Key messages from research on identifying and responding to disclosures of child sexual abuse

Debra Allnock, Pam Miller and Helen Baker
The International Centre (University of Bedfordshire) and NSPCC
September 2019

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Note: The term ‘children’ in this document refers generally to individuals under 18 years of age.

Key messages

Children’s disclosures of sexual abuse vary in the mode of communication, intent, spontaneity and amount of detail that is included. Disclosure is best understood as a process which is influenced by relationships and interactions with others and may extend over a considerable period of time.

Rates of verbal disclosure are low at the time that abuse occurs in childhood. However, children say they are trying to disclose their abuse when they show signs or act in ways that they hope adults will notice and react to. This is particularly important for disabled children.

Professionals need to keep in mind that any child could be attempting to disclose, but certain children may face additional barriers to disclosure because of their disability, gender, ethnicity and/or sexual orientation.

The act of disclosing sexual abuse can heighten shame and guilt. Others‘ negative reactions to disclosures may compound these impacts. This should not stop professionals from providing opportunities to children to disclose, but it is essential that children and their families receive appropriate support following disclosure.

A range of complex and interacting individual, relational and social barriers may prevent children from disclosing abuse, to professionals or anyone else.

Teachers are the professionals to whom children will most commonly disclose, but the disclosure process can be helped or hindered by the way in which any professional engages with a child about whom concerns exist.

Children want to be noticed by friendly, approachable and caring professionals, with whom they have built a trusted relationship. They want to be asked how they are doing and what is going on, so they have an opportunity to have an open dialogue.

Confidentiality is important to children, but can be difficult to balance with professionals’ safeguarding responsibilities. Professionals may experience a tension around this in their relationship with the child. If maintaining confidentiality after a disclosure may not be possible, it is important to be open, honest and transparent with the child.

What do we mean by disclosure?

The term ‘disclosure’ is open to different interpretations across professional contexts. Here, disclosure is broadly defined as ‘one person conveying their experience to another’. Children convey these experiences in many different ways.

Disclosure of child sexual abuse (CSA) is best understood as a ‘process’ which is influenced by the characteristics and qualities of relationships in children’s lives, and may evolve over an extended period of time. Although there is a growing body of UK research into children’s disclosures that draws on their voices, there has been little research into professionals’ experiences in recognising and receiving disclosures.

Disclosures of abuse occur within, and are facilitated by, relationships that children have with others. When responding to disclosures, it is critical to understand the different ways in which children disclose according to four overlapping factors: mode of communication, intent, spontaneity and detail.

Mode of communication

Some children communicate their abuse directly through verbal means, while others do so indirectly (e.g. “I don’t want to go to grandpa’s house any more”), or they may use terminology that the perpetrator has used (e.g. talking about ‘secrets’ or ‘games’) or adult language that is not appropriate for their stage of development.

Non-verbal means of expression include letter-writing, drawing pictures or playing with dolls. Younger children may appear clingy or display temper tantrums, while older children and adolescents may withdraw, self-harm, exhibit anger, avoidance and run away. Even positive behaviours such as ‘being good’ can be a sign that children want to be noticed.

Disabled children may be more likely than others to exhibit behaviours as signs, particularly where they are unable to communicate verbally with adults. It is important that these behaviours are understood, and not simply attributed to the child’s impairment.

Intent

Some children disclose abuse purposefully – to stop abuse from occurring, to seek emotional support, or to protect siblings or other children who they worry may be at risk. Others may ‘want to tell’ but equally ‘do not want to tell’, one consequence of which may be an unwilling disclosure.

Disclosures can be unintentional, where children feel forced, coerced or pushed into a disclosure following third-party witness to the abuse, discovery of evidence or prompts from others to understand what might be behind the child’s behaviour.

Where disclosure is non-verbal, the child’s behaviour may be intentional, to convey a message that something is wrong. Even if behavioural signs are unintentional, they may signal that something is wrong, and professionals should recognise and respond to this.

False allegations are rare, but where they do occur, they are usually the result of undue influence by a third party or unsuitable questioning styles.

Spontaneity

Some disclosures are ‘spontaneous’, following the child’s recognition, over time, that abuse has occurred. Disclosure may be triggered by a lesson in school, a TV programme or an escalation of the abuse, or may be made accidentally. Disclosures may build over time until a child cannot contain the secret any more – a ‘pressure cooker effect’.

Alternatively, disclosure may not be spontaneous at all, occurring only when prompted during, for example, a medical examination, an investigative interview or a therapeutic session – or simply when a teacher or health professional notices something may be wrong and asks.

Detail

The detail provided within a disclosure may be vague or absent. The nature of disclosure as a process means that some disclosures are partial; more detail may or may not emerge over time. And detail will be entirely missing when disclosure is communicated through behaviours or other signals.

Who discloses child sexual abuse?

Studies have found considerable variation in rates of disclosure of CSA, depending on the sample and the way that disclosure is measured. In a recent study, non-verbal attempts to communicate abuse were not reported in a survey, but were described by young people in follow-up interviews. In studies of Scandinavian adolescents, between 79% and 83% who had experienced CSA said they had spoken to someone about it, while a review of 13 international studies found that 31% to 45% of adults with histories of CSA had talked about their abuse to an adult soon afterwards or during their childhood.

Girls who experience CSA are more likely than boys to tell someone about their abuse during childhood.

The evidence is more mixed when considering ethnicity. While unique barriers to CSA disclosure by children from some black and minority ethnic backgrounds exist, it is unknown whether this translates into lower disclosure rates.

Disabled children are less likely than other children to disclose their abuse; this has been found to be the case across a range of disabilities.

There is no available evidence on disclosure rates among lesbian, gay, bisexual, trans and queer/questioning children. We know little about disclosure rates among children in varied contexts, such as children in care or in institutions.

What are the impacts of disclosure?

Disclosure can be traumatic and have short- and long-term effects on children’s emotional wellbeing. This does not mean that professionals should not provide children with the opportunity to disclose, but it does mean that children, and their families, will need support through the process.

Some children report feeling ‘relief’ and ‘pride’ after disclosing. However, children also report feeling embarrassment, anger and sadness. Some describe their life “falling to pieces” after disclosing sexual abuse, and say that “things get worse before they get better”. Disclosure can lead to heightened feelings of shame and guilt, both of which are important emotional processes in the development of CSA-related post-traumatic stress disorder (PTSD). PTSD has been found to be heightened particularly where there are negative reactions to the disclosure by others. Adolescents appear more susceptible to longer-term problems such as depression and low self-esteem following abuse becoming known.

Family members may struggle to understand and respond appropriately to disclosures, particularly where abuse has been carried out by someone within or close to the family. Negative reactions by others to disclosure are harmful to children’s wellbeing and may deter them from making further disclosures. Professionals should consider appropriate support for children, and their families, in the immediate period following disclosure.

Withdrawals of disclosure may occur even where there is corroborative evidence. Studies of cases involving substantiated CSA have reported withdrawal rates of well below 10%, although one study – focusing on substantiated cases where disclosure could result in the child’s removal from the family home – found that 23% of disclosures were withdrawn. Withdrawal of disclosures is more common in younger children, where non-abusing parents/carers are unsupportive or where the perpetrator is a close family member.

Disclosures can also affect the wellbeing of professionals. Some professionals state they rarely feel or express emotion during a disclosure, as their focused attention is on the child, and they manage the emotional impact outside the workplace. Professionals have indicated their concern about conveying an appropriate level of emotion to a child who is disclosing, noting the importance of controlling their own facial expression when reassuring a child.

The disclosure journey

Many children do not verbally disclose CSA until well into adulthood. Non-disclosure and delayed disclosure must be understood in the context of the significant challenges that children face in seeking help following sexual abuse. Children’s disclosures are influenced by developmental and emotional challenges, by relationships and by wider community and social norms and practices.

Disclosure in informal, everyday settings

A child’s disclosure experience in informal, everyday contexts, such as the home and community, influences the way they will engage with and disclose to professionals they encounter. For instance, children who have disclosed to a family member or friend are more likely to disclose to professionals within forensic interview settings.

Children may not disclose if they do not understand abuse, or if the abuse is normalised in everyday contexts. Children also report that fear of not being believed stops them from disclosing to family members at the time when abuse is occurring. Coercive tactics used by a perpetrator to silence a child can inhibit disclosure, as can the nature of the relationship between the child and the perpetrator. Children are less likely to disclose if they expect negative reactions from family members, and they worry about disrupting the family with disclosures, particularly if the family is experiencing multiple adversities.

In some communities, fears around preserving family and/or community honour, oppressive norms related to child obedience, respect for elders and taboos around sex and sexuality all deter children from disclosing. Recognition of children’s fears about others’ reactions to disclosure may prevent professionals from informing parents that a referral to children’s services has been made – but informing parents following such a referral is an important step in helping them to access help, and can help reduce tension in the home that may arise from a referral being made.

When children decide to disclose, they most commonly turn to family or friends before reporting to professionals. Mothers are the most common familial disclosure recipients. However, other family members, family friends and neighbours may receive disclosures. Younger children are more likely to confide in a parent or family member, while adolescents are more likely to confide in a friend or peer; friends play a significant role in recognising when their peers are struggling, and in receiving disclosures of CSA. For professionals, understanding children’s trusted networks within and outside the family home is important in understanding prior disclosure experiences and developing strategies for supporting them.

Disclosure in universal settings

Professionals in universal settings such as health and education are well placed to identify children who are experiencing – or have experienced – abuse and may be trying to communicate this. Teachers are the professionals to whom children most commonly make initial disclosures.

Children have described mixed experiences of disclosure to teachers, which highlight key practice messages for all practitioners. Children want teachers to notice signs such as self-harm; eating disorders; acting out in class; school attendance; and being alone and withdrawn at school. Professionals and children both highlight the importance of a trusted relationship between a child and a reliable professional which provides the child with the opportunity to disclose. Both ‘noticing’ and ‘opportunity’ emphasise that disclosure is relationally dependent and emerges through open dialogue. Children may require significant periods of time to build the trusted relationship that supports disclosure, particularly if they have had previous negative experiences of interacting with authority figures. Professionals can experience a tension between going at a child’s pace and responding to safeguarding protocol.

Confidentiality is also important to children who worry about losing control over their information. Professionals have highlighted the challenges of balancing confidentiality with safeguarding responsibilities. Sharing information too early may jeopardise a child’s sense of trust, but not acting on information risks further abuse to the child as well as a failure to comply with organisational safeguarding procedures. Professionals stress the importance of being open, honest and transparent if maintaining confidentiality may not be possible following a disclosure.

Children want to be kept informed about what will happen next. Professionals recognise the importance of taking the time to clearly explain what might happen next, but face difficulty when protective action needs to be taken against the child’s wishes. In such cases, trust can be rebuilt by involving children in conversations about what action needs to be taken, why and when. Issues of confidentiality and keeping children informed will be relevant to all professionals working with children, including those working in the child protection and criminal justice systems.

Disclosure in formal child protection settings

Children are least likely to disclose CSA to professionals working in the child protection system. Such professionals are more likely to receive reports of abuse following reporting by others, by discovery of evidence or through an investigation.

An initial disclosure to police is also unlikely, because children may not believe the abuse is a crime; they do not believe the police will keep them safe; they feel they will not be believed; or they are afraid of being blamed, getting in trouble or getting the perpetrator in trouble. Regardless of how or why police come into contact with children, the initial contact is central in building a child’s confidence and may support disclosures. Children want police to act with sensitivity and respect, not judge them, positively engage in making decisions, and keep them informed.

Children are unlikely to disclose to social workers because they may fear what will happen when social workers become involved and worry that social workers will judge them. Children want social workers to show an active interest in them, even when visiting for other reasons; to understand the nature of their problems and behaviours; to be impartial when assessing the home environment; to talk to them separately from other family members; and to ask the right questions, which will help provide a pathway for them to disclose abuse.

Professionals stress the importance of counteracting negative perceptions of police and social care, recommending that those working with children appear friendly, approachable and caring. They recognise that many children need to feel believed when they disclose. On the other hand, their responses must be in line with safeguarding policies, which may include guidance on ensuring that the disclosure is not influenced by their work or actions. Professionals feel that it is important to accept a child’s account and feelings without judgement, and that focusing on what the young person is communicating – particularly paying attention using positive body language and listening skills – is critical to creating a supportive environment for disclosures to happen. They highlight a need to try to not act surprised or shocked at what the child says.

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