By Pam Gillin,
Registered Nurse – Greater Baltimore Medical Center – SAFE Program
Board of Directors – No More Stolen Childhoods
Child sexual abuse (CSA) is a complex problem with considerable dimensions. The Centers for Disease Control and Prevention (CDC) have identified child sexual abuse as “a significant, but preventable public health problem.” The best available data suggests that 1 in 5 girls and 1 in 13 boys will experience sexual abuse before the age of 18. These numbers are alarming, but we also know that CSA is vastly under-reported. CSA is also associated with long-term impacts on the physical and mental health of those affected.
I am a registered nurse and Sexual Assault Forensic Examiner (SAFE) at Greater Baltimore Medical Center (GBMC). I perform medical forensic examinations of children affected by child sexual abuse, and can attest to the magnitude of this issue. In 2020, our GBMC SAFE Team cared for 94 child victims from Baltimore County. Despite the complexities of the issue and the reality that all victims don’t come through our doors, I know we are helping change the trajectory for those we care for. The abuse will stop for these children, but it makes me wonder, how could this abuse have been prevented? Wouldn’t it be better to focus our efforts as a community, to do everything we can to keep these children from ever needing this care?
No More Stolen Childhoods agrees with the CDC that the goal is to stop child sexual abuse from happening in the first place. This starts with raising awareness and understanding in order to reframe this issue from a taboo topic that is closeted away into an openly discussed public health issue. Normalizing talking about CSA is essential to preventing it.
We need to be honest about who perpetrates child sexual abuse. An abuser is rarely a stranger, with research suggesting 90% of abuse is committed by someone a child knows and trusts, and nearly half by a relative or someone living with the child. Maybe even more surprisingly, over half of all sexual offenses committed against prepubescent children are committed by older, more powerful children.
With our partners at GBMC, No More Stolen Childhoods is offering evidence informed child sexual abuse prevention trainings to adults in our community. We cannot expect children to carry the burden of protecting themselves. Children are often reluctant to disclose, and often developmentally ill-equipped to process the abuse.
The Stewards of Children training highlights five steps for adults to take to protect children:
- Learning the facts about child sexual abuse in order to prevent it.
- Educating caregivers on how to minimize the opportunities for sexual abuse. The focus is on eliminating isolated, one on one encounters, between children and adults. CSA requires privacy. Limiting opportunity in the home, school, and child-serving community organizations is vital. As our GBMC SAFE team has seen in practice, it only takes a quick trip to the restroom for an offender to exploit this situation and for abuse to occur.
- Talking about the issue to empower children to have control of their bodies and to say no to unwanted touch. It is an ongoing educational process starting with open, age-appropriate communication with children about their bodies, boundaries, and sex. Children should know anatomically correct names for body parts and be taught that no one should ever ask them to take their clothes off. They also need to know that no one should take their clothes off in front of them. This is especially important with online interactions. An online predator will lose interest quickly in a child who won’t comply.
- Recognizing the signs that child sexual abuse may have occurred. At GBMC SAFE we say, “It is normal to be normal.” In over 90% of our cases there will be no physical injury. Behavioral changes such as unexplained anger, nightmares, and regression sometimes appear, but not always, and these signs in isolation don’t necessarily mean a child has been abused, but they do present an opportunity for continued dialogue and examination.
- Reacting Responsibly to suspicions of abuse. This training equips parents, and trusted adults, with a playbook detailing how to respond and what to do if a child discloses sexual abuse or if it is observed or suspected. The training challenges adults to think creatively in their own homes and communities, around how they can plan that one on one interactions between adults and children are avoided.
Through these steps, parents and trusted adults can be equipped with the tools to prevent, identify, and intervene on child sexual abuse, which are responsibilities we share as a community.
In Delaware, the Beau Biden Foundation set out to educate 5% of the adults with the Stewards of Children training. The plan embraces Malcolm Gladwell’s premise that major societal change occurs quickly once we reach “the tipping point,” the critical mass needed for change. Help us make Maryland a tipping point state. Take the training and be part of a movement to protect our children.