CSE advice for professionals
What can professionals do about CSE?
Child Sexual Exploitation (CSE) traps children in a world of misery - but every time an exploited child comes into contact with a professional, there's an opportunity for someone to notice something, say something, do something…
Exploited children come into contact with doctors, nurses, sexual health practitioners, social workers, teachers and youth workers. When children who had experienced CSE were interviewed* it was found that:
- All of them had been subjected to physical violence - and 48% had visited A&E because of their injuries.
- 85% had self-harmed or attempted suicide
- 75% had received treatment for sexually-transmitted infections including chlamydia, herpes and gonorrhoea . Pregnancy, miscarriages and terminations were also common.
* "I thought I was the only one." The Office of the Children's Commissioner's Inquiry into Child Sexual Exploitation in Gangs and Groups Interim report November 2012
If you work with children in a hospital, clinic, health centre, A&E or any other area, you are in a unique position to notice the signs of CSE and help end the nightmare. But only if you know what to look for.
As a professional, you need to know:
- What is CSE?
- What are the signs?
- What could prevent you from recognising them?
- What to do if you suspect CSE.
What is CSE?
CSE - Child Sexual Exploitation - is when a child (any girl or boy under age 18) is forced or manipulated into sexual activity in return for affection, gifts, money, drugs or alcohol.
CSE can be carried out by individuals, by street gangs or by groups. It happens in the real world and online. It can be motivated by money or by sexual gratification. But in all cases, there is an imbalance of power - vulnerable children are controlled and abused by adults or by other children.
Perpetrators gain control over children by grooming them, offering excitement, drugs, alcohol, gifts and affection. As the exploitation gets worse, terrifying threats and violence may be used to keep children compliant. They are sexually exploited not just by the original perpetrators but often by many other abusers.
Exploited children are trapped because they often believe the abuse is their own fault - they fear they will be blamed or punished if they tell anyone what is happening. They are ashamed of what they are forced to do and are scared they will not be believed.
In many cases, children believe they are in a loving relationship with their exploiter. What's more the perpetrator will do everything they can to isolate children further by convincing them that no-one cares about them, and that professionals are to be feared and avoided.
What are the signs of CSE?
The warning signs that professionals are most likely to see include:
- physical injury
- bruising and scarring, which the child may try to hide
- sexual health problems
- self harming, attempted suicide
- depression and other mental health problems
- looking exhausted and unwell
- drug and alcohol misuse
- involvement in crime
- having older friends, boyfriends, girlfriends (although not all perpetrators are older).
- Other signs of CSE include changes in a child's behaviour:
- becomes especially secretive
- stops seeing their usual friends
- sudden changes of taste in dress or music
- sexualisation of their appearance and behaviour
- receives increased number of calls and messages
- sharp, severe mood swings
- starts using a different 'street language' or name
- absence from school; repeatedly running away from home
- having new, expensive items that they couldn't afford, such as mobile phones, iPods or jewellery.
What could prevent you from recognising the signs of CSE?
There are a number of assumptions, myths and misunderstandings that can lead even vigilant professionals to miss the signs of CSE. Professionals need to be clear about the key issues:
Exploited children almost invariably believe they are in a consensual relationship, voluntarily engaging in sexual activity with the person who is exploiting them. But a child cannot by law consent to being sexually exploited
The fact that a child is 16 or 17 years old and has reached the legal age of being able to consent to sex does not mean that they are not being sexually exploited.
Giving children labels (such as 'promiscuous' or 'engaging in risky behaviour' or 'a danger to themselves') implies that they are complicit in the exploitation and somehow therefore responsible for their own abuse. But for exploited children, saying 'no' isn't an option - failure to comply with demands for sex are likely to result in serious harm to them and/or their family. Professionals need to consider the possibility of coercion.
Boys can be victims of CSE too - and they are most often identified by services due to their criminal behaviour. So professionals need to look at criminal behaviour as a possible indicator of underlying problems or risk of CSE - just as it would be for girls. Going missing and having an older 'girlfriend' are also often missed as indicators of a boy being at risk of CSE.
Challenging vs vulnerable
Children who are being sexually exploited may appear abusive and anti-social and may become involved in bullying and exploitative activities towards others. This can make it hard for professionals to recognise and respond to the young people's vulnerability.
60% of CSE happens online. Professionals need know how to monitor online spaces and request access reports where they have suspicions that a child is being groomed online, for example, at school, youth groups or in libraries.
What to do if you suspect CSE
If you believe a child is, or could be, in immediate danger, call 999
If you have concerns that a child might be at risk of CSE, call Sussex Police on 101
Do not confront the alleged abuser - this could place the child in greater physical danger and may give the abuser time threaten them into silence.
Try to speak to the child alone, ask questions.
If a child tells you they are being sexually exploited, listen to them, believe them, and reassure them that you will take action to keep them safe.
Make sure you know who the child protection lead is in your workplace and that you are aware of the procedure to follow if you have concerns about a child.
Further guidance can be found in 'Safeguarding Children and Young People from Sexual Exploitation'
"I wanted someone to ask me what was happening… I would have told them everything."
Emma Jackson (Exploited child, Author: 'The End of My World') interviewed in the Independent
More resources for professionals
There are many resources available online for professionals, many of which are free to use.
CSE e-learning tool - an online course designed to help health professionals identify children who are at risk of or have been sexually abused.
ThinkUKnow for Teachers - an e-learning tool for professionals on how to keep children safe online
Barnados 'Wud U?' - a useful app from Barnardo's that you can download. Wud U? is a free educational tool that aims to show young people the behaviours that could put them at risk of being sexually exploited, through illustrated, interactive stories.
CSE: Perception vs Reality
Perception: It only happens in certain ethnic/cultural communities
Reality: In spite of what we have seen in the media about high profile cases, both perpetrators and victims can come from a variety of different ethnic and cultural backgrounds. But research shows that he majority of known perpetrators in the UK are lone white males.
Perception: It only happens to children in care
Reality: The majority of victims of CSE (80%) are living at home. However, children in care can be particularly vulnerable.
Perception: It only happens to girls
Reality: Boys are also victims of CSE. However, they may be less likely to tell anyone because of the stigma of being a male victim, and the fear that they will not be believed.
Perception: It is only perpetrated by men
Reality: There is evidence that women can be perpetrators of this crime too. They may use different grooming methods but are known to target both boys and girls.
Perception: It is always adults abusing children
Reality: Child-on-child sexual exploitation happens too - for example, children are sometimes used to 'recruit' others, by inviting them to locations for parties where they will then be introduced to adults or forced to perform sexual acts on adults.
Perception: It only happens in large towns and cities
Reality: CSE can and does happen in all parts of the country, in rural and coastal areas as well as towns and cities. Children can also be transported (trafficked) between towns, cities, villages etc., for the purpose of being sexually exploited.
Perception: Children are either victims or perpetrators
Reality: Around 6 per cent per cent of victims are also perpetrators. But although children may appear to be willing accomplices in the abuse of other children, this is because they are themselves controlled by an abuser.
Perception: Parents should know what is happening and should be able to stop it
Reality: Parents may not be able to identify what is happening: they may suspect that something is not right but not be able to stop it due to the perpetrator's control and threats.
Perception: Children can consent to being exploited.
Reality: A child cannot consent to their own abuse.
Ÿ Firstly, the law sets down 16 as the age of consent to any form of sexual activity.
Ÿ Secondly, any child under 18 cannot consent to being trafficked for the purposes of exploitation.
Ÿ Thirdly, regardless of age, a person's ability to consent may be affected by a range of other issues including influence of drugs, threats of violence, grooming, and a power imbalance between victim and perpetrators. This is why a 16 or 17 year-old can be sexually exploited even though they are old enough to consent to sexual activity.
Perception: If it happens online, it is not CSE.
Reality: If a child is being manipulated or forced into take part in sexual activity, it is CSE, even if it takes place online.