A new study finds that local, community-wide education efforts can drastically lower incidence of sexual abuse of children.
The sexual abuse of children affects 15 percent of girls and 8 percent of boys worldwide, incurring high public costs and devastating consequences for its survivors. In the United States, at least one in four girls and one in 20 boys experience sexual abuse. A US Preventive Services Task Force report recently concluded there's not enough evidence that prevention is effective.
Now, a new study published in JAMA Pediatrics provides the missing evidence that coordinated, community-wide primary prevention efforts can significantly reduce child sexual abuse rates. The counties in the study that received the educational measures saw a 17 percent decrease in substantiated child sexual abuse cases, and a 34 percent drop in unsubstantiated sexual abuse cases, compared to a control group that didn't receive these measures.
"That translates to 110 fewer abused children and substantial public cost savings because of fewer unsubstantiated cases that needed to be investigated," says lead author Jennie Noll, a professor in the Department of Psychology at the University of Rochester and the executive director of the University's Mt. Hope Family Center. The center is one of just three academic institutional partnerships chosen by the National Institutes of Health to serve as a national resource for child maltreatment research and training.
In 2015, Noll and other researchers first devised and then, from 2018 to 2020, field tested education and information strategies designed to prevent child sexual abuse across five counties in Pennsylvania. As a control group, the team tracked another set of five Pennsylvania counties that did not receive the interventions.
What lies at the core of the intervention's success? Education measures that are geared at three distinct groups, according to the findings.
1. Training for elementary school children
Elementary students in all five counties (about 17,000 second graders in total) received the evidence-based Safe Touches program, delivered in a single class period. The training used puppets and age-appropriate scenarios to teach body safety rules, how to identify a safe adult, and how to disclose sexual abuse.
According to Noll, this first component reached the largest target audience-close to 100 percent of second graders in the five studied counties. The school-administered intervention, she says, essentially boils down to teaching children what sexual abuse is, how to spot it, that it's never their fault, that "if something happens to them that feels icky-it likely is icky," that there are safe adults and non-safe adults, and that telling a safe adult is always a good idea.
"It's basically teaching kids that there are safe environments and unsafe environments-and how to know the difference, and how to get help," says Noll.
Noll and other child sexual abuse prevention experts highlight what every elementary-aged child should know about sexual abuse:
- Know what kind of touching is not acceptable-from any adult or child.
- Identify a trusted adult in whom you can confide.
- Don't keep quiet.
- Don't let others (kids or adults) pressure you into anything sexual.
- If somethings feels "icky" to you, it probably is.
- No adult may ask you to keep secrets from your parents/trusted adult.
- Sexual abuse is never your fault.
2. Training for parents
Parents were educated via Smart Parents, Safe and Healthy Kids, a prevention program for those enrolled in parent-training programs that teaches parents healthy sexual development, communication skills regarding sexual topics, and child safety education, such as vetting babysitters and identifying online and offline exploitive situations.
For parents, Noll offers the following guidance:
- Be actively involved in your child's life and encourage talking and sharing. Create opportunities to talk about sexual topics, including sexual abuse. Let children know they won't get in trouble for speaking up.
- Get to know the people in your child's life, especially other adults.
- Choose caregivers carefully: screen caregivers and vet babysitters.
- Know what "grooming behaviors" look like.
- Talk about how digital and social media can lead to exploitation. Learn how to protect kids online.
- Familiarize yourself with the warning signs of child abuse, such as behavioral and emotional changes.
- Teach your child about healthy boundaries and that no one has the right to touch them or make them feel uncomfortable.
- Know how to get help and whom to call if you suspect sexual abuse.
- Knowing how to protect your own child will help you protect others.
Parents can learn more about preventing child sexual abuse on the Mt. Hope Family Center's website.
3. Educating the general public
A county-wide media campaign with billboards, TV and radio spots, social media components, press releases, targeted mailings, and email blasts was created to raise community awareness about sexual abuse and explain where to access evidence-based adult programming (Stewards of Children). This program, offered either as an in-person workshop or an online self-directed course, was designed to increase awareness about the definition, scope, causes, and consequences of child sexual abuse, and to explain how to make a report to authorities when warranted.
According to Noll, the first component, educating elementary school kids, reached the largest target audience-close to 100 percent of second graders in the five studied counties. The school-administered intervention, she says, essentially boils down to teaching children what sexual abuse is, how to spot it, that it's never their fault, that "if something happens to them that feels icky-it likely is icky," that there are safe adults and non-safe adults, and that telling a safe adult is always a good idea.
The following video was used as part of the study to raise the general public's awareness of sexual child abuse.
A 'systemic, scientific, and rigorous' intervention
When it comes to research into finding strategies to prevent child sexual abuse "the pot of gold at the end of the rainbow is to be able to show that your intervention changes rates at the population level, because that's what we're after," says Noll. "We're after saving kids from such an egregious experience.
"To be able to show that this particular intervention did exactly that-in a systematic, scientific, and rigorous way, with this kind of effect-that is huge," she adds.
What's next? Hopefully being able to roll out a similar program in the Greater Rochester area at the county level, and then scale it up across New York state, says Noll.
Besides Noll, fellow Mt. Hope researcher Justin Russotti was part of the research team, which also included researchers from Pennsylvania State University and New York University. The research was supported by grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
