Complexity and evidence in protecting children

Abstract

Since Child Abuse Review last went to press the UK Royal College of Paediatrics and Child Health has published an updated handbook of The Physical Signs of Child Sexual Abuse in April 2008. This review of the scientific evidence on the physical signs of child sexual abuse is based on five years' work by experts and leading paediatric specialists. It is the first evidence based review of the research literature and guidance in this area and is intended to assist paediatricians' and other child protection professionals' decision making. Yet, as a recent English court case has revealed, child sexual abuse remains a complex and contentious area and the role of the expert witness is coming under increased scrutiny (Dyer, 2008). In the current climate of evidence based practice, all practitioners are increasingly being required to understand where evidence exists, to have the skills to appraise the quality of that evidence and to assess where information is weak, contradictory or even absent.It was the inquiry into the events in Cleveland, UK in 1987 which first drew attention to the need for professionals to agree on the scientific evidence about the signs and symptoms when child sexual abuse is suspected (Royal College of Paediatrics and Child Health, 2008). Twenty years after Butler-Sloss's (1988) Inquiry into Child Abuse in Cleveland, it is timely that in this issue of Child Abuse Review, Heather Bacon (2008) and Sue Richardson ( 2008), both of whom were practitioners involved in the events in Cleveland, provide some personal and professional reflections on what they have learned about intervening in child sexual abuse cases since that time. The first paper considers the main changes in approach to child sexual abuse since the events in Cleveland. Heather Bacon (2008) argues that while society as a whole is more willing to acknowledge child sexual abuse, considerable complexities and uncertainties face professionals working in this field and she is doubtful about whether outcomes for these children have improved. The paper draws attention to the number of child protection registrations in England for child sexual abuse, which has fallen annually since 2003, while there has been an increase in the registration rate for 'all' abuse and neglect categories. The author concludes that child sexual abuse is still not properly recognised