The handling by social services of suspected cases of sexual abuse of children does not differ essentially from the handling of other cases where it is suspected that children are faring badly. An investigation has to be launched as soon as anything comes to the knowledge of the social welfare committee which may require it to take action. The task of investigating, treating and supporting children and families makes heavy demands on the knowledge, competence and preparedness of those concerned. In all cases the guiding principle must be an understanding of each individual's unique personality and situation.
There are no patent solutions for the handling of these cases by social services, but, in the light of the knowledge presented in this report, the task of the social services when a suspected case of sexual abuse is reported can be summarised as follows: carrying out a swift initial investigation of the suspicion, assessing and providing for the child's need of protection and remedial measures, assessing and providing for the family's need of care and support, deciding whether or not to file a complaint with the police, assessing the possible need for information to those concerned, liaising with other authorities and consulting child and youth psychiatric services. A rule in derogation of secrecy empowers, but does not oblige, social services to report suspected cases of sexual abuse to the police.
The documentation of a case must show decisions and measures taken, actual circumstances and material events. The documentation must be drawn up with due respect for the privacy of the individual.
Section 9 of the Social Services Act requires allowance to be made for the child's wishes, "having regard to its age and maturity". This rule derives from the UN Convention on the Rights of the Child. In cases where sexual abuse comes to be suspected, it is often the child itself who relates the matter to an adult in whom it has confidence. The child's story plays a central part in the investigation.
Competent handling of cases concerning sexual abuse requires a knowledge of the symptoms, reactive patterns and effects of traumatic experiences on individuals of different ages, in the short and long term, and also a knowledge of family dynamics. Knowledge concerning normal and deviant sexuality in children and young persons is important, as well as a knowledge of problems other than sexual abuse which may underlie any symptoms. There are, however, no mental symptoms which can be unambiguously construed as indicating that a child has been sexually abused. Certain symptoms, however, may corroborate a child's story.
In order to arrive at a complete assessment of a case where it is feared that a child is faring badly, and in order to offer the child and its family the requisite support, social services are dependent on co-operation and interaction with other agencies. In suspected cases of sexual abuse, close co-operation is needed with the police, with child and youth psychiatric services, possibly with paediatric medicine and with other agencies. The Board's study of consultation groups has shown their work to be seriously undertaken, impartial and dedicated. Consultation groups confer co-ordination benefits, raise the standard of competence and enhance the security of handling procedures.
Every year in Sweden, the police receive between one and two reports of suspected sexual abuse per 1,000 children aged under 15. Swedish studies indicate that approximately seven or eight per cent of women and between one and three per cent of men have at some time during their childhood or adolescence been sexually abused.
According to international research and Swedish statistics, roughly one-third of all sexual offences are committed by young persons. About half of all adult sexual offenders have shown sexually deviant behaviour at an early age, and have committed their first offence before the age of 18.
A complex interaction of many different factors can help to explain the occurrence of sexual abuse of children. One prerequisite is the existence of a potential offender who is sexually and emotionally motivated, has deficient social competence and has little control over his or her sexual impulses. In addition there has to be a child who attracts the offender, is inadequately supervised and is incapable of warding off a sexual approach. Thus there are several obstacles which the offender has to overcome in order for an offence to take place - inward, personal barriers and safety mechanisms, outward obstacles in the situation surrounding the child, and also the child's own resistance.
Most commonly, the offender is known to the child and is part of the child's immediate surroundings. Girls run between two and five times as much risk as boys of being sexually abused. International studies show the average age of the abused children to be between about eight and ten years, but boys, generally speaking, are somewhat older than girls when sexually abused. Family factors such as substance abuse and violence in the family or failure of parental care distinctly augment the risk of vulnerability to sexual abuse.
The treatment of children and young persons who have been sexually abused is based on many different theories and employs a variety of therapeutic methods. The consensus of international research is that children who have been enabled to process their experiences in therapy generally feel better than those who have not had the opportunity of doing so.
Although research into different aspects of sexual abuse has intensified in recent decades, this is a field of study in which a great deal still remains to be accomplished. Hidden statistics make it hard, for example, to gauge the true extent and character of the problem. More research is needed in this field, not least with reference to conditions in Sweden.
The social services possess an extensive and coherent knowledge of the handling of cases of suspected sexual abuse of children, knowledge which needs to be summarised and systematised. There is also a need for development work and for a follow-up and evaluation of the different measures undertaken by social services, especially with regard to their responsibility for children in families where suspicions of sexual abuse exist but have not been confirmed.