Summarises key findings and learning points from cases of intra-familial sexual abuse (IFSA), including sibling sexual abuse. Learning points include: acting on early concerns, using the Strengths and Needs Form; remaining alert to the possibility of all types of bias including unconscious gender bias and female abusers; awareness of how practice can be influenced by family social status; considering the viewing and sharing sexual images online in the context of family history and response to trauma; effective communication, with practitioners both sharing and seeking information, and using clear language; using available tools to identify different types of IFSA, for example a multi-agency chronology; ensuring that assessments consider and include the whole family and that all children in the family have been seen individually and had their voices heard; analysing parental motivations and capacity as part of risk assessments; reflecting on the impact of inter-generational abuse on parenting capacity and the need for practitioners to be trauma aware; understanding practitioners confidence levels around specific types of IFSA, especially sibling sexual abuse; consideration of what additional support may be needed when ending work with a family if parents are vulnerable; encouraging fathers to be included and participate in discussions; the impact of Covid-19 on families and service delivery; and the need to update the national practice of categorising abuse in the child protection process when there are multiple risk factors, for older children, or where there is intra-familial (sibling) abuse. Recommendations are embedded in the learning points.
      
 Title:  Intra-familial sexual abuse (IFSA): a thematic review of Oxfordshire local child safeguarding reviews. LSCB: Oxfordshire Safeguarding Children Board Author: Oxfordshire Safeguarding Children Board Date of publication: 2023  This case review report was deposited by the publishing LSCB(s) with the national SCR repository, a partnership between the Association of Independent LSCB Chairs and the NSPCC.  This report is available online via the NSPCC Library Catalogue. Copyright of this report remains with the publishing LSCB(s) listed above.                             1 Intra-familial sexual abuse (IFSA): A Thematic Review of Oxfordshire Local Child Safeguarding Reviews  This thematic review considers IFSA, including sibling and intra-family sexual abuse and highlights key practice issues found in Oxfordshire learning reviews.  It links with national research & other learning reviews.  The review gives an overview of findings and learning for building confidence & strengthening practice when working with situations of IFSA.  Key findings  Finding one: Professional curiosity and unconscious or conscious bias “It was not seen” • Practitioners should remain curious in their practice and consider all possibilities when working with children and their families. In the cases reviewed, there were examples where practitioners were not questioning enough in their practice, where self-reported information was taken at face value and where unconscious or conscious bias may have led to assumptions being made • Professionals must access specialist Sexual Abuse training to be able to understand harmful sexual behaviours and risk indicators between siblings and in families and know the indicators to consider the likelihood of sexual abuse   Finding two: Information sharing and working together to gain a full picture/history   • Important historic information was not consistently shared across the safeguarding system, leading to assumptions being made about who knew what and what information had been shared  • Crime records by the Police need to be clear, consistent and use the appropriate terminology when detailing sexual abuse.  In one Review when sharing information with Children’s Social Care the relevance of what was being shared was not recorded appropriately  • Agency records need to show all key information concerning each child and adult in the family, evidencing that they have each been spoken to.  In one Review the Police and CSC had not spoken to the other children in the family and this impacted on risk being assessed/known • It can be a professional and system challenge to have a ‘collective memory’ as practioners will change and so it is imperative that all relevant/key points are recorded on systems to show a child’s story over time and in chronological order  Finding three: The need for practitioners to be trauma aware when understanding Inter-generational patterns of abuse   o Research Key messages from research on intra-familial child sexual abuse has shown that there are clear links between inter-generational abuse and how this might impact on parenting capacity  • Adverse childhood experiences (ACEs) and responses to childhood trauma : One parent’s behaviours    weren’t recognised as a response to trauma but instead were seen as being attachment seeking - including sexualised behaviour, sharing of sexual images and being vulnerable to sexual exploitation  Finding four: Understanding individual children’s worlds in their families and hearing their voice  • Remember - behaviour is a way of a child communicating their distress • Each child in the family needs to be seen and spoken to when assessing risk   Finding five: Working with families to understand barriers and enablers  • In one Review it was evident that the parental social status shaped professional interactions and outcomes for the children due to assumptions made and a fixed view taken   2 • Working in a whole family systemic way when there are worries of sibling sexual abuse is important • In one review little work was done with the father – valuable information could have strengthened the findings  Finding six: Impact of the covid-19 pandemic  • The COVID-19 pandemic, subsequent lockdown and change in service delivery meant children were not being seen as regularly and parental vulnerabilities, e.g., stress, distress, feelings of loneliness and isolation increased.     Strengths in Practice  • In one case the Family Nurse Partnership (FNP) was a consistent, supportive and child focussed presence, there was evidence that the parent was benefitting from input and the children were developing appropriately. FNP identified that parent’s mental health was deteriorating, that the children were exhibiting signs of distress in their behaviour, sought advice and made attempts to get additional help • In some situations, referrals to Children’s Social Care were comprehensive, including parent’s family history, experiences of abuse, sexual exploitation, self-harm and experiences of care • There were a number of examples where practitioners ensured that face to face meetings were held with families and that information was shared well across partners • In one review, professionals involved clearly had concerns that children were being abused and pursued different specialist and social work assessments to establish evidence  • There were high levels of involvement across agencies to support families through children in need and child protection plans   • In some of the situations reviewed, there was strong evidence of appropriate information sharing across partnerships and some good examples of working together • In some of the reviews, the views of the children were clearly recorded in assessments • There was expertise seen in CAMHS specialist provisions  of the partnership regarding sibling sexual abuse • In one review there was evidence of good transitional arrangements when a child reached 18 years old   Practitioner Learning points to build confidence and strengthen practice  • Keep a constant focus on the child and their lived experiences • Try and build a connection with each child in the family so as to understand their lived experience and hear their voice • Understand the relationship and dynamics between siblings – remember observational skills as part of your analysis • There are likely to be barriers and enablers to understanding a child’s world – unpick these carefully with the family and professional network and in supervision   Early intervention:  • Act on early concerns, using the Strengths and Needs Form (S&NF), https://www.oscb.org.uk/early-help-forms-tools  formerly the Early Help Assessment (EHA) to better understand what is going on and to decide the best way forward.  • If you are not confident in using the assessment, EHA training is available, or you can seek support from your LCSS link worker or Designated Safeguarding Lead (DSL)    Unconscious bias:  • Practitioners must remain alert to the possibility of all types of bias including ‘unconscious gender bias’. Whilst the sexual abuse of children by women, especially by mothers of their own young children, is rare;   3 practitioners must recognise that some females do abuse and be alert and seek specialist advice and supervision when considering the differences in offending behaviours, victim profiles and personal characteristics in male and female offenders:  Centre of expertise on child sexual abuse (CSA Centre): research, resources and training  • Be aware of how practice can be influenced by family social status when working with differing social class, professional status, and academic qualifications   Viewing and sharing sexual images online:  • When parents with a history of familial sexual abuse report that they are sharing sexual images, practitioners should consider the context and implications of early childhood trauma, and question whether the parents behaviour has an impact on their parenting and risk to children.  • There was evidence of sharing of explicit images, in at least two of the cases reviewed, both with and without consent. This behaviour can be viewed as common practice by young people and was not considered by professionals in the context of family history and response to trauma  Information sharing and effective communication:  • Double check that ALL key information has been shared with relevant professionals – it can be easy to miss significant things when there are competing demands • Check out information with the family • Effective communication requires practitioners to both share and seek information, and to use clear language to avoid any misinterpretation  • See and note behaviours as potential evidence of child sexual abuse. Be specifc and detailed in your recording of what you observe in a child / what a child tells you or retracts / what they may draw / interactions and dialogue with siblings / parents and wider family dynamics • Consider whether you have spoken to everyone you need to, that all involved agencies have contributed to assessments and that you are sharing relevant information to strengthen your analysis   Use of available tools to identify different types of IFSA:  • Use available tools to support your practice, and to contribute to effective assessments and plans , for example a multi-agency chronology (MAC) can provide a good insight into the child’s life  Assessments:  • Ensure that assessments consider and include the whole family, e.g., who is in the family, do you have a genogram and what are the family members’ needs, family background? Does your assessment consider the child’s social context?  • Have all the children in the family been seen individually and their voices heard? • Keep a firm focus on potential risk, reflect on existing evidence and assessment, re-assess risk factors and triggers, and use escalation between agencies when risks are not reducing despite intervention • Make sure you analyse parental motivations and capacity as part of your risk assessments  Manager Learning points to strengthen oversight and direction in formal/informal supervision  • When working with parents / families where there have been generational patterns and cycles of abuse and childhood trauma, robust supervision and management oversight is essential to enable practitioners to reflect on the impact this might have on parenting capacity and risk to children • Safeguarding supervision and management conversations should be both supportive and challenge practitioners’ thinking, and a chronology of events/multi-agency chronology completed to indicate patterns or areas of concern  • When ending work with a family, or stepping down a service, supervision, management, and safeguarding advice should enable reflection, to help practitioners see the wider context along with family history to ensure the decision-making is safe and proportionate for the child • Understand practitioners’ confidence levels around specific types of IFSA and especially sibling sexual abuse as there can typically be a lack of professional awareness and awkwardness in practice    4 pag  • Consideration of what additional support may be needed when ending work with a family, or when a plan is to be stepped down if parents are especially vulnerable, for example care experienced young parents to ensure a think family approach • Consideration should be given to whether teenage parents, in particular ‘Children We Care For’ should be identified as needing more focussed support and interventions that acknowledge trauma and potentially greater safeguarding risk • Training and resources must support practitioners’ knowledge and understanding of sexual abuse, including female abusers and abuse of infants and sibling sexual abuse • All agencies need to ensure they understand the nature of risk, and a shared language which enables effective discussion, assessment, and intervention in relation to the use of the internet and social media as a platform for child abuse • All agencies should ensure that when working with parents with a history of sexual abuse, or they understand the family history, trauma and responses to trauma. This must be an integral part of the assessment of parenting capacity and risk • Child Protection Conferences need to provide robust scrutiny, bring balance and avoid over optimism • Categorising the nature of abuse at a Child Protection Conference should not prevent wide ranging discussion of all the risk factors. Participants should remain mindful that for many children, the risk may reflect more than one category • Whilst the pre-birth assessment is led by Children’s Social Care, it is imperative that all agencies with both knowledge of the family and the issues impacting on them, participate and contribute • The role of the Leaving Care Personal Assistant (PA) needs to be well understood by other agencies across the Partnership and must be fully integrated into any partnership working • The impact of the COVID-19 pandemic on families and service delivery should be evaluated and used to inform future planning • Practitioners should consider how fathers can be included and participate in discussions/ meetings regarding their children and services should be designed to enable their involvement           National learning The national practice of categorising abuse in the Child Protection process is out of date and does not work well  when there are multiple risk factors, for older children, or where there is intra-familial (sibling) abuse. As per a reccomendation from one case review -  a letter on behalf of Oxfordshire Safeguarding Children Board (OSCB) has been sent to the Department for Education (DfE) asking for a review of the categories of risk, to ensure it reflects current safeguarding practice and is fit for purpose.         If you do one thing…… learn the signs and indicators of child sexual abuse, Children are unlikely to tell anyone that they are being abused and particularly if this is between brothers/sisters Remember that behaviour is talking for a child   Stubborn challenges: • The need for robust supervision and management oversight • Interpreting information in a way that supports existing theories and beliefs • Over - optimism • Continuous sharing of information and effective communication across the network  • Use of chronologies to indicate patterns of behaviour and areas of concern   5 Did you know? The following links offer useful further information and guidance:   • Centre of expertise on child sexual abuse (CSA Centre): research, resources and training  o Key messages from research on intra-familial child sexual abuse o Signs and indicators template o Communicating with children guide o Supporting practice in tackling child sexual abuse film series o Helping education settings identify and respond to concerns o Supporting Parents and Carers Guide • OSCB training; including OSCB Generalist and Designated Safeguarding Lead Courses, and themed courses, e.g., Digital Safeguarding, Domestic Abuse, Healthy and Unhealthy Sexual Behaviours training • OSCB online procedure manual: o Child Protection Conferences o Information sharing • Multi-agency practitioner’s toolkit: o Professionals only meeting guidance o Guidance on chronologies o Safeguarding conversations poster  Sibling Sexual Abuse • BBC radio 4 podcast. Sibling Abuse – the last taboo?  • Understanding sexualised behaviour in children | NSPCC LearningAd·https://learning.nspcc.org.uk/ Download the SSA report (PDF, 1.6MB) Other guidance / resources • The National Child Traumatic Stress Network: Creating trauma informed systems    