Creating a Policy Brief to Advocate for Child Sexual Abuse Prevention and Awareness

The intent of this thesis is to examine barriers that exist regarding dialogue around child sexual abuse (CSA) and CSA prevention education (CSAPE) in early childhood settings. The end product of my research, a policy brief specific to Utah early childhood settings, focused on the knowledge, attitudes and beliefs of child care providers in licensed child care settings in the Salt Lake City region of Utah. My data collection supports the assertion that many child care providers lack the knowledge and confidence necessary to adopt policies and procedures that enhance protective measures for children and that the many child care providers are not comfortable discussing CSA with parents and/or staff. Through my analysis of best practices for CSAPE programs for child care providers, parents, and the community I ascertained that collaborative efforts of parents and educators result in the most effective protective strategies. The advantages of educating parents and child care providers about developmental norms of children and healthy sexuality is one prevention strategy considered to be best practice in preventing CSA. My collaborative work with the state Child Care Licensing Bureau Advisory Committee regarding the implementation of mandated CSA training for licensed child care providers is indicative that child care providers can work collaboratively with policy makers within the community to improve the safety of children. By raising awareness, initiating dialogue and providing training for caregivers the safety of children in early childhood settings can be improved.

Creating a Policy Brief to Advocate for Child Sexual Abuse Prevention and Awareness by Sandy Craft, BA A thesis submitted in partial fulfillment of the requirement for the degree of Master of Arts in Community Leadership Westminster College Salt Lake City, Utah April 2013 CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES ABSTRACT The intent of this thesis is to examine barriers that exist regarding dialogue around child sexual abuse (CSA) and CSA prevention education (CSAPE) in early childhood settings. The end product of my research, a policy brief specific to Utah early childhood settings, focused on the knowledge, attitudes and beliefs of child care providers in licensed child care settings in the Salt Lake City region of Utah. My data collection supports the assertion that many child care providers lack the knowledge and confidence necessary to adopt policies and procedures that enhance protective measures for children and that the many child care providers are not comfortable discussing CSA with parents and/or staff. Through my analysis of best practices for CSAPE programs for child care providers, parents, and the community I ascertained that collaborative efforts of parents and educators result in the most effective protective strategies. The advantages of educating parents and child care providers about developmental norms of children and healthy sexuality is one prevention strategy considered to be best practice in preventing CSA. My collaborative work with the state Child Care Licensing Bureau Advisory Committee regarding the implementation of mandated CSA training for licensed child care providers is indicative that child care providers can work collaboratively with policy makers within the community to improve the safety of children. By raising awareness, initiating dialogue and providing training for caregivers the safety of children in early childhood settings can be improved. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES DEDICATION For all children, everywhere, especially my grandchildren. I am working toward a world free of child sexual abuse for all of you. For my husband, Dwayne Finley for believing in my ability to achieve anything I set my mind to, for your tremendous support and for sharing my passion for child sexual abuse prevention. To my mother Patricia Ann who passed before I could achieve this milestone and left this world carrying the guilt and shame she harbored regarding my childhood sexual abuse. I love you mom, it wasn't your fault. For my daughter Tasha, for being the supportive, inspirational, amazing woman and mother that you are. To my friends, Rebecca Parr and Karen Ameloot, who helped keep my spirits high during those times when I felt overwhelmed during this process. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES ACKOWLEDGEMENTS I would like to thank my professor Peggy Cain for creating the Master of Arts in Community Leadership program and for being an inspiration to me as an aspiring community leader. I would like to thank my professor and thesis advisor, Jamie Joanou, for her patience and mentoring during my final year in the program. Thank you to Alana Kindness of the Utah Coalition Against Sexual Assault for your very important work and your mentorship during my Capstone project. Many thanks to Bobby and Nancy Craft, for planting the seeds early my life, to pursue higher education, and for believing in me. To Conrad Craft for recognizing my potential at a very young age and for encouraging me in this direction. Thank you to the Darkness to Light organization for giving me hope on my path of child sexual abuse prevention and awareness. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES Table of Contents Section I…………………………………………………………………………………1 Chapter I: Child Sexual Abuse Barriers to Prevention and Awareness ………………...1 Project and Research Objectives………………………………………………...4 Collaboration with Community Organizations………………………………….6 Personal Learning Objectives…………………………………………………....6 Chapter Two: Literature Review………………………………………………………...7 Child Sexual Abuse Prevention Perspectives for parents………………………..7 Child Sexual Abuse Prevention Perspectives for Child Care Providers………..11 Chapter Three: Data Collection………………………………………………………...16 Preliminary Interviews……………………………………………………….....16 Archival Research………………………………………………………………16 Observational Research…………………………………………………………16 Participant Survey……………………………………………………………….17 Data Analysis…………………………………………………………………....17 Survey Results…………………………………………………………………..17 Synthesis of Findings…………………………………………………………....19 Expertise & Ethical Concerns…………………………………………………...19 Section II: The Product and Discussion………………………………………………....21 Chapter Four: The Policy Brief………………………………………………………….21 Chapter Five: Learning and Career Goals…………………………………………….....26 Personal Learning Objectives…………………………………………………………....26 Recommendations………………………………………………………………………..27 How the Policy Brief Will Be Used……………………………………………………...27 Future Research Projects for CSA Prevention…………………………………………...29 Limitations……………………………………………………………………………….29 Next Steps………………………………………………………………………………..30 CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES References………………………………………………………………………………33 Appendices……………………………………………………………………………...35 A. Survey Protocol…………………………………………………………35 B. Survey Consent Form…………………………………………………...36 C. Participant Categories and Survey Questions…………………………...37 CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 1 Section I: The Proposal Chapter I: Child Sexual Abuse Prevention and Awareness One of the challenges around child sexual abuse (CSA) prevention is the inherent secrecy, taboo and shame around the issue which can lead to a lack of disclosure from victims and lack of reporting by witnesses or institutions. Some victims of CSA do not divulge for fear of the reaction(s) by their family or community as noted by Browne and Finkelhor (1986) "although silence may cause suffering for a child, social reactions to disclosure may be less intense if the event is long past." I am passionate about this issue as I am an adult survivor of CSA. As a young child I experienced first hand the emotional trauma and witnessed the irreparable damage CSA can cause children, families and communities. I have worked in the early childhood profession since 1987 and the health and well­being of children has been my primary focus. During my tenure as an early childhood educator I recognized a deficiency in the Utah early childhood profession regarding education and open communication between teachers, staff and families about CSA prevention and age appropriate healthy sexuality education. Utah is not immune to CSA. According to the Utah Division of Family Services 2011 Annual Report there were 1,887 cases of substantiated CSA. This number, however, does not take into account unreported cases. The cost of CSA to society and the victims is vast. Research indicates that 70­80% of CSA survivors report excessive drug and alcohol abuse, young girls who are sexually abused are more likely to develop eating disorders, and more than 60% of teen first pregnancies are preceded by experiences of molestation, rape or attempted rape ("Darkness to Light" n.d.). One study asserts that among male survivors, 50% have CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 2 suicidal thoughts and more than 20% attempt suicide both male and female victims are reported to be more likely to engage in prostitution (Browne & Finkelhor, 1986) and approximately 40% of sex offenders claim to have been victims of CSA ("Darkness to Light" n.d.). The impacts of CSA can be damaging to communities economically due to physical and psychological repercussions as well as financial liabilities incurred by alleged abuse. The amount of abuse settlement payments the Catholic Church has paid due to CSA committed by clergy continues to grow as the allegations persist. Over 3,000 civil lawsuits have been filed in the United States between 1984 through 2009 and over $3 billion in awards and settlements have been made ("Bishop Accountability" n.d.). One finding from a five­year study conducted by the Catholic Church around the sexual abuse scandal blamed the sexual revolution of the 1960's and 1970's for the increase in sexual abuse by priests. Another source claimed the social upheaval of the 1960's removed priestly inhibitions on sexuality and dissent (Goldstein, 2003). The outcome of the study seems to assert that it is acceptable to blame the crimes of clergy on the general public for societal trends and the evolution of less taboo around sexual behavior. Blaming is not the answer to preventing CSA. Through my research on the topic of CSA I have found studies that indicate that the epidemic is due, in part, to lack of awareness of prevention strategies in the community and prevailing attitudes of parents and families about perpetrators ("Darkness to Light" n.d.). Experts assert that 90% of perpetrators are someone the family knows and trusts and most of the parents who participated in the survey claimed they were unaware of that statistic (Hunt & Walsh 2011). Some participating parents also indicated that they learned most of what they know about CSA from the media as opposed to gaining insight CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 3 from a CSAPE program (Hunt & Walsh 2011). It is my intention to advocate for CSA prevention education (CSAPE) for adults and specifically, child care providers licensed by the Utah Bureau of Child Care Licensing. The recent highly publicized CSA scandals have brought attention to the issue more than any era in history. The Catholic Church scandal was a tipping point in the exposure of perpetrators of CSA as it brought to light the magnitude the lack of reporting for suspected and witnessed abuse as well as the tactics of organizations for protecting the perpetrators rather than the victims. The same lack of reporting and the protection of perpetrators rather than victims was exposed in the Penn State and Boys Scouts of America scandals. As more scandals are publicized it appears more victims have gained the courage to come forward. The statistics from the Catholic Church case are staggering: Thousands of Catholic clergy and religious affiliates have raped and sodomized tens of thousands of children­perhaps more than 100,000 children­since 1950. These crimes were committed in secret, and bishops nurtured that secrecy. Nearly 15,000 survivors have broken through the silence, and their accounts have created an in­depth picture of the crisis, both in their own writings and in the work of journalists and law enforcement officials. Attorneys have obtained diocesan documents that reveal additional survivor witnesses and also document parts of a huge cover­up. But for every account that is known, hundreds are not yet public. In order to understand the crisis fully and take the necessary policy actions, the in­depth testimony of individual survivors must be combined with data that capture the breadth of the crisis. The U.S. bishops have reported receiving allegations of CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 4 abuse by 5,948 priests from 1950­2010, or 5.4% of the 109,694 U.S. priests active since 1950. ("Bishop Accountability" n.d.) Project and Research Objectives It is my observation that there is a lack of CSA prevention programs being utilized and little or no implementation of policies regarding CSA prevention and awareness in child care settings. I perceive that child care providers and parents may have little knowledge regarding the signs and symptoms of CSA and lack skills and/or confidence in discussing, responding to and reporting suspected or witnessed abuse. My research will focus on successful CSA prevention and awareness strategies and translate my findings to the child care profession. I will examine current knowledge, perspectives and policies of child care providers and parents in relation to CSAPE in child care settings. I will examine archival research to establish what is considered best practice in CSAPE programs for caregivers and look at existing CSAPE programs being utilized to determine if any specifically target the needs of child care providers and early childhood educators. As an early childhood professional it is my assumption that there is a need for CSAPE programs designed to meet the needs of child care providers. I will survey child care providers in the community to determine their needs, beliefs and attitudes around CSA prevention. To date there is not a mandated training component on the topic of CSA by the Utah Bureau of Child Care Licensing. Following the analysis and synthesis of my research I will develop a policy brief based on my findings and use the brief to advocate for mandated CSAPE for licensed child care providers and eventually other youth workers in the community. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 5 As a culmination of my research I will produce an advocacy policy brief based upon the topic of CSA prevention and awareness. The policy brief is intended for an audience consisting of, but not limited to, the Utah Bureau of Child Care Licensing, the Utah Child Abuse & Neglect Council and Prevent Child Abuse Utah. I have chosen the aforementioned organizations because they are community stakeholders in advocating for child safety and wellbeing. One principal function of the Bureau of Child Care Licensing is to require mandated training for licensed child care providers with the ultimate goal being the health and safety of children in licensed child care. The Child Abuse & Neglect Council (CAN) is a committee that advocates for the elimination of child abuse and neglect. CAN is affiliated with the Division of Child and Family Services and meets regularly with stakeholders in the community regarding the safety and wellbeing of children. Prevent Child Abuse Utah is an agency that is committed to breaking the cycle of child abuse through education and training. I will present the policy brief to the prospective audience of community stakeholders in an attempt to compel them to assist me in my advocacy work to change current policy and encourage new poly be adopted that addresses CSA prevention education for child care providers. Guiding Questions The research questions guiding my project include: · What do experts on the topic of CSAPE consider to be best practices? · By facilitating education based on best practices for CSAPE for care givers and children, is there potential to decrease the occurrence of CSA and change attitudes about CSAPE? CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 6 · What barriers exist for implementing CSAPE programs for care givers? Collaboration with Community Organizations In addition to working with the Bureau of Child Care Licensing on policy change I will also work with the Utah Coalition Against Sexual Assault (UCASA). While collaborating with UCASA, together we will craft a policy brief that may be utilized for ongoing community advocacy, compile a fact sheet that summarizes the consequences of CSA in Utah and a fact sheet that outlines risk and protective strategies for the sexual victimization of children. The Executive Director of UCASA has expressed interest in adopting a CSA component at UCASA as there have been requests from members of the community for CSA prevention education and UCASA does not currently offer any. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 7 Chapter II: Literature Review The purpose of this literature review is to examine factors related to the knowledge, attitudes and barriers around discussing child sexual abuse (CSA) prevention and age appropriate healthy sexuality education with child care providers, parents, and with young children to determine best practices for CSAPE. Schorr and Marchand (2007) assert: Preventing child abuse is a shared community concern and effective strategies require multiple actions at the individual, family, and community levels to reduce risk factors and strengthen protective factors. And yet, child abuse remains a taboo subject for many people one that is highly sensitive, very emotional, and not easily discussed. In order to be the advocates that young children need, we must get over our reluctance to discuss this sensitive issue and speak up for children. (p. ii) This literature review is divided into sections that address two groups within the population who may interact with children: parents and child care providers/teachers. Parents Looking at CSAPE for parents is essential in evaluating best practices as it is more likely that parents will educate their children about self protection and safety than teachers or child care providers. Parents who know about CSA are better able to predict their child's knowledge of CSA (Hunt & Walsh, 2011). Most parents who discuss CSA with their children report being educated on the issue, and/or have experience with CSA or know someone who has had experience with CSA (Kenny, Thakkar­Kolar, Ryan & Runyon, 2008). According to Hunt and Walsh (2011) parents who attended CSA CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 8 workshops had greater intentions of talking to their children about CSA. However, 99% of parents reported they obtained information about CSA from the media (Hunt & Walsh, 2011) and not from participating in workshops. The study sample consisted of voluntary participants who were parents that reported being comfortable discussing the topic of CSA. Therefore, the study did not include the opinions of parents who were uncomfortable discussing the topic. The Kenny study posits that the majority of parents in their sample believe that all preschools and child care centers should have CSAPE programs and that self protection skills should be taught at home as well (Kenny, et al., 2008). Kenny, et al. (2008) purport: Overall, children who received body safety training (BST) demonstrated greater knowledge about sexual abuse and personal safety skills than children in a control group. Additionally, children taught by their parents showed greater improvements in recognizing inappropriate touch and personal safety skills than those taught by teachers. However, children taught by both parents and teachers demonstrated greater gains in knowledge of appropriate touch and personal safety skills than children taught only by teachers. (p.44) According to Tutty (1997) most studies have established that about half of parents surveyed discuss sexual abuse with their children and the most effective discussions of CSA should come in the form of education about healthy sexuality. Just as parents discuss other types of safety, such as fire and traffic safety, they can adapt discussions of body safety to the developmental and cognitive level of the child (Kenny, et al., 2008). CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 9 Some parents are reluctant to teach the correct names of genitalia to their children because they believe they are too young and fear the words are "too harsh" (Sciaraffa, 2012). However, using correct terminology and information when educating children is reported to decrease confusion about sexuality and body awareness (Boyle & Lutzker, 2005). When children are taught correct terms for their genitalia they are more able to effectively communicate experiences of inappropriate touching (Boyle & Lutzker, 2005). Sexual offender literature asserts that offenders are less likely to target children who have knowledge of sexual matters such as appropriate and inappropriate touching and know correct names of their genitalia (Elliot & Kilcoyne, 1995). Teaching the accurate names of body parts to children aids in developing a healthy respect for bodies (Krazier, 1996) and may help reduce taboo and confusion around sexuality. Parents may be the best teachers for preschool age children as reported by Deblinger, Thakkar­Kolar, Berry and Schroeder (2001): Studies have demonstrated that preschoolers retain more knowledge about appropriate genitalia terminology when taught by parents as compared to those taught by teachers. Involving the family in the educational process may help reduce the secrecy surrounding the topic of CSA and stimulate parent child discussion around sexuality in general. Children trained by their parents also receive repeated exposure to prevention information in their natural environment. (p. 98) Deblinger, et al. (2001), and Wurtele, et al. (1991) stated several reasons for parents not wanting to discuss CSA prevention with their children. Their responses included: they thought their child was too young to understand, they CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 10 didn't know how to talk to their child about it or they thought it would frighten the child. A small percentage thought there was no need for CSA programs in schools because CSA was uncommon and public education about it was unnecessary. Elrod and Rubin (1993) noted that there were differences in what mothers and fathers considered to be appropriate CSA concepts to teach preschool age children. Some concepts both male and female parents considered inappropriate for preschool age children to learn: The three topics expected to be threatening to parents did appear to be threatening to both mothers and fathers. "Who abusers are" was rated as unacceptable for preschoolers by 54% of parents. "Why abuse happens" was rated as an unacceptable topic by 69% of parents, and the "likelihood of abuse happening to the child" was rated unacceptable by 80% of parents. (p.531) Elrod and Rubin (1993) interviewed parents regarding methods they considered appropriate for teaching children about CSA and responses included: private discussions; books and booklets; television shows and films; puppet shows; discussion groups; "what if" games; role playing; using toys such as dolls and formal school curriculum. Fathers preferred "what if" games and books, and mothers preferred private discussions and "what if" games. Hunt and Walsh (2011) concluded that parents and teachers/caregivers must collaborate for best results: CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 11 It appears clear that CSAPE for parents should be hand­in­hand with CSAPE for children so that messages can be delivered consistently at home and at school…school­based programs should not be introduced without first preparing the home environment, thus ensuring that parents are familiar and comfortable with the content and delivery approaches, are able to handle disclosures, and know how and where to find support services. (p. 74) Due to time constraints of my project timeline I will not survey parents at this time regarding CSAPE for families but will focus on the attitudes and willingness of child care providers to engage in conversation with parents on the issue of CSA. Child Care Providers/Teachers It is imperative for caregivers to understand common and acceptable sexual behaviors of children according to age and developmental stage and that there are difference in children's and adult's sexuality (Sciaraffa, 2012). If caregivers are educated regarding common behaviors and those that are cause for alarm children will be better served and protected (Chrisman & Couchenour, 2002). Caregivers can be educated regarding appropriate ways to respond to sexual behaviors that help a child to understand societal norms and may use responses as an opportunity to teach children about not allowing others to touch their genitals. For instance, according to Chrisman and Couchenour (2002) a caregiver could respond to self pleasuring with positive guidance and redirection by saying something such as: "You've discovered that it feels good to touch CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 12 yourself. This is something you can do when you are alone." A child's self­pleasuring (masturbation) does not directly imply that a child will engage in premature sexual behavior or that a child is being sexually abused (Petty, 2001). It is essential for caregivers to understand this is not a sign or symptom of abuse. Kenny, et al. (2008) assert that children as young as three can be taught self­protection skills yet, most CSAPE programs have been conducted with children age six to thirteen. According to deYoung, (1988) "There is also a persistent finding in this literature that children, especially young children do not retain the prevention concepts for any appreciable length of time". deYoung posits that "good touch, bad touch" (GTBT) curricula may not be sufficient because teaching children the difference between good touch and bad touch is most difficult to achieve when many children may actually regard sexual touching as acceptable. If sexual touch is done under the guise of love and care for the child it may not seem bad and if its done by a person the child loves it may not seem confusing at all (Kenny, et al., 2008). Consistent in CSA literature is the concept of teaching children the correct names for genitalia as it may be a deterrent for perpetrators and assists children when making disclosures of abuse (Kenny, et al., 2008). Yet, according to Sciaraffa (2012) caregivers are often ill prepared to handle common questions from children regarding sexuality due to lack of training and information. Caregivers have an opportunity to play an integral part in the education of children around healthy sexual development. Helping children to understand that sexuality is a natural part of life and not to be treated as shameful or CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 13 secretive can contribute to positive self­image and potentially aid in healthy development. Frailberg (1996) asserts: How a child feels about himself, how he values himself, will also be tied up with his feelings about his own body. If parents or caregivers ignore or punish children's curiosity, this will likely have a negative influence on children's development. (p. 211) Caregivers are in a complex position due to the varying beliefs and values of each family they serve. Parent education and collaboration is essential for best practices to be implemented. Education is they key according to Lumsden (1991): Ultimately, the greatest challenge may lie in attempting to alter social attitudes and conditions that foster or tolerate the sexual abuse of children. With knowledge about child sexual abuse comes the power to prevent it. By educating yourself about child sexual abuse, you can become a powerful force in making the world a safer place for kids. You can prevent child sexual abuse and protect children from harm. (p. 5) Caregivers can begin a conversation around CSA prevention with families by discussing developmental norms for children at different ages and stages and by sharing established policies and procedures the child care center or in­home provider has adopted. One policy that experts recommend be implemented is that of mandating staff to be trained on CSA prevention (Taylor & Lloyd, 2001). If parents are aware that CSA training is mandated and prevention strategies will be adhered to in the child care setting, CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 14 they may be interested in learning more about training available for them. Taylor and Lloyd (2001) note: Research has shown that teachers who participated in certain training programs were better able to apply their knowledge to hypothetical cases of child abuse, were less likely to blame the child, were more likely to acknowledge the severity of sexual abuse in the community, to discuss the seriousness of sexual abuse with colleagues, and were more likely to report suspected abuse. (p.1) Other factors that enhance prevention strategies for child care providers include becoming familiar with community resources and assessing the community context of children enrolled in their child care program (CSSP, 2003). According to the Child Welfare League (2005), "Research indicates that child abuse and neglect is a community responsibility and that care and education centers are part of a larger array of community resources, services and supports." The responsibility of protecting children falls upon all adults within communities. Summary This literature review, in conjunction with my data collection, will support my claims in my final project. I will collect data from local child care providers, in the form of a survey, with the objective being to examine knowledge, attitudes, organizational policies and potential barriers to CSA prevention and training. I hope to conclude from my data collection that there is a correlation between the lack of training of providers and their confidence level in discussing CSA prevention with parents. Upon compiling my CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 15 data I will produce a policy brief to utilize in my advocacy work for CSA prevention education for child care providers and early childhood educators. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 16 Chapter III: Data Collection Methods Preliminary Interviews I have conducted informal interviews and have corresponded with administrators of the aforementioned organizations to ascertain the needs of the community prior to conducting my research project. My objective was to determine if they were aware of any CSA prevention programs being administered to adults who work with children and to elicit their expert advice regarding working with bureaucratic institutions that facilitate child centered policy changes. No one knew of any CSA education programs being utilized or mandated. I was invited to attend meetings at two of the three agencies. Following my inquires I deduced that compiling data by surveying child care providers and parents would be the most beneficial method to use in developing a policy brief that will illustrate to policy makers the need for CSA prevention and awareness programs. Archival Research I will gather statistical data from published reports and journals that support the prevalence of CSA and postulate the need for more CSA prevention education. The literature research will include evidence based studies and statistics retrieved from public agencies such as the Utah Department of Health, the Center for Disease Control and the Division of Child and Family Services. The policy brief will be supported by literature that asserts the pervasiveness of CSA locally and nationally. Observational Research In order to begin networking with organizations that have a common goal of the health and well being of children in Utah I will attend meetings with community stakeholders including the Child Care Licensing Bureau and the Child Abuse & Neglect CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 17 Council. While in attendance I will take field notes about the activities I witness and analyze the processes for being heard by those attending the meetings. I will speak during public commentary periods regarding my perspective on the benefits of mandating CSA prevention education for child care providers. I hope to gain insight into the protocol used to request revisions to existing mandated training for licensed child care providers and become aware of potential funding sources for providing training on CSA prevention programs in child care settings. Participant Survey Preventing child abuse is a shared community concern and effective strategies require multiple actions at the individual, family, and community levels to reduce risk factors and strengthen protective factors (Schorr & Marchand, 2007). I will compile surveys for specific groups within the population of licensed child care providers (i.e. directors, teachers and in­home). In an attempt to illicit non­biased responses the survey will be anonymous and distributed randomly to child care administrators and staff. I will distribute 50 surveys to four in­home providers, two director/owners and 44 child care center providers. I hope to gain insight into common opinions, assumptions and attitudes about CSA prevention education. The estimated time to complete the survey is 15­30 minutes. Each participant will receive an incentive gift certificate upon completion of the survey, which will be placed in an envelope left at the site by with the surveys. Data Analysis Survey Results The purpose of the survey is to evaluate the participant's: · Definition and/or knowledge of CSA and where they gained their knowledge CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 18 · Participation (or lack of) in CSA prevention training · Participation (or not) in CSA prevention training and if they thought it was beneficial including reasons why or why not · Knowledge of the signs and symptoms of CSA in young children · Frequency or existence of implementing policies and procedures for CSA prevention in their child care setting · Skills and/or confidence in discussing, responding and reporting suspected or witnessed abuse · Beliefs and/or attitudes about discussing CSA with parents and/or staff · Opinions regarding CSA prevention training being mandated by the state Child Care Licensing Bureau · Opinions about participating in CSA prevention training if it were available and affordable · Views regarding best way(s) for child care providers to learn about CSA prevention · Other comments on the topic I will examine each survey and organize survey results into groups that will provide insight into: the most and least common ways providers obtain knowledge/training about CSA, common/uncommon attitudes and beliefs about CSA and CSA prevention programs, the percentage of the sample group that utilizes CSA CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 19 prevention policies and procedures, and the most common barriers for not obtaining CSA training and/or communicating about it. I will compile and synthesize the survey results that may substantiate the need for CSA prevention and awareness training for those who care for young children. Synthesis of Findings Following my data collection I will draft a policy brief to be used in advocacy efforts with the aforementioned organizations. The policy brief will be demonstrative of knowledge I have gained through in depth research and the synthesis of my findings as it will contain data gathered from my survey and my literature review. As I share my policy brief with each organization I will exhibit my skills in professional writing, speaking and diplomacy gained throughout my graduate program. I will use the policy brief in lobbying efforts during legislative sessions and for appealing to local stakeholders who advocate for issues concerning child welfare. I predict one challenge may be in convincing administrators to adopt policies that would generate changes and strain their already insufficient budgets and full agendas. The disturbing nature of CSA creates barriers in many settings causing some to opt not to address it unless they are mandated to. If organizations do adopt policies to require CSA training a lack of facilitators for CSA prevention programs could present a challenge. Expertise & Ethical Concerns I have no personal ethical concerns as an investigator as I will not be interviewing participants in person. I have chosen to use an anonymous survey because of my professional relationship with the child care community. I am assuming that participants may feel uncomfortable discussing CSA and disclosing their knowledge or lack thereof CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 20 around the issue. The survey may elicit richer data by eliminating potential barriers created during focus group discussions or interviews. One consideration is that owners/directors of child care programs may be reticent to share their perspectives and knowledge for fear they might appear ignorant or unwilling to address the issue, whether in a survey or an interview. By surveying more than one owner/director and keeping their survey anonymous, I hope to avoid influencing their responses. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 21 Section II: The Product and Discussion Chapter IV: The Policy Brief The Urgency for Child Sexual Abuse Prevention Education In Utah Early Childhood Settings April 2013 Child Sexual Abuse in Utah According to the Utah Division of Family Services 2012 Annual Report, there were 1,763 cases of substantiated child sexual abuse (CSA). This number, however, does not take into account unreported cases. According to the organization Darkness to Light, only 27% of children tell someone within the first year. Magnitude of Social Consequences The cost of CSA to society and the victims is extensive. Research indicates that 70-80% of CSA survivors report excessive drug and alcohol abuse, girls who are sexually abused are more likely to develop eating disorders, and more than 60% of teen pregnancies are preceded by experiences of molestation, rape or attempted rape. In a recent study, 50% of male survivors reported suicidal thoughts and more than 20% had attempted suicide, both male and female victims are reported to be more likely to engage in prostitution. Utah Economic Impact The Attorney General's 2013 budget appropriated $3,651,800 for the Children's Justice Centers of Utah where services for children are available while the child abuse investigative process is underway. Recommendations There is a lack of CSA prevention programs being utilized and little or no implementation of policies regarding CSA prevention and awareness in child care settings in Utah. A recent survey of child care providers indicated that many providers have little knowledge regarding the signs and symptoms of CSA and lack skills and/or confidence in discussing, responding and reporting suspected or witnessed abuse. There is lack of funding for training and a lack of accessible CSA prevention education programs available for child care providers and early childhood educators in Utah. "I think that CSA is something that isn't talked about much so it's something we are not comfortable with. More knowledge would help." Anonymous survey participant CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 22 April 2013 BARRIERS TO CSA PREVENTION Child Care Providers in Utah · In a recent anonymous survey administered to licensed child care providers, less than half the participants thought they could recognize the signs and symptoms of CSA. · The survey demonstrated that only 10% of respondents have significant knowledge of CSA and the level of knowledge of the remaining respondents is questionable due to lack of detail in the responses. · When asked to respond regarding the existence of barriers for discussing CSA, 30 0f 47 participants stated they thought barriers do exist. · 100% of survey participants think that the Child Care Licensing Bureau should mandate CSA prevention education for licensed child care providers. Preferred Methods of Child Care Providers for CSA Prevention Training Nine out of ten survey respondents prefer face to face classroom settings for CSA prevention education (CSAPE) and believe it is the most effective method for training. When asked if they thought the Child Care Licensing Bureau should mandate CSAPE for child care providers, 100% agreed that it should be mandated. The majority of participants said they would participate in CSAPE programming if it was accessible and affordable. Nine of 17 participants said they had enrolled in CSAPE classes on their own, it was not required by their employer. Those who said had received CSAPE training stated they believed the training was beneficial. None of the respondents named CSAPE curricula that was used during their training. Thus, reviewing curriculum used was not applicable. Barriers Within Communities for CSA Prevention Education "I think that CSA is so important for anyone caring for children including parents. The more we know the more adults and caregivers can be advocates for prevention of CSA and help." Anonymous survey participant CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 23 Barriers Within Communities for CSA Prevention Education April 2013 One of the major barriers is lack of funding for CSAPE programs as there are no programs in Utah being funded that facilitate CSAPE programs or for research of evidence based CSAPE programs. Another significant barrier is that parents and educators are often uncomfortable discussing the topic of sexuality and particularly CSA. In a recent survey administered to Utah childcare providers, 90% stated they perceived the existence of barriers for discussing CSA with parents. The most common perceived barriers were: uncomfortable/sensitive topic, lack of knowledge/training about CSA, fear of seeming accusatory and societal attitudes. In addition, the varying beliefs and values of each family that caregivers serve puts them in a complex position. Parent education and collaboration is essential for best practices to be implemented and education is they key 1 . 1 Lumsden, L.S. (1991). The role of schools in sexual abuse prevention and intervention. ERIC Digest Series 61, ERIC Clearinghouse on Educational Management, Eugene, OR do not retain the prevention concepts for any significant length of time and that "good touch, bad touch" curricula may not be sufficient because teaching children the difference between good touch and bad touch is difficult to achieve because children may actually regard sexual touching as acceptable 2 . Funding is needed for the research and analysis of CSAPE best practices and evidence based CSAPE programs to best serve the communities of Utah. 1 Kenny, M.C., Capri, V., Thakkar‐Kolar, R.R., Ryan, E., Runyon, M.K., (2008) Child sexual abuse: From prevention to self‐protection. Child Abuse Review, 17, 36‐54. 2 deYoung, M. (1988). The good touch bad touch dilemma. Child Welfare, 67(1), 60‐68. When to Begin and How to Teach Children CSA Prevention Strategies Children as young as three can be taught self‐protection skills, yet, most CSAPE programs have been conducted with children age six to thirteen 1 . It is essential to look to CSAPE that is age appropriate and evidence based. Some research indicates that children, especially young children "I feel like if providers are given a chance to learn how to better protect and provide for their students then there should be trainings on prevention monthly." Anonymous survey participant CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 24 Recommendations for CSA Prevention Education April 2013 Ways Child Care Providers Learn About CSA and Accuracy of Knowledge Of the child care providers surveyed more than three quarters indicated they had received training on CSA from classes. Most reported that they had received the CSA training in classes offered by a local Child Care Resource & Referral agency. However, the curriculum for the class they referred to does not specifically address CSA. This finding indicates that providers do not know what genuine CSAPE is. Approximately one third of the respondents stated they had learned what they know about CSA from television. Of the few respondents who claimed they could recognize the signs and symptoms of CSA their responses indicated they had misconceptions and inaccurate knowledge regarding signs and symptoms of CSA. These misconceptions are demonstrative of the necessity for CSAPE for child care providers. stages and by sharing established policies and procedures the child care center or in‐home provider has adopted. One policy that experts recommend be implemented is that of mandating staff to be trained on CSA prevention 1 . If parents are aware that CSA training is mandated and prevention strategies will be adhered to in the child care setting they may be interested in learning more about training available for them 1 . Child care providers play a vital role in prevention of CSA. Research has shown that teachers who participated in certain training programs were better able to apply their knowledge to hypothetical cases of child abuse, were less likely to blame the child, were more likely to acknowledge the severity of sexual abuse in the community, discuss the seriousness of sexual abuse with colleagues, and were more likely to report suspected abuse 1 . 1 Taylor, S., & Lloyd, D. (2001), Mandatory reporting and child sexual abuse: Contextualizing beliefs and attitudes. Association for Research in Education Advantages of CSAPE for Child Care Providers Caregivers can begin a conversation around CSA prevention with families by discussing developmental norms for children at different ages and CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 25 "I think every center should have a mandatory training on this (CSA). As a mom I want to make sure my children's teacher knows the best ways to protect them." Anonymous survey participant Community Collaboration for Best Practices in CSA Prevention April 2013 Importance of Parental/Familial Involvement in CSA Prevention Ideally parents and child care providers should collaborate to attain the most effective CSA prevention strategies. CSAPE for parents should go hand‐in‐hand with CSAPE for children so that messages will be consistent at home and at school 1 . It is recommended that school based programs should not be introduced without first preparing the home environment, thus ensuring that parents are familiar and comfortable with the content and delivery approaches, are able to handle disclosures, and know how and where to find support services 1 . 1 Hunt, H. & Walsh, K. (2011). Parents' views about child sexual abuse prevention education: A systemic review. Australasian Journal of Early Childhood, 36(2), 63‐76. Community CSA Prevention Strategies for Child Care Providers By becoming familiar with community resources and assessing the community context of children enrolled in their child care program, child care providers and parents can enhance prevention strategies 1 . Research indicates that child abuse and neglect is a community responsibility and that child care and education centers are part of a larger group of community resources, services and supports 2 . The responsibility of protecting children falls upon all adults within communities. 1 CSSP (Center for Study of Social Policy). (2003) Strengthening families through early care and education: Advancing child abuse and neglect protective factors: The role of early care and education infrastructure. Retrieved from www.cssp.ort/doris/index.html 2 Child Welfare League of America. (2005). Standards of Excellence: CWLA Standards of excellence for child care, development and education services. Washington, DC. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 26 Chapter V: Learning and Career Goals Personal Learning Objectives My personal goal in my project development was to become an expert in CSA prevention strategies specifically for early childhood settings. I was driven to uncover information that would support my assertions that child care providers could work collaboratively with parents, policy makers and the community to improve the safety of their children in relation to CSA. I researched root causes of barriers to child sexual abuse CSA prevention strategies and identified community assets in order to develop a plan of action. I realized that the Utah State Child Care Licensing Bureau Advisory Committee was a community asset that I could utilize in advocating for mandated CSA education programming for child care providers. The policy brief I drafted is demonstrative of my community organizing and advocacy skills as I researched needs within the community, used my findings to organize a community organization and practiced advocacy in a public­policy arena. The policy brief, supported by my data collection and analysis, enhanced my awareness of attitudes and beliefs around CSA in the local child care provider community. By approaching and collaborating with the Child Care Licensing Bureau I gained skills and confidence necessary to successfully advocate for public policy modifications that lead to the adoption of a new policy. I was actively involved in a democratic group process within the Child Care Licensing Advisory Committee. I facilitated a dialogue with a diverse group of committee members with differing and opposing viewpoints. In the end the group voted unanimously to proceed with the process and protocol required to mandate the policy modification I recommended. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 27 Recommendations How the Policy Brief May be Used in Collaboration with Community Organizations While conducting my literature review I examined what experts in the field considered to be barriers to CSA prevention education (CSAPE) and knowledge, attitudes and beliefs of early childhood educators, child care providers and parents around the topic. The literature supported my assertions regarding the need for prevention education for families and child care providers and that collaboration between them results in the mot effective protective strategies. The advantages of educating parents and child care providers about developmental norms of children and healthy sexuality was prevalent throughout the literature as well. I used the literature to draft a policy brief that I will use to report to policymakers, community organizations, child care providers and parents about the importance of CSAPE programming. My data collection supported the notion that many child care providers lack the knowledge and confidence to adopt policies and procedures that enhance protective measures for children. My data analysis also concluded that the majority of child care providers reported that they had been trained in CSA prevention strategies when, in fact they had not. I reached this conclusion by reviewing comments of survey participants who claimed they had taken a class that was offered by the agency I am employed with, and were trained in CSA prevention and awareness. There is no section in the curricula used by my organization that addresses CSA specifically. Most survey participants, 33 of 46, stated they had learned what they know about CSA from classes. I am unaware of any training available in Utah that specifically addresses CSA designed with chills care providers in mind. In addition, 44 of 47 said they would CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 28 participate in CSAPE if it was available an affordable. Two respondents said they might participate and one participant said "no, I feel I know enough and it's uncomfortable." One hundred percent of respondents stated they thought the Child Care Licensing Bureau should mandate CSAPE training to licensed child care providers. According to my survey, most providers believe they have policies and procedures in place that address CSA prevention. Of the majority who stated that most reported that their policy was to report any suspected abuse. The reporting of suspected abuse does not fall into the category of prevention. Responding to suspicion of abuse is required by all child care providers. Only three of the 42 who responded regarding policies and/or procedures in place for CSA prevention actually commented on effective policies for CSA prevention. When asked if they would feel comfortable discussing prevention strategies with parents approximately 25% of respondents said they would not feel comfortable. The most common reason for being uncomfortable discussing CSAPE with parents was that providers felt they lacked sufficient training on the topic, although 36 of 47 respondents declared they had received CSAPE in prior question. The findings of my survey substantiate the need for CSAPE in child care settings because providers seemed to interpret the policy of reporting abuse as a preventative strategy, very few respondents understood effective policies/practices for prevention and they lack training in CSAPE; therefore they do not feel confident discussing prevention strategies with parents. In addition to working with the Bureau of Child Care Licensing on policy change I also worked with the Utah Coalition Against Sexual Assault (UCASA). While collaborating with UCASA, a policy brief was drafted that will be utilized in ongoing CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 29 community advocacy. The Executive Director of UCASA plans to use my policy brief to advocate for funding for a CSA component at UCASA. Together we plan to utilize the policy brief in advocacy work by participating in the next Utah Legislative sessions to lobby for funding and expansion of CSAPE programming through UCASA and make it available in the public school sector and other youth serving organizations. Future Research Projects on the Topic of CSA Prevention Limitations Through my data collection I learned that survey questions can be easily misinterpreted by participants. In developing data collection for future research I will attempt to predict responses to the questions and write questions that will potentially illicit responses that more accurately reflect the knowledge of participants and the substance of training they have received. For instance I inquired if child care providers would feel comfortable discussing CSA prevention strategies with parents or staff. Of 43 respondents 11 said they would not feel comfortable. Most of those who said they would not feel comfortable stated it was due to lack of training and fear that the parents would think they were being accusatory that the parent was abusing their child and/or implying that their child was being abused by someone. My intention was to assess how many would feel comfortable discussing preventative measures not how many would feel comfortable discussing the potential of the child being abused. Also, I asked if the participants thought there were barriers to discussing CSA with parents and/or staff many interpreted the question to be a question of whether there should be barriers in communicating about CSA. Many respondents said there should be open communication even if parents/staff think it is uncomfortable. Other respondents interpreted the question CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 30 posed to mean would there be barriers if there was suspected abuse and they were required to discuss suspected abuse with parents/staff. One finding in my data analysis was that of 46 surveyed, four appeared to have significant knowledge regarding the definition of CSA. Of the 46 surveyed several noted what they consider to be signs and/or symptoms of a child being a victim of CSA. Most of the stated signs/symptoms are not, in fact, necessarily signs of CSA. For instance some thought that if a child touches or handles their own genitalia, is withdrawn/timid, irregularities in behavior, refers to sexuality or has diaper rash, he or she may be a victim of CSA. My research was focused and limited to a small sample of child care providers. In the future I hope to survey a larger sample group and gather more detailed information. Very few respondents shared enough information that indicated where they had received CSAPE training aside from a class that CSA is not addressed in. I have realized the importance of wording questions in way that may elicit more detailed and meaningful responses. There were limitations to my data collection and analysis due to the nature of many of the responses. The conclusion I reached, after analyzing the participants responses, was that many child care providers do not understand and/or feel comfortable discussing CSA even in an anonymous survey. Next Steps I intend to work more closely with organizations such as UCASA to better understand the dynamics that impact partnerships with policymakers. The topic of CSA prevention is being discussed in public health and social service communities and is being considered for incorporation into future budgets. I plan to be an integral contributor CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 31 in discussions within the aforementioned communities and offer insight I have gained through my research and coursework regarding best practices for CSAPE and barriers that exist in CSA prevention. I hope to survey parents and families to better understand perceived barriers in the context of CSAPE programs. I aspire to involve families in CSAPE advocacy by inviting them to be proactive in the process along with child care providers and youth serving organizations in the community. I believe if families insist on CSPE for everyone who is involved in their children's lives the movement to protect children from CSA will gain the impetus needed for significant change. If my proposal to the Child Care Licensing Advisory Committee mandating CSAPE for licensed child care providers passes the public commentary period and becomes a new licensing rule I will have gained credibility that will be beneficial when I approach other youth serving organizations. I anticipate that public school administrators will be more inclined to adopt CSAPE for staff and teachers if they are aware that it is a mandated training topic for child care providers. While conducting my literature review, I recognized that there is very minimal literature available on CSA prevention literature specific to child care providers. These findings are indicative that there is a need for action in the form of policy change and education. One of the root causes around CSA prevention is the secrecy, taboo and shame around the issue, which may attribute to the reasons child care providers and parents do not address it or seek out educational opportunities. In the survey I conducted my findings pin­pointed the need for participation in CSAPE due to prevalent beliefs and CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 32 attitudes and that there is a correlation between the lack of training of providers and their confidence level in discussing CSA prevention with parents and recognizing signs/symptoms of CSA. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 33 References Bishop Accountability (2011). Data on the crisis the human toll. August 26, 2011, Retrieved from (http://www.bishopaccountability.org). Boyle, C., & Lutzker, J. (2005). Teaching children to discriminate abusive from nonabusive situations using multiple exemplars in a modified discrete teaching format. Journal of Family Violence, 20(20), 55­69. Browne, A., Finkelhor, D. (1986). Impact of child sexual abuse: A review of the research. Psychological Bulletin, 99(1), 66­77 Child Welfare League of America. (2005). Standards of Excellence: CWLA Standards of excellence for child care, development and education services. Washington, DC. Chrisman, K., & Couchenour, D. (2002).Healthy sexuality development: A guide for early childhood educators and families. Washington, DC: NAEYC. CSSP (Center for Study of Social Policy). (2003) Strengthening families through early care and education: Advancing child abuse and neglect protective factors: The role of early care and education infrastructure. Retrieved from www.cssp.ort/doris/index.html Darkness to Light, Retrieved from (http://www.darkness2light.org). Deblinger, E., Thakkar­Kolar, R.R., Berry, E.J., Schroeder, C.M. (2001). Caregivers' efforts to educate their children about sexual abuse: A replication study. Unpublished manuscript, University of Medicine and Dentistry, School of Osteopathic Medicine, New Jersey, USA. deYoung, M. (1988). The good touch bad touch dilemma. Child Welfare, 67(1), 60­68. Elliot, M., Browne, K. Kilcoyne, J. (1995). Child sexual abuse prevention: What offenders tell us. Child Abuse & Neglect, 19(5). Elrod, J., & Rubin, R.(1993). Parental involvement in sexual abuse prevention education. Child Abuse & Neglect. 17(4), 527­538. Frailberg, S.H. (1996).The magic years: Understanding and handling the problems of early childhood. New York: Fireside. Goldstein, L. (2003). Trail of pain in church leads to nearly every diocese. The New York Times, p. 1. Hunt, H. & Walsh, K. (2011). Parents' views about child sexual abuse prevention education: A systemic review. Australasian Journal of Early Childhood, 36(2), 63­76. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 34 Karageorge, K., & Kendall, R. (2008). The role of professional child care providers in preventing and responding to child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services. Retrieved from www.childwelfare.gov/pubs/usermanuals/childcare/childcare.pdf Kenny, M.C., Capri, V., Thakkar­Kolar, R.R., Ryan, E., Runyon, M.K., (2008). Child sexual abuse: From prevention to self­protection. Child Abuse Review, 17, 36­54. Krazier, S. (1996). The safe child book: A commonsense approach to protecting children and teaching children to protect themselves. New York, NY. Fireside. Lumsden, L.S. (1991). The role of schools in sexual abuse prevention and intervention. ERIC Digest Series 61, ERIC Clearinghouse on Educational Management. Eugene, OR. Petty, K. (2001). When young children explore anatomy: Dilemma or development? Texas Child Care, Winter, 2­7. Schorr, L.B., & Marchand, V. (2007). Pathway to the prevention of child abuse and neglect. The Project on Effective Interventions, Pathways Mapping Initiative. Cambridge, MA: Project on Effective Interventions, Harvard University. Sciaraffa, M. (2012). Suzie's mom is having a baby: don't freak out! Child Care Exchange, September/October 2012, 104­108. Taylor, S., & Lloyd, D. (2001), Mandatory reporting and child sexual abuse: Contextualizing beliefs and attitudes. Association for Research in Education, School of Education, University of Ballarat, Victoria. Tutty, L.M. (1997). Child sexual abuse programs: Evaluating who do you tell. Child Abuse & Neglect, 21, 869­881. Wurtele, S.K., Melzer, A., Kast, L. (1992). Preschoolers' knowledge of and ability to learn genital terminology. Journal of Sex Education and Therapy 18, 115­122. Wurtele, S.K., Currier, L., Gillispie, E., Franklin, C. (1991). The efficacy of a parent implemented program for teaching preschoolers personal safety skills. Behavior Therapy, 22, 69­83. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 35 Appendices Appendix A: Protocol for Survey I will contact prospective participants via telephone and describe the research project. If the child care provider is interested in participating and having their staff participate (if applicable), I will schedule an appointment to deliver the surveys and further explain the process in person. The survey will be distributed to 46 child care providers in child care centers and four in home child care providers. Each survey will include a cover letter describing the potential side effects/risks, the voluntary and anonymous nature of the survey and contacts for my principle investigator and Chair of the IRB per Institutional Review Board requirements. The estimated time to complete the survey is 15­30 minutes. Upon completion of the survey the participant will place the completed survey in an envelope supplied by myself. Each participant will receive an incentive gift certificate upon completion of the survey which will be placed in an envelope left at the site by with the surveys. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 36 Appendix B: Survey Consent Form Dear Survey Participant, You have been invited to participate in a research study, the purpose of which is to access the knowledge and perspectives that licensed child care providers have concerning child sexual abuse prevention and awareness. The intention of the study is to provide policy makers with examples reflecting the need for more training on the topic of child sexual abuse. The duration of the study is expected to be 15­30 minutes. The potential side effects/risks associated with the study have been identified as emotional duress due to the subject matter. In the event that you are affected by these side effects/risks the investigator conducting the survey has provided a resource list of professionals that may assist you in dealing with emotional duress. Some side effects/risks may be unforeseeable. Your participation in this survey is entirely voluntary, and you may decline from participating at any time you wish without any penalty to you. If you have any questions about this study or wish to withdraw, please contact: Jamie Joanou 801.832.2485 [e-mail] Principal Investigator If you have any questions regarding your rights as a research participant, please contact: Robert Shaw 801.832.2474 [e-mail]____________________ Chair of IRB All personally identifiable study data will be kept confidential. However, the results of this study may be made available to you upon request or used in formal publications or presentations. CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 37 Appendix C: Participant Categories & Survey Questions Owner/Director of Child Care Center (participant must work on­site & supervise staff & interact with parents to participate in the owner/director survey) 1. How do you define child sexual abuse (CSA)? 2. How did you learn what you know about CSA (i.e. a class, television, internet, article or book)? 3. Do you feel confident you would recognize the signs and/or symptoms of CSA? Why or why not? 4. Do you know key ways to prevent CSA? If so what are they? 5. Have you received education/training in CSA prevention & awareness? If "no" why not? If "yes" where did you receive it? 6. If you have received CSA training did you enroll on your own or was it required? Did you think the training was beneficial and worthwhile? Why or why not? 7. If CSA training was available and affordable would you participate? Would you require your staff to participate? 8. Do you think the Bureau of Child Care Licensing should require training on CSA prevention for licensed child care providers? Why or why not? 9. Do you have policies in place at your child care center that address CSA prevention? If "yes" what are they? 10. Would you feel comfortable discussing CSA prevention strategies/policies with parents? If "no" why not? 11. Do you feel there are barriers to discussing CSA with staff and/or parents? If "yes" what are those barriers and what do you think contributes to them? 12. What do you think is the best way for child care providers to learn about CSA prevention (i.e. classroom setting, online, reading about it)? Child Care Provider in Child Care Center (classroom teachers) 1. How do you define about child sexual abuse (CSA)? 2. How did you learn what you know about CSA (i.e. a class, television, internet, article or book)? 3. Do you feel confident you would recognize the signs and/or symptoms of CSA? Why or why not? 4. Do you know any key ways to prevent CSA? If so what are they? 5. Have you received education/training in CSA prevention & awareness? If "no" why not? If "yes" where did you receive it? 6. If you have received CSA Training did you enroll on your own or was it required? If you have received CSA training did you think the training was beneficial and worthwhile? Why or why not? 7. If CSA training was available and affordable would you participate? Why or why not? 8. Do you think the Bureau of Child Care Licensing should require training on CSA for licensed child care providers? Why or why not? CHILD SEXUAL ABUSE PREVENTION AND AWARENESS STRATEGIES 38 9. Are you aware of any policies at your child care center that address CSA prevention? If "yes" what are they? 10. Would you feel comfortable discussing CSA prevention strategies/policies with parents? If "no" why not? 11. Do you feel there are barriers to discussing CSA with parents? If "yes" what are those barriers and what do you think contributes to them? 12. What do you think is the best way for child care providers to learn about CSA prevention (i.e. classroom setting, online, reading about it)? In Home Child Care Provider 1. How do you define child sexual abuse (CSA)? 2. How did you learn what you know about CSA (i.e. a class, television, internet, article or book)? 3. Do you feel confident you could recognize the signs and/or symptoms of CSA? Why or why not? 4. Have you received education/training in CSA prevention & awareness? If "no" why not? If "yes" where? 5. If CSA prevention training was available and affordable would you participate? 6. Do you think the Bureau of Child Care Licensing should require training on CSA for licensed child care providers? Why or why not? 7. Do you have policies in place that address CSA prevention? If "yes" what are they? 8. Would you feel comfortable discussing CSA prevention strategies/policies with parents? If "no" why not? 9. Do you feel there are barriers to discussing CSA with parents? If "yes" what are those barriers and what do you think contributes to them? 10. What do you think is the best way for child care providers to learn about CSA prevention (i.e. classroom setting, online, reading about it)?