Übersichtsarbeiten / Review Articles. Medizinische Versorgung von Minderjährigen nach sexualisierter Gewalt unter besonderer Berücksichtigung von technologiegestützter sexualisierter Gewalt / Medical Care for Minors After Sexual Violence, with Special Consideration of Technology-Assisted Sexual Violence

Online child sexual abuse and exploitation have become a global issue affecting the health and well-being of children and adolescents. Unlike traditional forms of sexual abuse and exploitation, online sexual abuse presents unique challenges due to the complexity of the situations involved. Parents play a crucial role as the first line of defense in preventing these incidents, yet the barriers they encounter have not been thoroughly explored. The objective of the systematic review is to identify the challenges parents face in preventing online child sexual abuse, to explore the factors that contribute to those challenges, and to highlight gaps in knowledge and practice regarding how to best support them. A comprehensive search will be conducted in MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), HealthSTAR (Ovid), Sociological Abstracts (ProQuest), CINAHL (EBSCOhost), Scopus (Elsevier), and the Cochrane Library (Wiley). The strategy will be developed with a research librarian. Regarding inclusion criteria, this review will include primary research studies (qualitative, quantitative, or mixed methods) that examine the perspectives of parents or primary caregivers of children and adolescents on online child sexual exploitation and abuse (OCSEA) prevention. Studies must focus on parental attitudes, fears, perceptions, or challenges related to OCSEA. Only studies published in English from 2018 onward will be considered. Studies that do not report on parental perspectives will be excluded. Two reviewers will independently screen studies and extract data, with conflicts resolved by a third reviewer. Findings will be narratively synthesized, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework. The search strategy has been developed in collaboration with a health sciences librarian and followed PRISMA-Search guidelines. Database searches, screening, and analysis are planned to commence in August, 2025. The findings of the review are anticipated to be ready by Febuary 2026 and will be presented following the PRISMA reporting standards. This protocol aims to structure a comprehensive and transparent process for a systematic review, which is expected to contribute to a better understanding of parental challenges in preventing OCSEA and provide insights into the types of supportive resources they need to combat OCSEA. This information will contribute to the development of comprehensive strategies that equip parents with the knowledge and tools necessary to effectively safeguard their children in the digital landscape.

The increase in online child sexual solicitation and abuse: Indicator 16.2.3 of the UN Sustainable Development Goals (SDG) documents a hidden and growing pandemic. Population-based surveys fail to capture the full picture.

The advent of technology has brought about unprecedented opportunities for communication and access to information which has helped in professional skills development, fostering learning, research and creativity. It has also created an avenue for criminals to exploit the ‘vulnerable’ in the society, particularly the children; thus, making the cyber space unconducive for them. This paper examines the legal protection of children against online sexual exploitation and abuse in Nigeria. It identifies the various types of online child sexual abuse, examines the legal framework for the protection of children against online sexual abuse, pinpoints the challenges associated with the legal framework and proffers durable solutions that will help tackle the exponential growth in online child sexual abuse in Nigeria. This paper adopts a mixed method research design and finds that there is significant increase in online child sexual abuse in Nigeria in spite of the laws and institutions in place to address this problem. Additionally, it is revealed that the legal framework for the protection of children against online child sexual abuse in Nigeria is fraught with deficiencies. The paper concludes that Nigeria owes the obligation to protect its children from online child sexual abuse and needs to take proactive steps to ensure this. The paper recommends that measures be taken to ensure that perpetrators of the heinous crime of online child sexual abuse are brought to book to serve as deterrents to others in the society.

Online Child sexual abuse (OCSA) is a major menace in the digitalized world. Every year, more than a billion children between the ages of 2–17 years are sexually abused. Despite the harsh reality of most incidents, they remain unreported. Not only that but activities on dark web platforms go unmoderated and it becomes very difficult and complex to trace the origin of abuse and exploitation of children. In cases of online abuse, the sources through which detection can be done are evaded. Although several government and non-government initiatives have been implemented worldwide to curb this social menace, their effectiveness and accuracy remain questionable. AI-based services if regulated and executed cautiously can be effective in diagnosing and preventing sexual abuse in children on virtual platforms. Existing literature implies that AI can be a potent armor to detect and predict child sexual abuse online. The ability of artificial intelligence to predict and stop sexual abuse in children is very promising. AI-based technologies that can aid in the identification and prevention of violence against children include mobile computing, the Internet of Things, chatbots, machine learning, pattern recognition, and cloud computing. Therefore, it is essential to examine the existing literature pertaining to the research area, to highlight the emergent need for more applied and evidence-based research in the area. Thus, this study aimed to identify interventions driven by artificial intelligence in preventing online child sexual abuse, its limitations, and future implications. We conducted an extensive systematic literature review to understand the trends and efficacy of AI-based services in preventing and tracing child sexual abuse. The selection of research studies was performed in accordance with the PRISMA standards. Relevant studies were extracted from databases such as ScienceDirect, Springer, IEEE, and MDPI. Articles were selected and screened based on inclusion and exclusion criteria. This study identified 35 papers that were strictly limited to the prospect of AI interventions for online child sexual abuse. The review helped in deducing 3 major themes, namely, current trends in the field of AI for preventing online child sexual abuse, algorithm evaluation (advantages and disadvantages of AI tools) in preventing OCSA, and recommendation for technique advancements of AI tools. However, there is scarce evidence that proves AI interventions are effective in solving online child sexual abuse issues, as shown in the paper, thereby encouraging more extant research to be conducted in the area.

Online child sexual abuse (OCSA) presents unique and evolving challenges for young people and those supporting them. Although the long-term psychological impacts of OCSA are increasingly recognized, there remains limited guidance for practitioners on how best to assess and respond effectively to its specific features. This study aimed to explore practitioners’ and researchers’ perspectives on current gaps in service provision, assessment practices, and interventions for young people affected by OCSA. An open-ended online questionnaire was emailed to UK-based practitioners (n = 10) and researchers with published expertise in OCSA (n = 36), of whom seven also had clinical experience (i.e., clinical psychologists, psychiatrists). A total of 46 responses were analyzed using thematic content analysis. Most participants defined OCSA broadly as ‘any sexually abusive act by an adult or peer with a digital or online component’. Both practitioners and researchers emphasized the need for responses that include psychoeducation, trauma-informed care, and safeguarding measures. Participants also highlighted challenges unique to OCSA, such as the permanence of abuse imagery and the perceived agency of victims in online interactions, factors which were seen to require specialized responses. Despite these needs, both groups highlighted gaps in specialist support, practitioner training, and co-ordinated multi-agency responses. The findings highlight the urgent need for further research to develop consensus-based, evidence-informed approaches to OCSA-specific assessment and intervention, ensuring services are equipped to meet the needs of this vulnerable population.

A systematic review and meta-analysis of medical and psychosocial care procedures for children and adolescents after (online) sexual abuse.

IntroductionThis qualitative study explored healthcare professionals' current understanding of, and clinical practices related to, Online Child Sexual Abuse (OCSA).MethodsData were collected across two UK sites (Manchester and Edinburgh). Interviews and one focus group were held with 25 practitioners working in services offering clinical support to young people who have experienced OCSA. Thematic analysis of the data identified three overarching themes and 10 subthemes related to the research questions: (1) the breadth of the problem; (2) working with OCSA; and (3) the emotionally charged nature of OCSA.ResultsWhile practitioners recognized OCSA as problematic, they differed in how they conceptualized it. There was a heightened awareness of the role that sexual images played in OCSA and concerns about first-person-produced imagery by Children and Young People (CYP). Practitioners described a generational gap related to their technology use and that of the young people they worked with. Practitioners also described a paucity of referral pathways and concerns that there was no training available to them. Organizational barriers meant that questions about technology use were not routinely included in assessments and often there was reliance on young people making disclosures.DiscussionNovel findings from this study were the psychological impacts that such cases had on practitioners, which may indicate a need for organizational support for staff as well as further training needs. Existing frameworks that help conceptualize and assess the role of technology as part of the ecology of the child may have great utility for practitioners.

Sexual abuse is increasingly facilitated by technology, but the prevalence and dynamics of such offenses have not been well delineated, making it difficult to design prevention strategies. To examine the frequency and characteristics of online and technology-facilitated sexual abuse against children and youth. In this nationally representative online survey study performed from November 19 to December 29, 2021, young adults aged 18 to 28 years were asked retrospectively about their childhood (<18 years) experiences of online and technology-facilitated abuse. The 2639 participants were sampled from an online panel. Participants were asked questions about 11 different kinds of online and technology-facilitated sexual abuse with follow-up questions about their dynamics and offenders. Prevalence rates were calculated for several cross-cutting concepts (online child sexual abuse, image-based sexual abuse, self-produced child sexual abuse images, nonconsensual sexting, online grooming by adults, revenge pornography, sextortion, and online commercial sexual exploitation). Survey weights were applied to obtain population prevalence estimates. A total of 2639 individuals (48.5% male, 49.8% female, and 1.8% other gender; 23.7% Hispanic, 12.6% non-Hispanic Black, 53.9% non-Hispanic White, 4.8% other race, and 5.0% ≥2 races) were surveyed. Childhood (before 18 years of age) prevalence rates were as follows: online child sexual abuse, 15.6% (SE, 1.0%); image-based sexual abuse, 11.0% (SE, 0.9%); self-produced child sexual abuse images, 7.2% (SE, 0.7%); nonconsensual sexting, 7.2% (SE, 0.7%); online grooming by adults, 5.4% (SE, 0.5%); revenge pornography, 3.1% (SE, 0.5%); sextortion, 3.5% (SE, 0.6%); and online commercial sexual exploitation, 1.7% (SE, 0.3%). The prime age of vulnerability across all categories was 13 to 17 years. Perpetrators in most categories were predominantly dating partners, friends, and acquaintances, not online strangers. The results of this national survey study suggest that a considerable portion of youth have experienced online child sexual abuse. Professionals planning prevention and intervention strategies for online sexual abuse should understand that dynamics include diverse episodes that are often extensions of dating abuse, sexual bullying, and sexual harassment, not only events perpetrated by adult internet predators.

IntroductionEven though Online Child Sexual Abuse (OCSA) has become a recognized phenomenon, there are still extensive gaps in knowledge and understanding of the implications of OCSA. A considerable number of children and adolescents (CAA) are affected daily by OCSA, and it has emerged as a growing threat to their physiological and psychological development.MethodThis study aimed to explore the experiences of the professionals working with OCSA in various agencies and roles, inclusive of their perception of how OCSA and their work impacts: Children and Adolescents, Caregivers, and Interagency Cooperation. Qualitative design with an inductive approach were used interviewing 43 Swedish professionals, including: forensic child interviewers, social workers, therapists within child psychiatry, and medical professionals. All had extensive, experience of working with children and adolescent victims of OCSA. The collected material was analyzed using Reflexive Thematic Analysis.ResultsThe analysis of the collected material resulted in three main themes and 12 subthemes related to the research questions. The three main themes are: (1) Victim Impact – Feeling Complicit; (2) Caregiver Impact – Sense of Inadequacy; (3) System Impact – System Error. Those interviewed voiced special circumstances highlighting the need for a tailored approach and organizational policies supporting interagency cooperation.DiscussionFindings bring to light the challenges professionals face managing the lack of policies and national guidelines affecting the support they can provide OSCA victims and caregivers. Participants in the study agree, OCSA victims and their caregivers should be privy to the same protocols applying to children subjected to other forms of crimes. These protocols include incorporating questions addressing potential OCSA, along with routine questions utilized as part of the assessment process in treatment/social service settings.

&lt;p&gt;This report presents the findings of a gap analysis of specialized services for victims and survivors of online child sexual exploitation and abuse (CSEA) in Canada. The analysis took place between March and July 2019 and was conducted to identify existing specialized support services for victims of CSEA, their families, and adult survivors of CSEA, as well as gaps in the availability of such services, any promising practices in Canada or elsewhere, and challenges to providing specialized supports for these victims and their families.&lt;/p&gt; &lt;p&gt;Very few support services and treatment practices are specifically related to online CSEA in Canada. Overall, the most promising practices currently offered in Canada are those that address child victims (children and youth up to the age of 18 years) of crime more generally, especially the services provided by the Child and Youth Advocacy Centre network that is expanding across the country, as well as those provided by the longstanding network of service providers that responds to victims of sexual assault. These networks have great potential to provide specialized supports for online CSEA victims and their families. However, they currently lack expertise in online CSEA, and need evidence-based guidance on how to best support these victims; methods demonstrated to be effective for sexual crime victims in general might not be effective or may even be harmful to victims of online crimes.&lt;/p&gt; &lt;p&gt;What is needed is investment in creating the evidence base – that is, data evaluating and verifying the appropriateness and effectiveness of specific support services and approaches to treatment for online CSEA – that would then inform best practices. These best practices could then be conveyed in training for service providers, and integrated into supervision and mentorship structures within organizations. Many of the individuals interviewed for this report are experts in the field of child sexual abuse. Other participants are well versed in providing referrals for clients needing specialized supports for child victims of sexual abuse. However, they did not believe that they had expertise specific to working with victims of online CSEA, and generally did not know of specialized services to which they could refer victims. The extensive and well-established networks of experts in the fields of sexual abuse and child sexual abuse should be mobilized to participate in, and contribute to, research in this area in order to develop evidence-based effective responses for victims of online CSEA.&lt;/p&gt;

&lt;p&gt;This report presents the findings of a gap analysis of specialized services for victims and survivors of online child sexual exploitation and abuse (CSEA) in Canada. The analysis took place between March and July 2019 and was conducted to identify existing specialized support services for victims of CSEA, their families, and adult survivors of CSEA, as well as gaps in the availability of such services, any promising practices in Canada or elsewhere, and challenges to providing specialized supports for these victims and their families.&lt;/p&gt; &lt;p&gt;Very few support services and treatment practices are specifically related to online CSEA in Canada. Overall, the most promising practices currently offered in Canada are those that address child victims (children and youth up to the age of 18 years) of crime more generally, especially the services provided by the Child and Youth Advocacy Centre network that is expanding across the country, as well as those provided by the longstanding network of service providers that responds to victims of sexual assault. These networks have great potential to provide specialized supports for online CSEA victims and their families. However, they currently lack expertise in online CSEA, and need evidence-based guidance on how to best support these victims; methods demonstrated to be effective for sexual crime victims in general might not be effective or may even be harmful to victims of online crimes.&lt;/p&gt; &lt;p&gt;What is needed is investment in creating the evidence base – that is, data evaluating and verifying the appropriateness and effectiveness of specific support services and approaches to treatment for online CSEA – that would then inform best practices. These best practices could then be conveyed in training for service providers, and integrated into supervision and mentorship structures within organizations. Many of the individuals interviewed for this report are experts in the field of child sexual abuse. Other participants are well versed in providing referrals for clients needing specialized supports for child victims of sexual abuse. However, they did not believe that they had expertise specific to working with victims of online CSEA, and generally did not know of specialized services to which they could refer victims. The extensive and well-established networks of experts in the fields of sexual abuse and child sexual abuse should be mobilized to participate in, and contribute to, research in this area in order to develop evidence-based effective responses for victims of online CSEA.&lt;/p&gt;

"She has a history of making things up": Examining the disclosure and reporting of online sexual abuse among children with disabilities.

Cases of online child sexual abuse (OCSA) are increasing dramatically in number, but research on this relatively new type of crime and its psychological consequences is limited, leading to major challenges for the judiciary. The present mixed methods study investigated 98 legal cases of OCSA (children aged 7–17 years, M = 12.3, SD = 1.92) in Swedish District Courts to see if and how children's experiences and psychological health were described in the written verdicts. The results revealed that the children's psychological health was mentioned in less than half (48.0%) of the cases. Thematic analyses identified several potential vulnerability factors (e.g. poor psychological health, low self-esteem, loneliness) and several potential psychological consequences (e.g. psychological suffering, self-harming and/or suicidal behavior, internalized self-loathing, impaired relationships) among the children, all of which were similar to what research has shown among victims of offline CSA. The sexual abuse situation was often perceived as threatening, and many children felt that they had no other choice than to comply. In addition, the sexually abusive act was depicted as distressing and sometimes painful. In light of these findings, we suggest that OCSA should not be viewed as essentially different or less severe than offline CSA.

As technology has become increasingly integrated into the everyday lives of young people and social interactions have moved online, so too have the opportunities for child sexual abuse. However, the risk factors for online sexual abuse, and their similarities or differences with those of offline sexual abuse have not been clarified, making it difficult to design prevention strategies. Using a nationally representative online survey panel of young adults ages 18 to 28, the current study sought to identify risk factors for online childhood sexual abuse and compare their relevance and strength in predicting offline sexual abuse. The 2,639 participants, ages 18 to 28, were sampled from the Ipsos KnowledgePanel and were asked questions about 11 different kinds of technology-facilitated online sexual abuse that occurred in childhood, follow-up questions about their dynamics and offenders, and a variety of potential risk factors. Results indicated that: (1) being cisgender female, nonheterosexual, and having parents with less than a high school education emerged as important demographic predictors of online child sexual abuse (OCSA); and (2) early offline sexual abuse was the strongest predictor of OCSA, when considering both its direct and indirect effects through online risky behavior. Findings suggest that prevention programs directed at reducing risk of sexual abuse, in general, are likely to be effective against online sexual abuse, provided they also incorporate efforts to educate youth on the need to avoid risky online behaviors.

The phenomenon of violence against a child is an act that has a very bad impact on the child and on the survival of a country. The development of child violence in the eastern Indonesian region suggests that this issue needs to be addressed seriously by various parties.The aim of this study is to analyze and describe the partnership between UNICEF and the East Indonesian Regional Knowledge Exchange (BAKTI) to address the problem of violence against children. UNICEF, as an organization focused on saving children's lives, is present to address the problem of violence against children in the East Indonesian Region.The government, as a national actor, has made various efforts to solve this problem, including working with UNICEF. The cooperation between the East Indonesian Knowledge Exchange (BaKTI) and UNICEF is through the implementation of online child sexual exploitation and abuse policies and programmes. The OCSE programme is a situation involving digital, internet and communication technology at a certain point during the continuum of abuse or exploitation. Online Child Sexual Exploitation and Abuse (OCSEA) includes sexual exploitation and abuse of children online. A growing range of practices include: child sexual abuse material (CSAM), child care online for sexual purposes, live streaming of child sexual harassment and other related behaviours such as sexual blackmail, sharing of self-made sexual content without consent involving children, and unwanted exposure of sexual content. Fenomena kasus kekerasan yang terjadi pada anak merupakan Tindakan yang memberikan suatu dampak yang sangat buruk bagi anak tersebut dan keberlangsungan suatu negara. Perkembangan kekerasan anak di Kawasan Timur Indonesia menunjukkan bahwa masalah ini harus mendapatkan penanganan serius dari berbagai pihak.Tujuan dari penelitian ini yaitu menganalisis serta mendeskripsikan kemitraan antara UNICEF dengan Bursa Pengetahuan Kawasan Timur Indonesia (BaKTI) untuk mengatasi masalah kekerasan terhadap anak. Penelitian ini menggunakan jenis kualitatif. UNICEF sebagai organisasi yang memiliki fokus untuk menyelamatkan kehidupan anak-anak hadir untuk mengatasi permasalahan kekerasan terhadap anak di Kawasan Timur Indonesia.Pemerintah sebagai aktor negara melakukan berbagai upaya untuk menyelesaikan masalah ini, termasuk menjalin kerja sama dengan UNICEF. Kerja sama yang terjalin antara Bursa Pengetahuan Kawasan Timur Indonesia (BaKTI) dan UNICEF adalah melalui implementasi kebijakan dan program Online Child Sexual Exploitation and Abuse. Program OCSE merupakan situasi yang melibatkan digital, internet dan teknologi komunikasi pada titik tertentu selama kontinum penyalahgunaan atau eksploitasi. OCSEA bisa terjadi sepenuhnya secara online atau melalui gabungan interaksi online dan tatap muka antara pelaku dan anak-anak. Online Child Sexual Exploitation and Abuse (OCSEA) termasuk eksploitasi dan pelecehan seksual terhadap anak secara online serangkaian praktik yang terus berkembang termasuk: materi pelecehan seksual terhadap anak (CSAM), perawatan anak secara online untuk tujuan seksual, streaming langsung pelecehan seksual terhadap anak-anak dan perilaku terkait lainnya seperti seksual pemerasan, pembagian konten seksual yang dibuat sendiri tanpa persetujuan yang melibatkan anak-anak, dan hal-hal yang tidak diinginkan paparan konten seksual.