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What’s Going On? How We Can Confront Child Sexual Abuse in America

Runaway or Lost Girl Holding Old, Ragged Teddy Bear

By Karen Ethridge, PhD, & Tonya Davis, PhD (Alabama A&M University)

The child welfare system is charged with promoting the wellbeing of children by ensuring their safety and strengthening their families, so they may successfully care for children. While the child welfare system is comprised of a complex set of procedures that vary by state, finding solutions to combat the collateral effects some children face when placed into the child welfare system may be just as complex, if not illusive. Child sexual abuse has heightened awareness among the public. This increased awareness escalates the need for specialized treatment and knowledge of the short- and long-term effects of sexual abuse in children, especially in the fluid families of Americans today.

The National Incidence Study of Child Abuse and Neglect (NIS), state child protection agencies, and law enforcement agencies serve as three official sources of data on the incidence of childhood sexual abuse. According to research conducted by these agencies, child abuse has become an alarming social issue in American society.

  1. On a yearly basis, the National Incidence Study of Child Abuse and Neglect (NIS) reports approximately 133,600 cases of sexual abuse among children.

  2. Further data from the Survey of Child Abuse and Neglect report that 330,000 children are sexually abused in a year, with law enforcement citing some 150,000 cases each year.

Considerable evidence reveals:

  1. At least 20% of American women and 5% to 10% of American men have experienced some form of sexual abuse as children.

  2. The peak age of vulnerability for abuse of both boys and girls occurs between the age of 7 and 13.

  3. The percentage of adults disclosing histories of sexual abuse range- from 2% to 62% for females and 3% to 16% for males.

There are numerous reasons that explain the rising number of sexual abuse reports. The first reason being the willingness to report and disclose. Another is the age group of children exposed to abuse appears to be younger victims. The last one is the heightened awareness from the general public and service professionals on the issue.

Mounting research indicates that childhood sexual abuse seems to be a major risk factor in negative adulthood psychological functioning. In fact, research conducted over the last decade indicates a definite causal relationship between emotional difficulties and sexual abuse. Children who have been sexually abused are more likely to meet the criteria for a host of psychological difficulties such as:

  1. generalized anxiety disorder,

  2. phobias,

  3. panic disorder,

  4. post-traumatic stress disorder, and/or

  5. obsessive compulsive disorder.

The sexually abused child may be anxious in the presence of intimate or close relationships, and especially fearful when interacting with authority figures. Sexual abuse survivors who recount a single incident with a supportive parent are more likely to report minimal negative symptoms or none of the typical negative symptoms. The problems and symptoms described in the literature include:

  1. post-traumatic stress,

  2. cognitive distortions,

  3. emotional gain avoidance,

  4. academic difficulties,

  5. impaired sense of self, and

  6. interpersonal difficulties.

Quote from a Former Child Protective Supervisor

“Child abuse by nature is threatening, disruptive and interferes with the child’s developing sense of security. They no longer believe in a safe, just world, so it shouldn’t be surprising that victims of sexual abuse are prone to chronic feelings of fearfulness or anxiety.”

Quote of a School Psychologist in a School Setting   

“Often times, these children show extremes in behaviors based on their age. Some children are hesitant to talk while others are very angry and act out in schools.”

Treatment for Child Sexual Abuse in the Child Welfare System

Most treatment settings for child sex abuse victims offer an array of psychological services intended to help the victim and their family cope with the immediate impact of the abuse. The services provided range from sexual abuse hotlines to individual and family counseling, group therapy, dyad counseling, marital counseling, and support groups.

Information about treatment programs normally adopts one or more of the four basic therapeutic aims:

  1. Relieving symptoms

  2. Destigmatizing

  3. Increasing self-esteem

  4. Preventing future abuse

Based on childhood sexual abuse research to date, an effective treatment program should include:

  1. Assessments of intellectual and social emotional functioning.

  2. Evidence-based techniques to address children struggling with more than one condition or more than one symptom.

  3. Social support services for the child and family members (i.e., non-abusing members)

  4. Systematic evaluation of the effectiveness of treatment including changes in the victim’s symptoms.

  5. Routine coordination of treatment with agencies that provide medical, social and legal services such as churches and other safe havens.

Call for Action   

Giving a voice to our youngest victims is the responsibility of every American. While childhood sexual abuse prevention education is one strategy, it cannot succeed in isolation. Additional services should have educational as well as a treatment-focused continuum that targets the general population and high risk groups (i.e., perpetrators or victims) to prevent recidivism. Compounding this problem is the fact that child sexual abuse is unpredictable – neither potential victims nor perpetrators can be reliably identified. Ultimately, our work is incomplete when it comes to altering the public’s opinion of childhood sexual abuse, as well as strengthening parental capacity to mature their child’s healthy emotional and sexual development. With increased knowledge and awareness, and effective treatment of sexual offenders, the public can help combat the immense societal problem of childhood sexual abuse.


Beutler, L. E. ,  Williams, R. E. , &  Zetzer, H. A.  (1998). Efficacy of treatment for victims of child sexual abuse.  The Future of Children, 4(2), 153-175.

Cecil, C. A., Viding, E., Fearon, P., Glaser, D., & McCrory, E. J. (2017). Disentangling the mental health impact of childhood abuse and neglect. Child Abuse & Neglect, 63, 106-119.

Cohen, J. A., Mannarino, A. P., & Iyengar, S. (2011). Community treatment of posttraumatic stress disorder for children exposed to intimate partner violence. Archives of Pediatrics & Adolescent Medicine, 165(1), 16-21.

Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., & Amaya-Jackson, L. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child & Adolescent Psychology, 37(1), 156-183.

U.S. Department of Health and Human Services, The National Center on Child Abuse and Neglect. (1993). National Incidence Study of Child Abuse and Neglect reports: Study of High Risk Child Abuse and Neglect Groups: United States, 1993.


Tonya Davis, PhD, is a Nationally Certified School Psychologist and a Licensed Professional Counselor Supervisor working in private practice for over 15 years providing counseling and assessment services for families and children. She has an extensive history of working with families and children from diverse ethnic backgrounds, as well as children who have experienced trauma. She currently serves on the faculty of Alabama A&M University as an Assistant Professor in the Psychology & Counseling Department. She completed her doctoral degree in School Psychology from the University of Alabama. She can be contacted at

Karen Ethridge, PhD, currently serves as an assistant professor at Alabama A&M University. She received her Bachelor of Science in Psychology and Sociology from The University of Alabama in Huntsville. She earned her Master of Science in Psychology (with a concentration in Personnel Administration and Industrial Organizational Psychology) from Alabama A&M University in Normal, Alabama. She completed her doctoral degree in Educational Psychology from Capella University. Her research interests are academic self-efficacy and academic success in college students. She is currently the co-director of the Prevention and Learning Lab at Alabama A&M University where one of the goals is to focus on instructional learning and efficacy. She has worked with the Madison County Department of Human Resources as a Social Service Supervisor from 1998 to 2004. Since 2004, she initially served as an adjunct professor, then as an assistant professor at Alabama A&M University in the Psychology and Counseling Department. She can be contacted at

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