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is incumbent upon the legal actors to not only remove a child from a sexual abuse situation, but to take the additional action to make sure law enforcement knows about the perpetrator. In situations of sexual abuse, it is strongly recommended that DFCS forward all documentation to the proper authorities, that forensic interviews are conducted to preserve evidence, and that there is an open line of communication and regular meetings as per local, mandated child abuse protocols between DFCS, law enforcement and the county District Attorney’s Office. This will serve to protect the child and the community from the perpetrator and create a record of behavior which serves as notification of the perpetrator’s propensity for sexual misconduct. Prosecution should lead to specialized treatment for offenders to reduce their risk of re-offending.

Children that have been sexually victimized need immediate evaluation and treatment by trained professionals.24 Many cold case children were identified as victims of sexual abuse, but never received specialized treatment until they started acting out in inappropriate sexual ways. The legal actors in a deprivation case should require forensic interviews as soon as allegations of sexual abuse are known. These interviews must include specific treatment recommendations that are acted upon swiftly to ensure children receive the services needed to deal with the trauma of sexual abuse. Treatment may also help lessen the likelihood of abuse victims becoming perpetrators themselves. Research shows that there is a victim-to-victimizer cycle in some males, especially those that have experienced parental loss in childhood due to death, separation, or dysfunctional family relationships.25 To end the cycle of abuse, sexual offenders must be prosecuted and children must receive the proper treatment to deal with the destructive effects of sexual abuse.

Recommendation #12: Provide independent oversight for children receiving mental health treatment.

One out of three cold case children resided in an institution or residential therapeutic treatment setting for mental health problems. A review of psychological assessments completed by mental health professionals indicates the most common diagnoses included Attention Deficit/ Hyperactivity Disorder (ADHD), Post Traumatic Stress Disorder (PTSD), Oppositional Defiant Disorder (ODD), and various cognitive issues. Half of cold case children were diagnosed with ADHD; one in four was diagnosed with PTSD. Two thirds of children were prescribed medication at some point and those on medication average two drugs per child.

Given the high rate of mental health issues and their influence on permanency options, all children receiving institutional care for mental health issues should be regularly reviewed by an independent psychiatric entity to ensure proper care. Immediate action should be taken when a child’s treatment is called into question. To promote quality care, advocates with mental health training should be encouraged to regularly visit institutionalized children and voice their needs.

Recommendation #13: Improve access to information on reproductive health for children in DFCS custody.

According to file reviews, 10% of the cold case children were consensually sexually active. Four females in our study were either currently pregnant

June 2010


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