Almost a third of alleged perpetrators of child sexual abuse were teenagers or children themselves, according to a landmark study of almost 450 survivors over five years.
The findings have prompted researchers to call for improved education about consent for young people, linking these behaviours to early access to the internet and exposure to pornography.
The study, published in the international paediatric journal Archives of Disease in Childhood, analysed 448 cases from 2018 to 2022 of children who attended Children’s Health Ireland (CHI) Tallaght’s forensic medical examination centre, Laurel’s clinic.
This clinic is CHI’s paediatric medical service available to children and young people when a concern or disclosure of child sexual abuse or sexual assault has been raised in relation to them. It is one of three in the State.
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The vast majority of the 448 patients (79 per cent) were woman, while more than a third (37.5 per cent) were aged five to 11 years old. There were also seven babies under the age of one.
Vaginal penetration occurred in 46 per cent of cases, with digital penetration being the most common method. Anal penetration was reported in 26 per cent of cases.
The researchers said a “key finding” is the low rate of physical findings in child sexual abuse, such as genital injury.
The abuse was most often perpetrated in the child’s home (35 per cent) or in the other parent’s home (18.6 per cent). A total of 58 patients were assaulted outdoors.
Nearly half of patients showed behavioural changes, with sexualised behaviour identified in 17 per cent of the patients. The study noted that behavioural changes, when unexplained, may be one of the few early signs of abuse.
Sexualised behaviour was more commonly reported in younger children, with 24 per cent of those displaying such behaviours aged under five, compared with six per cent of who were over 12. About 18 per cent of patients had developmental concerns.
Alleged perpetrators were mainly male (90.1 per cent), while more than a fifth were teenagers and 12.8 per cent were under 13. More than half of the cases involved repeated abuse.
Some two-thirds of the patients referred had made a disclosure.
Disclosure rates were higher with older ages: 88 per cent of children aged 11–18 years disclosed the abuse to someone, compared with 56 per cent of children under five.
Dr Sinéad Harty, consultant paediatrician at CHI and co-author of the study, said the research paints a “stark but necessary picture”.
She said: “One of the most concerning findings is the significant proportion of perpetrators who were themselves children or adolescents, which underlines the urgent need for improved education around consent, relationships and digital safety.
“As children gain earlier access to smartphones and online content, the risk landscape changes – and our public health and education responses must keep pace.”
The study revealed that nearly a third of children seen at the Laurel’s Clinic lived in blended family settings, with this proportion increasing from 19.7 per cent in 2018 to 35.3 per cent in 2022.
There was a family history of child sexual abuse in 18 per cent of cases, while 18 per cent of patients were autistic or had attention deficit hyperactivity disorder.
According to Dr Harty, the research highlights the need for clinicians, social workers, educators and policymakers to be aware that many children, particularly those with unexplained behavioural changes may be living with undisclosed trauma.
“We must remain vigilant, open, and child-centred in our care,” she added.
