Journal Issue: Preventing Child Maltreatment Volume 19 Number 2 Fall 2009
The second major strain of child sexual abuse prevention efforts has focused on education. Primarily targeted at children themselves, these efforts have also been aimed at families, teachers, youth service workers, and others who may be in a position to intervene.54 One central goal has been to impart skills to help children identify dangerous situations and prevent abuse—identifying boundary violations, unwanted forms of touching and contact, and other ways in which offenders groom or desensitize victims—as well as to teach them how to refuse approaches and invitations, how to break off interactions, and how to summon help. But the programs have also had clear secondary goals. One has been to short-circuit and report ongoing abuse. Another, most important from the prevention perspective, has been to mitigate the negative consequences of abuse among children who may have been exposed by helping them not to feel guilty or at fault. The educational programs have been most successfully delivered through schools, but have recently also been adopted by religious education programs and youth-serving organizations. Different programs have targeted children of different ages, ranging from preschoolers to elementary and middle school children. Increasingly the programs have been bundled into larger safety and health education curricula. Widely disseminated models include multisession curricula for school-age children such as the Talking about Touching program55 and the Child Assault Prevention Program.56
Although in wide use at one time during the late 1980s, the programs have drawn a variety of criticisms, among them that the concepts are too complicated to be easily learned, especially by young children. Some critics also believe that the programs have unintended negative consequences for children, such as creating anxiety or inhibiting cooperation with or trust in adults. Still others argue that children cannot reasonably be expected to foil the intentions of motivated and guileful adults bent on molesting them and that it is morally misguided and perhaps psychologically harmful to place the responsibility for preventing abuse on the shoulders of children.
Research on Educational Programs
Many researchers have conducted studies of these educational programs, but few have addressed the question of whether they prevent abuse. Analysts have, however, examined various aspects of program performance, and overall they have bolstered the credibility of the programs by producing more reassuring than discomfiting findings.
Do children learn the concepts? Many studies summarized in a variety of reviews find that children of all ages acquire the key concepts being taught.57 In fact, younger children show more learning than older children.58 An international meta-analysis found that children of all ages who had participated in an education program were six to seven times more likely to demonstrate protective behavior in simulated situations than children who had not.59 Such a finding is far from establishing that children can necessarily avoid abuse, but it lessens the concern that the concepts are categorically too complicated to be learned.
Are there unintended consequences? Research has not found increased anxiety among children in the wake of program exposure.60 Few parents and teachers report adverse reactions by children.61 Indeed, studies have found that parent-child communication improves after involvement in prevention education.62 Analysts have not found that exposure to the program makes children more likely to misinterpret appropriate physical contact and make false allegations.63 No research has yet addressed fully a sometimes expressed concern that these programs may have a negative effect on sexual development. Some research, however, has shown that program-exposed children use more correct terminology for and have positive feelings about their genitalia.64 Another study found no increase in sexual problems among adults exposed to prevention programs during childhood.65
Can offenders be foiled? Some observers have argued that the victim empowerment messages of education programs (getting children to say no or retreat from molesters) are doomed to failure because of the inherent authority, motivation, and guile of molesters.66 The argument is based in part on studies of convicted and incarcerated offenders who reported being highly motivated to abuse, unlikely to be deterred, and willing to use forceful or sophisticated strategies to engage their victims.67 Such a characterization of abusers and abuse dynamics, however, is greatly oversimplified. As noted, it fails to take into account the wide variety of offenders and offense situations, many of which would be suited for child refusal tactics.68 Such situations would include encounters with youthful offenders, such as babysitters or peers, and with adult offenders who may be tentative or anxious in their approach, as well as public encounters, such as on buses, where the child may be able to elicit assistance. In addition, the targets of such education extend beyond young children to include adolescents who have considerably more skill and authority in their own right. In addition, the goal of education is not only to teach resistance behavior, but also to promote disclosure, reduce self-blame, and mobilize bystanders. Meeting such goals could justify the programs even if resistance and avoidance were in themselves difficult to achieve.
Does education prevent victimization? No studies based on strong research designs have looked at the question of preventing abuse. Two observational studies that tried to assess the issue yielded somewhat mixed findings. One, based on a survey of 825 college students,69 concluded that women who had participated in a school-based prevention program were only about half as likely to have been sexually abused as children as those who had not.70 Another study, however, based on a two-wave national survey of youth aged ten to sixteen, found no differences in victimization rates between those who had and had not been exposed to comprehensive prevention programs.71 Program exposure in this study was, nonetheless, associated with a subjective perception of efficacy: when victimized later, youth with program exposure more often expressed beliefs that they had been able to protect themselves, kept the situation from being worse, and kept themselves from being injured.
Additional inferential support for educational programs to prevent sexual abuse comes from broader research on other forms of school-based prevention. A variety of programs with similar theoretical underpinnings have proven effective in high-quality randomized controlled evaluations.72 One such program attempts to reduce bullying.73 Other successful school-based prevention programs are aimed at drug use, pregnancy prevention, and interpersonal skills development. Like sexual abuse prevention programs, many of these programs are cognitively complicated, involve judgments about the intentions of other people, and attempt to train children to resist pressures from other, in many cases, more authoritative people. The scientific literature is conclusive that this type of approach works as a general prevention strategy.74
Does education accomplish other goals? Exposure to a sexual abuse prevention program also appears to have other benefits. A meta-analysis reports evidence that the programs result in increased disclosure.75 One study also found that program-exposed youth were less likely to blame themselves in the wake of victimization.76 Reductions in self-blame are believed to be associated with better mental health outcomes among those who experience sexual abuse.77
Summary. Although researchers have conducted no experimental evaluations of whether educational programs prevent sexual abuse, they have provided a variety of supportive empirical findings so far. They show, for example, that young people do acquire the concepts. One observational retrospective study found a reduction in abuse associated with program exposure; others found an increase in disclosure, a sense of personal efficacy, and a decrease in self-blame. Still others have dispelled concerns about negative effects such as anxiety and disobedience. All this evidence suggests that the approach offers promise and should be further developed and evaluated.
Intimations of potential success also undermine the argument among critics that it is not “moral” or fair to place the burden of prevention on children. Although researchers and practitioners agree that children should not be given sole responsibility for prevention, nonetheless, it might also be considered morally reprehensible not to equip children to take potentially effective actions to prevent sexual abuse. It might, for example, be said that adult motorists should be responsible for protecting children on bicycles from collisions with automobiles, but few would argue that children should not wear helmets when biking. Likewise, it might be said that the responsibility to protect children from kidnappers should be with adults and law enforcement, but few would argue against teaching children not to get into cars with strangers. The “burden of responsibility” argument may mean that adults should do everything they can. But it is not an argument against providing children with potentially useful prevention skills.
Educational Programs: Conclusion
Given some encouraging findings and a prevention model that has proven successful in other youth safety areas, it would seem prudent to continue to pursue educational strategies to prevent sexual abuse. The main challenge would appear to be access. Schools that are under pressure to enhance their academic programs are also receiving appeals to add sexuality education, dating and domestic violence, bullying, suicide prevention, and Internet safety content to their already-full curriculum. The key question for sexual abuse prevention is whether it can be successful if it is part of a more comprehensive prevention curriculum. Certainly there is overlap in many of the skills that these programs teach—refusal, help-seeking, emotion management, and decision making. It would be useful to develop and implement more comprehensive programs and then to evaluate them to assess whether their content allows prevention in each domain to be successful.
In addition, educational approaches should expand to encompass all types of sexual abuse and sex crimes against children, including peer sexual assault in dating relationships, statutory sex crimes between teens and considerably older adults,78 and both new and conventional kinds of sex offenses that are being facilitated by the Internet.79