Adverse Childhood Experiences
We Need Prevention Science to Prevent Child Sexual Abuse
Here’s what’s standing in our way.
Posted March 8, 2023 Reviewed by Devon Frye
Key points
- Safe, ethical, and confidential research on child sexual abuse is necessary to keep kids safe from harm.
- Confusion over how ethical principles, certificates of confidentiality, and mandatory reporting laws intersect affects prevention research.
- A tendency to err on the side of reporting has led to a lack of information about how to protect children from sexual abuse.
As a researcher who studies child sexual abuse prevention, most of my work entails asking people—including children—about their sexual experiences and behaviors. It’s fundamental: You can’t study sex without talking to people.
Over the last 30 years, we’ve made strides in our efforts to understand what works to prevent child sexual abuse. Yet there’s so much more we need to learn.
Our Current Approach: Prioritizing Punishment
Our national approach is to respond to child sexual abuse after harm has occurred and to prioritize punishment over prevention. As a result, our research base lacks critical data to inform prevention efforts, including:
- Empirically rigorous estimates of child sexual abuse perpetration prevalence
- Studies establishing risk and protective factors associated with the onset of child sexual abuse perpetration
- Rigorous evaluations of child sexual abuse prevention strategies, especially perpetration prevention strategies
It is necessary to support safe, ethical, and confidential research on child sexual abuse, as well as other forms of child abuse and neglect if we want to keep kids safe from harm.
Apprehension Over Ethical Principles, Certificates, and Reporting Laws
However, research in these and related areas is being compromised. A significant barrier is confusion and apprehension over the interplay of three means used to protect voluntary research participants from undue harm. They are:
- Ethical principles that govern human subject research, including principles of participant autonomy, beneficence (and nonmaleficence), and justice.
- Certificates of Confidentiality, which are automatically issued to research studies funded by the National Institutes of Health and other government funders to protect researchers against compelled disclosure of participant data on sensitive, illegal, or stigmatized experiences and behaviors.
- Child maltreatment mandated reporting laws that require adults to report suspected or known child abuse and neglect to the authorities.
Ethical principles, certificates, and reporting laws are all designed to keep people safe. But confusion over how these three types of protections are meant to play out in the context of child sexual abuse can lead institutional review boards and other regulatory bodies to disallow questions about child sexual abuse, or to require that researchers report to the authorities every participant who acknowledges past victimization or perpetration. Such requirements can have a chilling effect on science.
Research ethics principles require researchers to protect all research participants from unreasonable risks associated with participating in research. This includes protecting research participants who disclose previously unreported victimization experiences and undetected perpetration behaviors.
Certainly, researchers have an obligation to protect child safety and to report ongoing abuse or clear risk of abuse, but these events are rare. For example, following a survey of 3,264 children ages 12-15 about child sexual abuse victimization and perpetration experiences, participants were screened for acute distress. Just one participant (0.03 percent) was referred for CSA-related concerns.
However, institutional officials and funders may perceive these principles and certificate protections as conflicting with state or federal child maltreatment reporting laws, which are also intended to protect vulnerable populations.
In the context of child sexual abuse research, a tendency to err on the side of reporting has led to a stunning lack of information about how to protect children from sexual abuse, leaving children more, not less, vulnerable.
I am working with a group of colleagues—including experts on certificates, ethics, and reporting laws—to better understand and address this issue. As part of our work, we intend to create new materials for researchers, institutional review boards, and other stakeholders that provide clarity and guidance about how we can work together to engage in safe, ethical, and confidential research on child sexual abuse.
We can’t prevent child sexual abuse without prevention science.