Journal of Primary Prevention, 6(3), Spring, 1986
An Analysis of P r o g r a m s to P r e v e n t the Sexual Victimization of Children JON R. CONTE, CAROLE ROSEN, and LESLEE SAPERSTEIN ABSTRACT: This paper provides a review and analysis of current programs to prevent sexual abuse of children. Seven aspects of prevention programming are discussed: prevention content, the length of the program, occupation of the trainer, prevention materials, training formats, types of abuse covered, and assertiveness and self-defense skills. Three potential problem areas prevention should address are also discussed. These include: the cognitive orientation of much prevention training, uncertainty surrounding what prevention content should actually be taught, and the need for quality assurance procedures.
Programs to prevent sexual victimization of children are widely available throughout the United States. Although it is impossible to know how many children have received prevention training, it is clear that the number is quite large and becoming larger as increasing numbers of communities are responding to public recognition of the problem of sexual abuse of children. Prevention knowledge is transmitted to children through a wide range of media including: audio-visual materials such as films, filmstrips, and audio cassettes; printed matter such as books or comic strips; television shows including brief public service announcements as well as longer shows designed for specific age groups; plays and musicals; and programs which combine a number of these media with in vivo training by an adult trainer. With the exception of efforts to compile lists of programs or materials (National Committee) and a recent review of prevention programs prepared by David Finkelhor and Sharon Aragi (1984), there has been little critical analysis of the many approaches to prevention training. This paper provides a preliminary analysis of programs to prevent sexual abuse of young children. The paper is intended both to summaPaper presented at the Fifth International Congress on Child Abuse and Neglect, September 16-19, 1984, Montreal Canada. Jon R. Conte Ph.D. is an Assistant Professor at the School of Social Service Administration, University of Chicago. Correspondence and reprint requests should be addressed to: Jon R. Conte, Ph.D. School of Social Service Administration, The University of Chicago, 969 E. 60th St., Chicago, IL 60637. At the time of their work on this paper, Carole Rosen and Leslee Saperstein were students at the School of Social Service Administration, University of Chicago. ©1986 Human Sciences Press
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rize trends in prevention training for those interested in adopting or developing a prevention program in their own community and to raise issues for those currently involved in prevention training. The paper is based upon an analysis of current prevention programs. Individual prevention materials such as books or films have not been reviewed unless they are an inherent component of a prevention program. The reader is cautioned that the analysis offered here is illustrative of trends appearing in prevention programs throughout the United States. It was not possible to review all programs currently in existence. Although it appears that the programs reviewed are indicative of the state of the art in prevention training, programs were selected for review because of their reputation or availability. Consequently no claims for representativeness would be appropriate. Finally, the views offered in this paper are intended to stimulate discussion about prevention training and should not be taken as final words on prevention training. The paper will discuss seven of the dimensions along which prevention programs may differ and suggest a number of potential problem areas which current prevention programs should address.
Program dimensions Current prevention programs differ along a number of dimensions. At this time it is not clear if these dimensions are related to the effectiveness of the prevention program in teaching children prevention concepts and skills. Until research is available which informs decision making about how to structure prevention programs, it would seem important for those considering adopting these programs or developing their own programs to develop a rationale for how their programs are structured. Some of the dimensions along which programs are structured are described below: Prevention content. Most programs teach similar concepts which are thought to be useful in preventing sexual abuse. These concepts are: Body ownership which stresses that each child has the right to control access to her/his own body. The touch continuum describes a range of types of touches. Although the terms used to describe this continuum vary (e.g., good versus bad, ok versus not-ok) the essential concept deals with the differences between aggressive, sexual, and appropriate interpersonal touching. The concept of secrets teaches children that some secrets should not be kept. Surprises are secrets that are eventually told (e.g., birthday presents). Children are taught if someone touches a private part of their body and tells them to keep it a secret,
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they should tell someone about the touching. Some programs teach children to trust their own feelings. This concept gives children permission to act on their intuition when something seems wrong with a specific interaction with someone else. The concept saying "No" teaches children that they have a right to say "No" when they are touched in ways that make them uncomfortable. Some programs teach children assertive behaviors (e.g., maintain eye contact and speak loudly) for saying "No" to abuse. Support systems teach children about the range of persons they may turn to for help if someone touches private parts of their body or asks them to touch private parts of his body. Length of the program. The length of the programs vary greatly. Some programs consist of a single session of between a half-hour and one hour. For example, King County Rape Relief has a program for Kindergarten and first grade students which consists of one session of approximately twenty-five minutes (King County). In contrast, Tacoma Public Schools offer a prevention program for third and fourth graders which requires twelve hours spanning twelve days (Tacoma). The Committee for Children has developed a prevention curriculum for school age children consisting of thirty-eight lessons (Committee for Children, 1983). While the length of the program is partly a function of the number of concepts or skills to be covered and the age of the children, a number of other issues should be reviewed in deciding the appropriate length of the program. One of these concerns the ambiguity inherent in prevention training about whether the major goal is to identify children who are being abused at the time the program is offered versus preparing children to prevent abuse in the future. To the extent that the goal is case identification, some abused children will come forward after brief "prevention" efforts. For example, after the showing of a thirty second public service announcement in the Seattle Washington viewing area, a number of victims were identified as a direct result of viewing the announcement on television. While the number is small given the large number of victims, it does illustrate the potential power of even brief prevention presentations (Berliner, 1984). However, given the pressure on victims to maintain the secrecy surrounding their victimization, it is likely that many victims will require a degree of reassurance only available in longer programs before being willing to reveal their abuse. Perhaps more importantly, teaching children who are not being abused the complex set of concepts and skills thought to prevent abuse would seem to require a longer training period. Currently, it is unknown what number of sessions are asso-
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ciated with what level of knowledge gain in what age child. Recent research conducted by Carol Plummer suggests that children forget prevention knowledge over the months after training (Plummer, 1984). These data when viewed in light of JoAnn Ray's findings that a booster training session significantly increased childrens' retention of prevention knowledge suggests that an ideal training format would include periodic booster training sessions to insure that children maintain whatever knowledge gains they make during initial prevention training sessions (Ray, 1984). Occupation of trainer. Trainers come from a wide variety of occupations. These include: teachers, police officers, rape crisis counselors, mental health professionals, and community volunteers. It is not currently known whether the occupation of the trainer is significantly related to the effectiveness of the prevention programs. It is possible that some children may view certain occupations (e.g., police officers or teachers) in certain ways which may influence the effectiveness of these professions as trainers. However, until research identifies how children view the profession of the trainer and how these views are related to training effects, it is unclear what the influence of the occupation of the trainer is on the outcome of training. Programs which use professionals with on-going contact with children (e.g., teachers or day care personnel) argue that these personnel have greater familiarity with their children and therefore able to structure training to meet individual children's special learning needs, can incorporate the prevention training into the regular routine of the child's day, and are in a position to review material periodically over time to insure that children retain their learning. While this argument is a conceptually appealing one, it might also be true that some children (especially older children) may attend more or find it more comfortable to discuss prevention concepts with someone with whom they will not have ongoing contact. Research is needed to address the effectiveness of trainers indigenous to the child's environment versus special trainers entering the child's environment for a brief period of time. Other variables, such as the potential trainer's comfort with the material, skills in relating to and teaching children, and knowledge about sexual abuse may also be associated with the outcomes of training. What does seem clear is that some special groups of children may require special expertise of prevention trainers. Physically, developmentally, or emotionally handicapped children present special requirements for training efforts. Trainers of these special groups of children
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are likely to require specialized knowledge in communicating with the children and in understanding how these groups m a y be uniquely touched by sexual victimization or sexual abuse prevention concepts. Prevention programs for these special groups are becoming available (Seattle Rape Relief, 1980). Special training in delivering these programs also seems important. By the same token, training of professionals delivering the prevention program to any group of children seems important. Ann Downer indicates that her evaluation of the Committee for Children's teacherdelivered program seems to point to the fact that some teachers stressed assault by a stranger far more than did the Committee's curriculum. This apparently results from the deeply rooted notion that strangers are the greatest danger to children (Downer, 1984a). In a similar vein, Jon Conte and his colleagues in an evaluation of a program delivered by deputy sheriff officers found great variation in the program delivered to children and the program model upon which the deputies were trained (Conte, Rosen, Saperstein, and Shermack, 1983). While it is not clear why this variation existed, variation from the prevention content specified in a program can have a number of undesirable effects. By stressing material not part of the model, children m a y be exposed to information which is not likely to be useful in preventing their abuse, may frighten them, or have some currently unknown effect. While training may not completely ensure that variation does not occur, it does seem to be an important first step. Current training of trainers appears to vary greatly. Some programs provide no training at all. Others programs provide varying degrees of training. For example, the Sexual Victimization Prevention Project of Worchester, Massachusetts has developed a twelve hour training course which covers basic information on child sexual abuse and prevention. The Committee for Children has developed a comprehensive training format covering basic information about child sexual abuse, identification and reporting, and prevention eduction. (Committee for Children, 1983) One of the problems programs encounter in developing training experiences for prevention trainers is that knowledge about sexual victimization is quickly changing. Many current theories about adults who sexually abuse children are being seriously challenged by developments in knowledge. Also much is still not known (e.g., there exists no rigorous investigation of the processes employed by adults to engage children in sexual abuse). It is difficult to know upon what material to base trainer training. This state of current knowledge about
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sexual abuse cautions prevention programs that their prevention model and trainer materials are likely to undergo change as new developments become available. Prevention materials. There is an extensive array of materials from which to select when incorporating materials into prevention programs. These materials include films, filmstrips, audio-tapes, printed matter, and anatomically correct dolls. Many programs appear to use a number of different materials. Among the more popular materials in many programs are anatomically correct dolls. The dolls are used to teach children correct terms for body parts and as an aid in teaching the concept that parts of the body belong to the child and the child does not have to share them. The Touch Cards developed by the Illusion Theater are also often used. These cards depict scenes of different types of touching. (Illusion Theater B) A filmstrip series created by Krause House teaches children a number of concepts thought to prevent sexual victimization (e.g., that offenders can be people the child knows, not just strangers) (Krause House). A film titled No More Secrets depicts a group of friends discussing their own experiences with sexual abuse which include a girl whose brother is constantly coming into the bathroom when she is using it, an uncle who wrestles with his nephew and begins to touch his private parts, and a child being tucked into bed by an adult who begins touching him in ways that make him uncomfortable (ODN Productions). Another popular film is Better Safe Than Sorry (Part II) which uses a group of children going through a prevention program as the way to educate the children watching the film (Film Fair). The children in the film play a "Let's pretend" game in which they picture themselves in certain potentially abusive situations and are then asked to make a decision about what they would do. The film stresses saying "No" to abusive situations, getting away, and telling someone about it. Since there has been virtually no evaluation of the differential effectiveness of these various prevention materials, the selection of any specific set of materials from the total available must be made on other criteria. These might include the degree to which the content of the material conforms to current understanding of the nature of the problem of sexual abuse and sexual abuse prevention and the degree the material appeals to and is developmentally appropriate (e.g., comprehensible, not frightening or holds the interest of children) for the specific-age child to receive training. Several words of caution should be considered in selecting material for the use in prevention training. While much of the available materi-
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als seem potentially useful, it is not clear that the use of material is necessarily superior to training delivered by a trained adult. Prevention content may be just as successfully taught by an adult as by any of the existing materials. Indeed, one of the earliest prevention programs in the country, the program offered by King County Rape Relief in Washington State, uses no materials at all (King County). Future research efforts are likely to compare the effectiveness of in vivo adultdelivered versus audio-visual prevention training. Prevention materials m a y make it easier for some adults (e.g., teachers or parents) to talk to children about sexual abuse. Where trained prevention professionals are not available this would appear to make prevention knowledge available to children who might not otherwise receive the training. However, such a situation would seem to raise the potential danger that the untrained adults might add ideas of their own which are not accurate about sexual abuse (e.g., strangers are the danger) or are otherwise not helpful to children. There are a number of materials available for parents and teachers which adults who are to be involved with children in talking about sexual abuse should review prior to being involved with children around prevention. It is not always clear why particular programs select or arrange the array of prevention materials they employ. In part, the use of a variety of materials may be intended to offer different mediums which will appeal to different children or it may simply provide a means of reinforcing content from one medium to another. Reviewers of these various prevention materials might be aware that some prevention materials appear to be packaged more to attract the eye of the adult purchaser of such material than to present material to children in a form that children are likely to understand. Training formats. Programs present the prevention content using a number of different formats. Some programs consist of a single medium (e.g., a workbook or play). Others include a number of different types of materials. Several of the prevention programs in Washington State illustrate the various approaches programs may take in delivering their content. Lutheran Social Services of Washington has developed a workbook for children titled, My Very Own Book About Me. (There is also a guide for teachers, parents, and therapists) (Lutheran Social Service). The workbook can be used in conjunction with other materials or alone. The workbook teaches children about body ownership, different types of touching, it's ok to tell secrets about touching private parts of the body, and the importance of telling someone if someone tries to touch private parts of the body. The Coalition for
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Child Advocacy has developed a play which teaches children about touching, what "private zones" are and that others shouldn't touch the "private zones," and to tell someone if someone is touching their "private zones." The play can be incorporated into a school program or the Coalition will go to the school and give a one-hour presentation called Soap Box Sense. The Coalition's preschool curriculum, Feelings and Your Body uses a number of books, films and filmstrips, games and role play situations. The program teaches children about feelings (e.g., happy versus scared versus confused feelings); support systems, private parts of the body and the right to say "No," saying "No" when someone tries to touch the child's private zones, and how to identify problem situations (Coalition for Child Advocacy). King County Rape Relief provides a one-session program for children of different ages. The presentations teach children about touching, encourage children to trust their intuition if an interaction makes them feel uncomfortable, and to tell someone if they feel that an interaction makes them uncomfortable (King County and PBS). The Committee for Children has developed a series of curricula for preschoolers and school age children which teach children about decision making around personal safety, the touch continuum, assertive responses to abuse and potential abuse situations, and about using support systems to get help. The curricula are designed to be delivered by teachers who receive training from the Committee (Committee for Children, 1983). Types of abuse covered. Programs vary in terms of the number of potential victimization experiences they deal with. Some programs deal only with sexual abuse while others cover general safety content (e.g., what to do if the child is home alone and someone comes to the door or what to say when someone calls on the phone). Some programs indicate that the decision about whether to label a program sexual abuse prevention or safety information is a function of what the recipient agency finds the least threatening. Definitions of types of abuse also vary. Some programs specifically describe the nature of the behavior which children should avoid. For example, the Illusion Theater's prevention program for young children talks about "forced or tricked sexual contact or touch. There is also sexual abuse without touch, such as exposing, obscene phone c a l l s . . . " (Illusion Theater A). Other programs talk about good vs. bad touches, confusing touches, private zones, or touching parts of the body which are under a bathing suit or underwear. Some programs use the anatomically correct terms for body parts and teach children that they do not have to let other people touch those parts of the body.
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The decision about what terms to use to describe the behaviors which children are to be protected against may in part be a function of what terminology parents and agencies find acceptable. More importantly however, would seem to be some recognition that children may find various concepts easier to learn than others. The evaluation conducted by Jon Conte and his colleagues indicates that young and school age children have greater difficulty learning prevention content of an abstract rather than specific nature (Conte et al., 1983). Additionally, terms such as "good" or "bad" touch may be problematic labels to attach to sexual abuse behaviors. For example, defining "bad touches" as "touches which don't feel good" is problematic since many victims experience at least some of the touching as pleasing or associated with an on-going and otherwise positive relationship. The curricula developed by the Committee for Children appear to be the only prevention materials which teach children that even touches of private parts of the body which feel good can be abusive. Touches by health care providers or by parents in providing appropriate care to children are also often identified as appropriate touch of private body parts (Committee for Children, 1983). Research is necessary which describes children's ability to learn and understand various terms employed in prevention programs. For the time being, programs would do well to review whether their definitions are too vague to specifically identify for children the behaviors to be avoided and to ask whether the terms they use carry connotations which are not intended. Assertiveness and self-defense skills. Although all programs teach children to say "No" to abusive situations, programs vary in the extent to which they teach actual assertive behaviors for saying "No." The Talking About Touching curricula developed by the Committee for Children breaks assertiveness into its component skills of body language, the avoidance of reasoning with a potential offender, and the repetition of the simple declaration "No" (Committee for Children, 1983). Strategies for Free Children developed by Women Against Rape of Columbus, Ohio teach children basic self-defense skills (e.g., how to kick someone trying to grab the child) (Women Against Rape). The value of self-defense training may not be just in teaching children how to defend against assaults, but also that such skills increase children's confidence in their abilities to protect themselves. This increase in confidence may be assessed by potential offenders who sense the child is "not an easy mark." There has been little research on the extent to which children actually increase their assertiveness as a function of prevention training. Ann Downer in her evaluation of the curriculum
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developed by the Committee for Children used role play situations with puppets to assess children's assertiveness skill acquisition and found the curriculum did in fact increase children's assertiveness (Downer, 1984a). Since analogue measurement of children's performance may vary considerably from actual behavior, additional research is clearly needed (McFall, 1977). Although self-defense training is quite controversial, conceptually it deserves consideration. Even if children are not likely to be successful in using self-defense techniques to resist or escape abuse, if research indicates it does increase children's self-confidence it may be a helpful prevention technique. Potential problem areas The development of prevention materials and programs has been rapid and gives every appearance of much creativity. Since there has been little research analyzing the effects of these programs, they should be approached with the caution that any potentially powerful but unproven intervention deserves. Ultimately, research will be necessary to refine current program models and insure that they do in fact serve the purposes for which they were designed. A review of existing programs, models, materials, and specific local programs around the country raises a number of issues prevention professionals may wish to address. These issues are outlined in the remainder of the paper. Cognitive orientation. Most of the prevention efforts to date have taken an overwhelmingly cognitive approach to training. Training has consisted largely of teaching children concepts which adults believe will prevent their abuse. Concepts such as the difference between "ok" and not-ok" touch or "trusting your own feelings" vary considerably in terms of specificity and the cognitive abilities they require to discriminate between often subtle situations or interpersonal interactions. The evaluation by Jon Conte and his colleagues suggests that children have. difficulty in learning abstract rather than specific prevention content (Conte et al., 1983). While available evidence seems to suggest that children do learn most prevention concepts, the issue prevention professionals may wish to consider is whether cognitive teaching approaches are the best means to teach prevention skills. (Conte, 1984) It is clear that the ultimate goal of most prevention programs is teaching children behaviors (skills) which are thought to prevent their own abuse. While certain prevention skills are cognitive in nature (e.g., discriminating between appropriate and inappropriate touching),
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resisting or escaping abuse situations requires a set of behaviors (e.g., assertively saying "No"). Changing children's behavior is only partially a matter of changing children's understanding of concepts which influence or describe behavior. Behavior change is more effectively obtained through actions more directly linked to the desired behavior than are cognitively focused activities. Teaching techniques such as modeling of desired behavior, guided rehearsal in which a child is carried through the specific behavioral components of a complex skill, and reinforcement for approximations of the desired behavior are more likely to produce change in children's behavior. It appears that most current prevention efforts do not devote sufficient attention to efforts such as guided rehearsal. This failure may be more pronounced in the programs which are of a shorter duration. It is helpful to keep in mind that assertiveness training for adults who are far superior to children in their cognitive abilites and potential to learn skills through verbal descriptions of the desired behavior, takes ten to twelve weeks to learn even a more limited set of behaviors than are the goals of most child-centered prevention programs (Gambrill, 1977). Prevention content. Related to the issue of how prevention programs teach children is some concern over what is taught. It is helpful to keep in mind that the current set of prevention concepts and skills are based upon what adults believe will prevent sexual victimization. Although this prevention knowledge is based in part on anecdotal clinical experience, there exists no systematic investigation of the processes adults use to engage and maintain children in sexual abuse situations. As professionals' experience increases with sexually abused children, new prevention content is identified. For example, the limited amount of information available about the Manhattan Beach California day care abuse case suggests new concepts which should be taught children to debunk the lies, manipulations, and coercion adults use to engage and maintain children in sexual abuse. It appears that one of the things we need to teach children is how to overcome the fear created by watching small living animals crushed to death before their eyes and being told that the same thing would happen to their parents if they told about the sexual abuse (Newsweek, April 9, 1984). As professionals come to understand more about sexual abuse (e.g., why some children are selected by offenders or what offenders say and do to engage children) certain additional prevention content is likely to be identified. In time it is also likely that research will evaluate the
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relative importance of various prevention concepts and skills producing the kind of conceptual, attitudinal, and behavioral changes important in preventing abuse. For example, is self-defense training important in increasing children's sense of power to resist abuse or is teaching children the anatomically correct terms for body parts essential in teaching them to discriminate between "ok" or "not-ok" touching? In the near future samples of children trained in prevention concepts and skills will be available who will be able to describe how useful they found the information in resisting abuse. Quality assurance. The number of professionals and community volunteers involved in prevention training is greatly expanding. There has been very little discussion to date about how to insure the quality of training delivered by these adults. Most prevention programs and materials have been developed by professionals with expertise in child sexual abuse. These are professionals who understand the dynamics of sexual abuse and are aware of the realities of the problem rather than the myths surrounding sexual abuse. It is not clear what happens when professionals or volunteers with limited expertise or understanding of child sexual abuse become involved in prevention training. Additionally, since few of the programs or materials explain the rationale underlying what they teach and how they teach it, there are few inherent mechanisms for insuring the quality of what children receive. The possibilities of not following a prescribed training model or for inappropriately using some particular piece of prevention material seem unlimited. Anecdotal experiences illustrate some of the ways that materials may be misused. The first author has observed films designed for older children employed in prevention efforts with younger children. Some police department's Officer Friendly programs continue to deal with stranger assault exclusively. Other programs deal exclusively with intra-family abuse. Some programs encourage prevention efforts which are unlikely to assist children in resisting or escaping abuse. For example, while child fingerprinting programs may make body identification easier it has virtually no preventive advantage. The inappropriate use of existing prevention materials or of teaching children content not likely to be helpful in preventing abuse is potentially a problem for a number of reasons. Some children will be unduly frightened as poorly trained adults tell frightening stories about abused children (Conte et al., 1983). Other children may be taught information or skills which are useless and have taken prevention time away from learning concepts more likely to be helpful. Other children
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and their parents will be lured into a false sense of security because exposure to the prevention program has not in fact equipped the child to prevent his or her abuse. There are an increasing number of training materials which m a y be helpful in maintaining the quality of prevention training efforts (see example Committee for Children, 1984). Additionally, program sponsors should consider developing monitoring procedures to determine if the programs presented to children do in fact conform to the program outlined in the model or manual. Jon Conte and his colleagues audio-taped the program they were evaluating (Conte et al., 1983). Audio-tapes of programs presented to children can be randomly spot checked for conformity to an approved curriculum. This would be a more economical quality-assuring device than reviewing tapes of an entire program. Programs may wish to consider other mechanisms such as trainer completed checklists of approved content or periodic booster training sessions to insure the highest level of trainer preparation.
Conclusion
A considerable amount of professional time and energy has gone into the development of a creative array of prevention programs and materials. Continued work and research is likely to improve existing prevention approaches directed at potential victims of sexual victimization. However, m a n y professionals involved in sexual abuse prevention programs recognize that ultimately all materials and programs should be viewed as temporary efforts to help children resist and escape abuse until such time as other activities can be successful in changing the conditions which cause and support sexual abuse of children. These conditions which produce the kind of adult personalities who abuse children and which place children and those who care for them in socially, emotionally, and economically vulnerable positions are deeply embedded in American culture and society. While m a n y prevention professionals recognize that fundamental change in power relationships in families and in society from a sexist to equalitarian distribution will be necessary to prevent sexual vicitimization, ultimately as a professional group, not enough has been done to link political and cultural life and sexual vicitimization. For far too many professionals involved in responding to sexual abuse of children, the problem
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is a mental health one in which intra-individual and interpersonal variables are the major focus of attention. For others, sexual abuse is a function of children's ignorance about touching or unassertiveness. While these ideas are correct as far as they go, sexual abuse of children is also an inherent condition of a society which allows the strong to abuse the weak. Social and political conditions are linked to the behavior of individuals. These conditions might be family environment in which discord, abuse, and exploitation help produce adults who potentially abuse children. The conditions might also be political decisions made at federal or state levels of government which deprive children and the adults who care for them of the resources necessary to be safe. No single set of activities will create a society in which the vulnerable need not protect themselves because they are in fact not vulnerable. However, efforts by prevention professionals directed toward making the vulnerable strong and changing the social conditions associated with vulnerability will go a long way in preventing sexual abuse of children.
References Berliner, L. Personal communication, September 1984. Coalition for Child Advocacy. The Touching Problem, Feelings and Your Body, Sexual Abuse Prevention: A Lesson Plan. (Unpublished Manuscript). Available at Box 159, Bellingham, Washington 98227. Committee for Children (1983). Ruth Harms, Donna James, and Margaret Schonfield, Talking About Touching with Preschoolers. Ruth Harms and Donna James, Talking About Touching: A Personal Safety Curriculum. Available from Committee at P.O. Box 15190, Seattle Washington, 98115. Committee for Children (1984). Prevention of Child Sexual Abuse: A Trainer's Manual. Available from the Committee P.O. Box 15190, Seattle Washington 98115. Conte, J.R. (1984). Research on Prevention of Sexual Victimization of Children. Paper presented at Second National Conference for Family Violence Researchers. Durham, New Hampshire, July 1984. Conte, J.R., Rosen, E., Saperstein, L., Shermack, R. (1983). An evaluation of a program to prevent the sexual victimizationof young children. Child A buse and Neglect: The International Journal (In press). Downer, A. Personal Communication, April 1984a. Downer, A. (1984b). The Development and Testing of an Evaluation Instrument for Assessing the Effectiveness of a Child Sexual Abuse Prevention Curriculum. Doctoral Dissertation, University of Washington. Film Fair Communications. Better Safe Than Sorry H, (film). Available at 10900 Ventura Boulevard, Studio City California 91604. Finkelhor, D. and Aragi, S. The Prevention of Child Sexual Abuse: A Review of Current Approaches. (Unpublished Manuscript) Available from Family Violence Research Program, University of New Hampshire, Durham, New Hampshire 03824. Gambrill E. Behavior Modification: Handbook of Assessment, Intervention, and Evaluation, 1977, Jossey-Bass, San Francisco.
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Illusion Theater (A). Child Sexual Abuse Prevention Program, (Unpublished Manuscript) Available at 528 Hennepin Avenue, 309, Minneapolis Minnesota 55403. Illusion Theater (B). Touch Cards. Available at 528 Hennepin Avenue 309, Minneapolis Minnesota 55403. King County Rape Relief (1981). Talking to Children~Talking to Parents About Sexual Assault. Available from Agency at 305 South 43rd, Renton Washington 98055. Krause House. For Pete's Sake Tell (Filmstrip). Available from Krause House, P.O. Box 880, Oregon City, Oregon 97045. Lutheran Social Services. My Very Own Book About Me. (Unpublished Manuscript) Available at N1226 Howard, Spokane Washington 99201. McFall, R.M. Analogue Methods in J. Cone and R. Hawkins (Eds.) (1977) Behavioral Assessment, Brunner/Mazel, New York, 152-177. National Committee for the Prevention of Child Abuse (1984). Child Sexual Prevention Resources Available from National Committee, 332 South Michigan Ave., Suite 1250, Chicago, Illinois 60604-4357. Newsweek, April 9, 1984. A Sordid Preschool "Game". Strasser, S., Bailey, E., in Los Angeles & Bureau Reports. p. 38. ODN Productions. No More Secrets (film). Available at 74 Varick Street, Suite 304, New York, New York 10013. Plummer, C. (1984). Research on Prevention: What In School Programs Teach Children. Paper presented at Third National Conference on Sexual Victimization, Washington D.C., April 20-28, 1984. Available from author at Box 421, Kalamazoo Michigan, 49009-0421. PBS Television Special. Child Sexual Abuse: What Your Child Should Know, a four-part television prevention program available from A-V Center, Indiana University, Bloomington Indiana 47405. Ray, J. (1984). Evaluation of the Child Sex Abuse Prevention Project, 1984. (Unpublished Manuscript) Available from Rape Crisis Network, Spokane Washington. Seattle Rape Relief (1980). Sexual Assault of Handicapped Students. Available at 1825 South Jackson, Suite 102, Seattle Washington 98144. Tacoma School District. Prevention Curriculum. Available from District Office at Marlys Olson, Ed. D. Child Sexual Abuse Prevention Program, P.O. Box 1357, Tacoma Washington 98401. Women Against Rape, Child Assault Prevention Project. Strategies for Free Children. (Unpublished Manuscript) Sally Cooper, Yvonne Lutter, and Cathy Phelps. Available at National Project to Prevent Violence Against Women, P.O. Box 02180, Columbus Ohio 43202.
An Analysis of P r o g r a m s to P r e v e n t the Sexual Victimization of Children JON R. CONTE, CAROLE ROSEN, and LESLEE SAPERSTEIN ABSTRACT: This paper provides a review and analysis of current programs to prevent sexual abuse of children. Seven aspects of prevention programming are discussed: prevention content, the length of the program, occupation of the trainer, prevention materials, training formats, types of abuse covered, and assertiveness and self-defense skills. Three potential problem areas prevention should address are also discussed. These include: the cognitive orientation of much prevention training, uncertainty surrounding what prevention content should actually be taught, and the need for quality assurance procedures.
Programs to prevent sexual victimization of children are widely available throughout the United States. Although it is impossible to know how many children have received prevention training, it is clear that the number is quite large and becoming larger as increasing numbers of communities are responding to public recognition of the problem of sexual abuse of children. Prevention knowledge is transmitted to children through a wide range of media including: audio-visual materials such as films, filmstrips, and audio cassettes; printed matter such as books or comic strips; television shows including brief public service announcements as well as longer shows designed for specific age groups; plays and musicals; and programs which combine a number of these media with in vivo training by an adult trainer. With the exception of efforts to compile lists of programs or materials (National Committee) and a recent review of prevention programs prepared by David Finkelhor and Sharon Aragi (1984), there has been little critical analysis of the many approaches to prevention training. This paper provides a preliminary analysis of programs to prevent sexual abuse of young children. The paper is intended both to summaPaper presented at the Fifth International Congress on Child Abuse and Neglect, September 16-19, 1984, Montreal Canada. Jon R. Conte Ph.D. is an Assistant Professor at the School of Social Service Administration, University of Chicago. Correspondence and reprint requests should be addressed to: Jon R. Conte, Ph.D. School of Social Service Administration, The University of Chicago, 969 E. 60th St., Chicago, IL 60637. At the time of their work on this paper, Carole Rosen and Leslee Saperstein were students at the School of Social Service Administration, University of Chicago. ©1986 Human Sciences Press
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rize trends in prevention training for those interested in adopting or developing a prevention program in their own community and to raise issues for those currently involved in prevention training. The paper is based upon an analysis of current prevention programs. Individual prevention materials such as books or films have not been reviewed unless they are an inherent component of a prevention program. The reader is cautioned that the analysis offered here is illustrative of trends appearing in prevention programs throughout the United States. It was not possible to review all programs currently in existence. Although it appears that the programs reviewed are indicative of the state of the art in prevention training, programs were selected for review because of their reputation or availability. Consequently no claims for representativeness would be appropriate. Finally, the views offered in this paper are intended to stimulate discussion about prevention training and should not be taken as final words on prevention training. The paper will discuss seven of the dimensions along which prevention programs may differ and suggest a number of potential problem areas which current prevention programs should address.
Program dimensions Current prevention programs differ along a number of dimensions. At this time it is not clear if these dimensions are related to the effectiveness of the prevention program in teaching children prevention concepts and skills. Until research is available which informs decision making about how to structure prevention programs, it would seem important for those considering adopting these programs or developing their own programs to develop a rationale for how their programs are structured. Some of the dimensions along which programs are structured are described below: Prevention content. Most programs teach similar concepts which are thought to be useful in preventing sexual abuse. These concepts are: Body ownership which stresses that each child has the right to control access to her/his own body. The touch continuum describes a range of types of touches. Although the terms used to describe this continuum vary (e.g., good versus bad, ok versus not-ok) the essential concept deals with the differences between aggressive, sexual, and appropriate interpersonal touching. The concept of secrets teaches children that some secrets should not be kept. Surprises are secrets that are eventually told (e.g., birthday presents). Children are taught if someone touches a private part of their body and tells them to keep it a secret,
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they should tell someone about the touching. Some programs teach children to trust their own feelings. This concept gives children permission to act on their intuition when something seems wrong with a specific interaction with someone else. The concept saying "No" teaches children that they have a right to say "No" when they are touched in ways that make them uncomfortable. Some programs teach children assertive behaviors (e.g., maintain eye contact and speak loudly) for saying "No" to abuse. Support systems teach children about the range of persons they may turn to for help if someone touches private parts of their body or asks them to touch private parts of his body. Length of the program. The length of the programs vary greatly. Some programs consist of a single session of between a half-hour and one hour. For example, King County Rape Relief has a program for Kindergarten and first grade students which consists of one session of approximately twenty-five minutes (King County). In contrast, Tacoma Public Schools offer a prevention program for third and fourth graders which requires twelve hours spanning twelve days (Tacoma). The Committee for Children has developed a prevention curriculum for school age children consisting of thirty-eight lessons (Committee for Children, 1983). While the length of the program is partly a function of the number of concepts or skills to be covered and the age of the children, a number of other issues should be reviewed in deciding the appropriate length of the program. One of these concerns the ambiguity inherent in prevention training about whether the major goal is to identify children who are being abused at the time the program is offered versus preparing children to prevent abuse in the future. To the extent that the goal is case identification, some abused children will come forward after brief "prevention" efforts. For example, after the showing of a thirty second public service announcement in the Seattle Washington viewing area, a number of victims were identified as a direct result of viewing the announcement on television. While the number is small given the large number of victims, it does illustrate the potential power of even brief prevention presentations (Berliner, 1984). However, given the pressure on victims to maintain the secrecy surrounding their victimization, it is likely that many victims will require a degree of reassurance only available in longer programs before being willing to reveal their abuse. Perhaps more importantly, teaching children who are not being abused the complex set of concepts and skills thought to prevent abuse would seem to require a longer training period. Currently, it is unknown what number of sessions are asso-
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ciated with what level of knowledge gain in what age child. Recent research conducted by Carol Plummer suggests that children forget prevention knowledge over the months after training (Plummer, 1984). These data when viewed in light of JoAnn Ray's findings that a booster training session significantly increased childrens' retention of prevention knowledge suggests that an ideal training format would include periodic booster training sessions to insure that children maintain whatever knowledge gains they make during initial prevention training sessions (Ray, 1984). Occupation of trainer. Trainers come from a wide variety of occupations. These include: teachers, police officers, rape crisis counselors, mental health professionals, and community volunteers. It is not currently known whether the occupation of the trainer is significantly related to the effectiveness of the prevention programs. It is possible that some children may view certain occupations (e.g., police officers or teachers) in certain ways which may influence the effectiveness of these professions as trainers. However, until research identifies how children view the profession of the trainer and how these views are related to training effects, it is unclear what the influence of the occupation of the trainer is on the outcome of training. Programs which use professionals with on-going contact with children (e.g., teachers or day care personnel) argue that these personnel have greater familiarity with their children and therefore able to structure training to meet individual children's special learning needs, can incorporate the prevention training into the regular routine of the child's day, and are in a position to review material periodically over time to insure that children retain their learning. While this argument is a conceptually appealing one, it might also be true that some children (especially older children) may attend more or find it more comfortable to discuss prevention concepts with someone with whom they will not have ongoing contact. Research is needed to address the effectiveness of trainers indigenous to the child's environment versus special trainers entering the child's environment for a brief period of time. Other variables, such as the potential trainer's comfort with the material, skills in relating to and teaching children, and knowledge about sexual abuse may also be associated with the outcomes of training. What does seem clear is that some special groups of children may require special expertise of prevention trainers. Physically, developmentally, or emotionally handicapped children present special requirements for training efforts. Trainers of these special groups of children
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are likely to require specialized knowledge in communicating with the children and in understanding how these groups m a y be uniquely touched by sexual victimization or sexual abuse prevention concepts. Prevention programs for these special groups are becoming available (Seattle Rape Relief, 1980). Special training in delivering these programs also seems important. By the same token, training of professionals delivering the prevention program to any group of children seems important. Ann Downer indicates that her evaluation of the Committee for Children's teacherdelivered program seems to point to the fact that some teachers stressed assault by a stranger far more than did the Committee's curriculum. This apparently results from the deeply rooted notion that strangers are the greatest danger to children (Downer, 1984a). In a similar vein, Jon Conte and his colleagues in an evaluation of a program delivered by deputy sheriff officers found great variation in the program delivered to children and the program model upon which the deputies were trained (Conte, Rosen, Saperstein, and Shermack, 1983). While it is not clear why this variation existed, variation from the prevention content specified in a program can have a number of undesirable effects. By stressing material not part of the model, children m a y be exposed to information which is not likely to be useful in preventing their abuse, may frighten them, or have some currently unknown effect. While training may not completely ensure that variation does not occur, it does seem to be an important first step. Current training of trainers appears to vary greatly. Some programs provide no training at all. Others programs provide varying degrees of training. For example, the Sexual Victimization Prevention Project of Worchester, Massachusetts has developed a twelve hour training course which covers basic information on child sexual abuse and prevention. The Committee for Children has developed a comprehensive training format covering basic information about child sexual abuse, identification and reporting, and prevention eduction. (Committee for Children, 1983) One of the problems programs encounter in developing training experiences for prevention trainers is that knowledge about sexual victimization is quickly changing. Many current theories about adults who sexually abuse children are being seriously challenged by developments in knowledge. Also much is still not known (e.g., there exists no rigorous investigation of the processes employed by adults to engage children in sexual abuse). It is difficult to know upon what material to base trainer training. This state of current knowledge about
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sexual abuse cautions prevention programs that their prevention model and trainer materials are likely to undergo change as new developments become available. Prevention materials. There is an extensive array of materials from which to select when incorporating materials into prevention programs. These materials include films, filmstrips, audio-tapes, printed matter, and anatomically correct dolls. Many programs appear to use a number of different materials. Among the more popular materials in many programs are anatomically correct dolls. The dolls are used to teach children correct terms for body parts and as an aid in teaching the concept that parts of the body belong to the child and the child does not have to share them. The Touch Cards developed by the Illusion Theater are also often used. These cards depict scenes of different types of touching. (Illusion Theater B) A filmstrip series created by Krause House teaches children a number of concepts thought to prevent sexual victimization (e.g., that offenders can be people the child knows, not just strangers) (Krause House). A film titled No More Secrets depicts a group of friends discussing their own experiences with sexual abuse which include a girl whose brother is constantly coming into the bathroom when she is using it, an uncle who wrestles with his nephew and begins to touch his private parts, and a child being tucked into bed by an adult who begins touching him in ways that make him uncomfortable (ODN Productions). Another popular film is Better Safe Than Sorry (Part II) which uses a group of children going through a prevention program as the way to educate the children watching the film (Film Fair). The children in the film play a "Let's pretend" game in which they picture themselves in certain potentially abusive situations and are then asked to make a decision about what they would do. The film stresses saying "No" to abusive situations, getting away, and telling someone about it. Since there has been virtually no evaluation of the differential effectiveness of these various prevention materials, the selection of any specific set of materials from the total available must be made on other criteria. These might include the degree to which the content of the material conforms to current understanding of the nature of the problem of sexual abuse and sexual abuse prevention and the degree the material appeals to and is developmentally appropriate (e.g., comprehensible, not frightening or holds the interest of children) for the specific-age child to receive training. Several words of caution should be considered in selecting material for the use in prevention training. While much of the available materi-
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als seem potentially useful, it is not clear that the use of material is necessarily superior to training delivered by a trained adult. Prevention content may be just as successfully taught by an adult as by any of the existing materials. Indeed, one of the earliest prevention programs in the country, the program offered by King County Rape Relief in Washington State, uses no materials at all (King County). Future research efforts are likely to compare the effectiveness of in vivo adultdelivered versus audio-visual prevention training. Prevention materials m a y make it easier for some adults (e.g., teachers or parents) to talk to children about sexual abuse. Where trained prevention professionals are not available this would appear to make prevention knowledge available to children who might not otherwise receive the training. However, such a situation would seem to raise the potential danger that the untrained adults might add ideas of their own which are not accurate about sexual abuse (e.g., strangers are the danger) or are otherwise not helpful to children. There are a number of materials available for parents and teachers which adults who are to be involved with children in talking about sexual abuse should review prior to being involved with children around prevention. It is not always clear why particular programs select or arrange the array of prevention materials they employ. In part, the use of a variety of materials may be intended to offer different mediums which will appeal to different children or it may simply provide a means of reinforcing content from one medium to another. Reviewers of these various prevention materials might be aware that some prevention materials appear to be packaged more to attract the eye of the adult purchaser of such material than to present material to children in a form that children are likely to understand. Training formats. Programs present the prevention content using a number of different formats. Some programs consist of a single medium (e.g., a workbook or play). Others include a number of different types of materials. Several of the prevention programs in Washington State illustrate the various approaches programs may take in delivering their content. Lutheran Social Services of Washington has developed a workbook for children titled, My Very Own Book About Me. (There is also a guide for teachers, parents, and therapists) (Lutheran Social Service). The workbook can be used in conjunction with other materials or alone. The workbook teaches children about body ownership, different types of touching, it's ok to tell secrets about touching private parts of the body, and the importance of telling someone if someone tries to touch private parts of the body. The Coalition for
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Child Advocacy has developed a play which teaches children about touching, what "private zones" are and that others shouldn't touch the "private zones," and to tell someone if someone is touching their "private zones." The play can be incorporated into a school program or the Coalition will go to the school and give a one-hour presentation called Soap Box Sense. The Coalition's preschool curriculum, Feelings and Your Body uses a number of books, films and filmstrips, games and role play situations. The program teaches children about feelings (e.g., happy versus scared versus confused feelings); support systems, private parts of the body and the right to say "No," saying "No" when someone tries to touch the child's private zones, and how to identify problem situations (Coalition for Child Advocacy). King County Rape Relief provides a one-session program for children of different ages. The presentations teach children about touching, encourage children to trust their intuition if an interaction makes them feel uncomfortable, and to tell someone if they feel that an interaction makes them uncomfortable (King County and PBS). The Committee for Children has developed a series of curricula for preschoolers and school age children which teach children about decision making around personal safety, the touch continuum, assertive responses to abuse and potential abuse situations, and about using support systems to get help. The curricula are designed to be delivered by teachers who receive training from the Committee (Committee for Children, 1983). Types of abuse covered. Programs vary in terms of the number of potential victimization experiences they deal with. Some programs deal only with sexual abuse while others cover general safety content (e.g., what to do if the child is home alone and someone comes to the door or what to say when someone calls on the phone). Some programs indicate that the decision about whether to label a program sexual abuse prevention or safety information is a function of what the recipient agency finds the least threatening. Definitions of types of abuse also vary. Some programs specifically describe the nature of the behavior which children should avoid. For example, the Illusion Theater's prevention program for young children talks about "forced or tricked sexual contact or touch. There is also sexual abuse without touch, such as exposing, obscene phone c a l l s . . . " (Illusion Theater A). Other programs talk about good vs. bad touches, confusing touches, private zones, or touching parts of the body which are under a bathing suit or underwear. Some programs use the anatomically correct terms for body parts and teach children that they do not have to let other people touch those parts of the body.
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The decision about what terms to use to describe the behaviors which children are to be protected against may in part be a function of what terminology parents and agencies find acceptable. More importantly however, would seem to be some recognition that children may find various concepts easier to learn than others. The evaluation conducted by Jon Conte and his colleagues indicates that young and school age children have greater difficulty learning prevention content of an abstract rather than specific nature (Conte et al., 1983). Additionally, terms such as "good" or "bad" touch may be problematic labels to attach to sexual abuse behaviors. For example, defining "bad touches" as "touches which don't feel good" is problematic since many victims experience at least some of the touching as pleasing or associated with an on-going and otherwise positive relationship. The curricula developed by the Committee for Children appear to be the only prevention materials which teach children that even touches of private parts of the body which feel good can be abusive. Touches by health care providers or by parents in providing appropriate care to children are also often identified as appropriate touch of private body parts (Committee for Children, 1983). Research is necessary which describes children's ability to learn and understand various terms employed in prevention programs. For the time being, programs would do well to review whether their definitions are too vague to specifically identify for children the behaviors to be avoided and to ask whether the terms they use carry connotations which are not intended. Assertiveness and self-defense skills. Although all programs teach children to say "No" to abusive situations, programs vary in the extent to which they teach actual assertive behaviors for saying "No." The Talking About Touching curricula developed by the Committee for Children breaks assertiveness into its component skills of body language, the avoidance of reasoning with a potential offender, and the repetition of the simple declaration "No" (Committee for Children, 1983). Strategies for Free Children developed by Women Against Rape of Columbus, Ohio teach children basic self-defense skills (e.g., how to kick someone trying to grab the child) (Women Against Rape). The value of self-defense training may not be just in teaching children how to defend against assaults, but also that such skills increase children's confidence in their abilities to protect themselves. This increase in confidence may be assessed by potential offenders who sense the child is "not an easy mark." There has been little research on the extent to which children actually increase their assertiveness as a function of prevention training. Ann Downer in her evaluation of the curriculum
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developed by the Committee for Children used role play situations with puppets to assess children's assertiveness skill acquisition and found the curriculum did in fact increase children's assertiveness (Downer, 1984a). Since analogue measurement of children's performance may vary considerably from actual behavior, additional research is clearly needed (McFall, 1977). Although self-defense training is quite controversial, conceptually it deserves consideration. Even if children are not likely to be successful in using self-defense techniques to resist or escape abuse, if research indicates it does increase children's self-confidence it may be a helpful prevention technique. Potential problem areas The development of prevention materials and programs has been rapid and gives every appearance of much creativity. Since there has been little research analyzing the effects of these programs, they should be approached with the caution that any potentially powerful but unproven intervention deserves. Ultimately, research will be necessary to refine current program models and insure that they do in fact serve the purposes for which they were designed. A review of existing programs, models, materials, and specific local programs around the country raises a number of issues prevention professionals may wish to address. These issues are outlined in the remainder of the paper. Cognitive orientation. Most of the prevention efforts to date have taken an overwhelmingly cognitive approach to training. Training has consisted largely of teaching children concepts which adults believe will prevent their abuse. Concepts such as the difference between "ok" and not-ok" touch or "trusting your own feelings" vary considerably in terms of specificity and the cognitive abilities they require to discriminate between often subtle situations or interpersonal interactions. The evaluation by Jon Conte and his colleagues suggests that children have. difficulty in learning abstract rather than specific prevention content (Conte et al., 1983). While available evidence seems to suggest that children do learn most prevention concepts, the issue prevention professionals may wish to consider is whether cognitive teaching approaches are the best means to teach prevention skills. (Conte, 1984) It is clear that the ultimate goal of most prevention programs is teaching children behaviors (skills) which are thought to prevent their own abuse. While certain prevention skills are cognitive in nature (e.g., discriminating between appropriate and inappropriate touching),
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resisting or escaping abuse situations requires a set of behaviors (e.g., assertively saying "No"). Changing children's behavior is only partially a matter of changing children's understanding of concepts which influence or describe behavior. Behavior change is more effectively obtained through actions more directly linked to the desired behavior than are cognitively focused activities. Teaching techniques such as modeling of desired behavior, guided rehearsal in which a child is carried through the specific behavioral components of a complex skill, and reinforcement for approximations of the desired behavior are more likely to produce change in children's behavior. It appears that most current prevention efforts do not devote sufficient attention to efforts such as guided rehearsal. This failure may be more pronounced in the programs which are of a shorter duration. It is helpful to keep in mind that assertiveness training for adults who are far superior to children in their cognitive abilites and potential to learn skills through verbal descriptions of the desired behavior, takes ten to twelve weeks to learn even a more limited set of behaviors than are the goals of most child-centered prevention programs (Gambrill, 1977). Prevention content. Related to the issue of how prevention programs teach children is some concern over what is taught. It is helpful to keep in mind that the current set of prevention concepts and skills are based upon what adults believe will prevent sexual victimization. Although this prevention knowledge is based in part on anecdotal clinical experience, there exists no systematic investigation of the processes adults use to engage and maintain children in sexual abuse situations. As professionals' experience increases with sexually abused children, new prevention content is identified. For example, the limited amount of information available about the Manhattan Beach California day care abuse case suggests new concepts which should be taught children to debunk the lies, manipulations, and coercion adults use to engage and maintain children in sexual abuse. It appears that one of the things we need to teach children is how to overcome the fear created by watching small living animals crushed to death before their eyes and being told that the same thing would happen to their parents if they told about the sexual abuse (Newsweek, April 9, 1984). As professionals come to understand more about sexual abuse (e.g., why some children are selected by offenders or what offenders say and do to engage children) certain additional prevention content is likely to be identified. In time it is also likely that research will evaluate the
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relative importance of various prevention concepts and skills producing the kind of conceptual, attitudinal, and behavioral changes important in preventing abuse. For example, is self-defense training important in increasing children's sense of power to resist abuse or is teaching children the anatomically correct terms for body parts essential in teaching them to discriminate between "ok" or "not-ok" touching? In the near future samples of children trained in prevention concepts and skills will be available who will be able to describe how useful they found the information in resisting abuse. Quality assurance. The number of professionals and community volunteers involved in prevention training is greatly expanding. There has been very little discussion to date about how to insure the quality of training delivered by these adults. Most prevention programs and materials have been developed by professionals with expertise in child sexual abuse. These are professionals who understand the dynamics of sexual abuse and are aware of the realities of the problem rather than the myths surrounding sexual abuse. It is not clear what happens when professionals or volunteers with limited expertise or understanding of child sexual abuse become involved in prevention training. Additionally, since few of the programs or materials explain the rationale underlying what they teach and how they teach it, there are few inherent mechanisms for insuring the quality of what children receive. The possibilities of not following a prescribed training model or for inappropriately using some particular piece of prevention material seem unlimited. Anecdotal experiences illustrate some of the ways that materials may be misused. The first author has observed films designed for older children employed in prevention efforts with younger children. Some police department's Officer Friendly programs continue to deal with stranger assault exclusively. Other programs deal exclusively with intra-family abuse. Some programs encourage prevention efforts which are unlikely to assist children in resisting or escaping abuse. For example, while child fingerprinting programs may make body identification easier it has virtually no preventive advantage. The inappropriate use of existing prevention materials or of teaching children content not likely to be helpful in preventing abuse is potentially a problem for a number of reasons. Some children will be unduly frightened as poorly trained adults tell frightening stories about abused children (Conte et al., 1983). Other children may be taught information or skills which are useless and have taken prevention time away from learning concepts more likely to be helpful. Other children
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and their parents will be lured into a false sense of security because exposure to the prevention program has not in fact equipped the child to prevent his or her abuse. There are an increasing number of training materials which m a y be helpful in maintaining the quality of prevention training efforts (see example Committee for Children, 1984). Additionally, program sponsors should consider developing monitoring procedures to determine if the programs presented to children do in fact conform to the program outlined in the model or manual. Jon Conte and his colleagues audio-taped the program they were evaluating (Conte et al., 1983). Audio-tapes of programs presented to children can be randomly spot checked for conformity to an approved curriculum. This would be a more economical quality-assuring device than reviewing tapes of an entire program. Programs may wish to consider other mechanisms such as trainer completed checklists of approved content or periodic booster training sessions to insure the highest level of trainer preparation.
Conclusion
A considerable amount of professional time and energy has gone into the development of a creative array of prevention programs and materials. Continued work and research is likely to improve existing prevention approaches directed at potential victims of sexual victimization. However, m a n y professionals involved in sexual abuse prevention programs recognize that ultimately all materials and programs should be viewed as temporary efforts to help children resist and escape abuse until such time as other activities can be successful in changing the conditions which cause and support sexual abuse of children. These conditions which produce the kind of adult personalities who abuse children and which place children and those who care for them in socially, emotionally, and economically vulnerable positions are deeply embedded in American culture and society. While m a n y prevention professionals recognize that fundamental change in power relationships in families and in society from a sexist to equalitarian distribution will be necessary to prevent sexual vicitimization, ultimately as a professional group, not enough has been done to link political and cultural life and sexual vicitimization. For far too many professionals involved in responding to sexual abuse of children, the problem
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is a mental health one in which intra-individual and interpersonal variables are the major focus of attention. For others, sexual abuse is a function of children's ignorance about touching or unassertiveness. While these ideas are correct as far as they go, sexual abuse of children is also an inherent condition of a society which allows the strong to abuse the weak. Social and political conditions are linked to the behavior of individuals. These conditions might be family environment in which discord, abuse, and exploitation help produce adults who potentially abuse children. The conditions might also be political decisions made at federal or state levels of government which deprive children and the adults who care for them of the resources necessary to be safe. No single set of activities will create a society in which the vulnerable need not protect themselves because they are in fact not vulnerable. However, efforts by prevention professionals directed toward making the vulnerable strong and changing the social conditions associated with vulnerability will go a long way in preventing sexual abuse of children.
References Berliner, L. Personal communication, September 1984. Coalition for Child Advocacy. The Touching Problem, Feelings and Your Body, Sexual Abuse Prevention: A Lesson Plan. (Unpublished Manuscript). Available at Box 159, Bellingham, Washington 98227. Committee for Children (1983). Ruth Harms, Donna James, and Margaret Schonfield, Talking About Touching with Preschoolers. Ruth Harms and Donna James, Talking About Touching: A Personal Safety Curriculum. Available from Committee at P.O. Box 15190, Seattle Washington, 98115. Committee for Children (1984). Prevention of Child Sexual Abuse: A Trainer's Manual. Available from the Committee P.O. Box 15190, Seattle Washington 98115. Conte, J.R. (1984). Research on Prevention of Sexual Victimization of Children. Paper presented at Second National Conference for Family Violence Researchers. Durham, New Hampshire, July 1984. Conte, J.R., Rosen, E., Saperstein, L., Shermack, R. (1983). An evaluation of a program to prevent the sexual victimizationof young children. Child A buse and Neglect: The International Journal (In press). Downer, A. Personal Communication, April 1984a. Downer, A. (1984b). The Development and Testing of an Evaluation Instrument for Assessing the Effectiveness of a Child Sexual Abuse Prevention Curriculum. Doctoral Dissertation, University of Washington. Film Fair Communications. Better Safe Than Sorry H, (film). Available at 10900 Ventura Boulevard, Studio City California 91604. Finkelhor, D. and Aragi, S. The Prevention of Child Sexual Abuse: A Review of Current Approaches. (Unpublished Manuscript) Available from Family Violence Research Program, University of New Hampshire, Durham, New Hampshire 03824. Gambrill E. Behavior Modification: Handbook of Assessment, Intervention, and Evaluation, 1977, Jossey-Bass, San Francisco.
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Illusion Theater (A). Child Sexual Abuse Prevention Program, (Unpublished Manuscript) Available at 528 Hennepin Avenue, 309, Minneapolis Minnesota 55403. Illusion Theater (B). Touch Cards. Available at 528 Hennepin Avenue 309, Minneapolis Minnesota 55403. King County Rape Relief (1981). Talking to Children~Talking to Parents About Sexual Assault. Available from Agency at 305 South 43rd, Renton Washington 98055. Krause House. For Pete's Sake Tell (Filmstrip). Available from Krause House, P.O. Box 880, Oregon City, Oregon 97045. Lutheran Social Services. My Very Own Book About Me. (Unpublished Manuscript) Available at N1226 Howard, Spokane Washington 99201. McFall, R.M. Analogue Methods in J. Cone and R. Hawkins (Eds.) (1977) Behavioral Assessment, Brunner/Mazel, New York, 152-177. National Committee for the Prevention of Child Abuse (1984). Child Sexual Prevention Resources Available from National Committee, 332 South Michigan Ave., Suite 1250, Chicago, Illinois 60604-4357. Newsweek, April 9, 1984. A Sordid Preschool "Game". Strasser, S., Bailey, E., in Los Angeles & Bureau Reports. p. 38. ODN Productions. No More Secrets (film). Available at 74 Varick Street, Suite 304, New York, New York 10013. Plummer, C. (1984). Research on Prevention: What In School Programs Teach Children. Paper presented at Third National Conference on Sexual Victimization, Washington D.C., April 20-28, 1984. Available from author at Box 421, Kalamazoo Michigan, 49009-0421. PBS Television Special. Child Sexual Abuse: What Your Child Should Know, a four-part television prevention program available from A-V Center, Indiana University, Bloomington Indiana 47405. Ray, J. (1984). Evaluation of the Child Sex Abuse Prevention Project, 1984. (Unpublished Manuscript) Available from Rape Crisis Network, Spokane Washington. Seattle Rape Relief (1980). Sexual Assault of Handicapped Students. Available at 1825 South Jackson, Suite 102, Seattle Washington 98144. Tacoma School District. Prevention Curriculum. Available from District Office at Marlys Olson, Ed. D. Child Sexual Abuse Prevention Program, P.O. Box 1357, Tacoma Washington 98401. Women Against Rape, Child Assault Prevention Project. Strategies for Free Children. (Unpublished Manuscript) Sally Cooper, Yvonne Lutter, and Cathy Phelps. Available at National Project to Prevent Violence Against Women, P.O. Box 02180, Columbus Ohio 43202.
