General Considerations on Child sexual abuse

General Considerations on Child sexual abuse

Although there is no universal definition, sexual abuse is generally defined as the involvement of developmentally immature children or adolescents in sexual activities that they do not fully comprehend, to which they are unable to give informed consent and that violate social taboos of family or other adultchild relationships. Adults take advantage of the power and age differential which removes meaningful consent. The adult's intention to use children for his (or her) sexual arousal and gratification is an important element of the definition.

Other definitions describe the unwanted, manipulative and exploitative character of the interaction and recognize the importance of age difference (mostly 4–5 years). Developmental asymmetry and the use of coercion differentiate abuse from normal sexual play [Kempe, 1978; AAP, 1999; Hobbs et al., 1999a; Friedrich et al., 2001; Finkel and De Jong, 2001].

Sexual abuse includes a spectrum of sexual activities ranging from nontouching to invasive penetrative abuse. In contrast to the general public opinion CSA is mostly a chronic sexualized relationship over months and years between fathers, step-fathers, other relatives or known individuals and the child.
Abuse may start in early childhood and continue into adolescence.

Strangers as offenders make up approximately 10% of all cases. These occurrences tend to be rather single events and often are more accurately characterized as 'sexual assault'. Most of sexual abuse is committed by men (approx. 90%), with higher numbers of female perpetrators when boys are victimized (up to 25%). At least 20–25% of perpetrators are juveniles. This underscores the importance of early intervention including perpetrator treatment.

Probably this is the most effective measure of prevention of further abuse of other children. Offenders appear to be 'normal', socially well-adapted people essentially of all social backgrounds. Many, but not all, have been sexually abused as children, and many abuse more than one child.

Victims are girls in 70–80% of the subjects including all age groups, peaking in the prepubertal school age. Adolescents make up at least 25% of sexual abuse victims and tend to be victimized by peers ('date rape'). Lower socioeconomic status is not consistently demonstrated in the research and may be caused by assessment bias. However, unstable social conditions may predispose a child to sexual abuse. Single-parent homes and step-parents seem to be significant risk factors [Finkelhor, 1994; Leventhal, 1998; Finkel and De Jong, 2001]. Although not reported in all studies, developmentally disabled or handicapped children appear to be at higher risk for sexual abuse particularly when the disability affects communication [Elvik et al., 1990; AAP, 2001b].