Child Abuse Assessment and Reporting > Chapter 4 - Sexual Abuse
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Chapter 4: Sexual Abuse

In 1983, the mother of a 2 year-old boy reported to the police that her son had been sexually assaulted at the McMartin-Buckey pre-school by co-owner Ray Buckey. An investigation of this allegation rapidly became more bizarre each day, with children who attended the school reporting teachers took them on airplane rides, lured them into underground tunnels, that the teachers "flew in the air" and were "all dressed up like witches," and that they had been raped, sodomized and fondled. Ray Buckey and his elderly mother, Peggy McMartin, along with other teachers at the school were charged with 208 counts of child sexual abuse, with an alleged 125 victims. Both were held in jail without bail. After three years of testimony and nine weeks of jury deliberations, Mrs. McMartin was acquitted of all charges. Ray Buckey was acquitted of 39 charges, and re-trial of the other charges ended in a hung jury. Ray Buckey was freed after five years of incarceration, but was never convicted of any crime. Not one conviction was ever obtained in the McMartin-Buckey case; it was the longest and most expensive trial in American history and seriously jeopardized the Constitution’s mandate for a speedy trial. Shortly after the initial allegation by the young boy's mother, she was diagnosed with paranoid schizophrenia.

"When Janie was arrested, they found it underneath a chair. But nobody believed her - the man was such a sleaze, she ain't ever gonna be the same." --"Janie's Got a Gun"
Performed by Aerosmith

On August 20th, 1989, young adult brothers Eric and Lyle Menendez killed their parents, Jose and Kitty Menendez with close-range shotgun blasts. They stopped to re-load, and then continued to shoot until they were certain their parents were dead. In a highly publicized trial, Eric, Lyle, and their attorneys told the jury that the reason the brothers killed their parents was that Jose Menendez had been sexually abusing both boys since their early years, and their mother had not stopped the abuse, though she knew about it. After a hung jury, Eric and Lyle were re-tried and found guilty of first-degree murder. They are serving life sentences in California. The nation still debates whether the Menendez brothers truly were sexually abused by their father and if they were, should that excuse their crimes.

In the public's viewpoint, there is perhaps no other crime as heinous as the sexual abuse of children. Young, innocent, unable to defend themselves, children are forced to submit to whatever their attacker requires of them. There is no "safe" age in childhood; one of the country's most notorious cases occurred in Oklahoma in 1981 regarding the sexual abuse of a nine-day-old infant by her natural father. This case was successfully prosecuted as child sexual abuse.

The social problem of child sexual abuse by pedophiles and other predators could fill volumes. This course emphasizes sexual abuse that occurs within a family as well as outside the family. Statistically, the majority of victims are young females, and the majority of abusers are adult males. But let this not discount cases that are the exact opposite in composition i.e., mothers who sexually abuse their sons, or parents who abuse their children of the same gender.

Signs that a child may have been sexually abused include:

  • The child has difficulty walking or sitting.
  • The child suddenly refuses to change clothes for gym class or to participate in physical activities.
  • The child reports nightmares or bed-wetting.
  • The child's behavior regresses in years, becoming much younger-acting e.g. thumb sucking and curling in the fetal position.
    •
  • The child experiences a sudden change in appetite.
  • The child demonstrates bizarre, sophisticated or unusual sexual knowledge or behavior.
  • The child becomes pregnant or contracts a sexually transmitted disease, particularly if under the age of 14.
  • The child continuously runs away.
  • The child reports sexual abuse by a parent or other adult caretaker.
  • The parent is overly protective of the child or severely limits the child's contact with other children, especially those of the opposite gender.
  • The parent is secretive and isolated.
  • The parent is jealous or controlling with family members.
  • The parent describes marital problems involving family power struggles or sexual relations.
[QN.No.4.A child who has been sexually abused:]
In many cases, medical evidence suggests the occurrence of child sexual abuse. Forensic medical findings include:

  • Contusions, abrasions or lacerations around the mouth, genitals or anal areas.
  • Presence of fluids e.g. semen and/or saliva anywhere on the child's body, either wet or dried.
  • Forensic findings such as pubic hairs and skin cells collected from the child's body during examination.
  • Vaginal or anal enlargement that suggests the chronic insertion of a foreign object.
A forensic medical exam can be performed in an acute situation when it is suggested that the child was recently sexually abused, or in a situation when long-term abuse has occurred. In addition to what they see, physicians and nurses should also pay close attention to what they hear. It is not uncommon for a child to make a full disclosure of sexual abuse (acute or chronic) if they feel safe with these adults. It is as if they see their chance to get away from their abuser and they take it.

Sexual abuse is not always perpetrated by parents or adult caretakers. In an ominous number of cases, the abuse occurs by an older child with a younger sibling. The most common type of incest is between brother and sister. The signs and symptoms of this form of sexual abuse are very similar to those of parental abuse, but with these particular signs:
  • The child is fearful of her male sibling and seeks every opportunity to always be in the presence of adults to prevent abuse.
  • The adolescent abuser attempts to limit or completely prevent the victim from having age-appropriate friends for fear that she will either disclose the abuse or that she will prefer a friend over him.
  • The victim becomes pregnant and refuses to disclose the identity of the unborn child's father.
  • As the victim grows older, she leaves the home by going to college in another state or by getting married, thereby putting distance between herself and the perpetrator.
There are numerous legal and psychological theories about why parents and other family members commit or condone child sexual abuse. This course, however, is concerned with the "what" rather than the "why." While both are distressing, medical and mental health professionals must first insure the child's safety before even attempting to understand the psychodynamics of the perpetrator that led to the abuse.
 
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Child Abuse Assessment and Reporting > Chapter 4 - Sexual Abuse
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