School-based Child Sexual Abuse Prevention Research Articles

Randomized controlled trial of the Child Protection Unit: Grade and gender as moderators of CSA prevention concepts in elementary students

BackgroundDespite the importance of child sexual abuse (CSA) prevention, there are few recent randomized controlled trials of school-based CSA prevention programs. Objectives(1) To evaluate the effects of the Second Step Child Protection Unit (CPU) on students’ CSA prevention concept knowledge, ability to recognize, report, and refuse unsafe touches, and perceptions of teacher-student relations and (2) investigate the moderating role of age and gender on program effectiveness. Participants and settingEight elementary schools in a large suburban school district in the northeast United States were randomly assigned to the intervention or control condition, with analyses conducted on a total of 2172 students. MethodsStudents in intervention schools received the 6-week CPU and those in the control schools were exposed to business as usual. Students were administered assessments at baseline and then at post-test. ResultsUnivariate Analyses of Covariance revealed that students in the intervention schools had significantly higher scores on all outcomes than students in the control schools at post-test, even after controlling for baseline scores. Children in younger grades made greater gains from the program, and girls scored higher than boys in CSA knowledge and ability to recognize, refuse, and report unsafe touches, but both boys and girls made significant gains. ConclusionsResults support the importance of beginning early with school-based CSA prevention efforts. Although boys are still at a relative disadvantage in terms of their knowledge and ability in this area, they are able to make gains at the same rate as girls.

"I have the right to feel safe": Evaluation of a school-based child sexual abuse prevention program in Ecuador.

Child sexual abuse (CSA) is a complex public health problem that has lifelong implications for children's wellbeing. Interventions may provide children strategies to protect themselves against CSA, but few have been studied in Latin America. Evaluate the immediate and medium-term impact of a 10-week educational program on children's knowledge of CSA self-protection strategies in Ecuador. Children aged 7-12 years from six public elementary schools in Ecuador were cluster-randomized to either receive the intervention between October and November 2016 (Group 1, k = 4) or between March and April 2017 (Group 2, k = 2). To assess CSA knowledge, a random sample of students completed a questionnaire at three time points: 1) initial: before any group received the intervention, 2) intermediate: immediately after Group 1 completed the program but before Group 2 started it, and 3) final: after Group 2 completed the program. We evaluated changes in scores using mixed linear regression models with school as a clustering variable and adjusted degrees of freedom (df = 4). Pre-post effect estimates at program completion adjusted for age, sex and clustering by school were 6.5% (95% CI: 2.9, 10.0) and 6.8% (95% CI 3.0, 10.7) for Groups 1 and 2, respectively. Scores did not change among children who had not yet received the intervention at intermediate evaluation (0.94%, 95%CI: -6.0, 7.9). Children in Group 1 maintained the scores six months after the program ended. The self-protection program increased and maintained CSA knowledge six months after the intervention finished.

Evaluation of a sexual abuse prevention education program for school-age children in China: a comparison of teachers and parents as instructors

The aim of this present study was to evaluate the effectiveness of a child sexual abuse (CSA) prevention curriculum toward children and to compare the knowledge gains between children who were taught by teachers and their parents. Four hundred and eighty-four school-age children recruited from one primary school in Beijing, China, were randomly assigned to a CSA prevention program administered by teachers or their parents or to a wait-list control group. The findings reveal that children in the teacher education group demonstrated the highest level of CSA prevention knowledge and skills, followed by the parent education group, while children in the control group showed the least improvements. The knowledge and skills gains were retained at a 12-week follow-up. The present study shows that Chinese school-age children can benefit from CSA prevention program with increased knowledge and skills of personal safety. School-based CSA prevention education should be improved and implemented in other regions of China.

Fidelity in school-based child sexual abuse prevention programs: A systematic review

The aim of this study was to systematically review and evaluate the quality of the school-based child sexual abuse prevention education research in terms of implementation fidelity. A comprehensive literature search in PsycINFO, Medline, Education Resource Information Centre (ERIC) and the Cochrane Central Register of Controlled Trials was conducted. Articles included peer-reviewed, primary research studies related to the delivery of child sexual abuse prevention education programs within school settings published since 1996. In total, 3993 articles were identified and screened by two raters. Of those, 17 articles met the inclusion criteria. Implementation fidelity quality was assessed across the domains of: Intervention Design, Training Providers, Intervention Delivery, Intervention Receipt and Enactment of Skills, using the National Institute of Health Behavioral Change Consortium (NIHBCC) Fidelity Checklist. No study was identified as achieving high fidelity. Five studies (29%) reported including measures or processes to monitor implementation fidelity. There is an opportunity to improve the reporting of implementation fidelity related information within the school-based child sexual abuse prevention literature. This will allow more meaningful interpretations of treatment effects and increase confidence that changes attributed to the intervention are due to the intervention itself. Recommendations for such improvements are provided.

Knowledge Gains Following a Child Sexual Abuse Prevention Program Among Urban Students: A Cluster-Randomized Evaluation.

We evaluated a school-based child sexual abuse (CSA) prevention program, Safe Touches, in a low-socioeconomic status, racially diverse sample. Participants were 492 second- and third-grade students at 6 public elementary schools in New York City. The study period spanned fall 2012 through summer 2014. We cluster-randomized classrooms to the Safe Touches intervention or control groups and assessed outcomes with the Children's Knowledge of Abuse Questionnaire. Hierarchical models tested change in children's knowledge of inappropriate and appropriate touch. The intervention group showed significantly greater improvement than the control group on knowledge of inappropriate touch. Children in second grade and children in schools with a greater proportion of students in general (vs special) education showed greater gains than other participants in knowledge of inappropriate touch. We observed no significant change in knowledge of appropriate touch among control or intervention groups. Young children benefited from a school-based, 1-time CSA prevention program. Future research should explore the efficacy of CSA prevention programs with children before the second grade to determine optimal age for participation.

School-Based Child Sexual Abuse Prevention Programs: Moving Toward Resiliency-Informed Evaluation

Although recent years have seen an increase in the range of child sexual abuse prevention programs delivered in schools, there have been relatively few efficacy studies. Those conducted have focused primarily on intrinsic child factors and have often lacked an explicit theoretical framework. We offer resiliency theory as a useful and apposite theoretical framework for program evaluation. Resiliency theory suggests that a wider range of factors should be considered, including intrinsic (personal characteristics) and extrinsic (environmental) factors. Such factors may increase risk or, alternatively, protect children from the negative effects of adversity. We argue that a resiliency perspective to efficacy studies should recognize a long-term view on children’s capacity to cope and can employ both standardized and contextual resiliency-informed measures.

A preliminary evaluation of presenter effects in the delivery of abuse prevention interventions: Teacher and survivor perspectives

Few efficacy studies have explored the differences between types of presenter delivering school-based child sexual abuse (CSA) prevention programmes. This study was motivated by research which indicated that survivor presenters received substantially more disclosures of abuse than teacher presenters. Survivor experience suggested presenter beliefs about abuse may underlie these differences. The current exploratory study seeks to compare the beliefs of teachers and adult CSA survivor presenters in delivering programmes. An exploratory in-depth quasi-qualitative analysis is conducted on interview data from three guidance teachers, three primary school teachers and three adult survivors (CSA) following delivery of the Violence is Preventable programme. Findings suggest adult survivors held a more explicit goal and higher expectations of disclosure, sought to encourage more energised and interactive group processes and were more likely to emphasise children’s rights and safety. Teachers valued having survivors available for advice but were concerned at times about pupil behaviour. Both teachers and survivors thought parents needed to be more involved in the programme. Recommendations include increased opportunity for programmes to be delivered by adult survivors alongside teachers, with evaluation embedded into everyday programme delivery.

Exploratory Evaluation of a School-Based Child Sexual Abuse Prevention Program

Internationally, efficacy studies of school-based child sexual abuse prevention programs display a series of methodological shortcomings. Few studies include adolescent participants, recording of disclosures has been inconsistent, and no studies to date have assessed presenter adherence to program protocols or summated the costs of program implementation. A pretest–posttest waitlist control design was used to evaluate the Tweenees program delivered to grade 6 (n = 88) and grade 7/8 students (n = 117) compared to a control (n = 185). Outcome measures included a knowledge/skills questionnaire, systematic coding of disclosures, and video interaction analysis of lessons. Costs were calculated per student, class, and school. Adolescents made small knowledge and skills gains indicating a program ceiling effect. Implementation analysis suggests low levels of adult control facilitated disclosures. Program costs were relatively inexpensive. Recommendations are made for future research.

Pilot Evaluation of a Sexual Abuse Prevention Program for Taiwanese Children

The purpose of the current study was to develop and evaluate the efficacy of a school-based child sexual abuse prevention program for Taiwanese children. Forty-six Taiwanese children age 6 to 13 were divided into one of two groups based on their school grade and then randomly assigned to a skills-based child sexual abuse prevention program who received training immediately or a waiting-list control condition who received the training after a delay. Children's self-protection skills improved regardless of age after participation in the program. The program, however, did not successfully improve children's knowledge of sexuality and safety. Although future studies should modify the program content to better target knowledge of sexuality and safety, these results are promising for a pilot of this skills-based CSA prevention program in Taiwan.

School-Based Child Sexual Abuse Prevention Programs: A Review of Effectiveness

In this systematic and critical review of purely school based child sexual abuse prevention program efficacy studies, 22 studies meeting the inclusion criteria differed by target population, program implementation, and evaluation methodology. Measured outcomes for children included knowledge, skills, emotion, risk perception, touch discrimination, reported response to actual threat or abuse, disclosure, maintenance of gains, and negative effects. Many studies had methodological limitations (e.g., sampling problems, lack of adequate control groups, lack of reliable and valid measures). However, most investigators claimed that their results showed significant impact in primary prevention (increasing all children’s knowledge or awareness and/or abuse prevention skills). There was little evidence of change in disclosure. There was limited follow-up evidence of actual use and effectiveness of prevention skills, and the evidence for maintenance of gains was mixed. Several programs reported some negative effects. Very few studies reported implementation fidelity data, and no study reported cost-effectiveness. Implications for future research, policy, and practice are outlined.

School-based child sexual abuse prevention programmes: The evidence on effectiveness

Purpose – This narrative review explored the efficacy of school-based child sexual abuse prevention programmes between 1990 and 2002. There were 22 efficacy studies that met clear inclusion criteria. Results covered both methodological design and the range of outcome measures. Methodology was analysed through four dimensions (target population, prevention programme implementation, evaluation methodology and cost-effectiveness). Outcomes for children covered nine categories (knowledge, skills, emotion, perception of risk, touch discrimination, reported response to actual threat/abuse, disclosure, negative effects and maintenance of gains). The studies had many methodological limitations. Prevention programmes had a measure of effectiveness in increasing children ' s awareness of child sexual abuse as well as self-protective skills. Beyond minimal disclosure rates, there was no evidence to demonstrate that programmes protected children from intra-familial sexual abuse. For a small number of children prevention programmes produced minimal negative emotional effects. Recommendations for future research, policy and practice, include realistic outcomes for child participants and locating programmes within wider abuse prevention measures.

Teachers' Training Needs in the Area of Child Abuse and Protection

SUMMARY: In issue 5(2), Robert Webster outlined the issues in school-based child sexual abuse prevention. He argued that teachers were not being given the training they needed and wanted. This paper reports on a survey in one county of England, and shows the lack of training in child sexual abuse matters to be consistent with Robert Webster's experience. The authors go on to outline the types of training demanded by the vast majority of teachers.

Prevention of child sexual abuse in China: Knowledge, attitudes, and communication practices of parents of elementary school children

Objective Active involvement by parents may contribute substantially to the success of school-based programs to prevent child sexual abuse (CSA). In China, little is known about parental understanding of CSA. This study investigated Chinese parents’ knowledge, attitudes, and communication practices with their children about CSA. Method Six hundred and fifty-two parents of Grade 3 pupils of seven elementary schools in Jingzhou city, Hubei province (central China), completed an anonymous questionnaire (response rate = 81%). Results More than 95% of respondents agreed that elementary schools should provide programs to prevent CSA and were willing to have their children participate in such programs. Although nearly all parents talked with their children about stranger danger, they were much less likely to talk specifically about sexual abuse. Many parents personally lacked basic knowledge about characteristics of perpetrators, the sexual abuse of boys, and nonphysical consequences of CSA. About half (46.8%) expressed some concern that CSA preventive education could cause their children to know “too much about sex.” Contrary to expectations from research in western nations, parents who talked with their children about CSA did not have better knowledge or more supportive attitudes to CSA prevention than did parents who said they never discussed CSA with their children. Conclusion This study confirms and extends two recent surveys indicating strong support for the concept of school-based CSA prevention in China. However, given the apparently low levels of knowledge about CSA, even among those who talk about this problem with their children, future prevention programs should include community-wide efforts to educate adults to ensure that parental advice is accurate and hopefully, effective.

Child sexual abuse prevention programs: do they decrease the occurrence of child sexual abuse?

Objective: The primary goal of the current study was to determine whether rates of child sexual abuse differed among undergraduate women who either had or had not participated in a sexual abuse prevention program during childhood. A secondary goal was to determine whether differences emerged in sexual satisfaction or avoidance of sexual activity between those women who had or had not participated in such a program. Method: Eight hundred and twenty-five women undergraduates from a New England state university filled out a survey on “sexual experiences” for research credit. Respondents were asked detailed questions regarding past histories of child sexual abuse and participation in school-based prevention programs during childhood. Additionally, they responded to questions about their current sexual satisfaction and sexual behaviors. Results: Sixty-two percent of the sample reported having participated in a “good touch-bad touch” sexual abuse prevention program in school. Eight percent of respondents who reported ever having had a prevention program also reported having been subsequently sexually abused, compared to 14% of respondents who did not ever have a prevention program. No differences were found in adult sexual satisfaction or on behavioral measures of sexual activity between those respondents who had and had not participated in a prevention program. Conclusions: This is the first study to find that school-based child sexual abuse prevention programs are associated with a reduced incidence of child sexual abuse. Additionally, contrary to concerns voiced in the literature, there was no evidence that prevention programs are associated with decreased sexual satisfaction or avoidance of sex in adulthood. Implications of the results for further study are discussed.

School-based child sexual abuse prevention programs

Early prevention education training has been advocated by scholars and practitioners to intervene with children and youth who have been or are being sexually abused as well as to prevent sexual abuse from occurring. This study identified and surveyed major school-based child sexual abuse prevention programs in the country. Results obtained from 126 prevention programs indicated that most programs are conducted at a local level; that together they reach hundreds of thousands of students, parents, teachers, and other school staff; and that they offer a prescribed curriculum and resource materials. Nearly two-thirds receive state funding assistance, with less than a third charging the schools. Most were established in the early and mid 1980s and have well-educated staff. Further, most work to meet the needs of disabled students and provide means for disclosure of sexual abuse. Training format, duration, and materials vary.

The Failure of a School-based Child Sexual Abuse Prevention Program

Abstract Structured interviews were administered to 22 children, ranging in age from 6 to 10 years old, who did not disclose long-term sexual abuse by an auxiliary school employee, despite having been exposed to a school-based child sexual abuse prevention program. The results are presented in the context of a review of existing literature on school-based child sexual abuse prevention programs. Results point to the ineffectiveness of brief, single presentation, prevention efforts not geared to specific developmental levels of the audience, the need to explore the impact of the variable of group versus individual victimization on disclosure, and the need for further study of sexually victimized children who received prevention programming with the addition of a control group sample.

Prevention of Child Sexual Abuse: An Analysis of Issues, Educational Programs, and Research Findings

Although the main targets of the effort toward the prevention of child sexual abuse need to be the conditions that cause and support it, a prominent and popular aspect of the prevention effort that has emerged in the past decade involves educational programs aimed at children. Most of these programs are implemented in the schools. The goals of these programs are to provide children with knowledge about sexual abuse, including ways to respond to abusive approaches, and to aid children in disclosing abuse if they have been victimized. Although well intentioned, there is no published research support for the conceptual assumptions (largely involving empowerment) upon which the prevention education programs are based and as yet, sparse empirical support for their effectiveness. Thus, the decision of a school district to adopt and implement a sexual abuse prevention education program is a serious one. School psychologists are in a key position to inform decision makers about the potential and the limitations of child sexual abuse prevention programs and to assist in developing, implementing, and evaluating more effective school-based programs. In addition to discussing general issues about the etiology of child sexual abuse and the relationship of etiology to prevention efforts, five questions are addressed: (a) What is the nature of child sexual abuse prevention programs? (b) Do prevention programs prevent children from being sexually abused? (c) Do prevention programs identify children who have been sexually abused by facilitating disclosure? (d) Is it fair and reasonable to expect children to participate in efforts to prevent their own sexual abuse? (e) What issues do school psychologists need to consider in developing, implementing, and evaluating school-based child sexual abuse prevention programs? Data are presented on the nature of child sexual abuse prevention programs from a research study that systematically evaluated 41 commercially available written materials on child sexual abuse prevention.

Evaluation of a school-based sexual abuse prevention program: Cognitive and emotional effects

This study evaluated a school-based child sexual abuse prevention program which consisted of separate 2-hour workshops for children, parents, and teachers. Questionnaires concerning the children's knowledge about sexual abuse prevention and level of emotional distress were developed and administered to 88 children, ages 5–12, and 60 parents before and after the program. In addition, 12 teachers completed questionnaires about the children's level of emotional distress within 2 weeks after the program. Comparison of the children's knowledge before and after the program showed significant increases in knowledge about strategies for coping with potential abuse situations. Also individual children's responses were compared with their parents' responses. After the program the parents had a more accurate appraisal of their children's knowledge, and in addition, there was a significant increase in how much parents reported that they had talked with their children about sexual abuse. In terms of possible adverse emotional effects of the program, neither teachers nor parents noticed signs of increased emotional distress. In addition, the children reported that the program made them feel safer and better able to protect themselves. The findings support the value of providing sexual abuse prevention programs to children.