STABILITY AND CHANGE IN OUTCOMES FOR SEXUALLY ABUSED-CHILDREN

Objective: To evaluate sexually abused children and their families at intake and 18 months later, in comparison with a control group. Method : Eighty-four sexually abused children aged 5 to 15 years were assesse d at intake, with 64 being able to be reassessed at 18 months, the ass essment using measures of self-esteem relevant to their age; the Child ren's Depression Inventory, and the Achenbach Child Behavior Checklist . Parents were assessed with the McMaster Family Assessment Device and the General Health Questionnaire. Control children and families were similarly assessed. Additional measures at follow-up were a structured interview with the parents, the Indices of Coping Responses, and the Newcastle Child and Family Life Events Schedule, Therapists were conta cted to obtain information on type and duration of therapy. Results: W hile the control children's self-esteem, depression, and behavior scor es showed little change over time, the abused children's scores were m ore likely to move toward the normal range although 56% remained in th e dysfunctional range for self-esteem, 48% for behavior, and 35% for d epression. Improvement in child behavior was related to improvement in family function. While there was no direct relationship between child outcome and the relationship of the abuser to the child, family dysfu nction, which was related to child outcome, did correlate with the clo seness of the abuser to the child. Sixty-five percent of abused childr en had received therapy for an average of 9 months. No relationship wa s found between therapy and outcome. Conclusion: The major variable re lating to improvement in sexually abused children appears to be adequa cy of family functioning. There is a need for increased emphasis on th e evaluation of treatment.