School-based sexual abuse prevention programs are effective in increasing children’s skills in protective behaviors and knowledge of sexual abuse prevention strategies, according to a new systematic review.
Using data from 24 previously published trials involving almost 6,000 children around the world, researchers found that students who are taught about preventing sexual abuse through games, books and songs are more likely than others to report their own experiences of abuse.
The findings, which were published on Thursday, show that among children who did not receive any teaching about sexual abuse, four in 1,000 disclosed some form of sex abuse. Among those who were taught about it at school, the figure went up to 14 per 1,000.
Children who receive teaching on the subject also seem better equipped to deal with potentially dangerous situations, with those who participated in the education programs more likely than other children to try to protect themselves in a simulated abuse scenario in which they were asked to leave school with a stranger.
Whether such school-based programs actually reduce the incidence of abuse is still unclear, however, and the review’s authors have called for more research to build on their findings.
“Children’s increased knowledge of abuse should not be seen as a replacement for society’s responsibility to ensure child safety,” the authors, led by Kerryann Walsh, PhD, write. “But even if successful in only a small proportion of situations, given the prevalence of child sexual abuse, it is possible that the skills and knowledge learned in prevention programs may be of assistance to a considerable number of children.”
The findings are the result of a Cochrane review of data from trials of prevention programs in the U.S., Canada, China, Germany, Spain, Taiwan and Turkey. Cochrane is a highly regarded, not-for-profit global network of researchers and professionals that carries out systematic reviews of the best available health research.
Schools used a variety of methods to educate children about sexual abuse, including films, plays, songs, puppets, books and games. The children, who were almost all of primary-school age, were taught about safety rules, body ownership and who to tell. The report’s authors said there was little evidence that children who took part were worried or in any way adversely affected.
In one American school, children took part in a one-hour Stop program (stop, tell someone, own your body, protect yourself) taught through role-play; in Germany, children watched a live performance called (No) Child’s Play, and in Turkey there were four hour-long sessions based on a program called Good Touch, Bad Touch.
Globally it is estimated that at least one in 10 girls and one in 20 boys experience some form of sexual abuse in childhood. Those who have been abused are more susceptible to depression, eating disorders, suicidal behavior and drug and alcohol problems in later life, and are more likely to be victims of sexual assault as adults.
For many reasons, child sexual abuse remains vastly under-recognized and under-reported. Most often, child sexual abuse is a gradual process and not a single event, and the abuser is very likely to be someone familiar to the child — according to one study by the National Institute of Justice, three out of four children who have been sexually abused were victimized by someone they knew. One of the ongoing challenges in the prevention of child sexual abuse is teaching children to recognize abuse when it comes at the hands of a person they know and trust, such as a family member or neighbor.
“This review supports the need to inform and protect children against sexual abuse,” said Dr. Walsh. “But ongoing research is needed to evaluate school-based prevention programs, and to investigate the links between participation and the actual prevention of child sexual abuse. To really know whether these programs are working, we need to see larger studies with follow-up all the way to adulthood.”
The study also indicated that the programs were effective in increasing kids’ lasting knowledge of sexual abuse, with children remembering much of what they had been taught six months later. But the authors also said it was difficult to establish whether children had learned the skills that would necessarily translate to a real-life future scenario involving abuse.
“Even if a child demonstrates that they know how to behave in a certain scenario, it doesn’t mean they will behave the same in a real situation where there is potential for abuse,” said Dr. Walsh. “Tests cannot mimic real abuse situations very well. For example, we know that most sexual abuse is perpetrated by someone known to the child, whereas in the test situations, unfamiliar actors or research assistants were used.”