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During the first decade that reported child abuse case data were reliably collected in the United States (1986-1996), the frequency of child sexual abuse doubled. However, in the past decade, a 40% decrease in substantiated cases has been observed (from 1992 to 2000, substantiated cases decreased from to 140,800 to 89,355). Analysis of these data suggests that a real decline has occurred, and this is not just an artifact of changes in substantiation or data-collection practices. Hypotheses regarding this decline include the impact of aggressive prosecution and incarceration of sex offenders. Between 1991 and 1997 the incarceration in state correctional facilities for sex crimes against children increased nearly 40%. It is also possible that public educational activities of the past two decades, and fears of detection and prosecution, have deterred the potential offenders most able to control their actions, therefore resulting in a decline in the most readily preventable cases. However, there is evidence from one state suggesting the decline may be partly due to a backlash against those reporting sexual abuse.

Despite this decline, sexual abuse remains a significant public health problem. Various prevention approaches have been attempted. David Finkelhor, director of the Crimes Against Children Research Center, identified four preconditions to child sexual abuse:

1. Motivation for sexual abuse (being sexually aroused by children or fantasies involving children)

2. Overcoming internal inhibitors (using alcohol or drugs, acting impulsively)

3. Overcoming external inhibitors (having unsupervised access to children)

4. Overcoming the child's resistance (coercing or manipulating the child into participating)

Treatment of identified sex offenders usually focuses on attempts to reduce the first two factors, reducing deviant arousal and building inhibitions against offending. Law enforcement interventions have typically focused on creating external inhibitors (incarceration, sex offender registration and public notification, and postincarceration civil commitment). All states in the United States now have sex offender registries. There is no evidence to date as to whether registration and notification prevent sexual abuse, but they may result in quicker apprehension of repeat offenders.

Victimization prevention programs often focus on education of children to resist abuse and to disclose victimization. Studies of interventions to promote child resistance reveal that children often have difficulty learning and retaining the concepts in the educational programs (e.g., that an abuser may be someone they know), but the educational programs may increase earlier detection of abuse by encouraging children to report it.

A novel prevention approach has been advanced by Stop It Now!, a nonprofit group that promotes the use of four tools to address the root causes of child sexual abuse. Stop It Now! attempts to develop awareness in potential abusers and urge them to seek help; challenge those who abuse to stop immediately and seek treatment (a helpline and an Internet resource are provided); educate "bystanders" on how to confront abusers; and educate the public and the media to change the social climate to say, "We will no longer tolerate the sexual abuse of our children."

References:

1) Finkelhor, D., & Jones, L. M. (2004, January). Explanations for the decline in child sexual abuse cases. Juvenile Justice Bulletin. Retrieved from https://www.ncjrs.gov/pdffiles1/ojjdp/199298.pdf

2) Stop It Now! The Campaign to Prevent Child Sexual Abuse, http://www.stopitnow.com

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