Preventing and Responding to Child Sexual Abuse and Exploitation

167 Pages·2016·2.28 MB·English

by  Lorraine Radford

Preventing and Responding to Child Sexual Abuse and
Exploitation: Evidence review

Lorraine Radford, Debbie Allnock and Patricia Hynes

2015
About the authors
Lorraine Radford is Professor of Social Policy and Social Work at the University of Central Lancashire,
UK; Debbie Allnock is Lecturer in Child and Adolescent Studies at the University of Bedfordshire, UK;
and Patricia Hynes is Joint Head of the Department of Applied Social Sciences, University of
Bedfordshire.

Commented [TJ1]: Add UNICEF information

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Contents
List of tables and figures
Acronyms and abbreviations
Glossary/ definitions

Executive Summary
1. Introduction
1.1 Methodology
1.2 Report structure
1.3 Definitions
2. What is Known about Child Sexual Abuse and Exploitation and its Consequences
2.1. The nature and extent of the problem
2.2 Causes, risks and vulnerabilities
2.3 Consequences
2.4 Protective factors

3. Review of What Has Been Done
3.1 Measuring change
3.2 Evidence of progress in implementing the CRC
3.3 What is good evidence?
3.4 National responses
3.5 Prevention
3.6 Identification and protection
3.7 Recovery and reintegration

4. Implications for Policy
4.1 Understanding the problem
4.2 Identifying potentially effective responses
4.3 Existing guidance on child sexual abuse and exploitation
4.4 General recommendations
4.5 Recommendations for guidance
References
Appendices
A. Search Strategy
B. Guidance Documents Reviewed
C. Guidance Rating Framework
D. Prevalence of Child Sexual Abuse In Selected Regions
E. WHO Violence Typology
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List of tables and figures
Table 1. Prevalence of child sexual abuse by region from two meta-analyses, Andrews et al. 2004
and Stoltenborgh et al. 2011 (percentages)
Table 2. Risks of child sexual abuse and exploitation
Table 3. The impacts of child sexual abuse and exploitation
Table 4. Common protective factors for child maltreatment
Table 5. Framework for presenting findings on the evidence
Table 6. Summary of evidence on prevention
Table 7. Summary of evidence on identification and protection
Table 8. Summary of evidence on recovery and reintegration response
Table A1. Databases searched
Table A2. Search strings used

Figure A. Summary of evidence ratings
Figure 1. The different dimensions of child sexual abuse and exploitation in context
Figure 2. Risks for sexual violence against children

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Acronyms and abbreviations

ASEAN Association of South East Asian Nations
CBT cognitive behavioural therapy
CDC Centers for Disease Control and Prevention
CEDAW Convention on the Elimination of All forms of Discrimination against Women
CRC Convention on the Rights of the Child
ECPAT End Child Prostitution, Child Pornography and the Trafficking of Children for
Sexual Purposes
EMDR eye movement desensitization and processing
FGM/C female genital mutilation/cutting
GBV gender-based violence
HIC high-income country
ICT information and communication technology
ILO International Labour Organization
IRC International Rescue Committee
LMICs low- and middle-income countries
NAP national action plan
NGO non-governmental organization
OPSC Optional Protocol to the Convention on the Rights of the Child on the sale of
children, child prostitution and child pornography
RAP regional action plan
RCT randomized controlled trial
STI sexually transmitted infection
TF-CBT trauma-focused cognitive behavioural therapy
UNFPA United Nations Population Fund
UNHCR United Nations High Commissioner for Refugees
UNICEF United Nations Children’s Fund
UNSVAC United Nations Study on Violence against Children
VAWG violence against women and girls
WHO World Health Organization

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Glossary/definitions

Term (source) Definition

Armed conflict Resort to armed force between two or more States, or protracted armed
(International Committee of the confrontations occurring between governmental armed forces and the
Red Cross 2008)
forces of one or more armed groups, or between such organized groups

arising in the territory of a State which reaches a minimum level of
intensity
Child Any human being below the age of eighteen years unless under the law
(Article 1, Convention on the applicable to the child, majority is attained earlier
Rights of the Child (CRC))

Child maltreatment All forms of physical and/or emotional ill-treatment, sexual abuse,
(Krug et al. 2002) neglect or negligent treatment or commercial or other exploitation,
resulting in actual or potential harm to the child’s health, survival,
development or dignity in the context of a relationship of responsibility,
trust or power

Child protection Philosophies, policies, standards, guidelines and procedures to protect
children from both intentional and unintentional harm
(UNICEF 2008b)

Child protection system Structures, functions, and capacities, among other components that
(Wulczyn et al. 2010) have been assembled in relation to a set of child protection goals

Child sexual abuse (a) Engaging in sexual activities with a child who, according to the
(Article 18, Council of Europe relevant provisions of national law, has not reached the legal age for
Convention on the Protection of
sexual activities (this does not apply to consensual sexual activities
Children against Sexual
Exploitation and Sexual Abuse between minors), and (b) engaging in sexual activities with a child where
(Lanzarote Convention) use is made of coercion, force or threats; or abuse is made of a
recognized position of trust, authority or influence over the child,
including within the family; or abuse is made of a particularly vulnerable
situation of the child, notably because of a mental or physical disability
or a situation of dependence

Child sexual exploitation Child sexual abuse becomes sexual exploitation when a second party
benefits monetarily, through sexual activity involving a child. It includes
(Lanzarote Convention) harmful acts such as sexual solicitation and prostitution of a child or
adolescent and, in the Council of Europe Convention, covers situations
where a child or other person is given or promised money or other form
of remuneration, payment or consideration in return for the child
engaging in sexual activity, even if the payment/remuneration is not
made.

Child trafficking (a) the recruitment, transportation, transfer, harbouring or receipt of
(Article 3, Protocol to Prevent, persons, by means of the threat or use of force or other forms of
Suppress and Punish Trafficking in
coercion, of abduction, of fraud, of deception, of the abuse of power or
Persons, especially Women and
Children, Supplementing the of a position of vulnerability or of the giving or receiving of payments or
United Nations Convention against benefits to achieve the consent of a person having control over another
Transnational Organized Crime
person, for the purpose of exploitation
(Palermo Protocol))
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(b)Exploitation shall include, at a minimum, the exploitation of the
prostitution of others or other forms of sexual exploitation, forced
labour or services, slavery or practices similar to slavery, servitude or the
removal of organs
(c) the recruitment, transportation, transfer, harbouring or receipt of a
child for the purposes of exploitation shall be considered trafficking in
persons even if this does not involve any of the means set forth in
subparagraph (a)

Under the terms of this Protocol, children under 18 cannot give valid
consent and the ‘means’ of trafficking is therefore not relevant.

Evaluation The systematic and objective assessment of an on-going or completed
(DFID 2012a) project, programme or policy, its design, implementation, outcomes and

results in relation to specified evaluation criteria

Exploitation of a child in Any representation, by whatever means, of a child engaged in real or
pornography/ child simulated explicit sexual activities or representation of the sexual parts
sexual abuse materials of a child, the dominant characteristic of which is depiction for a sexual
(Article 2(c), Optional Protocol to purpose
the CRC of the Child on the sale of Intentionally causing, for sexual purposes, a child who has not reached
children, child prostitution and
the legal age for sexual activities, to witness sexual abuse or sexual
child pornography (OPSC);
activities, even without having to participate
Lanzarote Convention)

Exploitation of a child in The use of a child in sexual activities for remuneration or any other form
prostitution of consideration
(Article 2(b) OPSC)

Gender-based violence An umbrella term for any harmful act that is perpetrated against a
(IASC 2005) person’s will and that is based on socially ascribed (gender) differences
between males and females. While men and boys can be survivors of
some types of gender-based (particularly sexual) violence, around the
world, gender-based violence has a greater impact on women and girls.

Grooming The deliberate preparation of a child for sexual abuse or sexual
(Council of Europe 2007b) exploitation, motivated by the desire to use the child for sexual
gratification. It may involve the befriending of a child, drawing the child
into discussing intimate matters, and gradually exposing the child to
sexually explicit materials in order to reduce resistance or inhibitions
about sex.

Humanitarian crisis Any circumstance where humanitarian needs are sufficiently large and
situation complex to require significant external assistance and resources, and
(UNICEF 2010b) where a multi-sectoral response is needed, with the engagement of a

wide range of international humanitarian actors

Internally displaced Persons who have been forced or obliged to flee or to leave their homes
persons or places of habitual residence, in particular as a result of or in order to,
(OCHA 2004) avoid the effects of armed conflict, situations of generalized violence,
violations of human rights or natural or human-made disasters, and who
have not crossed an internationally recognized state border
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Online abuse There is no agreed definition of online abuse of children in international
law. For the purposes of this document, online child abuse is defined as
an umbrella term covering: use of the Internet, mobile phone or other
form of information communication technology to bully, threaten,
harass, groom, sexually abuse or sexually exploit a child.

Migration A process of moving, either across an international border or within a
( IOM 2004) State. It is a population movement encompassing any kind of movement
of people, whatever its length, composition and causes; it includes
migration of refugees, displaced persons, uprooted people, and
economic migrants.

Monitoring A continuous process, conducted internally throughout the project cycle,
(DFID 2012a) either by managers or by beneficiaries, to measure the progress of

development interventions against pre-defined objectives and plans

Neglect The failure of parents or carers to meet a child’s physical and emotional
(Pinheiro 2006; General Comment needs when they have the means, knowledge and access to services to
13 of the CRC Committee)
do so; or failure to protect him or her from exposure to danger.

Neglect includes failure to provide for the child’s physical, emotional,
health and educational needs and child abandonment.

Prevention Definition used is based on the World Health Organization (WHO)
WHO 2002 definition of ‘primary prevention’:

Stopping child sexual abuse and exploitation before it occurs
Protracted refugee Refers to situations in which refugees find themselves in a long-lasting
situations and intractable state of limbo. Their lives may not be at risk, but their
(UNHCR 2004) basic rights and essential economic, social and psychological needs

remain unfulfilled. A refugee in this situation is often unable to break
free from enforced external assistance.

Recovery Definition is based on the CRC approach to recovery, paraphrased as:
(Article 39, CRC) Enabling the child to overcome the harm caused by child sexual abuse or
exploitation and ensuring a safe and protective environment for the
return of the child to his/her home, city, country or place of origin. Such

recovery and reintegration shall take place in an environment that

fosters the health, self- respect and dignity of the child.

Refugee A person who owing to a well-founded fear of being persecuted for
(Convention Relating to the Status reasons of race, religion, nationality, membership of a particular social
of Refugees) group or political opinion, is outside the country of his nationality, and is
unable to, or owing to such fear, is unwilling to avail himself of the

protection of that country

Reintegration The process through which children associated with armed forces or
(Paris Principles and Guidelines on armed groups transition into civil society and enter meaningful roles and
Children Associated with Armed
Forces or Armed Groups) identities as civilians who are accepted by their families and
communities in a context of local and national reconciliation

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Sexting Sending sexual images or sexual texts via cell phone and other electronic
(Mitchell et al. 2012) devices

Sexual violence An umbrella term used here to refer to all forms of sexual victimization
(Based on definition in Krug et al. of women and children: child sexual abuse and exploitation, rape and
2002)
other sexual assaults, sexual harassment, abuse in pornography,
prostitution, trafficking and female genital mutilation.
Any sexual act, attempt to obtain a sexual act, unwanted sexual
comments or advances, or acts to traffic, or otherwise directed at a
person’s sexuality using coercion, by any person, regardless of their
relationship to the victim, in any setting, including but not limited to
home and work

Solicitation of child for Intentional proposal, through information and communication
sexual purposes technologies, of an adult to meet a child who has not reached the legal
(Article 23, Lanzarote Convention) age for sexual activities, for the purpose of engaging in sexual activities

or the production of child pornography

Violence against children All forms of physical or mental violence, injury and abuse, neglect or
(Article 19, CRC) negligent treatment, maltreatment or exploitation, including sexual

abuse

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Executive Summary
Introduction

This briefing is a summary of an independent review of evidence commissioned by the United
Nations Children’s Fund (UNICEF) to inform guidance for professionals, policy makers and field
workers on effective strategies to prevent and respond to child sexual abuse and exploitation. The
review involved desk-based research into a wide and varied range of literature on the extent, nature
and consequences of child sexual abuse and exploitation and responses made to this in high-,
medium- and low-income countries of the world. We included research published in English
language peer-reviewed journals, ‘grey literature’, legal instruments and resolutions, policy
documents, progress reports and guidance documents from 2000 to 2014. We built on a
bibliography compiled by UNICEF (Reza 2012), supplemented by searches of 17 electronic research
databases, websites, contents of key journals and grey literature, and articles referenced in papers
read.

‘Sexual abuse’ is defined in Article 18 of the Council of Europe Convention on the Protection of
Children against Sexual Exploitation and Sexual Abuse (Lanzarote Convention) (Council of Europe
2007a) as:
(a) engaging in sexual activities with a child who, according to the relevant provisions of
national law, has not reached the legal age for sexual activities (this does not apply to
consensual sexual activities between minors), and (b) engaging in sexual activities with a
child where use is made of coercion, force or threats; or abuse is made of a recognised
position of trust, authority or influence over the child, including within the family; or abuse is
made of a particularly vulnerable situation of the child, notably because of a mental or
physical disability or a situation of dependence.
Child sexual abuse becomes sexual exploitation when a second party benefits monetarily through
sexual activity involving a child. It includes harmful acts such as sexual solicitation and prostitution of
a child or adolescent.
Nature, prevalence and impact

Sexual abuse and exploitation of children takes many forms, does not always involve touching and
can occur in any setting. It includes situations where a child is sexually abused by a relative or carer
at home; made to sell sex in exchange for food, cash or favours; raped or sexually molested on the
way to or at school by an adult, a gang or a peer living in the community; groomed online by an older
man and lured into sex acts, exhibitionism or producing indecent images; trapped into sexual slavery
by organized groups of child sex offenders; or raped by a combatant in the context of war.
Worldwide, it is estimated that around 120 million girls under the age of 20 (about 1 in 10) have
experienced forced sexual intercourse or other forced sexual acts (UNICEF 2014a). Boys are subject
to sexual violence too, but data on this are lacking from most countries (ibid.). Moreover, huge
differences in the design and measures used in surveys make it difficult to accurately compare rates
of child sexual abuse and exploitation in different countries. A review of 58 prevalence studies,
including eight systematic reviews and meta-analyses, (Andrews et al. 2004; Barth et al. 2012; Ji et
al. 2013; Jones et al. 2012; Pereda et al. 2009; Pinheiro 2006; Stoltenborgh et al. 2011; UNICEF
2012a) found that, globally, child sexual abuse involving physical contact is reported by between 2
and 56 per cent of girls and 0.4 and 44 per cent of boys. Examples of reported rates of sexual
exploitation include 7 per cent for girls and 6 per cent for boys in Kenya (UNICEF Kenya et al. 2012),
5.7 per cent and 7.4 per cent of girls in Ethiopia and Uganda respectively (Stravropoulus 2006) and 6
per cent for both girls and boys in Sri Lanka (Miles 2000). Higher rates overall have been found in
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