Child Sexual Abuse Accommodation Syndrome – CSAAS was proposed by Roland C. Summit in 1983 to describe how he believed sexually abused children respond and adapt to ongoing, long-term sexual abuse. Summit observed that child victims of sexual abuse unconsciously and involuntarily develop coping mechanisms or strategies to manage the abuse. Roland stated: children “learn to accept the situation and survive. They have no means of escape and no place to run. A healthy, emotionally normal and resilient child will learn to adapt and accommodate to the reality of continued sexual abuse”.

Summit describes a series of stages in the child’s process of adaptation and accommodation to sexual abuse: 1. Keeping the secret; 2. Helplessness; 3. “Entrapment” and accommodation. 4. Delayed disclosure; 5. Retraction of the disclosure.

Bellow, we describe the content of each stage as conceptualized by Summit:

1. Keeping the secret: the child is either taught, subtly encouraged or directly instructed not to talk about the abuse. The maintenance of secrecy can be influenced by various emotional responses and motivations: feelings of guilt for having participated in the abuse, or for not disclosing it earlier; fears related to the possible consequences of disclosure (fear of the abuser’s reaction, fear of how caregivers will respond, fear of being separated from their family, or taken into the child protection system etc.)
2. Helplessness: once involved in sexual abuse situations, the child feels a prisoner of that situation and perceives in a distorted way that there is no way out of the situation of aggression. Distorted perceptions of the perpetrator as omnipotent and in absolute control of the situation, the minor perceives him/herself as helpless and perhaps most importantly, distorted perceptions of the family/caregiver as unable to provide necessary support. The child’s distorted perceptions of the perpetrator, self and the care environment can be explained by the immaturity specific to children, but also by the power and interaction dynamics between the perpetrator and the child.
3. Entrapment and accommodation: the child’s misperception that there is no escape from the abusive situation, that he/she is completely vulnerable and helpless and that the abuser is omnipotent, leads the child to develop a series of coping strategies to cope with the abuse (“coping mechanism”). Adaptation or accommodation to/with the abuse emerge as coping strategies for surviving the abuse. This phenomenon mainly applies to sexual assaults over a long period of time with multiple acts of aggression. The juvenile integrates the abuse into the rhythm of his/her daily life, often focusing on the pleasant realities in his/her life (e.g. school, relationships with friends, various hobbies) and cognitively and/or emotionally “separating” from the reality of the abuse;
4. Delayed disclosure: throughout the period when the child is being sexually abused, the child may consciously decide not to tell about the abuse. The child may also repeatedly try or decide to talk to someone he or she trusts, only to later give up on this intention on his or her own. It should be noted that the more time passes since the child has been sexually assaulted, the more difficult it may be for the child to disclose the assault. Many emotions and motivations may underlie this difficulty: guilt, the feeling of consenting to the abuse, or chronic helplessness and helplessness;
5. Retraction of allegations of abuse: after the initial disclosure, which may be voluntary or accidental, the child may retract what he or she initially said. There may be a variety of reasons for this retraction: reactions of people who have learned about the abuse, distrust shown by them, blaming the child, access to the child by the abuser even after the child has disclosed the abuse.

It is important to emphasize that, although Roland called CSAAS a “syndrome”, there is no syndrome and no diagnosis per se (just as there is no diagnosis of parental alienation per se), but rather this phenomenon of adjustment to abuse can be used to understand the particular way in which the minor reacts and responds to abuse (and not to prove the guilt of the suspect). CSAAS provides insight into how children may respond to sexual abuse, highlighting the complexity of their reactions. At the same time, however, it is important that we do not use CSAAS as a diagnostic tool or as evidence in court without careful assessment and appropriate context.

Bibliography:

1. Wikipedia Child sexual abuse accommodation syndrome – Wikipedia;
2. Sex, Lies, and Statistics: Inferences From the Child Sexual Abuse Accommodation Syndrome | Journal of the American Academy of Psychiatry and the Law;
3. IPT Journal – „Child Sexual Abuse Accommodation Syndrome: Issues of Admissibility in Criminal Trials”

Article written by Patricia Aramă, psychologist.