School-based education programmes for the prevention of child sexual abuse

A new global research review published by Cochrane: summary of findings

Cochrane have published a literature review of the evidence on what works in school-based education programmes that aim to improve students' protective behaviours and knowledge about sexual abuse prevention.

The review found that school-based prevention programmes did increase children’s knowledge of how to keep themselves safe from sexual abuse. However, the authors highlighted that everyone in society still has a responsibility to keep children safe and children are never to blame for abuse. One way of helping to achieve this would be to deliver programmes as part of wider community initiatives promoting the safety of children.

Findings from the review

  • There is evidence these programmes increased children’s knowledge of how to keep themselves safe from sexual abuse (measured through questionnaires and scenarios).
  • Follow-up demonstrated that children retained this knowledge 1 to 6 months after the programmes ended.
  • There is also evidence that school-based sexual abuse prevention programmes were effective in giving children the skills they needed to keep themselves safe from abuse.
  • Children demonstrated these skills in simulated at-risk situations.
  • The authors could not assume that children would respond in the same way in actual at-risk situations.
  • They also did not know if simulated at-risk situations involving strangers helped children deal with threats from familiar adults – who are most likely to sexually abuse children.
  • It is also possible simulated situations could desensitise children to similar things happening in real life.
  • There was no evidence that programmes increased or decreased children's anxiety or fear.
  • Parents’ levels of anxiety or fear as a result of their children participating in the programmes were not measured.
  • Children who participated in abuse prevention programmes were over 3 times more likely to disclose sexual abuse than those who had not.
  • None of the studies reported how disclosures were dealt with.
  • The authors of the studies collected insufficient data to evaluate the specific effects of programme type, duration, frequency or setting.
  • The authors did note that the majority of reviewed programmes covered multiple topics, used a combination of teaching strategies (for example, discussion, modelling, role-play, rehearsal and feedback), and integrated active, passive, behavioural and instructional approaches in one session (for example, children watched a video and then took part in activities).
  • Programmes have previously been categorised as active, passive, behavioural or instructional. As most programmes in the study were actually multidimensional, the authors suggest these categories are too rigid and artificial.
  • Further studies need to measure whether programmes reduce the long-term incidence and prevalence of child sexual abuse. Such studies would need to be large-cohort with repeated follow-up into adulthood.
  • Studies need to measure how much knowledge children retain more than 6 months after the completion of abuse prevention programmes.
  • Studies should evaluate the effectiveness of online abuse prevention programmes.
  • Research needs to address the level of skill and knowledge improvement which would result in clinically significant protective effects. This evidence is needed to assess programmes’ cost-effectiveness.
  • Further studies should consider methods for recording and responding to disclosures; linking data to child protection or police records; and interviewing or surveying participants at repeated follow-up intervals.
  • Future studies should measure parental fear and anxiety as a result of their children’s participation in abuse prevention programmes.
  • One study suggested children with greater self-esteem demonstrated better protective skills and knowledge after participating in programmes. This would warrant further investigation to see whether self-esteem training should be included as part of sexual abuse prevention programmes.

About the review

The review analysed findings from 24 studies of sexual abuse prevention education programmes in schools in the United States, Canada, China, Germany, Spain, Taiwan, and Turkey. 

The programmes involved 5,802 children. 98.8% of these children were from primary schools. 

The review evaluated evidence for the effectiveness of the programmes in the following areas:

  • children’s skills in protecting themselves from sexual abuse
  • children’s knowledge of how to keep themselves safe from sexual abuse
  • how well children remembered the skills and knowledge they had learned over time
  • how anxious and fearful children and their parents felt after participating in the programmes
  • whether children disclosed current or past abuse during or after the programmes.

The length of programmes ranged from a single 45-minute session to eight 20-minute sessions. 

Common features of the programmes included:

  • safety rules
  • body ownership
  • private parts of the body
  • awareness of different types of touches and different types of secrets
  • who to tell. 

Programme teaching methods and resources included:

  • film, video or DVD
  • plays
  • multimedia presentations
  • songs, puppets, comics and colouring books
  • rehearsal, practice, role-play, discussion and feedback. 

None of the included studies reviewed the effectiveness of web-based or online programmes.

Read the full review: Walsh, K. A. et al. 2015. School-based education programmes for the prevention of child sexual abuse. Cochrane Database of Systematic Reviews, 2015, Issue 4.

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