The following is a description of the progressive stages of grief observed in most parents who are dealing with the sexual abuse of their child. The progressive stages of grief apply to non-offending parental reactions and to parental reactions of extra-familial sexual abuse
1) Denial - It is a normal reaction for any parent to have some amount of denial when first hearing the highly emotional news that their young child was sexually abused. Over time as more facts unfold and conversations occur about the sexual abuse, denial usually gives way to the next stage of grief.
2) Anger - Once parental acceptance of at least some of the facts surrounding the sexual abuse has begun, anger will follow. This anger could be directed towards the perpetrator, child or parental self. This anger includes a realization of the "losses" that the parent will face as a secondary victim of their child's sexual abuse. Non-offending parents appear to suffer more losses. For example, if the perpetrator is a stepparent or live-in partner, he/she would likely be asked to leave the home and as a result the non-offending parent faces loss of companionship and finances.
3) Bargaining - Parents move from anger to a bargaining stage as greater acceptance of the sexual abuse occurs. Parents now accept the fact that the sexual abuse occurred but begin to struggle with the level of impact the sexual abuse had on the child and family and the need for recovery. Bargaining occurs when parents look and hope for a fast and less painful recovery. In doing so they may try to minimize the impact of the sexual abuse and unintentionally give messages that it will just go away.
4) Depression or Sadness - A normal response to serious changes suddenly forced upon one's life is sadness and depression. As parents move through this stage they come to realize the extent of changes and degree of impact on the child and family resulting from the sexual abuse. Parents in this stage acknowledge that recovery could be a long term process and that the sexual abuse is not going to go away. Non-offending parents appear to experience the effects of this stage to a greater degree than parents of extra-familial sexual abuse.
5) Acceptance - Parents who enter this stage are accepting of the facts and the impact of the sexual abuse. Recovery and healing processes are no longer feared by the parent(s). Parents in this final stage realize and acknowledge that their child and family can survive the losses, changes and recovery process.
HELPFUL and HARMFUL REACTIONS TO DISCLOSURE OF SEXUAL ABUSE
At the time of your child's disclosure your reaction will play a very large part in how your child and family cope and heal from the sexual abuse.
The most important helpful reaction is to believe and acknowledge your child's experience. Your child will learn from you as a parent and from other significant adults about the meaning of the sexual abuse experience.
For a young child the most harmful reaction that a parent(s) can give is verbal disbelief and punishment for the disclosure. Verbally expressed disbelief teaches a child that their internal sense of right and wrong cannot to be trusted. When punishment occurs children learn the consequence for disclosure is a negative reaction.
In general, sexually abused children recant disclosures and information when they feel that what they have said is not accepted or heard by significant adults. In particular, with incest cases, disbelief expressed by the non-offending parent can feel like pressure to a child to recant their disclosure.
Children may also recant disclosures for the following reasons:their perpetrator denies the disclosure; they are repeatedly questioned by child welfare authorities such as law enforcement, child protection workers,doctors and others in our legal system; and finally, when disbelief is expressed by other significant adults, such as teachers or family members, such as siblings.
As a parent(s) you may find it necessary to reduce further stress by limiting your child's contact with others who are not supportive or believing of the sexual abuse.
Once you tell your child that you believe them, it will be important to show them by giving support and reassurance. Being able to give your child support helps validate their perception of the sexual abuse situation. Two ways of verbally providing reassurance are to tell your child that you are sorry about what happened and to make a statement that it was not okay for the perpetrator to touch them in the way they did. Some children will benefit from reassurances that they will be protected from the perpetrator. A word of CAUTION: if you cannot protect your child from future contacts with the perpetrator, such as often occurs in disputed incest and custody cases, do not give false reassurances. Failure to keep promises of protection will contribute to your child's feelings of helplessness. Another way ofproviding reassurance is to be available to talk when it appears as though your child may need it the most, for example, prior to stressful transitions such as change in day care or at bedtime.
Talking with your child in a matter of fact, calm voice helps your child feel that you are in control and that you can help them survive their experience. Reactions of shock, such as, "you'll never be the same," reinforces feelings of difference and damage. Highly emotional reactions such as revenge and extreme anger can increase your child's fear and worry. Young children tend to feel responsible for parental reactions and feelings. It is harmful toshow your child that you are in a great deal of distress from their disclosure. Your child needs to know that you can survive the sexual abuse experience with him/her.
Children who feel responsible for causing the sexual abuse will suffer a more negative impact from the experience. As a parent you can lessen your child's burden of disclosure and feelings of responsibility for causing the sexual abuse. You can tell your child that it was not his/her fault and that it took a lot of courage to tell.
Parental reactions such as, "how could this happen", questions such as, "why didn't you tell me sooner" or "why didn't you tell me", can unintentionally intensify feelings of blame.
When parents indirectly or directly blame their child for causing the abuse, they are in effect excusing the perpetrator. Perpetrators are solely responsible for the sexual abuse of a child.
Parents can have the tendency to want to lessen their child's hurtful/painful feelings by minimizing the seriousness of the situation or event. Sexually abused children need to have acceptance of their feelings whatever they are. Empathy with your child's feelings shows acceptance and validates that you are listening.
It will be important that you resist the urge to treat your child differently. Should you begin to do so he/she may further believe that they are somehow damaged and different because of the sexual abuse. Parental reactions of guilt, such as, "I should have known", can lead to overprotection. Over protection can send the message that your child will not recover from his/her experience. Keeping daily routines and reducing changes can be comforting for your child.
When a disclosure is made a report to law enforcement or child protection usually follows. It is helpful to reassure your child about the involvement of these professionals in your life. For example statements such as, "other adults will help us" or "we need to find other adults to help us" or acknowledging that you don't have an answer but stating, "I will find someone who will answer that question", can be reassuring to a child.
There has been a great deal of research into the possible numbers and nature of false allegations made by children. Most professionals agree that false reports are rare. The majority of false allegations are made by adults, not children. Taking this into account, of all sexual abuse allegations, fewer than 2% are considered false when made by preschool and kindergarten aged children. For ages 6-12, 4.3% of all allegations made by children are considered false.
A false allegation does not mean that a young child actually lied about whether the sexual abuse occurred. More often with young childrena false allegation occurs from lack of understanding, misinterpretation and possible confusion of information. Generally preschoolers are very difficult to coach or "program" into giving intentionally false disclosures.
More recently, concerns have been expressed about a much higher rate of false sexual abuse allegations due to coaching or "programming" by vengeful parents in divorce and child custody cases. Thus far this concern has not been documented by valid information or research.
HELPING THE YOUNG CHILD VICTIM COPE FOLLOWING DISCLOSURE
Behavioral changes as a result of your child's sexual abuse experience are to be expected. These changes are normal responses to a highly stressful experience, even though that experience has stopped because of disclosure. Children have limited verbal skills in expressing their stress; therefore most children will express their distress through their behavior.
Professionals refer to behavioral difficulties or symptoms exhibited by your child immediately after disclosure as the "immediate or short term effects" of sexual abuse. Children also suffer "long term effects "from sexual abuse. The majority of professionals define long term effects as behavioral difficulties and symptoms experienced by a child victim upto two years after disclosure.
Children are affected by their sexual abuse experience in different ways and at differing degrees of severity. The following are some of the factors that will influence the degree of severity of the sexual abuse on your child:
1) Support and belief by parents and significant other adults is the most significant factor that can reduce the negative impact of sexual abuse. When a parent/child relationship is relatively healthy and positive, the negative impact is reduced for the child victim.
2) A child's own internal coping resources will impact the effects of the sexual abuse. For example, if a child is stress resilient and has not had any other serious life stressors there could be a reduced negative impact. When children have already experienced life stressors, such as physical abuse and domestic violence, their self esteem and resiliency is already lowered and they face even greater difficulties from an additional stress of sexual victimization.
3) The child's age and developmental level influences the impact of sexual abuse. Generally professionals believe that the younger the child's chronological age or the younger the developmental stage of the child the more serious the negative effects. Also girl victims appear to process the effects of their sexual abuse differently from boy victims. For example, boys are more apt to act out their anger about the abuse, where girls are prone to hold their anger inside and direct it at themselves.
4) Children who have a trusting, parental type relationship with their perpetrator appear to feel the effects of sexual abuse more seriously than children who were sexually abused by a baby-sitter or non-family member. Related to this relationship factor is denial by the child's perpetrator. For example, if a child has a close trusting relationship with their perpetrator who denies the sexual abuse, that child will suffer a more negative impact than when the perpetrator acknowledges and takes responsibility for the sexual abuse.
5) When physical abuse, threats or intimidation accompany the sexual abuse, children appear to be more seriously affected.
SEEKING OUT SPECIAL HELP FOR YOUR CHILD AND FAMILY
Child victims can exhibit a range of behaviors, including suffering from nightmares, fears, regression in self care skills, sexual acting out andrepeating or "replaying" the actual sexual abuse incidents with dolls or peers. There is no way to predict which behaviors your child will exhibit.
Children will attempt to process or understand their sexual abuse experience on their own. Therefore, children show various degrees of severity from the effects of sexual abuse. For example, a child fondled by a non-family member could show serious effects of his/her experience,where as a child involved in an incest experience may show minimal effects. To complicate matters more, children can function well in their day care/schoolsetting but not function well at home and vise-versa. As a parent it is your difficult job to judge the seriousness of your child's symptoms and whether your child could be in need of professional counseling.
How to judge the seriousness of your child's behaviors will probably feel confusing. The following are some thoughts and ideas to consider:
1) How long has your child been experiencing the behavior(s)? For example, has the behavior been occurring for a couple days or persisted for weeks?
2) How intense or frequent is the behavior(s)? For example, is your child having nightmares every night or once a week?
3) Is your child having behavioral difficulties at home, school or day care or in all of these settings?
4) Is the behavior(s) interfering with your child's ability to function or get through everyday routines?
5) Is the behavior(s) disturbing or upsetting the everyday routine of your family?
6) Could your child's behavior(s) be a result of a new "stage"of development experienced by most children his/her age and not specifically related to the sexual abuse?
7) Is your child accepting of help from you to change the problematic behavior?
Your child is probably in need of professional counseling and guidance if: behaviors persist over time, are disruptive to either his/her routinesor their family's routines, causes difficulty in either the school or daycare setting and he/she resists help from you.
We've discussed ways to tell when your child may need special help but how will you know if you may need special help to cope with your child's sexual abuse? Some things to consider are: if you feel overwhelmed or unable to help your child; when your own childhood issues of sexual abuse resurface because of your child's sexual abuse; and finally when the focus of your child's sexual abuse disrupts your everyday routines and your own emotional needs are not being met.
Professional helping services will probably focus on resolving your child's problematic behaviors but also reducing the negative effects from the sexual abuse that contributed to the behaviors. You are encouraged to involve yourself in these services to learn how to help your child with their difficult behaviors.
SPECIFIC PARENTING ISSUES
The next part of this manual will provide some ideas and strategies to help your child manage their problem behaviors. Helping your child means helping him/her identify and use activities that can make him/her feel better and reduce their anxiety. Some activities could include: finding someone to talk to, picture drawing, relaxation exercises, play activities with a special purpose or something as common as using a night light.
Some of the ideas and strategies will be more successful with some children than with others. It will be up to you as your child's parent to determine which ideas are better suited to your child's personality and specific situation.
Fears can be considered common in children between the ages of 2-6 years. More common fears include: fear of dogs or animals; fear of the dark; fear of thunder/storms; fear of ghosts; and fear of insects. Children learn to be afraid and parents often model fears for their children.
In the case of sexually abused children, key factors associated with fear are: fear of recurrence of the sexual abuse even after disclosure; fear of follow through on threats made by the child's perpetrator; fear of retaliation by the perpetrator; fear of negative parental reaction and a generalized fear towards persons who have physical features that resemble the perpetrator, for example: adult males who wear glasses and have a mustache like the child's perpetrator.
Often because of their age preschool children are unable to verbalize their fears including identifying why they are afraid. Unverbalized fears can take the form of anger, somatic complaints such as tummy aches and nightmares.
Parents can help their children most by helping him/her to identify and overcome unreasonable fears. Having a nonjudgmental and supportive attitude is crucial. For example, ask, "What can I do to help you feel safe?" OR you can provide suggestions such as, "I wonder if having a night light on in your room would help you feel safe?" OR validate your child's fear, such as, "It looks like this is going to be scary for you to do today, that's okay, I will help you get through it".
Some children will use their own resources and create routines and rituals to help feel safer. An example of a ritual is: checking the windows, closet and doors every night before bedtime. Other examples include: keeping a small light on in their room at bedtime, putting a flashlight under their pillow, or insisting that the bedroom door stay open/closed.
Parents can also help their children by providing explanations and reassurance. For example, when helping your child deal with fear of noises, provide a reasonable explanation about what could have caused the noise, such as the wind, the cat under the bed, etc. Providing reassurance,such as, "I will check on you while you sleep" OR "I will leave my door open so that if you need me you can yell and I'll hear you". Suggesting to your child that re-arranging their room might get rid of scary shadows could be reassuring as well as offering an explanation. Another way of being reassuring is to explain: "Your fear will get smaller and smaller" OR "We will work together to get over your fears" OR "I will help you feel safe from your fears".
With young children who are unable to verbalize fear, it is helpful to use feeling words similar to the following: "I wonder, when you check the closet, doors and windows if you are afraid" OR "Being scared makes your tummy hurt." Reflecting your child's feelings helps him/her to learn to identify their feelings while giving them permission to say what they might be feeling.
Modeling calmness and providing a message of optimism that your child can survive their fears is also very important. You could state,"I know you can get through this" OR "I know how brave you can be" OR "I remember, you were brave when ______ and I know you can be brave again like that now".
Some children are able to verbalize fear of their perpetrator. It could be reassuring to establish a plan of safety with your child. For example, when a perpetrator is not in jail and the child has expressed a fear of retaliation, a safety plan could include a calm, matter of fact review of adults in your child's life whom are possible protectors. Other kinds of safety plans could include a discussion about what-if situations and ideas about ways they could help keep themselves safe.
A more specific strategy useful in reducing anxiety around fear is to teach your child to "self-talk". This is where you teach him/her to talk to him/herself to get through a potential scary situation. For example: your child tells self, "I can do this." OR "I'm brave".
Another specific strategy is to read books about other children who have fears. This can help to normalize and lessen feelings of being different.
Play can be another means of "mastering" or overcoming fear. Children will use play to act out how to deal with their fear and to help to relieve/reduce their fear. Parents can interact with their child through play offering suggestions and practicing how to deal with specific fearfulsituations. For example: using a doll to coach another doll to be brave before going to the doctor or helping a doll to talk about his/her fears.
Relaxation can also help a child reduce their level of distress from fear. For example, a soothing back rub just before nap time, listening to calming music as part of a ritual or routine and teaching relaxation exercises such as deep breathing can be helpful to your child.
Sleep problems including nightmares are common in children ages 1-6. The two different kinds of sleep problems we will discuss are night terrors and nightmares.
Night terrors occur suddenly in a sleeping child, usually early in their sleep. The child will thrash about wildly, while screaming and appearing to be intensely frightened. The child may appear to be awake but is not. They will also appear to be confused and will be unable to communicate.
Children having night terrors will not be aware of their parents presence and will not remember the night terror event. If your child suffers night terrors it is usually best not to try to wake him/her. Most children will gradually relax and can then be encouraged to lay down and fall back asleep. Night terrors are not as common as nightmares in sexually abused children.
Nightmares are more common in children and are frequently associated with stress. Parents know about nightmares because their child wakes them up crying or yelling in fear. They usually occur late in a child's night time sleep. Nightmares are intense and frightening for the child and he/she has difficulty getting back to sleep. Children suffering from nightmares may need physical or verbal comfort from their parent(s).
Sexually abused children appear to have frequent nightmares. These nightmares could include actual content from the child's sexual abuseexperience or be the result of bottled up feelings such as anger or fear. Some nightmares include themes of monsters, "bad people" and snakes. Nightmares can be so intense and real that children may have difficulty distinguishing them as not real. The following are some specific ideas for helping your child with their nightmares:
1) Some children may be afraid to talk about their nightmares, believing that if they did the nightmare would come true. Encourage them to talk about, act out or draw pictures of their nightmare while explaining that nightmares are not real but make- believe.
2) Provide verbal reassurance, "If you need me to stay with you until you fall asleep, I will".
3) Provide statements that will normalize nightmares for your child, such as: "Other kids that had a touching problem like you, have nightmares too" or "Most kids have nightmares when they are scared." Read books about other children's nightmares and how they confronted them.
4) Bolster bedtime routines such as:
- provide a quiet time before bedtime
- read a comforting story
- talk about good dreams
- provide comforting music
- lie down with your child in their room and bed
- rock your child or give a back rub
- provide a relaxing bath
5) Be creative, think up and act out safe or humorous endings to nightmares.
6) Make a "dream helper" or "nightmare buster", a powerful yet friendly helper to protect from or chase away nightmares. For example, adream helper could be a special stuffed animal, a nightmare buster couldbe a picture of Batman drawn by your child and hung on the door.
7) When helping your child return to sleep afterbeing awakened by a nightmare it will be most helpful to provide physicalcomfort and verbal reassurance that, he/she is in a safe place and nightmaresare not real and can't hurt. It could also be helpful to turn on a lightin your child's bedroom to show them that are in a safe place. Any of theabove suggestions could also be helpful, such as: a back rub, lying downwith your child until they fall back to sleep, comforting music or a book.
Sexual behaviors observed in preschool and school aged children are a partof normal sexual development. When children are sexually abused they areprematurely introduced to sexual stimulation and pleasure that they are unableto understand and cope with because of their young age. Many of their sexualbehaviors are a learned response to the perpetrator and sexual abuse acts. Sexual abuse may also increase a child's normal interest in sexual matters.
Children most often tell parents, by their behavior abouttheir level of distress. Young children who are sexually abused appear tohave more problem behaviors in the area of sexuality. These include:
1) excessive masturbation,
2) sexual acting out with peers,
3) pseudomature or false mature sexual behaviors, and
4) confusion over sexual identity and what is appropriate sexually between children and adults.
When helping your child with problem sexual behaviors it is very important that you maintain a matter of fact, non-judgemental and firm attitude. Reacting in this way reduces the powerfulness of the behavior.
The following are some ideas and strategies helpful in dealing with excessive or public masturbation:
1) Reflect child's confusion, such as "you must be confused aboutwhat is okay, I'll help you". Follow-up with specific expectations and limits.
2) Explain and set limits in matter of fact tone and simple language. For example when masturbation is in public, you could state "masturbation can be done in the bathroom or bedroom but not in the living room or grocery store".
3) Distract child when masturbation occurs before sleep by offering a soothing alternative like a back rub or quiet music.
4) Interrupt public masturbation without punishing and suggest an alternative behavior such as playing a game.
The following are some ideas and strategies helpful in dealing with inappropriate sexual acting out with peers and play with toys:
1) Set limits with a matter of fact, firm voice but not a punitive voice.
2) Supervise or monitor your child's play with peers and toys,so if necessary you can interrupt and set appropriate limits.
3) When the play is with toys and in front of a peer, use words such as, "it doesn't look like your friend likes that kind of play"and redirect to another more appropriate activity.
4) Some sexual play with toys and sexual acting out with peers can be the result of sexual abuse memories experienced by your child. Your child may be demonstrating or re-enacting them through his/her play to gain control over or an understanding of what happened to him/her. When the play is with toys such as, two dolls having sex, you may choose to interrupt or allow your child the opportunity to replay the situation. If you choose to give your child time to re-enact their experience it is important that you watch for continuous, endless play. If your child appears to be involved in repetitive play without a resolution or a "safe" ending,you may want to join your child's play and act out a safer ending. Some parents may have difficulty helping their child with these kind of behaviors and if this is your experience you are encouraged to contact a child therapist for guidance.
5) Teach your child accurate sex education and sexuality information, using correct terms and correcting misinformation.
6) When the behavior is sexual acting out with a peer, use words such as, "it was not okay for _____ to touch your penis/vagina and it is not okay for you to touch ______ in their penis/vagina" OR "you are in charge of your penis/vagina, it's up to you to take good care of it." OR "it's up to you to make sure you give only safe touches."
7) When the behaviors are provocative or seductive,use words such as, "I like it much better when you give me a hug and kissl ike this, (demonstrate)". After you have set these limits and demonstrated for child, catch him/her giving the appropriate affection and praise him/her. OR use words such as this, "I think you are confused about what are okay ways of showing that you love