A global review finds children who take part in school programs to prevent sexual abuse are more likely to report it.
For the review, published in the Cochrane Database of Systematic Reviews, researchers examined published studies covering nearly 6,000 elementary and high school children in several countries around the world.
They found that of those children who received education in how to prevent sexual abuse, around 14 in 1,000 disclosed some form of sexual abuse, compared with 4 in 1,000 of children who did not receive it.
However, lead author Kerryann Walsh, an associate professor in the faculty of education at Queensland University of Technology in Brisbane, Australia, and colleagues note their results should be interpreted cautiously because of the "moderate" quality of the evidence.
They also conclude more research is needed before it can be said that school-based programs can actually reduce the incidence of sexual abuse.
Estimates suggest that worldwide at least 1 in 10 girls and 1 in 20 boys experiences sexual abuse. Children who experience sexual abuse are more likely to become victims of sexual assault when they grow up. They are also at higher risk of health and other problems in later life, including depression, suicide, eating disorders, drugs and alcohol.
Several countries - some since the 1980s - run school-based sexual abuse prevention programs that teach children how to recognize, react to and report sexual abuse. The review included data on 24 studies covering a total of 5,802 elementary and high school children in seven countries: the US, Canada, China, Germany, Spain, Taiwan, and Turkey.
Programs used various methods to teach children how to stay safe
The studies examined various types of program designed to prevent sexual abuse. These ranged from a single 45-minute session to eight 20-minute sessions on consecutive days, note the authors.
While the programs varied widely, some of the content was similar. For example, they taught the children about safety rules, body ownership, "private parts," how to differentiate between different types of touch, types of secrets, and who to tell.
The programs used various formats to deliver their messages, including film, video, DVD, theatre plays and multimedia. These were supplemented with other resources such as songs, comics, coloring books, games and use of puppets. Teaching methods also varied from rehearsal and practice to role-play, discussion, and feedback.
Prof. Walsh and colleagues found some evidence that such programs can increase children's knowledge about sexual abuse - four of the trials showed children remembered what they were taught six months later.
The review also showed that children who took part in sexual abuse education programs were more likely to try and protect themselves in a simulated abuse scenario than children without such education. The scenario involved a stranger asking them to accompany them out of the school.
The authors found little evidence that children experienced unnecessary worry or anxiety after taking part in the programs, and there were no reported adverse side effects.
Further research needed to assess whether the programs prevent sexual abuse
In discussing their findings, the researchers explain the difficulties of trying to assess whether children have grasped the skills required to keep themselves safe and report abuse. "Even if a child demonstrates that they know how to behave in a certain scenario, it doesn't mean they will behave the same in a real situation where there is potential for abuse," states Prof. Walsh.
She explains that role plays using actors and research assistants cannot mimic real life situations. For example, we know that most sexual abuse is perpetrated by someone the child already knows.
In conclusion, the researchers say their findings support the need to inform children and protect them against sexual abuse. However, they urge that research needs to continue to evaluate sexual abuse prevention programs in schools and explore whether they actually prevent sexual abuse. Prof. Walsh concludes:
"To really know whether these programs are working, we need to see larger studies with follow-up all the way to adulthood."
In October 2014, Medical News Today learned of a study that found childhood psychological abuse is as harmful as sexual or physical abuse. Researchers suggested that children who experience emotional abuse and neglect face similar and sometimes worse mental health problems as children who suffer physical or sexual abuse.