Factors that determine how a child is impacted by sexual abuse usually fall into three categories.
- The child's previous experiences and history:
- Critical pre-abuse factors that increase the risk that a child will develop serious problems include the child's prior psychological concerns, especially a history of anxiety problems. If the child has previously been sexually abused or experienced other trauma, the risk is higher.
- Many studies have shown that the more trauma and adverse life experiences a child has, the higher the risk of developing problems.
- Nature of the sexual abuse and the child's reactions:
- Abusive characteristics of the assault make a big impact on a child, especially those involving force and violence.
- The most impactful factor is if the child believed they were in extreme danger and might be killed or hurt during the assault.
- Abuse that occurs over time is also more harmful. This is likely because the child is living with the fear and worry about being abused instead of being able to put the experience behind them.
- When children believe that it is their fault, that they are ruined, or that no one can be trusted, they are more likely to be seriously affected.
- Responses by others upon disclosure of abuse:
- The most important response is how caregivers react to the abuse and that the response is not negative. Reactions that increase the risk for negative outcomes include disbelief, blaming the child for the victimization, or blaming the child for causing trouble to the family or the offender.
- The biggest complications arise when the offender is a parent or close relative. The family is torn about whom to believe, or wants to avoid complications of accepting that a person they care about would do such a thing.
- When the offender is a parent, the non-offending parent's response may be affected by their own sexual abuse history, dependency on the offender, and current relationship to the offender and child.
- However, even in family situations, most families do believe and support their children.
Children at different ages express the impacts of sexual assault experiences differently:
- Older children overall tend to be more affected because they have greater cognitive awareness of what sexual assault means and how it might impact other aspects of their lives.
- Younger children are primarily focused on their immediate safety and security.
- Anxiety and posttraumatic stress in young children are often expressed by developmental regression, aggression, and distress at separation from a caregiver.
- Older children are more likely to withdraw, avoid situations that are distressing, or shut down emotionally.
- Adolescents who experience severe anxiety may have panic attacks, abuse substances, or engage in self-harming behaviors.
No matter what the developmental stage of a child, caregivers are the most important influence on children. Insuring that caregivers have accurate information, are supportive to their children, and manage their own emotional reactions in a constructive way is by far the most important factor in helping children. When working with children and caregivers we always need to consider the impact that culture has on the child and caregiver.