Concern for the safety and welfare of vulnerable patients in our care has always been and continues to be important to Providence Alaska Medical Center caregivers.
Our job as adults and health care professionals is to protect children and to maintain standards that keep children safe within our community and hospital. Sadly, even when hiring processes and background checks are correctly performed and policies for reporting abuse are properly followed, abuse may still occur.
When we hear that a child has been harmed by sexual abuse, we feel anger at the perpetrator. Our anger increases when we learn, as in many cases, the abuse happened more than once.
According to the resource book "Children Can't Protect Themselves: It's Your Job," sexual abuse affects at least 20 percent of children in the United States. This is an alarmingly high number. As adults, we can all help reduce the prevalence of childhood sexual abuse by educating ourselves about myths related to abuse, strategies for prevention and how to respond to reports of abuse.
One of the biggest myths of child sexual abuse is the myth of "stranger danger." We teach children to be distrustful of strangers and to be aware of external dangers. In reality, children are most often sexually abused by adults they know and trust.
Another myth is that somehow children are at fault or responsible for sexual abuse. This is never the case. Perpetrators are responsible when they abuse children and should be held accountable. And adults as caregivers are responsible for protecting children. To do so, we must all understand how to keep our community safe.
The most important strategies for prevention of child sexual abuse include:
• Creating safe places for children, and diligently checking the background of those who work with children;
• Ensuring that adults who work or interact with children act in transparent ways. Adults who look for opportunities to spend time alone with children or who do not follow appropriate protocols, can compromise a child's safety by exploiting their vulnerability; and
• Paying attention to anyone who bends boundaries with children. Just as children should be believed when they talk about sexual abuse, adults should speak up about situations and behaviors that make them uncomfortable.
Another strategy is talking with children to make sure they know what kind of touching is acceptable and not acceptable. Parents and adult caregivers are responsible for initiating this conversation. Children also must hear from parents that no one should ever ask them to keep secrets about inappropriate touching.
The first step in recognizing abuse is learning how children disclose that something has happened to them. Children do not talk about sexual abuse until they feel safe to do so. There are a number of factors that keep children from disclosing, including fear, guilt and shame.
Children have difficulty disclosing because the abuser may be a trusted adult and the child does not feel they will be believed. Children are also unlikely to report sexual abuse to their parents. Since children have difficulty disclosing, we all must be prepared and open to listen to what children say and pay close attention to their words and behaviors.
In a recently completed study called "Test Balloons" published in "Child Abuse and Neglect, The International Journal," researchers found that children often put out verbal "test balloons" to see if it is safe to talk about abuse. The study found that children are likely to disclose when adults are open to the child and pay close attention to what they say without cutting the child off or making assumptive responses.
Listening is crucial and communicates support. Listening, believing and support – especially from a parent – increase the likelihood that a child will recover from the trauma of sexual abuse.
At Providence and other medical care facilities, we are required by law to report any concern or suspicion of abuse of a child under 18 to Child Protective Services. Supervisors support reporting and train caregivers on how to report in a way that keeps children safe.
Understanding the myths, following the strategies for prevention and responding and reporting cases of suspected child sexual abuse can help us all work toward the goal of a safer community for our children. Children are vulnerable. It's our responsibility as adults to keep them safe.
Adam Muhr serves as manager of Alaska CARES, an outpatient clinic of Providence Alaska Medical Center that provides sexual and physical abuse evaluations for children.
The views expressed here are the writer's own and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary(at)alaskadispatch.com.