An introduction to the subject of child sexual abuse, what we know about it and what we can do to prevent it happening.
Child sexual abuse remains a challenging topic which can be difficult to talk about. There is still a lot we don’t know about the extent of sexual abuse, the long-term impacts and the effectiveness of treatment and prevention. These pages aim to provide an introduction to the subject and a guide to the policy, practice and research as well as useful resources for anyone working with children or with an interest in child protection.What is child sexual abuse?
Child sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, and whether or not the child is aware of what is happening (HM Government, 2013).
Child sexual abuse includes:
Sexual abuse can be very difficult to identify. If you suspect or discover that someone is sexually abusing a child you can discuss your concerns with one of our counsellors by calling 0808 800 5000 or emailing firstname.lastname@example.org.
In 2000 the NSPCC published the first comprehensive study into the prevalence of child abuse in the UK (Cawson, 2000). A further prevalence study was then published in 2011 (Radford, 2011), during which, interviews with young adults, children and parents revealed that nearly a quarter of young adults experienced sexual abuse during childhood.
The Radford study also found that more than one in three children aged 11-17 (34%) who experienced contact sexual abuse by an adult did not tell anyone else about it, and, that four out of five children aged 11-17 (82.7%) who experienced contact sexual abuse from a peer did not tell anyone else about it.
Such low levels of disclosure and, that child sexual abuse is a crime that is usually only witnessed by the abuser and the victim, means that most sexual abuse goes unreported, undetected and unprosecuted.
Official statistics are published annually and tell us the amount of abuse that is recorded by the authorities during the year. This is the level of incidence of recorded abuse. 17,186 sexual crimes against children under 16 were recorded in England and Wales in 2011/12 (Chaplin, 2011).
These statistics on child sexual abuse should be regarded as significant underestimates because of the extent to which child sexual abuse is not disclosed and/or reported. The most popular analogy used for child sexual abuse is that of an iceberg, where only a portion of the whole is visible. In the UK and elsewhere across the world we are faced with the visible peak of a much larger problem.
Sexual abuse can be very difficult to identify. Children who have been sexually abused may show a variety of signs and symptoms, including:
For a few children these effects may be relatively short-term, depending on the individual child, the nature of the abuse and the help they receive. However, for many the effects can last into adulthood and cause a long list of problems, especially mental health problems and drug or alcohol misuse.
Other warning signs include a child who:
Parents should also be alert to any adults who pay an unusual amount of attention to their child, for example:
The causes of sexually abusive behaviour towards children are complex and not fully understood. As well as the abusers' sexual urges and willingness to act upon those urges, other factors may be involved: power and control issues, traumatic childhood experiences, and troubled families. Child sexual abuse can also be motivated by money, as it is in the case of child prostitution and pornography.
Factors contributing to child sexual abuse can be broadly categorised as:
It’s often argued that there is a link between someone being abused and then going on to be an abuser themselves in later life. Whilst some sexual abusers will have been abused as children, current research does not support the contention that being sexually abused increases the chances of someone becoming a perpetrator.
Acts of child sexual abuse are committed by men, women, teenagers, and other children. Sex offenders are found in all areas of society and come from a variety of backgrounds. As so much abuse goes undisclosed and unreported, the majority of perpetrators in our communities are not known to the authorities.
Paedophilia is one facet of child sexual abuse and can be defined as a primary sexual interest in pre-pubescent children. The majority of sex offenders are not paedophiles although this term is used frequently and often inaccurately.
Contrary to the popular image, abusers usually seem quite normal to others; friends, relatives and co-workers often find it hard to believe that someone they know has abused children. They are more likely to be someone that the child knows, like a relative, family friend or person in a position of trust, rather than a stranger. About 80% of offences take place in the home of either the offender or the victim (Grubin, 1998).
Our research suggests that the majority of child sexual abuse is perpetrated by men (Radford, 2011). However, the actual prevalence of abuse by females is not accurately known and such abuse is almost certainly under-reported. Females could be responsible for up to 5% of sexual offences committed against children (Bunting, 2005) but research into female offenders has been hindered by a belief that women do not behave this way towards children (Ford, 2006).
Our research also found that 65.9% of contact sexual abuse reported by children up to the age of 18 years was perpetrated by other children and young people under the age of 18 rather than by adults (Radford, 2011). The most typical child sexual abuser is likely to be close in age to the victim, for example a boyfriend, friend, fellow student or someone they meet whilst socialising (Cawson, 2000).
The great majority of children and young people with harmful sexual behaviour, with the appropriate support, treatment and guidance, will not develop into adult sex offenders. A key assessment task is to identify that relatively small group of children and young people who represent a higher risk.
Not all perpetrators begin offending against children when they are children or young people, some do but others will start to offend as adults.
Nearly a quarter of young adults have experienced sexual abuse during childhood with teenage girls between 15 and 17 reporting the highest rates (Radford, 2011). Children from all backgrounds and all communities suffer sexual abuse but there are factors which seem to increase the risk, these include:
Very young children and disabled children are particularly vulnerable because they may not have the words or the ability to communicate what is happening to them to someone they trust.
Child sexual abuse is most commonly perpetrated in circumstances where the victim is known and sometimes related to the perpetrator. Research shows that girls are at greater risk than boys of being abused by a family member whilst boys are more likely to be abused by a stranger (Maikovich-Fong and Jafee, 2010).
The relationship between abusers and victims tends to fit one of three types:
The impact of child sexual abuse on the victim can be long term and devastating. The duration and proximity of the abuse and the abuser, i.e. the relationship of the offender to the victim, are important factors that can influence the extent of the impact.
The abused child may be very confused about their feelings and may rationalise, or be persuaded, that what is happening is ‘normal’. They may not say anything because they think it is their fault, that no one will believe them, or that they will be teased or punished. The child may even care for an abusing adult – they will want the abuse to stop, but they may fear the adult will go to prison or that their family will break up.
Child sexual abuse may leave few physical scars and where there is physical injury, this will often heal relatively quickly. Far more enduring are the emotional and psychological impacts on the victim. These can include long-term problems with alcohol and substance misuse, aggressive behaviour, and, an inability to form and maintain consenting and equal adult friendships and relationships. Such behaviours may be driven by on-going feelings of betrayal, stigmatisation and powerlessness.
It is likely that the annual costs of child sexual abuse in our child and adult population run to many millions of pounds a year as a result of the expense of on-going support, poor health and low earnings amongst abuse victims.
A number of factors contribute to the development of sexually abusive behaviour. It is not a disease that can be cured and people are not born as child sexual abusers. The emphasis should be on reducing the risk of reoffending, addressing specifically the factors that have contributed to the offending.
Generally, in order for abuse to take place, the abuser has to overcome their own internal inhibitions; they usually know what they are doing is wrong and have to convince themselves through a process of cognitive distortions (rationalisations) that the abuse is not causing harm and that the victim wants the sexual contact. Because these cognitive and behavioural patterns which precede and inform sexual abuse are relatively predictable, it has been possible to develop treatment programmes which specifically target these patterns.
Treatment of perpetrators focuses on getting them to understand how they actively created situations to abuse and on the addictive and habitual nature of the behaviour. The aim is to help them understand that they can lead fulfilling and abuse free lives. Punishment alone is unlikely to stop perpetrators reoffending as it does not address the behaviour and thinking that leads to abuse.
Sadistic and psychopathic offenders do not go through the same process of cognitive distortions, or it is very truncated. Fortunately, these sorts of (very dangerous) offenders are relatively rare.
Abusers typically look for weak spots in a family, a community or an organisation where they will be able to gain unsupervised access to children and where their chances of not being detected are greatest. As well as targeting potential victims and planning abuse, abusers will also engage in a process of grooming, of the child, the child’s family and the child’s environment.
‘Grooming’ can leave the child victim feeling very confused and sometimes culpable. The more they are made to feel in some way to blame for the abuse the more difficult disclosure of the abuse can be. Therefore, understanding the specific ways in which grooming has taken place and the ways in which the child has been silenced by threats, both implicit and explicit, and by being made to feel in some way to blame for the abuse, is key to designing an effective treatment programme for the child as well as for the abuser.
Treatment of child victims of sexual abuse typically lasts for several months following a period of assessment and is based on a variety of cognitive behavioural and psychodynamic approaches to help them understand how they were tricked, groomed and coerced, and crucially that they are not to blame for what was done to them.
If you suspect or discover that someone is sexually abusing a child you can discuss your concerns with one of our counsellors. Alternatively, you can contact your local police or children's services. Confronting the alleged abuser may give them the opportunity to silence, confuse or threaten the child about speaking out about the abuse. It may also place the child in danger.
If you think a child is in immediate danger, contact the police on 999, or call the NSPCC on 0808 800 5000, without delay.
Child sexual abuse is a public health problem that requires a response which addresses:
This includes working with children who have been sexually abused to help them overcome their experiences and to keep safe from further abuse.
It involves working with children and young people with harmful sexual behaviour to help them break their patterns of behaviour before they become adult offenders.
And, it means working with adult sex offenders to understand what motivates them and how they operate so that barriers can be introduced to prevent their offending and keep children safe.
For this work to be effective, it must be multi-agency and multi-disciplinary, with communities placed firmly at the centre. Children, young people and adults need to be able to recognise what abuse is and understand how to respond to situations that might put children at risk. The NSPCC has developed the 'underwear rule' for parents to use to start a conversation with their children about keeping themselves safe from sexual abuse.
Read A safer future: preventing child sexual abuse and treating its effects (PDF), our introductory booklet explaining:
Bunting, L. (2005) Females who sexually offend against children: responses of the child protection and criminal justice systems. London: NSPCC.
Cawson, P., et al (2000) Child maltreatment in the United Kingdom: a study of the prevalence of child abuse and neglect. London: NSPCC.
Chaplin, R., Faltley, J. and Smith, K. (eds.) (2011) Table 2.04. In: Crime in England and Wales 2010/11: findings from the British Crime Survey and police recorded crime (PDF). London: National Statistics. p.43.
Ford, H. (2006) Women who sexually abuse children. Chichester: Wiley.
Grubin, D. (1998) Sex offending against children: understanding the risk (PDF). London: Home Office. pp.v-vi and p.26.
HM Government (2013) Working together to safeguard children: A guide to inter-agency working to safeguard and promote the welfare of children (PDF). London: Department for Education (DfE).
Maikovich-Fong, A. and Jaffee, S. (2010) Sex differences in childhood sexual abuse characteristics and victims' emotional and behavioural problems: findings from a national sample of youth. Child Abuse and Neglect, 34(6): 429–437.
Radford, L., et al (2011) Child abuse and neglect in the UK today (PDF). London: NSPCC.
Child sexual exploitation
Our pages covering guidance, research and practice on identification and protection of children or young people who are being sexually exploited.
Visit the NSPCC Library Online to search for more information on this subject.
NSPCC training courses
Learning resources and bespoke training courses to help those working with children, young people and families.
NSPCC services to prevent child sexual abuse
Read about the NSPCC's service to prevent and respond to child sexual abuse.
PANTS and the underwear rule
A resource for parents to start talking to children about keeping safe from sexual abuse.