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thesis entitled

THE EVALUATION OF A PERSONAL SAFETY

CURRICULUM FOR PRESCHOOLERS
presented by

Theresa Anderson-Varney

has been accepted towards fulfillment
of the requirements for

MASTER_QLARIS_ degree in JSXCHQLQGX

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THE EVALUATION or A PERSONAL SAFETY CURRICULUM FOR PRESCHOOLERS
By

Theresa Joan Anderson-Varney

A THESIS

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of
MASTER OF ARTS
Department of Psychology

1988

 

Jak377r

ABSTRACT
THE EVALUATION OF A PERSONAL SAFETY CURRICULUM FOR PRESCHOOLERS
By

Theresa Joan Anderson-Varney

This study evaluated the effectiveness of a personal safety
curriculum, the Grossmont College Child Sexual Abuse Prevention
Program for Preschoolers, designed to teach children self-protection
skills in an attempt to prevent sexual abuse. Twenty-five four year old
children in two daycare centers were assigned to either treatment or
control conditions depending on the daycare center they were attending.
Each child was individually interviewed using a questionnaire meant to
assess children's knowledge about sexual abuse, in addition to a measure
designed to elicit self-report of verbal and behavioral responses to
potentially abusive situations. Also utilized was an instrument meant to
determine if such a program causes fear in children. Children who
experienced the program demonstrated greater knowledge about sexual abuse.
In addition, their personal safety skills were enhanced when compared to
controls. The hypothesis stating that there would be no difference in
scores on the fear measure between treatment and control subjects was

also supported.

ACKNOWLEDGEMENTS

I would like to take this opportunity to thank Anne Bogat for her
help with this project. I would also like to thank Bill Davidson and

Bob Caldwell for their input. The individual who has shared the struggle

to the greatest degree is my friend and colleague Sharon Bradt. Special

thanks to her for her patience and support.

TABLE OF CONTENTS

INTRODUCTION ...................................................... 1-23
METHOD ........................................................... 24-26
PROCEDURE ........................................................ 26-27
RESULTS ......................................................... 28, 31
DISCUSSION ....................................................... 36-42
REFERENCES ....................................................... 43-46
FOOTNOTES ........................................................... 47
APPENDIX A Consent Forms ......................................... 48-5]
APPENDIX B Personal Safety Questionnaire ......................... 52-54
APPENDIX C "What If" Situations Test ............................. 55-60
APPENDIX D Fear Assessment Questionnaire ............................ 6|

 

 

LIST OF TABLES

Table 1

Analysis of Covariance for Condition Effects on the PSQ ........ 29
Table 2

Analysis of Covariance for Condition Effects on the WIST ....... 30
Table 3

Analysis of Covariance for Condition Effects on the Fear

Measure ........................................................ 32
Table 4

Correlation Matrix for All Measures ............................ 33
Table 5

Means and Standard Deviations for All Measures Utilized
Experimental Group ............................................. 34
Table 6

Means and Standard Deviations for All Measures Utilized
Control Group .................................................. 35

INTRODUCTION

Child sexual abuse is defined as contact or interaction between a
child and an adult or older person when the child is being used for the
sexual stimulation or either the perpetrator or another person. ”Child"
refers to a boy or girl under 18 years of age. The perpetrator need not I
be an adult, as long as the perpetrator is significantly older than the

victim and/or in a position of power over the victim. Child sexual abuse

 

includes a wide range of sexual activity ranging from "non-violent,"
non-touching offenses such as exposure to offenses that do involve physical
contact, and sometimes the use of violent physical force (such as oral,
genital, or anal stimulation and penetration), incest, and exploitation
of children through pornography and prostitution (Committee for Children,
1984). I

Until 1985, the American Humane Association (AHA), under contract from
the government, served as a clearinghouse for statistics on child abuse and
neglect gathered by individual states. Most of the states collect certain
basic statistics on child abuse and neglect from their child protective
agencies using a standardized form and report at least summary statistics
to the AHA. The AHA then extrapolates national estimates from these
reports. Data from I976 through 1983 indicates that the number of reported
cases has continued to increase markedly in each year. In 1976, the
estimate of sexual abuse cases reported by the AHA was 7,559, by 1983 this
figure had risen to 71,961.

Studies of the prevalence of child sexual abuse in the general
pOpulation suggest that official reports do not reflect an accurate

picture of the problem. In order to ascertain a more realistic rate of
l

2
sexual abuse, researchers have begun to survey the Victims. At least 15
of these studies have been conducted in the last decade alone. Many of
these studies have surveyed college students.

In a sample from six New England colleges and universities,
Finkelhor (1979) found 192 of females and 92 of males were victimized as
children or adolescents (N=796). Fritz, Stoll, and Wagner (1981) found
that 82 of females and 52 of males in a student sample of 952 had been
victimized. Another sample of 482 women students in undergraduate
psychology courses at Auburn University found ZZZ had been abused
(Fromuth, 1983). Seidner and Calhoun (1984) sampled 595 female and 490
male undergraduates at the University of Georgia. They found 112 of
females and 52 of males had had sexual experiences with older partners
prior to the age of 18.

The community samples include a 1980 random survey of 1054 Texas
driver's license holders. This study found 32 of males and 122 of
females experienced sexual abuse during childhood (Kercher, 1980). A
1983 random sample of 930 San Franciscan women f0und 28% had experienced
unwanted touching before the age of 14. Twelve per cent of these women
had been victimized by a relative. When attempted and completed forcible
rapes plus all forms of unwanted contact by relatives between the ages of
14 and 17 were included, the figure for sexual abuse before the age of 18
rose to 381. In a multistage stratified probability sample drawn by the
Institute for Social Science Research, equal numbers of Afro—American and
white women, ages 18 to 36, in Los Angeles County were recruited and
interviewed. The trained interviewers asked questions pertaining to
sexual history including sexual victimization. Sexual abuse prior to age

18 had been experienced by 571 of the Afro-American women and 672 of the

white women (62% overall). The percentage of abused women who reported
more than one abuse incident was 52% among Afro-American women as compared
to 482 among white women (Wyatt, 1985). Neither of these ethnic
differences was statistically significant. Another random survey of 415
women and 403 men in Central Minnesota found 132 of women and 32 of men
had experienced forced unwanted sexual activity by an adult prior to age
18 (Murphy, 1985).

Taken as a whole, these surveys indicate that child sexual abuse is
not an uncommon experience. Regardless of population, studies
consistently suggest that a high percentage of children will experience
abuse. The question is what happens to children who have this experience.

Empirical studies suggest that children often suffer both short-term
and long-term negative effects from sexual abuse. Short-term or initial
effects of sexual abuse are those reactions that occur within two years
of the termination of abuse (Finkelhor, 1984). Long-term effects date
from two years after the occurrence of abuse.

The most common short-term effect reported in empirical studies is
fear. However, exact proportions vary from a high of 832 reported by
DeFrancis (1969) to 402 in the Anderson, Bach, and Griffith (1981) study.
Gomes—Schwartz, Horowitz and Sauzier (1985) found that 452 of the 7 to 13
year olds had severe fears, compared to 132 of the 4 to 6 year olds.
Thirty-six percent of the 14 to 18 years olds had elevated scores on
"ambivalent hostility," or the fear of being harmed.

Friedrich, Urquiza, and Beilke (1986) studied 61 sexually abused
females who were referred by either a local sexual assault center for
evaluation or the outpatient department of a local hospital. The

researchers reported that 462 of their subjects had significantly elevated

4
scores on behaviors described as fearful, inhibited, depressed and
overcontrolled and 392 had elevated scores on aggressive, antisocial,
and undercontrolled behavior. Only 22 of a normal sample would be
expected to have elevated scores in either of these areas. Younger
children (up to age 5) demonstrated a tendency to score high for feeling
fearful, inhibited, depressed, and overcontrolled, and older children
(ages 6 through 12) were more likely to have elevated scores for feelings
that were aggressive, antisocial, and undercontrolled.

Another short-term effect in children is a reaction of anger and/or
hostility. Comes-Schwartz, Horowitz, and Sauzier (1985) found that 452
to 502 of the 7 to 13 year olds showed substantially elevated scores on
measures of aggression and antisocial behavior, as did 352 on the measure
of hostility directed outward. Of 4 to 6 year olds, 132 to 172 scored
above the norms on aggression and antisocial behavior; 252 of the 4 to 6
year olds and 232 of the adolescents had elevated scores on hostility
directed outward. In his study of court cases, DeFrancis (1969) noted
that 552 of the children showed behavioral disturbances, such as active
defiance, disruptive behavior within the family and quarreling or fighting
with siblings and classmates.

Other frequently observed reactions to child sexual abuse are guilt
and shame. DeFrancis (1969) reported that 642 of his sample expressed
guilt, although it was related more to the problems created by disclosure
than about the abuse itself. Anderson et a1. (1981) reported guilt
reactions and feelings of depression in 252 of victims.

It is also thought that sexual abuse has an effect on self-esteem,
but this effect has not yet been established by empirical studies. However,

DeFrancis (1969) did report 582 of victims expressed feelings of inferiority

 

5

or lack of worth as a result of the abuse. On the other hand,
Comes—Schwartz et al. (1985) found no evidence that sexually abused
children of any age had consistently lower self—esteem when compared to
a normal population of children.

Physical symptoms suggesting anxiety and distress are found in both
clinical reports and empirical literature. In a study of child victims
of intrafamilial sexual abuse, Peters (1976) reported that 312 had
difficulty sleeping and 202 experienced eating disturbances. Anderson
et a1. (1981), in their chart review of female adolescent victims, found
that 172 had experienced sleep disturbances and 52 to 72 showed changes
in eating habits after the abuse.

Inappropriate sexual behavior in child victims has been confirmed by
two studies (Tufts, 1984; Friedrich et al., 1986). The Tufts (1984) study
reported 272 of preschoolers scored significantly above clinical and general
population norms on a sexual behavior scale that included having had sexual
relations, open masturbation, excessive sexual curiosity, and frequent
exposure of the genitals. High levels of disturbance on the sexual behavior
measure were also found in the 7 to 13 year old age group with 362 scoring
above normal when compared to norms for either general or clinical school-age
populations. Friedrich et al. (1986) evaluated 3 to 12 year olds and found
702 of males and 442 of females scored at least one standard deviation above
a normal population of that age group on a scale measuring sexual problems.
Sexual problems were more common among the older boys and the younger girls.

Other effects of child sexual abuse found in the literature include
difficulties at school, truancy, running away, and early marriages by
adolescent victims. Meiselman (1978) reported that 502 of incest victims

in her sample had left home before the age of 18, compared with 202 of

 

women in a comparison group of nonvictimized female patients. Younger
children often went to a relative, while older daughters ran away or
eloped, sometimes entering into early marriages to escape the abuse.
Herman (1981) interviewed 40 patients in therapy who had been victims

of father-daughter incest, and compared their reports with those from a
group of 20 therapy clients who had seductive, but not incestuous fathers.
0f the incest victims, 332 attempted to run away as adolescents, compared
to 52 of the comparison group. In Peter's (1976) study, 102 of the child
victims quit school, although all of his subjects were under the age of
12 at the time. Anderson et a1. (1981) found problems at school,
including truancy, or quitting school, in 202 of their sample. Further,
DeFrancis (1969) reported that 112 of child victims in his study became
pregnant as a result of the abuse.

The empirical literature, then, suggests the presence of fear,
anxiety, depression, anger and hostility, and inappropriate sexual
behavior. Running away, school problems and truancy are also found in
some portion of the victim population. However, due to the lack of
standardized measures and satisfactory comparison groups, it is not
certain that all child victims experience these problems. At this point,
it is known that at least some of the victims will experience some of
these aftereffects of sexual abuse.

Turning to long-term effects of sexual abuse, the literature most
commonly reports elevated levels of depression among adults abused as
children. Bagley and Ramsay (1986) in a random sample of 387 women,
found that subjects with a history of child sexual abuse had higher
depression scores than did nonabused women (172 versus 92). Peters

(1984), in a random sample of 119 women, found that sexual abuse with

physical contact was associated with a higher incidence of depression and
a greater number of depressive episodes over time, and that women who had
been sexually abused were more likely to have been hospitalized for
depression than were nonvictims.

The link between child sexual abuse and depression has been
confirmed in other samples as well. Sedney and Brooks (1984), in a study
of 301 college women, found a greater likelihood for subjects with
childhood sexual experiences to report symptoms of depression (652 versus
432 of the control group) and to have been hospitalized for depression
(182 of the childhood sexual experiences group versus 42 of the control
group). These results are consistent with those found in a carefully
controlled survey of 278 undergraduate women by Briere and Runtz (1985)
who found that sexual abuse victims had more depressive Symptoms during
the 12 months prior to the study than did nonabused subjects.

Studies with both clinical and nonclinical samples have shown that
victims of child sexual abuse are more self-destructive than their

"walk-ins" to a

nonabused counterparts. In an extensive study of 153
community health counseling center, Briere (1984) found that 512 of the
sexual abuse victims, versus 342 of nonabused clients, had a history of
suicide attempts. Also, 312 of victims, compared to 192 of nonabused
clients, displayed a desire to hurt themselves. In their community
study, Bagley and Ramsay (1986), found an association between childhood
sexual abuse and suicidal ideation or deliberate attempts at self-harm..
Among college students, Sedney and Brooks (1984) found that 392 of those
with child sexual abuse experiences thought of hurting themselves and

162 had made at least one suicide attempt compared to 162 and 62,

respectively, of the nonabused comparison group.

Some attention has been given to somatic problems as a long-term
effect of childhood sexual abuse. Briere and Runtz (1985) observed
symptoms of anxiety and tension: 542 of sexual abuse victims were
currently experiencing anxiety attacks compared to 282 of nonvictims,
542 reported nightmares versus 232 of nonvictims, and 722 had difficulty
sleeping as compared with 552 of nonvictims. In their college sample,
Sedney and Brooks (1984) reported 592 of the victims were nervous and
anxious compared to 412 of nonvictims, 412 reported extreme tension
versus 292 of the controls, and 512 had trouble sleeping compared to 292
of controls. Bagley and Ramsay (1986), in their community sample,
found 192 of their subjects who had experienced sexual abuse reported
symptoms indicating somatic anxiety compared to 92 of nonabused subjects.
Briere and Runtz (1985) found sexual abuse victims in the clinic setting
reported symptoms of disassociation and "spaciness" (422 versus 222), as
well as "out of body experiences" (212 versus 82), and feeling that
things were unreal (332 versus 112). Briere and Runtz postulate that
disassociation is a strategy that victims use to escape from the
unpleasant sensations of the abuse experiences and this later becomes an
autonomous symptom.

The notion that sexual abuse victims continue to feel isolated and
stigmatized as adults also has some support in the empirical literature,
although these findings are only reported for clinical pOpulations. In
Briere's (1984) study, 642 reported feelings of isolation, compared to
492 of the controls. In the case of incest victims, the figures are
higher: Herman (1981) reported that all of the women who had experienced
father-daughter incest in her clinical sample had a sense of being

branded, marked, or stigmatized by the abuse. In Courtois' (1979) sample

of incest victims, 732 reported they Still had feelings of isolation and
alienation.

Although low self-esteem was not confirmed as a short—term effect,
some evidence indicates it may be a long—term effect. Bagley and Ramsay
(1985) found that women with very poor self-esteem were nearly four times
as likely to report a history of child sexual abuse as a comparison group.
There is a much greater incidence of low self-esteem among clinical
samples of incest victims. Eighty-seven percent of a community sample
reported that their sense of self had been moderately to severely
affected by the experience of sexual abuse from a family member
(Courtois, 1979). In her clinical sample, Herman (1981) found 602 of

' compared

incest victims reported a "predominantly negative self-imagefl
to 102 of the comparison group with seductive but not incestuous fathers.

A wide variety of interpersonal problems are reported by women who
have been sexually victimized as children. These include difficulty in
relating to both women and men, conflicts with their parents, and
discomfort in responding to their own children. DeYoung (1982) reported
that 792 of incest victims had predominantly hostile feelings toward
their mothers, and 522 were hostile toward the abuser. Meiselman (1978)
found that 602 of the incest victims in her psychotherapy sample disliked
their mothers and 402 continued to experience strong negative feelings
toward their fathers. Herman (1981) also noted that the rage of incest
victims in her sample was often directed toward the mother, and observed
that the victims seemed to regard all women, including themselves, with
contempt.

Victims also reported difficulty trusting others. Feelings included

reactions of fear, hostility, and a sense of betrayal. Briere (1984)

 

10

noted fear of men in 482 of his clinical subjects, compared to 152

of nonvictims. He also reported fear of women in 122, compared to 42

of those not sexually abused. It seems that incest victims are
especially likely to experience difficulty in close relationships. Of
the victims in Meiselman's (1978) study, 642 compared to 402 of the
control group complained of conflict with or fear of their husbands or
sex partners, and 392 of the sample had never married. These results are
supported by findings from Courtois's (1979) sample, in which 792 of the
incest victims experienced moderate or severe problems in relating to
men, and 402 had never married.

One empirical study supports the contention that childhood sexual
abuse also affects later parenting. Good, McCarthy and DiVasto (1981)
found that 242 of mothers in the child abusing families they studied
reported incest experiences in their childhoods, compared to 32 of a
nonabusive control group. These mothers maintained an emotional and
physical distance from their own children, therefore potentially setting
the stage for abuse. The authors-suggest that difficulty in parenting
results when closeness and affection are endowed with a sexual meaning.

Research also suggests that childhood sexual abuse may make women
more vulnerable for later sexual victimization. Russell (1986), in her
probability sample of 930 women, found that between 332 and 682 of the
sexual abuse victims (depending on the seriousness of the abuse suffered)
were subsequently raped, compared to an incidence of rape of 172 for
women who were not child victims. Fromuth (1983) also found evidence
that women who had been sexually abused before the age of 13 were
especially likely to later become victims of nonconsensual sexual

experiences. Miller, Moeller, Kaufman, DiVasto, Fitzsimmons, Pather and

1 1

Christy (1978) compared women who had been raped on more than one
occasion to those who were reporting a first-time rape. Researchers
found that 182 of the repeat victims had incest histories, compared to
only 42 of the first-time victims.

Victims of child sexual abuse also seem more likely to be abused
by husbands or other adult partners. Russell (1986) found that between
382 and 482 of the women who had been abused as children had physically
violent husbands, compared to 172 of women who had not been victims.

Also, between 402 and 622 of the women who had been abused as children

 

had later been sexually assaulted by their husbands, compared to 212 of
nonvictims. Similarly, Briere (1984) noted that 492 of his clinical
sexual abuse sample reported being battered in adult relationships
compared to 182 of the nonvictim group.

Empirical support is also found for an association between child
sexual abuse and later substance abuse. Peters (1984), found that 172
of the victimized women had symptoms of alcohol abuse versus 42 of
nonvictimized women, and 272 abused at least one type of drug compared
to 172 of nonvictimized women. Herman (1981) reported that 352 of the
women with incestuous fathers in her clinical sample abused drugs and
alcohol, compared to 52 of the women with seductive fathers. Briere
(1984) found that 272 of the childhood sexual abuse victims in his
sample had a history of alcoholism compared with 112 of nonvictims.
Also, 212 had a history of alcoholism compared with 22 of nonvictims.
0n the other hand, the Sedney and Brooks (1984) college sample reported
a low incidence of substance abuse and no significant differences
between groups.

Empirical studies confirm many of the short-term and long-term

12

effects of child sexual abuse discussed in the clinical literature.
Although researchers utilized many different instruments in their
attempts to determine what effects child sexual abuse has on individuals
both as children and adults, the results seem to be replicated again and
again. Even the problem of conflicting definitions seems to recede when
the research is brought together. Conclusions emerge in spite of
methodological problems. Children who experience abuse are likely to be
fearful, anxious, depressed, angry, hostile and exhibit inappropriate
sexual behavior. Some portion of the victims may run away, have problems
at school and be truants. Adult women victimized as children are more
likely to manifest depression, self-destructive behavior, anxiety,
feelings of isolation and stigma, poor self-esteem, a tendency toward
revictimization and substance abuse problems.

The research indicates that child sexual abuse must be recognized
as a serious problem of childhood that can affect many aspects of the
child's adult life as well. It makes sense, then, to protect children
from this crime. One way to keep children safe is to provide them with
information that will help them to become less vulnerable to sexual
exploitation. Their ignorance concerning what is normal, their
inexperience, and their inability to understand the dynamics of sexuality
contribute to their vulnerability. Children's knowledge of resources is
often limited. They can be coerced by threats of withdrawal of resources
such as family affection, food, money and shelter. Children often lack
awareness of other adults who can help them with problems.

Increased awareness of children's risk of sexual victimization has
resulted in growing efforts toward prevention. The rationale for

prevention is based on a number of facts about child sexual abuse.

 

13

First, a large percentage of all children are at risk for sexual abuse.
Second, in spite of recent advances in the availability of treatment
services to victims of child sexual abuse, it is clear that most child
victims of sexual abuse will not be identified let alone provided with
service. Third, and most importantly, the evidence suggests that
children do not reveal their victimization, and when they do, families
are still unlikely to seek help (Finkelhor, 1984). Because of these
three factors, treatment programs will only serve a small proportion of
children needing services. Preventing the problem before it begins is
critical.

Burgess and Holmstrom (1978) recommended that information on sexual
assault be given to children within the context of general safety
education. The preparation of school personnel is also suggested because
they will be needed by the child for support and advocacy. The authors
favored coordination of efforts by parents, schools, and community
agencies.

The tactics used by offenders are another source of important
information on prevention of sexual abuse. Offenders in treatment with
the Sex Offender Program at the Connecticut Correction Institute
suggested that parents establish trust and communication with their
children. They also recommended teaching children self-protection skills
and sex education (Sanford, 1980). The offenders often perceive the
child victim as a willing participant. If children resist or cry, most
offenders stop and seek a more passive child (Sanford, 1980). Other
techniques used by children to avoid sexual activity with an adult have
included delaying tactics, aggression toward the offender, and pretending

to be ill (Burgess and Holmstrom, 1978).

14

These approaches adopt the view that children have the right to
information, self-protective skills, and control over physical contact
or behavior that may be physically or emotionally harmful to them. They
also convey to children a sense of adult support, access to protection
and information resources, and that complaints about adult behaviors will
be considered believable. Schools as well as parents, routinely provide
children with information about safety and self-protection (e.g., Fire
Prevention Week, Dental Health Week, and bicycle safety instruction).

The need for children to obtain sexual self-protection skills are at
least as great as their need for information in these other health and
safety areas.

Recently, several standardized personal safety curricula for
children have been developed. Though differing in format, most of these
programs share common assumptions about the knowledge and actions a child
may use to prevent victimization. They include assertiveness, knowledge
of appropriate and inappropriate touch, and identification and reliance
upon adults who can help children with problems (Conte, Rosen &
Saperstein, 1986). To date only a few evaluations of these programs have
been conducted.

In an early study, Poche, Brouwer and Swearingen (1981) taught
self-protective behaviors to three preschool children in order to protect
them from abduction. Prior to training, the children showed
susceptibility to lures of adults. After training, the children
displayed a substantial improvement in self-protective skills. The
children's self—protective skills also seemed to generalize to new adults
and locations. In addition to the obvious ethical problems of placing a

child in a seemingly dangerous situation, the small number of subjects

15

makes generalization impossible. In 1984, Ray evaluated the
effectiveness of a workbook—based sex abuse prevention education program
with third graders. The children successfully learned concepts of child
abuse prevention when pretest scores were compared with posttest scores
on a short test of questions about sexual abuse. This knowledge seemed
to be maintained four weeks later at a follow-up retest. However,
children had difficulty understanding that sexual abuse may be
perpetrated by someone they know and that it could happen to boys as well
as girls.

Plummer (1984) evaluated the effectiveness of a three-day program
with fifth graders in a midwestern public school. The program was a
curriculum using the touch continuum to discuss the variety of touches
people experience as well as the film "No More Secrets." The students
were evaluated with a 23 question instrument assessing their knowledge
of and attitudes toward sexual abuse at four points: (1) prior to the
program, (2) immediately following the program, (3) two months later,
and (4) eight months later. The prepoint and immediate postpoint
comparisons suggested that children had significantly increased their
knowledge and attitudes about sexual abuse as a result of the program.
Particular gains were shown regarding knowledge that child abusers could
often be people known to them and that boys are frequent victims.
Unfortunately, there appeared to be a substantial loss of learning over
time, especially at the eight-month follow-up. Children seemed to revert
to their original notions that child abusers are primarily people they
do not know. However, this study suffered from several methodological
flaws. First, the effectiveness of the program cannot be adequately

evaluated because a randomly assigned control group was not used.

 

16

Second, only one school, one age group, and one geographic location was
studied. This makes it impossible to generalize results to the larger
population of children.

Downer (1985) evaluated the elementary school cUrriculum, Talking
About Touching, which was developed by the Seattle—based Committee for
Children and is used extensively around the country. A brief interview
and questionnaire about sexual abuse was administered before the program
and three weeks after the end of the program. A group of 70 fourth
graders who received training (15 to 20 minutes per day for two to three
weeks) was compared with 15 untrained students, using a 20-item multiple
choice questionnaire. Pre-post analysis indicated that the trained
students did significantly better, particularly on questions showing
knowledge of how to get help. Fifteen of the trained children and 13 of
the untrained children were also tested in an interview using puppets
and incomplete stories. The interview performance of the trained
children confirmed the findings from the knowledge test. The students
were able to demonstrate "assertive" verbal responses to threatening
situations, but they were judged not entirely convincing in their tone
of voice and body language. However, internal validity is a problem in
this study because not all students and school districts were randomly
selected. Generalizability is difficult due to the small sample size
(N=28) and must be limited to comparable students of between nine and
ten years of age.

Conte, Rosen, Saperstein, and Shermack (1985) assessed the
effectiveness of a sexual abuse prevention program with 40 children
aged 4 to 10 years, enrolled in after-school programs in a Chicago

suburb. Children randomly assigned to training and wait—list control

17

groups were interviewed the week before and the week after the prevention
training. The program was presented on three c0nsecutive days for one
hour each day and included instruction about various kinds of touching,
assertive behavior, and role-plays, as well as showing the film "Better
Safe Than Sorry." The children who received the training were found to
have learned many prevention concepts and retained them for at least a
week after training. Older children learned significantly more than the
younger children. However, children seemed to learn only slightly more
than half of the concepts the program was trying to teach and, therefore,
many misconceptions remained after the training.

Toal (1985) evaluated a Child Safety and Protection Training project
conducted in California that included 432 students from 13 schools.

Three forms of training were utilized with the fourth, fifth and sixth
graders. The programs were: the Child Assault Prevention Project
program, the "No More Secrets" program and the Personal Protection
Workshop. The children evaluated by way of a Child Safety Preparedness
Test that was administered three to four weeks after the training, and
again five weeks later. The preliminary results suggested that children
with training did better than the untrained children; there were no
consistent differences among the three programs. The evaluation also
suggested that children who had reported being victims of assault seemed
to be the least prepared to avoid future assaults.

Swan, Press, and Briggs (1985) evaluated a play designed to
entertain and educate children about the differences between appropriate
and inappropriate touching and that sexual abuse can occur within a
family. Children are actively involved in the play which includes a

fast-moving script, humor, and audience participation. The play was

 

18

evaluated in several different ways over a years time. Three separate
populations were tested in this study: urban elementary school students,
rural parents of elementary school students, and mental health
professionals and parents. The children's group included 63 school
children, 30 boys and 33 girls from 8 to 11 years of age, attending a
Catholic, urban school in a midwestern state. Children were randomly
assigned to one of two experimental conditions. In condition one, 44
children received a pretest, viewed the play, and then took the posttest.
In condition two, 19 children viewed the play and took the posttest.
The results indicated that children who were pretested were able to
identify nonsexual touch and sexual assault as depicted by videotaped
vignettes. In an effort to evaluate negative effects, both parents and
children were asked about the children's reaction to the play. Only 72
of the children did not like it, and only 52 of parents said their
children had shown negative reactions to it. The major methodological
flaw found in this study is that no control group was available.

Recently, Saslawsky and Wurtele (1986) evaluated the effectiveness
of the film "Touch" which is meant to teach personal safety skills to
children in kindergarten through sixth grade. Both younger and older
children seemed to increase their knowledge about personal safety skills.
However, because no pretest was given it is impossible to determine
whether the children already had the knowledge or gained it from the
program.

In an effort to compare the effectiveness of various educational
approaches for teaching personal safety skills to children, Wurtele et al.
(1986) evaluated the film "Touch" and a Behavioral Skills Training

program (BST) in which modeling, behavioral rehearsal, and social

19

reinforcement were utilized to teach personal safety skills. The
subjects were 71 children from two grade groups (kindergarten and first
grade, fifth and sixth grades). When compared with the control
presentation, the BST program, alone or in combination with the film,
was more effective than the film alone in teaching information about
sexual abuse. Posttreatment group comparisons suggested the superiority
of the BST program for enhancing personal safety skills. It was also
found that older children did better than younger children. The three
month follow-up showed that gains made directly after treatment were
maintained.

There has been some concern about whether sexual abuse prevention
programs produce anxiety and estrangement from adults among young
participants. Garbarino (1985) examined the reaction of elementary
school children to a special Spiderman comic book dealing with sexual
abuse. A week after receiving the comic, second, fourth, and sixth
graders were interviewed to judge their level of comprehension and their
emotional responses. Most children comprehended the message contained
in the comic: 852 of second graders, 862 of fourth graders, and 962 of
sixth. However, 502 of the fourth graders and 252 of the second and
sixth graders reported feeling "worried" or "scared." These findings
are the first to measure negative effects. However, because no pretest
was conducted, it is not possible to determine whether or not the
children held these fears prior to reading the comic.

Recently, Garbarino (1987) utilized the Spiderman comic with second,
fourth, and sixth graders in Pennsylvania. Thirty-six boys and 37 girls
participated in the study. Interviewers reported that the girls seemed

uncomfortable with the idea of reading a Spiderman comic because

20

Spiderman is a male-oriented character. Children were asked ten

multiple choice questions about the comic (6 related to sex abuse and 4
about minor details of the situation). The results suggested that
children understood the message; this was evidenced by the fact that

even 2nd graders answered more than 802 of the 6 sexual abuse questions
correctly. For 6th graders the figure was more than 902. Only in 4th
grade was there evidence of less than 802 correct answers among the girls
(762 for girls vs. 952 for boys).

In order to determine if the comic worried or scared the children,
they were asked several direct questions: "Did it make you feel worried?
Did it make you feel scared?" In 2nd and 6th grade, girls reported
feeling worried or scared more than boys (352 vs. 172 in 2nd grade and
302 vs. 172 in 6th grade). In fourth grade, boys and girls were equally
likely to say that the comic made them feel worried or scared. Most
children said they felt worried or scared because it made them realize
"it" could happen to them.

The most obvious problem with these two studies is the lack of a
pretest. The children who participated in the Garbarino (1987) study
were asked if anyone had ever spoken with them about sexual abuse. The
majority responded affirmatively with most saying that they had been told
to tell their parents if someone made sexual advances toward them. There
is no way to know how much new knowledge was gained from the comic or how
fearful the children were prior to reading it. These studies also lacked
control groups and each was conducted in only one school.

In an attempt to consider self-concept as part of an evaluation,
Hill and Jason (unpublished manuscript) evaluated a school-based child

sexual abuse primary prevention program with 58 black children between

21

the ages of three and five in Chicago. All children were interviewed
before and after program implementation. The interview included a
self-concept measure and a sexual abuse questionnaire. The results
indicated significant gains in knowledge about sexual abuse from pretest
to posttest. There were no significant differences on the self-concept
scale. However, because no control group was utilized, effectiveness
remains in question. Generalization may be limited due to the use of
only black children in one daycare center in one city in the midwest.

In an effort to evaluate the relationship between proximate measures
and actual behavioral changes attributable to intervention, Fryer,
Kratzer, and Miyoshi (1987) tested two groups of children enrolled in
kindergarten and first and second grades in an inner city elementary
school for their risk of stranger abduction. A simulation was utilized
in which a member of the research team asked the child to accompany him
to his car to help bring some things into the school. The control group
did better than the children participating in the training. However,
following the training, the experimental group did much better than the
control group. A six month follow-up with 30 of the original 44 children
was conducted. Each child was asked to accompany a stranger to his car
to bring in some equipment for the gymnasium. The training program was
presented again to all control group children and to the four children
in the experimental group who had failed the second simulation. The
experimental group children who had passed received no further
instruction. Results suggested that the intervention was effective.
There were two failures among the 29 (6.92 failure rate) children who
took part in the final simulation. Prior to any intervention, 23 of the

44 children failed (52.32 failure rate). It should also be noted that

22

all of the children who passed the final simulation immediately after
the intervention in the previous year passed the final simulation. This
means that they remembered the information for six months with no loss
of learning.

Although this study was well conducted, generalization is a problem
because only one elementary school in one city was employed. Also,
Conte (1987) raised the issue of possible risk to the subjects. As in
the Poche, Brouwer and Swearingen (1981) study, the actual risk to
children who are placed in simulated abuse situations to see how they
respond is unknown. Negative effects could reach far beyond the scope
of the study. Conte suggested that such simulations may teach children
that approach by strangers is not dangerous. The possibility of
sensitizing children to such danger must be considered in future research.
Also, the researchers did not evaluate possible feelings of fear or
anxiety that may have been present in the children.

Whether or not sexual abuse prevention programs have the desired
effect remains to be seen. Due to the limited number of evaluations
conducted and the methodological flaws found, sound conclusions cannot
be drawn. Most studies have found that training programs can help
children learn about sexual abuse. It appears that the idea that abuse
can come from acquaintances is a difficult concept for children to
maintain over time, possibly because it requires children to hold the
cognitively dissonant values that people you know can be both good and
bad. Most studies have not considered possible negative effects
resulting from sexual abuse prevention programs. In addition, previous
research has done little to evaluate programs targeted at preschoolers.

In fact, it is only recently that curricula have been developed for this

23
group. Future research has the responsibility of assessing both positive
and negative effects of prevention programs that are directed at all age
groups of children.

The present study evaluated the effectiveness and possible negative
effects of a child sexual abuse prevention curriculum for preschoolers.
Daycare centers in Grand Rapids and Lansing were contacted by the Director
of the Program for Young Children in each city. In Grand Rapids and
outlying areas a total of 79 daycare centers were contacted and asked to
participate in this study. A total of 35 centers were contacted in
Lansing. In both cities it became evident that there was a great deal of
opposition to such a program, even though both control and experimental
subjects would have the opportunity to experience the program. Control
subjects were to take part in the curriculum after completion of this
projeCt. The initial plan was to utilize 8 daycare centers (4 in Lansing
and 4 in Grand Rapids) randomly assigning half to control condition and
half to the experimental condition. As more and more centers refused to
participate, it became obvious that it would not be possible to obtain
consent from 8 centers. In fact, we were unable to arrange participation
from any daycare centers in Grand Rapids and only two in Lansing. This
once well-designed project had become a two group quasi-experimental design.
Randomization was not possible because only one school agreed to participate
in the curriculum, the other daycare center agreed to two interview dates

and had no intention of implementing the curriculum.

Hypotheses
H1: From time 1 (pre) to time 2 (post), children in the experimental

group will show greater knowledge of personal safety than control

subjects.

24

H2: From time 1 (pre) to time 2 (post), children in the experimental

group will be better able to say no to unwanted touches than will

control subjects.
H3: From time 1 (pre) to time 2 (post), there will be no difference

between experimental and control subjects on the fear measure.

METHOD

Subjects

Subjects were 25 preschoolers (all 4 years of age) who attended two
daycare programs in Lansing, Michigan. The total number of preschool
students enrolled at the time of contact was 21 (7 girls, 14 boys) at the
first daycare center (experimental group), and 20 (5 girls, 15 boys) at
the second (control group). Only children with parental consent took
part in the study; therefore the final number of subjects was 25;
15 (3 girls, 12 boys) experimental and 10 (1 girl, 9 boys) control subjects.
Materials

All measures were given to the children at both pretest and posttest
interviews.

The Personal Safety Questionnaire (PSQ) (Saslawsky and Wurtele, 1986)

 

is a 15 item questionnaire developed to assess children's knowledge about
sexual abuse. Children answer Yes, No, or I'm Not Sure in response to

two practice questions about stranger and fire safety and 15 personal
safety questions. The PSQ takes about 10 minutes to administer and

scores range from 0-15. The scale has an internal consistency reliability
(Kuder-Richardson) of .78 and one-week test-retest reliability of .64
(Saslawsky and Wurtele, 1986). (See Appendix B for a copy of this scale).

The "What If" Situations Test (WIST) (Saslwasky and Wurtele, 1986)

 

is an individually administered instrument that begins with a description

25

of two nonthreatening situations. The child is instructed to imagine
him/herself in that situation and is then asked to describe how s/he
would respond. Three vignettes describing potential encounters with
adults who make sexual advances are then read to the child: "changed"
touch (appropriate touch turned inapprOpriate), touch coerced through
bribery to touch others, and bribery to touch the child. After each
vignette the child is asked a standard list of questions to determine
the degree to which s/he is able to recognize the inappropriateness of
the touch situation; refuse the advance by making appropriate, assertive,
and persistent verbal responses to the offender; describe a behavioral
response that would remove her/him from the situation; and list the names
of contact persons to tell about the inappropriate touch incident. The
WIST takes approximately 10 minutes to administer and scores range from
_0-32 (a child can earn 8 points for each vignette). Cronbach's alpha for
the present study is .86. Some minor changes were made in the wording of
the WIST for use with preschool children but the meaning of the questions
remained unchanged. Also, one negative vignette was removed to make the
instrument more positive for young children (the original measure contained
four negative vignettes). Interrater reliability for coding the child's
descriptions (calculated as the number of agreements divided by the sum
of agreements and disagreements) was .99.1

Four additional scales were drawn from the WIST in order to determine
if other measures were present. These included: (1) questions relating
to a child's ability to list adults who would be helpful to her/him, alpha
score is .77, (2) questions pertaining to a child's ability to give
informative disclosure to an adult, alpha score .75, (3) questions

relating to a child's ability to remove him/herself from the situation,

 

26
alpha score .73, and (4) questions included in the negative vignettes
only, alpha score .93. The correlations for these subscales ranged from
.80 to .95. Therefore an Analysis of Covariance was conducted for the
entire scale only (See Appendix C for a copy of this scale and the scoring
code book).

The Fear Assessment Questionnaire is an 8 item questionnaire
developed by this researcher to examine fear in children. Children
answer either Very Scared, A Little Scared, or Not Scared in response to
questions concerning common fears found in children. These fears include
several pertaining to personal safety. This instrument takes about 5
minutes to administer with scores ranging from 0-16. Cronbach's alpha
is .80 (See Appendix D for a copy of this scale).

Procedure

The Grossmont College Child Sexual Abuse Prevention Program for
Preschoolers includes Teacher Training, a Parent Education Meeting, and
a five day Children's Curriculum for the Classroom. The Children's
Curriculum focuses on teaching children self-protective skills that
reduce vulnerability to abuse. Children learn to determine appropriate
and inappropriate touch, to assert their rights to say "no" to touches
that are uncomfortable or inappropriate, and to tell someone if they are
uncomfortable about a touch. The five-day program (20 minutes per day)
actively involves the children and culminates with a puppet presentation
on the fifth day.

Subjects were assigned to experimental or control conditions
depending on the daycare center they were attending. Due to the limited
number of daycare centers willing to participate and the fact that only

one of these was willing to implement the curriculum, it was necessary

27
to proceed with one school assigned to the exPerimental condition and
one to the control condition.

Parental consent was obtained through individual contact with
parents (by the daycare center director) at the daycare center (See
Appendix A for a COpy of the consent form).

Each child was individually interviewed prior to implementation of
the curriculum and again after the experimental group experienced the

curriculum. The interviews were conducted by this researcher or a trained

 

assistant. The interviews lasted from 15 to 25 minutes and were conducted
in the gym of one school and in the back of the church at the other.

After completion of the data gathering, children were given the
Opportunity to ask questions and/or discuss the material with the
interviewer.

Interviewers were graduate and upper-level undergraduate students
at Michigan State University. All interviewers took part in four hours
of training in how to administer the measures prior to the beginning of

the interviews.

28
RESULTS
The Analysis of Covariance (ANCOVA) was utilized in this study in order
to eliminate possible pretest differences between the two groups. Because
subjects were not randomly assigned to experimental and control groups it
was not possible to be certain that they were equivalent at prepoint.
Pretest scores were used as covariates.

Hypothesis 1. It was predicted that from time 1 (pre) to time 2

 

(post), children in the experimental group would show greater knowledge

of personal safety than control subjects, as measured by scores on the
Personal Safety Questionnaire (PSQ). The analysis of covariance resulted
in a significant effect for Condition [F(1,22)=4.86,_p<,038]. Children

in the experimental group (Time 1, Mé10.80; Time 2’.§T'3'20) had greater
knowledge of personal safety at both time points than control subjects
(Time 1, Me7.40; Time 2’.§=9'90)° Table 1 includes the breakdown of these
results.

Hypothesis 2. It was postulated that from time 1 (pre) to time 2

 

(post), children in the experimental group would be better able to say
no to unwanted touches than would control subjects, as measured by scores
on the "What If" Situations Test. The analysis of covariance indicated
a significant Condition effect L§(1,22)=18.98,‘p<.001]. Children in the
experimental group (Time 1, _;19.27: Time 2,.M525.60) were better able
to say no to unwanted touches than control subjects (Time 1, M;9.50;
Time 2’.§?9'60)' Table 2 contains these results.

Table 4 includes the correlation matrix for all measures utilized
in this study, including the subscales of the "What If" Situations Test.
The strong positive correlations found between the WIST and each of the

four subscales suggests that they all measure the same construct. Table 5

Table 1

29

Analysis of Covariance for Condition Effects on the PSQ

 

 

Sum of Squares df Mean Square F
Main Effects
Condition 18.95 1 18.95 4.86*
Residual 85.67 22 3.89

 

*E<'038

 

30
Table 2

Analysis of Covariance for Condition Effects on the WIST

 

 

Sum of Squares df Mean Square F
Main Effects
Condition 637.77 1 637.77 18.98*
Residual 738.89 22 33.58

 

*p<.001

31
contains the means and standard deviations for all measures for the
experimental group and Table 6 includes this information for the control
group.

Hypothesis 3, It was predicted that from time 1 (pre) to time 2

 

(post), there would be no difference in scores on the Fear Assessment
Questionnaire between control and experimental subjects. This hypothesis
was supported. The analysis of covariance did not reach significance

for Condition L§(1,22)=.63]. The scores on the Fear Assessment
Questionnaire indicated no difference between children in the experimental
group (Time 1, M;10.07; Time 2, M;10.40) and children in the control group

(Time ".§T'O°3O3 Time 2’.§T"°60)' Table 3 contains these results.

 

32
Table 3

Analysis of Covariance for Condition Effects on the Fear Measure

 

Sum of Squares df Mean Square F

Main Effects

Condition 4.03 1 4.03 .63

Residual 139.87 22 6.36

 

 

33
Table 4

Correlation Matrix for All Measures

 

 

PSQ FEAR WIST
PSQ .08 .59
FEAR OO

WIST

 

 

Table 5

34

Means and Standard Deviations for All Measures Utilized

EXPERIMENTAL GROUP

 

Time 1

 

Experimental Group

 

 

Measure Mean Standard Deviation
PSQ 10.80 2.16

FEAR 10.07 4.04

WIST 19.27 8.92

Time 2

PSQ 13.20 1.68

FEAR 10.40 4.14

WIST 25.60 5.96

 

35

Table 6

Means and Standard Deviations for All Measures Utilized

CONTROL GROUP

 

 

 

 

Time 1

Measure Mean Standard Deviation
PSQ 7.40 2.07

FEAR 10.30 4.99

WIST 9.50 5.02

Time 2

PSQ 9.90 1.45

FEAR 11.60 3.75

WIST 9.60 7.43

 

36
DISCUSSION

The Grossmont College Child Sexual Abuse Prevention Program for
Preschoolers purports to teach children appropriate self-protective
responses in an effort to prevent child sexual abuse. The present study
evaluated this program's effectiveness in that regard. It was predicted
that children in the experimental group would show greater knowledge of
personal safety than control subjects, as measured by scores on the
Personal Safety Questionnaire (PSQ); this hypothesis was supported.

Also, the results, as indicated by scores on the WIST, supported the
ability of the program to teach children the appropriate verbal responses
to make in potentially dangerous situations. Mean scores suggested that
children in the experimental group were better able to say no to

unwanted touches than control subjects at both prepoint and postpoint
interviews.

The program did not cause more fear in children nor did it lessen
any initial fears they may have bad. This was evidenced by scores on
the Fear Assessment Questionnaire. This measure was developed for this
study in order to consider the possibility that programs of this nature
may produce anxiety and estrangement from adults among young
participants. This is one of the first studies to consider such negative
effects.

Several limitations inherent in this study must be discussed. First,
the small number of same age participants greatly limits generalizability.
Secondly, because only two schools were willing to participate in this
project, randomization was not possible. One school was willing to

implement the curriculum, the other was not. In addition, only two

37

schools in one midwestern city were evaluated, again limiting

generalizability. Another limitation is that this study assessed children's

knowledge of sexual abuse and elicited verbal reports of what these
children claim they would say and do if confronted by a potential abuser.
Ethically, it seems unacceptable to place children in potentially
dangerous situations in order to determine whether or not these skills

are transferred to real-life situations, although several studies of this
nature have been conducted (Poche et al., 1981, Fryer, Kraizer, & Miyoshi,
Finally, this study evaluated only one approach to teaching personal safety
skills. It is important for future research to compare different
educational approaches to sexual abuse. However, teaching children to

be aware that being sexually stimulated by an adult is inappropriate and
providing them with skills necessary to extricate themselves from a
potentially dangerous situation seems to be an appropriate beginning.

Although this study has a great many limitations, it is helpful in
adding to our knowledge about evaluations of sexual abuse prevention
programs with preschoolers. The participants seemed to have the ability
to gain important protective skills from the program. Also, the program
.did not scare the children.

After reviewing the many limitations found in this study, several
questions remained. Why were we limited to two schools? Why was the
number of children so small? Why did we not venture into other communities
with this project? When this project was first proposed by the Department
of Social Services in Lansing, we planned to work in several cities
(Grand Rapids and Lansing). The number of daycare centers was to be at
least eight (4 control and 4 experimental). However, as time passed and

the Directors of the Programs for Young Children in Grand Rapids and

1987).

 

38
Lansing began to contact schools in their area, it became evident that
a problem existed. The directors of the daycare centers had many excuses
for not taking part in this study. Some felt they had no problem in their
school with sexual abuse, others did not have the time to teach their
staff the curriculum, and others did not feel that their teachers had the
necessary skills to teach such a program. Many excuses were forthcoming
with the ultimate result being that no schools in Grand Rapids agreed to
participate and only two in Lansing. Very quickly this once sizable study
became almost too small to proceed. Although both Program Directors had
originally felt that their communities were open to such a project and even
anxious to be part of it, this was not the case. It seems possible that
sexual abuse is still a topic that some would rather not face. It has been
suggested that a major consideration in terms of school acceptance of such
programs is parental approval. However, in this case, we were not able to
obtain school approval let alone parental approval. This problem may have
been avoided if we had been more aware of the reticence of the community
to utilize a personal safety curriculum. It has been suggested that
successful prevention programs do a great deal of work to create the
proper climate for gaining entry into a community. This includes developing
a group of influential people who support the use of the program and who
can lobby on its behalf (Finkelhor, 1984).

Studies of the effectiveness of sexual abuse prevention are
multiplying rapidly. To date most evaluations have utilized questionnaires
that tested the knowledge and the attitudes of children about sexual abuse.
This approach needs to be refined and supplemented.

Most importantly, sophisticated, valid and reliable instruments need

to be developed. We are in the first phase of this process. The many

39
evaluations that are being conducted arOund the country should afford
appropriate measures, but only time and a great deal of effort on the
part of dedicated researchers can make that happen.

However, tests of attitudes and knowledge are not enough; we must
remember that the real purpose of these programs is to prevent sexual
abuse. The ultimate test of prevention education is whether or not
children with training are less likely to be abused. This suggests
research designs that follow children for several years after training
to see if they are abused at rates different from their untrained
counterparts. The research conducted so far, which raises questions
about the long—term retention of prevention concepts (Plummer, 1984),
should advise us that long-term studies are really the true test.

Another focus for the future must be on possible negative effects.
Questions have been raised about whether or not prevention programs
might have such adverse effects as undermining parental authority, making
children afraid of adults or giving children negative messages about
touching and sex. It may be important to survey parents and teachers to
determine if they notice concerns and fears in children that were not
present prior to training. It is also important to consider the effects
of training on children's sexual attitudes and knowledge. For example,
prevention concepts have been used to simplify and make comprehensible
the notion of abuse, but do these simplifications create a potential for
misunderstandings of a new kind? The Touch Continuum teaches children to
identify and reject touch that makes them feel bad or confused.
Undoubtedly most sexual abuse does feel bad or confusing. But, there may
be some situations in which sexual abuse does not feel bad or confusing,

at least in the beginning; sexual abuse, or at least the affection and

4O
attention that comes with it, may actually £331 good. Will children
trained with the Touch Concepts be able to identify this?

From the other side, there is touch that may feel bad, but be good;
for example, many things doctors do to children. The Grossmont Program
makes an exception for doctors, but this nuance may be lost to some
children. Or, possibly, parents may indoctrinate children with the
message that sometimes peOple do things that feel bad, but that are good
and important. Parents may give this message to children in order to gain
their cooperation with doctors. This message may contradict the benefits
of a child's training in the Touch Continuum.

These criticisms are minor when compared with the contributions of
sexual abuse prevention programs. Prevention education cannot
realistically be expected to prepare children for all possible situations.
This is why children need to receive ongoing education about sexual abuse
from a variety of sources, each of which can emphasize a somewhat different
point.

Finally, future research must move beyond program evaluation
altogether. Other research approaches may provide a great deal of
information on prevention. One approach is to study attitudes, background
knowledge, and behavior of children who have been sexually victimized for
clues about how to avoid abuse. The content of most current prevention
programs was developed through clinical work with abused children and
knowledge of the histories they recounted (Finkelhor, 1984). However, no
one has done a systematic analysis of such children, their knowledge, and
their accounts of abuse for a better understanding of what the most
important prevention steps might be. How many children actually did not

know that what the abuser was doing was wrong? How many were afraid of

41
being physically harmed? How many believed that if they told the secret
something bad would happen to them or someone they loved? Finkelhor (1984)
suggested comparing a group of victimized children with a group who were
approached but escaped and told. It may be that the avoiders had more
knowledge about abuse and more awareness about their rights. But it may
be possible that the avoiders were different in some other way that we are
not currently aware.

Another approach that may provide important information is to study
the abusers themselves. Careful study of the molesters might reveal
additional factors that prevention educators should take into account.

Most molesters have had the experience of choosing which child to abuse.
Direct questioning of abusers about what considerations led them to
choose one child over another could supply essential information that
could then be taught to children. Sanford (1980) did some work with
molesters and it has proven to be very helpful in the development of
prevention programs.

Another possible approach is to study parent-child interaction.

Almost all professionals agree that parents are in the position to be the
most effective prevention educators (Finkelhor, 1984). Studying programs
directed at parents may be more helpful than studying school-based programs.
What do parents who have been educated about sexual abuse tell children that
is different from information given by parents who have not been educated?
What do children gain from these conversations? Finkelhor (1984) suggests
that comparison of what parents say they told children with what children
say they heard. It wOuld be helpful to observe conversations about sexual
abuse in laboratory settings to obtain an objective perspective on this

communication.

 

42

Sexual abuse prevention is becoming more and more prevalent in this
country. The content of sexual abuse prevention programs not only offer
the possibility of preventing sexual abuse, but also give children more
knowledge and confidence in coping with many situations. Whether or not
these programs have the desired effect remains to be seen. Careful,
methodologically sound evaluations are necessary. Questions have been
raised about whether or not this kind of education really protects
children from abuse, and whether or not there are unintended consequences
such as fear and worry in children. Future researchers will have to
address these concerns in addition to considering other approaches to
preventing sexual abuse. The result will be a better understanding of
the problem of sexual abuse and better ways of reducing its toll on

children.

REFERENCES

REFERENCES

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Anderson, S. C., Bach, C. M., & Griffith, S. (1981). Psychosocial
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Bagley, C.,& Ramsay, R. (1986). Disrupted childhood and vulnerability
to sexual assault: Long-term seguals with implications for counseling.
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Briere, J. (1984, April). The long-term effects of childhood sexual
abuse: Defining a post-sexual-abuse syndrome. Paper presented at the
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Briere, J., & Runtz, M. (1985). Symptomatology associated with prior
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Burgess, A. W., & Holmstrom, L. L. (1978). Accessory to sex: Pressure,
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Committee for Children. (1984). Prevention of child sexual abuse: A
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Conte, J. (1987). Ethical issues in evaluation of prevention programs.
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Conte, J. R., Rosen, C., Saperstein, L., & Shermack, R. (1985). An
evaluation of a program to prevent sexual victimization of young
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Conte, J. R., Rosen, C., Saperstein, L. (1986). An analysis of programs
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Courtois, C. (1979). The incest experience and its aftermath.
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43

44

DeFrancis, V. (1969). Protecting the Child Victim of Sex Crimes
Committed by Adults. Denver, CO: American Humane Association.

 

deYoung, M. (1984). Sexual Victimization of Children. Jefferson, NC:
McFarland.

 

Downer, A. (1985). The Development and Testing of an Evaluation
Instrument for Assessing the Effectiveness of a Child Sexual Abuse
Prevention Curriculum: Talking About Touching. Seattle, WA:
Committee for Children.

Finkelhor, D. (1979). Sexually Victimized Children. New York: Free
Press.

 

Finkelhor, D. (1984). Child Sexual Abuse:' New Theory & Research. New
York: Free Press.

Friedrich, W. N., Urquiza, A. J., & Beilke, R. (1986). Behavioral
problems in sexually abused young children. Journal of Pediatric

Psycholog , ll, 47-57.

Fritz, G. S., Stoll, K., & Wagner, N. A. (1981). A comparison of males
and females who were sexually molested as children. Journal of Sex

and Marital Therap , 1, 54-59.

Fromuth, M. E. (1983). The Long Term Psychological Impact of Childhood
Sexual Abuse. Unpublished doctoral dissertation, Auburn University.

Fryer, G. E., Kraizer, S. K., & Miyoshi, T. (1987). Measuring actual
reduction of risk to child abuse: A new approach. Child Abuse &
Neglect, 1i, 173-179.

Fryer, G. E., Kraizer, S. K., & Miyoshi, T. (1987a). Measuring children's
retention of skills to resist stranger abduction: Use of the simulation
technique. Child Abuse & Neglect, 1i, 181-185.

 

Garbarino, J. (1985). How do children respond to sexual abuse prevention?
The case of Spiderman. National Committee for the Prevention of Child
Abuse, (NCPCA), Chicago.

 

Garbarino, J. (1987). Children's response to a sexual abuse prevention
program: A study of the Spiderman comic. Child Abuse & Neglect, ll,
143-148.

Good, J., McCarthy, T., & DiVasto, P. (1981). Physical and sexual abuse
of the children of adult incest victims. In J. good (Ed.). Sexual
Abuse: Incest Victims and Their Families (pp. 101-156). Boston:

John Wright-PSC.

Comes-Schwartz, B., Horowitz, J., & Sauzier, M. (1985). Severity of
emotional distress among sexually abused preschool, school-age and
adolescent children. Hospital and Community Psychiatry, 36, 503-508.

 

45

Herman, J. (1981). Father-daughter incest. Cambridge, MA: Harvard
University Press.

 

Hill, J. L., & Jason, L. A. (1987). An evaluation of a school—based
child sexual abuse primary prevention program. Unpublished manuscript,
DePaul University.

 

 

Kercher, G. (1980). Responding to Child Sexual Abuse. Huntsville, TX:
Sam Houston University, Criminal Justice Center.

 

Meiselman, K. (1978). Incest: A Psychological Study of Causes and
Effects with Treatment Recommendations. San Francisco: Jossey-Bass.

 

Miller, L., Moeller, D., Kaufman, A., Divasto, P., Fitzsimmons, P.,
Pather, D., & Christy, J. (1978). Recidivism among sexual assault
victims. American Journal of Psychiatry, 135, 1103-1104.

 

Murphy, J. E. (1985, June). Untitled news release. (Available from
St. Cloud State University, St. Cloud, NM 56301).

National Committee for Prevention of Child Abuse. (1986). NCPCA Summary
Report: Spiderman and Power Pack Comic on the Prevention of Sexual
Abuse. Chicago, IL: Author.

Peters, J. J. (1976). Children who are victims of sexual assault and
the psychology of offenders. American Journal of Psychotherapy, 39,
395-421.

Peters, S. D. (1984). The Relationship Between Childhood Sexual
Victimization and Adult Depression Among Afro-American and White Women.
Unpublished doctoral dissertation, University of California at Los
Angeles. (University Microfilms No. 84-28, 555).

Plummer, C. (1984, August). Preventing Sexual Abuse and Later
Psychological Problems. Paper presented at the Second National
Conference for Family Violence Researchers, Durham, NH.

 

Poche, C., Brouwer, R., & Swearingen, M. (1981). Teaching self-protection
to young children. Journal of Applied-Behavior-Analysis, 14, 169-176.

Ray, J, & Dietzel, M. (1985). Teaching child sexual abuse prevention.
Unpublished manuscript.

Russell, D. E. H. (1983). The incidence and prevalence of intrafamilial
and extrafamilial sexual abuse of female children. Child Abuse &

Neglect, 7, 133-146.

Sanford, L. T. (1980). The Silent Children: A Parent's Guide to the
Prevention of Child Sexual Abuse. New York: McGraw-Hill.

 

Saslawsky, D. A., & Wurtele, S. K. (1986). Teaching personal safety
skills for potential prevention of sexual abuse: A comparison of
treatments. Journal of Consulting & Clinical Psychology, 54, 688-692.

46

Sedney, M. A., & Brooks, B. (1984). Factors associated with a history
of childhood sexual experience in a nonclinical female population.
Journal of the American Academy of Child Psychiatry, 23, 215-218.

Seidner, A. L., & Calhoun, K. S. (1984, August). Childhood Sexual Abuse:
Factors Related to Differential Adult Adjustment. Paper presented at

the Second National Conference for Family Violence Researchers, Durham, NH.

Swan, H. L., Press, A. N., & Briggs, S. L. (1985). Child sexual abuse
prevention. Does it work? Child Welfare, 64, 395-405.

Toal, S. D. (1985). Children's Safety and Protection Training Project:
Three Interrelated Analyses. Stockton, CA: Toal Consultation Services
(6333 Pacific Ave., Suite 261).

 

Tufts' New England Medical Center, Division of Child Psychiatry. (1984).
Sexually Exploited Children: Service and Research Project. (Final
report for the Office of Juvenile Justice and Delinquency Prevention).
Washington, DC: U. S. Department of Justice.

Wurtele, S. K., Saslawsky, D. A., Miller, C. L., Marrs, S. R., & Britcher,
J. C. (1987). Teaching personal safety skills for potential f
prevention of sexual abuse: A comparison of treatments. Manuscript
submitted for publication, Washington State University.

Wyatt, G. E. (1985). The sexual abuse of Afro-American and White American
women in childhood. Child Abuse & Neglect, 2, 507-519.

Footnotes
1Two graduate students studying clinical psychology coded the answer
sheets in order to determine interrater reliability. They used a scoring
code book that I developed for this study. The authors did not have a
scoring code book available at the time this study was conducted (See

Appendix C for a copy of the scoring code book).

47

APPENDICES

 

APPENDIX A

CONSENT FORMS

 

CONSENT FORM
Evaluation of a Personal Safety Curriculum for Preschoolers

As you know, several Child Care Centers in your area will be
conducting the Grossmont College Child Sexual Abuse Prevention Program.
Although the Child Care Center your child attends will not implement the
program immediately, the program will be presented in your Child Care
Center in the near future. Children are already taught caution about
fire, streets, and water. In the same manner, children will be taught
to protect themselves from sexual exploitation. The program will provide
information and self-protective skills to reduce children's vulnerability
to abuse. Children will learn to determine appropriate and inappropriate
touch, to assert their rights to say "no" to touches that are uncomfortable
or inappropriate and to tell someone if they are uncomfortable about a
touch. The Grossmont Program is a safety program and not a sex education
curriculum. It does not provide any explicit information about human
sexuality. The program will be presented by the Child Care Center's
teachers in coordination with the Michigan Department of Social Services.
In addition, as part of the program, a puppet program will be presented
by a representative of the Grossmont Program. In order to determine how
much of the information the children learn from the program, an evaluation
of the program will also be conducted. This will be done by interviewing
each child before the beginning of the program, and shortly after the
program is completed. The children in the Child Care Center your child
attends will be interviewed to determine how much they already know about
personal safety. They will be interviewed again about three weeks later
to see how much information they have retained. The interview will be
conducted by the researcher named below or a trained assistant. The
children will be told that we want to ask them some questions about
personal safety and that they can say whatever they like. We will use
puppets to act out situations abOut children's personal safety. This
evaluation will help us to determine how valuable this program is to
preschoolers. We can then make some recommendations in order to make it
better and more useful for other children.

1. I understand the above evaluation process of the Grossmont College
Child Sexual Abuse Prevention Program. An explanation of this project
has been given to me and I understand what my child's participation
will involve.

2. I understand my child's participation is optional.

3. I understand that I am free to discontinue my child's participation
in this project at any time without penalty and that my child will
still have the opportunity to participate in the Grossmont College
Child Sexual Abuse Prevention Program.

4. I understand that all results of the study will be kept in strict
confidence and all responses of my son or daughter will remain
anonymous. Within these restrictions the results of the study will
be made available to me at my request.

48

CONSENT FORM
Page 2

5. I understand that participation in the study does not guarantee any
additional benefits to my child or to me.

I hereby give my approval to allow my child to be interviewed as part of
the above project. I understand that this information will be used as
part of a research project being conducted by Theresa Anderson-Varney,
Michigan State University, telephone 616-642-6178.

Name of Child Birthdate

Signature of Parent/Guardian Date

49

CON SENT FORM
Evaluation of a Personal Safety Curriculum for Preschoolers

As you know, the Child Care Center your preschooler attends will be
conducting the Grossmont College Child Sexual Abuse Prevention Program.
Children are already taught safety rules about fire, streets, and water.
In the same manner, children will be taught to protect themselves from
sexual exploitation. The program will provide information and
self-protective skills to reduce children's vulnerability to abuse.
Children will learn to determine appropriate and uncomfortable or
inappropriate touch, to assert their rights to say "no" to touches that
are uncomfortable or inappropriate and to tell someone if they are
uncomfortable about a touch. The Grossmont Program is a safety program
and not a sex education curriculum. It does not provide any explicit
information about human sexuality. The program will be presented by the
Child Care Center's teachers in coordination with the Michigan Department
of Social Services. In order to determine how much of the information the
children learn from the program, an evaluation of the Program will be
conducted. This will be done by interviewing each child before the
beginning of the program, and shortly after the program is completed. The
interview will be conducted by the researcher named below or a trained
assistant. The children will be told that we want to ask them some
questions about personal safety and that they can say whatever they like.
This evaluation will help us to determine how valuable this program is to
preschoolers. We can then make recommendations in order to make it better
and more useful for other children.

I. I understand the above evaluation process of the Grossmont College
Child Sexual Abuse Prevention Program. An explanation of this project
has been given to me and I understand what my child's participation
will involve.

2. I understand my child's participation is optional.

3. I understand that I am free to discontinue my child's participation
in this project at any time without penalty and that my child will
still have the opportunity to participate in the Grossmont College
Child Sexual Abuse Prevention Program.

4. I understand that all results of the study will be kept in strict
confidence and all responses of my son or daughter will remain
anonymous. within these restrictions the results of the study will
be made available to me at my request.

5. I understand that participation in the study does not guarantee any
additional benefits to my child or to me.

I hereby give my approval to allow my child to be interviewed before and
after the personal safety program (Grossmont College Child Sexual Abuse
Prevention Program) is presented to the children. I understand that this
information will be used as part of a research project being conducted by
Theresa Anderson—Varney, Michigan State University, telephone 616-642—6178.

50

 

CONSENT FORM

Page 2

Name of Child Birthdate

 

Signature of Parent/Guardian

 

Date

 

SI

APPENDIX B

PERSONAL SAFETY QUESTIONNAIRE

 

Evaluation of a Personal Safety Curriculum

Directions to the Interviewer: This interview is being conducted to
The only
instance where the interview should be used to instruct the child is the
explanation of private parts. For all other questions read them as

determine the amount of knowledge the child has at this time.

written. Probe by repeating questions as written.

 

Introduction: (to child) Hi, my name is

can say whatever you want to.

Practice Items:

1. Does it sometimes snow in winter? Yes

2. Do you attend Child Care Center? Yes

3. Are you a girl/boy? Yes

Now try two more questions for practice.

A. If you are home alone, is it ok to open the
door and let a stranger come into your house?

Yes

B. Is it ok for kids to play with matches as
long as no one finds out? Yes

Good, you are ready to answer some questions about personal

C. Tell me what the word "Private Parts" means.

. What is your
I'm going to be asking you some questions. This isn't a test at all.

No

No

No

No

I'm Not

I'm Not

I'm Not

I'm Not

I'm Not

safety.

name?
You

Sure

Sure

Sure

Sure

Sure

 

 

(Do not continue until the child understands "Private Parts")

I. If a grown—up touches a kid's private parts,
is it the kid's fault? Yes

2. Do ou have to let rown-u s touch ou on
Y 8 P Y
your private parts? Yes

3. If someone's trying to touch a kid's private
parts, is it ok for the kid to ask for help?Yes

4. Would you tell a grown-up if someone touched
your private parts? Yes

52

Initially understood
Explained to child

I'm Not

I'm Not

I'm Not

I'm Not

Sure

Sure

Sure

Sure

53

If you tell a grown-up that somebody tried
touch your private parts, and that
grown—up doesn't help you, should

you forget about it?

Are strangers the only people who might
want to touch a kid's private parts?

If someone touched a kid's private parts
and promised never to do it again, should
the kid tell someone?

If a grown-up asks to see your private
parts, should you get away from them
right away?

Is it ok for a grown-up to touch your
private parts if it feels good?

Is it ok for your mom or dad to give
you a hug if you want one?

Would it be ok for your doctor to look
at your private parts if you had an "owey"
(hurt) there?

Is it right for grown-ups to make you
touch or look at their private parts?

Is your teacher the boss of your private
parts?

If your babysitter wants to look at your
private parts, what would you say?

to

No

No

No

No

No

No

No

No

Not

Not

Not

Not

Not

Not

Not

Not

Not

Not

Sure

Sure

Sure

Sure

Sure

Sure

Sure

Sure

Sure

Sure

Explanation of Private Parts
Some parts of your body are called your private parts. Do you know
where your private parts are? (SOme may be confused, some may call them
by slang terms.) Your private parts are the parts of your body that are
covered by underpants or your bathing suit. Show me where on your body
you wear a bathing suit. That's right. Is this a private part?
(touch your arm) Why isn't this a private part? (Because it isn't
covered by underpants or a bathing suit.) Is this a private part?
(Indicate the front area of your body where a bathing suit might be.)
Yes, that's right, because this part of my body is covered by underpants

or a bathing suit. These are your private parts.

54

APPENDIX C

"WHAT IF" SITUATIONS TEST

Practice A.

Practice B.

Changed
Touch

"What If” Situations Test
(Interviewer Script)

"Let's pretend you are on the playgrOund at school and you
fall down and cut yourself? What would you do?

(Feel free to discuss the child's answer with him/her)

Let's pretend you were playing in the front yard of your
house and a stranger drove up and asked you to get in the
car with him, what would you say? What would you do?
(Check here if child says would get in the car)

(Feel free to discuss the child's answer with him/her, accept
what they say.)

"Let's pretend you are having fun wrestling with your friend,
and all of a sudden your friend starts grabbing and feeling
your private parts?"

"Is there anything wrong with this?" Yes =1
(If answer is No, skip to the next item, and N0 =

no credit is given for Changed Touch)

"What would you say to your friend?"

 

 

"Let's pretend y0ur friend wouldn't stop; what
would you say next?"

Direct Rejection=2

 

Evasion =l

 

No Change =0
"What would you do/what action would you
take?"

Effective Escape=2

 

Vague Escape =l

 

Do Nothing/Stay =0

 

"Would you tell anyone about it? or would
you keep this a secret and not tell anyone?"
(If answer is secret, skip following 2 questions)

55

Bribe to

Touch
Child

 

56

"Let's pre;end you were at a park playing and a man who you
like says to you one day, "Take off your pants (name of child)
so I can touch your private parts and then I‘ll buy you an

ice cream cone."

"Is there anything wrong with this?"

(If the answer is No, skip to the next item, Yes :1
and no credit is given for Bribe to Touch No =0
Child)

"What would you say to the man?"

 

 

"What if the man wouldn't stop; what would you
say next?"

Direct Rejection=2

 

Evasion =1

 

No Change =0

 

"What would you do/what action would you take?”

Effective Escape=2

 

Vague Escape =1

 

No Change =0

 

"Would you tell anyone about it?" Or would
you keep this a secret and.not tell anyone?"
(If answer is secret, skip following 2
questions)

"Who would you tell if this happened to you?"
(record persons mentioned, and prompt for

additional contacts)

Two or more =2

 

One person =1

 

"Tell No One" =0

 

"What would say to (person(s) named above?"

Informative

 

Disclosure =l

 

Uninformative
Disclosure =0

 

57

"Who would you tell if this were happening to you?”
(Record persons mentioned, and prompt for additional

contacts)

Two or more=2

 

One person =1

 

"Tell No One"=0

 

"What would you say to (person(s) named above?"

Informative

 

Disclosure=l

 

Uninformative
Disclosure=0

 

Positive
Touch

"Let's pretend you were riding your bike and you fell off and
hurt your private parts and when you went home your parents
wanted to look at them to make sure they were all right?"

"Is there anything wrong with this?"
(If answer is Yes, skip to the next item,
and no credit is given for Positive Touch)

"Would you let your parents do that?"

 

 

"Why would it be ok for your parents to
look at your private parts?"

 

 

 

"Would yOu need to tell anybody that your
parents touched your private parts?"

 

 

Yes =0
No =2
Yes =2
No =0

Appropriate =2
Answer

Inappropriate=0
Answer

xi4i.LJ.L‘L........‘.A.....JJ..........---............................AL

Bribe to
Touch Others

58

"Let's pretend your babysitter promised you that you could
stay up late to watch your favorite TV show if you only touch
her private parts for a little while?"

"Is there anything wrong with this?" Yes =1
(If answer is No, skip to the next item
any no credit is given for Bribe to No =0

Touch Others.)

"What would you say to your babysitter?"

 

 

"Let's pretend the babysitter wouldn't stop;

 

what would you say next?" Direct Rejection=2
Evasion =1
No Change =0

 

"What would you do/what action would you
take?"

Effective Escape=2

 

Vague Escape =1

 

Do Nothing/Stay =0

 

"Would you tell anyone about it? Or would
you keep this secret?" (If answer is Secret,
skip following 2 questions)

"Who would you tell if this were happening
to you?" (record persons mentioned, and

prompt for additional contacts)

Two or more =2

 

One person =1

 

"Tell No One" =0

 

"What would you say to (person(s) named above?"

Informative
Disclosure =1

 

 

Uninformative
Disclosure =0

 

............................................................

59

"Since we have been talking about the ways people touch us, why don't we
talk about a kind of touch you really like? I'd like you to remember that
most people like to give and get touches they like. How do you like people
to tOuch yOu? How about one you like to give?"

(Feel free to discuss and prompt answers and examples of good touch)

"Any questions?"

"I'd like to thank y0u for talking to me."

"What If" Situations Test Code Book
Definitions

Direct Rejection (2 points) - to refuse in a straightforward manner; not
vague, e.g., a direct answer. Examples,
"No, I won't do that!", "No!”, ”Stop that
now'"

avoiding of something, question, excuse,
tending to avoid, not straightforward.
Examples, "Let's talk about something else."
"I don't think 50.", "Give me some ice cream
first.", "Not now, maybe later."

Evasion (1 point)

Effective Escape (2 points) - an escape that will produce a result; produces
a definite result. Examples, "I'm going to
go home and tell my mother!", "I'm going to
my room now!", "I'd run to my mom!"

Vague Escape (1 point) ~ no plan to get away, possibly avoidance.
Examples, "I don't know, I guess I'd try
to get away." "I want to play cards.”,
I watch tv first?".

"Can

60

APPENDIX D

FEAR ASSESSMENT QUESTIONNAIRE

Fear Assessment

How scared do you feel about:

1.

Getting into a fight when you are playing with friends?

Very Scared A Little Scared Not Scared

 

 

 

 

 

 

 

2. Falling off your bike?

Very Scared A Little Scared Not Scared
3. The dark at night?

Very Scared A Little Scared Not Scared
4. Someone you don't know talking to you?

Very Scared A Little Scared Not Scared
5. Someone asking you if they can touch your private parts?

Very Scared A Little Scared Not Scared
6. Being left at home with a sitter?

Very Scared A Little Scared Not Scared
7. Thunderstorms?

Very Scared A Little Scared Not Scared
8. Someone asking you to touch their private parts?

Very Scared A Little Scared Not Scared

 

61

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