Child abuse, and especially child sexual abuse, concerns everyone who works with children. Over the last thirty plus years protective behaviours programs of different kinds have been developed and used to try to help protect children from this kind of abuse. These programs are usually provided in schools or early childhood services such as preschools. They vary greatly in content, style of delivery and in duration and may have different names.
The content may include knowing the names of body parts, owning your own body, different kinds of touch, knowing who are safe people to tell and ways to avoid or get away from risky situations. Some also have aspects of awareness-raising and knowledge for parents and/or community. The programs may include giving information, using books, different kinds of dramatic play or presentation, videos or films and/or group discussions. There may be just one presentation or several over time.
Programs may have different stated goals but there is an implicit expectation that they will protect or help protect children from abuse and encourage them to tell someone safe if they are abused or threatened. Before undertaking this, or any other new program, educators will want to look at their effects through research and evaluations. In the case of protective behaviours programs there have been difficulties in this due to the wide variety of different programs and differences in research quality and methodology.
Evaluations have usually looked at effectiveness of the programs in enhancing children’s knowledge and protective behaviours such as telling someone, and any possible harm, such as increased anxiety resulting from the program. A recent meta-review by the Cochrane Collaboration (Walsh et al. 2015) gives an updated summary of current research. The studies assessed were conducted in USA, Canada, China, Germany, Spain, Taiwan and Turkey, with the majority from USA. The review focuses on protective behaviours, knowledge, retention of behaviours and knowledge over time, disclosures and any harm from the programs. The programs assessed included children from five years of age on.
What the reviewers found was that at least in the short term, immediately after the program, the children who received the training were more likely to use the protective behaviours they were taught in a simulated situation, than children who had not had the program. They also found that children with better knowledge and higher self esteem were more likely to use what they had learned than other children in the group.
In the area of knowledge, remembering information they had been given, children did better if there was some follow up after the initial program. They found, as might be expected, that older children (older than grade four) did better on retaining knowledge than younger children. Children who had been in the programs appeared more likely to tell someone if they had been or were being abused than children in the control groups.
Whether or not the program made some children more anxious or afraid was unclear from the results of the studies but from information available there may have been some children with worries about what might happen but not major anxiety or fears.
Researchers were unable to find out what aspects of programs were most helpful because most programs evaluated used a number of different approaches. They also queried whether simulated evaluation situations, as used in some studies, where children are invited to go with a stranger, are ethically sound and whether they may stress some children or imply to children that risk of sexual abuse is only about stranger-danger. Many studies in the past have not had control groups and so could not be accurately compared with this review. The reviewers recommend further rigorous research to explore the benefits of multi-dimensional approaches which many of the programs provide, and the longer term effects of the programs. They also recommend a further review of preschool programs which have different delivery methods and often parent involvement.
The reviewers concluded that protective behaviours programs ‘appear to increase knowledge and behaviours about sexual abuse’. However they did not have ‘evidence that the programs reduce the incidence of child sexual abuse’ which would in fact be very difficult to obtain. Finally they say that any learning from the programs should not take the place of adult responsibility to ensure that children are safe. They recommend that strategies for prevention of child sexual abuse must target not only children but the wider context of ‘family, community and society’.