Factors Associated with Return to a Child Advocacy Center for a Subsequent Sexual Abuse Allegation: A Longitudinal Analysis

Child sexual abuse is a widespread problem impacting substantial numbers of youth (Finkelhor, Shattuck, Turner, & Hamby, 2014). There are many factors that make telling someone about sexual abuse difficult for children, which can mean disclosures are delayed and children are at-risk longer. After initial victimization, there is increased risk for children to experience subsequent sexual abuse victimization (Pittenger, Pogue, & Hansen, 2018). Using the framework of Bronfenbrenner’s bioecological model, the present study examined predictors to distinguish children who are at the highest risk of returning to a Child Advocacy Center (CAC) for a subsequent sexual abuse referral. It also explored factors predicting that children will disclose sexual abuse or present with corroborating evidence of abuse. The bioecological model includes person-specific factors, microsystem (e.g., family) factors, and exosystem (e.g., community) factors. Case files of 4,971 youth who presented to a CAC for an initial sexual abuse referral between 2002 and 2012 were examined to identify factors across contextual levels. Almost one in five children experienced a subsequent sexual abuse referral and returned before 2017. Across all contextual levels, the following factors were associated with a return to the CAC: younger age, female gender, a mental health diagnosis, family history of substance abuse and/or domestic violence, mental health treatment, and lower neighborhood income. Predictors of disclosing abuse during the forensic interview included: older age, female gender, a mental health disorder, nonfamilial perpetrator, familial substance abuse and/or domestic violence, and therapeutic involvement. This study adds to the literature on child sexual abuse victimization and disclosure rates in addition to identifying factors that can be used to determine a child’s risk level for subsequent referrals. If the highest-risk children are identified and interventions are provided to mitigate risk, the need for subsequent referrals may decrease. The implications for CACs are discussed as well as techniques which have been developed and show promise at assisting children to disclose abuse (e.g., extended forensic interviews)