Executive Defense Technology, LLC

* In the U. S., it is averaged that 1.3 women are raped every 60 seconds. Thus, there are 78    rapes every hour 1,872 rapes every day 56,160 rapes every month and 683,280 rapes each year.

* 17.6 of all American women have survived a completed or attempted rape/sexual assault.

* Approximately, 91 % of all rape victims and survivors are female, and 9% are male.

* One out of every 10 rapes/sexual assaults occur to a male victim.

* One out of every 4 girls will be sexually assaulted by age 18, and so will one in every 6 boys.

* Adolescents between the ages of 12 and 17 are 2 - 3 times more likely to be sexually assaulted than adults.

* At the time of the rape, 22 % of victims were under age 12, 54 % were under the age of 18 and 83 % were under the age of 25.

* Women who were molested or sexually abused as children, or sexually assaulted as adults are up to 7 times more likely to be assaulted again/repeatedly.

* It is estimated than any where from 62 % to 82 % of all rapes are committed by someone known to the victim.

* 46 % of rapes/sexual assaults were committed by a spouse/partner/boy/girlfriend, or someone with whom the victim was in love. 22 % of rapes were committed by a friend, or someone the victim knew well. 19 % were acquaintance rape. Only approximately 4 % were committed by a stranger.

* Less than half of all rapes/sexual assaults (Approx. 25 - 37 %) are ever reported.

* Only 2 % of all rapists are ever convicted and imprisoned

* 93.7 % of rapists are male, and 6.3 % are female.

* Globally, at least 1 in every 3 women has been sexually abused, raped, or sexually assaulted at some point in her life time.

* The United States has the highest rape rate globally, of countries that report such statistics. This rate is 4 times that of Germany, 13 times higher than England, and 20 times higher than Japan.

* It is estimated that 683,000 women are raped each year in the United States.

* Over 260,000 rapes occurred in 2000.

* In 2004 - 2005, there was an annual average of 200, 780 victims of rape, attempted rape, or sexual assault.

* Women with disabilities, handicaps, or other severe medical issues are raped and/or abused at twice the rate of the general population.

* Rape/sexual assault survivors often have medical issues that arise as a result from their assault. Everything from Post-Traumatic Stress Disorder (PTSD) to Sexually Transmitted Diseases (STD's) to suicide, eating disorders, chronic pelvic pain, chronic vaginal infections, gastrointestinal problems, back pain, and more.

* Rape and sexual assault cost over $ 5.8 billion annually. These costs include $ 4.1 billion in medical and psychiatric treatments, as well as lost wages/productivity.

Often, it is the GP that a parent comes to when a child has some questionable symptoms, and/or has indicated sexual abuse. What is often not acknowledged is that a presentation such as this in the surgery may precipitate a crisis for the GP as well, particularly in rural communities.

Whilst the law is clear about our responsibilities to notify, it doesn't answer or solve the complexities that inevitably accompany the disclosure. One difficulty often encountered is that a child may give an unclear, contradictory or vacillating account of what has happened. Whilst it is not the role of the GP to investigate allegations of child sexual abuse, the following information may assist our understanding of a child's behaviour at the time of disclosure.

Sorensen & Snow* (1991) analysed the disclosures of 116 children aged between 3 & 17. They found that 74% of those disclosures were accidental, ie. revealed by chance rather than a deliberate effort on the part of the child; and 25% were purposeful, ie. when a child consciously decides to tell an outsider. However, for all children, disclosure was a process, not a single event - involving denial, tentative disclosure, active disclosure, recanting and reaffirming.

72% of all children denied having been sexually abused - for example, when questioned by a concerned parent/carer or when identified as potential victims and formally questioned. Only 7% of children who denied then moved directly to active disclosure - with tentative disclosure becoming the common middle step for the majority of the children (78%). The characteristics of this stage are

• Forgetting (I forgot);
• Distancing (It happened to Joe / or a long time ago );
• Minimising (It only happened once);
• Empowerment (He tried but I hit him and ran away);
• Dissociation (When he does that I go to the pink forest);
• Discounting (I was only kidding).

Active disclosure was eventually made by 96% - meaning they could give detailed, coherent, first-person accounts of the abuse. 22% of children then recanted their allegations - with pressure from perpetrator or family being amongst the major reasons. Of those who recanted, 92% went on to reaffirm their allegations. The time frame for this progression of disclosure ranged from within a single session to several months.

The common presumption that children will be able to give a detailed and coherent account of the abuse in a single investigative interview is not supported by these findings, which showed that only 11% were in active disclosure at the time of the initial interview. Sorensen & Snow's work challenges all health & welfare professionals to review how we listen to children, how we respond to disclosures that appear vague, oscillating and/or a bit unbelievable, and what protective action we take in response to disclosure.

This research implies that our response to children may be critical to how the process of disclosure unfolds. Some key reminders are:

• listen to the child's story
• be, and act, calmly
• let the child know s/he is believed
• explain what you are going to do
• make the child comfortable whilst you organise things.Ensure s/he is not left in a situation where s/he is pressured to change her/his story
• notify the Department of Community Services
• consult with Richmond Sexual Assault Service if needed.

  Atosha Clancy is the project officer for the NRDGP Sexual Assault Project.

  * Teena SORENSEN & Barbara SNOW "How Children Tell: The Process of Disclosure in Child Sexual Abuse", in Child Welfare Vol LXX No1 Jan/Feb, 1991 - copies available from Annabel Mead or Atosha Clancy