Sexual Abuse Prevention Programs: Can They Cause False Allegations?¹

James J. Krivacska^*

ABSTRACT: Current child sexual abuse programs may promote the perception in many nonabused children that they have been abused.  This paper demonstrates how false allegations arising from CSAP programs are inevitable and gives several anecdotal examples.  The problem may be especially serious when a child is involved in a divorce and custody situation.  Approaches to reducing false allegations are discussed.
  

The 1980s saw an explosion of reports of sexual abuse of children borne largely out of increased public awareness and acceptance of the occurrence of such abuse, and more aggressive identification and investigation tactics of child protection agencies.  With reported prevalence rates in the adult population as high as 38% of all adult women (abused prior to age 18), prevention of child sexual abuse has taken on a crisis perspective, despite the lack of hard data supporting either the reality of such high rates, or the effectiveness of prevention measures.

The proliferation of child sexual abuse prevention programs has led many authors to suggest the need to critically analyze and evaluate the effects and effectiveness of such programs (Gilbert, Berrick, Le Prohn & Nyman, 1989; Kraizer, 1986; Leventhal, 1987).  A detailed review and critique of current approaches to child sexual abuse prevention is not possible here and the interested reader is referred to several other works which provide such an analysis (Gilbert, et al., 1989; Krivacska, 1990a; Reppucci & Haugaard, 1989).

Within the past few years, concern has arisen over the potential for some accusations of sexual abuse to be false, particularly when evolving from a divorce or custody dispute.  Gardner (1987a) describes in considerable detail factors which may contribute to the likelihood that an allegation of sexual abuse is false.  In fact, Gardner developed a rating scale which may be used by an evaluator to ascertain the likelihood that a given allegation is true or false (1987b).  Of the reports made of child abuse, perhaps the largest proportion consists of those in which a determination as to whether abuse actually occurred could not be made (Besharov, 1986).

Relatively little, however, has been written about child sexual abuse prevention programs and the potential such programs might have for generating false allegations of sexual abuse.  This paper suggests that such potential is very real and may promote, in many children, the perception that they have been or are being abused when, in reality, such abuse is not occurring.

Many professionals have difficulty accepting that such an outcome may result from child sexual abuse prevention (CSAP) programs, particularly given what appears to be a good deal of face validity to the programs.  However, the face validity of many programs is based on an adult perspective of sexual abuse and derives from adult models of rape prevention and empowerment (Tharinger,. Krivacska, Laye-McDonough, Jamison, Vincent & Hedlund, 1988; Swift & Levin; 1987); a model which makes no sense when applied to children.  Additionally, CSAP programs frequently ignore critical developmental issues (particularly for young children) in the areas of cognition, language, concept formation, learning styles, perception, perspective taking, morality and sexuality (Krivacska, 1990a).
  

CSAP Programs as Identification Instruments

From their inception, the overall focus of sexual abuse prevention programs has been prevention, not identification of abuse (Anderson, 1986). Unfortunately, CSAP programs as they are currently being designed and implemented are highly unlikely to prevent any sexual abuse of children. Most such programs teach children about their bodies and their right to refuse touch which invades their privacy.  Typically this message is conveyed in one way or another as "No one should touch your private parts except for medical or hygienic reasons."  Children are taught various actions to take should someone attempt to touch their genitals, undress them, or engage in some other statutorily prohibited sexual behavior between an adult and a child.

The CSAP programs consider a child interrupting and reporting such abuse as preventive.  However, the sexually abusive approach (whether it be verbal solicitation or physical contact) is itself an abusive act.  While possibly less serious than if the abusive act had continued without interruption, a child who has been approached in a sexually abusive way has been sexually abused (with the approach itself, a prosecutable offense).  True prevention requires that the child not be approached in a sexual manner.

Some authors have spoken of increasing a child's competence (Finkelhor refers to it as the front of invulnerability) so that the child is less likely to be approached in a sexually abusive manner.  A program which promotes such invulnerability or competence may be considered a primary prevention program.  However, a program which teaches children how to respond after having been approached or experiencing the initial stages of sexual abuse is not a prevention program, but an identification program.  In all such programs, the child is instructed to tell someone of the abuse, another indication that such programs serve primarily the purpose of early identification.

Once one accepts the conclusion that CSAP programs serve an early identification purpose, the next question is the accuracy of these programs as identification devices.  Specifically, all identification or assessment devices have a known or unknown error rate.  As an identification device, CSAP programs may result in one of four outcomes.

1. The child may accurately discriminate a sexually abusive event as sexually abusive (true positive);

2. The child may inaccurately discriminate a nonsexually abusive event as sexually abusive (false positive);

3. The child may accurately discriminate a non-sexually abusive event as nonabusive (true negative);

4. The child may inaccurately discriminate a sexually abusive event as nonabusive (false negative).

The probability of each of these four results occurring may be statistically determined using a classification decision model (Wakefield & Underwager, 1988) and is linked to the accuracy of the identification instrument (in this case the CSAP Program) and the base rate of the event to be discriminated (in this case the incidence rate of child sexual abuse).  Base rates of sexual abuse have remained an area of controversy for some time.  For the sake of this illustration, a base rate of 15% will be assumed.  It is impossible at this time to determine how accurate CSAP programs are as identification instruments, however, two estimates will be compared.  The first, 80%, represents an extremely high accuracy rate (exceeding that of many, more standardized psychological measures), and the second rate, 60%, is more likely consistent with reality.  Given these two variables, two tables can be designed illustrating the probability of a child correctly discriminating an event.

  
As the tables illustrate, with an 80% accuracy rate CSAP programs will generate slightly more false positives than true positives.  In other words, slightly more children are likely to misperceive a non-sexually abusive event as sexually abusive than correctly perceive a sexually abusive event as sexually abusive.  When one assumes a 60% accuracy rate, nearly four times as many children will misperceive a non-sexually abusive incident as abusive than will correctly perceive a sexually abusive incident.

While the actual degree of false positives is hard to determine given lack of validated data on either incidence rates or accuracy rates of CSAP programs, false positives will inevitably occur.  This leads to two questions: 1) What factors contribute to the degree to which CSAP programs assist children in making accurate discriminations of adult behavior, and 2) Why has there not been a torrent of allegations arising from CSAP programs (most of which, by this analysis, would be false).

With respect to the second question, one needs to once again consider incidence and prevalence rates.

For example, to sustain a prevalence rate of 15% (of adults abused as children) in the adult population, the yearly incidence rate of sexual abuse must be at approximately 1% of the total childhood population.  Using New Jersey as an example, in 1988 there were approximately 1,500,000 children under the age of 18 in New Jersey (New Jersey State Department of Education, 1989).  In that same year, the Division of Youth and Family Services (the state child protection agency responsible for investigating child abuse allegations) substantiated 1,681 reports of sexual abuse (Leusner, 1990) representing .1% of all children in New Jersey.  To sustain an adult prevalence rate of 15%, however, would have required approximately 15,000 cases of sexual abuse.  Thus, one might argue that only 1 in 10 cases of sexual abuse is being reported in New Jersey.  Two characteristics of the 1,681 substantiated cases need to be pointed out.  First, DYFS data does not permit an analysis of how many of the 1,681 resulted from a child making a complaint, and second, the cases reported to DYFS are likely to be the more severe, long-standing forms of sexual abuse.

With regard to false positives resulting from CSAP programs, one should not conclude (in the case of 60% accuracy) that 60% of child reports of abuse will be false (340 of 430 reports made).  In reality, many children will self-identify as being abused and choose not to report (for both the true positive and false positive conditions).  These rates apply only to the child's self-identification, and do not infer a one-to-one correspondence between that self-identification and actual reports made.  Given that most children who are sexually abused make no report of that event, it is just as likely that children who are not sexually abused but believe they might have been would also rarely make a report.

Anecdotal examples of false positives are beginning to be collected and span a wide range of childhood experiences.  Kraizer (1986) reports a case of a child who chastised his father for patting him on the behind as he went up to bed, because the child had learned that the buttocks were a private part of the body.  I have received numerous reports, including one of a school teacher who described two of her first grade students coming to her after attending a sexual abuse prevention program, and confiding to her that they had been "sexually abusing" each other, because they had, on occasion, engaged in peer sex play with one another.  They were now reporting the "abuse" as required by the program.

Another parent reported that her six-year-old daughter came to her in hysterics after being tickled by her three-year-old brother.  She had been taught in school that tickling could be bad touch, and that she was to report any bad touches to the school.  She was frightened that she might be taken away from her mother if she reported this "bad touch" as required by the school program.  Each of these stories, and the many others that have arisen from CSAP programs, represent a false positive in which the CSAP program has served an identification function.

What factors contribute to the degree of accuracy of CSAP programs as identification instruments?  False positives result from two phenomena, misinformation and misinterpretation (Krivacska, 1989).  When a CSAP program presents information which is inaccurate, vague or misleading, or which is presented in a manner inconsistent with the child's developmental levels, misinformation has occurred.  Concepts commonly found in CSAP programs include the Touch Continuum, Secrecy, Intuition, Body Rights, Empowerment, Preventive actions, and Telling (Conte, Rosen, Saperstein, & Shermack, 1985; Tharinger, et al., 1988).  Most of these concepts are poorly conceptualized and defined, lack discriminative capacity, and are grounded in false assumptions about children's capabilities (Tharinger, et al., 1988).

For example, empowerment theory has been applied to child sexual abuse prevention.  However, empowerment implies choice, responsibility and competence (Dunst & Trivette, 1987; Fox, 1984; Rappaport, 1981).  CSAP programs proscribe any choice (the child is told what to do), presume competency (even for three and four year olds), and deny responsibility (the child is not at fault for either the abuse or the child's failure to prevent it).  Furthermore, the attempt at empowering children places the child in the position of having to contend with a world which does not recognize empowered children.  To ask a child who has been spanked, as one CSAP program does, to confront his or her parents and tell them they should not spank him or her, is asking too much of a child and places responsibility for empowering children on the child (Krivacska, 1990a).

Misinterpretation may arise from several sources, including limited cognitive development, poor instruction on the part of the trainer or teacher, and limited understanding of sexuality.  With respect to the latter, most CSAP programs assiduously avoid any mention or reference to sex.  Contrary to what many in the field propose, child sexual abuse is not borne of power inequities between adult males and children, but of a sexual disturbance on the part of the perpetrator. In an adaption of theoretical models of rape, attempts have been made to explain sexual abuse of children by arguing that such abuse represents an adult's exercise of power over a child with sex as a tool.  There are no research data to support this assumption.  Empirical evidence on perpetrators clearly indicates that the overriding motivation for the abusive act is sexual, with power as the tool for gratifying sexual needs (Krivacska, 1990b).

Consequently, sexual abuse is abuse of a child's sexuality and the use of a child's sexuality to satisfy adult needs.  In an attempt to avoid controversy over sex education, CSAP programs are trying to teach children about abuse without talking about what it is that is being abused.  Children are sexual beings and have sexual feelings and experiences.  Research dating back to the 1940s clearly demonstrates that children have sexual lives (Gebhardt & Johnson, 1979; Kinsey, Pomeroy, & Martin, 1948; Kinsey, Pomeroy, Martin & Gebhardt, 1953; Reevy, 1973).  Ignorance of this fact poses a great danger to children exposed to sexual abuse prevention programs.  Rarely is any attempt made to distinguish sexual abuse from such normative behaviors as masturbation, peer sex exploration, or non-sexual incidental genital contact with adults.  Consequently it is not surprising that anecdotal reports, such as the two first grade boys "confessing" to having "sexually abused" each other, are occurring.
  

Implications of CSAP Programs as Identification Instruments in Divorce or Custody Cases

When a child thinks that he or she may have been abused by an adult, the child is engaging in a first level screening of adult behavior.  Thus, children are being given a primary responsibility to screen adult behavior and determine what is abusive and what is not.

The implicit and, at times, explicit assumption of CSAP programs, is that the first level screening by children should be considered accurate; that children will not lie about abuse (Stone, 1986).  Ignored, however, is the issue of whether a child can make a mistake, with the consequence that all reports must be taken at face value.  Furthermore, this view ignores the possibility that a child may be questioning an ambiguous behavior which may or may not be abusive.

Adults receiving reports of child abuse from the child represent a second level of screening of child abuse.  However, in theory, virtually no screening takes place since judgments are not permitted at this level of investigation.  In most states, child abuse reporting laws specify that adults receiving initial reports of child abuse are not to make judgments or attempt to investigate the merits of the accusation, but rather make a direct referral to the local Child Protective Services (CPS) agency.  Thus, in theory, adults to whom a child has raised the issue of abuse (based on confusion over ambiguous contact) are required to report the alleged abuse rather than working with the child to clarify whether the child's experience constituted abuse.  Therefore, both true and false allegations are frequently passed on unchanged to the third level of screening, the CPS organization.

The reliability of the screening that takes place at the first level (the child making a determination as to the intent of an adult's behavior) is sufficiently low so as to result in a substantial number of false accusations by children.  In reality, we know that second level screeners (frequently teacher and parents) do indeed make judgments which reduce the number of referrals to level three (CPS).  However, there is at this time no research or evidence to suggest whether true cases of abuse are more likely to be let through and false allegations to be caught at that level, or whether true accusations and false accusations are equally likely to be passed along.  In other words, there is currently no information about the reliability of screening and identification of abuse at the second level either.  In either event, a number of false allegations will clearly be passed on to the CPS agencies.

When a child is involved in a divorce or custody case, the role of the parent as a second level screener takes on a different meaning.  Frequently such parents, particularly mothers, rather than screening out ambiguous experiences prior to CPS referral, may act upon vague statements from a child about a very ambiguous contact.  Their actions may include both a report to CPS and the reinforcement (to the child) of the view that he or she was indeed abused (rather than providing the clarification which the child may have sought).  The process by which this has been observed to occur has been detailed elsewhere (Gardner, 1987a).
  

Conclusions and Recommendations

As long as CSAP programs are going to serve either the implicit or explicit function of identification, they will result in false accusations of child abuse.  It is often argued that it is better to have more false positives than false negatives when you deal with an issue so critical to a child's well being as child abuse.  However, that does not absolve one of the responsibility of doing whatever is possible to reduce the number of false positives that are encountered.  Several factors inherent in CSAP programs are apt to increase the likelihood of false allegations without any appreciable gain in the reduction of the number of false negatives.

CSAP program developers would do well to consider what we know of child development and learning theory and engage in systematic and rigorous evaluation of their programs to determine the impact they are having on children and correct any misinterpretations that may arise as a result of the CSAP programs.  The main sources of such misinterpretations should be especially targeted for modification.  Reduction in the use of abstract and vaguely defined concepts, abandonment of the empowerment model applied to children, incorporation of age-appropriate sex education, and honest communication of benefits and risks inherent in CSAP programs to parents and program users (schools, in particular) will go a long way toward reducing the likelihood of a false allegation arising from a CSAP program.

Most sources of misinformation in CSAP programs protect or insulate the program from criticisms by parents (the avoidance of use of sexual terminology in order to avert labeling of CSAP programs as sex education), or an abdication of adult responsibility (to bring about the changes necessary in society to promote overall child welfare).  The placement of such a burden on children is unjustifiable, and will ultimately damage children and hamper efforts to prevent abuse of children.
  

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