Sexual abuse of children under 12 years of age: a review of 511 cases

In a retrospective study of 511 cases of alleged sexual abuse in children 12 years of age and under, data were analyzed with respect to the victim's age, sex, and the type of sexual abuse (intra- or extrafamilial). A total of 85.5% of the victims were female and 14.5% were male with ages ranging from 2 months to 12 years. The mean age of female victims was 6.8 years and that of male victims, 7.4 years. Most victims (68%) presented with histories of single assault by a known perpetrator (78%). Characteristics of abuse were found to be associated with the victim's age, sex, and relationship to the assailant. School-age victims were more likely to be abused by an individual outside the family or by a complete stranger. Older victims were also more likely to be involved in severe forms of sexual abuse (penetration, attempted penetration or oral-genital contact), associated with acts of abduction and with reports to the police. Male victims were more likely to be assaulted by a stranger, outside the home environment, and to suffer a more severe form of sexual abuse than female victims. Finally, extrafamilial sexual abuse was distinguished from intrafamilial sexual abuse insofar as it was more often a single episode, occurring outside the home environment, involving an act of abduction and physical force, and being reported to the police.     

Female child perpetrators: children who molest other children

Little is known about sexual perpetration by females or by young children. This paper describes the sexual perpetration behavior of 13 female child perpetrators between 4 and 13 years of age. These children were treated in a specially designed program for child perpetrators, the Support Program for Abuse-Reactive Kids (SPARK) at Children's Institute International of Los Angeles, California. All of these girls used force or coercion to gain the compliance of the other child or children. Of these child perpetrators, 100% had been previously sexually abused; 31% had been physically abused; 85% were molested by family members; 77% of the girls chose a victim in their family (the other 3 girls had no available family members). The mean age of their first known perpetration was 6 years, 9 months. The average age of their victims was 4 years, 4 months. The average number of victims of these girls was 3.5 with a range of 1 to 15. The girls victimized two times more boys than girls. There was a history of sexual, physical, and substance abuse in the families of these children. Hypotheses regarding the genesis of the sexually abusive behavior in these female child perpetrators are explored.     

Characteristics of a clinical sample of sexually abused children: how boy and girl victims differ

The article describes a clinical sample of 87 boy victims of child sexual abuse and compares them to 226 girl victims. Boys were on average 6.3 years of age at onset of the sexual abuse; girls were 5.5 years. Boys were more likely to be victimized by someone outside the family than girls, but about two-thirds of the boys were abused by someone within the family. Male victims were more often abused by someone who sexually abused other children than were female victims. The majority of perpetrators were men; however girls were more likely than boys to be abused by men, and boys by both men and women. Only a small percentage of the offenders were women acting alone, but boys were more likely to be abused by women than girls. In addition, data on the role relationship between victim and offender and how these relationships differ for boy and girl victims are presented.     

Child homicide and neglect in France: 1991–2008

The aim of this study is to investigate epidemiological characteristics of the victims and the offenders in children homicide cases and to propose preventive measures. We retrospectively investigated homicides and deaths by neglect involving children aged 15 or less, which have been autopsied in the Department of Pathology and Legal Medicine of the Raymond Poincaré Hospital, Garches, France, during the 18-year period from 1991 to 2008. Cases included were analyzed for victims’ age and gender, victim-assailant's relation, death cause and scenery, and offender's motivation. For the purposes of the study, victims were divided into four age groups: new born; infants (1–23 months); young children (2–5 years); and children (6–15 years). During the study period, 70 victims of homicide or fatal neglect were identified, which equates to a child homicide prevalence of 0.56 per 100,000 children per year. Slightly more than half of the victims (51.4%) were less than 1 year old. Neonaticide prevalence was 0.12 per 100,000 births with an equal distribution between genders. Neonates were most likely to be killed by their mothers while fathers were the most frequent assailants in both infants and children groups. Stepparents were involved in only one case. Familicide cases where children and spouses are killed were perpetrated only by fathers. The leading cause of death was blunt trauma (especially head trauma). In the neonaticide group, half of the victims died from passive neglect whereas gunshots were predominant in the children groups.     

Review of 125 children 6 years of age and under who were sexually abused

The authors present a chart review of 125 children, 6 years of age and under, who presented between early 1981 and mid 1983 to an acute care hospital because of sexual abuse. They represented one-third of the cases of alleged sexual abuse between infancy and 18 years of age referred to the hospital's multidisciplinary sexual abuse team. The ratio of females to males was 3.3:1. Sixty percent of the children were victims of intrafamilial abuse. Of the preschoolers, 72.5% were victims of intrafamilial abuse. At school age there was a reversal with 73% of 6 year olds being abused by extrafamilial offenders. The duration of the abusive relationship was greater in intrafamilial abuse. Purposeful disclosures were more frequent overall but were significantly less frequent when the perpetrator was intrafamilial or when the child was a preschooler. Two-thirds of the children had physical and/or behavioral symptoms. Parents of children who had been the victims of intrafamilial abuse were more likely to be separated or divorced. The difficulties in assessing young victims of alleged sexual abuse and the implications of the findings in this review are discussed.     

Fatal child maltreatment: Characteristics of deaths from physical abuse versus neglect

This study examined victim, family, and alleged perpetrator characteristics associated with fatal child maltreatment (FCM) in 685 cases identified by child welfare services in the state of Oklahoma over a 21-year period. Analyses also examined differences in child, family, and alleged perpetrator characteristics of deaths from abuse versus neglect. Case information was drawn from child welfare investigation records for all FCM cases identified by the state Department of Human Services. Fatal neglect accounted for the majority (51%) of deaths. Children were primarily younger than age 5, and parents were most frequently the alleged perpetrators. Moreover, most victims had not been the subject of a child welfare report prior to their death. A greater number of children in the home and previous family involvement with child welfare increased children's likelihood of dying from neglect, rather than physical abuse. In addition, alleged perpetrators of neglect were more likely to be female and biologically related to the victim. These results indicate that there are unique family risk factors for death from neglect (versus physical abuse) that may be important to consider when selecting or developing prevention efforts.     

Victim, perpetrator, family, and incident characteristics of infant and child homicide in the United States Air Force

OBJECTIVE: The present study describes factors related to fatal abuse in three age groups in the United States Air Force (USAF). METHOD: Records from 32 substantiated cases of fatal child abuse in the USAF were independently reviewed for 60 predefined factors. RESULTS: Males were over-represented in young child victims (between 1 year and 4 years of age) and child victims (between 4 years and 15 years of age) but not in infant victims (between 24 hours and 1 year of age). African-American infant victims and perpetrators were over-represented. Younger victims were more likely to have been previously physically abused by the perpetrator. Perpetrators were predominantly male and the biological fathers of the victims. Infant and young child perpetrators reported childhood abuse histories, while child perpetrators reported the highest frequency of mental health contact. Victims' families reported significant life stressors. Families of young child victims were more likely divorced, separated, or single. Incidents with infants and young children tended to occur without witnesses; incidents with child victims tended to have the victim's sibling(s) and/or mother present. Fatal incidents were more frequent on the weekend, in the home, and initiated by some family disturbance. CONCLUSIONS: Differences among groups in factors related to infant and child homicide across age groups may assist in the development of more tailored abuse prevention efforts and may also guide future investigations.     

Child abuse in Hong Kong revisited after 15 years: Characteristics of victims and abusers

The purpose of this paper was to examine the characteristics of the victims and abusers of child abuse cases on the Child Protection Registry in Hong Kong as of March 1995 and to compare findings with a similar community report of child abuse in Hong Kong conducted approximately 15 years earlier. As of March 31, 1995, there were 457 active cases of child abuse or suspected child abuse (44% male and 56% female) on the computerized Child Protection Registry. Fifty percent of the victims were grade school age children between 7–12, and 62.4% suffered physical abuse. The abusers or suspected abusers were 52% male and 48% female with nearly half (49%) in their thirties. The majority of abusers were married/cohabiting (75%) with only a grade school education (60%). As compared to 1979, there was an increase of sexual child abuse cases, female victims of child abuse, and an increase in male abusers or suspected abusers.     

Child perpetrators--children who molest other children: preliminary findings

While the seriousness of sexual abuse by adolescents is finally beginning to receive adequate attention from the professional community, the existence of child perpetrators is largely dismissed and denied. Forty-seven boys between the ages of 4 and 13 are described who have molested children younger than themselves. Coercion was involved in all of the cases included in this study. These children had been treated in a program especially designed for child perpetrators at Children's Institute International in Los Angeles. Prior to their own sexually abusive behaviors, 49% of these boys had been sexually abused and 19% physically abused. The children all knew the people who victimized them. These male child perpetrators all knew the children they molested. In 47% of the cases the sexual abuse was of a sibling. The average number of victims of these children was 2.1 with a range of 1 to 7. The mean age at the time of perpetration was 8 years, 9 months. The mean age of the victims of these children was 6 years, 9 months. There was a history of sexual and physical abuse in the majority of the families of these children, as well as a history of substance abuse. This population is compared to adolescent perpetrators.     

Testifying in criminal court: emotional effects on child sexual assault victims.

Child victims must cope not only with the emotional consequences of criminal acts but also with the potentially traumatizing effects of legal involvement. Dramatic increases in the reporting of child sexual abuse are bringing greater numbers of children into contact with the criminal justice system, raising fears that child victims of sex crimes will be further harmed by the courts. In the present study, the effects of criminal court testimony on child sexual assault victims were examined in a sample of 218 children. From this sample, the behavioral disturbance of a group of "testifiers" was compared to that of a matched control group of "nontestifiers" at three points following testimony: 3 months, 7 months, and after prosecution ended. At 7 months, testifiers evinced greater behavioral disturbance than nontestifiers, especially if the testifiers took the stand multiple times, were deprived of maternal support, and lacked corroboration of their claims. Once prosecution ended, adverse effects of testifying diminished. In courthouse interviews before and after testifying, the main fear expressed by children concerned having to face the defendant. Children who appeared more frightened of the defendant while testifying were less able to answer the prosecutors' questions; and later, after the cases were closed, they were more likely to say that testifying had affected them adversely. The two most pervasive predictors of children's experiences in the courtroom, however, were age and severity of abuse. Despite relevant laws, few innovative techniques were used to help the children testify. The results are discussed in relation to children's ability to cope with stressful situations, the interaction of the legal system with the child/family system, and debates about the need to protect child victims who testify in criminal court.     

The Development of Aggression within Sibling Conflict

Sibling physical aggression and parents' and children's responses to such aggression were observed in 40 families when children were approximately 2% and 4% years of age, and two years later when they were 4% and 6%. Aggression occurred in all families, with first-born siblings being more aggressive than second-borns, and second-born siblings being more likely to cry, especially at the first time period. Parents responded to half of their children's aggression, and were more likely to respond if victims had cried. Only when parents intervened did the conflict resolution indicate to the children that physical aggression was not acceptable. Most responses by both parents and child victims were simple commands to stop aggression, and discussion of issues that gave rise to the aggression. Less frequent parent and child responses, such as physical reactions or approval of aggression by parents, and discussions of feelings or rules, or crying by first-born children were related to only the aggression of second-born siblings at Time 1. Furthermore, the only variables that predicted aggression at Time 2 were the levels of aggression that the children exhibited at Time 1, with relatively aggressive first-born children and relatively unaggressive second-born children predicting higher levels of sibling aggression two years later. Results were discussed in terms of family influences in the development of relatively aggressive or unaggressive sibling relationships over time.     

‘Rape’ in children

‘Rape’ as a sexual offence has been existing since time immemorial. In a country like India with her conservative and traditional society, sex is not discussed freely and a sexual offence particularly in childhood is hushed up, for fear of the victimised girl's future. Here an attempt is made to study the relavent factors responsible for ‘rape’ in children. These individual cases were followed up, rescued and rehabilitated whenever possible. This paper deals with a prospective study of 130 cases, between the ages of 6 months to 18 years from Bombay, over a period of 15 months. Over 77.68% oases were more than 4 years of age and 6.15% were between the ages of 6 months and 6 years. Shockingly, 2 young infants were of 6 months of age. Majority of these girls belonged to various slums of Bombay. 34.5% of girls were illiterate, and 79.23% had some knowledge about sex. Surprisingly 36.16% were willing victims and the criteria for including these cases under ‘rape’ was their under age i.e. less than 18 years. Of these 130 victims, 23 conceived, of which 6 delivered after full term. The remaining 17 cases were medically terminated. Of the accused, neighbours were responsible in 51.53% of cases, the remaining being contributed by employer, relative, friend and known hooligans from the same area. Some of these girls were rehabilitated and some are still in the remand home. Few girls, though minor, were married to the accused and were still keen on accepting them as their husbands against the wish of their parents.     

Sexual abuse of children in Denver, 1979: Reviewed with implications for pediatric intervention and possible prevention

287 children involved in sexual abuse are reviewed. All were reported in Denver, Colorado, U.S.A., in 1979. Specific attention is given to the origin of the report of cases later determined to be unfounded. Sibling sexual involvement is examined, particularly with reference to the age differential. Perpetrators are categorized as fathers, stepfathers, mother's “boyfriend,” relatives or family friends. These in turn are related to the ages of the children involved. Attention is given to the frequency with which the victimized child had reported the incident(s) months to years before it was reported to an agency. In 50% of the cases the victimized children are under 12 years of age, and in 15% of the cases they are under 6 years of age. Suggestions are made regarding detection and preventive measures, particularly in the history-taking phase of the pediatrician-patient relationship and in vaginal physical findings.     

Childhood abuse and neglect and adult intimate relationships: a prospective study

OBJECTIVE: The present study extends prior research on childhood maltreatment and social functioning by examining the impact of early childhood physical abuse, sexual abuse, and neglect on rates of involvement in adult intimate relationships and relationship functioning. METHOD: Substantiated cases of child abuse and neglect from 1967 to 1971 were matched on gender, age, race, and approximate family class with non-abused and non-neglected children and followed prospectively into adulthood. Between 1989 and 1995, 1,196 participants (676 abused and neglected and 520 controls) were administered a 2-hour in-person interview, including a psychiatric assessment and a variety of standardized rating scales. RESULTS: Male and female abuse and neglect victims reported higher rates of cohabitation, walking out, and divorce than controls. Abused and neglected females were also less likely than female controls to have positive perceptions of current romantic partners and to be sexually faithful. CONCLUSIONS: Although previous research on childhood maltreatment and adult intimate relationships has emphasized outcomes for female victims of childhood sexual abuse, present findings suggest that other forms of early maltreatment (physical abuse and neglect) also have a negative effect on both males' and females' ability to establish and maintain healthy intimate relationships in adulthood.     

The Development of Aggression within Sibling Conflict

Sibling physical aggression and parents' and children's responses to such aggression were observed in 40 families when children were approximately 2% and 4% years of age, and two years later when they were 4% and 6%. Aggression occurred in all families, with first-born siblings being more aggressive than second-borns, and second-born siblings being more likely to cry, especially at the first time period. Parents responded to half of their children's aggression, and were more likely to respond if victims had cried. Only when parents intervened did the conflict resolution indicate to the children that physical aggression was not acceptable. Most responses by both parents and child victims were simple commands to stop aggression, and discussion of issues that gave rise to the aggression. Less frequent parent and child responses, such as physical reactions or approval of aggression by parents, and discussions of feelings or rules, or crying by first-born children were related to only the aggression of second-born siblings at Time 1. Furthermore, the only variables that predicted aggression at Time 2 were the levels of aggression that the children exhibited at Time 1, with relatively aggressive first-born children and relatively unaggressive second-born children predicting higher levels of sibling aggression two years later. Results were discussed in terms of family influences in the development of relatively aggressive or unaggressive sibling relationships over time.     

Reaction to videocolposcopy in the assessment of child sexual abuse.

OBJECTIVE: The purpose of this study was to clinically assess children's reactions to videocolposcopy with real-time observation of magnified anogenital images (VCO), and to evaluate whether these reactions are affected by patient or other characteristics such as response to preparation, disclosure of child sexual abuse (CSA), or examination findings. METHOD: Consecutive cases of children ages less than 18 years referred to a children's hospital clinic for nonemergent evaluation of suspected CSA during 1997 through 1999 were studied. We noted the child's response with clinical observation before and after videocolposcopy, and used the Genital Examination Distress Scale (GEDS) after evaluation. We compared these responses to patient gender, age, ethnicity, pubertal status, disclosure of child sexual abuse (CSA), and physical examination findings using univariate and regression analyses. RESULTS: Two hundred twenty-seven children (mean age 7.2 years, range 0-17) underwent videocolposcopy, of whom 55.1% disclosed sexual abuse and 17.2% had a positive examination. More than 80% were female, prepubertal, and non-Hispanic White. Most (85%) watched their examination on the monitor and were either cooperative or enthusiastic before and after videocolposcopy. Fewer very young children (ages 0-3 years) or female adolescents (13-17 years) watched the monitor. Summed GEDS scores were strongly correlated with observed responses after the procedure (p = .01), and children with CSA disclosure were three times more likely to watch the monitor and five times more likely than those without disclosure to have improved comfort. Other patient characteristics were not significantly associated with patient reaction to VCO. CONCLUSIONS: Most children are interested in watching their anogenital examination using magnified real-time images obtained during videocolposcopy and tolerate the procedure well. The GEDS is highly correlated with subjective clinical observation. While some children may particularly benefit from participating in their examination by using VCO, long-term effects of the evaluation and any relationship of a child's reaction to videocolposcopy with their history of sexual victimization remain to be established.     

Sexual interactions among siblings and cousins: experimentation or exploitation?

Incest by cousins has not been well documented compared with sibling incest. The purpose of this study was to describe the features of incest by cousins and siblings presenting to a sexual assault center and to differentiate cases of abusive behavior from normal sexual exploration. Four criteria were considered indicative of abusive behavior: (1) age difference of greater than or equal to 5 years between victim and perpetrator; (2) use of force, threat, or authority by abuser; (3) attempted penile penetration; and (4) documented injury in victim. Of 831 sexually abused children less than 14 years of age evaluated for sexual assault complaints, 49 cases of cousin incest (5.9%) and 35 cases of sibling incest (4.2%) were identified. A total of 54 male cousins abused 8 boys and 41 girls; brothers abused 3 boys and 32 girls. The victims' median age was 5 years for cousins and 7 years for siblings. The perpetrators' mean age was 16.2 years for cousins and 15.5 years for siblings, with only 16 (19%) of all perpetrators being greater than 16 years old. Of the perpetrators, 66 (79%) were greater than or equal to 5 years older than their victims. All 18 victims with age differences of less than 5 years met one or more of the other abusive criteria. A similar pattern of adolescent perpetrators having abusive sexual contact with young children was demonstrated by analysis of cousin incest and sibling incest in this study. Appropriate case management requires understanding of normal sexual experimentation and recognition of the abusive nature of these cases.     

Forensic medical results and law enforcement actions following sexual assault: A comparison of child,adolescent and adult cases

BackgroundIn sexual assault cases, little research has examined differences in forensic medical findings and law enforcement response by victim age across the entire age range.ObjectiveThis study addressed this gap by comparing four victim age groups: adults, adolescents over the age of consent, adolescents under the age of consent, and children under 12.Participants and settingCases were randomly sampled from a statewide database of medical reports on sexual assault examinations conducted in hospital emergency departments, including only cases reported to law enforcement (N = 563).MethodsData were combined from a medical report database, from coding of medical documentation and crime laboratory reports, and from case data provided by law enforcement.ResultsRates for both younger and older adolescent victims and adult victims were comparable, with no statistically significant differences on most variables: penetration, perpetrator use of force, non-genital and genital injuries, presence of biological evidence, generating assailant DNA profiles, DNA match to suspect, hits in the FBI’s DNA database, and law enforcement unfounding (i.e., determining allegations to be false or baseless). Child victims were significantly less likely to have a non-genital injury, and their cases were significantly more likely to be founded by law enforcement. Arrests were significantly more likely when victims were under the age of consent.ConclusionsDespite significant differences by victim age, similarity between adolescent and adult cases was substantial. Both younger and older adolescents may be at higher risk of physical violence during sexual assault than previously recognized, and need greater attention in response systems.