Seminar on Child Sexual Abuse
Ralph C. Underwager
V. Criteria for judging an allegation
A. A spontaneous disclosure made by a young child without evident adult influence is
more likely to be true.
B. The probability of the behaviors alleged
1. If the alleged behaviors are extremely improbable, then it is less likely that the
allegation is true.
2. A study of two samples of false allegations found many allegations of abuse that
were much more unusual, intrusive, and deviant than has been found in cases of verified
abuse (Wakefield & Underwager, 1994b).
3. It is crucial to think very realistically and practically about what would actually
have to happen in order for the alleged behavior to have actually taken place
4. Tollison and Adams (1979) describe the general behaviors engaged in by the
Pedophiliac behavior may involve caressing a child's body, manipulating a child's
genitals, or inducing a child to manipulate an adult's genitals. Occasionally, the
behaviors also include penile penetration (partial or complete--vaginal or anal), oral
sex, and any practice utilizing the sexual parts or organs of a child so as to bring the
person in contact with the child's body in any sexual manner. Pedophiliac acts may be
homosexual or heterosexual in nature and may include touching, caressing, masturbation,
oral-genital contact, and intercourse, as well as pedophilic exhibitionism, voyeurism,
rape, sadism, and masochism....Physical violence to the child occurs in only 2 percent of
instances... (page 326).
5. In homosexual pedophilia, the most common contact is masturbation - done to rather
than by, the boy. This is followed by fellatio. Anal intercourse is less common.
6. Vaginal and anal penetration is rare in young children and is extremely painful. It
results in injuries and laceration, not stretching of the involved organ. The molester
must have a strategy for muffling the child's screams (Erickson,
Walbek, & Seely,
7. Vaginal penetration is more likely with an older child and is more common in
clinical samples compared to community samples (Wakefield & Underwager, 1994b).
8. The original Kinsey report on the sexual behavior of females (Kinsey, et al., 1953)
provides information about the preadolescent sexual contacts their sample had with adult
Nature of Contact Percent
Approach only 9
Exhibition, male genitalia 52
Exhibition, female genitalia 1
Fondling, no genital contact 31
Manipulation of female genitalia 22
Manipulation of male genitalia 5
Oral contact, female genitalia 9
Oral contact, male genitalia 1
9. Bribery is more common than threat. Threatening a child is the way to assure the
quickest disclosure when the threatening agent is not present.
10. Aggression and violence are not usually part of the behavior. Sadistic, bizarre, or
homicidal forms of abuse occur but are extremely rare.
11. There is no evidence for satanic ritual abuse conspiracies.
12. In incest, a grooming process is often involved.
13. In false cases, the allegations may initially be very vague and not easily amenable
to being verified or refuted.
14. Female child sexual abusers (Wakefield & Underwager, 1991a).
a. Sexual abusers are primarily male.
b. There are widely different circumstances in which females may engage in behavior
that is defined as "child sexual abuse" and the circumstances that lead women to
sexually abuse children can often be differentiated from those causing men to do so.
C. Characteristics of the child's statement
1. Valid accounts of abuse will have appropriate details given the child's age,
especially affective and contextual details, and the child's affect will be appropriate to
2. If there is strong hatred expressed toward the accused that is based upon trivial
and vague reasons, this may be the result of learning from the accusing parent rather than
from actual abuse.
3. A child who is very eager to talk about the abuse may have learned that adults
reward such talk.
4. Significant contradiction and variation in the story across time, especially when
the account shows that the child has no visual image but is responding to verbal cues,
supports the possibility of the child learning the story from adults.
5. However, Ceci and Bruck (1995) found that professionals were unable to differentiate
between videotapes of children describing real events and children describing events they
had learned about through suggestive questioning. Adult judgments or opinions about the
accuracy of children's accounts may be no better than chance.
D. Recantation is not a good criterion for judging whether an allegation is true or
false since children who have been abused as well as children who have fabricated an
allegation may retract once they see the consequences of the allegation. Nevertheless,
recantations must be taken seriously and evaluated in the context of all information about
the specific allegations.
E. Personality characteristics of the persons involved
1. In divorce and custody cases, a personality disorder in the person making the
accusation may increase the possibility of an allegation being false (Wakefield &
2. The personality of the person accused
a. If it cannot be demonstrated that an accused person has the pathology associated
with most child sexual abusers, the likelihood of a false accusation increases.
b. However, a "normal" personality based on an MMPI or other assessment
techniques does not mean that the individual could not be a sexual abuser. A significant
minority of child sexual abusers have normal MMPIs and appear relatively normal.
c. The presence of psychological problems does not prove that the abuse is real.
d. Consideration of the personality characteristics of the accused is particularly
important when the allegations are of highly deviant behaviors.
e. Unusual or infrequent sexual behaviors in the life of the accused does not
necessarily increase the likelihood of being a child molester. An example is transvestite
behaviors which do not increase the probability of being a child abuser.
f. Minimization and rationalization are common in child sexual abusers.
F. Behavioral indicators
1. Various behaviors and behavior changes are often cited as signs of sexual abuse in
children and adolescents. For example, The Journal of the American Medical Association
in 1985 (JAMA, 1985, p. 798) includes the following as behavioral signs of sexual abuse:
a. Become withdrawn and daydream excessively
b. Evidence poor peer relationships
c. Experience poor self-esteem
d. Seem frightened or phobic, especially of adults
e. Experience deterioration of body image
f. Express general feelings of shame or guilt
g. Exhibit a sudden deterioration in academic performance
h. Show pseudomature personality development
i. Attempt suicide
j. Exhibit a positive relationship toward the offender
k. Display regressive behavior
l. Display enuresis and/or encopresis
m. Engage in excessive masturbation
n. Engage in highly sexualized play
o. Become sexually promiscuous
2. Such lists were widely disseminated through the media, pamphlets, popular articles,
seminars and workshop aimed at training or consciousness raising.
a. In 1892 Kellogg proposed a list of behaviors to determine if a child was
masturbating. If so parents were urged to take severe remedial steps, including
clitoridectomies and restraints.
b. The 1892 list is identical with current lists used as indicators of sexual abuse.
Those who do not know history are doomed to repeat the errors of the past
Wakefield, & Underwager, 1989).
3. Behavioral indicators result from stress in general and are not specific to the
stress of sexual abuse.
4. The base rates of the presence of many such behaviors in normal children, in
troubled children, in non-abused children, and as part of the developmental process for
all children is so high that any attempt to use them as indicating abuse will result in a
high rate of error.
5. Not all sexually abused children are symptomatic subsequent to sexual abuse so the
absence of behavioral symptoms cannot be used to rule out sexual abuse.
6. It is now generally accepted that such behavior changes cannot be used to conclude
that the child has been abused (Lamb, 1994).
7. Sexual behavior in children
a. This is often claimed to be a better behavioral indicator.
b. But nonabused children exhibit many sexual behaviors. Friedrich, et al. (1991)
report that their normal, nonabused sample of children showed a wide variety of sexual
behaviors at relatively high frequencies.
c. However, Friedrich et al. also found that behaviors more imitative of adult sexual
behavior were unusual. Therefore, if a child is found engaging in explicitly sexual
behavior, such as oral-genital contact, this should be carefully checked out.
d. But even this does not prove that the child was sexually abused by an adult. Peer
sexual play, inadvertently seeing adults having intercourse, or access to x-rated video
might account for it.
G. Medical evidence
1. Many parents, social workers, investigators, prosecutors, defense attorneys,
therapists, etc. erroneously assume that an abused child will show physical signs of the
2. In most reported cases of child sexual abuse, however, there is no physical or
medical evidence that a child has been sexually abused (Adams et al., 1994).
a. Inasmuch as a considerable portion of sexual abuse involves exhibitionism, breast
and/or genital fondling, and masturbation of the perpetrator, this finding is not
b. Therefore, a normal physical exam cannot rule out sexual abuse.
3. A medical examination ought be done whenever it may contribute helpful information
if a report is not immediately dismissed as unfounded. It is particularly important when
the allegations are of abusive behaviors that are likely to result in physical sequelae
(i.e., penile penetration of a young child).
4. The results of medical examinations for sexual abuse are frequently ambiguous and
must be carefully interpreted.
a. Base rate studies of nonabused children indicate that many of the findings often
used to support a conclusion of abuse are found in nonabused children (McCann et al.,
b. Some reported findings, such as lax sphincter tone and the anal dilatation reflex,
are controversial and rejected by many medical authorities.
5. However, there are now enough data on normal and nonabused children to classify many
findings as normal or nonspecific and others as lying on a continuum of certainty that
sexual abuse has occurred (Adams, 1995; Bays & Chadwick, 1993; Heger &
6. The only specific and unambiguous physical findings demonstrating sexual contact are
pregnancy or sperm in the vagina or anus (Krugman, 1989).