Sexual abuse in preschool children

To read the full-text of this research, you can request a copy directly from the authors.

No full-text available

Request Full-text Paper PDF

To read the full-text of this research,
you can request a copy directly from the authors.

Full-text available
FR: La destructivité d'un enfant ou d'un ado, c'est sa capacité à penser et à mettre en oeuvre une destruction de la réalité physique ou psychique de soi, d'un autre vivant ou des choses. l'article étudie son rapport avec la souffrance morale et la manière d'y faire face. ous trouverez de la documentation complémentaire sur mon site web dans le dossier thématique: EN : The destructiveness of a child or an adolescent, it is his capacity to think and to implement a destruction of the physical or psychic reality of oneself, of another living being or of the things. The article studies its relation with the moral suffering and the way to face it. You will find additional documentation on my website in the thematic folder:
Full-text available
informations plus détaillées sur mon site web : This article discusses the reliability of the child's narrative, when he reveals unacceptable aggressions against him, among others in the sexual field. The discussion is led referring to main categories of ages. The author goes into details to describe the main criteria of reliability or no-reliability. He also suggests guide-lines of effectiveness in the quite numerous cases in which deep doubts are persistent.
Full-text available
Recent recognition of child-to-child and adolescent-to-child sexual abuse raises the question, for the courts, educators, clinicians, and lay individuals, where do we draw the line between normal childhood sexual play, and abuse. This paper presents the results of a survey on normative childhood sexual play and games experiences that was distributed to 300 undergraduates at an all women's college. One hundred-twenty-eight returned the survey, 85% of whom described a childhood sexual game experience. Of these women, 44% described cross-gender play and there was a trend for women who had described cross-gender experiences to have seen the play as involving persuasion, manipulation, or coercion. A strong relationship was found between abuse and cross-gender play. Level of physical involvement in the game was correlated with perceptions of normality. A typology of six kinds of sexual play experiences was derived. Results are discussed in terms of their relation to differentiating childhood sexual abuse from play and gender socialization influences relating to the role rehearsal of coercive or manipulative relationships.
Full-text available
A review of 45 studies clearly demonstrated that sexually abused children had more symptoms than nonabused children, with abuse accounting for 15-45% of the variance. Fears, posttraumatic stress disorder, behavior problems, sexualized behaviors, and poor self-esteem occurred most frequently among a long list of symptoms noted, but no one symptom characterized a majority of sexually abused children. Some symptoms were specific to certain ages, and approximately one third of victims had no symptoms. Penetration, the duration and frequency of the abuse, force, the relationship of the perpetrator to the child, and maternal support affected the degree of symptomatology. About two thirds of the victimized children showed recovery during the first 12-18 months. The findings suggest the absence of any specific syndrome in children who have been sexually abused and no single traumatizing process.
Résumé La maltraitance sexuelle sur enfant demeure une problématique complexe concernant les volets individuels, familiaux, collectifs et sociétaux. Les chiffres de l’OMS sont éloquents et montrent combien l’abus sexuel de l’enfant existe encore et toujours. Rappelons combien celui-ci constitue un maillon vulnérable de la société susceptible de servir de surface de projections, d’objet de décharges pulsionnelles quand l’adulte éprouve mal-être, frustration et besoin de jouissance immédiate. Quelle que soit la nature de la maltraitance, qu’elle soit physique, sexuelle, psychologique ou qu’elle recouvre les diverses formes de négligence, l’enfant demeure à haut risque de connaître les multiples retombées du traumatisme. Selon les pays, la révélation d’abus portée par l’enfant ou par un tiers sera soit « judiciarisée » soit orientée vers le secteur médico-psychosocial. En 1997, notre ouvrage proposait repères et réflexions sur les aspects d’évaluation et du traitement de l’enfant victime d’abus sexuel et de sa famille. Nous avons estimé opportun, vingt ans après, de réaliser une actualisation des aspects développés en s’appuyant sur quatre axes réflexifs. La finalité consiste à montrer les évolutions de la pratique au regard des transformations intervenues sur bien des aspects et points d’attention que comprend la prise en charge des situations de maltraitance.
The SOS Children Confident Center of the Brussels Free University is set up in the structure of the Saint-Pierre University Hospital and is run as a full-fledged unit. Its ramifications both internal and external enable this unit, specialized in the multidisciplinary handling of ill-treated children, to utilize as a mean of intervention the hospitalization of abused children. In the cases of sexual abuse towards children, the hospital can fulfil a function both psychosocial and therapeutic. Place of security and cares, of crisis and transition, the hospital offers a necessary space for change. The advantages and drawbacks of such a tool are described. The hospital school plays a major part in this type of intervention. The consequences of the hospitalization on the abused child and his family are discussed. internal and external collaborations permit to improve the prognosis and the case treatment. Other intervention procedures and disinvolvement practices exist as alternatives to hospitalization.
While recalling the very current problem regarding false allegations of sexual abuse, the author also examines the difficulties encountered by those persons who, in the course of their professional life, have to collect and attempt to comprehend the information provided by a child confronted with this damaging situation. Given the various approaches, the elucidation of a doubt, absolute conviction and established fact, the awkward question of false positives and false negatives, a critical consideration of the situation is of utmost importance. Improved insight into the way that the child recounts facts of a sexual nature, a more subtle approach to the problem of sexual abuse, a better analysis of the content of the victim's declaration and a pluridisciplinary assessment can provide better support in these complicated and painful situations. By reason of his status, the child or adolescent is in a relationship of dependence toward the adult. This fact leads us to consider issues such as suggestibility, lying, story telling and credibility in the allegedly abused child. The consequences of an uncertain allegation made in the context of a divorce have been reported. It is rare that children who have been exposed to lengthy legal proceedings following a false accusation of sexual abuse remain unaffected by this exposure. Even if, in certain cases of conjugal conflict, the grounds for the allegation do not seem to be well founded, any allegation of sexual abuse regarding a child should be treated with the utmost circumspection. Validation of these allegations of sexual abuse regarding a child therefore demands a thorough knowledge of and practical experience in this particular field on the part of those professionally involved.
THE CLINICAL EVALUATION AND TREATMENT OF ADOLESCENT SEXUAL AGRESSORS : FROM SEXUAL TRANSGRESSION TO ABUSIVE STIGMATISATION Adolescence conceived as a psychopathological problem configuration is described more and more often in current scientific literature, in psychological and educational reviews in particular. Through this clinical, critical and ethical reflection, the author proposes an up-to-date synthesis of international scientific literature. Today, clinical preoccupations are linked to an inevitable social reality. In this register, and according to such current issues, attention is focused on adolescents presenting multiple problems or on pre-pubescent children who appear as psychosocially handicapped individuals or as potential physical or sexual agressors. The most marginal among this group of adolescents are represented by those who sexually abused younger children. Some see them as sexual abusers comparable to adult sexual delinquants. Following this very linear line of cause and effect reasoning, some professionals think that all minors who commit sexual abuse risk becoming adult abusers and that it is necessary to reeducate them as well as possible. Thus, at the risk of radicalization and of abusive, interpretive and systematic stigmatization, clinicians in Anglo-saxon countries have multiplied treatment programs adapted to this type of problem. So as to avoid this pitfall, a precise and rigorous evaluation should make it possible to orient decision making in a more adapted way. As important as it is that the personality profiles of adolescents who commit sexual transgressions be the object of diagnostic evaluation, other elements should also be taken into consideration : the circumstances of their act, the characteristics of their victim(s) and the nature of their offense(s). Such details will offer a better understanding of the problem configuration. In that a multifaceted program of educational guidance adapted to these young subjects can only be constructed in an institutional framework validated by ethical and solid judicial references, the therapeutic orientation of these adolescents should be elaborated on the basis of a complete and rigorous medico-psycho-social examination.
Reporting on the clinical characteristics of adolescent sex offenders treated in a specialised outpatient unit of the Parisian region, the authors describe the clinical and psychodynamic profiles of this population. They develop a theoretical model based on the notion that sexual offences in minor adolescents are produced by a conjunction of three processes: 1) difficulties in integrating sensations due to puberty; 2) problems in modulating emotions and 3) dysfunctions in the normal ability for action. The authors develop a treatment model associating group and individual therapy, together with a thourough netting of the family and social context. The group focuses on a common creative activity (the making of a movie for instance) leading the adolescents to interact and team work, and individual sessions are focused on the expression of their thoughts and feelings. The main objectives are to help the adolescents in overcoming their inhibitions of action, better monitoring their emotions and developing a better sense of self. This intervention model seems to yield good results.
When young children behave in a sexual manner, they may be suspected of having been sexually abused. However, this behavior may or may not indicate sexual abuse. Case studies suggest that nonsexually abused children can manifest an increase in erotic behavior on the basis of unusually intense but nonabusive sexual experiences or as part of a compulsion. When the sexual behavior is secondary to abuse, it can be related to posttraumatic stress disorder or intense and prolonged sexual experience.
Controversy exists regarding use of anatomically detailed dolls in child sexual abuse evaluations because of concerns that such dolls may provoke false positive demonstrations of sexually explicit behavior. This study shows that children referred for medical evaluation of sexual abuse will use sexually explicit behavior to demonstrate what has happened to them with nonanatomical dolls as frequently as when they are interviewed with anatomically detailed ones. Over a two-year period, 136 children (aged 24 months to 10 years) were interviewed by the same pediatric interviewer. During the first year sexually anatomically detailed dolls (SAD) were used, and in the subsequent year nonanatomic dolls (NAD) were used. Data was analyzed according to age, sex, and demonstration of sexually explicit behavior. There were 67 children in the NAD group and 69 in the SAD group. Of the NAD group, 72% showed sexually explicit behavior compared to 68% in the SAD group. Comparisons using chi-square analysis revealed no significant differences between NAD and SAD. Results indicated that in the sexual abuse interview setting, use of sexually detailed dolls did not increase children's use of sexually explicit behavior to describe what had happened to them when compared to use of nonanatomical dolls, and that use of either type of doll provides similar information in the interview setting.
The use of anatomical dolls in sexual abuse evaluations remains controversial because of concerns that the dolls induce normal, nonabused children to act out in sexual ways that are likely to be misinterpreted as evidence of sexual abuse. This study examines the incidence of explicit sexual doll play in a large, demographically diverse sample of 2- to 5-year-olds. The 6% incidence of demonstrations of apparent sexual intercourse found in this sample compared favorably with the rate of less than 2% across prior studies of anatomical doll play among presumably nonabused children. However, higher rates of explicit sexual play were associated with being older, poor, black, and somewhat with being male, with over 20% of some subgroups of children displaying such behavior. These results are interpreted as evidence that anatomical dolls are not overly suggestive to young, sexually naive children, but are useful in assessing sexual knowledge and exposure to sexual intercourse.
In assessing the credibility of young children's (ages 2-7) allegations of sexual abuse clinicians need to know how dynamics of sexual abuse affect disclosure, what situations are most commonly associated with fictitious allegations and how the child's developmental stage affects disclosures. Understanding these issues allows for clear decision making. A clear decision making process flows naturally from an understanding of these issues.
This paper reviews the existing literature on selected issues in relation to child and adolescent sex abuse perpetrators. The relatively recent recognition of this phenomenon and the multiple problems of definition in this field may have affected the figures for incidence and prevalence. Among known cases a high proportion of young sex abuse perpetrators have suffered earlier adversities such as sexual and physical victimisation, dysfunctional family relationships and peer isolation. Despite a slender research data base on which to draw, treatment programmes for this client group have proliferated and many of these have not been adequately evaluated. There is a pressing need for the adoption of agreed definitions of outcome targets and measures and establishing longterm outcome studies with this group of children and adolescents.
Handicap et maltraitance, Temps d'arrêt, Ministère de la communauté française édition
  • Clerebaut N
  • V Poncelet
  • Van Cutsem V
CLEREBAUT N., PONCELET V., VAN CUTSEM V. Handicap et maltraitance, Temps d'arrêt, Ministère de la communauté française édition, 2004.
Ces enfants qui tiennent le coup
  • Cyrulnik B
CYRULNIK B. Ces enfants qui tiennent le coup, Ed. Hommes et perspectives, 1998.
Existe-t-il des caractéristiques cliniques et psychopathologiques des agresseurs sexuels enfants et adolescents ? Psychopathologie et traitement actuels des auteurs d'agression sexuelle, conférence de consensus de l'AFP
  • D Frémy
Frémy D., Existe-t-il des caractéristiques cliniques et psychopathologiques des agresseurs sexuels enfants et adolescents ? Psychopathologie et traitement actuels des auteurs d'agression sexuelle, conférence de consensus de l'AFP, John Libbey Eurotext, 2001, 193-202.
Définir la maltraitance : limites des études épidémiologiques
  • Gabel M
GABEL M. Définir la maltraitance : limites des études épidémiologiques,
Le traumatisme du silence
  • E Hadjiski
Hadjiski E., Le traumatisme du silence, Revue de Pédiatrie, 1987, 23-7, 306-310.
La sexualité des enfants
  • J.-Y Hayez
Hayez J.-Y., La sexualité des enfants, Paris, Odile Jacob, 2004.
Neuropsychiatrie de l'Enfance et de l'Adolescence
  • Internet
Internet, Neuropsychiatrie de l'Enfance et de l'Adolescence, 2009.
L'abus sexuel sur mineurs d'âge, Encyclopédie médico-chirurgicale
  • Hayez J.-Y De Becker E
HAYEZ J.-Y., DE BECKER E. L'abus sexuel sur mineurs d'âge, Encyclopédie médico-chirurgicale, Paris, Elsevier, 1999, 37-204-H10.
Entretiens de couple et familiaux dans la prise en charge des agresseurs sexuels, Conférence de consensus : pathologie et traitement actuels des auteurs d'agression sexuelle
  • Hayez J.-Y De Becker E
HAYEZ J.-Y., DE BECKER E. Entretiens de couple et familiaux dans la prise en charge des agresseurs sexuels, Conférence de consensus : pathologie et traitement actuels des auteurs d'agression sexuelle, FFP, 2002, 131-145.
La pédophilie coll. Que penser de ?
  • Hayez J.-Y. De Becker E
HAYEZ J.-Y. DE BECKER E. La pédophilie coll. Que penser de ? Paris : Ed. Jésuites, 2018