Running head: PREVENTION PROGRAMS

CSA Prevention Programs 1 Running head: PREVENTION PROGRAMS

Child Sexual Abuse Prevention: Choosing, Implementing, and Evaluating a Personal Safety Program for Young Children

Maureen C. Kenny, Ph.D. Florida International University

Sandy K. Wurtele, Ph.D. University of Colorado at Colorado Springs Chapter to appear in Preventing Sexual Violence and Exploitation: A Sourcebook edited by Keith L. Kaufman (NEARI Press)

CSA Prevention Programs 2 Child Sexual Abuse Prevention: Choosing, Implementing, and Evaluating a Personal Safety Program for Young Children Despite widespread occurrence and negative consequences, child sexual abuse (CSA) is not clearly understood by the general public. Myths still prevail regarding incidence and “stranger danger” continues to be taught by parents and teachers. All children, especially young ones, are vulnerable to sexual exploitation because of their total trust and dependence on adults and lack of knowledge regarding this crime. As we concluded in our previous chapter, it is imperative that young children receive appropriate education about sexual abuse. CSA prevention efforts can equip children with the necessary vocabulary and skills to potentially identify, resist, and report CSA. This chapter will offer suggestions for choosing, implementing, and evaluating CSA prevention programs aimed at young children. Suggestions for Youth-Serving Organizations Overview of Selected CSA Prevention Programs Taking a developmental perspective, CSA educational programs can begin in preschool by focusing on personal safety training, and continue into adolescence, with a shift in focus to teaching dating skills, assertiveness, and awareness of acquaintance rape and Internet victimization. As most sexual victimization of children begins before age 12, this chapter will review prevention programs developed for young children. Given the plethora of programs and materials that are available, schools, community agencies, or interested stakeholders may have difficulty selecting a program that fits their needs. Table 1 provides a list of some of the more commonly used programs, their content, and format.

CSA Prevention Programs 3

Criteria for Choosing a Program The choice of a particular program may be affected by many factors, including available funding, age of the target children, availability of time and presenters, and administrator and parental support (Payne, Gottfredson, & Gottfredson, 2006). We suggest that a committee of parents and agency personnel be involved in the selection of the program so that all interested parties feel a sense of ownership in the process, rather than having a program thrust upon them. In schools, asking teachers to squeeze a program into an already full schedule and putting more work on them may not yield positive results (Plummer, 1997). Speaking with teachers and gauging their enthusiasm about the program as well as concerns they have can help avoid resistance later in the implementation stage. Programs vary according to types of presentations (i.e., video, theatrical presentation) and duration, ranging from single contact programs (“one time”) to multilesson programs. Although research has consistently demonstrated that programs employing repeated exposure to material are more effective than those taught on one occasion (Davis & Gidycz, 2000; National Center for Missing and Exploited Children, 1999), the majority of programs continue to employ single contacts. In her review of over 87 CSA prevention programs, Plummer (2001) found that 63% were one-session programs. In their analysis of 30 programs, MacIntyre and Carr (2000) found program duration for children ranging from 25 minutes to 1.5 hours per week for one academic year, with the majority of interventions comprising three sessions lasting between 15 minutes and 1.5 hours in duration.

CSA Prevention Programs 4 Most programs utilize a range of materials including videos, photo cards, coloring books, story books, puppets, guided discussions, and audio material (songs). Videos are often used to educate, prompt discussion, and teach problem-solving and decisionmaking skills. Another technique that can be used is story telling, where the teacher begins telling a story and a child finishes it. Puppets can also be used to demonstrate situations. Teachers will act out an appropriate or inappropriate touch and then have children identify the type of touch and show (through the use of puppets or dolls) what action they might take in that situation. Photo cards showing safety situations can also be used as visual stimuli for children during a lesson (Committee for Children, 1996; 2001). Referring to the picture, the teacher can ask questions to prompt critical thinking such as, “What is happening in this picture? What can he do?” Techniques such as these allow young children to discuss their own thoughts, ideas and feelings through displacement rather than directly (Webb, 1991). Programs that encourage active participation of children (e.g., through modeling or role-playing techniques) have been shown to be more effective than programs using more passive methods (e.g., watching videos or plays) (Davis & Gidyez, 2000; Goth Mace, 2000; Wurtele, 1987; Wurtele, Marrs & MillerPerrin, 1987). Content Considerations. Almost all child-focused prevention programs teach children how to recognize inappropriate touching (i.e., okay and not okay touches), include resistance skills (i.e., say “no” to unwanted touches), encourage reporting of abuse (i.e., telling a trusted adult), reduce self-blame, and enhance children’s self-esteem. Common objectives often include the following: 

Define and describe sexual abuse

CSA Prevention Programs 5 

Describe perpetrators (examples should include authority figures (including babysitters), family members, and strangers



Describe potential victims (examples should include both males and females of all races, ages, sizes, and physical abilities/limitations)



Help children distinguish between appropriate and inappropriate touches



Help children identify the private parts of their bodies using correct anatomical terms



Teach children self-protective skills to avoid abuse (say “no,” try to get away)



Stress body ownership and self-pride



Teach children decision-making skills



Promote disclosure by instructing children to tell an adult (even if sworn to secrecy) and to keep on telling until they are listened to



Emphasize that abuse is never the fault of the child

Another essential component of prevention programs is to teach children the correct terms for their genitals. This knowledge serves as a foundation for the later education on appropriate and inappropriate touching and gives the child the necessary vocabulary to assist in disclosure of abuse. When children do not know the correct terms for their genitalia, disclosure of abuse may be hampered by their inability to communicate what happened (Deblinger & Heflin, 1996; Deblinger et al., 2001; Wurtele, 1993; Wurtele, Melzer, & Kast, 1992b). Supportive parents and caretakers may not understand the disclosure and thus not provide the support and early intervention that is needed for a healthy outcome for the child. Krazier (1996) believes the term “private parts” can be problematic for those children who have learned the correct terms for their genitals, so

CSA Prevention Programs 6 curriculum materials should educate children using both terms (i.e., “private parts” and correct genital terminology). The most compelling evidence for teaching children correct genital terminology comes from sex offender literature. Some sex offenders do not target children who know the correct names for their genitals, as this knowledge implies to them that these children have been educated about body safety and sexuality, and that there is open communication between the parent and child (Elliot, Browne, & Kilcoyne, 1995; Sprengelmeyer & Vaughan, 2000). In addition to the benefits for sexual abuse disclosure, teaching young children proper names for all body parts helps them develop a healthy, positive body image (Wurtele, 1993; Wurtele et al., 1992b). As recommended by the American Academy of Pediatrics (2007), educating children about genital body parts is part of the sexual education parents need to give their children. The Academy states that making up names for body parts may give the idea that there is something bad about these body parts. Diversity Considerations. Given the emerging diversity of the United States, program selection should also include a consideration of the needs of participants who are culturally and linguistically diverse. Very few programs make significant reference to modifying materials to meet the demands of culturally diverse people. Plummer (2001) found that only 17% of the 87 prevention programs she surveyed were aimed at culturally specific groups, thus indicating a need for a greater sensitivity to this topic. Tobin and Kessner (2002) advise that programs include culturally appropriate materials (dolls) and culturally relevant names in role plays with children. Clearly, having program materials translated into other languages is a minimum criterion to ensure children’s comfort and

CSA Prevention Programs 7 comprehension. Table 1 includes some programs available in different languages. Programs need to develop innovative strategies to work within the cultural values of a given group. For example, Millan and Rabiner (1992) suggested that prevention materials for Latino children include the use of “novellas,” (i.e., soap operas), and “cuentos,” (i.e., story telling). Although culture is beginning to be addressed by some programs, other issues of diversity, particularly disabilities, seem largely ignored. It is well documented that children with disabilities are at an increased risk for sexual abuse due to communication difficulties, along with their dependency on others (Putnam, 2003). Plummer (2001) reported that approximately 33% of programs in her review addressed special-needs children. Table 1 also describes some programs developed for special-needs children. Limited research has been done on CSA prevention programs with individuals with developmental disabilities (Lee & Tang, 1998; Lumley, Miltenberger, Long, Rapp, & Roberts, 1998). Briggs and Hawkins (1997) emphasize the need for programs for children who are particularly vulnerable to abuse, such as those with intellectual and physical disabilities. Unique instructional strategies will need to be developed to ensure learning for these populations. Parental Involvement Considerations. The active participation of parents in CSA educational programs contributes to the program’s success. Wurtele, Kast, and Melzer (1992) found numerous advantages to including parents in programs, including increased opportunities for practicing newly learned skills at home, along with enhanced communication in the home about the topic of childhood sexual abuse. Increased communication between parent and child potentially decreases the chance of a child

CSA Prevention Programs 8 keeping the abuse a secret (Fieldman & Crespi, 2002). Although many programs are school based and teacher taught, increasing the involvement of parents in their child’s CSA education is essential for positive results. There are a number of ways to involve parents. Kenny (2009) provides a parent educational group which meets at the same time the preschool children are in an educational group, thus providing both sets of participants the same information to enhance practice and learning. Educational material in the form of handouts can be particularly helpful for parents and assist them in practicing skills at home with their children. There are also a plethora of children’s books available on this topic which can be used by parents. Wurtele and colleagues found parents to be effective teachers of a personal safety program (Wurtele et al., 1992b). Age of Child Considerations. The research on the effectiveness of programs with different age groups is inconsistent. Tutty (2000) found that younger children (ages 5-7) did not benefit from the Who do you tell? program as much as older children (ages 8-13); older children showed greater gains in learning compared to younger. Contrary to these findings, Wurtele and Owens (1997) demonstrated significant learning of concepts and skills among a large preschool-aged sample of children. Others conclude that when using a developmentally appropriate approach, children as young as three can benefit and learn from educational programs (Deblinger, Stauffer & Steer, 2001). It has been suggested that programs for children under the age of seven should avoid abstract concepts, provide multiple opportunities to practice skills, use stimulating material, and occur over several days (Wurtele & Owens, 1997). Younger children may have difficulty understanding certain concepts (e.g., abuse is never the child’s fault)

CSA Prevention Programs 9 presented in some prevention programs. Due to their limited memory and cognitive abilities, they also have difficulty learning certain skills (e.g., reporting the abusive experience) (Wurtele & Owens, 1997). Preschool children are more likely to learn skills when they have ample opportunities to practice, both at school and at home, and when they are given the opportunity to repeatedly rehearse the skill during role plays depicting differing scenarios (Boyle & Lutzker, 2005; Deblinger et al., 2001). Avoid the Use of “Good Touch” and “Bad Touch” Concept. Historically, some programs defined sexual abuse as “bad” or “confusing” touches, and taught children to rely on their feelings to decide whether a touch was safe or not. Research has shown the use of feelings to be too confusing for young children (Wurtele, Kast, Miller-Perrin, & Kondrick, 1989). Instead, we recommend teaching young children the difference between “okay” and “not okay” touches as this avoids asking children to use their feelings as a guide for their behavior. Others (Tobin & Kessner, 2002) discuss touches in the context of those we like and those we dislike and those that are confusing. Still other programs use the “safe” and “unsafe” distinction (e.g., Talking About Touching). As Johnson (1997) states, “it is important that children see the whole range of touch” (p. 36) and that there is an array of touching that is rather normative in children. She further claims that touching and sexuality must not be associated with fear, shame, or guilt for children so as to not be an impediment to their developing sexuality. Implementing a Program The first step in implementing a program at a school, day care center, or youthserving organization is to secure the permission of administrators. We suggest scheduling a meeting with the decision makers (directors, principals) and presenting the need for the

CSA Prevention Programs 10 program as well as providing some sample lessons and materials for review. Generally, when the determination is made to implement a program, decisions are made in this “topdown” (administration to staff) fashion. Having the support of head administrators will go far in program acceptance and implementation. Once a youth-serving organization has committed to offering a program, parents ultimately have the right to make a final decision about whether or not their children will participate (Tobin & Kessner, 2002). Due to the sensitive nature of the lessons, most schools and after-school programs send home consent forms to parents, asking for their permission to have their children participate. If the program is to be implemented in a school, repeated take-home letters with registration forms can be used. Additionally, planning a parent educational session in the evenings where staff is available to explain the program is a good way to ease parents’ concerns and educate them about the goals of the program. This also allows parents to meet the staff, take a look at the curriculum, and ask questions about content. Program staff should be ready to respond to any parental concerns or resistance (Plummer, 1997). Some parents may present with criticism of the program or cite reasons why they do not want their children to participate. Many parents hold misconceptions about the prevalence of abuse and may believe that their children will be harmed by participation. Being equipped with information and statistics relevant to parental worries can assist in alleviating these concerns. Emphasizing the goals of any given program, namely educating children so that they are better able to protect themselves and report abuse, can help parents recognize the need for programs. Oftentimes marketing the program around the issues of safety, not sexuality, can help parents understand the importance of this type of education (Plummer, 1997).

CSA Prevention Programs 11 Other prevention programs employ a number of strategies which can be used with sexual abuse prevention programs as well. These include posters in school hallways, letters, registration brochures at schools, recruiting at preschool registration days, radio advertisements, features in community newspapers, displays in shopping centers, and personalized invitations (Heinrichs, Bertram, Kuschel, & Hahlweg, 2005). Programs for children have been successfully taught by school nurses, guidance counselors, classroom teachers, social services personnel, and community volunteers (Plummer, 1997). As long as staff members are appropriately trained and adhere to the curriculum, the degree to which children report benefiting from the program does not appear to be associated with whether the program is conducted by teachers, law enforcement officers, or other non-school-based personnel (MacIntyre & Carr, 2000). In school settings, where the curriculum will be integrated into the school day, teachers are the likely choice for trainers. In youth-serving organizations, screening and appropriate background checks should be performed on any staff member who is teaching the program to children. All staff members involved in the administration and delivery of the program need to be adequately instructed in a number of areas. Training in the area of childhood sexual abuse may be necessary for some staff. Even the most experienced teacher may need more information and an update on related CSA material as this is a rapidly changing field with much new research. Staff should be knowledgeable about the signs and symptoms of childhood sexual abuse as well as in handling disclosures. Understanding how children disclose sexual abuse and supporting them during this difficult time is a necessary component of this training. Knowledge of relevant abuse

CSA Prevention Programs 12 reporting procedures should be reviewed and staff should be made aware of when and how to report abuse. Hotline numbers should be provided and administration should be supportive of staff making reports. Ensuring a safe environment for children during lessons is critical to assisting children in the learning process. Before implementing the program, staff needs to be trained in all aspects of the program. Ideally, they should be given an opportunity to read and review all sessions, content and materials, and then discuss the subject matter and delivery with someone more experienced in program delivery (Johnson, 1997). A trainer’s comfort and familiarity with the program are essential to successful implementation. For all trainers, being prepared prior to beginning a session is imperative. Payne et al. (2006) recommend clear and explicit materials and guidelines of the program for staff. Preparation of handouts, overheads, and video materials can make implementation easier and deviation from intended content less likely. One person should be given primary responsibility for a leadership role which includes making sure all materials for the lessons are ready (Johnson, 1997). Co-trainers (facilitators) can be useful for a number of reasons, including allowing for demonstration of role plays, presenting alternating viewpoints, and of course, the presence of one if the other has to be absent (Fontes, 2005; Kenny, 2009). Further, the general style of all trainers should be an open, positive, reassuring attitude toward children that allows the children to enjoy and learn from the exercise (Johnson, 1997). Understanding the cultural values and mores of a particular group is essential to implementing a successful program. It may be necessary to modify materials and curriculum when working with specific cultural groups. For example, in many cultures

CSA Prevention Programs 13 (including Hispanic and Asian), discussion of sexual matters appears to be taboo, particularly discussions with children about sex (Futa, Hsu, & Hansen, 2001; Kenny & McEachern, 2000; Lira, Koss, & Russo, 1999; Russell, 2004). Thus, taboos regarding open discussion of sexuality need to be explored. Other issues relate to the ability of some children from certain cultural backgrounds (e.g., Asian) to assert oneself and say “no” to a family member (Boyle & Lutzker, 2005). Furthermore, Latino culture emphasizes certain codes of behavior typified by the concepts of “respeto” (respect) and “verguenza” (shame) that may hinder the disclosure of sexual abuse on the part of the child (and parents), particularly if the offender is a family member (Millan & Rabiner, 1992). Many African-American families typically have extended family members (e. g., grandparents) living in the household, so involving those caretakers may be critical to program success (Hines & Boyd Franklin, 2005). Program staff can facilitate discussions with diverse parents geared toward understanding their cultural background and ways parents can stay “loyal” to their culture, while also supporting the goals of the program. Evaluation In order to demonstrate and document the effectiveness of prevention programs, evaluation at different times and on several levels is necessary. It is important to assess children’s skills before, during, and after the intervention as a means of evaluating progress (Lumley & Miltenberger, 1997). Employing a variety of data sources (i.e., children, parents, implementers) will provide greater breadth of information and allow for comparisons across individuals. A mixed-methods approach that includes both quantitative and qualitative data is recommended, particularly when working with

CSA Prevention Programs 14 culturally diverse populations (Lee, 2007). Clearly, multi-modal, multi-informant assessments are necessary to document behavioral change and increases in knowledge. Many programs limit their outcome measures to those that are knowledge based, rather than skill (or behavior) based. The inherent limitation in these approaches is that knowledge does not always lead to behavior change. After evaluation, the question often remains, will children generalize the knowledge and prevention skills learned to real-life situations? The best way to assess behavior change would be to observe the child utilizing the skills learned (i.e., verbal refusal, physical escape, and disclosure to parent). However, for obvious ethical reasons, sexual abuse lures in role playing are not recommended (Lumley & Miltenberger, 1997; Roberts & Miltenberger, 1999; Tutty, 1997). Hébert et al. (2001) used an innovative means to measure children’s preventive abilities in the face of abusive situations. Several video vignettes depicting potentially abusive and non-abusive situations were shown to the children and then children were asked (individually in an interview) how they would react in each situation. Similarly, in the ‘What If’ Situations Test (WIST; Wurtele, Hughes, & Owens, 1998), one of the few psychometrically sound instruments available, children are read vignettes about potentially abusive and non-abusive situations and asked to recognize and respond to these hypothetical abusive requests. Some of the more commonly used instruments are described in Table 2. Along with dollar costs, many evaluators measure participant satisfaction. Questions are aimed at parents or child participants. Typically participants are asked if they liked the program and if they would recommend it to others. Most studies found that participants enjoyed the program and found the material useful (e.g., Finkelhor, Asdigian

CSA Prevention Programs 15 & Dziuba-Leatherman, 1995; Lumley, et al., 1998; Wurtele & Owens, 1997). Additionally, Finkelhor et al. (1995) found that 95% of their youth participants said that they would recommend the program to other children. Research concerning the cost effectiveness of programs must be conducted to justify future funding. Goth Mace (2000) contends that the cost of implementing childfocused personal safety training is relatively inexpensive, particularly when compared to the costs associated with the mental health treatment and criminal justice services for victims and offenders. For example, in California after the Maxine Waters Child Abuse Prevention Training Act was passed, it provided $11.4 million per year for prevention of all school-aged children. Daro (1994) calculated the cost per student at that time was approximately $7. Finally, MacIntyre and Carr (2000) recommend that evaluation studies should include a measure of program integrity. Blind raters could observe sessions and lessons to gather data on the degree to which the sessions adhere to the accompanying manuals. Efforts should be taken to ensure trainer fidelity to the curriculum. When discussing appropriate evaluation, the question arises: Who should do the evaluation? Most agencies do not have the staff expertise for advanced research design and statistical analysis or the appropriate software systems needed to manage large databases. We suggest collaboration between these agencies and university faculty, who are well versed in evaluation. Likewise, Lutzker (2004) recommends that program administrators affiliate with very solid research teams, which have considerable expertise in evaluation and a record of producing published works.

CSA Prevention Programs 16 Summary Given the high rates of sexual abuse of children, primary prevention programs are a necessary part of childhood education. There are a variety of programs focused on increasing children’s knowledge about sexual abuse and teaching them skills that can assist them when confronted with a situation of inappropriate touching. Modifying any given program to meet the needs of the selected population, with regard to language of instruction, time, format, and setting, may be necessary for successful implementation. Choosing a prevention program should be based on careful selection from a list of evidence-based programs. Heinrichs et al. (2005) reports the “catch 22” of universal prevention programs. While recruitment and retention may be difficult, small effects on individual levels may reap large effects into the general population over time. The longterm goal is to equip all children with safety prevention education to assist them in healthy development and increase their likelihood of disclosure in the event that they are victims of abuse.


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CSA Prevention Programs 18 Elliot, M., Browne, K. & Kilcoyne, J. (1995). Child sexual abuse prevention: What offenders tell us. Child Abuse & Neglect, 19(5), 1995. Fieldman, J.P. & Crespi, T.D. (2002). Child sexual abuse: offenders, disclosure, and school-based initiatives. Adolescence, 37, 151-160. Finkelhor, D., Asdigian, N., & Dziuba-Leatherman, J. (1995). Victimization prevention programs for children: A follow-up. American Journal of Public Health, 85, 1684–1689. Fontes, L. (2005). Child abuse and culture. New York, NY: Guilford Press. Futa, K. T., Hsu, E., & Hansen, D. J. (2001). Child sexual abuse in Asian American families: an examination of cultural factors that influence prevalence, identification, and treatment. Clinical Psychology, 8(2), 189–209. Goth Mace, P. (2000). What works in prevention of child sexual abuse: Child-focused prevention techniques. In G. Alexander & P. Curtis (Eds.) What works in child welfare. Washington, DC: CWLA Press. Hébert, M., Lavoie, F., Piché, C., & Poitras, M. (2001). Proximate effects of child sexual abuse prevention program in elementary school children. Child Abuse & Neglect, 25, 505-522. Heinrichs, N., Bertram, H., Kuschel, A., & Hahlweg, K. (2005). Parent recruitment and retention in a universal prevention program for child behavior and emotional problems: barriers to research and program participation. Prevention Science, 6(4), 275-286.

CSA Prevention Programs 19 Hines, P., & Boyd Franklin, N. (2005). African American families. In M. McGoldrick, J. Giordano, & N. Garcia-Preto (Eds). Ethnicity & family therapy (pp. 87-100). New York: Guilford Press. Johnson, T. (1997). Sexual, physical and emotional abuse in out-of-home care: Prevention skills for at risk children. New York, NY: Haworth Maltreatment and Trauma Press. Kenny, M. (2009). Child sexual abuse prevention: Psychoeducational groups for preschoolers and their parents. The Journal for Specialists in Group Work, 34 (1), 1-19. Kenny, M. C., & McEachern, A. G. (2000). Racial, ethnic, and cultural factors of childhood sexual abuse: A selected review of the literature. Clinical Psychology Review, 20(7), 905-922. Kenny, M. & McEachern, A. (2007). Family environment in Hispanic college females with a history of childhood sexual abuse. Journal of Childhood Sexual Abuse, 16(3), 19-3. Krazier, S. (1996). The Safe child book: A commonsense approach to protecting children and teaching children to protect themselves. New York, NY: Fireside. Lee, K. (2007). The importance of culture in evaluation: A practical guide for evaluators. Denver, CO: Colorado Trust. Lee, Y. K., & Tang, C. S. (1998). Evaluation of a sexual abuse prevention program for female chinese adolescents with mild mental retardation. American Journal on Mental Retardation, 103(2), 105-116.

CSA Prevention Programs 20 Lira, L., Koss, M. & Russo, N. (1999). Mexican American women’s definitions of rape and sexual abuse. Hispanic Journal of Behavioral Sciences, 21(3), 236-265. Lumley, V. A., & Miltenberger, R. G. (1997). Sexual abuse prevention for persons with mental retardation. Am J Ment Retard, 101(5), 459-472. Lumley, V.A., Miltenberger, R.G., Long, E.S., Rapp, J.T., & Roberts, J.A. (1998). Evaluation of a sexual abuse prevention program for adults with mental retardation. Journal of Applied Behavior Analysis, 31, 91-101. Lutzker, J. (May 3, 2004). Health Talk: Preventing child maltreatment. State Health News, 2., MacIntyre, D. & Carr, A. (2000). Prevention of child sexual abuse: Implications of programme evaluation research, Child Abuse Review, 9, 183-199. Millan, F., & Rabiner, S. S. (1992). Toward a culturally sensitive child sexual abuse prevention program for Latinos. Journal of Social Distress and the Homeless, 1, 311-320. National Center for Missing and Exploited Children (1999). Guidelines for programs to reduce child victimization: A resource for communities when choosing a program to teach personal safety to children. Alexandria, VA: Author. National Sexual Violence Resource Center (2005). Preventing child sexual abuse: A national resource directory and handbook. Enola, PA: Author. Payne, A. A., Gottfredson, D. C., & Gottfredson, G. D. (2006). School predictors of the intensity of implementation of school-based prevention programs: Results from a national study. Prevention Science, 7(2), 225-237.

CSA Prevention Programs 21 Plummer, C. A. (1997). Preventing Sexual Abuse (2nd ed.). Holmes Beach, FL: Learning Publications. Plummer, C.A. (2001). Prevention of child sexual abuse: A survey of 87 programs, Violence and Victims, 16, 575–588. Putnam, F. (2003). Ten-year research update review: Child sexual abuse. Journal American Academy of Child and Adolescent Psychiatry, 42(3), 269-278. Roberts, J.A., & Miltenberger, R.G. (1999). Emerging issues in the research on child sexual abuse prevention. Education & Treatment of Children, 22, 84-102. Russell, S. (2004). Practitioners’ perspectives on effective practices for Hispanic teenage pregnancy prevention. Perspectives in Sexual and Reproductive Health, 36, 142-149. Smolkowski, K., Biglan, A., Barrera, M., Taylor, T., Black, C., & Blair, J. (2005). Schools and homes in partnership (SHIP): long-term effects of a preventive intervention focused on social behavior and reading skill in early elementary school. Prevention Science, 6(2), 113-125. Sprengelmeyer, M.E & Vaughan, K. (2000, October 8). Stalking children. Denver Rocky Mountain News, pp. 5a, 41-45a. Stauffer, L. B., Deblinger, E. (2003). Let’s talk about taking care of you: An educational book about body safety. Hatfield, PA: Hope for families, Inc. Stauffer, L., Deblinger, E. (2004). Let’s talk about taking care of you: An educational book about body safety for young children. Hatfield, PA: Hope for families, Inc. Tobin, P., & Kessner, S. L. (2002). Keeping kids safe: A child sexual abuse prevention nd

manual (2 Ed.). Alameda, CA: Hunter House Publishers

CSA Prevention Programs 22 Tutty, L.M. (1997). Child sexual abuse prevention programs: Evaluating who do you tell. Child Abuse & Neglect, 21, 869-881. Tutty, L.M. (2000). What children learn from sexual abuse prevention programs: Difficult concepts and developmental issues. Research on Social Work Practice, 10, 275-300. Webb, N. (1991). Play therapy crisis intervention with children. In N. B. Webb (Ed.) Play Therapy with Children in Crisis. (pp. 26-42) New York, NY: Guilford Press. Wurtele, S. K. (1987). School based sexual abuse prevention programs: A review. Child Abuse & Neglect, 11 (4), 483-495. Wurtele, S.K. (1993). Enhancing children’s sexual development through child sexual abuse prevention programs. Journal of Sex Education and Therapy, 19, 37-46. Wurtele, S.K., Gillispie, E. I., Currier, L. L., & Franklin, C. F. (1992). A comparison of teachers vs. parents as instructors of a personal safety program for preschoolers. Child Abuse & Neglect, 16, 127-137. Wurtele, S. K.., Hughes, J., & Owens, J. S. (1998). An examination of the reliability of the "What If" Situations Test: A brief report. Journal of Child Sexual Abuse, 7(1), 41-52. Wurtele, S., Kast, L., & Melzer, A. (1992a). Sexual abuse: Prevention education for young children: A comparison of teachers and parents as instructors. Child Abuse & Neglect, 16, 865-876 Wurtele, S. K., Kast, L. C., Miller-Perrin, C. L., & Kondrick, P. A. (1989). A comparison of programs for teaching personal safety skills to preschoolers. Journal of Consulting and Clinical Psychology, 57, 505-511.

CSA Prevention Programs 23 Wurtele, S.K., Marrs, & Miller-Perrin (1987). Practice makes perfect? The role of participant modeling in sexual abuse prevention programs. Journal of Consulting and Clinical Psychology, 55(4), 599-602 Wurtele, S. K., Melzer, A., & Kast, L. (1992b). Preschoolers’ knowledge of and ability to learn genital terminology. Journal of Sex Education and Therapy, 18, 115-122. Wurtele, S., Owens, J. (1997). Teaching personal safety skills to young children: An investigation of age and gender across five studies. Child Abuse & Neglect, 21, 805-814.

CSA Prevention Programs 24 Table 1 Selected Child Sexual Abuse Prevention Programs For Children Program/Organization Name ACT for Kids

Audience

Materials

Contact Person

Preschool Elementary Middle School Adolescents Special-Needs

Books, Videos

ACT for Kids Spokane, WA Toll Free: 866-348-5437 www.actforkids.org

Body Safety Training Program

Preschool Elementary

Script, Pictures, Role Plays, Token Reward System, Take-Home Materials

Sandy Wurtele, Ph.D. University of Colorado at Colorado Springs Phone: 719-262-4150 [email protected]

Child Assault Prevention (CAP) Project

Child Lures

Preschool Elementary Middle School Adolescents Special-Needs Elementary Middle School

Role Plays, Group Discussions

Role Plays, Videos, TakeHome Materials

No-Go-Tell!

Preschool Elementary Special-Needs

Lesson Pictures, Teaching Dolls

Preventing Child Sexual Abuse

Elementary Middle School Adolescents Faith-based

Faith-based curriculum

Red Flag, Green Flag© People

Preschool Elementary Special-Needs

Safe TOUCH

Elementary

Safe Child Program


Videos, Lesson plans, Games, Role-Plays


Photo-lesson Cards, Take Home Materials, Big Book, Poster, Video, RolePlays, Songs Classroom Presentations, Book, TakeHome Materials Videos, Pictures, Discussion, RolePlays

Talking About Touching

Three Kinds of Touching

Preschool Special-Needs

Who Do You Tell?

Elementary

Yellow Dyno


Videos, Work Book , RolePlays, Discussions. Films, Songs, Role-Plays, Activities

Curriculum, Videos, Songs

National Center for Assault Protection Sewell, NJ Toll Free: 800-258-3189 www.ncap.org Child Lures Prevention Shelburne, VT Phone: 802-985-8458 www.chihldlures.org James Stanfield Publishing Santa Barbara, CA Toll Free: 800-421-6534 www.stanfield.com Faith Trust Institute Seattle, WA Toll Free: 877-860-2255 www.faithtrust.institute.org Red Flag Green Flag Resources Fargo, ND Toll Free: 800-627-3675 www.redflaggreenflag.com Migima Designs Portland, OR Phone: 503-244-0044 www.migima.com Coalition for Children Denver, CO Toll Free: 800-320-1717 www.safechild.org Committee for Children Seattle, WA Toll Free: 800-634-4449 www.cfchildren.org

Pennsylvania Coalition Against Rape Enola, PA Toll Free: 800-692-7445 www.pcar.org Communities Against Sexual Assault Calgary, AB CANADA Phone: 403- 237-6905 www.calgarycasa.com Yellow Dyno Austin, TX Phone: 512-288-2882, ext. 100 www.yellodyno.com

School or Parent School, Parents

School, Parents

School, Parents

Languages English, Cambodian, Lao, Vietnamese, Chinese, Korean, Spanish English, Spanish

English Spanish, French, Japanese, Russian, Slovenian

School, Parents

English, Parent in Spanish

School

English

School, Parents

English , Parent materials in Spanish, Korean

School , Parents

English, Spanish, French

School

English

School, Parents

English, Spanish, Creole, French

School, Parents

English, Parent Materials in Spanish

School, Parents

English, Braille, Spanish

School, Parents

English

School, Parents

English, Spanish


Table 2 Commonly Used Outcome Measures in CSA Prevention Programs Measure Children’s Knowledge of Abuse Questionnaire1

Number Age of Range Items (years) 33 5 - 11

Child Sexual Behavior Inventory2

38

2- 12

Parent Perception Questionnaire3 Personal Safety Questionnaire3

19

3-9

11

3-9

Content

Child or Parent Completed

Measures knowledge Child of appropriate and inappropriate touch in a true/false format Rating of child’s Parent sexual behaviors on a 4 point Likert scale, includes two subscales Yes/no responses Parent

Yes/NO/DK Child responses, it measures CSA concepts 6 3-9 Interview format Child ‘What if’ Situations includes vignettes of Test-III4 abusive and nonabusive touches and measures recognition, resistance skills and reporting skills 1. Tutty, L. (1995). The revised Children's Knowledge of Abuse Questionnaire: Development of a measure of children's understanding of sexual abuse prevention concepts. Social Work Research, 19(2), 112-120. 2. Friedrich, W. N., Grambsch, P., Damon, L., Hewitt, S., Koverola, C., Lange, R., Wolfe, V., & Broughton, D. (1992) The Child Sexual Behavior Inventory: Normative and Clinical Comparisons. Psychological Assessment, 4, 303-31. 3. Wurtele, S.K., Gillispie, E.I., Currier, L.L., & Franklin, C.F. (1992). A comparison of teachers vs. parents as instructors of a personal safety program for preschoolers. Child Abuse & Neglect, 16, 127-137. 4. Wurtele, S.K., Hughes, J., & Owens, J.S. (1998). An examination of the reliability of the ‘What If’ Situations Test: A brief report. Journal of Child Sexual Abuse, 7, 41-52.