The dominant approach to prevention of child sexual abuse has been to rely on victims to avoid potentially abusive situations, to resist attempts to victimize them, and to report attempted and successful sexual abuse. This approach has been summarized as "say no, yell, and tell.'' Sexual abuse prevention programs have been developed for and delivered to children from preschool age through adolescence. Most are delivered in school settings. Some programs involve classroom teachers and parents. There were initial concerns by program designers about program content because of the sensitivity of the topic and anticipated parental resistance. Because of this, many programs focused on ''stranger danger'' and avoided addressing the possibility that the offender could be, and in fact was much more likely to be, someone known to the child. Presently, many programs are imbedded in broader ''personal safety'' programs that address a variety of risks children may encounter. These include safety when crossing the street and riding a bike, physical abuse, bullying, and kidnapping.
These prevention programs have been the targets of considerable criticism. First, and justifiably, they have been criticized for making the child responsible for prevention. This especially is an issue with preschoolers. There have been concerns that the victims will not be successful at saying no, resisting, and yelling help and then will blame themselves if they are unable to protect themselves. Critics have queried, "Why not target the offenders rather than the potential victims?'' Better still, programs in high school aimed at potential parents and potential perpetrators might be more efficacious.
Prevention supporters counter these arguments as follows: If children receive this training as children, they will not victimize children when they become adolescents and adults. Further, supporters state that the fact children receive this kind of training may inhibit offenders from trying to abuse them. Offenders will fear children are on guard.
Second, prevention programs have been criticized because of their impact on the recipients. Specifically, there are worries that the programs may engender fear and cause trauma. Moreover, they may create a gulf between children and important adults in their lives because these programs put children on notice that adults, even those closest them, may not be trustworthy. In addition, prevention programs have been criticized as the source of some false allegations of sexual abuse. However, outcome studies indicate that only a very small minority of children experience an elevation in anxiety because of participation in prevention programs. No empirical support has been found for the assertions that prevention programs result in fears of caretakers or generate false allegations of sexual abuse.
Third, prevention programs have been challenged for their lack of effectiveness. For example, children may not understand all of the concepts they are being taught; may not be able to use the concepts to defend themselves; and may soon forget what they have learned. These criticisms have especially been leveled at preschool programs. Prevention program supporters reply that critics are expecting too much of the programs. These programs should be one of several approaches to preventing sexual abuse. Moreover, it is unrealistic to expect a program of an hour or even of several hours over time, to have a lasting or lifetime effect. Regular, periodic doses of prevention that occur at least on a yearly basis are what is needed.
Although prevention programs are far from a panacea, they can be beneficial. Finkelhor and colleagues
Child Sexual Abuse recently conducted a national telephone survey of youth and their parents related to these programs. This study was funded by the Boy Scouts of America and intended to address some of the above noted criticisms. Using a representative sample of 2000 young people, ages 10 to 16, these researchers found that about 70% had participated in a prevention program, 36% in the past year. Younger children were more likely to have participated in the previous year. The vast majority of both the youth and their parents rated the programs positively and 26% of youth reported using some of the skills they had learned. Girls, African American children, and children from lower socioeconomic status families rated programs more positively.
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