Journal Issue: Sexual Abuse of Children Volume 4 Number 2 Summer/Fall 1994
Children at High Risk for Sexual Abuse
One of the things that has contributed to the controversial nature of the problem of sexual abuse is that it has few clearcut risk markers. With physical abuse, for example, markers in the child's environment, such as single-parenthood, extreme poverty, and drug abuse in the family, have made the problem easier to identify and target for prevention. (See the article by Daro in this journal issue.) Such markers also give the problem a stereotypical profile. The public appears to believe that child molesters and their victims also fit a stereotypic profile, even though research has not been able to identify reliable risk markers. When the public expects the majority of cases to conform to a profile that research shows is unrealistic, the public is naturally skeptical of large prevalence estimates or disclosures about offenders who "don't seem to be the type."
Some risk markers for sexual abuse, such as gender and age of the child, are seemingly established, but research has found them to be weaker markers than expected. Other presumed risk markers, such as low socioeconomic status, have received little support from research results. What follows is the current knowledge about risk markers.
Girls are victimized more often than boys, as indicated earlier. But retrospective surveys suggest that boys are much more frequently abused than the ratio of reported cases would suggest. Because one-third of all victims are probably boys, the stereotype of the victim as a female likely results in the nondetection of many cases. Parents may supervise boys less closely, and teachers, pediatricians, or other potential reporters may be less likely to suspect abuse of males or to respond to subtle disclosures made by male victims.
In a review of studies, Finkelhor and Baron64 found peak vulnerability for abuse of both boys and girls to occur between the ages of 7 and 13. But victimization can occur at any age, and there is good reason to believe that abuse under 6 is particularly undercounted because young children do not disclose it and because, in adulthood, they may not remember it.39 Clinical studies, for their part, show a large overrepresentation of older children among reported cases,69,70 but this is primarily because it is often not until a child develops the independence of adolescence that she or he finds the courage to disclose. Thus, this higher incidence of reporting among older children is not evidence of higher vulnerability at older ages, and one cannot easily describe a typical sexual abuse victim in terms of age.
A similar discrepancy exists between clinical and retrospective studies on the issue of social class and risk. Among cases of sexual abuse coming to the attention of professionals, lower-class families are overrepresented, although less so than for other types of maltreatment. But in adult retrospective surveys, people coming from economically disadvantaged backgrounds report either no more abuse36,43,71 or only slightly more abuse than their more socially advantaged counterparts.9,17,72 It could be that individuals who are lower on the socioeconomic scale (SES) are less willing to disclose in surveys, masking the higher risk for lower-SES families that appears in clinical case loads. But a more plausible explanation, consistent with current knowledge about surveys and the child protection system, is simply that sexual abuse is easier to detect and report when it occurs to lower-SES children. Current evidence suggests that lower social class is but a weak risk marker for sexual abuse.
Little evidence exists that minorities are at higher risk for sexual abuse. No studies find higher rates for African Americans,25 and several actually find lower rates.17,27,73,74 Two studies that did find higher rates for Hispanic women16,43 are counterbalanced by another, specifically targeted to a large Hispanic population, that in fact found rates to be lower among Hispanics than among other ethnic groups.21
The risk factors for sexual abuse that do show up most consistently in epidemiological studies are those elements of the child's environment related to parental inadequacy, unavailability, conflict, and a poor parent-child relationship. In many studies, for example, children who lived for extended periods of time apart from one parent have been found to bear elevated risks for sexual abuse.l7,64,75 Children with alcoholic, drug abusing, or emotionally unstable parents are also at risk, as are those with parents who are punitive or distant.8,76 Marital conflict also seems to create vulnerability for abuse. However, the strength of such associations should not be exaggerated. It is still true that many victims of sexual abuse display none of these markers.
The factors mentioned appear to increase children's risks for abuse in two ways. First, they decrease the quantity and quality of supervision and protection that children receive. Second, they produce needy, emotionally deprived children who are vulnerable to the ploys of sexual abusers, who commonly entrap children by offering affection, attention, and friendship.64
In summary, probably the most important markers to look for in identifying children at potential risk for sexual abuse are children separated from their parents or children whose parents have problems that substantially compromise their ability to supervise and attend to their children. But exclusive use of these indicators will cause social workers to miss many victims.