A CHILD-CENTERED RESPONSE TO SEXUAL ABUSE The Problem Child sexual abuse is much more widespread than the average person imagines. It occurs in every socio-economic group, every walk of life and every neighborhood. While estimates of the occurrence of sexual abuse vary widely, many experts now estimate that the rate among adult females may be as high as 20-25% -- that is one in every four women was sexually abused as a child. For boys, the rate is estimated to be one in seven by age 16. Social research has also determined that among long-term welfare populations and populations of prisons and mental health facilities, the rate is much higher. In Philadelphia, the Department of Human Services documents 140–180 cases of reported sexual abuse a month; the police report an additional number of cases. While some of these cases are not substantiated, many other cases go unreported because of the fears and taboos surrounding sexual abuse. Everyone Must Be Concerned about Child Abuse. Child abuse affects all of us. Abused children come from all racial, ethnic and socioeconomic backgrounds. We read about it in the paper and we see it on television and in the news. We think it couldn’t happen to our own children, to our relatives’ children, to our neighbors’ children. But it does happen to children we know, and the effects can be devastating. Abused children often suffer from emotional, physical, social and academic problems. Without intervention, these children can endure the effects of abuse for the rest of their lives. Sometimes as adults they commit crimes, have difficulty functioning in society or become abusive themselves. Sexually abused children are at risk to engage in sexual activities at an earlier age, and sexually abused girls are at greater risk to become teenage mothers. They are more likely to drop out of school and face reduced job prospects or become dependent on public welfare. Adults who were abused as children, without intervention and treatment, are at greater risk to suffer longterm drug and alcohol problems and depression, or enter into troubled relationships. Not all child sexual abuse victims suffer later life problems. But a child who does not receive adequate help in sexual abuse cases may sometimes suffer a lasting impact and greater later-life problems, as may the community in which he/she lives. With help, families can resolve the problems that led to abuse. With help, victims of abuse can begin to heal, emotionally and physically. With help, the cycle of abuse can be broken. What Happens When a Child Reports Sexual Abuse? Again and again, experience has shown that both the abusive act itself and the disclosure of the abuse can be extremely damaging to both children and their families. Child victims of sexual abuse experience anxiety and fearfulness, difficulty in eating, sleeping, concentrating in school and relating to others. Many children show none of these symptoms before the abuse is disclosed. Then they may experience anger, flashbacks, anxiety, sexualized behavior, early sexual activity, and bouts of delinquency or even mental illness. Families are thrown into turmoil. Parents may sometimes have difficulty believing their child, resisting the potential loss of a breadwinner or companion, or even an older sibling. Children are asked to reveal embarrassing details to many strange and powerful adults, while the alleged offender and other family members may be pressuring them to deny that the abuse occurred. The child may experience tremendous guilt and may feel responsible for destroying the family. Such a crisis can rob a family of its ability to put a stop to the abuse and take away the ability to provide the much-needed emotional, social and financial support to child victims. Families arrive at the Children’s Alliance frightened, distrustful, embarrassed and shocked. Parents also frequently need an appropriate outlet for expressing problems and reactions about the abuse to help them support their children in healing. Sometimes they are abuse survivors themselves, who must now face issues from their own past. Improving The System Designed to Help The Alliance serves children ages 2 to 17 who have told someone that somebody has done something sexual, or "wrong" to them, or has touched them in a way that doesn't feel right. Sometimes a child will tell a parent or relative, sometimes a trusted friend or teacher. Occasionally a young child does not recognize the abuse and a caring adult will identify it through behaviors or other physical characteristics. (See Identifying Abuse.) The children who come to the Alliance are accompanied by family members, a guardian or a foster parent, and this "non-offending caretaker" is offered continued support throughout the investigative process. The Children's Alliance serves the entire City of Philadelphia, and children are referred to the Alliance from the Police or from the Department of Human Services, as well as the state Department of Public Welfare. The Alliance staff also fields calls from the public for information on and help with child sexual abuse, and they provide information to adult survivors of child sexual abuse. All of the services of the Children’s Alliance are provided free of charge, regardless of the amount of service or time spent with a client. In many cases transportation is provided, for both interviews and support group activities. The Alliance serves the full spectrum of the population, and its location in West Philadelphia, easily accessible by public transportation, makes the facility available to everyone. At the Alliance, children and their families are treated with respect and sensitivity. In a child-friendly facility with child-sized furniture and a waiting room full of toys and games, they are constantly supervised by a child care specialist and provided with nutritious snacks while they wait. An entire team of specialists meets with the child and the family, including a police officer, who is experienced in working with "special victims," and an investigator from the Department of Human Services, who assures a safe situation for the child. The Alliance's specialist in child forensic interviewing is a key member of the team and is usually the person who interviews the child. Through the Victim Services Staff, families receive whatever services they need during and following the investigation – crisis counseling, support groups, and assistance in completing crime victim compensation forms as well as referrals for counseling or therapy, legal services, medical care, financial help, and other support services.