As a prospective adoptive parent, you may have some valid concerns about
sexual abuse. You may wonder what the special needs are of children who
have been sexually abused and whether you will be able to meet those needs.
By acquiring more knowledge, you will feel more confident in taking on
the challenges and rewards of adopting a child with special needs.
Many parents who have already adopted sexually abused children feel that
their greatest obstacle was lack of information about sexual abuse in
general; about their particular child's history; and about helpful resources
such as support groups, skilled therapists and sensitive reading materials.
This article will provide you with some basic information about child
sexual abuse as well as some special considerations for parents who adopt
Child sexual abuse is any forced or tricked sexual contact by an adult
or older child with a child. Usually the adult or older child is in a
position of power or authority over the child. Physical force is generally
not used, since there is usually a trusting relationship between the adult
or older child and the child who is abused.
There are various types of sexual activity which may take place. It can
include open mouth kissing, touching, fondling, manipulation of the genitals,
anus or breasts with fingers, lips, tongue or with an object. It may include
intercourse. Children may not have been touched themselves but may have
been forced to perform sexual acts on an adult or older child. Sometimes
children are forced or tricked into disrobing for photography or are made
to have sexual contact with other children while adults watch.
Child sexual abuse does not always involve physical touching. It can include
any experience or attitude imposed on a child that gets in the way of
the development of healthy sexual responses or behaviors. For example,
a child may be a victim of "emotional incest." If a mother tells
her son, in great detail, about her sexual exploits, or if a father promises
his daughter that she will be his life partner when she turns 18, these
would be scenarios in which the child could be considered sexually abused.
Siblings who are aware of a brother or sister's victimization, but are
not actually abused themselves, may also suffer many of the same effects
as an abused child.
In addition, some children experience ritualistic and/or satanic abuse.
Ken Wooden, founder of the National Coalition for Children's Justice,
defines ritualistic abuse as a bizarre, systematic continuing abuse which
is mentally, physically, and sexually abusive of children, and for the
purpose of implanting evil.
Estimates are that approximately 1 in 4 girls and 1 in 8 boys experience
sexual abuse in some way before they are 18. Data on how many of these
children live in foster or adoptive homes are not available. Foster care
and adoption social workers are now saying they believe the percentages
of boys and girls in foster care who have been sexually abused are much
higher than in the general population, perhaps as high as 75%. Many came
into foster care initially because of sexual abuse and others are children
who were re-victimized while in foster care, either by an older foster
child or by an adult.
While no one sign or behavior can be considered absolute proof that sexual
abuse has occurred, you should consider the possibility of sexual abuse
when one or several of these signs or behaviors are present.
Scratches, bruises, itching, rashes, cuts or injuries, especially in the
Pregnancy in (young) adolescents
Blood or discharge in bedding or clothes, especially underwear
Aggressive behavior towards younger children
Advanced sexual knowledge for the child's age
Seductive or "sexy" behavior towards adults or peers
Pseudo-mature behavior (for instance, a girl who is eight and dresses
like a 16 year-old, wears makeup and generally acts "too old for
her age," or a young boy who attempts to be his mother's "man"
in every sense of the word)
Regressed behavior (for example, the child who has been toilet trained
starts wetting the bed)
Excessive masturbation, masturbation in public places, difficulty with
being re-focused to another behavior
Poor relationships with peers
Fear of a particular person, place or thing (for example, if the abuse
occurred in the bathroom, the child may show fear in that room)
Sudden or extreme changes in behavior (for instance, a previously good
student starts having trouble with school work, a child who was not sad
before starts crying frequently or acting sad, or a formerly cooperative
child acts defiantly or is uncooperative or unusually overly cooperative)
Eating disorders (overeats, undereats)
Additional Behavioral Signs in Pre-teens and Adolescents
Self-mutilation (the child may repeatedly pick at scabs, cut him/ herself
with a razor blade, bite his/her finger or arm, burn him/ herself with
Threatening or attempting suicide
Using drugs or alcohol
Becoming promiscuous (a child is sexually active without discrimination,
or just has that reputation)
Being prudish (the child avoids any sexuality, does not see him/ herself
as a sexual being in any way)
Isolating self or dropping friends
Pre-occupation with death (the child may write poems about death, may
ask a lot of questions about death, such as "What does it feel like
and where do people go?")
Some Additional Behavioral Signs in Children Who Have Been Ritualistically/Satanically
Sadistic play (for example, mutilation of dolls or small animals)
Pre-occupation with death
Increased agitation on certain dates which represent satanic high holy
A constant fear of harm and extreme fear of being alone
There is a myth that all children who have been sexually abused are "damaged
goods" and that the damage is for life. In fact, with guidance and
support a child who has experienced sexual abuse can certainly recover
and go on to live a happy, successful life with loving and trusting relationships.
However, there are many factors which influence the extent of the child's
trauma and subsequent healing process. Some of these are:
The age of the child when the abuse began. Children abused very early
in life may carry body or sensory memories of the abuse but will not have
the words to express their rage. One adult survivor of sexual abuse figured
out, with the help of therapy, that the reason she became sexually stimulated
when she heard and felt a room fan was because a fan had always been on
when she was molested as a child. Children who are abused pre-pubescently,
during the time when their sexuality is emerging, may carry greater effects
of the abuse.
The relationship of the primary perpetrator to the child. A child's trust
of his/her primary caretaker is central to their relationship. Therefore,
when abuse occurs in this context, the betrayal is intensified.
How long the abuse occurred. The longer the abuse occurred, the more likely
the victim is to feel that he/she should have been able to stop it and
thus he or she feels more "guilty."
Whether there was violence involved. In most cases where the abuse included
violence or potential violence (that is, the victim was made to understand
that without cooperation there would be violence) the child will have
experienced additional trauma and therefore damage to his/her development
The social system available to the child at the time of abuse. The child
who had someone to tell about the abuse will suffer less than the child
who had no one to tell. And even in some cases where the support system
is available, the child may choose not to tell for fear of the consequences.
For example, the child may think, "If I tell my father that my brother
is abusing me and he believes me, then my father may do something drastic
like hurt my brother or send me to jail."
When children reveal their secrets, the response of adults will vary.
It is important to stay as calm as possible so as not to further traumatize
the child. The rage you may feel is natural, but the child may perceive
that it is directed at him or her. The child needs a safe, supportive
atmosphere in which to talk. Children also benefit enormously from hearing
that this has happened to other children, male and female.
Ego development of the child at the time of the abuse. If the child has
a firmly established concept of his or her sexual identity, the abuse
will have less impact. Children who are abused by a same sex perpetrator
often have deeply felt fears about whether this means they are homosexual.
One way in which parents can help allay this fear is to explain that our
bodies have many nerve endings. If these nerve endings are stimulated,
they will react. For example, if a bright light hits your eyes, your first
response will be to blink or to shade them from the light. A simple concept
to use with children is that of tickling. If a child is ticklish, he or
she will laugh when tickled. It does not matter whether the person tickling
is male or female; the child is reacting to the experience.
If the perpetrator is of the opposite sex, questions of identity may also
come into play. For example a boy who is abused by a woman and is not
aroused, may doubt his masculinity. If he is aroused physically, but not
emotionally, he may equally doubt his masculinity. The same identity issues
for girls may hold true.
If the child has a positive self-concept, that is, if he or she feels
valued at the time the abuse occurred, there will be fewer repercussions.
In fact, children with good self-esteem are more likely to feel they can
say no and/or tell someone about the abuse.
Boys who are sexually abused face some additional problems because of
persistent myths in our society. Males are rarely viewed as fitting the
victim role. When boys get hurt, they are often told "act like a
man," "don't be a sissy," "control your emotions."
The message to boys is to stand on their own two feet and to take care
of themselves. Under these circumstances, a male victim is less likely
to tell and therefore cannot begin a healing process. This increases the
chances that he may take on the role of the victimizer in an attempt to
master his own experience.
A further complication for boys is that the media portray boys who have
sexual experiences with older women as going through a "rite of passage"
rather than as victims of sexual exploitation. Movies such as "Summer
of '42" and "Get Out Your Handkerchiefs" are prime examples
Some children who have been sexually abused go on to abuse other children.
While this is a serious problem, the exact percentage of sexual abuse
victims who become abusers is not known.
It is important to realize that these children are victims as well as
offenders and need to receive counseling from qualified therapists who
understand both aspects of the problem. The therapist must be able to
be empathic and understanding of the "victim" but confrontational
with the "victimizer."
Victimizers have triggers that precede their behavior. For example, a
child may abuse another child when he or she finds him or herself in a
vulnerable or stressful situation. Sometimes this is because he or she
lacks control or power. This may be when the child gets called a name
at school or believes he or she is being punished unfairly. The therapist
must help the child to not only recognize his/her own individual triggers
but also, to understand the consequences of acting out these impulses.
In other instances, past experiences have left the child overly sexually
stimulated. The child needs education and suggestions of alternative positive
behaviors to replace the sexually victimizing behavior.
Parents who adopt children who have experienced sexual abuse need the
wisdom of Solomon, the strength of Hercules and the patience of Mother
Theresa. If you fall short in any of these areas, do not despair. You
are in good company. Perhaps, more important is your desire to help a
young person grow into a healthy, trusting adult. This is a privilege
and one which brings real satisfaction to those who have adopted.
What Do Parents Need to be Aware of About Themselves?
It is very important for you as prospective adoptive parents to be honest
with yourselves and with your adoption worker about a number of things:
Is there a history of sexual abuse in either the mother or father's past?
If there is, how were those experiences resolved? Did you decide to "just
forget about it" and chalk it up as one of those things that just
happened? Or did you get help, from your parents, a teacher, a minister,
a therapist or someone who could help you work through your feelings about
having been abused? Parents with unresolved abuse experiences in their
history may be at greater risk for either abusing the child again, or
for keeping too much physical and emotional distance, for fear of abusing
the child. Parent/Survivors in local support groups regularly address
How comfortable are you as prospective parents, with your own sexuality
and with your sexual relationship(s)? Can you talk comfortably about sex?
Do you give yourselves permission to acknowledge your own sexual feelings,
thoughts, fantasies and fears? Do you have a well- established relationship
which allows for direct and open communication? A child who has been sexually
abused may need to talk about what happened to him or her. The child's
behavior may be seductive or blatantly sexual at times. A parent must
be able to deal with this.
In addition, there are some other issues that are important for adoptive
parents to consider. They are:
A willingness to "be different," or experience embarrassing
situations, at least for a while. Children who have been sexually abused
may behave toward their adoptive parents in ways which are different than
non-abused children. For example, Lisa, age 8, began shouting loudly,
in public places like the supermarket, that her father had abused her.
In fact, it was her biological father and not her adoptive father who
had abused her, but the strangers in the supermarket obviously did not
make the distinction.
An ability to wait for the child's commitment while not putting off making
your own. An abused child is often untrusting and tied to the past. A
child may repeatedly test your commitment to him or her. She or he may
feel that if you really and truly saw her or him as they are, with all
the scars, that you would not really want him or her.
Many parents have the hope that their love will immediately ease the mistrust
their child has of the world and all its adults. What one adoptive parent
learned was "love has a different meaning for my daughter. To her,
it's simply a deal: You do this for me and I'll do that for you. What
a shock to discover that love is not enough." A true, trusting love
based on more than just bargaining can come to pass with a sexually abused
child, but it will take time, consistency and patience.
A sense of humor. As with most situations in life, a good hearty laugh
Children who have experienced sexual abuse will probably need help in
learning new behaviors and ways of relating. Some of the behaviors and
emotions you may see expressed by your child are:
Withdrawal: Overwhelmed by the feelings she or he has experienced, the
child may retreat physically or emotionally. As a parent, you may feel
confused or resentful. It can be very isolating to have someone close
to you tune you out. Unless you think there is danger of physical harm
to the child or others, the best course of action is to reassure the child
that you care and that you will provide the limits and boundaries that
your child needs.
Mood Swings: A moment's tenderness can quickly explode into anger. The
child may be full of confidence one day, only to sink into despair the
next. It is difficult to see someone you care about in pain, but you cannot
control the feelings of someone else. Point out that these mood swings
are occurring. Do not allow yourself to be unfairly blamed. Try to stay
calm and accepting that sometimes the child does not even know when or
why his/her mood swings are occurring. Crying jags can be part of these
mood swings. Accept that it is beyond your power to make it all better.
Sometimes when a parent tries to rescue a child from his or her pain,
he or she ends up feeling guilty, resentful and frustrated when it does
not work. When a caterpillar is emerging from the cocoon, it must have
a period of time to build strength in its wings. If the butterfly is released
from its cocoon before its time, its strength will be diminished and it
will not be able to survive on its own.
Anger: The first target for the child's angry feelings may be the person
he or she has come to feel the safest with -- you. When a person's angry
feelings are completely out of proportion to what is going on, it probably
has nothing to do with the present situation. Something in the present
is triggering and re-stimulating old memories and feelings. The safety
of the current situation allows these feelings to be expressed. Recognize
that this is actually a sign of health, but do not accept unacceptable
behavior; and never expose yourself to physical violence.
You can assure your child that you are willing to work out the problem
at hand, but in a safe and supportive manner. For example, a child may
be offered a pillow to beat on in order to vent his or her anger.
Unreasonable Demands: Some children learn the survival skills of manipulation
and control. They may feel entitled to make unreasonable demands for time,
money or material goods. It is important not to play into or get trapped
by these demands. You need to maintain a healthy relationship with your
child. This will help the child reduce these demands.
Sexual Behaviors: Since the abuse was acted out sexually, the child needs
help in sorting out the meaning of abuse, sex, love, caring and intimacy.
Some children may try to demand sexual activity, while others may lose
interest in any form of closeness. Think of all the needs that are met
through sex: intimacy, touch, validation, companionship, affection, love,
release, nurturance. Children need to be re-taught ways that these needs
can be met that are not sexual.
A child who has been sexually abused may feel:
I am worthless and bad
No person could care for me without a sexual relationship
I am "damaged goods" (no one will want me again)
I must have been responsible for the sexual abuse because
it sometimes felt good physically
it went on so long
I never said "no"
I really wasn't forced into it
I never told anyone
I hate my body
I am uncomfortable with being touched because it reminds me of the abuse
I think I was abused but sometimes I think I must have imagined it
I blame my (biological) mother or father for not protecting me but I can't
talk about it; I don't want to hurt him/her
A child who has been sexually abused will benefit from clear guidelines
that set the rules both in the home and outside. These kinds of rules
will help provide the structure, comfort and security which all children
need to grow into healthy adults. Experts in the field of adoption and
child sexual abuse believe these guidelines are particularly important
during the first year after placement, when the child is working hard
to establish new relationships with his/her adoptive family and to build
The following guidelines address topics with specific reference to children
who have been sexually abused.
Privacy: Everyone has a right to privacy. Children should be taught
to knock when a door is closed and adults need to role model the same
Bedrooms and Bathrooms: These two locations are often prime stimuli
for children who have been sexually abused, since abuse commonly occurs
in these rooms.
By the time children enter first grade, caution should be used about children
of the opposite sex sharing bedrooms or bath times.
It is not advisable to bring a child who has been sexually abused into
your bed. Cuddling may be overstimulating and misinterpreted. A safer
place to cuddle may be the living room couch.
Touching: No one should touch another person without permission.
A person's private parts (the area covered by a bathing suit) should not
be touched except during a medical examination or, in the case of young
children, if they need help with bathing or toileting.
Clothing: It is a good idea for family members to be conscious
of what they wear outside of the bedroom. Seeing others in their underclothes
or pajamas may be overstimulating to a child who has been sexually abused.
Saying "No": Children need to learn that it is their
right to assertively say "no" when someone touches them in a
way they do not like. Help them to practice this.
Sex Education: All children, including the child who has been sexually
abused, need basic information about how they develop sexually. They also
will benefit from an atmosphere in which it is OK to talk about sex. Appropriate
words for body parts, such as penis, vagina, breasts and buttocks, will
give the child the words to describe what happened to him or her. Suggestive
or obscene language is sometimes a trigger for old feelings for a child
who was sexually abused, and should not be allowed.
No "Secrets": Make it clear that no secret games, particularly
with adults, are allowed. Tell children if an adult suggests such a game,
they should tell you immediately.
Being Alone With One Other Person: If your child is behaving seductively,
aggressively or in a sexually acting out manner, these are high risk situations.
During those times, it is advisable not to put yourself in the vulnerable
position of being accused of abuse. In addition, other children may be
in jeopardy of being abused. Therefore, whenever possible during these
high risk situations, try not to be alone with your child or allow him/her
to be alone with only one other child.
Wrestling and Tickling: As common and normal as these childhood
behaviors are, they are often tinged with sexual overtones. They can put
the weaker child in an overpowered and uncomfortable or humiliating position.
Keep tickling and wrestling to a minimum.
Behaviors and Feelings: Help children differentiate between feelings
and behaviors. It is normal to have all kinds of feelings, including sexual
feelings. However, everyone does not always act on all the feelings he
or she has. Everyone has choices about which feelings he or she acts on,
and everyone (except very young children) must take responsibility for
his or her own behavior.
It is very likely that at some time or other parents of a child who was
sexually abused will need professional help and support for themselves
and their child. The type of therapy that will be the most helpful, that
is, individual, couple or family therapy, will depend on a family's particular
situation. When a child is being seen in individual therapy, it is important
that the parents, who have the primary responsibility for the child, be
in close contact with the therapist, or included in the therapy. Try to
choose a therapist who is knowledgeable about both sexual abuse and adoption
issues and with whom you feel comfortable. If parents are not familiar
with the therapy resources in their area, they may want to ask their adoption
agency or local mental health center for a referral. There are also some
resources listed at the end of this paper which may be helpful with referrals
to therapists who are knowledgeable about sexual abuse.
Support groups for adoptive parents or sexually abused children and support
groups for victims/survivors are another helpful resource. Adoptive parents
who have had a chance to talk with others who understand the experience
of parenting a sexually abused child say that this kind of sharing is
very useful. Dr.Nicholas Groth, a leading psychologist in the field of
sexual abuse, along with many children and adult victims/survivors, say
that groups for children can be most effective in the healing process.
The opportunity to talk and share with other children who have also experienced
sexual abuse reduces a child's sense of isolation and belief that he/she
is the only one to whom this has ever happened.
Recovery from child sexual abuse is an on-going process. As this process
unfolds, the child will ideally move from victim to survivor to thriver.
Developmental stages, particularly adolescence and young adulthood, may
trigger old feelings about the abuse. For example, the time when an adolescent's
body begins to develop physically, or when he or she marries, or becomes
a parent may restimulate old feelings and memories.
As discussed earlier, so many factors can influence the extent of the
damage to the abused child. While adoptive parents cannot erase what happened
to their child earlier in his/her life, you have a wonderful opportunity
to provide your child with new, healthier experiences. Those who have
made the commitment to parenting a sexually abused child say that the
rewards of helping a child grow into a healthy, vibrant adult are very
This paper was written for the National Adoption Information Clearinghouse
by Rosemary Narimanian of Philly Kids Play It Safe and Julie Marks of
the National Adoption Center in 1990.
Sweet, Phyllis. Alice Doesn't Babysit Anymore. McGovern and Mulbacker,
For Parents and Professionals
Bass, Ellen and Davis, Laura. The Courage to Heal, A Guide for Women Survivors
of Child Sexual Abuse. Harper & Row, New York, 1988.
Father Flanagan's Boys Home. Sexually Abused Children in Foster Care.
Boys Town, Nebraska. May be ordered by contacting Father Flanagan's Boy's
Home, Boys Town Center, Family Based Programs, Boys Town, NE, 68010, (402)
Gil, Eliana. Outgrowing the Pain. Launch Press, California, 1983.,
Gil, Eliana. Children Who Molest: A Guide for Parents of Young Sex Offenders.
Launch Press, California, 1987.
Lew, Mike. Victims No Longer: Men Recovering From Incest and Other Sexual
Child Abuse. Nevraumont Publishing Company, New York, 1988.
Maltz, Wendy and Holman, Beverly. Incest and Sexuality. Lexington Books,
Lexington, MA, 1986.
McFadden, Emily Jean. Fostering the Child Who Has Been Sexually Abused.
Eastern Michigan University, Ypsilanti, MI, 1986.
McFarlane, Kee and Cunningham, Carolyn. Steps to Healthy Touching: A Treatment
Workbook for Kids 5-12 Who Have Problems With Sexually Inappropriate Behavior.
Kidsrights, Mount Dora, FL, 1988.
Parents Anonymous of Delaware. All In My Family. Parents Anonymous, DE,
Burgess, Ann; Hartman, Carol; McCormick, Arlene; and Janus, Mark David.
Adolescent Runaways, Causes and Consequences. Lexington Books, Lexington,
Finkelhur, David. Child Sexual Abuse, New Theory & Research. The Free
Press, New York, 1984.
James, Beverly and Nasjleti, Maria. Treating Sexually Abused Children
and Their Families. Consulting Psychologists Press, Inc., Palo Alto, CA,
MacFarlane, Kee and Waterman, Jill. Sexual Abuse of Young Children. The
Guildford Press, New York, 1986.
Sgroi, Suzanne. Handbook of Clinical Intervention in Child Sexual Abuse.
Lexington Books, Lexington, MA, 1988.
The National Resource Center on Child Sexual Abuse provides information,
resources and technical assistance to organizations and professionals
on child sexual abuse. It publishes the "Round Table" Magazine
and offers training for professionals. It also maintains lists of treatment
programs for victims in various parts of the country. Write to the Center
at 106 Lincoln Street, Huntsville, AL 35801, or call (205) 533-KIDS (533-5437).
The National Clearinghouse on Child Abuse and Neglect collects and disseminates
information on child sexual abuse. It will do research upon request on
a particular subject at a very low cost. It also has general publications
which you can request. Write to the Clearinghouse at 330 C Street, SW,
Washington, DC 20447 or call at 1-800-394- 3366. Website: http://www.calib.com/nccanch/
The National Adoption Information Clearinghouse maintains a list of adoption
experts who have expertise in many areas of adoption, including the adoption
of children who have experienced sexual abuse. Contact the Clearinghouse
for referrals to these experts by writing the Clearinghouse at 330 C Street,
SW, Washington, D.C. 20447 or by calling 703-352-3488 or 1-888-251-0075.
The C. Henry Kempe National Center for the Prevention and Treatment of
Child Abuse and Neglect provides training, consultation, research and
program development on all forms of abuse and neglect. Write to the Center
at 1205 Oneida Street, Denver, CO 80220, or call at 303-321-3963.
The National Adolescent Perpetrator Network is housed at the C. Henry
Kempe Center (see above). It can provide professionals and parents with
a bibliography on juvenile sex offenders and with referrals to treatment
programs for adolescent offenders. It also operates a Perpetration Prevention
Project which provides training to professionals and paraprofessionals
on "Understanding the Sexual Behavior of Children." Write to
the Network at 1205 Oneida Street, Denver, CO 80220, or call at 303-321-3963.
The National Runaway Switchboard is a 24 hour crisis line for runaway
youth and children considering running away. The Switchboard offers limited
problem solving in a confidential, non- judgmental manner. It also offers
a message service and a referral service for youth in need of shelter.
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you are going to work with ritual abuse survivors, you must also get educated
if you want to be effective. And you must learn to be humble. Trauma survivors
do not need to be around ignorant, modern-day Pharisees. Survivors in
pain need people who will connect with them on an emotional level, get
right down in there where they are, and listen. --Kathleen Sullivan