not to tell” by intrafamilial offenders; (3) more convictions and longer jail sentences for intrafamilial offenders; and (4) no intra-extrafamilial differences in victim sex preference.
Conclusions: Boys are younger than girls at the time of first abuse in samples of criminal justice and hospital referrals, although only for older aged victims, for example, 8 to 17 years. Although statistically significant, there is little difference in level of intrusion perpetrated by intrafamilial and extrafamilial offenders, both are highly intrusive. Both intrafamilial and extrafamilial offenders use physical/verbal force with older victims; extrafamilial offenders more often choose older victims, and therefore more often use force. Intrafamilial victims suffer greater physical and emotional injury, resulting from greater intrusion not duration of abuse. It’s not clear that victim sex preferences of intra- and extrafamilial offenders exist.
French abstract was not available at time of publication.
Objetivo: La diferencias entre el abuso sexual infantil intrafamiliar y extrafamiliar no están claras. El propósito de este estudio es proporcionar clarificación de estas diferencias.
Método: De los archivos de la policı́a de dos ciudades del oeste de Canadá con 180.000 habitantes, se obtuvieron datos relativos a 1037 casos de abuso sexual infantil. Dos asistentes de investigación formados para ello, codificaron y transcribieron los datos.
Resultados: (1) Las vı́ctimas de abuso sexual intrafamiliar presentan una aparición más temprana, una duración mayor, un nivel más alto de intrusión y un mayor daño fı́sico y emocional; (2) los ofensores intrafamiliares presentan una menor utilización de la fuerza fı́sica o verbal, y de la seducción y una mayor utilización de la instrucción “no decirlo”; (3) los ofensores intrafamiliares tienen más condenas y sentencias de prisión más largas; (4) no se aprecian diferencias entre ambos tipos de abuso sexual en la preferencia del sexo de la vı́ctima.
Conclusiones: En el grupo de edad entre 8 y 17 años, los niños varones son más jóvenes que las niñas en el momento de ocurrir el primer episodio de abuso, en muestras de casos que provienen de la justicia penal y de notificaciones de hospitales. A pesar de que sea estadı́sticamente significativa, se aprecia una escasa diferencia en el nivel de intrusión de los casos intra y extrafamiliares. Ambos pueden ser considerados como altamente intrusivos. Ambos tipos de ofensores utilizan la fuerza fı́sica y verbal con las vı́ctimas más mayores. Los ofensores extrafamiliares eligen más a menudo vı́ctimas mayores, y por tanto, utilizan de manera más frecuente la fuerza fı́sica. Las vı́ctimas de abuso intrafamiliar sufren un daño fı́sico y emocional más severo, que es el resultado de un abuso más intrusivo y no de la duración del abuso. No queda claro que existan diferencias en las preferencias del sexo de la vı́ctima entre ambos tipos de abusadores.

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^☆: Presented in part at the Sixth International Congress on Child Abuse and Neglect, Sydney, Australia, August 12,1986.

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One thousand fifty-nine children with a chief complaint of sexual abuse☆

Abstract

Résumé

Resumen

Child Abuse & Neglect

Child Abuse & Neglect

Pediatrics

Pediatric Emergency Care

American Journal of Diseases of Children

American Journal of Diseases of Children

Child Abuse & Neglect

Child Sexual Abuse: New Theory and Research

Sexual abuse of children: Current concepts

American Journal of Diseases of Children

Hillsborough County population by age and sex

Hillsborough County population by age and sex

Child sexual abuse: A study of prevalence in Great Britain

Child Abuse & Neglect