Nature of child sexual abuse: risk factors & dynamics

The Australian Child Maltreatment Study (ACMS), the first nationally representative study of child maltreatment rates, found that girls experience double the rate of child sexual abuse than boys (37.3% c.f. 18.8%) (Mathews, Pacella, Scott, et al., 2023).

The ACMS also found that for 78% of children who experienced child sexual abuse, the abuse happened more than once. For 42% of children who experienced child sexual abuse, it happened six or more times, and for 11% of children who experienced sexual abuse, it happened more than 50 times (Mathews, Pacella, Scott, et al., 2023).

Research shows that children with a learning disability are 2.5 times more likely to be the subject of a sexual abuse allegation than children without a learning disability, regardless of other confounding factors (Helton, Gochez-Kerr & Gruber, 2018).

Adolescents in institutional care have a high lifetime prevalence of sexual victimisation when compared with nationwide samples – a German study with adolescents from residential care facilities and boarding schools showed lifetime rates of sexual victimisation of 46.7% for girls and 8% for boys. Offenders were mostly adolescents of the same age (Allroggen, Rau, Ohlert & Fegert, 2017).

The age at which abuse commenced varied depending on the type of abuse experienced. The average age at which the first incident of abuse occurred was (Australian Bureau of Statistics, 2016):

• 8.8 years for persons who experienced sexual abuse only;
• 8.1 years for persons who experienced physical abuse only; and
• 6.8 years for persons who experienced both physical and sexual abuse.

In 48% of cases, the first instance of sexual abuse experienced by women before the age of 15 occurred between 5 and 9 years of age. In 48% of cases, the first instance of sexual abuse experienced by men before the age of 15 occurred between 10 and 14 years of age (Australian Bureau of Statistics, 2021).

Quadara and colleagues (2015) discuss Putman’s (2003) review of the literature on risk factors for child sexual abuse, which indicated that the following factors are important:

• Gender – girls are at 2.5 – 3 times higher risk of child sexual abuse than boys (although this pattern does not hold for abuse in religious institutions, where victims are more often male than female)
• Age – risk for sexual abuse rises with age. Over a third of victims are aged 12 or older, a quarter between the ages of 8 – 11
• Disabilities – physical disability is associated with increased risk, particularly where the child’s perceived credibility may be impaired. Increased vulnerability is associated with dependency, institutional care and communication difficulties
• Socioeconomic status – a higher number of cases reported to child protection services are from among those with low socioeconomic status
• Family – the absence of one or both parents, parental impairments (e.g. illness or alcoholism), and a family’s social isolation increase the risk of child sexual abuse.

While girls are more commonly victimised globally, in some contexts boys are at higher risk of sexual exploitation than are girls (ECPAT International, 2021).

Children in residential care have an increased risk of child sexual abuse (Euser, Alink, Tharner, Van IJzendoorn, & Bakermans-Kranenburg, 2013). Further, children with a mild intellectual disability in out-of-home care are at even greater risk of child sexual abuse (Euser, Alink, Tharner, Van IJzendoorn, & Bakermans-Kranenburg, 2015).

Research with perpetrators has found that offenders target vulnerable children who exhibit certain traits, behaviours or characteristics that perpetrators feel they will be able to manipulate (Quadara, Nagy, Higgins & Siegel, 2015).

Family structure is among the most important risk factors for child sexual abuse. Children who live with two married biological parents are at low risk for abuse. The risk increases when children live with step-parents or a single parent. Children living without either parent (foster children) are 10 times more likely to be sexually abused than children that live with both biological parents. Children who live with a single parent that has a live-in partner are at the highest risk: they are 20 times more likely to be victims of child sexual abuse than children living with both biological parents (Sedlak et al., 2010).

Research involving young girls presenting to a forensic examination centre in the UK found that the following factors were associated with victimisation:

Alcohol or drug use in the family or by the victim

• Physical and/or learning disability
• Being cared for by someone other than parents
• A history of sexual activity
• A history of psychiatric support (Davies & Jones, 2013).

A systematic review exploring the demographic and psychosocial factors associated with child sexual exploitation (defined as “coerced sexual acts between a child or a young person and an individual or a group in exchange for money, gifts, substances, or other commodities”), found 52 factors described across 37 unique studies. The strongest factors significantly associated with exposure to sexual exploitation were engagement in sexual risk behaviours, having more than 5 sexual partners, a diagnosis of posttraumatic stress disorder, historical exposure to child pornography, and a history of childhood sexual abuse (Laird, Klettke, Hall, Clancy & Hallford, 2020).

The majority of child sexual abuse occurs within familiar – and familial – relationships. As such, it tends to be characterised by prolonged or repeated victimisation, secrecy and delayed disclosure (Quadara et al., 2015).

Research with children seen for evaluation in a child sexual abuse centre in Ireland found that the onset of abuse for more than half the children (52%) was age 0-8 years. The majority of children (60.5%) experienced intra-familial abuse (defined as abuse by a parent, step-parent, mother’s boyfriend or other relative), and over ninety per cent (92.3%) of the alleged perpetrators were male (McElvaney, Moore, O’Reilly, Turner, Walsh & Guerin, 2020).

A meta-analysis of child sexual abuse characteristics showed that intra-familial sexual abuse was more likely to be experienced at a young age. Additionally, this study showed that abuse was more frequent and/or committed over a longer period of time when it involved more contact or force when a relative was the perpetrator, and when the abuse commenced at a younger age (Ventus, Antfolk, & Salo, 2017).

Research has shown that perpetrators use a range of grooming strategies to identify and build a connection with a potential victim, including:

• identifying children who are particularly vulnerable
• identifying vulnerable or receptive families (e.g. single mothers)
• isolating the child from other children or their guardian
• making a child feel that they hold a “special status”
• over time, desensitising the child to sexual touch
• ensuring they become “indispensable” to significant adults in the child’s life and putting themselves in a position of trust (Quadara et al., 2015).

Alongside the different strategies that perpetrators employ to create opportunities for offending, they also frequently employ various means such as bribes, threats, coercion, denial and blackmail to continue the offending and to ensure victims’ remains silent and compliant (Quadara et al., 2015).

A qualitative study of the grooming process from the perspective of male survivors of child sexual abuse showed common themes relating to grooming stages. The two key stages of grooming were (a) the initial stage of creating a relationship, which focused on inducements and environmental grooming; and (b) keeping the child compliant after the onset of abuse and avoiding disclosure, which involved inducements, relationship development and/or coercive behaviours. Only the second stage was relevant for survivors of intrafamilial abuse, whereas most survivors of extrafamilial abuse experienced both stages. Both survivors of intrafamilial and extrafamilial sexual abuse indicated that three factors served to facilitate the grooming process: (a) their own vulnerabilities and the abuser’s exploitation of these; (b) the abuser’s social position, which was usually one of trust and authority; and (c) the broader social context which often involved social avoidance of abuse (Plummer, 2018).

A study comparing reported grooming behaviours between adults who experienced child sexual abuse and those with no sexual abuse history revealed several behaviours that indicated a high level of risk (“red flags”) for sexual grooming (being reported significantly more often by those with a history of sexual abuse):

• increased sexualised touching of the child over time
• seemingly innocent or non-sexual touching of the child
• accidental touching or distraction while touching the child
• exposing naked body to the child
• watching the child undressing or while naked
• showing the child pornography
• telling the child about past sexual experiences
• separating or isolating the child from peers and family (Jeglic, Winters, & Johnson, 2023).

Research suggests that children who have experienced sexual abuse are also more likely to have experienced some other type of abuse. Experiences of abuse or neglect seldom occur in isolation; the majority of individuals with a history of maltreatment report exposure to two or more subtypes (Price-Robertson, Higgins, & Vassallo, 2013).

References

Allroggen, M., Rau, T., Ohlert, J., & Fegert, J. (2017). Lifetime prevalence and incidence of sexual victimization of adolescents in institutional care. Child Abuse & Neglect, 66, 23-30.

Australian Bureau of Statistics (2021). Sexual violence: Victimisation. Canberra: ABS.

Australian Bureau of Statistics (2016). Personal Safety, Australia. Canberra, ABS.

Davies, E. A., & Jones, A. C. (2013). Risk factors in child sexual abuse. Journal of Forensic and Legal Medicine, 20(3), 146–150.

ECPAT International (2021). Global boys initiative: A global review of existing literature on the sexual exploitation of boys. ECPAT International.

Euser S., Alink L.R.A., Tharner A., Van IJzendoorn M.H. & Bakermans-Kranenburg M.J. (2015). The prevalence of child sexual abuse in out-of-home care: Increased risk for children with a mild intellectual disability. Journal of Applied Research in Intellectual Disabilities, 29, 83-92.

Euser S., Alink L.R.A., Tharner A., Van IJzendoorn M.H. & Bakermans-Kranenburg M.J. (2013). The prevalence of child sexual abuse in out-of-home care: a comparison between abuse in residential and in foster care. Child Maltreatment, 18, 221–231.

Helton, J.J., Gochez-Kerr, T., & Gruber, E. (2018). Sexual abuse of children with learning disabilities. Child Maltreatment, 23(2), 157-165.

Jeglic, E.L., Winters, G.M., & Johnson, B.N. (2023). Identification of red flag child sexual grooming behaviors. Child Abuse & Neglect, 136, doi: 10.1016/j.chiabu.2022.105998

Laird, J.J., Klettke, B., Hall, K., Clancy,. E., & Hallford, D. (2020). Demographic and psychosocial factors associated with child sexual exploitation: A systematic review and meta-analysis. JAMA Network Open, 3(9): e2017682. doi:10.1001/jamanetworkopen.2020.17682

Mathews, B., Pacella, R.E., Scott, J.G., Finkelhor, D., Meinck, F., Higgins, D.J., Erskine, H.E., Thomas, H.J., Lawrence, D., Haslam, D.M., Malacova, E., Dunne, M.P. (2023). The prevalence of child maltreatment in Australia: Findings from a national survey. Medical Journal of Australia, 218 (6 Suppl.), S13-S18. doi: 10.5694.mja2.51873.

McElvaney, R., Moore, K., O’Reilly, K., Turner, R., Walsh, B., & Guerin, S. (2020). Child sexual abuse disclosures: Does age make a difference? Child Abuse & Neglect, 99, doi: 10.1016/j.chiabu.2019.104121

Plummer, M. (2018). Lived experiences of grooming among Australian male survivors of child sexual abuse. Journal of Interpersonal Violence, 33(1), 37-63.

Price-Robertson, R., Higgins, D., & Vassallo, S. (2013). Multi-type maltreatment and polyvictimisation: A comparison of two research frameworks. Melbourne: Australian Institute of Family Studies.

Putnam, F. W. (2003). Ten-year research update review: Child sexual abuse. Journal of the American Academy of Child & Adolescent Psychiatry, 42(3), 269–278.

Quadara, A., Nagy, V., Higgins, D. & Siegel, N. (2015). Conceptualising the prevention of child sexual abuse: Final report (Research Report No. 33). Melbourne: Australian Institute of Family Studies.

Sedlak, A.J., Mettenburg, J., Basena, M., Petta, I., McPherson, K., Greene, A., and Li, S. (2010). Fourth National Incidence Study of child abuse and neglect (NIS–4): Report to Congress, Executive Summary. Washington, DC: Department of Health and Human Services, Administration for Children and Families.

Ventus, D., Antfolk, J., & Salo, B. (2017). The associations between abuse characteristics in child sexual abuse: a meta-analysis. Journal of Sexual Aggression, 23(2), 167-180.