Recognizing and Preventing Sexual Abuse

Protecting our children and loved ones from sexual abuse and violence is of the utmost importance. For those living with autism and other disabilities, this protection is even more critical. Sexual abuse is tragically far too prevalent in today’s society. The statistics are staggering: According to the Centers for Disease Control and Prevention (CDC), approximately 1 in 6 boys and 1 in 4 girls suffer from sexual abuse before the age of 18. Additionally, the U.S. Department of Justice's National Crime Victimization Survey, the country's largest and most reliable crime study, reports that every two minutes a person is sexually victimized in the United States—and the numbers for individuals with disabilities are even higher.

A study done in Nebraska of 55,000 children showed a child with any type of intellectual disability was four times more likely to be sexually abused than a child without disabilities (Sullivan & Knutson, 2000). While no specific numbers exist for individuals with autism, research suggests that this population is extremely vulnerable.

With this troubling information in mind, Autism Speaks has set out to provide families with valuable information regarding sexual abuse. Below you will find advice and information from experts on the best ways to talk about sexuality and sexual abuse, tools to help prevent abuse, signs to look for to detect abuse, and steps to take if you feel a loved one has been victimized. We have also provided numbers to call for help and guidance, as well as state and national resources.

Autism Speaks recognizes the difficulty of the topic at hand, but urges families to address the dangers of sexual abuse in ways that are comfortable for them. Being aware and educating yourself and your loved ones will help to keep everyone safe. This section is broken down into 

How to Talk About Sexuality
How to Prevent Sexual Abuse
Warning Signs of Sexual Abuse
Getting Help
Resources

How to Talk About Sexuality

Many parents feel anxious teaching their children about sexuality, especially children with autism. Some parents feel that it is less important to teach young adults with autism about sexuality with the assumption that it is unlikely to become a part of their lives. But sexuality education from parents is arguably more important for individuals with autism as they are less likely to learn about it from their peers, movies, or other similar sources. It is also crucial for individuals with autism to understand the difference between appropriate and inappropriate behavior, and to distinguish between the various types of healthy relationships.

Though the task may seem overwhelming, it is critical to start as EARLY as possible and to be as DIRECT as possible!

Peter F. Gerhardt, EdD, a member of the Autism Speaks Family Services Committee and an expert on applied research across the lifespan, discusses autism and sexuality:

Although generally difficult to talk about in an open and honest manner, sex and sexuality are central to our understanding of ourselves as individuals and are integral to our individual determination of quality of life. Contrary to some preconceived notions about sexuality instruction it is not designed to titillate, arouse or excite and it does not focus primarily on the physical act of having sex. Sexuality instruction, instead, focuses first and foremost on personal safety and self knowledge. So while sexuality education may be both frightening and complex, it should be considered an integral element of a comprehensive transition plan assuming that the goal of such a plan education is to be a safe, competent, and confident adult.

Perhaps surprisingly, sexuality education starts very early in life (differences between boys and girls; using the boys room or girls room, etc.) and continues well into adulthood (dating, marriage, and parenting). Comprehensive sexuality education consists of instruction in three distinct (yet interrelated) content areas: 1) Basic facts and personal safety; 2) Individual values and; 3) Social competence. As such, an instructional focus on some basic safety skills should be considered both necessary and appropriate for individuals on the autism spectrum. These skills would include, but not be limited to, closing and locking bathroom or stall doors, understanding personal privacy and who can and who cannot help you in the bathroom or with personal care skills, body part identification using adult terminology (e.g., penis instead of peepee), using public restrooms independently, the restriction of nudity to personal bathroom or bedroom, and the issue of personal space for both self and others.

Sexuality education with learners with ASD is often regarded as a “problem because it is not an issue, or is an issue because it is seen as a problem.” (Koller, 2000, p. 126). In practice this means we generally ignore sexuality as it pertains to learners with ASD until it becomes a problem at which point we generally regard it as big problem. A more appropriate and, ideally, more effective approach is to address sexuality as just another, albeit complex, instructional focus, the teaching of which promotes the ability of the individual to be safer, more independent and more integrated into their own communities resulting in a more positive quality of life.
- References: Koller, R., (2000). “Sexuality and adolescents with autism.” Sexuality and Disability, 18, (125-135).

How to Prevent Sexual Abuse

Parents, caregivers and friends want to protect their loved ones from being victimized. Though there is no sure way to do so, the National Child Traumatic Stress Network provides some helpful tips on protecting children from sexual abuse:

  • Teach children accurate names of private body parts.
  • Avoid focusing exclusively on “stranger danger.” Keep in mind that most children are abused by someone they know and trust.
  • Teach children about body safety and the difference between “okay” and “not okay” touches.
  • Let children know that they have the right to make decisions about their bodies. Empower them to say “no” when they do not want to be touched, even in non-sexual ways (e.g., politely refusing hugs) and to say “no” to touching others.
  • Make sure children know that adults and older children never need help with their private body parts (e.g., bathing or going to the bathroom).
  • Teach children to take care of their own private parts (i.e., bathing, wiping after bathroom use) so they don’t have to rely on adults or older children for help.
  • Educate children about the difference between good secrets (like surprise parties—which are okay because they are not kept secret for long) and bad secrets (those that the child is supposed to keep secret forever, which are not okay).
  • Trust your instincts! If you feel uneasy about leaving a child with someone, don’t do it. If you’re concerned about possible sexual abuse, ask questions.

The best time to talk to your child about sexual abuse is NOW

Warning Signs of Sexual Abuse

Parents, caregivers and friends can protect their loved ones by learning certain signs that may indicate victimization. It is important to remember that each person is different and can show different symptoms. Recognizing possible signs of abuse can help you to assist the victim in getting help and stopping the abuse as soon as possible.

The American Psychological Association outlines behaviors common in children who have been abused:

  • An increase in nightmares and/or other sleeping difficulties
  • Angry outbursts
  • Anxiety
  • Depression
  • Difficulty walking or sitting
  • Withdrawn behavior
  • Pregnancy or contraction of a venereal disease, particularly if under age 14
  • Propensity to run away
  • Refusal to change for gym or to participate in physical activities
  • Regressive behaviors depending on their age (e.g., return to thumb-sucking or bed-wetting)
  • Reluctance to be left alone with a particular person or people
  • Sexual knowledge, language, and/or behaviors that are unusual and inappropriate for their age

Take it very seriously when a child reports sexual abuse by a parent or another adult caregiver.

For children with autism, the signs may manifest differently. In her article Sexual Abuse Of Children With Autism: Factors That Increase Risk And Interfere With Recognition Of Abuse, Dr. Meredyth Goldberg Edelson, of Willamette University, notes:

“Children with autism sometimes display self-stimulatory behaviors, self-injurious behaviors, and stereotypic and repetitive behaviors (APA, 2004; Cunningham & Schreibman, 2008). Should a child with autism be sexually abused, the child's attempts to cope with or make sense out of that abuse may lead to an increase in the intensity and frequency of these behaviors or to the development of new behaviors that were not previously present.

“Research suggests that children with autism who are nonverbal exhibit more behavioral difficulties than those who have verbal communication abilities (Dominick, Davis, Lanihart, Tager-Flusberg, & Folstein. 2007). This may relate to frustration caused by the inability of others to understand what the child is trying to communicate. For example, Dominick et al. (2007) found that there was a significant inverse relationship between the display of self-injurious behaviors and expressive verbal language ability in a sample of children with autism. For children with autism who wish to disclose their abuse, behavioral reactions to sexual abuse may develop if others cannot understand their communication about the abuse, but these behaviors may be misinterpreted by others as merely a manifestation of autism. Therefore, the fact that the child was, or continues to be, sexually abused may be missed.

“In addition to the difficulty in determining whether or not a child with autism has been sexually abused based solely on behavior, there is also the potential for behavioral signs of sexual abuse to be misattributed as signs of autism.”

Getting Help

Discovering that someone close to you is a victim of sexual abuse is devastating. Once you know, step one is to report the abuse. The National Child Traumatic Stress Network offers the following advice:
"If a child discloses abuse, it is critical to stay calm, listen carefully, and NEVER blame the child. Thank the child for telling you and reassure him or her of your support. Please remember to call for help immediately. If you know or suspect that a child is being or has been sexually abused, please call the Childhelp® National Child Abuse Hotline at 1.800.4.A.CHILD (1.800.422.4453) or visit the federally funded Child Welfare Information Gateway Responding to Child Abuse & Neglect page. If you need immediate assistance, call 911."
Many communities also have Children’s Advocacy Centers (CACs) that offer coordinated support and services for victims of child abuse (including sexual abuse). For a state-by-state listing of accredited CACs, visit the National Children’s Alliance website.

After learning a loved one has been abused, it is critical to take proper steps to get them help. The effects of sexual abuse can be devastating for both the victim and their families. The American Psychological Association offers the following advice on getting help for the victim:

There are a number of empirically validated treatments for children who have been sexually abused, including:

  • Individual therapy
  • Family therapy
  • Group therapy
  • Trauma-focused cognitive behavioral therapy
  • Child-centered therapy

There is no “one size fits all” treatment for sexual abuse. Therapists may take a range of approaches to treatment depending on the individual characteristics of the child and the length of treatment.

Recovery is possible - children can be very resilient and with a combination of effective treatment and support from parents/caregivers, they do recover from abuse.

For individuals with disabilities, The ARC offers this information:
"In the past, the benefit of psychotherapy for people with intellectual disabilities was questioned, as well as the impact of sexual violence (whether or not it impacts people with intellectual disabilities as strongly as others without disabilities). Today, however, it is widely acknowledged that all people who experience sexual violence are affected and do require therapeutic counseling, even if they are non-verbal.

Locating a qualified therapist may be difficult since the person should be trained in child/adult sexual abuse and sexual assault treatment as well as intellectual disabilities. The therapist should also be trained in non-verbal mind-body healing modalities that do not require an intellectual processing component of the therapy. Payment for the therapy can be obtained through victim witness programs, community mental health centers or developmental disability centers."  

Resources

National Child Traumatic Stress Network: Sexual Abuse

Texas Association Against Sexual Assault: Sexual Abuse of People with Developmental Disabilities

Sexual Abuse Of Children With Autism: Factors That Increase Risk And Interfere With Recognition Of Abuse

Autism Society: Information for Domestic Violence and Sexual Assault Counselors

American Academy of Child & Adolescent Psychiatry: Child Sexual Abuse

American Psychological Association: Sexual Abuse

Lauren's Kids Foundation
Our mission is to prevent sexual abuse through awareness and education and to help survivors heal with guidance and support.

Signs of Sexual Abuse in Children and Adolescents
A video from Lauren Book, founder and CEO of the Lauren's Kids Foundation

VAOnline.org Disability and Victimization Resources

National Coalition Against Domestic Violence: Domestic Violence and Disabilities

American Professional Society on the Abuse of Children
1-312-554-0166

National Center for Missing and Exploited Children
24 hour hotline: 1-800-THE-LOST

Prevent Child Abuse America
1-800-CHILDREN

Child Welfare Information Gateway (formerly National Clearinghouse on Child Abuse and Neglect Information)
1-800-394-3366 

US Department of Justice Office of Victims of Crimes
1-800-851-3420

National Center for Victims of Crime
1-800-394-2295

National Domestic Violence Hotline
1-800-799-7233

National Resource Center on Domestic Violence
1-800-537-2238

Rape, Abuse & Incest National Network (RAINN)
1-800-656-4673

LEAN on Us (Law Enforcement Awareness Network)

Autism Risk and Safety Management

You Are in Charge of Your Body
A three-part educational video series that teaches young children how to recognize sexual abuse, how to protect themselves from a potential abuser, and how to disclose what happened to a trusted adult. Cost: $185 

**Find local resources for victims of crime at Autism Source™, the Autism Society’s online referral database.