(Reuters Health) - Children who learn about preventing sex abuse in school more often report abuse in their own lives than do kids who are not taught about it, according to a new research review.
This reinforces the findings of previous reviews, said lead author Kerryann Walsh of Queensland University of Technology in Brisbane, Australia.
"The programs increase children's knowledge of child sexual abuse concepts and their skills in reacting and responding to risky situations," Walsh told Reuters Health by email.
But, "these programs are not an inoculation against child sexual abuse," she added.
The reviewers analyzed 24 trials of school-based prevention programs, including a total of almost 6,000 elementary and high school students in the U.S., Canada, China, Germany, Spain, Taiwan and Turkey.
The programs all varied in their methods, but many taught kids safety rules, body ownership, private parts of the body, distinguishing types of touches and types of secrets, and who to tell. Some used films, plays, songs, puppets, books or games, and others included role-play and discussion.
The shortest programs consisted of a single 45-minute session, while others involved up to eight 20-minute sessions on consecutive days.
Based on questionnaires and vignettes used to test the programs' effects, kids in the programs demonstrated greater knowledge of protective behaviors and knowledge of sex abuse prevention concepts. And those knowledge gains seemed to last at least six months after the school program ended, according to four of the trials.
About four in 1,000 kids who did not participate in the prevention programs reported some form of sexual abuse, compared to 14 of every 1,000 kids in the prevention programs, the authors report in the Cochrane Library.
Anecdotally, the programs do seem to increase disclosures, Walsh said, but many of the studies included in the review did not collect this data.
This is unfortunate; it would be so valuable in assessing which programs are working better than others. It's probably impossible to count all the occurrences when a child was able to avoid molestation because of their awareness, but I suspect it is working there too.
"Of the small number of studies that did, the data was somewhat imprecise so we conclude that programs do increase disclosures, but with caution that further studies are needed to determine if this is a true effect," Walsh said.
The prevention programs did not seem to increase or decrease kids' levels of anxiety or fear.
The review supports the continued use of prevention programs in schools. They've been in use in the U. S. since the 1980's, and are now conducted in many developed countries and some developing countries, Walsh said.
"These types of programs are similar to the interactive school based prevention programs for smoking and drug use which have documented effectiveness," said Elizabeth L. Jeglic, who conducts sex offender research at John Jay College of Criminal Justice in New York, and was not part of the new review.
The new results suggest that prevention efforts should be continued and standardized, she told Reuters Health by email.
"While there is evidence that these programs can work, the content of what actually works is often not spelled out," said Georgia Babatsikos, who researches child sexual abuse at Deakin University in Victoria, Australia. "Also the focus on children and the lack of evaluation of prevention programs targeting parents and caregivers is worrisome."
Babatsikos was not part of the review.
Parents should start talking to kids about sexual abuse at three to four years of age, using age-appropriate language and discussing safety in snippets, she told Reuters Health by email.
"These conversations need to occur regularly throughout childhood and teenagehood," she said.
In addition to student education, teachers must know how to recognize and respond to abuse disclosures, and have a protocol for mandatory reporting, Walsh said.