A Boston Globe Editorial: Stopping sexual abuse

Enraged adults seemed willing to turn the world upside down in recent weeks to impeach Judge Maria Lopez, who sentenced a convicted abductor and attempted child rapist, Charles Horton, to probation for crimes that called for harsher punishment. But public outrage is rare on behalf of the hundreds of children in Massachusetts who are sexually abused each year by step-parents, acquaintances, and biological parents.

Roughly 90 percent of the 1,500 children who are raped and molested in Massachusetts each year know their attackers, according to local district attorneys. And most of the perpetrators skate away without so much as probationary sentences. In 1999, Suffolk County prosecutors worked on 500 cases of child sexual abuse substantiated by the Department of Social Services. Yet prosecutors managed to bring charges in only 40 percent of these cases, largely because medical professionals determined that child victims would be further traumatized if compelled to testify. Of the cases that went forward, prosecutors won convictions in 65 percent of them, solid by national standards but disturbing nonetheless.

''The perpetrators are good at targeting the kids who won't testify,'' says Assistant District Attorney David Deakin, who heads the Suffolk County child abuse unit. ''The kids are too vulnerable and you can't prove the case without the victim's testimony.'' In Suffolk County, the perpetrator is most likely to be a live-in boyfriend or stepfather. In Middlesex County, biological fathers make up the biggest share of offenders at almost 16 percent, followed by acquaintances and family friends.

Like domestic violence of decades past, the sexual abuse of children feeds on secrecy. Co-defendants are rare. And the young victims often stay silent under threat of harm to themselves or loved ones. The National Center for Assault Prevention estimates that 50 to 80 percent of all incidents of child sexual abuse go unreported.

Massachusetts now has a historic opportunity to develop a statewide plan for the prevention and treatment of child sexual abuse. Experts from law, medicine, and the Department of Social Services worked from January to June to analyze crime statistics, work force requirements, and funding sources. Results and recommendations from the nonprofit Massachusetts Citizens for Children are due out later this fall. If the plan is as thorough as anticipated, the state will be in the strongest position to help child victims since 1973, when the Legislature passed the ''mandated reporter'' law requiring teachers, nurses, and other professionals to report suspected cases of child abuse to DSS.

It is likely that the report will call for better screening and assessment of initial child abuse complaints. Some states, including Florida, use teams of doctors, nurses, and police to respond to serious abuse complaints regardless of time of day. In Massachusetts, screening is slower and classification is less precise. Such a response team, carefully trained, could provide key physical evidence and boost the success rate for prosecution of child sexual abusers.

Early detection of both victims and perpetrators is essential to break the abuse cycle. Some children's advocates are reluctant to discuss anything that might stigmatize young victims. But sexual and physical abuses seriously diminish the cognitive and social functioning of children and appear to increase the likelihood that they will hurt others.

Craig Latham, a Natick forensic psychologist who treats both victims and perpetrators, says that more than half of children who do ''sexually aggressive things'' have been abused in verifiable ways. And law enforcement officials frequently find themselves dealing with children who are simultaneously victims in one case and perpetrators in another. '

'We wrestle with this all the time,'' says Suffolk Assistant DA Deakin.

For years, Massachusetts Citizens for Children and other advocates have been urging multi-disciplinary evaluations of victims by medical, forensic, and law enforcement professionals. But the teams were never organized statewide for lack of funds and political will. That may change under current DSS Commissioner Jeffrey Locke, a former Norfolk County district attorney who understands the benefits of collaborations and already stations social workers at Children's Hospital.

DSS is the last line of defense. When perpetrators walk beyond the reach of law enforcement, state social workers take up the trail. Frequently, that culminates with a home visit to the nonoffending parent, who is offered a choice: remove the abusive adult from the home or DSS will remove the child. But emergency intervention is rarely enough for a traumatized youngster.

Proper evaluation and treatment will require insurers, including Medicaid, to recognize and reimburse the kinds of multi-disciplinary teams that can restore a child's emotional health. Schools now squeamish about programs that introduce the topic of sexual abuse by loved ones will need to take another look. Statistically, ''stranger danger'' is not the major threat.

By focusing obsessively on Horton and other ''stranger'' cases, says psychologist Latham, the public acts like the man who looks for a lost key under the lamp post only because the light is better there. It is better, for children's sake, to illuminate the dim recesses closer to home.

This story ran on page A14 of the Boston Globe on 10/10/2000.