Child Abuse Detection, Reporting and Treatment > Chapter 9 - Special Topics in Child Maltreatment

Chapter 9: Special Topics in Child Maltreatment

There are several areas of child abuse and neglect that fall outside the normal ranges of those areas usually associated with physical, sexual and emotional abuse and neglect:

A) Munchausen’s Syndrome by Proxy

B) Fetal Alcohol Syndrome

C) Drug addicted newborns

D) Shaken Baby Syndrome

E) Child exploitation

F) School bullying

In the 18th century, German dignitary Baron von Munchausen was especially known for his many “tall tales” about his exploits, none of which were factual. In this spirit, Munchausen’s Syndrome by Proxy (MSbP) is a Factitious Disorder described in the DSM-IV-TR. In this syndrome, a parent or caretaker, usually a mother deliberately makes her small child ill and/or convinces others that the child is sick by lying about the child’s alleged symptoms, exaggerating minor symptoms or by deliberately inducing symptoms. The child is seen by a battery of physicians and specialists, none of whom can pinpoint the etiology of the child’s symptoms. An exhaustive amount of medical tests, medications, hospitalizations and surgeries are unable to determine the cause of the child’s symptoms or a beneficial treatment of these symptoms. For most parents, the thought of continually causing harm and pain to their child seems abhorrent, yet in MSbP the perpetrator’s eye is on his/her own needs rather than the benefit of the child. As a form of child maltreatment, MSbP is baffling and difficult to prove. The syndrome is unlike other forms of physical abuse because it is distinctly pre-mediated; the perpetrator intends to harm the child and carefully plans how and when this will be accomplished. Other forms of physical abuse like excessive discipline are most often the result of anger, stress or frustration, or a lack of appropriate, effective parenting skills. A parent who spanks a child too often and too harshly on impulse usually feels remorse afterwards; the MSbP parent does not.

[QN.No. 9.Munchausen's Syndrome by Proxy:]

It is to goal of perpetrators to gain the attention, sympathy and admiration of medical personnel for their seemly devoted self-sacrifice in caring for a chronically ill child. Perpetrators appear so caring and attentive towards the child that medical personnel frequently fail to suspect that this loving mother could ever harm her child; 98% of perpetrators are female. Physicians, nurses, physician’s assistants and other medical personnel should be vigilant for the following signs that may indicate the presence of MSbP:

  • A child between the age of infancy through age 16 who has chronic, multiple, and puzzling medical problems that do not respond to treatment.
  • Physical and/or laboratory findings that are very unusual, don’t match the child’s medical history, or are clinically impossible.
  • Short-term symptoms that appear to stop when the caretaker is not present.
  • The caretaker disbelieves and is not reassured by test and exam results that reveal no medical problems; she continues to assert that the child is sick and continually changes doctors.
  • The caretaker has an unusual degree of medical knowledge and is fascinated with medical details; she appears to enjoy being in a hospital environment.
  • The caretaker is unusually calm and stoic about serious difficulties with the child’s health.
  • The caretaker vacillates between support of the child’s physicians, being angry and demanding further intervention for the child and second opinions, and insisting on transfers to more sophisticated medical centers.
  • The caretaker is overly reluctant to leave the child alone in the hospital.
  • A family history of similar, unexplained illness or death of other children of the caretaker.
  • The caretaker herself is excessively needy, emotionally, with the medical team that is caring for her child.
In the most severe cases, the child’s mother goes to great lengths to make her child appear to be sick; administering toxic substances, human and/or animal fecal matter, overdoses of laxatives and emetics, or causing skin rashes and necrosis of the skin by rubbing oven cleaner, lye, and other caustic substances on the child’s body. It is also common for an MSbP caretaker to smother her small child into unconsciousness and then rush the child to the ER.

When a medical team suspects MSbP, the law allows hospitals to use hidden cameras in the child’s room to record the mother’s actions. Mothers have been observed switching medications, injecting the child with urine to cause a dangerous systemic infection, placing drops of blood in the child’s urine and fecal samples, injecting nail polish remover into the child’s feeding tube, removing IV tubing and other covert ways to sicken the child. It is important to remember that a caretaker with MSbP does not wish to kill the child; this would end her involvement in the hospital environment, end approval and attention from medical staff, end participating in the usual hospital gossip and end her friendships with other parents and child patients. Her goal is attention and approval, not ridding herself of the child who makes all this possible. It is not uncommon for a mother to have more than one child with MSbP symptomology.

Munchausen’s Syndrome by Proxy is a violation of criminal statutes against child abuse; the perpetrator is usually charged with aggravated assault on a child, and other children in the home are immediately removed into the custody of CPS. If the child dies, the perpetrator can be charged with second-degree murder or first-degree manslaughter. The most frequent identifiers of possible MSbP are the hospital nursing staff. This cannot be over-emphasized, since nurses and nursing aids have the most contact with a hospitalized child. Children’s lives are often saved by the vigilance and knowledge of nursing personnel.

A child who survives abuse via MSbP can develop skeletal damage, mental retardation, permanent brain damage, blindness, malnutrition, chronic gastric dysfunction, seizures and paralysis.

Psychologically, the emotional damage can be devastating especially if the child grows old enough to understand what was done to him/her. The insidious cycle completes itself when children learn to court the attention of medical personnel by becoming perpetrators of MSbP with their own children.

Fetal Alcohol Syndrome

Drinking alcohol during pregnancy is the leading known cause of birth defects, according to the Merk Manual of Medical Information, Home Edition. Since the amount of alcohol required to cause Fetal Alcohol Syndrome (FAS) is unknown, medical personnel should advise pregnant women to abstain altogether from alcohol consumption.

In addition to FAS, drinking alcohol during pregnancy causes low birth rate, higher risk of miscarriage, failure to thrive, and sudden infant death syndrome (SIDS).

FAS is the most serious complication of alcohol consumption during pregnancy. A FAS child often has a distinctive “look;” facial defects, a small head size due to inadequate brain growth, abnormal positioning of the joints, and a noticeable crease in the child’s palm(s). In addition, a FAS child is usually mentally retarded, has abnormal behavioral development and heart defects. As the child grows, severe anti-social behavior can occur along with Attention Deficit with Hyperactivity Disorder. With the harmful effects to unborn children widely publicized in the past two decades, the current controversy about FAS is whether or not drinking alcohol during pregnancy is a form of child abuse and, if so, should this type of abuse be criminalized? The American Medical Association and the American Osteopathic Association are addressing these questions in order to take an official “stand” on the issue. At this time, alcohol consumption during pregnancy that results in the child’s development of FAS is not formally acknowledged as a form of child abuse, nor is it illegal. However, it is becoming more common for obstetricians, pediatricians and ob/peds nurses who are aware of alcohol use by a pregnant woman to report the case to CPS.

Every year, an increasing number of children are born to drug-addicted mothers. The most common drugs of abuse among pregnant women are cocaine and opiates like heroin or morphine. These drugs, like alcohol, pass the placental barrier; if the mother of the fetus is addicted, so is the fetus. The risk of passing conditions like hepatitis and HIV is very high, as is the probability of premature birth, low birth weight, and failure to thrive. The use of cocaine during pregnancy results in children with small heads, defects of the brain, eyes, kidneys and genitals. Newborns will suffer severe cocaine withdrawal symptoms after birth. As they grow, they have behavioral disorders, hyperactivity, uncontrollable trembling, and learning disabilities. Children born to opiate-addicted mothers also suffer withdrawal symptoms but rarely have the birth defects associated with cocaine and alcohol use during pregnancy except for low birth weight that can be life-threatening.

[QN.No.11.Many legal and illegal drugs:]

As early as the mid 1980’s, there was growing concern about babies who were born drug addicted; research was emerging which suggested that these babies were, themselves, at great risk for developing drug addiction by their mid-teens. Heavy metal music superstar Ozzy Osbourne – himself no stranger to addiction – dubbed these children as “crazy babies” in his song of the same name, bringing to the forefront the issue of “born addicted – always addicted.” Longitudinal studies over the past 20 years that have followed the growth and social development of babies who were born addicted is still inconclusive, but ominous nonetheless. An axiom of forensic addiction therapists is, “The body doesn’t forget.” Thus, it’s theorized that babies born addicted are merely in remission until they’re old enough to obtain and use drugs on their own – the “crazy baby” has virtually no chance of living drug-free.

The same issues of child maltreatment by drug-using mothers arise as those children born with FAS. The harm done to the child is not intentional like children who are victims of MSbP, yet the harm is a life sentence of medical and behavior problems for the affected child. Lawmakers tend to focus on a specific issue: if FAS, drug and alcohol use during pregnancy and MSbP were incorporated formally into the legal definition of aggravated assault and child abuse, would this make a significant difference in lowering the occurrences of these behaviors?

There is one form of child maltreatment that is classified as both child physical abuse and criminal aggravated assault and child abuse; the Shaken Baby Syndrome (SBS). According to the National Institution of Neurological Disorders and Stroke, SBS is a type of inflicted traumatic brain injury that occurs when a baby is violently shaken. Infants have large heads but weak neck muscles. When a baby is shaken, the fragile brain bounces back and forth inside the skull, causing bruising, swelling and bleeding in the brain. SBS victims can suffer permanent brain trauma or death.

[QN.No.12.Shaken Baby Syndrome:]

SBS knows no boundaries of economic or racial status, but it does occur most often among young, single, poor, unskilled, minority mothers whose pregnancy was unplanned and unwanted. After shaking the baby out of frustration for its crying and neediness, such a mother may present to medical professionals with an infant who is extremely lethargic, poor appetite, breathing problems, convulsions, vomiting and pale or bluish skin. Upon examination, the baby will have bleeding in the brain and eyes, damage to the neck and spinal cord, and broken ribs. Emergency treatment involves life-sustaining measures and surgery to stop the bleeding in the brain and optical nerves.

The prognosis for a shaken baby is very poor. If the child survives, he/she will most likely require life-long medical care and, most often, institutionalization. Damage to the retinas causes permanent blindness. Irreversible brain damage causes neurological and/or mental retardation and cerebral palsy. Of all the forms of child abuse, SBS is the most tragic for the child and the perpetrator because it can be prevented through pre-natal social services and parenting support and education. SBS victims are reported to CPS by physicians and nurses; the signs and symptoms are unique and very specific; SBS injuries surpass those of accidental brain injury. It is a medical, social, and legal problem with tragic consequences.

[QN.No.10.Fetal Alcohol Syndrome:]

The Exploitation of Children

The issue most disturbing about this form of child maltreatment is that it is always done deliberately by adults for profit or gain. The perpetrators may be the child’s parents, a family member, a trusted family friend, or a stranger. No thought at all is given about the devastating (usually life-long) consequences for the child; for those that exploit children, they see them only as objects, not as little people who feel pain, loneliness, confusion and terror about what is happening to them. Exploiters have no remorse and no feelings towards children in a manner that we would call “human.” In these individuals’ “hard-wiring,” something is missing; a conscience, empathy and the desire to do what is right towards others. In his classic book Without Conscience: the Disturbing World of Psychopaths among Us, criminologist, forensic behavioral specialist and researcher Robert Hare described these individuals as psychopaths, sociopaths, or people with Antisocial Personality Disorders. According to Hare, the psychopath is completely legally sane; he knows his actions are considered to be morally wrong and illegal, but does them anyway. Although America’s prisons are filled with psychopaths, they are also present in our homes and in top organizational boardrooms. They are convicted criminals, parents, spouses and CEOs. The one thing that they have in common is a complete lack of regard and empathy for others. They prey upon vulnerable targets: in this case, children. Who is more vulnerable, easy to manipulate and helpless than a child? The sociopath who preys upon children is basically a bully, using his/her age and position of power to force children to capitulate to their will.

In this section, we will examine three types of child exploitation:

  • The buying and selling of children
  • The sexual exploitation of children, non-pedophile type
  • Sexual exploitation, pedophile type
[QN.No.13.The sexual exploitation of children:]

Children for Sale

For the right price, anything can be bought or sold. Everything has a price tag, if the buyer can afford to pay it. Luxury automobiles, vast quantities of illegal drugs, magnificent mansions, wives from other countries, the very best lawyers, miraculous medical specialists, and children; if you know where to look, and whose palm to grease, you can find anything you want.

Children are bought and sold in various ways. For example, infants from America or another country can be purchased and the so-called parents can be supplied with phony adoption papers that are worthless in a legal sense. This insidious practice is considered to be child abuse because these infants come to their ready-made parent(s) with no medical history at all. The infant comes with no guarantee of medical soundness. Child brokers sell infants afflicted with any number of hidden birth defects, diseases that require intense and very expensive medical treatment, mental health issues, and fatal diseases such as leukemia, Tay-Sachs disease, irreversible brain damage, cleft palate, massive systemic infections, fetal drug or alcohol syndrome, sickle cell disease, spina bifida, porphyria, internal organ malformation, blindness, deafness, mental retardation, autism and a vast array of other serious conditions. Child sellers don’t give refunds to dissatisfied customers, and the purchasers of these children certainly have no legal recourses since their actions too were grossly illegal. In legal adoptions of infants born in America or outside our borders, the children are medically examined and the adoptive parents are given full disclosure of the infant’s health status; if the child should ever need extensive medical care, his/her health history is known and the adoptive parents can safely and effectively insure the child.

Once a dangerous and potentially life-threatening condition is identified by the buyers, they dare not seek medical care for these infants lest they be discovered as a purchaser of human lives. They know that their fake adoption papers will never withstand legal scrutiny if a physician should have doubts about the origins of the child in question, especially an infant from a third-world country. Most health care providers become suspicious when a parent cannot relate the child’s medical history and report their suspicions to CPS personnel. However, the illegal parents are proficient at making up plausible stories about how they came to be in possession of the child, e.g. “He’s my nephew and his mother dumped him and took off. We know nothing about the baby.” Well, it could happen. But it’s unlikely. The upshot of illegal trafficking in infants is that many times the child’s condition is unknown and remains untreated, even to the point of death. Medical neglect of these infants is pervasive in all respects.

According to the National Center of Missing and Exploited Children, infants who are illegally bought and sold have a much higher rate of physical, sexual, emotional abuse and neglect, especially if they are deficient medically, mentally challenged, or grow up to display learning disabilities and/or ADHD. As long as the child is medically, socially, emotionally and academically sound, the risk of maltreatment is lessened but not eliminated. Adopted and “purchased” children of all ages are more at risk for sexual maltreatment since the perpetrator(s) do not see their actions as incest since there is no blood relationship between them. Purchased children are also more prone to physical abuse; the instinctual parental boundaries that exist between natural and legally adopted children are thin with a purchased child, especially if the child has behavioral or emotional problems.

In the past decade, adoptions of children from Russia – both legal and illegal – have become a popular charity. Interestingly, the purchase of Russian mail-order brides is just as popular, with entire web sites devoted to choosing the bride of any man’s dreams; until, that is, she obtains her green card long enough to become a resident alien. The purchase of Russian children who are orphaned by the thousands are made available for legal adoption and for black market child selling. Heart-wrenching pleas for adoption are everywhere on television, which also opens the door to illegal Russian infant trafficking. Would-be parents who feel desperately sorry for these orphans but have no funds or an unsuitable home for children resort to purchasing Russian children illegally.

Statistically, these unfortunate Russian infants – innocent victims of circumstances – are the most inclined to either suffer abuse and neglect, or if the adoption was legal, to have the adoption decree vacated by a family court judge. These children are so damaged by the time they are imported into America that they suffer from Reactive Attachment Disorder of Infancy or Early Childhood. The Diagnostic and Statistical Manual of the American Psychiatric Association, Version Four, Text Revised (DSM-IV-TR) describes the diagnostic criteria for this disorder as follows (paraphrased for brevity):

  • Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age five.
  • Persistent failure to initiate or respond in an appropriate fashion to most social interactions.
  • Excessively inhibited, hypervigilant or highly ambivalent in response to adult caretakers.
  • Inhibited social attachments.
  • Pathogenic care by the child’s original caretakers: disregard for the child’s basic emotional needs for comfort, stimulation and affection, disregard for the child’s physical needs, and repeated changes of primary caregivers that prevent the formation of stable attachments.

In sum, these children are unable to bond with their new parents due to extensive abuse and neglect by their former caretakers. Most often, the children come from very large orphanages in Russia where they spend their days in a crib, totally lacking in normal human bonding. Receiving no care or comfort, their ability to bond is irreversibly impaired. Although parents who legally adopt these children at least have a general idea of what to expect, the buyer of one of these children knows nothing about the child’s history that will inevitably cause severe impairment in attaching and bonding with new parents or others. Again, child sellers don’t give refunds. These children may be kept in the home of their buyers, largely ignored, neglected and resented because of their emotional flatness or else physically abused by frustrated buyers. On the other hand, these children are often abandoned in rescue homes, shelters or CPS offices while the purchasers simply walk away from them.

Television movies and talk shows are bountiful on the subject of surrogate mothers who are paid to carry a child for a childless couple and then relinquish the child to the couple. While surrogacy, in many ways, is a viable opportunity for childless couples to provide a loving, stable home for the child, problems arise when the surrogate mother changes her mind and wants the child she carried back. The family courts are heavily laden with such cases. Judges, lacking the wisdom of King Solomon, must decide what is in the best interests of the child, sometimes when the child is old enough to be thoroughly bonded with his/her parents and has no knowledge of the surrogate.

Only recently has attention focused upon surrogacy and its too-common complications as a form of child maltreatment and exploitation of the child for personal gain and with no regard for the child’s needs and feelings.

Case Vignette

“We paid for Sherry’s pre-natal care, living expenses while she was pregnant and a settlement of $20,000 to carry my husband’s biological child since I was unable to do so, through in vitro fertilization of Sherry’s egg,” Molly told her therapist. “Everything was completely legal and above-board. When Chad was born, we brought him home with us three days later. We were so grateful to Sherry for creating this miracle for us, and she seemed very happy for us, too. Per the terms of our contract with Sherry, her parental rights were terminated and I legally adopted Chad and we had no further contact with her. When Chad turned five, Sherry contacted us through an attorney and demanded full custody of Chad since she was his biological birth mother. Sherry wanted “her” child back. She had not seen him since he was born, but as his true mother, she sued for custody saying that she was coerced into giving up her parental rights. What nonsense! We had a deal, we had a contract, and then she decided that Chad was rightfully hers. This was only the beginning of a three-year court battle with Sherry. She wanted her parental rights restored and my adoption decree set aside. And she wanted Chad. While the case was being heard, Sherry was granted visitation rights with Chad for three hours every week first in our home, and eventually in her home. Chad was so confused. He didn’t know who Sherry was, but she told him to call her “Mama.” She told him I wasn’t his real mother and that he would soon be coming to live with her. Chad cried and screamed every time Sherry picked him up for visitation; he didn’t want to go with her. He started having horrible night terrors and he wet the bed almost every night. When Sherry came for him, he hid under furniture or in the closet. He screamed at us for being mean and making him go with Sherry. How do you explain a court order to a five-year-old? When Chad started to bang his head on the wall, we decided that enough was enough. We took Chad to see a child therapist who placed him on antidepressant medication; a five-year-old on that kind of medication! But it did seem to help a little. My husband was frantic. He said that since there was no dispute about him being Chad’s biological father, he would hide Chad and let the judge put him in jail for contempt of court. At our next hearing, our attorney called three expert witnesses who told the judge that all of this was emotionally abusive to Chad. Since they were mandatory reporters, they reported to CPS that Chad was being emotionally abused by Sherry. The judge appointed a guardian ad litem, an attorney who represented only Chad, not Sherry and not us. After a few months, the guardian’s report said that Chad was emotionally devastated over having to see Sherry and being told that he was going to live with her and that he would never see me again. The guardian ad litem’s expert witness stated on the record that Chad was being emotionally abused by Sherry. She used Chad to fill her own emotional void and she didn’t care that she was hurting him. We finally won the case, but Sherry filed an appeal so we’re right back where we started. Chad is still being abused.”

Child Sexual Exploitation

There are two types of child sexual exploitation: actions by non-pedophiles who exploit children for personal gain and actions by pedophiles who personally exploit children for sexual gratification. According to the DSM-IV-TR, pedophilia is defined as (paraphrased for brevity):

* Recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a pre-pubescent child or children, generally under 13 years of age.

* Acting on these sexual urges, or the urges or fantasies cause marked distress or interpersonal difficulty.

Pedophiles may be sexually attracted to males, females, or both. The great majority of pedophiles are men, but some women have been diagnosed with this disorder in rare cases. There can be no doubt that the sexual exploitation of children, whether by a non-pedophile for financial gain or by a pedophile for sexual gratification, constitutes child sexual abuse in its worst form. The relevant and all-important question in this course is how to tell if a child is being sexually exploited.

As previously mentioned and discussed now in more detail, children are sexually exploited by a number of perpetrators:

  • Parents “pimp out” their children as targets of sexual exploitation for financial gain and/or as the result of severe personality disturbances. Many of these parents were themselves victims of sexual abuse.
  • Non-pedophile strangers lure children into exploitation for financial gain. They have no sexual interest in children; making money is their only motivation.
  • Pedophiles manipulate children into exploitation for their own sexual satisfaction; their sexual partners of choice are children.
  • A non-parent family member e.g. grandparent, uncle, or older sibling sexually exploits children either as pedophiles or “for profit” non-pedophiles.
  • Children are sexually exploited by trusted family friends like coaches and ministers. This trust is betrayed by these individuals who are almost always pedophile-type exploiters who lead a double life and lure the child into feeling safe with them. Ever so gradually, they win the trust of the child and his/her parents, rendering the child vulnerable to slow but steady sexual advances.

There is a sixth category of child sexual exploiters: the pedophile that abducts, rapes and then kills his victim, whom he does not know. Consider the case of John Walsh, host of television’s America’s Most Wanted and the co-founder of the National Center for Missing and Exploited Children. Walsh’s six-year-old son, Adam, was abducted, raped and beheaded. Although technically Adam’s murder remains unsolved, a homosexual convict and drifter named Ottis Toole is believed to have committed this horrific crime. Toole died of AIDS while in prison for other crimes. The killer pedophile is beyond the scope of this course since the child victim is forever silenced; these cases must be resolved by law enforcement, not mandatory reporters.

The pedophile’s focus is on pre-pubertal, anorgasmic children. This is quite different from the hebophile who focuses upon post-pubertal, orgasmic pre-teens or teenagers who are easily influenced to have sex with an adult for orgasmic pleasurable gratification. Unlike pedophilia, hebophilia is not classified as a mental disorder and is not contained in the DSM-IV-TR. However, adults who have sex with children in this age group can be charged with statutory rape since the child has not reached the age of consent to have sex; states vary in their laws concerning the age of consent, but in the majority of states that age is sixteen.

Pedophiles are categorized as either fixated, meaning that they are exclusively sexually attracted to children, or regressed, meaning that they prefer sexual activity with adults but become attracted to children episodically, usually when they experience emotional, relational or performance difficulties with an adult sexual partner.

Non-Pedophile Exploitation

To make money from the sexual exploitation of children, one doesn’t have to be a pedophile. However, for those who traffic in child sex, their customers are pedophiles. In Hare’s model of the psychopath without a conscience, the non-pedophile sexual exploiter of children is only in it for the money. Sexual deviance involving children costs money – lots of it – and the pedophile predators are willing to hand it over as long as they receive what they paid for; sexual encounters with children.

The following are specific categories of child sexual exploitation:

  • Explicit talking about sex and/or genitalia.
  • Touching or being touched by a child in a seductive, sexual manner.
  • Enticing a child to give and/or receive oral sex.
  • Vaginal or anal assault upon a child with an instrument like a broom handle or other penis-like instrument.
  • Dressing a female child in a sexy, seductive and overly mature clothing.
  • Communicating with children in a sexual manner via the Internet
  • Communicating with non-pedophile traffickers in sexual encounters with children.
  • Communication with other pedophiles via the Internet, the postal service, and in underground organizations like the North American Man-Boy Love Association (NAMBLA).
  • Taking photographs or making videos of children who are nude, seductively dressed, and/or posed in sexual positions.
  • Exchanging these photos and videos with other pedophiles.
  • Collecting novels, comic books, newsletters, poetry and magazines that depict sexual encounters with children.
  • Using children as models for erotic paintings, sketches or sculpture.

Every deviation on the above list can be bought – for the right price – from a non-pedophile exploiter. With today’s technology, these individuals primary use the Internet to sell their “wares” and magazines focusing on erotica and pornography. To escape detection, web sites use clever wording that may deceives the unaware, but is easily recognizable to pedophiles and hebophiles.

Where do non-pedophiles find the children they exploit?

  • School activities like sporting events open to the public
  • Church youth groups
  • Unsupervised children at playgrounds
  • Internet chat rooms
  • Playing unsupervised in their neighborhoods
  • Walking home from school
  • Boy and girl scouting activities
  • Abduction
  • From the child’s parent(s)

Another commonly asked question is “What happens to these children when the for-profit exploiters are finished with them?” In most cases, the child is bribed, coerced or threatened into remaining silent. For example, the exploiter will offer money, food and candy, technical equipment like video games and game players, trips to theme parks, sports equipment, and anything that the children want and value, but does not receive at home. The exploiter will coerce the children’s silence by telling them that it’s their fault that they were “bad,” and if they talk about it they could go to jail or be abandoned by their parents. Often the children’s silence is a result of threats; the exploiter tells them that if they tell, their pets and/or family members will be killed, their house will be burned down, or that they will be kidnapped, exploited again and then killed. If the exploiter believes that the child will tell regardless of threats, coercion or bribery, the child’s doom is sealed. The darkest side of psychopathic behavior occurs when the exploiters makes a video of the child being sexually brutalized and then killed – referred to as a “snuff” film. These authentic death films are worth thousands of dollars to violent, sadistic pedophiles that fantasize about raping and killing children.

Exploiters move around a lot to avoid detection by law enforcement. They also change their web sites and email names, use aliases, and use post office boxes instead of residential addresses. Local and federal law enforcement agencies have specially trained task forces that work specifically to identify and apprehend non-pedophile exploiters.

Sexual Exploitation by Pedophiles

The above quote is the motto of the Lewis Carroll Society, and underground organization of pedophiles that sexually exploit children and then share their stories with other pedophiles. Carroll is the author of the children’s classics Alice in Wonderland (1865) and Through the Looking Glass (1871). His real name was Charles Dodgson. Carroll was a highly-educated man and was a member of the faculty of mathematics at Oxford University in England. According to the Lewis Carroll Society, Carroll was also a fixated pedophile who preyed upon very young girls. The Encarta Encyclopedia states that Carroll was “always a friend of children, particularly little girls; Carroll wrote thousands of letters to them, delightful flights of fantasy, many illustrated with little sketches.” Carroll was also fond of photography, but came under criticism for taking pictures of children in various costumes and poses, as well as nude. He abandoned photography in 1880. Carroll once wrote to a friend, “I am fond of children –except boys.”

The two “Alice” books were written by Carroll in 1862 for a young girl he fancied named Alice Liddell, daughter of the Dean of Christ Church College. These books have been translated into many languages, and we still use terms of speech from the books like “Mad as a Hatter” and “Grinning Like a Cheshire Cat.” Whether Carroll succeeding in sexually exploiting Alice Liddell is unknown. However, pedophiles of the Lewis Carroll Society believe that he did, and many more young girls as well. If this is true, Carroll would be categorized as a fixated pedophile, preferring young girls as sexual partners. Using Carroll’s reputation as a pedophile, it is easy to see how he might have sexually exploited Alice Liddell:

  • Carroll was an educated man who knew how to speak and write well for children.
  • He was never married and had no children of his own.
  • He identified his liking of little girls in an authenticated letter.
  • He was a soft-spoken, not unattractive man.
  • With his clever stories about Alice’s adventures in Wonderland and what she found through the looking glass, he was able to lure, flatter and enthrall Alice Liddell and other young girls.
  • Carroll was known to use children both nude and in costumes as photographic subjects.
  • Carroll related best to young girls on their own level rather than with adults of his age and degree of education.
Thus, more than a century and a half later, we can clearly see how Carroll – if he was indeed a fixated pedophile –still fits the profile of today’s pedophiles. While it is true that many pedophiles abduct children unknown to them, the majority do know their victims and lure them into sexual exploitation gradually and with stealth, enticing them with flattery and making them feel special, as Alice Liddell must have felt when Carroll wrote two enchanting books especially for her. Young children are eager to please adults, even agreeing to pose nude for pictures that make their way onto the Internet and sent through the mail to other pedophiles (a federal crime). Pedophiles are often childlike themselves; they are unable to relate to other adults but easily play children’s games, talk like children, and even shave their body hair to appear more childlike and appealing to young children. As they gradually build up the children’s trust in them, they reassure them that sexual behavior between them is safe, loving and natural. They insure the children’s silence by again making them feel special; “This is a wonderful secret just between the two of us. If you tell anyone, I won’t love you anymore.” This lure is effective because every child wants to be loved.

Shakespeare’s tragic heroine, Juliet, was not quite 14 when she married Romeo; if such young love and sex was not abnormal in Shakespeare’s time, says the Lewis Carroll Society, why should it be now? The society should perhaps re-read the Bard’s tale: Romeo was only slightly older than Juliet. Pedophilia involves an adult in a position of power and authority over a young child.

The North American Man-Boy Love Association (NAMBLA) is a well-known and well-organized group of about 1,000 pedophiles that advocates the abolition of all state and federal laws regarding the age of consent and the immediate release of all men who are incarcerated for “non-coercive” sexual behavior with children. NAMBLA’s headquarters is in New Your City, with chapters in Boston, Los Angeles, San Francisco and Toronto.

While the huge majority of Americans believe that the sexual exploitation of children is legally and morally wrong, at least NAMBLA is consistent in their firm belief that children actually want to have sex with adults; in fact, they crave sexuality with adults they love and trust. NAMBLA’s position is that sex between men and boys teaches love, warmth, emotional and physical intimacy and kindness. Using photos and videos of men having sex with young boys, NAMBLA members desensitize these children to sexual behavior with adult men over a period of time. Both NAMBLA and the Lewis Carroll Society are very different from the pedophile who engages in child abduction and the vicious rape of their victims. These two organizations know their victims well and groom them carefully so that they will be eager instead of frightened of having sex with an adult male. NAMBLA has been known to law enforcement agencies for several decades and these pedophiles are quite careful in keeping their public behavior just barely within the confines of the law and maintaining tight secrecy over their illegal sexual relations with young boys.

Identifying and Reporting the Sexual Exploitation of Children

Sexually exploited children have most symptoms in common with other sexually abused children, with several exceptions:

  • They are less likely to disclose since they have been carefully groomed to believe that sex with adults is normal and that they have a special relationship with a pedophile exploiter. With non-pedophile exploiters, they are severely threatened if they disclose.
  • Teachers and medical personnel may notice that they dress and behave like “little adults.” This is especially true if the child’s parents have made him/her available for sexual exploitation.
  • Exploited children usually isolate themselves from other age-appropriate peers. They have little in common with other children who focus on school, making friends, and playing games. They prefer to interact with adults since their childhood has been stolen from them.

The sexual exploitation of children is a major felony in every state in the U.S. In addition, it is a federal crime if the exploiter(s) used the Internet or the postal service to lure children and communicate with other exploiters by sending stories, magazines and pictures of exploited children through the mail. Pedophiles who have been convicted, served time, and have returned to their (or any) community must register with local law enforcement as sex offenders; the public has access to a list of pedophiles living in their vicinity. When the pedophile is convicted and loses his freedom, he also loses his right to privacy for the protection of the public.

Rehabilitating parents who sexually exploit their children and non-pedophile exploiters is difficult, at best. These individuals are devoid of conscience and a sense of remorse, closely fitting the Antisocial Personality Disorder. No amount of therapy can make an exploiter “grow” a conscience; they either get it, or they don’t. They know that their actions are illegal and socially deviant, but they simply don’t care. The best way to keep them from re-offending is first permanently removing the child from their reach. If they are convicted and serve prison time, they can either serve their full sentence or be released under very strict parole conditions. As much as the public cries out to have these exploiters incarcerated for many years, this isn’t a practical option. If they serve out their sentences, they are no longer monitored closely as they would be if they were released on parole; parole is a continuation of their prison sentence that they serve outside the prison. Any parole violation would result in a revocation of their parole and return them to prison. Thus, it is in the public’s best interest to have these exploiters serve a portion of their sentences and then be paroled and monitored very closely by the strictest parole officer in the county, using frequent visits to their PO, surprise visits from their PO at all hours, removal of all child pornography and other deviant material from their homes, and the use of electronic monitoring devices to insure that they are always where they are supposed to be.

The outlook for successfully rehabilitating pedophiles is even more grim. These predators like what they do and intend to keep on doing it. The large majority of pedophiles do not respond to therapeutic approaches because they do not want to alter the objects of their sexual desires.

Currently, two practices are in use for preventing pedophiles from re-offending. The first is “aversion therapy,” a technique that involves having a certified hypnotist place the subject into a deep state of hypnotic suggestibility, and then planting the unconscious phrase “If I become sexually aroused by thinking about having sex with (boys, girls, etc.) I will become physically sick to my stomach, and I will not have an erection.” This technique’s effectiveness is questionable, since hypnosis is merely a state of deep, physical and unconscious relaxation. Hypnotized subjects, contrary to urban legend, cannot be coerced into doing something that they would not normally do. For example, a law-abiding hypnotized subject cannot be implanted with the suggestion that he rob a bank. The theory behind this technique is that in a hypnotic state, the subject’s deep subconscious can be accessed and utilized for a specific purpose such as smoking cessation and alcohol/drug cessation, and weight loss. These subjects clearly wish to stop their behavior; pedophiles don’t. Thus, hypnosis is likely to have little or no effect.

The second technique to avoid pedophile recidivism is the use of Depot-Provera, an injected, monthly drug used with women who have menstrual irregularities by manipulating the bioavailability of their estrogen levels. Use with men results in less testosterone levels that govern sexual urges and increased estrogen levels, thus “feminizing” the pedophile. Often called “chemical castration,” this technique is usually successful, but has come under fire for violating the “cruel and unusual punishment” guarantee contained in the Constitution. Arguments in favor of using Depot-Provera with pedophiles are that a pre-release inmate voluntarily receives the first few injections. Plus, he also has the right to decline this treatment and serve out his time without being paroled.

School Bullying

Children can and do perpetrate child abuse, physical or emotional, upon their peer group and/or younger children. On April 20th, 1994, Columbine High School in Littleton, Colorado, experienced a horrific tragedy. Students Eric Harris and Dylan Klebold entered the school and opened fire upon anyone they could see; they killed 12 students and teachers, and wounded 18 others before shooting themselves. In an in-depth investigation, they found that for a prolonged period of time, Eric and Dylan had been harassed, ridiculed and bullied at school. Another student falsely reported that they brought marijuana to school; their lockers were publicly searched, bringing even more ridicule on them. One day, other boys smeared ketchup all over them and called them “faggots.” A teacher witnessed this incident but made no attempt to stop it or report it. In his suicide note, Eric Harris indicated that he and Dylan had been continually bullied at school and felt completely isolated from other students. “It’s payback time,” he wrote.

School bullying is so prevent in the U.S. that it spawned the term “bullycide;” A deeply disturbing number of school-age children commit suicide to escape being bullied.

Categories of child abuse relevant to school bullying include:

  • The bullying of a target child of the same age or younger in a physical, emotional or sexual manner.
  • Cyber-bullying the target by spreading false, derogatory and humiliating emails and text messages.
  • Parents who neglect to detect and ask about whether their child is being bullied.
  • Mandated reporters (teachers, counselors and medical staff) who suspect or have witnessed bullying of a child and failed to report these incidents.
  • Peer group bystanders who witness or join in bullying without reporting it to a school staff member.
[QN.No.14. School bullying:]

Breaking down the issue even further, the following is a list of bullying behaviors:

  • Verbal abuse and harassment
  • Deliberately excluding others from a peer group
  • Spreading false rumors about others
  • Sending another person mean or threatening notes
  • Making harassing, threatening phone calls
  • Sending mean or threatening e-mails
  • Actively encouraging a peer group to dislike and isolate another person
  • Physical abuse
  • Making continual threats to harm another person and/or the person’s family
  • Stealing or destroying another person’s property
  • Playing “pranks” on another person in front of his or her peer group
  • “Visual” abuse, e.g., making obscene gestures to another person
  • Drawing obscene or humiliating graffiti about another person
  • Continually using humiliating racial slurs towards another person
  • Touching another person and/or making sexual comments
  • “Mobbing,” i.e., several bullies act in concert to harm another person
  • Completely and pointedly annoying another person
  • Frightening another person through physical or emotional intimidation
  • Forcing another person to do something he or she does not want to do
  • Stalking the victim, instilling fear, rage, and helplessness into the victim’s everyday life
Case Vignette

He was born "No-name Maddox" on 12 November, 1934. His mother, Kathleen, was a teenage alcoholic and prostitute. Unwanted and unloved, his mother offered to sell him to a bartender for a pitcher of beer. His mother briefly married an older man who gave the child his last name: Manson. Charles Milles Manson was left to virtually fend for himself in life when he was six years old. Kathleen and her brother were incarcerated for robbing a gas station. Charlie was passed around from relative to relative who did not want him. "I can still remember hearing grownups refer to me as "the little bastard." If Charlie cried about anything, his uncle called him a "sissy" and punished him by dressing him in girls' clothes and sending him to school. "I was teased and hit so much, I went into a rage and started fighting everyone. I was the fightin'est little bastard they ever saw. I was sick of being teased, laughed at, hit, kicked, not allowed to play with the other boys. All that changed me."
Because his mother could not care for him, Charlie was made a ward of the court and placed in a religious-oriented school, the Gibault Home for Boys in Indiana. Discipline was strict at Gibault; for even minor infractions Charlie, age 12, was whipped with a leather strap or wooden paddle. Charlie described his life at Gibault: “I was a small kid. I was easy pickings for those who were inclined to be bullies. I saw a lot of things. I saw kids forced into homosexual acts. I was told all kinds of ways to beat the law. If you care too much about a part of your life, like me wanting to see my mom, others take advantage of it and ridicule you constantly.” Charlie ran away from Gibault, was caught, and taken to the Indiana School for Boys at Plainfield, Indiana. Charlie was constantly in trouble for rule violations. The first night he was there, he was beaten and raped repeatedly by older boys. He alleged in his biography that the administrators of the school not only knew about the constant beatings and rapes, they often encouraged such treatment for a troublemaker like Charlie. He was a victim of bullying and severe sexual assaults; in turn, he himself raped and beat younger, smaller children. At Plainfield, rapes and beatings were like a spectator sport; these incidents were always observed by the other boys and some staff members. Charlie was released from Plainfield when he turned eighteen years old.

On the nights of August 9 and 10, 1969, a total of seven people were horrifically murdered and mutilated in an affluent section of Los Angeles. Charles Manson ordered five members of his so-called “family” to commit these murders and told them exactly how to kill the victims. By the time of the Manson Murders, Charlie, at age 35, had been incarcerated most of his juvenile and adult life. He had no empathy for others. He was ruthless in his violent acts; these murders were the result of Charlie’s desire to control others. Not many Americans over 40 do not recognize the name of Charles Manson; a national magazine called him “the Most Dangerous Man Alive.” Now 73 years old, Charlie remains incarcerated in California. His last parole hearing was on 22 May 2007; none of the "Manson family" killers have ever been paroled; Charlie knows he will die in prison.

Charles Manson was first bullied as a small child. At Gibault, he was bullied by older boys. At Plainfield, he was repeatedly beaten and raped. These are the life experiences that, perhaps, created a killer. It should be noted, however, that at various stages of his life, Manson was the victim of bullying, the bully, and a bystander to the bullying of other boys at Plainfield. For at least 40 years, forensic behavioral experts have attempted to understand all that led up to those two nights of murder in 1969. Not all killers were bullied, and not all bullies grow up to be killers. In all the years that have passed since the Tate-LaBianca murders that were planned by Charles Manson and carried out by members of his “family” of other outcasts and misfits, forensic examiners, have tried to discover the social “recipe” that created one of the most vicious killers of our time. Only one thing is known for certain: Manson was bullied, was a bystander to bullying, and then became a bully all before his 18th birthday. The society that created him paid a terrible price, i.e. the death of at least seven innocent people.

America has a strange fascination with bullies. On television, movies and in books, we seem to secretly admire the bully’s ruthlessness in getting what he/she wants because we are either too “civilized” to emulate their acts and/or are afraid of the consequences of our actions. While Charles Manson is an extreme case, still the research on school shootings and “bullycide” indicates that school bullying can have tragic consequences that could have been prevented if parents, teachers, school nurses, and principals knew more about bullying and instituted a zero-tolerance policy for bullying. Being mandated reporters, these professionals are way behind the power curve if they don’t recognize bullying when they see it or when it is reported to them.

To help the mandated reporter in determining that a child may be the target of bullying, the following are physical, emotional, and academic effects of being bullied:

  • Increased illnesses, particularly stress-related illnesses
  • Physical injuries resulting from being bullied
  • Attempted and completed suicide
  • Feelings of isolation, exclusion, and alienation
  • Difficulty forming deep relationships
  • Increased fear and anxiety
  • Depression
  • Feelings of incompetence and powerlessness
  • Truancy to avoid the bully
  • Increased absence from school due to stress-related illnesses
  • Lower academic achievement and class participation
  • Difficulty concentrating on schoolwork

“But I was just teasing him! Can’t he take a joke?” This is an infamous line given to school personnel by children who don’t know the difference between teasing and bullying. Especially if a child is injured by the bully and is seen by the school nurse, clear lines must be drawn between the two:


  • The teaser and the one being teased often swap roles with each other easily.
  • Is not intended to hurt or humiliate the other person.
  • Sill maintains the dignity of all involved.
  • Makes fun of someone in a lighthearted, clever, and benign way.
  • Intended to make both parties laugh.
  • Is but a small part of the activities of a peer group.
  • Is innocent in motive.
  • Is discontinued when the person who is being teased becomes upset with the teasing.


  • Is based upon an imbalance of power and is one-sided.
  • Is intended to harm and humiliate.
  • Is cruel, demeaning, and bigoted, thinly disguised as jokes.
  • Encourages laughter at the victim rather than with the friend.
  • Has the goal of diminishing the self-esteem of the target.
  • Induces fear in the victim about further taunting and physical harm.
  • Is sinister and mean-spirited in motive.
  • Continues unabated despite the victim’s distress or objection to the taunting.
[QN.No.15.In school bullying:]

If a mandated reporter suspects that a child has been, or is being bullied, he/she should report the matter, along with evidence seen or heard, to the school principal, who must in turn report to CPS. It should be left to the CPS worker’s discretion as to when the target’s and the bully’s parents should be notified. Most mandated reporters are unaware of any neglect, violence, threatening or exploitation occurring in the home of either child. The CPS worker may elect to have law enforcement and/or juvenile court intake officers assist in assessing the home before the parents are informed.
Child Abuse Detection, Reporting and Treatment > Chapter 9 - Special Topics in Child Maltreatment
Page Last Modified On: September 6, 2014, 10:04 PM