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Working Together to Safeguard Children defines sexual abuse as behaviour which:

'Involves forcing or enticing a child or young person to take part in sexual activities; the child may or may not be aware that this is abusive behaviour, and the act of the sexual abuse may or may not be accompanied by violence.

The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. Abuse may also include non-contact activities, such as involving children in looking at, or participating in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse. Sexual abuse can take place online, and technology can be used to facilitate offline abuse.

Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.'

Whilst the above provides a broadly encompassing definition of what constitutes sexual abuse it does not provide any detail or direct reference to Intra - familial sexual abuse (abuse within the family environment). There are very few definitions of Intra - familial sexual abuse available in literature and research. Below is the definition of Intra - familial abuse from the Children's Commissioner Report ‘Protecting children from Harm‘, which provides more detail of what constitutes Intra - Familial child sexual abuse.

Child sexual abuse perpetrated or facilitated in or out of the home, the family network, against a child under the age of 18, by a family member, or someone otherwise linked to the family context or environment, whether or not they are a family member. Within this definition, perpetrators may be close to the victim (e.g. father, uncle, stepfather), or less familiar (e.g. family friend, baby sitter)’.

Sexual abuse sometimes occurs in conjunction with the other forms of harm, and almost always involves emotional abuse. Sexual abuse can have a long-term impact on emotional, social and educational development and can be linked to the development of mental health issues in later life.

Potentially, any child from birth onwards may be subjected to sexual abuse.

See also the procedures for Child Sexual Exploitation (CSE) and Child Criminal Exploitation (CCE), Online Safety, Harmful Sexual Behaviour and Under Age Sexual Activity.

Risks and Indicators

Sexual abuse perpetrated within family environments often remains hidden and can be the most secretive and difficult type of abuse for children and young people to disclose.

Many children and young people do not recognise themselves as victims of sexual abuse; a child may not understand what is happening to them; they may even interpret the abuse as a normal family relationship. Perpetrators can and do seek to reduce the risk of disclosure by including in the following ways:

  • Disguising the sexual abuse as part of loving / caring;
  • Threatening the child or young person e.g. with loss of activities, breakup of the family;
  • Telling the child or young person that they will not be believed;
  • Holding the child/YP responsible for their own abuse.

Perpetrators of sexual abuse are very sophisticated in their behaviour which means it is often difficult to detect. Where more than one child / young person is being abused within a family it may be possible to identify by patterns of referrals or presentations to different agencies in their local community over time.

Children may disclose sexual abuse verbally while others may attempt to disclose by non-verbal means including changes in their behaviours, this requires those around them not just to focus on the behaviour but to try and understand why the behaviour may be happening. This is particularly the case for pre-verbal children who rely solely on adults around them notice and respond.

Children may exhibit a range of signs but any one sign doesn't necessarily mean that a child is being sexually abused; however the presence of a number of signs should indicate that you need to consider the potential for sexual abuse and consult with others who know the child to identify whether they also have concerns.

Signs that can indicate sexual abuse include:

  • The adults behaviour around the child e.g. being over familiar, treats child differently to other children in the family;
  • Changes in behaviour, including becoming more aggressive, withdrawn, clingy, loss of eye contact;
  • Problems in school, difficulty concentrating, drop off in academic performance;
  • Sleep problems and/or regression i.e. bed wetting;
  • Frightened of or seeking to avoid spending time with a particular person;
  • Knowledge of sexual behaviour/language that seems inappropriate for child’s age, level of understanding;
  • Physical symptoms including pregnancy in adolescents where the identity of the father is vague or secret, STIs, discharge or unexplained bleeding;
  • Poor hygiene, which often leads to social isolation in school;
  • Injuries and bruises on parts of the body where other explanations are not available especially bruises, bite marks or other injuries to breasts, buttocks, lower abdomen or thighs;
  • Injuries to the mouth particularly but not exclusively in babies e.g. torn frenulum, which may be noted by dental practitioners; and
  • Disclosures to adults or another child / young person.

Other Factors

  • Isolation of children (and other members) within the family from practitioners, and the wider community;
  • Failure to register with a GP;
  • Frequent visits to the GP with non-specific complaints;
  • Frequent absences from school;
  • Failure to cooperate with agencies or to let Police, Children's Social Care or other agencies into the home, or not letting children be seen alone by professionals;
  • Attempts to disguise injuries or attribute them to other causes;
  • A child or young person who self-harms, misuses drugs, alcohol, and / or develops mental health problems;
  • Domestic abuse within the family heightens the risk;
  • Repeated pregnancies with no evidence of a father;
  • Genetic abnormalities in pregnancy or in children who are born.

The Centre of Expertise on Child Sexual Abuse uses a model proposed by Finkelhor and Browne, (1986) to describe four likely impacts of child sexual abuse:

  1. Traumatic sexualisation (where sexuality, sexual feelings and attitudes may develop inappropriately).
  2. A sense of betrayal (because of harm caused by someone the child vitally depended upon).
  3. A sense of powerlessness (because the child’s will is constantly contravened).
  4. Stigmatisation (where shame or guilt may be reinforced and become part of the child’s self-image).
In addition, the Centre highlights the impact that secrecy (including the fear and isolation this creates) and confusion (because the child is involved in behaviour that feels wrong but has been instigated by trusted adults) has on the child. While these impacts are not unique to Child Sexual Abuse in the Family Environment, their combination and intensity in the context that they take place makes the experience particularly damaging.

The potential long term impact for children and young people who have been sexually abused means hey are more likely to suffer with depression, anxiety, eating disorders and post-traumatic stress disorder (PTSD). They are also more likely to self-harm, become involved in criminal behaviour, misuse drugs and alcohol, and to take their own lives as young adults.

Protection and Action to be Taken

Whenever a child reports that they are suffering or have suffered significant harm through sexual abuse the initial response from all practitioners should be to listen carefully to what the child says and to observe the child's behaviour and circumstances. Practitioners must:

  • Clarify the concerns;
  • Offer reassurance about how the child will be kept safe;
  • Explain what action will be taken and within what timeframe;
  • As soon as is reasonably possible make a written record of what the child has said, the child’s demeanour which should include detail of the three above points.

The child must not be pressed for information, led or cross-examined or given false assurances of absolute confidentiality, as this could prejudice police investigations, especially in cases of sexual abuse.

See Contacts and Referrals with Children’s Social Care Procedure and Child Protection Enquiries - Section 47 Children Act 1989 Procedure.

Where a Strategy Discussion / Meeting takes place the core agencies involved with the child should participate. A clear plan should be agreed and circulated to each agency participant. Wherever possible these should be face to face meetings rather than telephone discussions to allow better analysis of the available information.

At the conclusion of the investigation, if the case does not proceed to an Initial Child Protection Conference, a second de-briefing Strategy Meeting should be held to ensure that any ongoing risks are understood and protective action can be undertaken.

Any child protection medical assessment must be planned carefully in order to secure any forensic evidence, if it is judged to be appropriate.

Visually recorded interviews must be planned and conducted jointly by trained police officers and social workers in accordance with the Achieving Best Evidence in Criminal Proceedings: Guidance on interviewing victims and witnesses, and guidance on using special measures (Home Office 2011). All events up to the time of the video interview must be fully recorded. Consideration about the appropriateness of the use of video recorded evidence should be taken into account in situations where the child has been subject to sexual abuse using video recording equipment.

Visually recorded interviews serve two primary purposes:

  • Evidence gathering for criminal proceedings;
  • Examination in chief of a child witness.

Relevant information from this process can also be used to inform Section 47 Enquiries, subsequent civil childcare proceedings or disciplinary proceedings against adults, where allegations have been made.

Issues to Consider for Children and Young People

The single and most important consideration is the safety and well-being of the child or children. 

Children may disclose for a number of reasons possibly because they are not able to cope with the abuse any longer or because the abuse is getting worse. They may disclose in order to protect others from abuse or because they are seeking justice. Primarily the child wants the abuse to stop.

In reconciling the difference between the standard of evidence required for child protection purposes and the standard required for criminal proceedings, emphasis must be given to the protection of the children as the prime consideration.

The investigation and enquiries must also address the religious, cultural, language, sexual orientation and gender needs of the child, together with any special needs of the child arising from illness or disability.

A victim support strategy and service should be established at the outset. Support will be required in pre-trial, trial and post-trial periods if the case/s proceed to court. Minimum periods for contact should be established. It is clear from experience in research about sexual abuse investigations that many victims and families feel strongly that it is important that they remain in contact with the same practitioners throughout the investigative process.

Where an Initial Child Protection Conference takes place great care should be taken beforehand if the child / young person wishes to participate. The child should not be put in the position of meeting the alleged perpetrator or of attending the meeting at the same time.

Barriers to Disclosure

Barriers to disclosure include, among other issues, the fear of not being believed and the consequences of telling, embarrassment, shame and not having anyone to tell or the language to tell. Some groups of children and young people will have additional challenges in disclosing due to communication, religious, language, cultural or sexuality issues.

Children and young people may disclose sexual abuse while it is still ongoing, there may be a significant delay between the onset of the abuse and any disclosure. The younger the age of the child when the sexual abuse starts, the longer it usually takes to disclose.

Many children are experiencing multiple forms of abuse and may live in households that are not safe and in which emotional support is not available to them.

Disclosures are more likely to come in adolescence as they learn about healthy relationships and how to recognise abusive behaviour. Schools have a very important role to play in aiding the disclosure process in providing developmentally appropriate education and a safe space within which to disclose.

Children with disabilities are at increased risk of experiencing sexual abuse especially due to communication and developmental issues. For those children who need support with personal care there is also an increased risk of being sexually abused.

Whenever a child / young person chooses to disclose, it is important that they are:

  • Believed;
  • Told what will happen next;
  • Kept informed; and
  • That they are provided with emotional support.

Research into young people’s experience showed that they wanted someone to notice that something was wrong and to be asked direct questions.

Practitioners must be mindful of managing information to minimise the risks to the child when responding to any concerns or disclosures.

There will be situations where due to lack of forensic evidence or corroborating witnesses the threshold for criminal proceedings is not met. It is important in these cases that the lack of police action is not interpreted as disbelieving the child’s disclosure.

Learning from Serious Case Reviews and Points of Good Practice

'Pathways to Harm, Pathways to Protection: A Triennial Analysis of Serious Case Reviews 2011 to 2014' made the following findings about child sexual abuse in the family environment:

"The 13 children in the study who were subjected to intra-familial abuse had a median age of 10 years, and four were aged five or under. All were female. The perpetrator, where known from the final report, was the mother's partner (38% of cases), the father (25%), a male relative (one instance), the mother (one instance) or both parents (one instance). Two of the children were on a child protection plan at the time, and five had been previously. In the eight instances where the detailed child's social care history was available, all had been known to children's social care; three were open cases at the time of the incident, four were closed cases at the time, and one had not reached the level for assessment at the time of referral."

There are lessons for local safeguarding practitioners to consider in how the work with children and young people is carried out when assessing concerns about sexual abuse in the family.

Points for good practice:

  • 'Hearing the voice of the child' requires safe and trusting environments for children to be seen individually, speak freely, and be listened to;
  • Practitioners must consider how to enable children to express their views while taking account of the child's age, development, and language. This will be compounded if the child is in any way threatened or coerced by an abusive parent, or if the child has other underlying developmental or communication needs;
  • Previous research emphasises how children have extreme difficulty in expressing their concerns and that practitioners should not expect children to disclose abuse;
  • The onus falls to the practitioners and requires an interest in how children express themselves through their behaviour and what they say rather than seeing them as 'difficult' or 'demanding';
  • An active effort must be made to actually see and assess children in their families. This is a lesson 'so important that it must be re-emphasised and potentially relearnt as people, organisations and cultures change';
  • Considerations must be made for children who do not communicate in English.

Further Information

Protecting Children from Harm (Children's Commissioner for England) - A critical assessment of child sexual abuse in the family network in England and priorities for action.

Child Neglect and its Relationship to Sexual Harm and Abuse: Responding Effectively to Children's Needs - open access resource considering the potential relationship between neglect and forms of sexual harm and abuse.

'Making Noise: Children's Voices for Positive Change after Sexual Abuse' - Children's experiences of help-seeking and support after sexual abuse in the family environment.

Preventing Child Sexual Abuse: The Role of Schools - examines the important role schools can play in enabling children to recognise abuse.

Measuring the Scale and Changing Nature of Child Sexual Abuse and Child Sexual Exploitation - Scoping Report July 2017, Professor Liz Kelly and Kairika Karsna (Centre of Expertise on Child Sexual Abuse)

Investigating Child Sexual Abuse - examines timescales for sexual abuse prosecutions and makes recommendations.

Therapeutic Services for Sexually Abused Children and Young People Scoping the Evidence Base, Prepared by Debra Allnock and Patricia Hynes Summary Report December 2011.

Child maltreatment: when to suspect maltreatment in under 18s (NICE) - This guidance which contains advice for practitioners on how to identify and respond to concerns in relation to Child Sexual Abuse in the family is new and was added to the online procedures in June 2018.

Key Messages from Research on Intra-familial Child Sexual Abuse (Centre of Expertise on Child Sexual Abuse)

Therapy: Provision of Therapy for Child Witnesses Prior to a Criminal Trial (CPS)

Amendments to this Chapter

Risk and Indicators was updated in September 2019 to reference a model developed by the Centre of Expertise on Child Sexual Abuse outlining some of the likely impacts of Child Sexual Abuse was included.