Recommendations for Preventing Child Sexual Abuse in Youth-Serving Organizations: Implications From an Australian Royal Commission Review of the Literature

Abstract

Evidence suggests that tens of millions of children and adolescents are involved in youth-serving organizations (YSOs) outside of their homes on a daily basis. Children’s involvement with YSOs clearly offers a broad array of emotional, social, and personal development benefits. This involvement can, however, also be associated with a variety of safety risks, including the potential for child sexual abuse (CSA) victimization and the myriad short- and long-term consequences to its victims and their families. Recognizing the significance of CSA within YSOs, the Australian Royal Commission into Institutional Responses to Child Sexual Abuse funded a comprehensive review of the literature on risk and protective factors related to CSA in institutions. This yielded more than 400 primarily research articles from the United States, United Kingdom, and Australia, examining institutional CSA victims, perpetrators, and settings. Findings were provided regarding six specific types of institutional settings, including faith-based, early childhood education, childcare and schools, health care, out-of-home/foster care, and sport. This article is based on the findings of Kaufman and Erooga’s comprehensive literature review and Royal Commission findings. It provides a brief review of critical risks associated with CSA victims, perpetrators, and organizational settings, as well as highlights risks particular to specific types of YSOs and risks that are present across these organizations. Optimal prevention directions and strategies are outlined in response to identified patterns of organizational risk. Recommendations for YSO policy enhancements are also provided to complement the article’s prevention focus. Finally, suggestions are offered for future research directions to foster the development of an evidence-based foundation for work in this area.

Keywords

child sexual abuse prevention youth-serving organizations

Evidence suggests that the vast majority of children in the United States and other countries are regularly involved with youth-serving organizations (YSOs; Kaufman, Tews, Schuett, & Kaufman, 2012). YSOs are diverse, and range from out-of-home care placements, to schools, health care programs, community youth sports programs, individual tutoring, and after-school programs (e.g., YMCA, Boys & Girls Clubs of America, Big Brother and Big Sisters of America, and Swimming Australia). For example, more than 50 million children attend U.S. public schools (National Center for Education Statistics, 2018) and 60% of them (i.e., 45 million) are regular participants in community-based youth sports (S. Johnson, personal communication, October 18, 2015; Noble & Vermillion, 2014). In the United Kingdom, more than 8.7 million children attend state-funded schools (Department of Education, 2018), while approximately 60,000 children were in out-of-home placement (Holmes & Soper, 2010). In Australia, close to four million children regularly attend school (Australian Bureau of Statistics, 2018) and about 60% of all children aged 5 to 14 years participate in some type of organized sports outside of school hours (Australian Bureau of Statistics, 2012).

YSOs provide support and services, paid or voluntarily, to children (18 years of age and below) and assume responsibility for the children’s welfare (Gallagher, 2000). Clearly, YSOs offer a broad array of potential emotional, social, and personal development benefits to the children that they serve. Participation in YSOs can result in increases in self-esteem, life skills, and interpersonal enhancement with peers as well as adults (Trocmé & Schumaker, 1999; Vella, Cliff, Magee, & Okely, 2014). Elementary and middle schoolers who participate in YSOs also show improvements in behavior and academic work habits (Reisner, Lowe, Pechman, Pierce, & Bolt, 2007). These benefits notwithstanding, involvement in YSOs can also expose children to various forms of maltreatment including child sexual abuse (CSA; Irenyi, Bromfield, Beyer, & Higgins, 2006; Kaufman & Erooga, 2016; Mathews, 2017; Smallbone, 2017).

The actual scope of CSA in YSOs is difficult to estimate as epidemiological data generally do not specifically identify child maltreatment in organizational settings (Kaufman et al., 2012; Wurtele, 2012). “Moreover, while the focus of this investigation is child sexual abuse, recent work in the area highlights the clustering of various forms of child maltreatment, including emotional, physical, and sexual abuse” (Dong et al., 2004; Finkelhor, Turner, Hamby, & Ormrod, 2011; Herrenkohl & Kilka, 2019). In the United States, a pooled analysis of survey results from more than 13,000 children who were the focus of three national surveys of children’s exposure to violence found that sexual abuse in YSOs by adult teachers, coaches, and youth group leaders is relatively rare. In this study, Shattuck, Finkelhor, Turner, and Hamby (2016) reported that 0.8% of children and adolescents experienced some form of maltreatment within YSO settings during their childhood, and 0.4% experienced maltreatment in the past year. Of those who experienced maltreatment, for 6.4% of the sample, the maltreatment was characterized as CSA.

In contrast, however, other studies suggest higher rates of CSA in YSOs. For example, Gallagher (2000) estimated that organizational CSA across YSOs accounted for 52% of extrafamilial abuse in England and Wales. Furthermore, studies commissioned by the U.S. Council of Catholic Bishops and carried out by John Jay College of Criminal Justice researchers chronicle widespread abuse by Catholic priests between 1950 and 2002 (John Jay College of Criminal Justice, 2004, 2010).

In North America, Shakeshaft (2004) found a wide range of estimates of the percentage of U.S. students subjected to sexual misconduct by school staff, varying from 3.7% to 50.3%. She suggests that the carefully drawn sample and survey methodology of the American Association of University Women (2001) study, which found that nearly 9.6% of students are targeted in this way at some time during their school career, presents the most accurate available data.

CSA is also common in sports, recreational, arts, and cultural settings (Bjørnseth & Szabo, 2018; Leahy, Pretty, & Tenenbaum, 2002); juvenile detention (Beck, Harrison, & Guerino, 2010); and schools (Young, Grey, & Boyd, 2009). A recent study in Quebec utilizing a representative sample drawn from the general population and including 6,450 adolescents aged between 14 and 17 years found that 0.5% of adolescents reported experiencing CSA perpetrated by a sports coach (Parent et al., 2016). At the same time, the news media has continued to be the “bellwether” for organizational CSA, reporting on a broad range of offenders in YSO settings that include, but are not limited to, schools (e.g., teacher, William Vahey—United Kingdom), health care (e.g., pediatrician, Dr. Earl Bradley—United States), youth sports (e.g., soccer coach, Barry Bennell—United Kingdom), elite sports (e.g., U.S. Olympic team physician, Larry Nassar—United States), and the church (e.g., Gerald Ridsdale—Australia).

Recognition of the pervasive nature of CSA in YSOs, the tendency for it to be concealed by some organizations, and the need to address this form of abuse, along with other national cases and scandals, some contemporary and some historical, led to the convening of the Australian Royal Commission into Institutional Responses to Child Sexual Abuse (Australian Government Royal Commission, 2017). The largest of its kind, this Royal Commission was in session from 2013 through 2017 with a mandate to inquire into CSA in the context of YSOs and recommend directions provided to improve youth safety. With a budget of AUD372 million and with more than 300 employees, the Royal Commission conducted 8,013 private interviews with CSA survivors, produced more than 40 externally commissioned research projects, released 11 articles on key topics, and completed 57 case studies and public hearings (Australian Government Royal Commission, 2017; Mathews, 2017; Wright, Swain, & McPhillips, 2017).

This article draws from a research project commissioned by the Royal Commission involving a comprehensive literature review of more than 400 studies from the United States, United Kingdom, and Australia (primarily peer review publications) examining CSA risk and protective factors, as well as prevention strategies, to enhance YSO safety (Kaufman & Erooga, 2016).¹ The review focused on six specific types of YSO settings that emerged as dominant in the literature: (a) faith-based, (b) early childhood education, (c) child care and schools, (d) health care, (e) out-of-home/foster care, and (f) youth sports. Findings reflected risk factors across, as well as specific to, each of these six types of settings and prevention recommendations that were gleaned from the review.

The focus of the current article is to provide prevention directions for addressing CSA perpetrated in the YSO context. It draws from and expands upon Kaufman and Erooga’s (2016) Royal Commission review of the international literature and is in response to existing CSA risks (for a discussion of risk factors, see Kaufman and Erooga, 2016). The discussion of CSA prevention in YSOs begins by exploring the role of understanding offenders’ modus operandi in guiding the development of effective prevention strategies. Next, situational prevention is described and applications for its use in the YSO context are presented. This is followed by a review of promising educational approaches to YSO safety. Finally, a discussion of policy modifications to create a safety-oriented organizational climate concludes this article.

Preventing CSA in YSOs

Prevention is most effective when it is part of an integrative organizational framework that promotes a safe climate, clear policies, and the use of best practice strategies (Saul & Audage, 2007). Moreover, a focus on creating prevention approaches that are rooted in strong theory and evidence-based practice whenever possible creates a strong foundation for the development of approaches that are most likely to be effective. At the same time, consideration should be given to the applied realities of prevention strategies, seeking to tailor approaches to the specific needs of particular YSO contexts. These factors, as well as the nascent status of prevention approaches directed at YSO CSA, should be kept in mind when reviewing the following discussion of prevention recommendations to improve YSO safety for the children and adolescents they serve.

Understanding Offenders’ Modus Operandi

Findings from a variety of studies have underscored the value of understanding abusers’ modus operandi as a foundation for the planning of prevention programs. The modus operandi of CSA offenders is defined as the “behavior prior to, during, and following sexual abuse” (Kaufman et al., 1998, p. 350) and remains one of the most important CSA risk factors for effective prevention programming to consider (Kaufman, Mosher, Carter, & Estes, 2006; Kaufman & Patterson, 2010; Leclerc, Proulx, & McKibben, 2005). To date, much of the research on this subject has employed the Modus Operandi Questionnaire (MOQ; Kaufman, 1994, 2015) to assess adult and juvenile child sex offenders’ approaches to abuse. The MOQ assesses key behavioral markers that characterize much of child sexual offending, including where offenders find and access their victims, what strategies they use to groom potential victims (and caregivers) prior to abuse onset, their use of bribes or enticements and threats or coercion to gain compliance in abusive acts, and tactics used to maintain victim silence after abuse onset (Kaufman, 1994, 2015)

Findings from these studies describe offenders’ behaviors, as well as differentiating offenders’ grooming behaviors, based on their relationship to the victim (Kaufman et al., 1998); the age of the offender (Kaufman et al., 1998); victim, perpetrator, and offense characteristics (Kaufman, Hilliker, & Daleiden, 1996); situational or environmental factors (Kaufman et al., 2006; Leclerc, Beauregard, & Proulx, 2008); and the resistance strategies employed by potential victims (Barber, Kaufman & Winchester, 2002; Leclerc, Wortley, & Smallbone, 2010). The majority of the literature, however, has focused on CSA in general rather than offending within organizational settings.

Modus Operandi in Organizational Settings

A small number of studies address the grooming patterns of CSA perpetrators in organizational settings. These investigations have identified offender characteristics and modus operandi that highlight the need for stronger prevention programming development based on a clearer understanding of salient risk factors (Erooga, Allnock, & Telford, 2012; Leclerc & Cale, 2015; Leclerc et al., 2005; Miller, 2013; Smallbone & Wortley, 2000; Sullivan & Quayle, 2012). What has been discovered about perpetrators’ behaviors in organizations provides some important insights into this phenomenon. CSA perpetrators in this context are likely to present with a late onset of offending, a high incidence of nonsexual crimes, a low incidence of chronic offending, a low incidence of “stranger” abuse, a low incidence of offender networking and collaboration, and a relatively low incidence of long-term planning. Interestingly, findings from these investigations suggest that rather than creating opportunities in YSOs for offending, many perpetrators appear to capitalize on the opportunities or organizational vulnerabilities that are presented to them. Offenders in one study reported that they took advantage of organizational processes that were “relaxed and complacent and, in a few cases, careless” (Erooga et al., 2012, p. 80). Likewise, Sullivan and Quayle (2012) explained how offenders in their sample took advantage of organizations that lacked a strong “culture of safety” and an “ethos of accountability.”

Even when suspicions were aroused, offenders often used “the adversarial nature of disciplinary procedures to personalize the issue, deny the charges, marginalize the accuser, and encourage others to take sides” (Sullivan & Quayle, 2012, p. 96). This strategy underscores the importance of rigorous investigations of CSA accusations, carried out by relevant authorities, prompted by responsible organizations in an environment of accountability regarding safety procedures (Sullivan & Quayle, 2012). Study findings also demonstrated that offenders take advantage of environmental factors that permit access to potential victims and, in some cases, a setting conducive to carrying out the abuse itself (Leclerc & Cale, 2015; Sullivan & Quayle, 2012). With this in mind, it has been suggested that opportunities to commit CSA can be significantly reduced by better regulating interactions between children and employees or volunteers, increasing onsite supervision, restricting or monitoring access to unsupervised facility areas (Leclerc & Cale, 2015; Leclerc et al., 2005; Sullivan & Quayle, 2012), implementing strong systems for oversight and accountability, and enhancing the physical visibility of settings through environmental design (Miller, 2013).

Situational Prevention Approaches (SPAs) to Address Sexual Violence

Rather than focusing solely on individuals, risk management also needs to address environmental factors (Beyer, Higgins, & Bromfield, 2005), in what is generally referred to as an SPA. Situational prevention is a theory for crime prevention rooted in more than 60 years of safe housing design and more than 25 years of successful community crime prevention around the world (Bullock, Clarke, & Tilley, 2010; Clarke, 1995; Cornish & Clarke, 2002). Cornish and Clarke’s (2002) situational prevention model (SPM) suggests that certain setting-based factors may allow or even facilitate criminal behavior. Conversely, limiting or eliminating such factors will reduce opportunities for crime, minimize rewards associated with perpetration, and prevent future crime. At the heart of the SPM are three criminological theories: defensible space theory (Newman, 1972), routine activity theory (Cohen & Felson, 1979), and rational choice theory (Cornish and Clarke, 2002). This criminological approach provides a framework for examining the contextual and situational risks that increase the potential for crimes to occur in a given setting (Clarke, 1995; Clarke & Homel, 1997). Drawing from these theories, SPM assumes that (a) perpetrators are active decision makers, continually evaluating the likelihood of successfully committing a crime and balancing these odds against the possibility of incurring consequences; (b) the presence of a motivated offender, an available victim, and the potential for compromised supervision through lack of a capable guardian; and (c) environmental factors, both physical and symbolic, can contribute to the risks of crime occurring in a particular situation or setting. In summary, the SPM is a probabilistic model, concerned with factors that either increase or decrease an offender’s perception that they could successfully perpetrate a crime.

Kaufman’s SPA

Kaufman and his colleagues built on the SPM (which was initially conceived for criminal activity in general), to develop the SPA for use more specifically in the prevention of CSA (Kaufman et al., 2006; Kaufman & Patterson, 2010; Kaufman et al., 2012). The SPA is rooted in a number of well-regarded criminal justice theories (e.g., rational choice theory (Cornish & Clarke, 1986), routine activity theory (Cohen & Felson, 1979), and defensible space theory (Newman, 1972), as well as an extensive research literature on the effectiveness of the underlying SPA; see Kaufman et al., 2012, for a more in-depth discussion).

The SPA also considered literature on child sex offenders’ modus operandi (Kaufman, Barber, Mosher, & Carter, 2002; Kaufman et al., 1998). Designed as a process-based approach for YSOs, the SPA was conceptualized with the complexities of situational prevention theory in mind and designed for ease of implementation, sustainability, and to maximize effectiveness. The intention was to create a prevention approach that could be carried out with minimal training, would benefit from staff expertise and experience, and would address a broad array of risks to children and adolescents within the organization. The goal of the SPA was to identify as many risk-related concerns as possible in an organizational setting at a given point in time (Kaufman, Hayes, & Knox, 2010; Kaufman & Patterson, 2010; Kaufman et al., 2012) and to engage staff in developing a practical and effective local solution addressing each of these concerns. In this way, the SPA can assist an organization in shifting its focus toward prevention (i.e., addressing safety risks when they are small and manageable and prior to when they might lead to a child being harmed).

The SPA is carried out as a four-step process that includes (a) brainstorming critical safety risk factors; (b) developing effective and affordable prevention or risk-reduction solutions for each identified risk, using existing organizational strengths and/or protective factors as the foundation for solutions, whenever possible; (c) prioritizing solutions for implementation based on the associated degree of safety concern and organizational capacity; and (d) creating and taking action on simple solution-oriented implementation plans. In the first step of the SPA, seven prompts are used for brainstorming safety risks: (a) characteristics of at-risk children, (b) high-risk locations, (c) facilitators or issues that can contribute to multiple risks (e.g., poor staff-to-child ratios and lapses in staff supervision), (d) organizational and community policies, (e) lifestyle and routine activities (i.e., on the part of the child, their family, or YSO staff), (f) the larger community environment, and (g) health concerns, accidental injury, and physical safety.

In an unpublished report, Kaufman (2016) described the development of the SPA for use in more than 4,100 Boys & Girls Clubs of America (BGCA). This 4-year project, funded by the Pennsylvania Coalition Against Rape, focused first on tailoring the SPA to BGCA’s organizational culture, policies, and practices. This resulted in the development of an SPA Implementation Manual, which was then used in a formative evaluation with 16 BGCA clubs across four U.S. states. Evaluation results indicated high satisfaction with the SPA process from administrators, staff, parents, and youth, with average ratings between satisfied and highly satisfied (i.e., 3.2 on a 4-point scale across evaluation items). Finally, when comparing clubs using the SPA with those engaging in “business as usual” within the same “umbrella organizations,” the clubs using the SPA were able to identify 7 to 10 times more risks in their environments, created practical solutions to address each risk, and implemented solutions for concerns they had control over in a timely fashion. Application of the SPA in this fashion is consistent with the Centers for Disease Control and Prevention’s (CDC) four-step prevention process that relies on implementation of strategies for prevention of risk factors translating into child harms, in this case, CSA (Rogers, Green, & Kaufman, 2010).

These preliminary findings are very promising and suggest the need for a larger scale assessment of the SPA’s efficacy within BGCA as well as testing the efficacy of the SPA in other YSOs. It should be noted that Kaufman is just beginning a collaborative project with the U.S. Olympic Committee–affiliated U.S. Center for SafeSport to develop a version of the SPA for use with Olympic and Paralympic athletes. This Department of Justice–funded prevention program development project will be completed over the next 3 years (2019-2021).

Other Situational Prevention Studies

Smallbone and McKillop (2015) focused on situational prevention and considered how a “place-based” approach might inform particular types of prevention strategies. This approach closely examines the influence of the setting on the manifestation of the problem to better tailor prevention strategies. Their study summarized CSA findings as they relate to four distinct types of settings: domestic, organizational, public, and virtual. The authors also suggested ways in which these settings could be redesigned to reduce risk factors and foster protective factors. They went on to assert that “a comprehensive prevention framework requires an understanding of the context, dynamics, and risk factors associated with the perpetration of CSA within different settings, as well as understanding the individuals involved” (p. 19). An example of how such a place-based approach may result in qualitatively different prevention can be seen by contrasting what situational prevention strategies may be required in YSOs serving different populations and engaging in different activities. Compared with a YSO delivering informal group guitar lessons for boys aged 14 to 18 years, for example, a YSO focused on elite gymnastics for girls aged 6 to 16 years has a range of significant risk factors due to the nature of the activities, the nature of the relationships, and the personal characteristics of the participants and will require different prevention strategies.

Consideration of the particular YSO setting is critically important. As situational prevention is a broad conceptual approach recommended for all YSO prevention strategies, its effectiveness will be optimized by being customized to the specific features, activities, and risks of the particular setting. Aspects of risk related to the specific YSO context and activities embraces matters, such as (a) the particular child clientele (age, gender), (b) the type of activities in which the organization is engaged and how the activities are conducted (e.g., whether there are field trips or overnight stays and the level and type of supervision provided), and (c) the degree of control and authority over the child exercised by the YSO staff and volunteers (e.g., whether it extends to training, diet, medical treatment, social activity, and physical touch; whether there are ongoing relationships; whether there are rewards systems; the extent of pressure involved in the child’s performance, progression, and selection for elite teams and career pathways; Erooga et al., 2012; Kaufman, Hayes, & Knox, 2010; Kaufman et al., 2012; Kenny & Wurtele, 2012; Mathews, 2017; Wurtele, 2012). Heightened CSA risks may be associated with required elements of some sports. For instance, training may require direct physical contact as part of instruction (e.g., in gymnastics, dance, and swimming). Furthermore, postcompetition physical therapy may include massage, which can be intrusive. Moreover, in some sports (e.g., dance, swimming, and gymnastics), specialized attire that exposes much of the athlete’s body may contribute to risk. At the same time, being in close proximity to a child may make it easier to observe signs of physical abuse (e.g., bruises) or other welfare concerns (e.g., signs of self-harm).

Communal changing rooms, showers, and treatment rooms may also be a regular part of sports participation and may be a concern. Travel to competitive events can heighten safety risk, given that a great deal of offending occurs in situations involving travel, overnight stays, and interactions in the offender’s residence (Smallbone & Wortley, 2000). Finally, highly competitive organizational hierarchies, where youth compete for status, the opportunity to compete, awards, and career progression, can increase the closeness and dependency between coach and athlete, creating safety risks. The literature suggests that safer institutional settings can be created through environmental modification to improve natural surveillance, active supervision and monitoring, educating adults and professionals about abusers’ key modus operandi, and promoting children’s disclosure of CSA.

Education and Training Strategies

Education and training strategies may be the most commonly suggested approaches for the prevention of CSA (Kaufman, Sitney, & Glace, 2018; Wurtele, 2012). Training of this nature typically provides a foundation regarding common CSA risk factors, early signs of boundary violations and grooming, strategies for prevention, and how to report questionable behavior as well as suspicions of abuse (Wurtele, 2012). It is particularly important for those who work or volunteer in YSOs, and for those who represent YSOs’ leadership, to be knowledgeable about CSA in YSOs (Mathews & Collin-Vézina, 2016; Wurtele, 2012). Key foundational areas include what acts constitute CSA; its prevalence; who experiences CSA and at what ages; who perpetrates abuse; the criminality of CSA; the serious harms and consequences typically caused to the child, their family, and the host organization; many organizations reluctance to report abuse (i.e., given the potential impact on their reputation, funding, etc.); how children typically disclose CSA; common emotional, social, and behavioral responses of children after victimization; principles of consent, children’s rights, and gender equality; professional boundaries and appropriate versus inappropriate interactions with children; duties to report known and suspected cases of abuse (based in both law and policy); how to respond to concerns and disclosures; and how to respond and report in different kinds of circumstances. Moreover, education and training should be designed and delivered to different YSO groups: professionals and volunteers, YSO leaders, children and youth themselves, and parents (Kaufman & Erooga, 2016; Kaufman, Erooga, et al., 2018; Mathews & Collin-Vézina, 2016; Wurtele, 2012).

These educational strategies are typically implemented either through in-person training or via web-based training. Evidence suggests the efficacy of online training, which is easily implemented and has a minimal delivery cost for large groups of parents, children, and professionals (Kenny, 2007; Paranal, Thomas, & Derrick, 2012; Rheingold, Zajac, & Patton, 2012). Paranal and colleagues (2012) examined online prevention training for volunteers and employees of YSOs and found it to be an effective tool for enhancing prevention education. At the same time, however, there are indications that organizations may benefit more from in-person training due to the added insights gained from discussions between trainers and participants (Paranal et al., 2012). Furthermore, Rheingold and colleagues (2012) found that both in-person and web-based training in the prevention of CSA were feasible to implement and acceptable to professionals. However, when comparing formats, the in-person format was favored in terms of participant comfort level and the likelihood of sharing information with others. This study also found that technology issues inhibited some participants from engaging in web-based training. Taken together, these studies suggest that in-person and online training approaches each have strengths and limitations. It seems that online training, with its potential to reach a greater number of individuals and its lower cost, compared with in-person training, could be enhanced to offer an online discussion component that would make it the clear favorite between these two approaches. At the same time, it is important to consider whether technology-based training platforms restrict accessibility by traditionally underfunded YSOs who are more likely to serve marginalized communities.

Whether it is in-person or web-based training, most researchers agree that CSA education and prevention training is necessary for all YSO employees and volunteers working with children (Kenny, 2007; Mathews, 2011, 2017; Mathews & Collin-Vézina, 2016; Wurtele, 2012; Wurtele, Mathews, & Kenny, 2018). Wurtele (2012) argued that “education is the cornerstone of preventing CSA and sexual boundary violations by YSO staff members” (p. 248). At the same time, however, she clarified that only a handful of exceptional organizations actually provide prevention training. She goes on to encourage YSOs to integrate prevention training into their staff and volunteer orientation and education. Irenyi and colleagues (2006) made a similar point regarding the need for broad-based professional training, noting the importance of incorporating training for teachers to address child protection issues and the potentially positive and long-lasting impact of such protective efforts. They highlighted the need for vigilance in all YSOs and recommended that teachers and other professionals working with children also be trained in the situational crime prevention approaches. In some countries, governmental funding is already supporting the development of online training for professionals working with children in other areas. For example, the Australian Government’s Department of Health is funding the Australian Psychological Society to create evidence-based online learning modules to improve their understanding of the issues faced by people affected by past forced adoption policies and practices (www.psychology.org.au/forced-adoption). This training was designed to educate health and allied health professionals. A similar model could be applied to training for organizations in how to be “child safe,” which would support existing resources and accreditation programs (e.g., the Australian Childhood Foundation’s Safeguarding Children Program: www.safeguardingchildren.com.au) as well as foster comprehensive training across YSOs.

Applying Prevention Strategies in Nonmajor YSOs

While much of the literature focuses on policy and prevention strategies in general, few studies have focused on settings outside major organizations such as schools, sports, medical/health care settings, and churches. Studies examining nonmajor organizations have investigated juvenile correctional facilities, day care nurseries, and day camps. In a study of youth incarcerated in juvenile correctional facilities, Beck et al. (2010) reported a high prevalence of sexual victimization and suggested the need to integrate effective prevention programming in such settings. Abner, Browning, and Clark (2009) developed a sexual abuse prevention guide specifically for frontline community correction officers and supervisors working in youth correctional facilities. The guide offers a broad range of recommendations to enhance prevention of CSA, including clearly establishing professional boundaries, informing inmates of their right to be protected, and creating a culture of zero tolerance for sexual abuse.

Wonnacott (2013) focused on CSA in nurseries (day care centers), suggesting that offenders may consider them an ideal environment for perpetrating. Wonnacott identified the limitations of relying solely on basic safety policies and procedures in such a setting with its complex environmental and relational risk factors and instead urged the use of a more dynamic framework based on the SPM (Cornish & Clarke, 2002) that can address the whole system encompassed by each particular nursery.

Finally, Johnson (2014) examined the policies of five separate day camps (including nonresidential recreational activity facilities), serving approximately 300 children, by interviewing the camp directors. Study findings indicated that, for the most part, these camps lack a written policy for preventing and addressing CSA and had failed to educate staff about early warning signs of CSA, symptoms of CSA, or related concerns as part of their onboarding orientation. Moreover, nearly all of the camp directors themselves struggled to identify the steps they would take to address a CSA allegation at their camp. Johnson (2014) recommended that camp directors be better educated on the importance of developing policies and procedures pertaining to the protection of campers and staff. Best practice would dictate the development of written policies, completion of staff orientation and participation agreements, and the purchase of insurance to ensure that both children and staff members were protected in the event of CSA allegations (Johnson, 2014).

Recommendations for YSO Policy Enhancements

There is now a general consensus about the types of strategies that should be adopted by YSOs to minimize risk and ensure appropriate safety responses. This is evident in approaches and organizational tools proposed by the CDC (Saul & Audage, 2007), the Australian Childhood Foundation (Tucci, Mitchell, Holmes, Hemsworth, & Hemsworth, 2015), by leading scholars (Kaufman, Erooga, et al., 2018; Kaufman, Erooga, Higgins, & Zatkin, 2018; Kaufman, 2010; Kenny & Wurtele, 2012; Leclerc & Cale, 2015; Wurtele, 2012), and by strategies that have been adopted in other areas of intervention with children (Parent & Demers, 2011; Walsh et al., 2013). Of note is the fact that the CDC has recently secured funding to update its 2007 publication on prevention in YSOs to better reflect prevention directions for enhancing safety in YSOs.

The existing literature suggests the need for clear organizational safety policies in six key areas that include (a) staff and volunteer screening, (b) establishing codes of conduct, (c) monitoring the implementation of safety practices, (d) creating safe organizational environments, (e) appropriately educating/training staff and volunteers, and (f) responding to as well as reporting child safety concerns (Mathews, 2017; Wurtele, 2012). Clearly defined and effectively implemented policies and practices are foundational to establishing a “safety culture” that protects children involved with YSOs (Saul & Audage, 2007; Tucci et al., 2015). In a report developed by a group of experts in collaboration with the CDC, Saul and Audage (2007) recommended institutional policies and strategies to enhance child safety in YSOs. In their document, the authors stressed the importance of creating “. . . a safe space, having clear goals pertaining to the prevention of CSA, creating a process for developing CSA prevention policies and practices, and including appropriate CSA policies and practices in the prevention plan” (pp. 33-34).

Theoretical and practical support for such approaches is found in the situational crime prevention and the offender modus operandi literatures. CSA offenders in Erooga et al.’s (2012) study, for example, noted that many of their YSO’s leadership failed to provide a clear organizational commitment to children’s welfare. In fact, most messages during onboarding for employment or volunteering offer no more than basic briefings about child protection. Many YSOs described by participants did not place an emphasis on providing clarity about organizational rules and regulations. In particular, expectations about the relationships between staff and youth were rarely spelled out and/or not consistently enforced. Some organizations were described as being more committed to managing children’s behavior than to ensuring their welfare. Researchers have similarly noted the gap between policy directives and implementation by YSOs (Quadara, Nagy, Higgins, & Siegel, 2015). This information is significant in that it helps guide YSOs in addressing common critical youth safety.

Given the emerging nature of this area, it is unsurprising that gaps remain in the literature regarding optimal prevention approaches. At the same time, however, there is broad consensus on the general characteristics of sound prevention approaches in YSOs. This raises the question of how broader policy efforts can and should support the creation and sustained implementation of prevention efforts across YSO “sectors” (i.e., major categories of YSOs, such as schools or youth sports organizations). Two recent studies examined the larger issue of governmental responses (or lack thereof) to national inquiries into organizational CSA. These studies focused on the recommendations that resulted from these inquiries and were intended to promote more effective prevention policies (Budiselik, Crawford, & Chung, 2014; O’Mahony & Kilkelly, 2014). Budiselik and his colleagues (2014) expressed concerns regarding the fact that recommendations resulting from CSA inquiries have typically not been implemented in Australia. They conclude by posing a question directed at Australia’s decision makers: “How can better outcomes be achieved from the effort put into inquiries?” (p. 580). Budiselik, Crawford, and Squelch (2009) urged both government authorities and the YSOs themselves not to rely exclusively on criminal history checks. Instead, they recommended broader government-authorized child protection strategies. Others have noted the need for specific prevention measures in YSOs to accommodate the heightened risk to children with disabilities (Robinson, 2015), based on multiagency collaboration, statutory oversight, and rights-focused practice guidelines for staff working with children (France, Munro, & Waring, 2010; Murray & Osborne, 2009). Along with governmental responsibility, researchers find that YSOs must also accept responsibility, on an individual basis, for their part in keeping children safe from sexual abuse by implementing policies rooted in evidence-based prevention practices and by actively taking responsibility for past safety transgressions (Bublick, 2014; Hildyard & Wolfe, 2002; O’Mahony & Kilkelly, 2014; Saul & Audage, 2007; Tucci et al., 2015).

Effective sectorwide policy development and support in this sense, combined with individual YSO efforts, can produce a more sustained impact and reach a greater segment of the population than isolated YSO prevention (Bunnell et al., 2012). Underlying effective policy change at this broader level may often require collaborative efforts to create new legislative or policy schemes by government and nongovernment agencies providing care and services to children (Her Majesty’s Government, 2013; New South Wales Government, 2006). Both lived experience and regulatory theory has demonstrated that it is not sufficient to allow YSOs unrestricted freedom to self-regulate their efforts without any oversight or external accountability (Mathews, 2017). Also, from perspectives of diversity and protection of the vulnerable—considering sex, religiosity, culture, and age—these policy mechanisms and oversight methods are crucially important considerations. CSA generally affects girls 2 to 3 times as frequently as boys (Stoltenborgh, Van, Ijzendoorn, Euser, & Bakermans-Kranenburg, 2011), boys are likely to experience CSA at higher levels in some religious settings (Wright et al., 2017), that closed religious settings are particularly resistant to change and independent governance (Smith & Freyd, 2014), that cultural factors also predispose CSA to silence and cover-ups (Fontes & Plummer, 2010), and that children generally are at an age and developmental stage of profound vulnerability at the typical age of onset.

An example of this broader sectorwide policy development and oversight can be seen in the Australian state of Victoria. In response to the findings of a state Inquiry, the Victorian Government created a legislative scheme in 2015 to implement a set of Child Safe Standards in a broad range of CYSOs (Mathews, 2017). The Child Wellbeing and Safety Act of 2005 (Vic) Part 6, s 17, together with a Ministerial Order, requires the following standards to be met by YSOs in multiple sectors (including education, early childhood education and care, out of home care, health, religious, cultural, sporting and recreation services, and other welfare services:

Standard 1: Strategies to embed an organizational culture of child safety, including through effective leadership arrangements;

Standard 2: A child safe policy or statement of commitment to child safety;

Standard 3: A code of conduct that establishes clear expectations for appropriate behavior with children;

Standard 4: Screening, supervision, training, and other HR practices that reduce the risk of child abuse by new and existing personnel;

Standard 5: Processes for responding to and reporting suspected child abuse;

Standard 6: Strategies to identify and reduce or remove risks of child abuse;

Standard 7: Strategies to promote the participation and empowerment of children.

An independent body, the Commission for Children and Young People, has substantial powers of oversight and enforcement (Mathews, 2017). This Commission also provides other guidance to support YSOs in implementing the Standards (Victorian Commission for Children and Young People, https://ccyp.vic.gov.au/child-safety/being-a-child-safe-organisation/).

A second Australian example is also instructive. Similar to the earlier Victorian initiative, the Australian Government Royal Commission into Institutional Responses to Child Sexual Abuse made recommendations for the implementation of Child Safe Standards in YSOs. In its Final Report, the Royal Commission recommended that YSOs adopt comprehensive measures to prevent, identify, and respond appropriately to CSA, and that governments require implementation of these measures through legislative schemes (Australian Government Royal Commission, 2017, Recommendations 6.4-6.11). In condensed paraphrased form, Recommendations 6.4-6.11 state that

Rec. 6.4: All institutions should uphold the rights of the child, and should act with the best interests of the child as the primary consideration; to achieve this, institutions should implement the Child Safe Standards.

Rec. 6.5: There are 10 Child Safe Standards (these include the seven broad dimensions discussed above, while using different terminologies).

Rec. 6.6: Institutions should be guided by the following components when implementing the Standards (multiple components are then listed for each standard).

Rec. 6.7: The Child Safe Standards should be adopted in the new National Statement of Principles for Child Safe Organisation, and endorsed by the Council of Australian Governments.

Rec. 6.8: State and territory governments should require all institutions engaging in child-related work to meet the Child Safe Standards.

Rec. 6.9: Legislative requirements to comply with the Child Safe Standards should cover all institutions providing education, health, religious, childcare, coaching, and residential functions, and multiple other designated services and activities (these are then listed).

Rec. 6.10: State and territory governments should ensure there is an independent oversight body that monitors and enforces the Child Safe Standards.

Rec. 6.11: The oversight body should have multiple additional designated functions (these are then listed).

To date, individual Australian States and Territories have taken different steps to consider and implement these recommendations. In the state of New South Wales, the Children’s Guardian published nonbinding “Principles for Child-Safe Organisations” which were informed by Recommendations 6.4 to 6.11. In Western Australia, the Commission for Children and Young People has developed “Child Safe Organisations WA: Guidelines.” Most recently, at a national level, the federal government has engaged the Australian Human Rights Commission to develop a National Statement of Principles for Child Safe Organizations, with State and Territory Community Services Ministers supporting this work. The draft National Principles substantively duplicate the Child Safe Standards and have been agreed to by Community Services Ministers. They will be submitted to the Council of Australian Governments—a body comprising all State and Territory Community Services Ministers—for endorsement in late 2018 (Australian Human Rights Commission, 2018). It is not yet clear exactly how these National Principles will be translated into legislation or policy.

Future Directions for Prevention

In considering directions for the prevention of CSA in YSOs, it is useful to consider both the “big picture” and a more systematic public health framework for next steps in the field. In broadly considering how CSA is driven by a variety of factors concerning the victim, the perpetrator, and the situation or organization, Quadara and her colleagues (2015) argued that effective prevention demands strategies to address knowledge about each of these factors, integrated with each other. These strategies include (a) protective behaviors education for children, (b) situational crime prevention, (c) pre–criminal justice therapeutic interventions for problematic sexual behaviors and sexually abusive behaviors, (d) post–criminal justice involvement for therapeutic prevention of reoffending (with juvenile and adult offenders), (e) criminal justice and other statutory responses, and (f) therapeutic work with children/adolescents who have been sexually abused. In this way, organizational safety is maximized through multiple layered evidence-based prevention approaches that create a safety “patchwork” countering a broad array of organizational CSA risk factors. Similarly, and in addition, the broader sexual abuse prevention literature would suggest that work is needed at the population level to address the factors shown to facilitate CSA: socioemotional skill deficits, empathy deficits, attitudinal and cognitive distortions, a sense of sexual entitlement, and a construction of masculinity emphasizing sexual performance and dominance (Jewkes, Fulu, Roselli, & Garcia-Moreno, 2013; Seto, Babchishin, Pullman, & McPhail, 2015; Whitaker et al., 2008).

In addition to the broad focus on potential content areas for future research suggested by Quadara and colleagues (2015) as well as others in this review, there is a need for a framework to help develop a more systematic response to organizational CSA. With this in mind, we would encourage the adoption of the highly successful public health research approach (Lutzker & Wyatt, 2006; Rogers et al., 2010) as a process for enhancing safety in YSOs. This would involve a more concerted focus on research in five key domains. First, epidemiological and “basic” research to better understand the broad range of individual and situational strengths and risk factors that are salient in the YSO context, as well as how these factors differ based on critical organizational dimensions (e.g., type of service[s] provided, organizational size and staffing, and populations served). Second, intervention studies that draw from both theory and basic research to test the efficacy of various prevention strategies. These interventions would benefit from both, considering approaches that could be applied across organizations within a particular sector (e.g., across schools or across out-of-home care settings) and, at the same time, would allow for tailoring to the particular characteristics of individual YSOs (e.g., strengths, risks, and capacity). Third, investigations that focus on the role of leadership, policy, and climate enhancement to create organizational cultures that foster youth safety. While these areas are intertwined, efforts should be undertaken to separately examine the contribution of each to fostering organizational safety. Fourth, a multifaceted approach should be undertaken to better understand the differential strengths and risk factors associated with underserved communities utilizing YSOs. Research of this nature will allow for the development of prevention approaches tailored to the differential needs and drawing on the strengths of traditionally underserved youth and their families. Fifth, and finally, evaluation research would be especially useful in fostering the development of prevention approaches that are appropriate for broad dissemination in organizations across major YSO sectors (e.g., health care and schools). Early on in this emerging area, it will be important to encourage the incorporation of evaluation research into applied studies exploring the impact of specific YSO prevention approaches, policies, and climate interventions to help identify promising strategies. These studies will also provide feedback to hone theory and, once incorporated, can then facilitate more effective applied research. In the long run, large-scale evaluation studies (e.g., randomized control studies) will help move the field toward the goal of developing a broad array of evidence-based prevention approaches to effectively address key safety risk factors and in turn enhance children’s safety while participating in YSO programming.

Such a program of research will, of course, require adequate fiscal support to be successful. As noted, Australia has recently provided close to AUD400 million in support of its Royal Commission on CSA in YSOs as well as committing to many hundreds of millions of dollars more for the development of prevention programming to address identified child safety risks. This national commitment on the part of Australia provides a precedent and offers hope that other countries will embark on a more systematic response to organizational CSA in the near future.

Footnotes

Acknowledgements

We gratefully acknowledge the support of the Australian Royal Commission into Institutional Responses to Child Sexual Abuse in funding the review from which this article is drawn. We also thank Elizabeth Letourneau, PhD (Professor of Public Health, Bloomberg School of Public Health & Director, Moore Center for the Prevention of Child Sexual Abuse, Johns Hopkins University) for her insightful comments on an earlier version of this article. The views expressed in this article are those of the authors and do not necessarily represent those of the aforementioned.

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iDs

Marcus Erooga

Benjamin Mathews

Notes

Author Biographies

Keith L. Kaufman, PhD, is a professor in the Department of Psychology at Portland State University (Portland, OR). His research focuses on the prevention of sexual violence, with an emphasis on understanding key etiological factors in juvenile sex offenders as well as the impact of situation prevention approaches to improve safety. He is currently completing a DOJ-funded project to develop a situational prevention approach to address safety on university campuses and starting a project with the U.S. Center on SafeSport to enhance Olympic and Paralympic athletes’ safety.

Marcus Erooga is an independent safeguarding consultant, an associate editor and past editor-in-chief of the Journal of Sexual Aggression, and a past chair of NOTA (the National Organisation for the Treatment of Abusers). He is author of some 80 publications on child abuse and sex offender–related issues, most recently an edited book, Protecting Children and Adults From Abuse After Savile: What institutions and Organizations Need to Do (2018, Jessica Kingsley Publishers), which considers the learning from the 70+ inquiry reports published in the wake of revelations about Jimmy Savile’s criminality.

Benjamin Mathews is a professor in the School of Law at Queensland University of Technology (QUT) in Brisbane, Australia, and is senior research fellow in the QUT Faculty of Law. He is codirector of the Children’s Health Program in the Australian Centre for Health Law Research. He is also a professorial fellow to the Australian Government Royal Commission into Institutional Responses to Child Sexual Abuse. He holds adjunct positions at the University of Colorado and Penn State University and is a member of the editorial board of Child Abuse & Neglect.

Erin McConnell is a recent graduate from Portland State University with an MS in psychology. Her research interests include sexual violence and abuse prevention within the contexts of higher education, sports organizations, and youth services. Currently, her work involves the design, implementation, and evaluation of evidence-based programming to improve institutional safety outcomes.

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