Child Sexual Abuse

Working Together to Safeguard Children defines sexual abuse as behaviour which:

'Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening.

The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse.

Sexual abuse can take place online, and technology can be used to facilitate offline abuse.

Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.'

Sexual abuse often occurs in conjunction with the other categories of child abuse especially emotional abuse in order to maintain control and secrecy.  Child sexual abuse is complex, illegal, harmful and has lasting impacts on children. It is important to remember that Child Sexual Exploitation (CSE) is Child Sexual Abuse (CSA).

Work carried out by the Centre of Expertise on Child Sexual Abuse has identified a wide range of sexual abuse offending:

Child sexual abuse within the family environment: sexual abuse of a child or young person by an adult family member, or by an adult who is connected to the family or to one of its members.

Child sexual abuse through trusted relationships outside the family environment: sexual abuse of a child or young person by someone who holds a position of authority over them as a result of a professional or vocational role.

Child sexual abuse through an intermediary: sexual abuse of a child or young person which is carried out by more than one perpetrator; the perpetrator who initiates the abuse (the initiating perpetrator) seeks to gain access to the child, or to images of the child, through another perpetrator (the intermediary perpetrator).

Child sexual abuse through online interaction: abuse where a perpetrator, operating online, encourages/deceives/ coerces a child or young person to take part in online sexualised conversations or sexual acts, and/or to produce images (photos or videos) of themselves that they share with the perpetrator online.

Child sexual abuse through viewing, sharing or possessing images: the viewing of images of CSA that have already been created. This can include viewing, possessing and sharing images (photos or videos) with others, generally (but not exclusively) online.

Child sexual abuse through groups and networks: sexual abuse committed by perpetrators who are part of a group or network. This may be a social group, gang or network that meets in person, or a group or network in which members interact online and remain anonymous.

Child sexual abuse arranged and perpetrated for payment: sexual abuse of a child or young person by one or more perpetrators where, in return for payment (either financial or other), a perpetrator (‘the seller’) offers other perpetrators (‘buyers’) access to the child or young person for contact abuse and/or creates and sells images (photos or videos) of abuse, e.g. via live-streaming.

Child sexual abuse through a personal connection: abuse committed by a perpetrator who establishes a personal connection with a child or young person and grooms or coerces them into sexual abuse.

Child sexual abuse through attack by an unknown person: abuse where a perpetrator, who is unknown to the child or young person, attacks and sexually assaults them.

While there are a range of ways of perpetrating, there are two types of sexual abuse; contact and non-contact, as sexual abuse can be perpetrated in person or online.

Contact abuse is where an abuser subjects a child to physical contact, this includes;

• Sexual touching or any part of the child’s body, whether they’re clothed or not;
• Using a body part or object to rape or penetrate a child;
• Forcing a child to take part in sexual activities;
• Making a child undress and touch someone else;
• It includes touching, kissing and oral sex- sexual abuse isn’t just penetrative.

Non-contact abuse is where an abuser subjects a child to abuse without touching them. This can be in person or online and includes;

• Exposing or flashing;
• Showing pornography;
• Exposing a child to sexual acts;
• Making them masturbate;
• Forcing a child to make, view or share child abuse images or videos;
• Making, viewing or distributing child abuse images or videos;
• Forcing a child to take part in sexual activities or conversations online or through smartphones.

Children from the age of birth onwards may be subjected to sexual abuse. Sexual abuse can have a long-term impact on emotional, social and educational development and is linked to the development of mental health issues in later life.

See also the procedures for: Children Affected by Harm Outside of the Home (including Exploitation, Modern Slavery, Trafficking & Gangs), Online Safety, Harmful Sexual Behaviour and Underage Sexual Activity.

Sexual abuse which takes place within family environments often remains hidden and is the most secretive and difficult type of abuse for children and young people to disclose. It may be particularly difficult to disclose abuse by a sibling.

Any child is at risk of being sexually abused however girls are disproportionately more likely to be victims of sexual abuse, but it is important to remember that both boys and girls can be sexually abused. Most children who have been sexually abused were abused by someone they know. Children with disabilities are more likely to be subjected to sexual abuse, especially those who are unable to tell someone what is happening or don’t understand what is happening to them. Some abusers target children who are isolated or will seek to isolate the person they wish to abuse to groom them. Both males and females can groom & perpetrate sexual abuse.

Many children and young people do not recognise themselves as victims of sexual abuse - a child may not understand what is happening and may not even understand that it is wrong especially as the perpetrator will seek to reduce the risk of disclosure by threatening them, telling them they will not be believed or holding them responsible for their own abuse.

Where sexual abuse is being perpetrated on one or more family members, it may be possible to identify by patterns of referrals or presentations to different agencies in their local community over time. There may be a range of signs but any one sign doesn't necessarily mean that a child is being sexually abused; however, the presence of number of signs should indicate that you need to consider the potential for abuse and consult with others who know the child to see whether they also have concerns.

Signs include:

• Changes in behaviour, including becoming more fearful, aggressive, withdrawn, clingy;
• Problems in school, difficulty concentrating, appearing distracted and distant or dissociated, drop off in academic performance;
• Sleep problems, nightmares or regressed behaviours i.e. bed wetting;
• Frightened of or seeking to avoid spending time with a particular person;
• Knowledge of sexual behaviour/language that seems inappropriate for their age;
• Physical symptoms including pregnancy in adolescents where the identity of the father is vague or secret, STIs, discharge or unexplained bleeding;
• Poor hygiene, which often leads to social isolation in school;
• Injuries and bruises on parts of the body where other explanations are not available especially bruises, bite marks or other injuries to breasts, buttocks, lower abdomen or thighs;
• Injuries to the mouth, which may be noted by dental practitioners.

Other Indicators

• Frequent house moves;
• Isolation of children (and other members) within the family from practitioners, and the wider community;
• Failure to register with a GP;
• Frequent absences from school;
• Failure to cooperate with agencies or to let police, children's social care or other agencies into the home, or letting children be seen alone by professionals;
• Attempts to disguise injuries or attribute them to other causes;
• A child or young person who self-harms, misuses drugs, alcohol or solvents, and/or develops mental health problems;
• Domestic abuse within the family heightens the risk;
• Repeated pregnancies with no evidence of a father;
• Genetic abnormalities in pregnancy or in children who are born.

Finkelhor and Browne, (1986) describe four likely impacts of CSA:

1. Traumatic sexualization (where sexuality, sexual feelings and attitudes may develop inappropriately);
2. A sense of betrayal (because of harm caused by someone the child vitally depended upon);
3. A sense of powerlessness (because the child's will is constantly contravened);
4. Stigmatisation (where shame or guilt may be reinforced and become part of the child's self-image).

The Centre of Expertise on Child Sexual Abuse highlights the impact that secrecy (including the fear and isolation this creates) and confusion (because the child is involved in behaviour that feels wrong but has been instigated by trusted adults) has on the child. While these impacts are not unique to Child Sexual Abuse in the Family Environment, their combination and intensity in the context that they take place makes the experience particularly damaging.

See: Key Messages From Research on Identifying and Responding to Disclosures of Child Sexual Abuse (Centre of Expertise on Child Sexual Abuse)

In the long-term people who have been sexually abused are more likely to suffer with depression, anxiety, eating disorders and post-traumatic stress disorder (PTSD). They are also more likely to self-harm, become involved in criminal behaviour, misuse drugs and alcohol, and to commit suicide as young adults.

Whenever a child reports that they are suffering or have suffered significant harm through sexual abuse the initial response from all practitioners should be to listen carefully to what the child says and to observe the child's behaviour and circumstances. Practitioners must:

• Clarify the concerns;
• Offer reassurance about how the child will be kept safe;
• Explain what action will be taken and within what timeframe.

The child must not be pressed for information, led or cross-examined or given false assurances of absolute confidentiality, as this could prejudice police investigations, especially in cases of sexual abuse.

See Referrals Procedure and Child Protection Enquiries - Section 47 Children Act 1989 Procedure.

Where a Strategy Discussion / Meeting takes place the core agencies involved with the child should participate. This may include a representative from the local Sexual Abuse Referral Centre (SARC). A clear plan should be agreed and circulated to each agency participant. Wherever possible these should be face to face meetings rather than telephone discussions to allow better analysis of the available information.

At the conclusion of the investigation, if the case does not proceed to an Initial Child Protection Conference a second de-briefing strategy meeting should be held to ensure that any ongoing risks are understood and protective action can be undertaken.

Any child protection medical assessment must be planned carefully in order to secure any forensic evidence, if it is judged to be appropriate. However, the examination should not be undertaken purely for forensic reasons. Outside the forensic window, an examination can identify significant findings, and a normal examination can be therapeutic and reassuring for the child and family. A SARC medical will also address emergency contraception needs, STI screening and access to counselling, so even if the child/YP declines examination, a SARC assessment may still be warranted. If the child declines this, thought will need to be given to accessing medical and therapeutic support.

Visually recorded interviews must be planned and conducted jointly by trained police officers and social workers in accordance with the Achieving Best Evidence in Criminal Proceedings: Guidance on interviewing victims and witnesses, and guidance on using special measures (Ministry of Justice). All events up to the time of the video interview must be fully recorded. Consideration of the use of video recorded evidence should take into account situations where the child has been subject to abuse using recording equipment.

Visually recorded interviews serve two primary purposes:

• Evidence gathering for criminal proceedings;
• Examination in chief of a child witness.

Relevant information from this process can also be used to inform Section 47 Enquiries, subsequent civil childcare proceedings or disciplinary proceedings against adults, where allegations have been made.

The single and most important consideration is the safety and well-being of the child or children. 

In reconciling the difference between the standard of evidence required for child protection purposes and the standard required for criminal proceedings, emphasis must be given to the protection of the children as the prime consideration.

The investigation and enquiries must also address the religious, cultural, language, sexual orientation and gender needs of the child, together with any special needs of the child arising from illness or disability.

A victim support strategy and service should be established at the outset. Support will be required in pre-trial, trial and post-trial periods if the case/s proceed to court. Minimum periods for contact should be established. It is clear from experience in research about sexual abuse investigations that many victims and families feel strongly that it is important that they remain in contact with the same practitioners throughout the investigative process.

Where an Initial Child Protection Conference takes place great care should be taken beforehand if the child / young person wishes to participate. The child should not be put in the position of meeting the alleged perpetrator or of attending the meeting at the same time.

Barriers to Disclosure

While some children communicate the abuse directly through verbal means, others do so indirectly (e.g. “I don’t want to go to grandpa’s house any more”), or they may use terminology that the perpetrator has used (e.g. talking about ‘secrets’ or ‘games’) or adult language that is not appropriate for their stage of development.

Non-verbal means of expression include letter-writing, drawing pictures or playing with dolls. Younger children may appear clingy or display temper tantrums, while older children and adolescents may withdraw, self-harm, exhibit anger, avoidance and run away. Even positive behaviours such as ‘being good’ can be a sign that children are trying to communicate abuse.

Children and young people often disclose abuse while it is still ongoing, there may be a significant delay between the onset of the abuse and any disclosure. The younger the age of the child when the sexual abuse starts, the longer it usually takes to disclose.

Many children are experiencing multiple forms of abuse and may live in households that are not safe and in which emotional support is not available to them.

Disclosures are more likely to come in adolescence as they learn about healthy relationships and how to recognise abusive behaviour. Adolescents often first ‘reach out’ to friends and peers after an experience of sexual abuse and these relationships can have significant influence on young people's emotional wellbeing after experiencing sexual abuse. Schools also have a very important role to play in aiding the disclosure process in providing developmentally appropriate education and a safe space within which to disclose. Professionals and children both highlight the importance of a trusted relationship between a child and a reliable professional as an important to aid disclosure.

See Helping Education Settings Identify and Respond to Concerns.

Children may disclose for a number of reasons possibly because they are not able to cope with the abuse any longer or because the abuse is getting worse. They may disclose in order to protect others from abuse or because they are seeking justice.

Barriers to disclosure include fear of not being believed, embarrassment and shame and fear of the consequences of telling. Some groups of young people will have additional challenges in disclosing due to communication, religious, language, cultural or sexuality issues.

Children with disabilities are at increased risk of experiencing sexual abuse especially due to communication and developmental issues. Children with disabilities may be more likely than others to exhibit behaviours as signs, particularly where they are unable to communicate verbally with adults. It is important that these behaviours are understood, and not simply attributed to the child’s impairment.

Whenever they choose to disclose, it is important that they are believed, that they are told what will happen next and kept informed and that they are provided with emotional support.

Research into young people's experience showed that they wanted someone to notice that something was wrong and to be asked direct questions.

Practitioners must be mindful of managing information to minimise the risks to the child when responding to any concerns or disclosures.

There will be situations where due to lack of forensic evidence or corroborating witnesses the threshold for criminal proceedings is not met. It is important in these cases that the lack of police action is not interpreted as disbelieving the child's disclosure.

The Centre of Expertise on Child Sexual Abuse, is a multi-disciplinary team, funded by the Home Office, hosted by Barnardo’s and who work closely with key partners from academic institutions, local authorities, health, education, police, and the voluntary sector. Their aim is to reduce the impact of child sexual abuse through improved prevention and a better-informed response.   

The CSA Centre has developed a suite of resources to support more effective professional practice in response to child sexual abuse. The response resources are for all professionals whose roles brings them into contact with children and their families when there may be concerns or reports that a child is being or has been sexually abused. It is therefore particularly relevant to social workers, teachers, police officers, health professionals and those in the voluntary sector who work with children and families.

The response resources highlight good practice when there are concerns that a child is being or has been sexually abused. It aims to bring clarity to professionals’ responsibilities and actions at key points, in order to meet children’s needs for safety and support and address their wider wellbeing. Advice is provided about intrafamilial child sexual abuse, sibling sexual abuse, harmful sexual behaviours and extra-familial sexual harm. These are all forms of child sexual abuse.

Information and guidance has been developed with people with lived experience, professionals and sector specialists; it explains how the needs of the child or young person can be met throughout their contact with Services. It has three main aims:

• Make the needs and perspectives of children central in professionals’ responses to child sexual abuse;
• Bring clarity to key response points so that professionals’ responses to child sexual abuse meet the needs of children who are being or have been sexually abused, and the needs of their families;
• Improve professionals’ responses to child sexual abuse by providing a pathway that is grounded in evidence and good practice.

The Safeguarding Children Partnerships within the West Midlands region are currently working with the Centre of Expertise to implement the resources and best practice guidance into practice in a way that supports frontline practitioners.  This pathway approach can be found here: pathway (csapathway.uk)

Alongside the practice guides, the CSA Centre have developed additional resources to support professionals in identifying and responding to child sexual abuse:

• Signs and Indicators: A template for identifying and responding to concerns of child sexual abuse. It helps professionals to gather the wider signs and indicators of sexual abuse and build a picture of their concerns;
• Communicating with children: A guide for those working with children who have or may have been sexually abused. This guide aims to help you communicate with children in relation to child sexual abuse, including when you have concerns that such abuse is happening;
• Supporting parents and carers: A guide for those working with families affected by child sexual abuse. This guide helps professionals provide a confident, supportive response when concerns about the sexual abuse of a parent or carers child have been raised or identified;
• Safety Planning in Education: A guide to support education professionals' knowledge, skills and confidence to understand and respond to incidents of harmful sexual behaviour and ensure the safety of all children and young people is addressed;
• Helpful 12 part short film series: The CSA Centre have produced an accompanying 12-part short film series which distils key information from these resources quickly and accessibly for professionals. These films are designed for anyone whose role brings them into contact with children and young people under 18 years old or their parents or carers; including social workers, teachers, police officers, health professionals, voluntary-sector workers or faith leaders/workers – whether they are new to the role, still in training or highly experienced;
• Practice Resources  – CSA Centre’s latest evidence and insights from practice and experts by experience to develop new approaches and apply learning in practice. Also see Research, Practice Guidance and Reports by the CSA Centre;
• Find a support service - CSA Centre directory to find help for yourself or others affected by child sexual abuse in England and Wales.

Useful Websites

Key messages from research on intra-familial child sexual abuse (Centre of Expertise on Child Sexual Abuse).

Key Messages from Research on Child Sexual Abuse Perpetrated by Adults (Centre of Expertise on Child Sexual Abuse).

Protecting Children from Sexual Abuse (NSPCC)

Getting Support with Ssxual Abuse (Childline) help for children in talking about sexual abuse

Shore Website (Lucy Faithful) safe space for teenagers worried about sexual behaviour.

Protecting Children from Harm - A critical assessment of child sexual abuse in the family network in England and priorities for action.

National review into child sexual abuse within the family environment - Child Safeguarding Practice Review Panel

Data Insights Hub access to local and national data on child sexual abuse in England and Wales to enable professionals, commissioners and researchers to find, understand and use official data on child sexual abuse.

Safeguarding Children as Victims and Witnesses (Crown Prosecution Service)

Pre-Trial Therapy (inc Annex A: Specific considerations for children) (Crown Prosecution Service)