Specific Parenting Issues in Dealing with Child Sexual Abuse

Ideas and strategies to help your child manage their problem behaviors resulting from sexual abuse.

Helping your child means helping him/her identify and use activities that can make him/her feel better and reduce their anxiety. Some activities could include: finding someone to talk to, picture drawing, relaxation exercises, play activities with a special purpose or something as common as using a night light.

Some of the ideas and strategies will be more successful with some children than with others. It will be up to you as your child's parent to determine which ideas are better suited to your child's personality and specific situation.

Problem Behaviors You Might See in a Sexually Abused Child and What You Can Do to Help

Fears

Fears can be considered common in children between the ages of 2-6 years. More common fears include fear of dogs or animals; fear of the dark; fear of thunder/storms; fear of ghosts; and fear of insects. Children learn to be afraid and parents often model fears for their children.

In the case of sexually abused children, key factors associated with fear are: fear of recurrence of the sexual abuse even after disclosure; fear of follow through on threats made by the child's perpetrator; fear of retaliation by the perpetrator; fear of negative parental reaction and a generalized fear towards persons who have physical features that resemble the perpetrator, for example: adult males who wear glasses and have a mustache like the child's perpetrator.

Often, because of their age, preschool children are unable to verbalize their fears including identifying why they are afraid. Unverbalized fears can take the form of anger, somatic complaints such as tummy aches and nightmares.

Parents can help their children most by helping him/her to identify and overcome unreasonable fears. Having a nonjudgmental and supportive attitude is crucial. For example, ask, "What can I do to help you feel safe?" OR you can provide suggestions such as, "I wonder if having a night light on in your room would help you feel safe?" OR validate your child's fear, such as, "It looks like this is going to be scary for you to do today, that's okay, I will help you get through it".

Some children will use their own resources and create routines and rituals to help feel safer. An example of a ritual is: checking the windows, closet and doors every night before bedtime. Other examples include: keeping a small light on in their room at bedtime, putting a flashlight under their pillow, or insisting that the bedroom door stay open/closed.

Parents can also help their children by providing explanations and reassurance. For example, when helping your child deal with fear of noises, provide a reasonable explanation about what could have caused the noise, such as the wind, the cat under the bed, etc. Providing reassurance, such as, "I will check on you while you sleep" OR "I will leave my door open so that if you need me you can yell and I'll hear you". Suggesting to your child that re-arranging their room might get rid of scary shadows could be reassuring as well as offering an explanation. Another way of being reassuring is to explain: "Your fear will get smaller and smaller" OR "We will work together to get over your fears" OR "I will help you feel safe from your fears".

With young children who are unable to verbalize fear, it is helpful to use feeling words similar to the following: "I wonder, when you check the closet, doors and windows if you are afraid" OR "Being scared makes your tummy hurt." Reflecting your child's feelings helps him/her to learn to identify their feelings while giving them permission to say what they might be feeling.

Modeling calmness and providing a message of optimism that your child can survive their fears is also very important. You could state, "I know you can get through this" OR "I know how brave you can be" OR "I remember, you were brave when ______ and I know you can be brave again like that now".

Some children are able to verbalize fear of their perpetrator. It could be reassuring to establish a plan of safety with your child. For example, when a perpetrator is not in jail and the child has expressed a fear of retaliation, a safety plan could include a calm, matter of fact review of adults in your child's life whom are possible protectors. Other kinds of safety plans could include a discussion about what-if situations and ideas about ways they could help keep themselves safe.

A more specific strategy useful in reducing anxiety around fear is to teach your child to "self-talk". This is where you teach him/her to talk to him/herself to get through a potential scary situation. For example: your child tells self, "I can do this." OR "I'm brave".

Another specific strategy is to read books about other children who have fears. This can help to normalize and lessen feelings of being different.

Play can be another means of "mastering" or overcoming fear. Children will use play to act out how to deal with their fear and to help to relieve/reduce their fear. Parents can interact with their child through play offering suggestions and practicing how to deal with specific fearful situations. For example: using a doll to coach another doll to be brave before going to the doctor or helping a doll to talk about his/her fears.

Relaxation can also help a child reduce their level of distress from fear. For example, a soothing back rub just before naptime, listening to calming music as part of a ritual or routine and teaching relaxation exercises such as deep breathing can be helpful to your child.

Nightmares

Sleep problems including nightmares are common in children ages 1-6. The two different kinds of sleep problems we will discuss are night terrors and nightmares.

Night terrors occur suddenly in a sleeping child, usually early in their sleep. The child will thrash about wildly, while screaming and appearing to be intensely frightened. The child may appear to be awake but is not. They will also appear to be confused and will be unable to communicate.

Children having night terrors will not be aware of their parents presence and will not remember the night terror event. If your child suffers night terrors it is usually best not to try to wake him/her. Most children will gradually relax and can then be encouraged to lay down and fall back asleep. Night terrors are not as common as nightmares in sexually abused children.

Nightmares are more common in children and are frequently associated with stress. Parents know about nightmares because their child wakes them up crying or yelling in fear. They usually occur late in a child's nightime sleep. Nightmares are intense and frightening for the child and he/she has difficulty getting back to sleep. Children suffering from nightmares may need physical or verbal comfort from their parent(s).

Sexually abused children appear to have frequent nightmares. These nightmares could include actual content from the child's sexual abuse experience or be the result of bottled up feelings such as anger or fear. Some nightmares include themes of monsters, "bad people" and snakes. Nightmares can be so intense and real that children may have difficulty distinguishing them as not real. The following are some specific ideas for helping your child with their nightmares:

1) Some children may be afraid to talk about their nightmares, believing that if they did the nightmare would come true. Encourage them to talk about, act out or draw pictures of their nightmare while explaining that nightmares are not real but make- believe.

2) Provide verbal reassurance, "If you need me to stay with you until you fall asleep, I will".

3) Provide statements that will normalize nightmares for your child, such as: "Other kids that had a touching problem like you, have nightmares too" or "Most kids have nightmares when they are scared." Read books about other children's nightmares and how they confronted them.

4) Bolster bedtime routines such as:

• provide a quiet time before bedtime
• read a comforting story
• talk about good dreams
• provide comforting music
• lie down with your child in their room and bed
• rock your child or give a back rub
• provide a relaxing bath

5) Be creative, think up and act out safe or humorous endings to nightmares.

6) Make a "dream helper" or "nightmare buster", a powerful yet friendly helper to protect from or chase away nightmares. For example, a dream helper could be a special stuffed animal, a nightmare buster could be a picture of Batman drawn by your child and hung on the door.

7) When helping your child return to sleep after being awakened by a nightmare it will be most helpful to provide physical comfort and verbal reassurance that, he/she is in a safe place and nightmares are not real and can't hurt. It could also be helpful to turn on a light in your child's bedroom to show them that are in a safe place. Any of the above suggestions could also be helpful, such as: a back rub, lying down with your child until they fall back to sleep, comforting music or a book.

Sexualized Behaviors

Sexual behaviors observed in preschool and school-aged children are a part of normal sexual development. When children are sexually abused they are prematurely introduced to sexual stimulation and pleasure that they are unable to understand and cope with because of their young age. Many of their sexual behaviors are a learned response to the perpetrator and sexual abuse acts. Sexual abuse may also increase a child's normal interest in sexual matters.

Children most often tell parents, by their behavior about their level of distress. Young children who are sexually abused appear to have more problem behaviors in the area of sexuality. These include:

1) excessive masturbation,

2) sexual acting out with peers,

3) pseudo-mature or false mature sexual behaviors, and

4) confusion over sexual identity and what is appropriate sexually between children and adults.

When helping your child with problem sexual behaviors it is very important that you maintain a matter of fact, nonjudgemental and firm attitude. Reacting in this way reduces the powerfulness of the behavior.

The following are some ideas and strategies helpful in dealing with excessive or public masturbation:

1) Reflect the child's confusion, such as "you must be confused about what is okay, I'll help you". Follow-up with specific expectations and limits.

2) Explain and set limits in a matter of fact tone and simple language. For example, when masturbation is in public, you could state "masturbation can be done in the bathroom or bedroom but not in the living room or grocery store".

3) Distract child when masturbation occurs before sleep by offering a soothing alternative like a back rub or quiet music.

4) Interrupt public masturbation without punishing and suggest an alternative behavior such as playing a game.

The following are some ideas and strategies helpful in dealing with inappropriate sexual acting out with peers and play with toys:

1) Set limits with a matter of fact, firm voice but not a punitive voice.

2) Supervise or monitor your child's play with peers and toys, so if necessary you can interrupt and set appropriate limits.

3) When the play is with toys and in front of a peer, use words such as, "it doesn't look like your friend likes that kind of play" and redirect to another more appropriate activity.

4) Some sexual play with toys and sexual acting out with peers can be the result of sexual abuse memories experienced by your child. Your child may be demonstrating or re-enacting them through his/her play to gain control over or an understanding of what happened to him/her. When the play is with toys such as, two dolls having sex, you may choose to interrupt or allow your child the opportunity to replay the situation. If you choose to give your child time to re-enact their experience it is important that you watch for continuous, endless play. If your child appears to be involved in repetitive play without a resolution or a "safe" ending, you may want to join your child's play and act out a safer ending. Some parents may have difficulty helping their child with these kinds of behaviors and if this is your experience you are encouraged to contact a child therapist for guidance.

5) Teach your child accurate sex education and sexuality information, using correct terms and correcting misinformation.

6) When the behavior is sexual acting out with a peer, use words such as, "it was not okay for _____ to touch your penis/vagina and it is not okay for you to touch ______ in their penis/vagina" OR "you are in charge of your penis/vagina, it's up to you to take good care of it." OR "it's up to you to make sure you give only safe touches."

7) When the behaviors are provocative or seductive, use words such as, "I like it much better when you give me a hug and kiss like this, (demonstrate)". After you have set these limits and demonstrated for child, catch him/her giving the appropriate affection and praise him/her. OR use words such as this, "I think you are confused about what are okay ways of showing that you love."

Sources:

• Dane County Commission on Sensitive Crimes