ChddAbuse&

Ne&cr, Vol. 12, PP. 555.561.

Printed ,n the U.S.A. All rights reserved.

CHILD

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Copyright Q I988 Pergamon Press plc

1988

SEXUAL ABUSE PREVENTION: EVALUATION

OF A TEACHER TRAINING MODEL
CAROL KLEEMEIER,

PH.D.,

CAROL WEBB,

AND ANN HAZZARD,

Department

of Psychiatry,

PH.D.,

PH.D.

Emory University

School of Medicine

JUDITH POHL, M.A.

Georgia

State University

Abstract-Teachers
are potentially helpful resource persons for large numbers of sexually abused children who may
have difficulty disclosing abuse, particularly
to family members. In the present study, the effectiveness of a 6-hour
teacher training workshop on child sexual abuse prevention was evaluated. Responses of 26 female elementary teachers who participated
in the workshop were compared to responses of 19 control teachers on several pre-, post-, and
follow-up measures. Relative to controls, trained teachers demonstrated
significant increases from pre- to post-testing
in knowledge about child sexual abuse and pro-prevention
opinions. On a post-only vignettes measure, trained teachers were better able than control teachers to identify behavioral indicators of abuse and suggest appropriate
interventions for hypothetical
sexually abused children. Over a 6-week follow-up period, trained teachers read more about
child abuse than control teachers but did not differ on other behavioral dimensions such as reporting suspected abuse
cases. Further research will examine the effects of additional teacher training over an extended follow-up period.

INTRODUCTION
AS COMMUNITIES AND CLINICIANS have become more aware of the problem of child
sexual abuse, there has been an increase in efforts to teach children how to protect themselves.
Prevention
programs are now being conducted
in thousands of communities
in the United
States, reaching over one million children in the past five years [ 11.
While one result of prevention programs has been a rise in the number of children disclosing
abuse, most professionals
believe that the majority of child sexual abuse cases are still not
reported to anyone [2-51. Many children are reluctant to report sexual abuse because of feelings ofguilt and responsibility,
fear that they will not be believed [5,6], subtle and overt threats
from the abuser [7], and uncertainty
about whether the abusive activity is inappropriate
[8].
Prevalence studies suggest that many sexually abused children are abused by a family member [3]. Disclosure is particularly difficult for these victims, who often face disbelief or inaction
if they tell family members about the sexual abuse [5,9].
Because of the difficulties children experience in revealing sexual abuse to family members,
many victims may look outside of the family to find help and support. Teachers, by virtue of
This research

was supported

Paper presented
Received

at American

for publication

by a grant from the National

Psychological

October

Requests for reprints should

SE., Atlanta, GA 30335.

Association,

6, 1987: final revision

be sent to Ann Hazzard,

Institutes

of Mental Health (MH4 1 16 I-O I).

New York, August

1987.

received March 25, 1988: accepted

Ph.D.,
555

Box 26065,

Grady

Memorial

March 3 1, 1988.
Hospital,

80 Butler St.

556

Carol Kleemeier,

Carol Webb, Ann Hazzard

and Judith

Pohl

their accessibility to the children in their classrooms and their expertise in child development,
are in a unique position to intervene and respond to the sexually abused child [lo].
However, teachers appear to have limited training and knowledge about child abuse issues.
Two studies surveying college education
curricula found that 33% did not include information about child abuse in their regular curricula [ 11. 121. Hazzard and Rupp found that teachers were significantly less knowledgeable
about child abuse than pediatricians
or mental health
professionals
[ 131. Levins survey of 285 teachers revealed that most teachers rated themselves
as lacking knowledge
about behavioral
symptoms
of child abuse, particularly
sexual
abuse [ 141.
Teachers are mandated to report child abuse in all 50 states, and 13% of child abuse reports
are made by school personnel [ 151. However Levins results suggest that as a result of teachers
lack of knowledge about child abuse [ 141, they may hesitate to intervene to protect children.
Although most teachers who responded to his survey felt personally or morally obligated to
report abuse, only 34% had ever reported a suspected physical abuse case. Even fewer teachers
(5%) had ever reported a suspected sexual abuse case.
Numerous curricula and program materials have been developed to help train and prepare
teachers and other professionals
to more adequately
respond to the problemof child sexual
abuse [ 161. However, only one recently published study has utilized an experimental
methodology to evaluate the etfectiveness of a teacher training program. Hazzard evaluated a teacher
workshop which covered all types of abuse and documented
teacher changes in knowledge,
increased empathy for abusive parents, and increases in several prevention
behaviors such as
talking to individual
children to determine
if abuse might be occurring
[ 171. The current
study builds upon this previous research by evaluating a teacher training workshop focusing
specifically on child sexual abuse. The study was conducted as part of a larger federally funded
clinical research grant in which different sexual abuse prevention
models were evaluated. As
part of the teacher training research. measures of knowledge, attitudes, victim identification
and communication
skills, and teacher prevention
behaviors were developed and validated.

METHOD

Forty-five female third and fourth grade teachers from a suburban southeastern
school district volunteered
to participate in the study. Twenty-six teachers from four schools were randomly assigned to the treatment
group and attended a six-hour training workshop on child
sexual abuse. Nineteen teachers from four other schools were randomly assigned to the control group.
The teachers had a mean age of 4 1 years and a mean of 12.5 years of teaching experience.
They were predominantly
white (75%). married (7 1%) with children oftheir own (65%). Over
75% had graduate school training.
Teachers prior experience with the area of sexual abuse was varied with 44% reporting no
previous professional
or personal experience.
However, 72% of the teachers had received at
least one hour of prior education about child sexual abuse.
There were only two significant differences between the treatment
and control groups in
terms of demographic
or experiential
variables. In contrast to the control group, the treatment
group included four lead teachers and one library assistant in addition to the regular third and
fourth grade teachers. Also, the treatment
teachers were more likely than control teachers to
have previously suspected that specific children had been abused, x (2) = 5.92, p < .05.

Sexual abuse prevention:

Teacher

training

model

551

Measures
Teacher Knowledge Scale. A 30-item true-false scale constructed by the authors was designed
to assess a teachers knowledge about child sexual abuse. A pilot version of this scale was
initially used during a prior teacher training workshop and shown to adequately differentiate
between trained and untrained
teachers.
The scale included items concerning the definition and prevalence of sexual abuse, interpersonal dynamics in abusive situations, identification
of victims, reporting, treatment, and prevention. Sample items are Children who are truly sexually abused rarely retract their stories
(F) and Most cases of child sexual abuse involve physical force (F). Each item had three
response alternatives:
true, false, and I dont know. Only accurate responses were scored as
correct, with inaccurate and I dont know responses being scored as incorrect. All but three
item-total
correlations
were above .25 and the overall internal consistency
of the scale as
assessed by coefficient alpha was .84. The 2-week test-retest reliability of the scale based on
control teachers scores was .90.
Teacher Opinion Scale. A 25-item Likert scale was constructed by the authors to measure
teacher attitudes and opinions about child sexual abuse. The scale was piloted during a prior
teacher training workshop and successfully
differentiated
between trained and untrained
teachers.
The scale assessed a teachers opinions about the importance
of the problem of child sexual
abuse; attitudes toward the victim, perpetrator,
and nonoffending
parent: opinions of community agencies involved in child sexual abuse; attitudes toward prevention;
and confidence
about dealing with child sexual abuse as a teacher. Teachers responded to each item on a 4point continuum
ranging from strongly disagree to strongly agree. Sample items are Reporting a case of suspected child sexual abuse to the Department
of Family and Childrens Services
usually does more harm than good and I would be comfortable
having a child sexual abuse
program in my class. Items were scored from 0 to 3, with 3 points given to pro-prevention
responses. All but 4 item-total correlations
were above .25, and coefficient alpha for the scale
was .78. Test-retest reliability for control subjects was .79.
Teacher Vignettes Measure. An 8-item written vignettes measure was developed by the authors in order to assess teachers skills in victim identification
and teacher-child
communication related to abuse. After four vignettes portraying possible sexual abuse situations, teachers
were asked to identify behavioral indicators of potential sexual abuse, to decide on an appropriate course of action, and to suggest how to initiate a conversation
with the hypothetical
child. Responses were scored according to the number of behavioral indicators correctly identified, the likelihood that the recommended
course of action would provide useful information or help for the child, and the degree of warmth and openness conveyed in the teachers
opening statement to the child. Teachers could receive negative scores for responses which
were judged likely to produce negative effects on the hypothetical
child.
Four other vignettes presented child disclosures of sexual abuse, and teachers were asked
how they would verbally respond to each disclosure. A sample disclosure vignette follows:
Karen comes up to you after class one day and says, I dont want to go to music class anymore.
bothering me when no one else is around. He keeps putting his hands up my shirt.

Mr. Smith has been

Teachers responded in a free response written format, and responses were scored according
to whether they (1) included helpful components
taught in the workshop (e.g., belief, nonblame, offer to help); and (2) demonstrated
awareness of how to handle difficult disclosure
issues (e.g., disguised disclosures, requests to keep disclosure secret). Total scores on the mea-

558

Carol Kleemeier. Carol Webb, Ann Hazard and Judith Pohl

sure could range from -4 to 52. Coefficient

ity was .99.

alpha for this scale was .78. and interrater

reliabil-

Teuchrr Pwvention BehaviorMeasurc~. A follow-up measure was designed to assess a teachers

self-reported
behaviors related to abuse prevention:
(1) reading about abuse, (2) discussing
abuse with colleagues. (3) implementing
prevention
activities in the classroom, (4) discussing
possible abuse with individual children, and (5) reporting suspected abuse cases.
Morkshop Evuhation. Treatment teachers completed a workshop evaluation which assessed
their subjective reactions to training, utilizing several Likert scale and free response items.
Teachers were asked to rate the overall quality of the workshop, the presenters, their comfort
dealing with child sexual abuse issues, and their likelihood of reporting suspected abuse cases.
Information
was also gathered concerning
the most and least helpful portions
of the
workshop.

The 6-hour teacher training workshop was conducted

by two psychologists with expertise
in child sexual abuse. The workshop addressed incidence and dynamics, indicators, short- and
long-term effects, basic interviewing
techniques,
reporting, treatment resources, and primary
prevention.
Teaching techniques included didactic presentations,
videotapes. experiential
exercises, role-plays, group discussion, and a question-and-answer
session with a child protective
services worker. Since the workshop was held on a Saturday, participating
teachers received
a 50-dollar stipend.
Control and treatment subjects completed a demographics
questionnaire
at pre-testing and
and Knowledge and Opinion Scales at pre- and post-testing.
At post-testing only, all subjects
completed the Vignettes Measure, and treatment subjects also completed the Workshop Evaluation. Following the teacher workshop, child prevention
programs were presented by project
staff members to the classrooms of half of the control and treatment
teachers as part of a
related research project. Six weeks following the teacher workshop. all subjects completed the
Prevention
Behavior Measure. After this follow-up measure was returned. control subjects
received a packet of written materials about sexual abuse in compensation
for their participation.

RESULTS

Spearman
rank-order
correlational
analyses were conducted
to determine
how demographic and experiential
variables related to each other and to teachers pre-Knowledge
and
Opinion scores. Teachers with more personal experiences
of sexual abuse (e.g.. knowing a
friend or family member victim or having been personally victimized)
were more likely to
have suspected that children in their classrooms were abused, r = .3X, p < .O 1. Teachers with
higher pre-Knowledge
scores (r = .27, p < .05) and more adaptive attitudes (r = .32, p < .Ol)
were more likely to have previously reported suspected child abuse cases.
A 2 x 2 repeated measures analysis of variance on knowledge scores was conducted
with
treatment condition serving as a between-subjects
independent
variable and time serving as a
within-subjects
independent
variable. The Condition
X Time interaction
was highly significant, F ( 1, 43) = 5 1.14, p < .OOOO I, with workshop participants
increasing their knowledge
more than controls (see Table 1). Significant main effects were also present for Condition,
F

Sexual abuse prevention: Teacher training model

Table 1. Means and Standard Deviations

PostTest

PreTest
Scale
Knowledge Scale
Control
Training
Opinion Scale
Control
Training
Vignettes
Control
Training

559

for Teacher Measures

SD

SD

14.2
14.8

5.96
6.04

13.6
23.3

6.4 1
2.85

54.9
52.1

6.35
7.69

52.8
56.6

4.89
7.89

25.2
35.7

7.86
5.46

(1,43) = 11.89, p < .OOl; and Time, F( 1,43) = 37.87, p < .OOOOl-both due to the dramatic
increase in the treatment groups post-test scores.
A similar repeated measures analysis was conducted on teachers opinion scores. Again, the
Condition X Time interaction was significant, F ( 1, 43) = 13.57, p < .OO1. Control teachers
slightly decreased their positive opinions while workshop participants showed an increase in
positive opinions (see Table 1). Main effects for Condition and for Time were nonsignificant.
Vignettes Measure
The Vignettes Measure, given to both workshop and control teachers at the time of posttesting, was analyzed using a t-test. As predicted, workshop participants were significantly
more able to respond appropriately to the hypothetical situations presented to them, t = 4.99,
p < .OOOl.Workshop participants mean score on the measure was 35.7, compared to control
subjects mean score of 25.2 (see Table 1).
Workshop Evaluation
A content analysis of the workshop evaluation form completed by participants immediately
following training indicated very positive reactions to the experience. The workshop was rated
by 96% of the teachers as very much worth attending, the highest rating on a 4-point Likert
scale. When asked what the most useful information had been, the most frequently mentioned
items were the examples given of helpful responses to children disclosing abuse, indications
of sexual abuse, and how to report abuse. Eighty percent of the teachers rated themselves as
very likely to report a case of suspected child sexual abuse to the county child protective
services agency.
Prevention Behavior Follow-Up
Both control and workshdp participants were sent a follow-up questionnaire 6 weeks after
the workshop, and 80% of the teachers responded. Individual items were analyzed using chisquares to assess the impact of training on teachers subsequent behaviors. No significant
differences between groups were reported in terms of classroom activities or discussions
about abuse or discussions of child abuse issues with a friend or colleague, or
discussions. . . with individual children. Four control teachers and four treatment teachers
had discussed potential abuse with individual students. There was a significant difference in
the time spent reading about sexual abuse, with workshop teachers reporting more time
(t = 5.4, p -c .05), probably because they had been provided with handouts during the
workshop.

560

Carol Kleemeier,

Carol Webb. Ann Hazard

and Judith

Pohl

DISCUSSION

Elementary
teachers in this study appeared to benefit from comprehensive
child sexual
abuse training in several ways. Compared to control teachers, trained teachers increased dramatically in knowledge about the scope of the problem, dynamics of child sexual abuse, behavioral indicators.
reporting procedures.
treatment
alternatives.
and prevention
concepts.
Furthermore.
trained teachers appeared to be able to apply their knowledge to hypothetical
situations
which teachers might actually face. On the Vignettes Measure, trained teachers
were better able than control teachers to identify specific indicators of sexual abuse and to
respond to hypothetical
sexually abused children in helpful, supportive, and appropriate ways.
Trained teachers also exhibited changes in their opinions relative to control teachers, although
these changes were smaller in magnitude
than observed changes on the Knowledge and Vignettes Measures. Trained teachers were more willing to acknowledge the severity ofthe problem of child sexual abuse, were less blaming of the victim, more likely to see community
agencies such as child protective services as helpful, more supportive of prevention
programs
for children, and more confident of their own role in addressing the problem.
Replication
of these results would be helpful to determine if teachers from other geographical regions or from more rural school systems respond similarly to training programs on child
sexual abuse. The absence of male teachers within the sample may also influence the generalizability of the results, although the majority of teachers at the elementary
level are female.
The positive changes on the Knowledge, Opinions, and Vignette Measures following training supports the validity of these measures as well as the effectiveness of training. In addition,
teachers pre-test scores on the Knowledge
and Opinions
Scales were positively correlated
with previous reports of suspected abuse: These results further support the validity of these
measures. The development
of reliable and valid outcome measures for sexual abuse training
programs for teachers is an important
contribution
of this study.
The major shortcoming
of the teacher training program was its limited impact on assessed
teacher behaviors during the 6-week follow-up period. The limited behavioral changes may
be partially due to the short follow-up period. which was necessitated by the end of the school
year. For example. disclosures of sexual abuse are relatively infrequent
events, and six weeks
may not have been an adequate time span in which to observe possible treatment-control
differences on this variable. Furthermore.
it is possible that the control teachers were motivated to focus on the issue of child abuse as a result of completing the measures. Finally, since
child prevention
programs were presented by project staff members in half of the control and
trained teachers classrooms. teachers probably felt less personal responsibility
for discussing
child abuse with their classes or with individual
children.
In sum. the 6-hour teacher training workshop produced clear changes in teachers knowledge. opinions, and anticipated
behaviors with sexually abused children. Further long-term
follow-up research is necessary to determine whether such training significantly affects teachers actual efforts to prevent or intervene in child sexual abuse. Behavioral changes might be
more likely to occur ifteachers were more directly and personally involved with at-risk children. For example, training teachers to implement
personal safety curricula which teach children self-protection
skills may be an even more effective way to increase teachers involvement
in the identification
and referral of sexually abused children. The next phase of our
research will assess how this more experiential
training affects later teacher preventive behaviors. We will also focus on whether children respond differently to prevention
programs presented by teachers versus sexual abuse consultants
from the mental health field.

,l~krzolz,/c~d~c,r??c~nt-The authors

gratefully

acknowledge

the contributions

of Sandra

Woods and Lisa Angert.

Sexual abuse prevention:

Teacher

training

model

561

REFERENCES
I. NELSON, M. and CLARK, K. The Educators Guide to Preventing Child Sexual Abuse. Network Publications,
Santa Cruz (1986).
2. KEMPE, R. S. and KEMPE C. H. The Common Secret: Sexual Abuse of Children and Adolescents. W. H.
Freman, New York (1984).
K. and WATERMAN,
J. Sexual Abuse 0s Young Children, Guilford. New York ( 1986).
3. MACFARLANE,
4. RUSSELL, D. The Secret Trauma. Basic Books, New York (1986).
D. When the Victim is a Child: Issuesfor Judges and Prosecutors. US Government
Printing Office,
5. WHITCOMB,
Washington,
DC (1985).
6. BROWNING,
D. and BOATMAN,
B. Incest: Children at risk. American Journal ofP.svchiatrv 134:69-72 (1977).
7. GELINAS, D. J. The persisting negative effects of incest. Psychiatry46:3 12-332 (1983).
8. BERLINER, L. and STEVENS. D. Clinical issues in child sexual abuse. In: Social Work and Child Sexual Abuse.
J. Conte and D. Shore (Eds.), pp. 93-108. Haworth, New York (1982).
for practice. Social Casework 62:60 l-606
9. CONTE, J. and BERLINER, L. Sexual abuse of children: Implications

(1981).
10. RIGGS, R. Incest: The schools role. The Journal ofSchool Health 52:365-370 (1982).
R. An investigation
of child abuse/neglect
instruction
offered in early childhood and elementary
11. BARTLETT,
education
preservice programs. Dissertations Abstracts International 38:6064-6065 (10-A) (University
Microfilms, No. 7804506) (1978).
COMMISSION
OF THE UNITED STATES. Teacher Education: An Active Participant in Solv12. EDUCATION
ing the Problem of Child Abuse and Neglect. Author, Denver (1978).
A. and RUPP, G. Knowledge and attitudes of professional groups toward child abuse. Journal of
13. HAZZARD,
Community Psychology 14:2 19-223 (1986).
Child Weljare62: 14-20 (1983).
14. LEVIN, P. Teachers perceptions, attitudes, and reporting ofchild abuse/neglect.
HUMANE
ASSOCIATION.
National Analysis of Offtcial Child Neglect and Abuse Reporting:
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Annual Report. Author, Denver (1981).
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Resume-Les
instituteurs sont des personnes qui ont la capacitd dintervenir utilement dans les situations de s&vices
sexuels i legard denfants. Les enfants, en effet, ont souvent de la difficult; a parler de ce quils subissent particulierement aux membres de leur propre famille. La pr&.cnte etude avait pour but devaluer Iutilite dun atelier de formation
dune duree de 6 heures pour les enseignants sur la prevention des &ices sexuels. 26 maitresses decole ont participe
i latelier et ont et& interrogees avant, apris latelier, ainsi que pendant une periode de suivi; ces reponses ont et&
comparees avec celles de 19 enseignantes
servant de temoins. Par rapport aux temoins, les enseignantes
qui avaient
suivi la formation en atelier, ont demontre de facon significative quelles avaient acquis des connaissances
nouvelles
dans latelier et change leur opinion quant i la prevention. Dans le cadre dune evaluation i laide de scenarios apres
Iatelier, les maitresses dicole ont montre quelles etaient mieux i meme que les enseignantes
tkmoins didentifier
des comportements
revelateurs de s&vices et mieux i meme de suggerer des interventions
approprides ides situations
oti lon supposait que les enfants avaient potentiellement
pu etre victimes de s&ices scxuels. Au tours dune p&ode
de suivi dune duree de 6 semaines, on a pu voir que les enseignantes
qui ont suivi la formation lisent davantage de
publications
sur le sujet de la maltraitance
que les enseignants temoins mais nont pas change leur comportement,
et
naiment pas denoncer les cas suspects de mahraitance.
11 va falloir done entreprendre
un autre projet de recherche
pour &valuer les effets dune formation supplementaire
sur Iattitude des maitresses decole et cela sur une p&ode de
suivi plus longue.
Resumen-Los
maestros de escuela son potencialmente
personas a las cuales pueden acudir un gran nimero
de
menores sexualmente
abusados que encuentran
d&i1 revelar el abuso, especialmente
a miembros de la familia. En
la presente investigation
se examino la efectividad de un taller de education
de maestros, de 6 horas de duration,
acerca de la prevention
del abuso sexual de menores. Les respuestas de 26 maestras de escuela primaria que habian
participado
en el taller fueron comparadas
con las respuestas de 19 maestras que no habian participado
(controles), a
traves de una serie de tests administrados
antes y despues de1 taller. Relativos a 10s controles las maestras que habian
participado en el taller demostraron,
posteriormente
a su participation.
un aumento significativo en su conocimiento
acerca de1 abuso sexual de menores asi coma en sus opiniones a favor de la prevention.
De acuerdo con 10s tests
posteriores a su participation
en el taller, las maestras que participaron
fueron mas capaces que 10s controles de
identificar las conductas indicadoras
de abuso y de sugerir intervenciones
adecuadas en cases hipoteticos de abuso
sexual de menores. En las seis semanas subsecuentes
al taller las maestras que participaron
leyeron mis acerca de1
abuso de menores que 10s controles pero no se encontro otras diferencias, por ejemplo en el reportaje de cases de
abuso. Investigaciones
futuras examinarin
10s efectos de education
adicional de las maestras a travis de un period0
extendido.