Scope

Child sexual abuse is generally defined as a type of maltreatment that refers to the involvement of a child or youth in sexual activity to provide sexual gratification or financial benefit to the perpetrator, including contacts for sexual purposes, molestation, statutory rape, prostitution, pornography, exposure, incest, or other sexually exploitative activities. ⁵ Children and youth of all ages, races, ethnicities, and socioeconomic backgrounds can and do experience sexual abuse in all kinds of neighborhoods, communities, youth-serving organizations, and schools. In the vast majority of cases, the child victim knows the perpetrator. The Massachusetts-specific definitions of child sexual abuse and other forms of child maltreatment can be found in Appendices E and L.

The Children’s Bureau of the U.S. Department of Health and Human Services collects national child abuse incidence data on an annual basis and posts the most recent data on its website. Its most recent report, Child Maltreatment 2021 ⁶ (published in 2023) reported that an estimated 4 million referrals, involving the alleged maltreatment of approximately 7.2 million children were received by Child Protection Services (CPS) agencies across the country. Of the substantiated allegations, 76 percent of the children suffered from neglect, 16 percent suffered physical abuse, and slightly more than 6 percent (6.4%) suffered emotional or psychological abuse. The report also estimated that 1,086 children were victims of sex trafficking, and 1,820 children died from abuse and neglect. A little more than 10 percent (10.1%) of the cases involved sexual abuse. It has been estimated in various studies that 25-40% of women and 5-13% of men experience at least one episode of sexual abuse victimization before they reach their 18th birthday. ^{7 , 8 , 9}

Sexually abusive acts can include sexual penetration, sexual touching, sexual exploitation or non-contact sexual acts such as exposure, voyeurism, sending/receiving nude or sexually explicit photos, and showing a child pornography. National statistics also indicate that, instead of strangers, the majority of these sexual offenses (85 – 90%) are carried out by a person the child knows or trusts (i.e., in the child’s family or social network). ¹⁰ Another common misperception is that it is only adults who sexually assault children. Approximately 40 percent of the reported cases concerning those who commit sexual offenses against children under the age of 11 years are juveniles – many of whom have been victimized themselves. ^{11 , 12} However, more recent research based on self-reports from a sample of over 13,000 children indicates that the prevalence of sexual offenses by children and adolescents involving other children and youth could be as high as 70 – 77%. ¹³ Unfortunately, estimates are that between 70 and 90 percent of child sexual abuse cases are never reported. ^{14 , 15} The under-reporting of sexual abuse is so significant that we must address specifically what researchers now document is affecting as many as one in ten children nationwide. ¹⁶

The scope of child abuse and neglect in Massachusetts is no less concerning. In FY2022, the Massachusetts Department of Children and Families (DCF) received 91,427 reports of the alleged abuse or neglect of children under the age of 18 through the 51A report process. Historically, as well as currently, first responders, school personnel, and childcare and health care providers in the Commonwealth are the source of the vast majority reports received. FY2022 saw a post-pandemic increase in those reports from both school and public safety personnel. More than 49,000 reports were screened in for a response. The most frequently present allegation types were neglect (73.1%), physical abuse (21.3%), and sexual abuse (12.1%).

Following the DCF response, the number of supported allegations of abuse/neglect or concerns for risk represented the maltreatment of a minor child in Massachusetts approximately every 20 minutes. At the end of June 2020, DCF was serving 86,453 open consumers across the Commonwealth. ¹⁷ In approximately 80% of these cases, DCF provides supervision/services to these children and families while they remain in their own homes.

Given these national and state statistics, it is clear that child abuse and neglect are significant and persistent public health problems. More than two decades of research on thousands of adults who experienced various levels of childhood abuse, neglect, and family dysfunction as children have identified links between childhood trauma and adult illness and death (heart disease, chronic pulmonary lung disease, hormonal dysfunction, hepatitis, depression, and suicide) in the United States. ¹⁸ In a heartbreaking cycle, exposure to these traumatic childhood experiences leads to social, emotional, and cognitive impairment in children, which leads to the adoption of risky health behaviors in adolescents and adults, which in turn leads to disease, disability, social dysfunction, and earlier death than those who did not experience such trauma. Scientists have also discovered that brain development can be negatively altered through exposure to trauma. ¹⁹

It is clear from these studies that child abuse is detrimental to lifetime health in a number of ways. Beyond the psychological and emotional effects that we have come to understand as the consequence of childhood abuse and neglect, we are now learning that its effects are lifelong and life threatening in ways that were unknown only a few years ago. In light of the above, the researchers themselves, in the closing remarks of many of these studies, have identified a number of societal and community strategies as essential in combating the problem of adverse childhood experiences – the very first being strategies that include the prevention of their occurrence.

⁵ Child Welfare Information Gateway. (2022). Definitions of child abuse and neglect. U.S. Department of Health and Human Services, Administration for Children and Families, Children’s Bureau. https://www.childwelfare.gov/topics/systemwide/laws-policies/statutes/define/

⁶ U.S. Department of Health & Human Services, Administration for Children and Families,
Administration on Children, Youth and Families, Children’s Bureau. (2023). Child Maltreatment 2021. Available from https://www.acf.hhs.gov/cb/data-research/child-maltreatment (NOTE: In this edition, Chapter 7 focuses on racial and ethnic differences within child maltreatment data).

⁷ Finkelhor, D. (2009). The prevention of childhood sexual abuse. The Future of Children, 19(2). (http://unh.edu/ccrc/pdf/CV192.pdf).

⁸ David Finkelhor, Anne Shattuck, Heather A. Turner, & Sherry L. Hamby, The Lifetime Prevalence of Child Sexual Abuse and Sexual Assault Assessed in Late Adolescence, 55 Journal of Adolescent Health 329, 329-333 (2014). (https://www.unh.edu/ccrc/resource/lifetime-prevalence-child-sexual-abuse-sexual-assault-assessed-late-adolescence)

⁹ Darkness to Light, Child Sexual Abuse Statistics, (https://www.d2l.org/wp-content/uploads/2017/01/all_statistics_20150619.pdf).

¹⁰ David Finkelhor (2009). The Prevention of Child Sexual Abuse The Future of Children, 19(2).(http://unh.edu/ccrc/pdf/CV192.pdf).

¹¹ Snyder, Sexual Assault of Young Children as Reported to Law Enforcement: Victim, Incident and Offender Characteristics (2000), National Center for Juvenile Justice, NCJ 182990 (http://www.bjs.gov/content/pub/pdf/saycrle.pdf).

¹² Finkelhor, David; Ormrod, Richard and Chaffin, Mark (2009). Juveniles who commit sex offenses against minors. Juvenile Justice Bulletin – NCJ227763 (1-12pgs). Washington, DC: US Government Printing Office. https://scholars.unh.edu/cgi/viewcontent.cgi?article=1014&context=ccrc

¹³ Ateret Gewirtz-Meyden and David Finkelhor (2019). Sexual Abuse and Assault in a Large National Sample of Children and Adolescents, Crimes Against Children Research Center, UNH (https://www.unh.edu/ccrc/sites/default/files/media/2022-03/sexual-abuse-and-assault-in-a-large-national-sample-of-children-and-adolescents.pdf )

¹⁴ Collin-Vezina, et. al. (2015). A Preliminary Mapping of Individual, Relational, and Social Factors that Impede Disclosure of Childhood Sexual Abuse, Child Abuse & Neglect, Volume 43, May 2015, Pages 123-134. (https://www.sciencedirect.com/science/article/pii/S0145213415000940?via%3Dihub)

¹⁵ Manay, N., Colin-Vezina, D. (2021) Recipients of children’s and adolescents’ disclosures of childhood sexual abuse: A systematic review, Child Abuse & Neglect Volume 116, Part 1, June 2021 (https://www.sciencedirect.com/science/article/pii/S0145213419303692)

¹⁶ Pérez-Fuentes G, Olfson M, Villegas L, Morcillo C, Wang S, Blanco C. Prevalence and correlates of child sexual abuse: a national study. Compr Psychiatry. 2013 Jan;54(1):16-27 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3518746/)

¹⁷ Massachusetts Department of Children and Families Annual Report for FY2022 (December 2022). https://www.mass.gov/doc/fy-2022/download (https://www.mass.gov/doc/dcf-annual-reportfy2021/download?_ga=2.200245546.582646129.1642524849-1577966823.1609852691)

¹⁸ Felitti VJ1, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, Marks JS., Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study (1998 May) American Journal of Preventive Medicine;14(4):245-58. (see: https://pubmed.ncbi.nlm.nih.gov/9635069/)

¹⁹ Carrion, V., Weems, C., Reiss, A. (2007) Stress Predicts Brain Changes in Children: A Pilot Longitudinal Study on Youth Stress, Posttraumatic Stress Disorder, and the Hippocampus, Pediatrics, 2007; 119:509 (https://www.researchgate.net/publication/6474878_Stress_Predicts_Brain_Changes_in_Children_A_Pilot_Longitudinal_Study_on_Youth_Stress_Posttraumatic_Stress_Disorder_and_the_Hippocampus)