3.11.2 Safeguarding Children and Young People who may have been Sexually Abused by a Family Member

1. Introduction

There is often a culture of 'the quiet word' that exists in relation to intra-familial child sexual abuse. This may occur when there is no direct disclosure from anyone in the family, resulting in professionals sharing concerns that abuse is likely to have taken place, and if they think children or pregnancies may have been conceived as a result. However, no decisive action is taken. This was evident in a Serious Case Review in Sheffield published in 2010.

'The SCR identifies that a culture of 'the quiet word' existed where informal unwritten information was passed between services sometimes because the professional did not have the understanding or knowledge to escalate their concerns, particularly as the belief was that the evidence was either not there to investigate (genetic, DNA) or that the situation had been investigated by the police with no further action required or possible.' (Q Family Serious Case Review, 2010).

As well as the culture of the 'quiet word', the Q Family Serious Case Review found other issues that influenced the lack of action taken by agencies, including:

'The professionals who knew about the accusations concerning the Q Family since 1988 generally appear to have been paralysed, a collective helplessness by the situation both personally and professionally. On more than one occasion people talked about incest as the last taboo.'

Clearly we, as professionals, have to be proactive when faced with cases we suspect of being intra-familial child sexual abuse. This procedure, therefore, has been developed by Sheffield Children Safeguarding Partnership, for use by all partner agencies. It provides information about intra-familial sexual abuse and other types of sexual abuse, such as rape, that may take place within a family. Child sexual abuse within a family is a child protection issue, as it is when the abuser is external to the family, and it needs an immediate response. This document also provides information about what action professionals who suspect such a situation should take, and what evidence can be collected. This includes the role of specialist professionals who can offer support to the child or young person, other family members, and involved professionals.

This protocol should be read in conjunction with Recognition of Significant Harm and Types of Abuse and Neglect Procedure.

It should be noted that a family member who sexually abuses a child or young person within their family, may also be a child or young person. See Sexual, Physical and Emotional Abuse by Children and Young People of other Children and Vulnerable Adults Procedure for more information.

As well as children and young people, vulnerable adults are also at risk from sexual abuse from family members. If you suspect that a vulnerable adult within a family is being abused, you should report your concerns immediately to Adult Social Care (0114 273 4908) or South Yorkshire Police (0114 220 2020).

For more information see Referrals Procedure.

2. Definitions

Sexual Abuse

Working Together to Safeguard Children defines sexual abuse as follows:

Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet). Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children.

Intra-familial Sexual Abuse

Intra-familial sexual abuse is sometimes referred to as incest, which is defined as:

'Sexual relations between people classed as being too closely related to marry each other' (Oxford English Dictionary)

Under the law, a child or young person is categorised as a child until their 18th birthday. For the purposes of safeguarding children and young people, therefore, a family member who involves a child or young person in (or exposes them to) sexual behaviour/s, is committing intra-familial child sexual abuse. 

Sexual behaviour between family members is illegal, even though this may take place between apparently consenting adults, including a step- parent. The context and history of such a 'relationship' should be fully explored as part of any investigation / assessment. Section 15, Relatives who cannot Marry, provides information about which relatives cannot marry and, therefore, cannot be involved in any sexual contact.

Rape

Offences committed before 1 May 2004 are prosecuted under the Sexual Offences Act 1956. Under the 1956 Act, the statutory definition of rape is any act of non-consensual intercourse by a man with a person, and the victim can be either male or female. It does not include non-consensual oral sex. Offences committed on or after 1 May 2004 are prosecuted under the Sexual Offences Act 2003. The 2003 Act extends the definition of rape to include non-consensual oral sex. The 2003 Act also changes the law about consent and belief in consent. 'Consent' in relation to rape is now defined in the Sexual Offences Act 2003. A person consents if he or she agrees to have sex, and has the freedom and capacity to make that choice. The essence of this definition is the agreement by choice.

Rape and incest are separate offences and are distinguished by the fact that mutual consent is required for incest but not for rape. When the female is below the age of consent recognised by law however, the same act can be both rape and incest.

3. The Impact of Intra-familial Sexual Abuse on a Child or Young Person

Child sexual abuse is always traumatic for the victim. Intra-familial child sexual abuse may have an additional impact however, as family and home life is a place where all children and young people should feel safe and protected. It is also the place where the norms should be established to enable children and young people to develop healthy relationships in the future, both sexual and emotional. Abuse of such trust is, therefore, very significant for the victim.

Remember: there may be more than one perpetrator of child sexual abuse within a family, or extended family network.

Finkelhor et al (1985) suggested four categories to help professionals understand the impact of child sexual abuse: traumatic sexualisation, stigmatisation, betrayal, and powerlessness. Whilst these are applicable to all types of child sexual abuse, they are particularly relevant when the abuser is a family member. Each category includes the process by which the perpetrator sets up the abuse, as well as its impact on the child or young person.

Traumatic sexualisation may include:

• The abuser rewarding the child / young person for inappropriate sexual behaviour;
• The abuser giving the child / young person false ideas about sex and sexuality;
• The abuser conditioning the child / young person's sexual behaviour, emotions and memories;
• The child / young person becoming confused about their sexual identity and what are sexual norms;
• The child / young person being confused about the concepts of love, sex and care-giving;
• The child / young person developing negative associations and aversion to sexual activity.

This can result in becoming preoccupied with sex; developing compulsions; involved in precocious sexual activity; aggressive sexual behaviours; promiscuity; being sexually exploited outside of the family; sexual dysfunctions; flashbacks, and phobias.

Stigmatisation may include:

• The abuser blaming the child / young person;
• The child / young person feeling guilt and shame, and seeing the shock of others at the disclosure;
• The child / young person being frightened of being blamed, and stereotyped as 'damaged';
• The child / young person becoming isolated; they may use alcohol and drugs, may self-harm and / or turn to crime.

Betrayal may involve:

• The abuser both manipulating and breaking trust of others around him / her;
• The child / young person experiencing grief, depression, impaired judgement of others, anger and hostility as a result of the betrayal;
• The child / young person becoming clingy, vulnerable to further abuse, having intimate relationship difficulties, or be aggressive and / or delinquent as a result of the betrayal.

Powerlessness may include the child / young person:

• Feeling they are unable to protect themselves;
• Being concerned that others will not believe them about the abuse;
• Adopting a victim persona;
• Having poor self esteem;
• Needing to control situations and people;
• Identifying with the aggressor;
• Having nightmares;
• Having phobias;
• Having somatic complaints (complaining of health problems that have no physical origin);
• Having an eating and / or sleeping disorder;
• Being depressed;
• Dissociating from what is happening / has happened;
• Running away from home;
• Aggression and bullying behaviour towards others;
• Becoming an abuser.

4. Other Risk Factors

There may be other factors that exist within the family, which should be considered as cause for concern for involved practitioners. These are often an attempt by the abuser to continue to conceal the abuse that is taking place within the family. It should be noted, however, that the majority of the following risk factors are not specific to intra-familial sexual abuse, and may be a feature in other situations of concern. They include:

• Frequent house moves;
• Isolation of children (and other members) within the family from professionals, and the wider community;
• Failure to register with a GP;
• Frequent absences from school;
• Failure to cooperate with agencies;
• Failure to let police, children's social care or other agencies into the home, or letting children be seen alone by professionals;
• Attempts to disguise injuries or attribute them to other causes;
• A child or young person who self-harms, misuses drugs, alcohol or solvents, and / or develops mental health problems;
• Domestic abuse within the family;
• Repeated pregnancies with no evidence of a father;
• Genetic abnormalities in children who are born;
• Repeated miscarriages or terminations due to genetic abnormalities.

5. Disclosing Sexual Abuse

Children are a key and sometimes the only source of information about what has happened to them especially in child Sexual Abuse cases but also in physical and other forms of abuse. Accurate and complete information is essential for taking action to safeguard and promote the welfare of the child, as well as for any criminal proceedings that may be instigated concerning an alleged perpetrator of abuse. When children are first approached, the nature and extent of any harm suffered by them may not be clear, nor whether a criminal offence has been committed. It is important that even initial discussions with children are conducted in a way that minimises any distress caused to them and maximises the likelihood that they will provide accurate and complete information. It is important, wherever possible, to have separate communication with a child. Leading or suggestive communication should always be avoided. Children may need time and more than one opportunity in order to develop sufficient trust to communicate any concerns they may have, especially if they have a communication impairment, learning disabilities, are very young or are experiencing mental health problems.

Paragraph 5.66 of Working Together to Safeguard Children 2010 (now archived).

As a result of the emotional trauma that the child or young person will suffer as a result of the abuse, disclosing what has happened will invariably be very difficult. The abuse will have taken place in private, and the abuser will usually be in a position of power over the child or young person. Many survivors of childhood sexual abuse do not ever reveal the abuse they suffered, or do so years later (Finkelhor et al 1990). Research carried out by the National Commission Inquiry into the Prevention of Child Abuse revealed that only about 10% had felt able to tell anyone about the abuse directly. Many others believed that they had given out enough signals to indicate that they were being, or had been abused, but that no one had asked them if they needed any help (Wattam and Woodward, 1996).

This point is key: professionals must take action if they think that a child or young person is indicating that they have been abused. Never dismiss the possibility of that abuse is taking, or has taken place, without first talking with the child or young person. Even if the child or young person denies that sexual abuse is happening, it may still be taking place.

Historical Abuse

It is not uncommon for adults to disclose intra-familial sexual abuse that happened when they were a child or young person. For a number of reasons, they may have felt unable to disclose the abuse at the time, or indeed they may have told someone but no action was taken, or evidence was not found at the time to substantiate the allegation.

In such cases it is important to consider not only the needs and wishes of the adult victim, but the likelihood of significant harm being suffered by their own children, if the perpetrator is still present within the family or extended family network.

If an allegation of historical abuse is received, you should report it to the police. If you have concerns about children who may currently be suffering or are likely to suffer Significant Harm, see Referrals Procedure.

Disclosing Sexual Abuse in Stages

Disclosing sexual abuse is incredibly difficult for anyone, but particularly if the victim is a child or young person and the abuser is a family member. The abuser will have stressed to the child or young person that they should not tell anyone about the abuse, and they are likely to have made threats about what will happen if they do tell. The child or young person may already be suffering, or have suffered, physical abuse and intimidation, as well as the sexual abuse. By the nature of what is already happening, or has happened, they are being emotionally abused as well.

Research has shown that children and young people may disclose the abuse in stages of revealing and denying it (Sorenson and Snow, 1991; Summit 1986). However, there is not much research about how disclosure takes place; there is far more about what factors may inhibit disclosure.

Other factors which may inhibit disclosure include action taken by the abuser to ensure secrecy such as blackmail and threats. These may include: not being believed, being responsible for the breakup of the family, violence and intimidation and further sexual abuse, if the victim is a parent the perpetrator may say they will have their children taken away, having to leave the family home, being responsible for the abuser going to prison, bringing shame upon the family, and / or everyone knowing about the allegations of abuse. The level of intimidation and abuse possible within a family should never be under-estimated. It is fear that usually enables the abuse to continue, with the child or young person too frightened to take action to protect themselves. Should the disclosure not be taken seriously, or action is not taken to protect them, the child / young person knows that the level of abuse will probably get worse.

The abuser, particularly if a parent, may easily be able to isolate the child or young person from a situation where s/he may reveal the abuse such as school, friends or supportive family members.

It is male family members who are most likely to be perpetrators of sexual abuse. However, the possibility that sexual abuse may be committed by a female (or who is at least be aware that the abuse is happening), or a child or young person in the family should never be ruled out.

Enabling Potential Disclosure

It is vital that you listen to what the child or young person is saying, or indicating, to you. If you think they are trying to tell you that they have been sexually abused, you must find a way to ask them, as soon as possible.

Ask them yourself, or ensure that someone that knows them better or has a closer working relationship with them, speaks directly to them.

If the child or young person denies abuse, or alternatively reveals abuse and then later retracts it, this should not be taken that abuse has not taken place. They may be frightened of the repercussions of telling someone, especially a professional. It may also be part of the process of revealing sexual abuse (see Disclosing Sexual Abuse, for more information).

If you think a child or young person wishes to make a disclosure, make sure you give them the opportunity in which they may feel able to do so. This should include:

• Finding the right physical environment where they feel comfortable and not be interrupted;
• Giving them emotional space - they should not feeling pressurised to disclose;
• Being aware of their needs;
• Ensuring they feel supported by you.

They should not be seen with the person who you suspect is their abuser. However, they should be allowed to have someone else with them when they tell you about what has happened, if they want.

When a child or young person makes a disclosure, use open questions such as 'Is everything alright?' or 'When did it happen? etc. Do not ask them leading questions such as 'It was Daddy that did this, wasn't it?'

If a disclosure is being made, ask open questions to enable it to happen. However, once you have information that indicates abuse took place and that criminal offences may have been committed, you need to take action to refer it to the appropriate agencies (see Referrals Procedure). Support the child or young person in what they are telling you, but do not encourage detailed disclosures.

You should tell the child or young person that you cannot keep the information they have given you confidential, and you should inform they what you need to do and who you need to tell. Reassure them that they have done the right thing by telling you, and that the abuse should now stop.

At the earliest opportunity, make detailed records of what has been said and what action has been taken (see Section 7, Recording Information).

Effects of Disclosure on a Non-abusing Parent or other Family Members

The child or young person will probably be acutely aware of the impact of them telling someone about the sexual abuse they are suffering at the hands of a family member. As mentioned in Section 3, The Impact of Intra-familial Sexual Abuse on a Child or Young Person. The impact of intra-familial sexual abuse on a child or young person, the abuser may take a lot of steps to ensure the continued secrecy of the sexual abuse.

A small study by Mudaly and Goddard (2006), found that most children and young people, once they had disclosed, felt supported and believed by their non-abusing parents. But the enormity of revealing the abuse to them did mean that the child or young person did not want to tell them in the first place, or talk about it afterwards. They were also frightened about possible aggressive reactions by their father, to the abuser. The research found that support from non-abusing parents, particularly mothers is an important factor in deciding whether or not to disclose abuse.

Whilst this was the findings of this specific research, it should be remembered that intra-familial child sex abusers can be any member of the family, including for example uncles, brothers or mothers.

6. What to do if you are concerned that a Child or Young Person is being Sexually Abused by a member of their own Family

Intra-familial sexual abuse, like any other type of child abuse, is a child protection issue. You do not need a direct disclosure from victims in order to take action. Having concerns, based on the indicators in Section 3, The Impact of Intra-familial Sexual Abuse on a Child or Young Person. The impact of intra-familial sexual abuse on a child or young person, are sufficient reason to report your concerns.

If you are concerned that a child or young person is likely to suffer Significant Harm, you should make a referral as soon as possible to Sheffield Safeguarding Hub.

7. Recording Information

It is vital that you make sure that you make a full record of:

• What is said, by whom, when and where;
• What you have said;
• What action you have taken;
• To whom you have referred the child / young person and when;
• What they have said to you about the referral and any subsequent action.

All paper based records should be signed, dated, and timed and include your contact details. Electronic records should automatically record time, date and who completed them, via user identification numbers used for system logins.

Open questions should be used when talking with children, young people or family members; leading or suggestive questions should always be avoided.

Caution is required about how information is recorded and shielded within the organisation / on internal systems.

7.1 Chronology

A Chronology of all concerns relating to a child or young person and their family, dated and sourced, should be recorded in the files of all concerned practitioners. A chronology lists in date order all the major changes and events in a child or young person's life. It can be a useful way of gaining an overview of events in someone's life. It should be used as an analytical tool to help practitioners understand the impact, both immediate and cumulative, that events and changes may have on the child or young person's developmental progress.

A chronology should include, for example, changes in the family composition, addresses and any moves, educational establishments and any moves, the child or young person's legal status, any injuries, periods in hospital or other medical treatment, and any disclosure of abuse.

7.2 Creating a Genogram (Family Tree)

It is good practice when working with any family to use a Genogram in developing assessments. When working with a family of whom there are concerns about the possibility of intra-familial sexual abuse, each agency file should contain a genogram. This will, at least, raise the issue of paternity at an early stage.

A genogram should include each member of the family including grandparents, step and birth parents, aunts and uncles, brothers, sisters, half and step siblings. Section 16, Genograms provides information about the different symbols used in creating genograms. A genogram is referred to as a 'pedigree' in the field of genetics.

Genograms can be hand drawn and kept in paper based files, or scanned into electronic files if the agency / professional does not have the required computer skills. Since genograms contain information about extended family members, care should be taken with confidentiality issues. Genograms can be compiled using Word or Power Point.

Individual agency genograms should be shared with the multi-agency group. This will enable any discrepancies in understanding of which family members are to be resolved and confirmed. See also Section 3, Information Sharing and Confidentiality of Underlying Principles and Values.

8. Investigating Intra-familial Child Sexual Abuse

See Child Protection Enquiries (Section 47) Children Act 1989 Procedure for more information.

A typical investigation of any allegation of abuse will include:

• Visually Recorded Interviews of the victim to record their statement in relation to the alleged incident(s);
• Forensic medical examination of the victim to determine whether there is any forensic evidence in support of the allegation;
• Paediatric medical examination in relation to the victim's physical wellbeing;
• Any other supporting evidence, including examination of the scene(s), offender's clothing, mobile phones, computers, etc.

Consideration should be given to inviting professionals to the conference such as experts / specialists in intra-familial sexual abuse, or genetics and DNA testing in situations where there have been pregnancies resulting from the abuse (see Section 9, The Role of Agencies involved in verifying Children born or Pregnancies that have resulted from Intra-familial Sexual Abuse).

An informed decision will then be taken about whether there is sufficient evidence to arrest or conduct a voluntary interview under caution with the alleged offender(s). The potential outcomes following police interview are:

• Released due to insufficient evidence;
• Released on police bail - whilst police make further enquiries;
• Released on conditional bail - whilst police make further enquiries;
• Charged to court and bailed with or without conditions;
• Charged and remanded in custody (in prison until court date).

The Crown Prosecution Service (CPS) will be involved in any decision as to whether to prosecute an alleged offender.

Two weeks prior to the court hearing, the victim will be offered the opportunity to view their visually recorded interview as a means of refreshing their memory. A court familiarisation visit will also be arranged to assist them understand the processes.

At the end of the court case, the police will start to withdraw their involvement. The victim may still require support and the appropriate partner agencies, for example Children, Young People and Families (CYPF), GP, counselling services, will continue to offer assistance, as required.

9. The Role of Agencies involved in Verifying Children Born or Pregnancies that have Resulted from Intra-familial Sexual Abuse

There are a number of different agencies that can play a crucial part in the investigation and verification of children born or pregnancies that have resulted from intra-familial child sexual abuse. These include the police, geneticists, and the Forensic Science Service - in relation to DNA testing.

It is particularly important, where there are concerns about intra-familial sexual abuse, that all the professionals who can contribute their area of expertise are consulted as part of an investigation, as it is only by bringing together all parts of the picture that the facts will emerge. Therefore it is essential that geneticists are invited to any Initial Child Protection Conference, or reviews, as appropriate.

The Police

Intimate samples can only be taken from suspects in police detention if an Inspector has reasonable grounds to believe that the sample will tend to confirm or disprove the suspect's involvement in a recordable offence, and the Inspector gives authority with the suspect's written consent. If the suspect refuses, inferences can be taken from such a refusal and the suspect should be warned that the refusal may harm his case if it comes to trial. However, a non-intimate sample could be taken without consent and the above applies. The DNA sample will tend to prove or disprove his involvement in a recordable offence as a result of intra-familial child sexual abuse. There must be samples obtained from the victim, or exhibits secured as a result of the police investigation, to be referenced against for comparison purposes.

Geneticists

Many professionals do not understand the role of clinical genetics, and how geneticists may help confirm or refute that children have been born or pregnancies conceived as a result of intra-familial sexual abuse. They may not be able to state categorically whether particular autosomal recessive conditions and disabilities are solely the result of such abuse. However, their expertise in such cases is invaluable, particularly in examining Genograms (see Section 7.2 Creating a Genogram (Family Tree)) and in relation to gene testing for specific genetic conditions. Clinical genetics services do not provide paternity testing which would be performed by the Forensic Science Service.

The Forensic Science Service

The Forensic Science Service (FSS) tests the DNA samples of suspects, which have been taken in police custody or other such settings. DNA profiling and testing are one of the most significant advances in the history of forensic science. They hold the national DNA database and are involved in the development of increasingly sensitive recording and matching systems. They also conduct paternity testing, when requested.

10. Support for the Child or Young Person

Any child or young person who has been sexually abused, especially if the perpetrator was a member of their family, is very likely to be emotionally traumatised by what has happened. Different types of therapy or other support are available, which may be useful in coming to terms with the abuse.

It is the decision of the Strategy Meeting, the Core Group (if the child or young person receives a Child Protection Plan) or the Team around the Child (if the child / young person does not receive a Plan but there is ongoing multi-agency involvement) to make a referral to the appropriate agency. However, this must be done in consultation with the wishes of the child / young person and a non-abusing parent / carer (as appropriate).

If it is known that there will be a criminal investigation or that the child will be a witness in a criminal prosecution, careful consideration should be given to ensure an investigation or trial is not impeded by therapeutic intervention. However, the needs of the child are paramount in such circumstances. For further information please see Provision of Therapy for Child Witnesses during a Police Investigation or a Criminal Trial.

11. Support for Non-abusing Family Members

It is vital that non-abusing parents / carers are given help to be able to support their children. They will probably feel very guilty about the fact that they were unable to protect their child. This will be mixed with other emotions such as anger, betrayal, particularly if the abuser is someone they have introduced to the family, such as a new partner, or if they themselves were similarly abused in their childhood. They may also feel they are being judged, by professionals and family / friends / neighbours etc. about their ability as a parent. The long term effect of such abuse on relationships with their child, other family members and future relationships may be significant, and should not be underestimated.

Siblings also need to be supported, once the disclosure of intra-familial sexual abuse has been made. The possibility that other children in the family, and the extended family network, have been abused should always be investigated by the police, jointly with Children, Young People and Families (CYPF). It is essential that non-abusing parents talk to their other child/ren once they have been told about the abuse, and would be appropriate for them to be the first to tell them if possible. If the abuser is the father of the sibling, this may cause them to question the basis of their relationship with other family members, including the abused sibling. The issue of trust within the family will be significant, as they wonder who knew what. They may also experience guilt, if they had wondered or known that abuse was taking place, but had not felt able to do anything about it.

Any subsequent trial at court and resulting sentence, whether served in prison or in the community, will have a significant impact on all of the family. Children and young people and their non-abusing parents should be given particular support at this time. This may be made significantly worse depending on the level of press coverage and public knowledge about the abuse.

12. Staff Training and Supervision

Training about intra-familial child sexual abuse is available for practitioners from Sheffield Safeguarding Partnership for Children and Young People. For further information, please visit Safeguarding Sheffield Children website or contact the SCSP Training Service on (0114) 205 3486.

Practitioners who receive disclosures about child sexual abuse, whether intra or extra familial, may be affected by what they are told. They should speak to their line manager to receive support and supervision relating to the disclosure. More in-depth supervision may be available if required via their agency. However, this should be discussed with the line manager.

13. Support Organisations

Childline website

Tel: 0800 1111

NSPCC website (National Society for the Prevention of Cruelty to Children)

Child Protection Helpline - 0808 800 5000

Free text phone for people who are deaf or hard of hearing - 0800 056 0566 free

The Samaritans website

Tel: 116 123

Sheffield Rape and Sexual Abuse Centre (SRASAC) website

Tel: 0808 802 0013

Sheffield Children Safeguarding Partnership website

Stop it Now! website

Stop it Now! UK & Ireland is a campaign, managed by the Lucy Faithful Foundation, which aims to prevent child sexual abuse by raising awareness and encouraging early recognition and responses to the problem by abusers themselves and those close to them. Tel: 0808 1000 900.

Sheffield Women's Counselling Service

Tel: 0114 275 2157 (free counselling service for young women and women aged over 16)

14. References

Finklehor, D & Browne, (1985) A. The Traumatic Impact of Child Sexual Abuse: A Conceptualization. Family Violence Research Program, University of New Hampshire, Durham.

D Finkelhor, G Hotaling, L Lewis and C Smith. Sexual abuse in a national survey of adult men and women: prevalence, characteristics and risk factors.

Child Abuse and Neglect, 1990, volume 14, pp 19-28.

Hill, A. Research Review: Child Sexual Abuse. Community Care

N Mudaly and C Goddard The Truth Is Longer Than a Lie: Children's Experiences of Abuse and Professional Interventions. Jessica Kingsley Publishers, 2006.

And do I abuse my children? No!': Learning about prevention from people who have experienced childhood abuse', in National Commission of Inquiry into the Prevention of Child Abuse.

Childhood Matters: Report of the National Commission of Inquiry into the Prevention of Child Abuse, 1998, volume 2: background papers, The Stationery Office, 1996.

How children tell: The process of disclosure in child sexual abuse. T Sorensen and B Snow. Child Welfare, 1991, volume 70, pp3-15

The child sexual abuse accommodation syndrome. R Summit. Child Abuse and Neglect, 1983, volume 7, pp177-193

Confidentiality and the social organisation of telling. C Wattam in N Parton and C Wattam (eds)

Child Sexual Abuse: Responding to the Experiences of Children. John Wiley and Sons, 1999

15. Relatives who Cannot Marry

The following people cannot marry, under any circumstances. Therefore, it is also illegal for them to have sexual relations. This is due to their blood relationship, and the increased risk of congenital disorders.

Adopted children and their genetic parents and genetic grandparents may not marry. If they do, the marriage will be automatically void, even if they do not know they are related.

Adopted children may not marry their adoptive parents but they are allowed to marry the rest of their adoptive family, including their adoptive brother or sister.

People who are step relations or in-laws may marry only in certain circumstances.

Source: Citizen's Advice Bureau - Getting Married.

16. Genograms

A Genogram is created with symbols representing the gender, with various lines to illustrate family relationships. A genogram can contain a wealth of information on the families represented. It will not only show the names of people who belong to the family lineage, but how these relatives relate to each other.

Click here to view Genogram Symbols.

The above are the most useful symbols for the genogram for families about who there are concerns about intra-familial sexual abuse. However there are other symbols available that track more detailed family relationships, emotional relationships, and medical illnesses. Genograms using medical terms or symbols may be particularly useful is there is concern that children have been conceived or born with disabilities as a result of intra-familial sexual abuse.

N.B. A genogram is known in the field of genetics as a pedigree.

Source: Wikipedia.

17. Further Information

The Centre of Expertise on Child Sexual Abuse

The Centre of Expertise on Child Sexual Abuse, is a multi-disciplinary team, funded by the Home Office, who have produced a range of resources to support professionals. These resources aim to give professionals the knowledge to identify concerns of child sexual abuse and the confidence to respond to it, not just with the child, but with the whole family.

These include:

• Key Messages from Research on Child Sexual Abuse Perpetrated by Adults (Centre of Expertise on Child Sexual Abuse);
• Signs and Indicators: A template for identifying and responding to concerns of child sexual abuse. It helps professionals to gather the wider signs and indicators of sexual abuse and build a picture of their concerns;
• Communicating with children: A guide for those working with children who have or may have been sexually abused. This guide aims to help you communicate with children in relation to child sexual abuse, including when you have concerns that such abuse is happening;
• Supporting parents and carers: A guide for those working with families affected by child sexual abuse. This guide helps professionals provide a confident, supportive response when concerns about the sexual abuse of a parent or carers child have been raised or identified;
• Safety Planning in Education: A guide to support education professionals' knowledge, skills and confidence to understand and respond to incidents of harmful sexual behaviour and ensure the safety of all children and young people is addressed;
• Helpful 12 part short film series: The CSA Centre have produced an accompanying 12-part short film series which distils key information from these resources quickly and accessibly for professionals. These films are designed for anyone whose role brings them into contact with children and young people under 18 years old or their parents or carers; including social workers, teachers, police officers, health professionals, voluntary-sector workers or faith leaders/workers – whether they are new to the role, still in training or highly experienced.

Protecting Children from Harm - A critical assessment of child sexual abuse in the family network in England and priorities for action.

Child Neglect and its Relationship to Sexual Harm and Abuse: Responding Effectively to Children's Needs - open access resource considering the potential relationship between neglect and forms of sexual harm and abuse.

'Making Noise: Children's Voices for Positive Change after Sexual Abuse' - Children's experiences of help-seeking and support after sexual abuse in the family environment.

Preventing Child Sexual Abuse: The Role of Schools - examines the important role schools can play in enabling children to recognise abuse.

Measuring the Scale and Changing Nature of Child Sexual Abuse and Child Sexual Exploitation - Scoping Report July 2017, Professor Liz Kelly and Kairika Karsna (Centre of Expertise on Child Sexual Abuse)

Investigating Child Sexual Abuse - examines timescales for sexual abuse prosecutions and makes recommendations.

Therapeutic Services for Sexually Abused Children and Young People Scoping the Evidence Base, Prepared by Debra Allnock and Patricia Hynes Summary Report December 2011.