Vol. 20, No. 1 • November 2015

Recognizing and Responding to Disclosure or Signs of Sexual Abuse

by Donna Gillespie Foster

If you are a foster or adoptive parent, I am sure you will believe me when I say that my 17 years as a foster parent positively changed my life forever. I bet you can say the same thing.

I Felt So Unprepared
Starting out I felt capable of helping children who had experienced physical and emotional abuse. But when it came to meeting the needs of children who had been sexually abused, I felt emotionally paralyzed. I doubted my ability to help these children. I knew so little about the signs of sexual abuse or how to help children feel safe with us. So I went on a personal mission to learn all I could.

After years of fostering and of teaching the course "Fostering and Adopting the Child Who Has Been Sexually Abused," I am in a good position to share the following information with you. I hope it will help you feel more prepared to care for children who have been sexually abused.

Be Ready for Disclosures
When children first enter foster care, agencies--and therefore foster parents--often don't know that they've been sexually abused. It is only after they start trusting other children or the adults in their foster home that some children disclose this secret to us through their words or actions. Reasons children don't disclose sexual abuse include:

• The behavior is "normal" in the family, so the child doesn't know it is abuse.
• They are told by family members to keep the secret or the family will be divided.
• They love the abuser and don't want them convicted.
• They feel responsible for the sexual abuse.
• They feel guilty and ashamed.
• They don't know how to tell. Young children don't know the words to use.
• The children have been taught to obey and respect adults without exception.
• Children don't trust adults. They've learned that big people hurt little people.

"Sam's" Story It is so important to share with your child's social worker and therapist if you observe something that concerns you. When I was fostering I would write down what I observed, the date and time of day, and the environment when I saw a certain behavior. I encourage you to do the same. I once cared for a teen I'll call Sam, who showed signs that he had been sexually abused. Sam always wanted to be last when going up the stairs. He never wanted to be touched. At night he had bowel movements in his underwear and hid them under the bed. I found them and told him it was OK. I gave him a garbage can with a liner and asked him to put them in the can. I told him I would buy him more underwear so he would have clean ones to wear. Never did I scold him. I did what I could to make him feel safe in my home. When he told me he had nightmares and needed a light on all night, he got it. All of this I shared with his social worker. It wasn't until Sam was in his late twenties that he told me he had been sexually abused for years. He said he just couldn't tell anyone because he loved the person who abused him. He thanked me for keeping him safe and not making him feel guilty. Today Sam is a part of our family. He knows I will always be in his corner.

Know the Signs
As Sam's story above illustrates, some young people disclose sexual abuse not with their words, but with their behaviors, so it is important to know the signs outlined in the box below. Please note that many of the "other common indicators," such as bedwetting and trouble sleeping, can occur after sexual abuse, but they may also be due to a medical problem or some other crisis in a child's life and not sexual abuse.

No child will show all the signs, but please learn what they are so when you see one you can record it and seek help from the team.

Signs of Possible Sexual Abuse

The Most Significant Behaviors Source: Cooper, et al., 2005 Engaging in "sexualized" behavior with toys or in talk and seeing sexual meanings where there may be none Precocious sexual knowledge: sexually explicit drawings, comments that indicate knowledge beyond their developmental age Acting out sexual acts on other children, with or without their consent Excessive or compulsive masturbation that continues despite attempts at redirection or sanction; excessive or compulsive means masturbation that occurs until the child injures themselves or masturbates to the exclusion of other pleasurable activities Other Common Indicators Sources: Aprile, et al., 2009; Crosson-Tower, 2015 Fear and anxiousness Nightmares or sleep disturbances Withdrawal from family and friends Low self-esteem, shame, depression, or suicide attempts Eating disorders, substance abuse, running away Regressive behaviors (bedwetting, thumb sucking) Aggression, anger, rage Poor or decreasing school performance NOTE: Many of these "other common indicators" can be caused by other stressors or crises in a child's life and do not necessarily indicate child sexual abuse.

How You Can Help
Here are some strategies for meeting a child's needs when they disclose (or you suspect) they have been sexual abused:

1. Believe them. Don't question whether they are telling the truth.
2. Listen without problem-solving, and with your undivided attention. If you're driving, pull to the curb and listen.
3. Let them know their feelings are OK. They may be full of confusing emotions.
4. Don't say you know how they feel. Even if you were sexually abused as a child, every situation is different. Instead say, "Thank you for trusting me enough to tell me."
5. If it's a new disclosure, don't promise not to tell. Say you will only share with someone who can help. Tell the child's worker.
6. Have house rules for everyone that provide privacy and security. Ask the child what they need to feel safe.
7. Never talk badly about the birth family. Degrading them is degrading the child.
8. Create opportunities for normal fun family times, such as family bowling, laughing, playing board games, cooking together, and other family activities.
9. Be an active part of the child's team (social worker, therapist, and teacher) by working together on a plan for the child.
10. Keep learning! You can always learn something new about this topic by taking courses, reading, and talking to other foster and adoptive parents.

I hope this encourages you. You are not alone when caring for children. Children don't need you to make all their problems go away. They need you to be there for them; to care and accept them. I believe you can do that.

Donna Foster is a national trainer, consultant, and author of the series "Shelby and Me: Our Journey Through Life Books" (reviewed here in this issue).

Click here for references

~ Family and Children's Resource Program, UNC-CH School of Social Work ~