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List of Tables
1. Review of Recent Literature and Research
The History of Child Protection Work
From child rescue to child protection
The rediscovering of child abuse
Child sexual abuse
Defining Child Abuse
The cultural context of child abuse definition
Definitions of child abuse
2. Research Design and Methodology
Details of the Research Project
The Research Process
Presenting the Findings
3. The Research Findings
The Child Protection Students
Demographic profile of respondents
The Attitude Scales
Responses to Statements Relating to Child Protection Work
and Child Sexual Abuse
Responses to Statements relating to Child Abuse in General
The Open-ended Questions
The Child Protection Trainers
The Attitude Scales
Responses to Statements Relating to Child Protection and
Child Sexual Abuse
Responses to Statements Relating to Child Abuse in General
The Open-ended Questions
The Senior Social Work Managers and Child Protection Trainer
The social work role within child protection practice
The impact of child abuse inquiries such as the Orkney inquiry
on today ’ s child protection practice
Specialised and improved training
Working in partnership
Guidelines and Procedures
Negative effects on the social work profession and their practice
Public information and education about child abuse and the
social work role
Self-image and dilemmas of the social work profession
Appendix 1 The Scottish Child Protection System
Appendix 2 Evidence of consent for dissertation topic
Appendix 3 The Questionnaires
Appendix 4 The Interview Schedule
1. Socio-demographic data of respondents
2. Profession of respondents
3. Child protection work of total caseload of respondents
4. Responses to statements relating to the impact of Orkney on Child protection procedures and training
5. Responses to statements relating to the impact of Orkney on Child protection work
6. Responses to statements relating to how child protection workers Experience public opinions towards child protection workers
7. Responses to statements relating to child abuse in general
8. Responses to statements relating to defining child abuse
9. What support or resources do you need/want
10. Measures needed to shift attitudes towards child sexual abuse
This dissertation would not have been possible without the assistance, both direct and indirect, of many people. I am grateful for the co-operation and help giving to me by all the professional people who were generous in giving their time to be questioned and interviewed by me: senior social work managers of the two local authorities and child protection trainers as well as child protection students of the Scottish University. My tutor Ian Brodie from the Glasgow Caledonian University has provided me with a great deal of learning, support and inspiration during my study and the research process. In addition, the lecturers of the Glasgow Caledonian University in the Division of Social Work have been a great source of learning and encouragement. I would like to thank the Leipzig University of Applied Science and the Glasgow Caledonian University for providing generous support in terms of time and resources to undertake this course of study. I would also like to thank Professor Dr. Thomas Fabian for friendship and support, inclusive of reading and commenting on the research and the draft chapters. Finally, my family and my friends in Germany and Scotland have provided me with love, support and understanding throughout this whole period.
Glasgow, June 2000 Sven Guenther
In November 1999 the Sunday Mail ran a story Orkney in new kid-sex scandal. Within the article, the social workers at Orkney were accused of doing nothing because the mother thought that the Orkney inquiry in 1992 damaged them so much they were happier pretending this was not happening. Furthermore, an ‘unnamed insider’ stated “it’s true that sex abuse allegations are handled with kid gloves within the department. It’s only natural after what happened here before.”
The purpose of this study is to explore the recent history of child protection in Scotland and the impact of intra-familiar child abuse inquiries on today’s child protection work. The main question hereby is: Are children more at risk?
Crystallisation was used as a general research methodology to obtain a wide range of information and to increase the validity of results. The data was derived from social work sources - interviews with two senior social work managers of two local authorities in the West of Scotland as well as a child protection trainer and questionnaires presented to child protection trainers and 32 students of two West of Scotland cohorts currently undertaking a post-qualifying child protection programme.
The study was carried out between February and April 2000 and examined the perceptions and attitudes of child protection workers and how recent inquiries into child abuse have influenced today’s protection work and policy.
It was found that there has been both a positive and a negative impact on child protection work. All agreed that the partnership approach with parents and children and the inter- agency approach are important for good practice within child protection work. However, most of the respondents felt also a negative impact of the inquiries not necessarily on practice but on the social work profession itself. Furthermore, most agreed that children are not under greater risk owing to the reluctance of social workers to believe children’s allegations. At the same time, there was a good deal of realism, mixed with frustration, about the limits of intervention created be evidential requirements.
The findings from the professionals reveal that social work needs to be more pro-active in educating and informing the wider public about the phenomenon of child abuse and to shift negative perceptions towards social workers, about the roles, responsibilities as well as limitations of social work in the protection process. Finally, to enhance the professional status of social work, it is necessary and vital that social work becomes an all graduate profession with a professional and regulatory social work body.
The purpose of this dissertation is to explore the recent history of child protection in Scotland and the impact of intra-familiar child abuse inquiries on today's child protection work.
Thomas and Pierson (1995) defined child protection as an action taken by social workers and others to safeguard children from harm inflicted deliberately or through neglect. It is the general term for the measures, steps and procedures taken when a child is reported to have been abused.
During the late 1980s, the term 'child protection' gained currency to describe actions by official agencies to prevent, respond to or alleviate child abuse. Even more specifically, child protection has come to denote the investigation processes in relation to suspected child abuse (Appendix 1). Suspected child abuse should be reported to local authorities, who have a duty to cause inquiries to be made and, if necessary, inform the children's reporter. The reporter will then investigate whether there are sufficient grounds to refer the matter to a Children's Hearing for consideration and determination.
In Scotland, in late 1999 and early 2000, child protection came again under the spotlight of the media interest and the community. There was the death of Michelle Kearney (16) in October 1999, who died on a heroin overdose just one day before her Children's Hearing should have taken place (Daily Record, March 13, 2000), the Monkey Girl Case (Sunday Mail, January 23, 2000) - the neglect of a five-year-old girl in Glasgow and the alleged sexual abuse of a six-year-old girl in Orkney. In all three cases social work was blamed and accused of doing nothing.
On the 7th November 1999 the Sunday Mail ran a story Orkney in new kid-sex scandal - police probe paedophile ring by C. Lavery. The mother (Janice, 34) of the six-year-old Karen fled from Orkney to the mainland from a paedophile ring run by her ex-husband (Ian) after the police in Kirkwall did apparently nothing after she reported her claims. Within the article the social workers at Orkney were accused of doing nothing because the mother "felt social workers there were unwilling or unable to help." She "believes Orkney's social workers abandoned her because the last thing they wanted to hear was evidence of another child-sex ring on the island." She stated "I got the impression that the social workers didn't want to even hear the word sex abuse much less investigate. I think the ritual abuse inquiry damaged them so much they were happier pretending this wasn't happening.” And at the end of the article an ‘unnamed insider’ at the council stated "It's true that sex abuse allegations are handled with kid gloves within the department. It's only natural after what happened here before."
This story is especially interesting in relation to the Orkney Inquiry in 1992, which strongly influenced the Children (Scotland) Act 1995 and the role of the media at this time. In February 1991 nine children from four families were removed from their homes on the island and flown to the mainland. Their disclosures had led social workers to believe they were at risk from organised ritual abuse involving a number of adults on the island including the local Church of Scotland minister. Later on the sheriff dismissed the application of the social work department for place of safety orders for the nine children and announced that in his view ‘the children were safer at home.’ The children were returned to their parents on 4th April and a public inquiry was set up. The inquiry, the Clyde Report (1992), found that the actions of all the agencies involved were shown to be seriously flawed and was highly critical of them.
Orkney came to symbolise a power struggle between the state represented by social workers, the police and the RSSPCC who were said to have engaged in a witch hunt, and the parents who were universally presented in the media as innocent victims. The social workers were variously compared to Gestapo, Saddam Hussein and Satan busters (The Scotsman, 5 March 1991), while parents were represented as trapped and powerless. The children themselves had no voice. The parents, those accused of abuse, were accepted unquestioningly by the press as advocates on the children's behalf.
The long term consequences of Orkney have cast a shadow over child protection practice and, more especially, have harmed the relationship between child protection workers and parents. Social workers are no longer trusted. Orkney has come to symbolise the interfering state and the powerlessness of parents (Abrams, 1998) and the media created "a climate of opinion that clouded our consciousness" (Campbell in The Scotsman, 3 June 1997).
While social work practice with child abuse is a well-documented topic, this dissertation actually changes the focus. Instead of concerning itself with the ways in which the task of preventing and detecting child abuse, emotional, physical and sexual, can be more effectively undertaken, this research presents a critical analysis of the task itself as it is currently conceived in the light of the Children (Scotland) Act 1995.
There have been a number of public inquiries, often after a tragic death, in which social workers have been severely criticised, and as a result the social work profession itself has been stigmatised (Reder et al., 1993a, b). This dissertation will argue that it is the simultaneous statutory duty of social workers to prevent and detect child abuse and also to rehabilitate children with abusing parents or caretakers that at times will produce situations in which social workers are focused to a greater extent on any one of these duties at the expense of the others. Merrick (1996) argues that this leaves them vulnerable to the periodic charge that they are either intervening to too great or too little an extent.
The study will analyse and discuss the historical context and the impact of inquiries, like Orkney, into this particular field of social work as well as its consequences for today's child protection practice.
One focus of this dissertation lies in the two areas of family life - the public area (e.g. the social status, relationships with others) and the private area. The question of the latter is "What is going on behind the closed doors of families?" (e.g. domestic violence, abuse and the problem of power). This is a very important issue for research into families and abuse, because child protection work is mainly interested in and focuses on the private area, with what is going on within relationships. After cases like Cleveland and Orkney - social work moved back from the private area, which is infected through/by policy as well as by the law and since then, influenced by the question of protection or prevention, child protection work has tried to move back into this private zone.
Research and inquiries have shown that the triangular relationship between children, parents and state is particularly problematic in the area of child abuse (DoH, 1991a; Clyde, 1992; Reder et al., 1993). For centuries, it has been acknowledged that the state has a quasi-parental duty to safeguard children's welfare, but at the same time, strong norms of parental responsibility and family privacy mean that the state should not interfere in family life unless there are significant grounds for doing so. Nevertheless, children have a right to be protected from such harm and it is social work’s statutory responsibility to do so. However, Chapter 1 will show that by turns, there have been major criticisms of both insufficient and excessive action to protect children.
The main concern of this study is with the role played by social workers in child protection work. This focus stems both from my own background and interests, and from the fact that social workers, while by no means the only profession operating in this field, have key responsibilities throughout the spectrum of child protection work, from initial investigations to long-term involvement with children and families.
The aim is to use data from a study carried out between February and April 2000 to examine the perceptions and attitudes of child protection workers as well as how recent inquiries into child abuse have influenced today's protection work and policy. The data is derived from social work sources - interviews with senior social work managers of two local authority areas in the West of Scotland as well as a child protection trainer and questionnaires presented to frontline child protection workers and trainers (Appendix 2). However, despite my own professional background, the intention is not to produce a social work apologia. Rather, it is to try and draw out from the findings how social workers see the public opinion towards their profession and ultimately how the public as well as the media could support and not stigmatise professional’s child protection work.
The format of the dissertation is as follows. Chapter 1 looks at recent research and literature on child protection practice. It will discuss two things, which are connected with each other: the problem for professionals in defining the term child abuse and the historical context of child protection work. Chapter 2 outlines the research methods employed in the study. Chapter 3 presents and discusses the data relating to the study sample. Chapter 4 looks to the future and makes recommendations for policy and practice. Finally, there are four Appendices. The first outlines the current Scottish child protection system and the second includes the evidence of consent for the dissertation topic. The third Appendix includes the questionnaires and the fours the interview schedule used in the study.
The aim of the following Chapter is to provide a brief historical overview of the phenomenon of child abuse and of child protection work from the late Victorian times up to the end of the twentieth century. The history of child abuse is a history of the state's recognition of abuse and its attempts to legislate to protect the victims and punish the perpetrators and is essentially a history of public awareness of the phenomenon focusing on two distinct periods. The founding of ‘child rescue’ organisations like the Scottish SNSPCC and the English NSPCC in the 1880s, after children became economically less important, and the legislative barrage between the 1889 Prevention of Cruelty to Children Act and the 1908 Children Act is the first period. The second commences with the discovery of ‘battered baby syndrome’ in the 1960s and has proceeded with little respite until the 1990s, encompassing physical cruelty but more specifically focusing on sexual abuse.
In Scotland, the SNSPCC (later the RSSPCC) with its branches in Glasgow and Edinburgh helped to focus attention on the plight of neglected and mistreated children in general and quickly established itself as the key agency responsible for the surveillance of families and the enforcement of child protection legislation. 'The cruelty' as the Society's officers were commonly known, were both respected and feared. They targeted working-class areas where neglect was easier to find and were vigorous in rooting out neglect, acting on tip-offs from neighbours and initiating visits to problem families. Abrams (1998: 205) cites that the Officers "possessed the powers to protect children but also to remove them from their homes despite the Society's avowed intention not to relieve parents of their responsibilities but to impress and enforce responsibility upon parents."
The Society influenced a series of legislative impulses by the broadening of definitions of neglect, cruelty and abuse. In Scotland, under Scottish common law, "the wilful and culpable neglect of a child [...] or cruel treatment was already a crime punishable by imprisonment, but the Prevention of Cruelty to and Protection of Children Act 1889 [...] gave child cruelty a higher public profile. [...] The Children Act 1908 consolidated all previous legislation and in addition criminalised incest" (Abrams, 1998: 207).
Abrams (1998) stresses that the legislative monument from the 1880s up to the Second World War progressively emphasised the independent rights of the child to be protected from neglect, ill-treatment and cruelty, and to be safeguarded by the state. The inevitable consequence was the downgrading of the birth family and an emphasis on the rehabilitation of the child in an alternative environment.
Although the RSSPCC paid lip service to the notion that abuse was classless and acted on referrals, Abrams (1998: 213) argues that “their actions spoke louder than words [as the] Officers patrolled working-class districts looking for neglect and misuse.” Child cruelty and neglect was widely perceived as a problem of the working classes. Neglect and starvation, three quarters of all cases in Scotland before the First World War, signified the failure of the poor to fulfil their responsibilities towards their children. The middle classes and the "respectable" working class could rest easy in the knowledge that they were unlikely to be accused of such a crime. Poverty, ignorance, incompetence and bad habits (e.g. drinking, gambling) were blamed for child neglect and interventions in middle-class households were few and far between.
Child abuse was not only predominantly seen as a working-class phenomenon it was also gendered. Women and men were not regarded as equally responsible for either children's protection or their abuse. Women, as the primary care provider, were responsible for childcare and thus also blamed for child neglect. Because men were not associated with the domestic sphere, therefore male abuse took the form of physical cruelty. However, men were much more often prosecuted then women up to 1970.
Middle-class concern about working-class motherhood has continuously coloured child protection policy and practice. For example, women who failed to nurture their children in the approved way were not fulfilling their natural role. Therefore, neglect was female.
While neglect and sexual abuse or assault was seen as a working-class phenomenon, cruelty was classless. It was relatively easy to chastise poor mothers for their inadequate child-care skills, but it was difficult for the Inspectors, the majority of whom were men, to challenge the authority of fathers in their own homes.
In the wake of the wartime experience and the Clyde and Curtis Reports of 1946 (Murphy, 1992), the 1948 Children Act reflected a new ethos in child protection policy which focused upon family-oriented support work with preventive work now in the ascendancy; the natural family was to be given help and encouragement in order to fulfil the requirements of parental responsibility.
In the USA child abuse was formally rediscovered in 1962 as Henry Kempe, a paediatrician, and his colleagues coined the term the ‘battered child syndrome', which described and explained the process that led to parents, but essentially mothers, physically assaulting their babies and young children. Corby (1993: 27) stated that "Kempe and his colleagues were the first confidently to attribute injuries seen on children to deliberate mistreatment rather than to the outcome of accident or disease". Kempe argued that child abuse was far more widespread than anyone had previously considered and that professionals (doctors in particular) had been turning a blind eye to it.
It is hard to pinpoint the reasons for the re-emergence of the phenomenon of child abuse at this time but two major reasons have been suggested: firstly technological development, such as the use of X-rays and secondly that Kempe saw child abuse as a result of a psychological syndrome. Corby (1993: 27) cited that "Kempe's ideas were in tune with the times in that the notion of parents abusing their children as a result of a psychological syndrome was more acceptable than attributing such cruelty to poverty or ignorance. By giving child abuse a medical label and seeing it as a treatable condition, the new forms of intervention into family life were not seen as a threat to the independence of families in general because they were aimed only at the families that had the illness".
In Britain, influenced by Kempe, during the late 1960s and the 1970s child protection work was brought into the public and professional spotlight by the RSSPCC and their English counterpart, the NSPCC, as well as by the two orthopaedic surgeons, Griffiths and Moynihan. They used the term 'battered baby syndrome' in an influential article in the British Medical Journal to indicate that an infant had been injured by their parents or by other adults. Corby (1993: 28) stated that "the NSPCC was prolific in its publications on the subject of child abuse and was highly influential in placing it firmly on the social problem agenda".
What finally led to child abuse being recognised and raised the awareness of child abuse was the Maria Colwell (7) case (DHSS, 1974) who was murdered by her stepfather in 1973. She had been in foster care for several years following a period of neglect and low standards of care by her mother. After Maria's mother remarried she was returned (even Maria was very resistant to returning to her mother) into her mother's care and died 13 month later, grossly under-nourished and severely beaten by her stepfather.
Her death did not immediately cause a great deal of national concern, but after the Minister of the Department of Health and Social Security (DHSS) decided to hold a public inquiry into what had happened, the case, aided by media reports, captured the attention of the public.
The resulting inquiry vilified Maria's social worker. The social work profession was blamed as well as considered to be too soft and permissive and the more benign family approach to child neglect issues was thrown into question (Parton, 1979).
The Maria Colwell report strongly influenced the Children Act 1975. As a consequence, inter-agency co-operation was improved and intervention into families with children considered to be at risk thus became more focused and intrusive. Corby (1993: 29) argues that on the child protection front the Children Act 1975 made two major changes: "First, it incorporated among the grounds for care proceedings the fact that a child was or might be living in the same household as a person who had committed offences under Schedule 1 of the 1933 Children and Young Person Act. Second, it required the appointment of guardians ad litem to act exclusively on behalf of the child.”
The definition of child abuse broadened over time and this is well demonstrated by the changes in terminology. The term 'baby battering' was replaced by 'child abuse' in 1980 and the DHSS (1980) publication Child Abuse: Central Register Systems outlined four categories of abuse or risk of abuse: physical injury; physical neglect; failure to thrive incorporated emotional abuse; and living in the same household as someone convicted with a Schedule 1 offence. Notably sexual abuse of children was not considered to be a category for registration at this time.
Corby (1993: 31) stresses "that increased state intrusion into family life between 1975 and 1985, while being officially encouraged, was in practice being tentatively implemented. The focus was still on working with families as far as possible." While the social work profession was accused of still operating in a relatively benign way with families and being too liberal democratic, Parton (1985) cites the increase in the use of place of safety orders in the 1970s and of the gross numbers of children in care as evidence of a more intrusive approach towards families.
At the same time as social workers were being encouraged to take a firmer stance on child abuse, there were, at the end of the 1970s, counter concerns being put forward about the dangers of over-intrusive practice and, ten years after the Colwell murder inquiry, social worker and child protection practice came again under the scrutiny of the public.
In 1985 the Jasmine Beckford report was published (London Borough of Brent, 1985). Jasmine (4) died in July 1984, emaciated and horrifically beaten over an extended period of time by her stepfather, Morris Beckford (Merrick, 1996). The inquiry report made 68 recommendations and its main concerns were that social workers were too optimistic with regard to the families with which they were working. The report stressed that social work's essential and primary task was to protect children and that, where necessary, social workers should employ the full force of the law to ensure this.
The findings of the Beckford inquiry had an immediate impact on child protection policy and practice. The DHSS (1986) published draft guidelines setting out recommendations for improving inter-professional co-ordination in child abuse work and excluding parents from child protection conferences, which are professional meetings. Emphasising the statutory obligation placed on local authorities to act primarily on behalf of children wherever risk was perceived, the main proposed changes consisted of reframing child abuse work as child protection work. In addition, it was proposed that area review committees be re-termed joint child abuse committees, but, in 1988, in the final guidelines, renamed Area Child Protection Committees and that child abuse registers became child protection registers.
The key role of social workers was again reaffirmed and strengthened and they were allocated the main responsibility to co-ordinate work with families whose children's names had been added to the child protection register. The message was, "the focus of attention was to be shifted to the protection of children first and to consideration of the needs and rights of parents second" (Corby, 1993: 33).
Between 1985 and 1989 the Beckford report was followed by a series of other child abuse inquiries, like the cases of Kimberley Carlile (London Borough of Greenwich, 1987) and Tyra Henry (London Borough of Lambeth, 1987), which are summarised in a study of inquiry reports (Department of Health (DoH), 1991b). What all this inquiries into child physical abuse had in common was they were critical of social work misjudgement, blamed social work for not doing enough intervention and for failing their statutory responsibilities (Parton, 1991). The central question was why did social work not see what happened?
First, the abuse took place within the own children’s families and social work did not find the appropriate balance between representing officialdom and befriending people in real difficulties. The social workers were mainly concerned with the parents and it was said they never spoke to the children. In addition, there is the assumption that the social worker, like the wider public, did not want to believe in abuse (Parton, 1991). Subsequently, since then two social worker undertake the investigations and there is specialised training for social worker within the child protection field.
Second, in the Beckford and Henry cases, there was a racial issue too. In the Beckford case, the social workers’ approach to the family was seen as a misplaced ‘rule of optimism’, which “meant that the most favourable interpretation was put upon the behaviour of the parents and that anything that may question this was discounted or redefined” (Parton, 1991:55). This concept was based on the work of Dingwall et al. (1983) but stripped from its social and organisational context and reduced to individual attitudes and behaviour. Further, this tendency in social workers was attributed to two devices - ‘natural love’ and ‘cultural relativism’.
Parton (1991: 55-56) argues that “ by cultural relativism was meant that all cultures were equally valid in formulating human relationships. Thus members of one culture, such us white middle-class social workers, as in the Beckford case, had no right to criticise members of another culture, for example black working-class parents, as with the Beckford family, by using their own standards of judgement. Natural love referred to the belief that the relationship between a parent and a child was instinctual and grounded in human nature.” In the Tyra Henry's case the social worker made assumptions about Caribbean culture that placed heavy expectations on this child's grandmother to provide care and protection for her (Corby, 1993). West Indian grandmothers were stereotypically considered to be the linch-pins of the family as far as childcare was concerned, but in this case, nothing could be further from the truth. Tyra's grandmother had experienced the death of her husband and the severe mistreatment of her grandson. She was a lone parent with three children dealing with her own problems, was inadequately housed and had multiple depts. Therefore and as events proved, she was completely unable to protect Tyra.
Child sexual abuse was, during the late 1970s and the early 1980s, considered to be a rare phenomenon and was almost synonymous with incest. Corby (1998) argued that it was associated in most people's minds with families, which were grossly deprived and of low intelligence, often living in isolated or rural communities. Research showed (La Fontaine, 1988; Corby, 1998), that while such behaviour was illegal and seen as unacceptable (e.g. in Britain incest was a criminal offence from 1908) little attention was paid to its impact on the child or young person and a view prevailed that it was probably best left alone.
This approach towards child sexual abuse was strongly targeted by the feminist movement, which subsequently has influenced sexual abuse work since the early 1970s. Feminists saw women’s experiences of male sexuality as reflection of patriarchy and the oppressiveness of these male-female relations was most clearly demonstrated by rape and the abuse of female children within the family. Feminism challenged and criticised the conventional analysis that the ‘cause’ of child sexual abuse is ‘family dysfunction’, implicitly blaming poor mothering, rather than focusing on poverty and lack of material resources. Coulborne Faller (1989) stressed that one particular persistent theme at this time was implicitly to blame mothers either for not discharging their sexual obligations to their partner or for not managing to protect their children from abuse. This analysis ignored the fact that by far the greater number of abusers were men and that this rested on the extreme differences of power held by men and others in the family.
Accounts of women who experienced sexual abuse such us Rush (1980), who saw child sexual abuse as a direct effect of the oppression of women by men and institutionalised by patriarchy, encapsulated the feminist perspective in clear and unequivocal language.
In late 1986 influenced by the feminist movement and the BBC-1 programme Childwatch, but perhaps signified most explicitly with the media launch of ChildLine, the public, professional and political awareness of child abuse grew considerably. Parton (1991: 92) argues that Childwatch which was broadcast at peak viewing time “was aimed at a family audience and encouraged children to disclose to adults incidents of abuse. It also launched ChildLine the first national freephone helpline for children in trouble and danger [and] provided an examination of the phenomenon of child abuse based on specially commissioned research."
Then, in summer of 1987, newspaper reported a child sexual abuse scandal in Cleveland and social work in England was again in the media spotlight but this time childcare professionals were accused of doing too much.
Between February and July 1987, 121 children were diagnosed by two consultant paediatricians in Cleveland as having been sexually abused. The paediatricians relied heavily on a method of diagnosis called anal dilatation. The majority of the children were compulsorily removed from home or kept in hospital under court orders. The crisis became heated and aroused national debate when parents began to complain vigorously about the allegations of abuse levelled at them and about the way they and their children were treated: removal of children without prior notice, restrictions on their visiting the children, lack of consultation and information, and the impossibility of appeal. The involvement of the local Labour MP, and the subsequential coverage of the affair by the media on the parents' side, highlighted a breakdown in confidence in the local social services department.
Up to this time, the issue of child sexual abuse had been a relatively minor concern for child protection agencies in Britain. Previous to Cleveland, pioneering work into this field had been carried out, as with physical abuse, mainly from the American experience (Corby, 1993; 1998). Corby (1993) argues that the main protagonists there were survivors of sexual abuse, feminist writers such as Armstrong (1978) and Rush (1980) who saw such abuse as symptomatic of gender power inequalities, and the medical profession. Again Kempe and his associates were prominent (Kempe and Kempe, 1978). Professionals at the Great Ormond Street Hospital for Children developed techniques for helping children disclose the fact that they had been sexually abused, using drawings, play, anatomically correct dolls and video recordings (Corby, 1998).
Paediatricians in Leeds developed the anal reflex dilatation test (Hobbs and Wynne, 1986), to provide definite physical evidence of sexual abuse, which up to this time had been almost impossible to prove in the courts.
Sigmund Freud's work had a major impact on the development of thinking about sexuality in general and sexual abuse of children in particular. He had a central importance to the history of child sexual abuse discovery, though many feminist writers would dispute this in the case regarding women (Sydie, 1987). There is evidence that Freud was aware of the sexual abuse of children in the 1880s. Based on his experiences in clinical work, at this time he was of the view that childhood sexual abuse was a key factor in the development of hysteria in women. In the beginning of the twenties century, with his theory of psycho-sexual development, Freud reformulated his idea on the subject, and considered adult women's neuroses as a result not of actual experiences of sexual abuse, but of repression of their instinctive sexuality. He also formed the idea that accounts of childhood sexual abuse by adults could be fantasies or wish fulfilments rather than reality. This view is currently raised again under the title of false memory syndrome.
Freud's theory of psycho-sexual development had the effect of reducing the likelihood that those who alleged that they had been sexually abused as children would be believed by medical and other professionals.
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