Application of a child abuse prevention programme in an educational context

Aplicación de un programa de prevención del maltrato infantil en el contexto educativo

 

 

Juan M. Moreno-Manso, Elena García-Baamonde, Macarena Blázquez-Alonso y José M. Pozueco-Romero

Department of Psychology, Faculty of Education, University of Extremadura (Spain)

Correspondence

 

 

---

ABSTRACT

This study analyses the effectiveness of a child abuse prevention programme in an educational context. The proposal for action is based on the use of stories as an instrument of primary prevention. The programme aims to improve a child's capacity to face potentially threatening situations and was applied in 10 primary schools of Extremadura (Spain) to 317 pupils aged 9 and 10 years old. There were 12 sessions whose aim was for the children to gain an awareness of abuse, identify situations of abuse and learn strategies to face them. This was done through the use of tutorials and by linking the programme to the aims of the pupils' educational stage. The evaluation of the programme shows that the pupils in the experimental group resolved the situations with increasing skill, confidence and determination; and that they could see more clearly where to look for help in terms of protection measures. The tutors evaluated the programme positively, considering the contents useful for prevention.

Key words: child abuse; primary prevention; programme; education context.

---

RESUMEN

El estudio analiza la eficacia de un programa de prevención del maltrato infantil en el contexto educativo. La propuesta de actuación parte de la utilización del cuento como instrumento para la prevención primaria. El programa trata de mejorar las capacidades de los niños para enfrentarse a situaciones potencialmente amenazantes. El programa fue aplicado en 10 colegios de Educación Primaria de Extremadura (España), a un conjunto de 317 alumnos de 9 y 10 años. Se estructura en 12 sesiones en las que se trata de que los niños tomen conciencia del maltrato, identifiquen situaciones de abuso y aprendan estrategias de afrontamiento, utilizando para ello la acción tutorial y vinculando el programa a los objetivos de la etapa educativa de los alumnos. La evaluación del programa, demuestra cómo los alumnos del grupo experimental resuelven las situaciones con mayor habilidad, confianza y firmeza, y tienen más claro cuáles son las fuentes de ayuda a las que recurrir como medida de protección. Los tutores valoran positivamente el programa, considerando los contenidos útiles para la prevención.

Palabras clave: maltrato infantil; prevención primaria; programa; contexto educativo.

---

 

Introduction

Child protection should concentrate its efforts on eliminating situations of abuse. This supposes the setting up of very different types of intervention programmes, among which the following are included: programmes aimed at rehabilitation treatment for parents/carers; recuperation programmes for minors who have suffered abuse; programmes to incorporate some victims to other institutional or family environments, or those for whom affective ties have to be reestablished; and prevention programmes aimed at eliminating the negative conditions that predispose minors to abuse or provide the spark to set it off, while also encouraging favourable conditions to avoid it, with the aim that new situations of abuse should not appear. It is in this latter type of programme, the prevention programmes, where the greatest efforts should be made, since they allow the conditions of risk to be minimised and measures of protection against child abuse to be developed.

Prevention is one of the most difficult themes to evaluate, both in its applicability and its effectiveness. It is, however, the most effective alternative to avoid the suffering and negative consequences of child abuse (Costa, García & Morales 1997; Mersky, Topitzes & Reynolds, 2011; Patno, 2011; Topping & Barron, 2009).

Prevention programmes of child sexual abuse proliferated in the U.S.A. and Europe during the 1980s (Brassard, Tyler & Kehle, 1983; Daro, 1991; Hébert, Lavoie, Piché & Poitras, 2001; Kolko, 1988; Plummer, 1999; Roberts & Miltenberger, 1999). The consideration of sexual abuse as a fundamental priority at the research and treatment level for minors meant that many resources were dedicated to prevention (Finkelhor, 2007; Pereda, Guilera, Forns & Gomez-Benito, 2009). Some programmes were aimed at educating the child population in general, considering all children as potential victims, to recognise, avoid and control the possible situations of abuse that could occur. These programmes were also aimed at making children aware of the existence of sexual abuse, providing them with the means to avoid it (Conte, 1985; Kenny, 2010; Liang, Bogat & McGra, 1993; Rispens, Aleman & Goudena, 1997; Taal & Edelaar, 1997; Tutty, 1992). From among these programmes, special mention can be made of those that were carried out in the context of education. One example is the programme carried out by Borkin and Frank (1986), based on the use of puppets to educate children between three and five years of age with respect to "inappropriate touching". In another, the authors Hazzard, Webb, Kleemeier, Angert and Pohl (1991) applied the programme "Feeling Yes, Feeling No" over three sessions to children in the third and fourth courses of primary education, comparing the results with a control group. Fryer, Kraizer and Miyoshi (1987) did the same with children in the first and second courses of primary, using role-play as the procedure for learning self-protection skills. Ray and Dietzel (1984) used audiovisual methods (films and slides) as a prevention technique with children in the third course.

Most of the programmes carried out in the educational context have focused on: the self-protection of the children, making them aware of their rights and their capacity to reject sexual abuse and to report it; helping them to identify the danger signs, to label contexts and behaviours, to reject inappropriate touching, to look for adult support, and to discriminate between those secrets that can be kept from those that should not (Johnson, 1994).

Yet the fact that children increase their capacity to recognise a situation of child abuse is not enough in itself; it is also necessary that they be adequately capacitated to face such situations (Kenny, Capri, Thakkar-Kolar, Ryan & Runyon, 2008; Kenny, 2010). Abuse may occur in many different ways, so prevention programmes may be useful for some forms of abuse but not for others (Reppucci & Haugaard, 1989, Melton, 1992). The efforts on the preventive level should place greater emphasis on promoting individual skills that can be applied in real life (will the children be able to put the skills they have learnt for their self-protection into practice?) and on the evolutive perspective (are the contents adapted to the child's age?). In this way, a prevention programme may be useful for a particular age, but not for another, and it should have continuity in time, being implemented in successive stages that adapt to the child's evolutive changes.

While prevention programmes have dedicated special attention to sexual abuse because of both the long- and short-term consequences it has on the children (Berliner & Elliot 2002; Kilpatrick et al., 2003; Noll, Trickett & Putnam, 2003; Paolucci, Genuis & Violato, 2001; Tyler, 2002), it can be seen that interventions with respect to prevention of other forms of child abuse are scarce (Fanslow, Robinson, Crengle & Perese, 2007; Fergusson, Horwood & Lynskey, 1997; Fergusson, Horwood & Woodward, 2000; Finkelhor, 1994; Moreno, Garcia-Baamonde & Blazquez, 2011; Mullen, Martin, Anderson, Romanos & Herbison, 1996; Patno, 2011; Silverman, Reinherz & Giaconia, 1996). Such is the case of physical neglect or emotional abuse. It is worth noting that, in spite of the fact that physical neglect is currently considered the most widespread form of abuse, a lack of knowledge concerning the factors that are involved in this form of abuse is still very high, and this in turn makes prevention more difficult (Black, Heyman & Smith, 2001; Johnson, 2002; May-Chahal & Cawson, 2005).

The impact of physical neglect or emotional abuse can have physical and psychological consequences just as important as those caused by other forms of child abuse which may be more easily detected (Eckenrode, Laird & Doris, 1993; Moreno, 2002a; Moreno, 2003; Stevenson, 1998; Yates & Wekerle, 2009). For all the above reasons, we believe that it is necessary to act on all forms of abuse in the sphere of primary prevention.

As pointed out by Ayoub and Jacewitz (1982), Ayoub, Jacewitz, Gold and Milner (1983), Gibson and Leitenberg (2000), Hammond (2003), Prieto (2005), and Zwi et al. (2007); the educational context is, without a doubt, an ideal arena for prevention, although it is not necessarily the best nor the only one. Preventive intervention should be based on standardised contexts and the role of the teaching staff is relevant for working on prevention, detection and notification of situations concerning child abuse. Professionals in the education sector have privileged access to different aspects of the underage population and they are direct observers of the minors. Certain parental practices which are a risk factor can be detected in schools through observation by the staff of the effects such factors have on the minors in question.

Thus, we decided to design a programme to be carried out in the educational context, based on the use of stories as a resource for prevention. The telling of a fantasy tale has always had a willing audience. Stories excite the child's interest, provide relaxation against the tensions of daily life, encourage imagination and teach children to listen, think and speak. From a more technical point of view, the possibilities that this type of story offers for dramatisation and revitalisation, as well as the facility with which it can be adapted to children's different interests and evolutive moments makes it the ideal element for the prevention of child abuse. Stories can evolve from being a written or narrated tale to a game or lived experience. It can even include interaction in the form of a sequence of movements and actions. If, in addition to all this, we take into account the possibility of creating a story especially for the occasion, or that the children themselves can create a story through play, then we have a wide range of possibilities.

The programme is based on the knowledge of some of the variables that have been shown to have a tendency to predict the appearance of situations of child abuse. The question is to reduce the child's vulnerability to abuse, without losing sight of the complex, interactive and multi-factorial reality of each situation, as well as the different forms of child abuse that may need to be faced. In general, the aim is to avoid minors falling into a situation where there is a risk of abuse. The children should increase their knowledge with respect to abuse and they should be given strategies for reacting to potentially threatening situations. The children should be provided with personal resources, encouraging individual competences that can allow them to face potential abuse through reflecting on the problem, becoming aware of the risk it supposes and open discussion of their own feelings. We must teach the child to identify the situations, to say no when faced with threatening questions, strategies to resolve problems and to take decisions, and practical measures of self-protection. We must also favour the child's communication skills, skills that will encourage communication within the family and in the school.

In short, the aim of the programme was to improve the children's capacity to face potentially threatening situations and to successfully overcome them. In the short term, the prevention programme aims to provide children with greater knowledge concerning child abuse, as well as providing more resources to face this type of situations. In the long term, the aim is to contribute to the decrease of the prevalence of child abuse in all its forms.

 

Methods

Participants

The prevention programme was applied in ten primary schools in the Region of Extremadura (Spain). It was applied to 9 and 10-year-old pupils. The sample was made up of 317 children divided into two groups selected at random. The first group was made up of 176 pupils (85 boys and 91 girls) who underwent the prevention programme; while the second group, made up of 141 children (76 boys and 65 girls), did not participate in the programme. None of the children in either group were institutionalised in a children's home or under supervision of the social services child protection department. Neither was there any previous record concerning any other minor belonging to the same family in a situation of neglect.

Instruments

The programme (Moreno, Sánchez & Alcántara, 2006) was built around twelve sessions, in which the aim was for the children to gain an awareness of child abuse, identify situations of abuse and learn strategies to face such situations. The children were given basic knowledge of the main types of child abuse (physical and emotional abuse, physical and emotional neglect and sexual abuse) through the telling of stories and their representation. They were shown how to recognise the sentiments of others, what the causes and consequences of some forms of abuse are, how feelings influence people's behaviour, how to verbalise and represent feelings in diverse situations through role-playing, and how to become aware of the sentiments and needs of others.

The contents were worked on in 12 sessions, distributed as follows (table 1):

 

Procedure

First of all, before contacting the educational centres, the pertinent authorisation was obtained from the competent authority in educational matters of the Region of Extremadura (General Management of Education Policy). The schools were then contacted in writing, enclosing information about the programme to be undertaken. A meeting was also requested with the staff in charge of the school in which the management team of the school was informed in detail concerning the programme, as well as the procedure to be followed. The selection of the children was carried out by the teachers of the state schools in which the programme was to be implanted. The parents were given prior information and their authorisation was obtained. The children for the control group were also chosen by the teachers. These children attended the same classes as the minors chosen for the experimental group and shared a similar physical and socio-economic environment. Both groups were within the same age range. The programme was implemented by teachers and psychologists specialised in the subject of child abuse.

In our experience, we believe that the ideal framework for developing the sessions is the tutorial action. This is linked to the teaching function in order to achieve the goals of education and, consequently, the objectives of the educational stage. Orienting our programme towards the tutorial function meant giving greater weight to the individualised and integral nature of teaching, which is very often lost when learning is generalised, parcelling off teaching into subjects. Considering the current importance of the theme being dealt with in this programme and that, despite the fact that current legislation states that "the tutorial and orientation of pupils will be part of a teacher's responsibilities", tutorials in Primary Education do not occur at any concrete hours; the different sessions of our programme were worked on over a period of six months. The total duration of the programme was of twenty-four hours, with one hour per week. Thus, each session of the programme took two weeks.

Each session began with a story, which is used as an essential instrument in the prevention of child abuse. It is important that each story should come alive for the pupil. The physical, psychological and behavioural manifestations of the different forms of abuse, the carer's behaviour, the consequences for the child, and the attitude of the spouse, are all stressed through the story. The children had to propose several different endings for the story, and to do so, they were asked questions such as: What do you think the character(s) did? Who did he/she ask for help? What did he/she tell them? What happened when he/she told them what he/she knew? What happened to the father/mother? They were also asked to propose characteristics, qualities and feelings for the characters in the story. They were asked to give their reactions and to propose strategies to face such problems with questions such as: What should we do if that happened to us? Who should we ask for help? The story is then represented with different endings.

The space we had was sufficiently large as to be able to carry out all the exercises included in the programme, always taking into account the number of children we were working with. The sessions ended by working on contents related to the comprehension of the theme being dealt with, or by generating other kinds of activities related to the story (drawing, plasticine, music, group work, activities to be done at home with the parents...).

At the end of each session, the contents were evaluated by making a report. The pupils, on finishing the activities proposed in each session, individually answered a series of questions dealt with previously. The evaluation report for each session, called "Check this out", allowed us to evaluate the amount of knowledge acquired by the pupils.

Below is the programming of the sessions (Table 2).

Table 3 gives an example of a story and demonstrates the importance of this resource for the prevention of child abuse in educational context.

 

Results

The evaluation of the programme was carried out at two different times: immediately after the end (post-test) and 6 months after the application of the programme (monitoring).

In order to evaluate the pupils' acquired knowledge, we compared the pupils' answers to the questions they were asked at the start and end of the programme, concerning several hypothetical situations of abuse (similar to the approach used by Wolfe, McPherson & Blount, 1986; Wurtele, Kast & Kondrick, 1988). The pupils had to say how they would react to each of the situations, and where and to whom they would go for help in case of need. The post-test allowed us to check how the children as a whole in the experimental group resolved the situations with greater skill, confidence and determination. They also had a clearer idea of the places and people to go to for help as a means of protection (Moreno et al., 2006).

Next, in table 4, we can see the global scores before and after the implementation of the programme in both the experimental and control groups. We can see the results of the programme's application through the 20 items listed. The evaluation criterion used is a scale from 0 to 3, in which 0 indicates the lack of any knowledge on the subject being dealt with in the programme and 3 indicates a high level of knowledge on the pupils' part.

Table 4 shows the effects of the implementation of the programme. The change is notable in all 20 indicators. Initially, the knowledge the pupils have concerning child abuse is 0 or 1 (none-low) and later, after the application of the programme, the score is between 1 and 2 (medium-high).

Worthy of note is the pupils' greater knowledge in such questions as: human rights, and in particular children's rights, and the importance of respecting those rights; the detection of different forms of child abuse through their indicators and/or manifestations; the possibility of resolving conflicts through non-violent means; the consequences that the different types of abuse have for children (physical, emotional, social development, etc.); the importance of the effect on parent-child relationships; how to help and support companions who have suffered experiences of this kind; developing the capacity to ask for and/or give help in child abuse situation; how to avoid and/or control possible situations of neglect; how to distinguish between respect and extreme obedience with respect to authority figures and/or figures of affection; ways to express one's feelings and emotions to others; strategies to be able to trust in others and how to ask for help from other people when we find ourselves in situations of abuse; to differentiate between the kind of secrets that should be told to a trusted adult and those that should be kept secret; the importance of reporting situations of child abuse and exploitation; and many, many more.

Similarly, table 5 shows the considerable significant differences existing between the pre-test and the post-test in the pupils of the experimental and control groups. It also includes the results of the evaluation carried out six months after the application of the programme (monitoring), in which it can be clearly seen that much of the acquired knowledge is retained.

On the other hand, the tutors evaluate the programme positively and they consider that the contents are useful for the prevention, detection and notification of child abuse situations in the school context. The results of the impact or change that the programme has exercised on the pupils are highly positive. The entire experimental group of children are capable of recognising and identifying the indicators of the five main forms of child abuse (initially the percentage was around 15%). The professionals consider the information received to be excellent. Similarly, they believe that a greater inter-institutional coordination between the social and school environments is necessary in monitoring pupils and in the return of information relating to the notifications that are made in school.

 

Discussion and conclusions

On the basis of the results, it can be seen that there are different levels of intervention to face the problem of child abuse with the approach from the educational context. The school can intervene through primary prevention activities aimed at avoiding the presence of risk factors and encouraging protective factors, promoting and spreading behaviour patterns that can counteract the situation of child neglect. Educational centres must assume actions aimed at training the pupils in strategies that minimise the probability of the appearance of situations of neglect. Such actions should be aimed at making the pupils aware of the different forms that child abuse can take, and especially, how to act when faced with this type of situation (Michelena, Pons-Salvador & Cerezo, 2001; Mas, Simo & Martinez, 2000). As pointed out by Casas (1998), the most effective procedure to prevent child abuse is the use of services aimed at the entire population. Similarly, it is essential to design preventive strategies that take into account the homogeneity of the group to which they are addressed (Vega & Moor, 2013). It is precisely at this level that preventive actions can train children to handle potential situations of child abuse. That is why the integration of this type of learning transversally into the curriculum is so important (Mersky et al., 2011).

As we have seen, the prevention programme we have carried out has a highly positive impact on the pupils in the experimental group, increasing their knowledge of the subject and improving the skills they have to face such situations. The comparison with the control group confirms the effectiveness of the programme. The children who participated in the programme acquired greater knowledge and skills than those who received no kind of intervention. Similarly, in the monitoring evaluation after six months, evidence shows that this improvement is maintained or even further improved with the passage of time.

One of the programme's strong points has been the use of stories for primary prevention in educational centres. The usefulness and great potential of stories in primary education for the prevention of child abuse must be stressed. At first, as the subject is one with such considerable emotional connotations, the centres were reluctant to apply the programme. The teaching staff, orientation teams and parents all expressed their worries. Later, once the contents of the programme (appropriate to the children's age of maturity) and the procedure (the use of stories as a resource), the adequacy of the contents to the children's language skills, that unnecessary fears would be avoided and that there would be no interference with parental functions were known, the programme was given the green light. The materials that we used for the work have a narrative structure which allowed a story to be followed and are especially attractive. The programme uses illustrated stories with characters that capture the children's attention and which are remembered later. This provides the children with a framework in which learning makes sense. The pupils' contributions were collected and commented on.

Stories have the power to entertain us, make us excited, and help us to understand the world around us and our own feelings. They make communication easier and help us to express ourselves. They provide us with new experiences and new things to learn, and make it possible for us to go beyond our limitations. They are part of a language of fantasy that children of all ages can understand and enjoy. There is, however, one proviso; teachers must always keep in mind the chronological age of the children, adapting their language to the evolutive stage the children are going through to make understanding as easy as possible. We need to be sensitive to the evolutive stage of the children at all times, when introducing new contents, adapting the information to the evolutive characteristics of the age group to which it will be applied. One of the main difficulties of such a programme as this one is precisely the presentation of such a complex phenomenon as child abuse, adapting it to their level of cognitive and emotional development, so that they can understand it (Finkelhor, 2007).

For this reason, the programme was designed, in format, duration and presentation, to be attractive and motivational for the children. Feelings of anxiety or fear on the children's part during the sessions were avoided at every moment. The sessions lasted 45-50 minutes and the activities were varied and adequate for their ages. The activities were not only aimed at acquiring knowledge for self-protection, but also at teaching strategies aimed at stimulating the children's self-confidence and assertiveness. They learnt to discriminate between situations in which they could be assertive and situations where they could not, or when they should defend their rights, generating changes in the children's behaviour when faced with threatening situations.

With this programme, we have tried, as far as possible, to resolve several of the limitations inherent to any primary prevention measure. One of the main difficulties prevention programmes must face is how to measure the changes in the children's behaviour due to their participation in the programme. Several researchers cast doubt on the effectiveness of prevention programmes, stressing the difficulty of putting the acquired knowledge to use in a real situation (Berrick & Gilbert, 1991; Finkerhor, 2007; Krivacska, 1990; Melton, 1992).

Finkelhor and Baron (1986), Finkelhor and Dziuba-Leatherman (1995), Hébert, et al. (2001), Kolko (1988), MacIntyre and Carr (1999), Reppucci and Haugaard (1989) and Sylvester (1997), all consider that such programmes should concentrate on the teaching of strategies that can be applied in real situations. Thus, our programme has stressed the teaching of skills that can be applied in real life, training the pupils to learn answers and strategies to face real situations, practicing the strategies in simulations and stressing interpersonal and intrapersonal skills as well as the solutions to problems.

Neither should we forget that the long term evaluations of the prevention programmes demonstrate that children tend to forget some of the important questions that they have been taught (Berrick y Barth, 1992; Carroll, Miltenberger & O'Neill, 1992; Croteau, Hébert & Lavoie, 1998; Finkelhor & Strapko, 1992; MacMillan, MacMillan, Offord, Griffith & MacMillan, 1994; O'Donohue, Geer & Elliott, 1992; Rispens, Aleman & Goudena, 1997).

As pointed out by Weatherley, Siti Hajar, Noralina, John, Preusser, Yong (2012), it would be slightly realistic to expect children to be sufficiently prepared to protect themselves against different forms of child abuse, with the implementation of the programme in a single moment in time. That is why the repetition of the contents in the different evolutive stages is so important as a reinforcement strategy (Kenny et al., 2008). In this sense, the programme was designed to incorporate the training within the regular school curriculum, with the aim of periodically revising the acquired knowledge and reinforcing the content dealt with, including reinforcement sessions every so often to facilitate the retention of the material. As in Briggs and Russell (1994) and Kenny et al. (2008), we stress the importance of integrating the contents dealt with in the daily teaching as a measure to assist in the retention of knowledge. That is why taking the educational and curricular project of the centres into account is so important.

As for the age when the programme should be implemented, various studies stress the difficulties that pre-school children have to extract and understand some of the contents dealt with in prevention programmes (limitations in cognitive and moral development). They also stress the benefits for primary and secondary school children (Faller, 1988; Garbarino, 1987; Tutty, 1992, 1994). Although children can become victims at any age, the age group at greatest risk would seem to be the 7 to 13-year-olds (MacLennan, 1993; U.S. Department of Health and Human Services, Administration on Children, 2009). That is why we consider children aged 9 and 10 to be the optimum age for participating in the programme. At this age, the children are sufficiently mature to take on the matter in hand. On the other hand, in our programme, we have adapted the contents to the children's evolutive level, transmitting the information in a manner suited to their age and with a minimum risk of negative emotional reactions. The information was transmitted prudently, at all times avoiding the assumption on the children's part that interpersonal relationships would be threatening, which could generate anxiety and a rejection of contact with others. In order to facilitate comprehension, the verbal information transmitted was associated with graphic representations (images) while, in the various activities carried out in each session, the contents were repeated to reinforce the message and make it clear.

Finally, we would like to stress the importance of involving the parents in primary prevention programmes, as this increases their effectiveness (Burgess & Wurtele, 1998; Finkelhor, Asdigian & Dziuba-Leatherman, 1995a; Maiquez, Blanco-Villasenor, Rodrigo & Vermaes, 2000; Weatherley et al, 2012; Wurtele & Kenny, 2008). The developed programme has probably benefitted from the involvement and participation of the parents, as far as several of the activities carried out are concerned, strengthening the knowledge acquired by the children.

As pointed out by Brassard, Tyler and Kehle (1983), Conte, Rosen, Saperstein and Shermack (1985), Deblinger and Heflin (1996), Deblinger and Runyon (2005), Finkelhor, Asdigian and Dziuba-Leatherman (1995b), Moreno (2002b), the effectiveness of a programme of this kind depends on the active participation of both parents and teachers. Primary prevention based on the strengthening of parental competences and on awareness campaigns aimed at the general population are necessary (Budin & Johnson, 1989; Rosenberg & Reppucci, 1985). However, we believe that measures aimed at the professionals who are in daily contact with children and who have the duty to assume the protection of the children's rights are even more important. Throughout their professional careers, many teachers have probably been in contact with children who have suffered some form of abuse, recognising the presence of indicators and/or manifestations of the effects of such abuse on the minors themselves. As persons who act as references for their pupils and as someone who knows about child development, they logically become good observers of possible situations of neglect. It is the area educational advisory team (psychologists, educationalists, physicians, social workers and speech therapists), together with the centre's orientation advisor, who have the responsibility of evaluating the minor's situation, providing the protocol to be followed and reporting the detected case to the competent authority in the protection of minors.

In short, in spite of the limitations inherent to a primary prevention programme, the implementation of our programme has allowed us to increase the knowledge children have concerning child abuse, teaching them ways to resist and escape from abuse, encouraging the reporting of such abuse, strengthening the children's sense of control and facilitating the available resources of support and protection. As in Besten (1997), Del Campo and López (2006) and Kenny (2010), we believe that it is a priority for children to learn to protect themselves, that they have people beside them they can trust and that there are prevention resources available.

As pointed out by Mersky, Berger, Reynolds, y Gromoske (2009), there is still limited knowledge about the effectiveness of prevention programmes in the different forms of child abuse, and a shortage of interventions with a proven effect. Most evaluations of prevention initiatives have suffered significant methodological limitations (Reynolds, Mathieson & Topitzes, 2009; Topping & Barron, 2009).

Therefore, our programme aims to be an open and adaptable method which can allow further development and encourage new, better coordinated and more effective intervention and prevention proposals. In no event will providing the child with tools to face child abuse replace the responsibility of society to ensure the protection of minors (Zwi et al., 2007).

 

References

1. Ayoub, C. & Jacewitz, M. M. (1982). Families at risk of poor parenting a descriptive study of sixty at risk families in a model prevention program. Child Abuse & Neg/ect, 6, 413-422. Doi: 10.1016/0145-2134(82)90085-0        [ Links ]

2. Ayoub, C., Jacewitz, M. M., Gold, R. G. & Milner, J. S. (1983). Assessment of a program's effectiveness in selecting individuals at risk for problems in parenting. Journal of Clinical Psychology, 39, 334-339. Doi: 10.1002/1097-4679(198305)39:3<334:AID-JCLP2270390306>3.0.CO;2-9        [ Links ]

3. Berliner, L. & Elliot, D. M. (2002). Sexual abuse of children. Thousand Oaks, CA: Sage.         [ Links ]

4. Berrick, J. D. & Barth, R. P. (1992). Child sexual abuse prevention: research review and recommendations. Social Work Research and Abstracts, 28, 6-15.         [ Links ]

5. Berrick, J. D. & Gilbert, N. (1991). With the best of intentions. New York: Guilford Press.         [ Links ]

6. Besten, B. (1997). Abusos sexuales en los niños. Barcelona: Herder.         [ Links ]

7. Black, D.A., Heyman, R.E. & Smith, A.M. (2001). Risk factors for child physical abuse. Aggression and Violent Behavior, 6, 121-188. Doi: 10.1016/S1359-1789(00)00021-5        [ Links ]

8. Borkin, J. & Frank, L. (1986). Sexual abuse prevention for pre-schoolers: a pilot program. Child Welfare, 65, 75-82.         [ Links ]

9. Brassard, M. R., Tyler, A. H. & Kehle, T. J. (1983). School programs to prevent intrafamilial child sexual abuse. Child Abuse & Neglect, 7, 241-245. Doi: 10.1016/0145-2134(83)90075-3        [ Links ]

10. Briggs, F. & Russell, M. F. (1994). Choosing between child protection programmes. Child Abuse Review, 3, 272-284. Doi: 10.1002/car.2380030406        [ Links ]

11. Budin, L. E. & Johnson, C. F. (1989). Sex abuse prevention programs: Offenders' attitudes about their efficacy. Child Abuse & Neglect, 13, 77-87. Doi: 10.1016/0145-2134(89)90031-8        [ Links ]

12. Burgess, E., & Wurtele, S. (1998). Enhancing parent-child communication about sexual abuse: A pilot study. Child Abuse & Neglect, 22(11), 1167-1175. Doi: 10.1016/S0145-2134(98)00094-5        [ Links ]

13. Carroll, L. A., Miltenberger, R. G. & O'Neill, H. K. (1992). A review and critique of research evaluating child sexual abuse prevention programs. Education and Treatment of Children, 15, 335-354.         [ Links ]

14. Casas, F. (1998). Infancia: perspectivas psicosociales. Barcelona: Paidós.         [ Links ]

15. Conte, J. R., Rosen, C., Saperstein, L. & Shermack, R. (1985). An evaluation of a program to prevent the sexual victimization of young children. Child Abuse & Neglect, 9, 319-328. Doi: 10.1016/0145-2134(85)90027-4        [ Links ]

16. Costa, M., García, M. & Morales, J.M. (1997). Child abuse prevention. Psychology in Spain, 1, 3-9.         [ Links ]

17. Croteau, P., Hébert, M. & Lavoie, F. (1998). L'evaluation des programmes de prevention des abus sexuels au préscolaire. Revue Sexologique, 6(2), 9-32.         [ Links ]

18. Daro, D. (1991). Child sexual abuse prevention: separating fact from fiction. Child Abuse & Neglect, 15, 1-4. Doi: 10.1016/0145-2134(91)90084-Q        [ Links ]

19. Deblinger, E., & Heflin, A. H. (1996). Treating sexually abused children and their nonof-fending parents: A cognitive behavioral approach. Newbury Park, CA: Sage Publications.         [ Links ]

20. Deblinger, E., & Runyon, M. K. (2005). Understanding and treating feelings of shame in children who have experienced maltreatment. Child Maltreatment, 10, 364-376. Doi: 10.1177/1077559505279306        [ Links ]

21. Del Campo, A. & López, F. (2006). Evaluación de un programa de prevención de abusos sexuales a menores en Educación Primaria. Psicothema, 18, 1-8.         [ Links ]

22. Eckenrode, J., Laird, M. & Doris, J. (1993). School performance and disciplinary problems among abused and neglected children. Developmental Psychology, 29, 53-62. Doi: 10.1037/0012-1649.29.1.53        [ Links ]

23. Faller, K. (1988). Child sexual abuse: an interdisciplinary manual for diagnosis, case management and treatment. New York: Columbia University Press.         [ Links ]

24. Fanslow, J.L., Robinson, E.M., Crengle, S. & Perese, L. (2007). Prevalence of child sexual abuse reported by a cross-sectional sample of New Zealand women. Child Abuse & Neglect 31, 935-945. Doi: 10.1016/j.chiabu.2007.02.009        [ Links ]

25. Fergusson, D. M., Horwood, L. J., & Lynskey, M. T. (1997). Childhood sexual abuse, adolescent sexual behaviors and sexual revictimization. Child Abuse & Neglect, 21, 789-803. Doi: 10.1016/S0145-2134(97)00039-2        [ Links ]

26. Fergusson, D. M., Horwood, L. J., & Woodward, L. J. (2000). The stability of child abuse reports: A longitudinal study of the reporting behavior of young adults. Psychological Medicine, 30, 529-544.         [ Links ]

27. Finkelhor, D. & Baron, L. (1986). High-risk children. En D. Finkelhor (Ed.), A soucerbook on child sexual abuse (pp. 66-80). Beverly Hills (Ca): Sage.         [ Links ]

28. Finkelhor, D. & Dziuba-Leaterman, J. (1995). Victimization prevention programs: a national survey of children's exposure and reactions. Child Abuse & Neglect, 19, 129-139. Doi: 10.1016/0145-2134(94)00111-7        [ Links ]

29. Finkelhor, D. & Strapko, N. (1992). Sexual abuse prevention education: a review of evaluation studies. In D. J. Willis, E. W. Holden & M. Rosenberg (Eds.), Prevention of child maltreatment: developmental perspectives (pp. 150-167). New York: John Willey & Sons.         [ Links ]

30. Finkelhor, D. (1994). The international epidemiology of child sex abuse. Child Abuse & Neglect, 18, 409-417. Doi: 10.1016/0145-2134(94)90026-4        [ Links ]

31. Finkelhor, D. (2007). Prevention of sexual abuse through educational programs directed toward children. Pediatrics, 120, 640-645.         [ Links ]

32. Finkelhor, D., Asdigian, N. & Dziuba-Leaterman, J. (1995b). Victimization prevention programs for children: a follow-up. American Journal of Public Health, 85, 1684-1689.         [ Links ]

33. Finkelhor, D., Asdigian, N. & Dziuba-Leatherman, J. (1995a). The effectiveness of victimization prevention instruction: An evaluation of children's responses to actual threats and assaults. Child Abuse & Neglect, 19, 141-153. Doi: 10.1016/0145-2134(94)00112-8        [ Links ]

34. Fryer, G. E, Kraizer, S. K. & Miyoshi, T. (1987). Measuring children's retention of skills to resist stranger abduction: use of the simulation technique. Child Abuse & Neglect, 11, 181-185. Doi: 10.1016/0145-2134(87)90056-1        [ Links ]

35. Garbarino, J. (1987). Children response to a sexual abuse prevention program: a study of the Spiderman comic. Child Abuse & Neglect, 11, 143-148. Doi: 10.1016/0145-2134(87)90044-5        [ Links ]

36. Gaudin, J. M. (1993). Effective intervention with neglectful families. Criminal Justice and Behavior, 20, 66-89. Doi: 10.1177/0093854893020001006        [ Links ]

37. Gibson, L., & Leitenberg, H. (2000). Child sexual abuse prevention programs: Do they decrease the occurrence of child sexual abuse?. Child Abuse & Neglect, 24, 1115-1125. Doi: 10.1016/S0145-2134(00)00179-4        [ Links ]

38. Hammond, W. R. (2003). Public health and child maltreatment prevention: The role of the Centers for Disease Control and Prevention. Child Maltreatment, 8, 81-83. Doi: 10.1177/1077559503253711        [ Links ]

39. Hazzard, A., Webb, C., Kleemeier, C., Angert, L, & Pohl, J. (1991). Child sexual abuse prevention: evaluation and one-year follow-up. Child Abuse & Neglect, 15, 123-138. Doi : 10.1016/0145-2134(91)90097-W        [ Links ]

40. Hébert, M., Lavoie, F., Piché, C., & Poitras, M. (2001). Proximate effects of a child sexual abuse prevention program in primary school children. Child Abuse & Neglect, 25, 505-522. Doi: 10.1016/S0145-2134(01)00223-X        [ Links ]

41. Johnson, B. (1994). Teacher's role in the primary prevention of child abuse: dilemmas and problems. Child Abuse Review, 3, 259-271. Doi: 10.1002/car.2380030405        [ Links ]

42. Johnson, P. (2002). Predictors of family functioning within alcoholic families. Contemporary Family Therapy, 24, 371-384. Doi: 10.1023/A:1015307626704        [ Links ]

43. Kenny, M. C. (2010). Child sexual abuse education with ethnically diverse families: A preliminary analysis. Children and Youth Services Review, 32, 981-989. Doi: 10.1016/j.childyouth.2010.03.025        [ Links ]

44. Kenny, M. C., Capri, V., Thakkar-Kolar, R. R., Ryan, E. E., & Runyon, M. K. (2008). Child sexual abuse: From prevention to self-protection. Child Abuse Review, 17(1), 36-54. Doi: 10.1002/car.1012        [ Links ]

45. Kilpatrick, D. G., Ruggerio, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the national survey of adolescents. Journal of Consulting and Clinical Psychology, 71, 692-700. Doi: 10.1037/0022-006X.71.4.692        [ Links ]

46. Kolko, D. J. (1988). Educational programs to promote awareness and prevention of child sexual victimization: A review and methodological critique. Clinical Psychology Review, 8, 195-209. Doi: 10.1016/0272-7358(88)90059-1        [ Links ]

47. Krivacska, J.J. (1990). Designing child sexual abuse prevention programs. Springfield (II): Charles C. Thomas.         [ Links ]

48. Liang, B., Bogat, A., & McGra, M. P. (1993). Differential understanding of sexual abuse prevention concepts among preschoolers. Child Abuse & Neglect, 19, 641-650. Doi: 10.1016/0145-2134(93)90085-J        [ Links ]

49. MacIntyre, D., & Carr, A. (1999). Evaluation of the effectiveness of the Stay Safe primary prevention programme for child sexual abuse. Child Abuse & Neglect, 23, 1307-1325. Doi: 10.1016/S0145-2134(99)00092-7        [ Links ]

50. MacLennan, B. W. (1993). Special issue: Group treatment after child and adolescent sexual abuse: Introduction. Journal of Child and Adolescent Group Therapy, 3, 3-11. Doi: 10.1007/BF00973639        [ Links ]

51. MacMillan, H. L., MacMillan, J. H., Offord, D. R., Griffith, L. & MacMillan, A. (1994). Primary prevention of child sexual abuse: a critical review. Journal of Child Psychology and Psychiatry and Allied Disciplines, 35, 857-876.         [ Links ]

52. Máiquez, M. L., Blanco-Villasenor, A., Rodrigo, M. J., & Vermaes, I. (2000). Efficiency of a program for family intervention. Psicothema, 12, 533-542.         [ Links ]

53. Mas, E., Simó, S. & Martínez, M. J. (2002). El papel del ámbito educativo en la detección y abordaje de situaciones de desprotección o maltrato infantil. Consejería de Bienestar Social: Generalitat Valenciana.         [ Links ]

54. May-Chahal, C. & Cawson, P. (2005). Measuring child maltreatment in the United Kingdom: A study of the prevalence of child abuse and neglect. Child Abuse & Neglect, 29, 969-984. Doi: 10.1016/j.chiabu.2004.05.009        [ Links ]

55. Melton, G. B. (1992). The improbability of prevention of sexual abuse. In D. Willis, E. Holden & M. Rosenberg (Eds.), Prevention of child maltreatment: developmental perspectives. New York: Wiley Interscience.         [ Links ]

56. Mersky, J. P., Berger, L. M., Reynolds, A. J., & Gromoske, A. N. (2009). Risk factors for child and adolescent maltreatment: A longitudinal investigation of a cohort of inner-city youth. Child Maltreatment, 14(1), 73-88. doi:10.1177/1077559508318399        [ Links ]

57. Mersky, J. P., Topitzes, J., & Reynolds, A.J. (2011). Maltreatment prevention through early childhood intervention: A confirmatory evaluation of the Chicago Child-Parent Center preschool program. Children and Youth Services Review, 33(8), 1454-1463. Doi:10.1016/j.childyouth.2011.04.022        [ Links ]

58. Michelena, A., Pons-Salvador & Cerezo, M.A. (2001). Programa experimental de prevención del maltrato infantil desde el ámbito escolar. Consejería de Bienestar Social: Gobierno de Baleares.         [ Links ]

59. Moreno, J. M. (2002a). Estudio sobre las variables que intervienen en el abandono físico o negligencia infantil. Anales de Psicología, 18, 135-150.         [ Links ]

60. Moreno, J. M. (2002b). Maltrato infantil. Teoría e investigación. Madrid: EOS.         [ Links ]

61. Moreno, J. M. (2003). Estudio sobre las repercusiones lingüísticas del maltrato y abandono emocional. Revista de Logopedia, Foniatría y Audiología 23, 211-222.         [ Links ]

62. Moreno, J. M., García-Baamonde, M.E., Blázquez, M. (2011). Design of a language stimulation program for children suffering abuse. Children and Youth Services Review, 33, 1325-1331. Doi: 10.1016/j.childyouth.2011.03.003        [ Links ]

63. Moreno, J. M., Sánchez, C. & Alcántara, A. M^a. (2006). Prevención del maltrato infantil en la familia. Programa de sensibilización escolar (9-12 años). Madrid: CEPE.         [ Links ]

64. Mullen, P. E., Martin, J. L., Anderson, J. C., Romans, S. E., & Herbison, G. P. (1996). The long-term impact of the physical, emotional, and sexual abuse of children: A community study. Child Abuse & Neglect, 20, 7-21. Doi: 10.1016/0145-2134(95)00112-3        [ Links ]

65. Noll, J. G., Trickett, P. K., & Putnam, F. W. (2003). A prospective investigation of the impact of childhood sexual abuse on the developmental of sexuality. Journal of Consulting and Clinical Psychology, 71, 575-586. Doi: 10.1037/0022-006X.71.3.575        [ Links ]

66. O'Donohue, W., Geer, J. H. & Elliott, A. (1992). The primary prevention of child sexual abuse. In W. O'Donohue & J. H. Geer (Eds.), The sexual abuse of children. Clinical Issues (vol. 1) (pp. 476-517). New Jersey: Laurence Erlbaum.         [ Links ]

67. Paolucci, E. O., Genuis, M. L., & Violato, C. (2001). A meta-analysis of the published research on the effects of child sexual abuse. The Journal of Psychology, 135, 17-36. Doi: 10.1080/00223980109603677        [ Links ]

68. Patno, K M. (2011). 64-The Prevention of Child Abuse and Neglect. Child Abuse & Neglect, 605-609.         [ Links ]

69. Pereda, N., Guilera, G., Forns, M., & Gomez-Benito, J. (2009). The international epidemiology of child sexual abuse: A continuation of Finkelhor (1994). Child Abuse & Neglect, 33, 331-342. Doi: 10.1016/j.chiabu.2008.07.007        [ Links ]

70. Peterson, L., Gable, S., & Saldana, L. (1996). Treatment of maternal addiction to prevent child abuse and neglect. Addictive Behaviors, 21, 789-801. Doi: 10.1016/0306-4603(96)00036-6        [ Links ]

71. Plummer, C. A. (1999). The history of child sexual abuse prevention: a practitioner's perspective. Journal of Child Sexual Abuse, 7, 77-95. Doi: 10.1300/J070v07n04_06        [ Links ]

72. Prieto, E. (2005). Proyecto: respuesta en red. El abuso sexual y otras formas de maltrato infantil. Una visión desde los centros escolares de la ciudad de Alcalá de Henares. Pulso, 28, 97-123.         [ Links ]

73. Ray, J. & Dietzel, M. (1984). Teaching child sexual abuse prevention. Washington: Spokane.         [ Links ]

74. Reppucci, N. D. & Haugaard, J. J. (1989). Prevention and child sexual abuse. American Psychologist, 44, 1266-1275. Doi: 10.1037/0003-066X.44.10.1266        [ Links ]

75. Reynolds, A. J., Mathieson, L., & Topitzes, J. (2009). Do early childhood interventions prevent child maltreatment?: a review of research. Child Maltreatment, 14(2), 182-206. Doi:10.1177/1077559508326223        [ Links ]

76. Rispens, J., Aleman, A. & Goudena, P. P. (1997). Prevention of child sexual abuse victimization: a meta-analysis of school programs. Child Abuse and Neglect, 21, 975-987. Doi: 10.1016/S0145-2134(97)00058-6        [ Links ]

77. Roberts, J. A. & Miltenberger, R. G. (1999). Emerging issues in the research on child sexual abuse prevention. Education and Treatment of Children, 22, 84-102.         [ Links ]

78. Rosenberg, M. S. & Reppucci, N. D. (1985). Primary prevention of child abuse. Journal of Consulting and Clinical Psychology, 53, 576-585. Doi: 10.1037/0022-006X.53.5.576        [ Links ]

79. Silverman, A. B., Reinherz, H. Z. & Giaconia, R. M. (1996). The long-term sequelae of child and adolescent abuse: A longitudinal community study. Child Abuse & Neglect, 20, 709-723. Doi: 10.1016/0145-2134(96)00059-2        [ Links ]

80. Stevenson, O. (1998). Neglect: where now? Some reflections. Child Abuse Review, 7, 111-115. Doi: 10.1002/(SICI)1099-0852(199803/04)7:2<111::AID- CAR479>3.0.CO;2-0        [ Links ]

81. Sylvester, L. (1997). Talking about Touching: Personal Safety Curricula (1996 Editions) Preschool to Grade 3. Curriculum Evaluation Summary. Seattle, WA: Committee for Children.         [ Links ]

82. Taal, M., & Edelaar, M. (1997). Positive and negative effects of a child sexual abuse prevention program. Child Abuse & Neglect, 21, 399-410. Doi: 10.1016/S0145-2134(96)00179-2        [ Links ]

83. Topping, K. J., & Barron, I. G. (2009). School-based child sexual abuse prevention programs: A review of effectiveness. Review of Educational Research, 79, 431-463. Doi:10.3102/0034654308325582        [ Links ]

84. Tutty, L. M. (1992). The ability of primary school children to learn child sexual abuse prevention concepts. Child Abuse & Neglect, 16, 369-384. Doi: 10.1016/0145-2134(92)90046-T        [ Links ]

85. Tutty, L. M. (1994). Developmental issues in young children's learning of sexual abuse prevention concepts. Child Abuse & Neglect, 18, 179-192. Doi: 10.1016/0145-2134(94)90119-8        [ Links ]

86. Tyler, K. A. (2002). Social and emotional outcomes of childhood sexual abuse: A review of recent research. Aggression and Violent Behavior, 7, 567-589. Doi: 10.1016/S1359-1789(01)00047-7        [ Links ]

87. U. S. Department of Health and Human Services (2009). Administration for children and families. Child Maltreatment, 2007. Washington, D.C: Government Printing Office.         [ Links ]

88. Vega, M. T. & Moro, L. (2013). La representación social de los malos tratos infantiles en la familia: Factores psicosociales que influyen en la percepción de las conductas de maltrato. Psychosocial Intervention, 22, 7-14. Doi:10.5093/in2013a2        [ Links ]

89. Weatherley, R., SitiHajar, A. B., Noralina, O., John, M., Preusser, N. & Yong M. (2012). Evaluation of a school-based sexual abuse prevention curriculum in Malaysia. Children and Youth Services Review, 34, 119-125. Doi: 10.1016/j.childyouth.2011.09.009        [ Links ]

90. Wolfe, D. A., McPherson, T. M., Blount, R. & Wolfe, V. (1986). Evaluation of brief intervention for edicating children in awareness of physical and sexual abuse. Child Abuse & Neglect, 10, 85-92. Doi: 10.1016/0145-2134(86)90036-0        [ Links ]

91. Wurtele, S., & Kenny, M. (2008). Primary prevention of child sexual abuse: Child- and parent-focused approaches. In K. Kaufman (Ed.), Preventing sexual violence and exploitation: A sourcebook. Oklahoma City, OK: Wood & Barnes Publishers.         [ Links ]

92. Wurtele, S. K., Kast, L. C. & Kondrick, R. A. (1988). Development of an instrument to evaluate sexual abuse programs. Atlanta: American Psychological Association.         [ Links ]

93. Yates, T. M. & Wekerle, C. (2009). The long-term consequences of childhood emotional maltreatment on development: (Mal)adaptation in adolescence and young adulthood. Child Abuse & Neglect, 33, 19-21. Doi: 10.1016/j.chiabu.2008.12.002        [ Links ]

94. Zwi, K J., Woolfenden, S. R., Wheeler, D. M., O'Brien, T. A., Tait, P., & Williams, K. W. (2007). School-based education programmes for the prevention of child sexual abuse. Cochrane Database of Systematic Reviews, 3 CD004380.         [ Links ]

 

 

Correspondence:
Juan M. Moreno-Manso
Department of Psychology
Faculty of Education
University of Extremadura
Avd. de Elvas, s/n
06006 - Badajoz (Spain)
E-Mail: jmmanso@unex.es

Article received: 9-6-2012
Revision received: 5-11-2013
Accepted: 11-11-2013