In the event of maltreatment, the most important thing for children to do is to get help from an adult.  Children should never be held responsible for resolving a distressing situation involving abuse on their own. It is the responsibility of the adults in a child`s life to prevent or intervene in the face of maltreatment and it is imperative that children know who they can get help from, where they can do so, and how this process might unfold. This critical information can make a world of difference for a child who is experiencing or is at risk of experiencing abuse. Another important aspect to the message of getting help is for the child to keep telling adults what is happening until they receive the help needed. It is a devastating reality that the first person a child approaches may not always provide the help that is needed. In these scenarios, it is imperative that the child knows they can continue telling until help is received.

In order to ensure children have access to the help they need, it is important to understand the barriers impeding children from reaching out for help in the event of child abuse. The decision to get help (or not) is a complex one that is informed by a diversity of factors. Exploring what some of these barriers are may help to improve access to support. Some commonly cited barriers will be explored first and then certain specific barriers will be examined in detail. It is important to keep in mind that the barriers presented here do not represent a comprehensive list nor do they fully convey the complex interactions amongst the different factors involved. When receiving children’s requests for help or disclosures of abuse, it is imperative to keep in mind the complexities involved behind one’s decision to tell and to respond with appropriate sensitivity and openness.

Across a number of studies examining impediments to children’s disclosure of abuse, common barriers identified involve concerns about the self, concerns about the perpetrator, and concerns about impact on family (Alaggia, 2010; Crisma, et al., 2004; Jensen, et al., 2005; Paine & Hansen, 2002; Ungar, et al., 2009). In relation to the self, children have reported not really understanding what was happening to them and whether it constituted as abuse. This speaks to the necessity of education through prevention programs to ensure children have communication strategies to express what is happening to them and adequate knowledge about how to get help in the event of abuse (Kenny, et al., 2008). Children have also expressed that they did not get help due to feeling responsible for the abuse and/or fearing that they would not be believed if they did tell. Furthermore, not knowing what the disclosure process entailed also impeded children from getting help in fear of any negative consequences. In terms of concerns involving the perpetrator, some children have reported being threatened by the perpetrator not to tell. When the perpetrator was a familiar individual to whom children felt a sense of attachment, they reported not getting help due to concern for what would happen to this person. Finally, children reported not getting help due to their fear of the negative consequences such disclosure would have on their family. When the family environment was relatively unstable, children also said they were less likely to ask for help. Overall, children were found to be extremely sensitive to and accurate about the perceived responses of their families in the event of disclosure (Hershkowitz, et al., 2007; Jensen, et al., 2005; Staller & Nelson-Gardell, 2005). When children expected a negative response from the adults around them, they were less likely to disclose experiences of maltreatment since they did not think the adults would respond effectively.

Family, Neighbourhood, Community-level Factors

It is important to recognize that a child’s surrounding environment significantly impacts whether or not they would get help in the event of child maltreatment. Researchers have reported a number of barriers to disclosure at the family level (Alaggia, 2010; Alaggia & Kirshenbaum, 2005; Crisma, et al., 2004; Kogan, 2004). For example, when children live in family environments where relations between family members are unstable, when communication is closed and indirect, and when violence is involved, they report being less likely to approach family members for help about abuse. It is possible that someone in the family is perpetrating the abuse, rendering it even more difficult for a child to disclose due to their fear of the negative consequences this would have on the perpetrator and on the family as a whole. When family dynamics are unstable, a child may feel isolated within the family or the family itself experiences isolation from the greater community. This further decreases access to adults in the community for help. Other barriers at the community level include lack of neighbourhood and school involvement in child safety or abuse prevention programs. This can leave children not knowing where or how to access resources for help.

Cultural Factors

A variety of cultural factors influence whether or not children reach out for help and/or receive the support they need upon disclosure of abuse (Alaggia, 2010; Aronson Fontes & Plummer, 2010; Chan, et al., 2011; Paine & Hansen, 2002; Shalhoub-Kevorkian, 2005). Aronson Fontes and Plummer (2010) cited the following cultural factors as impediments to disclosure of child sexual abuse: cultural definitions of concepts such as shame, modesty, respect, and honour, culturally-prescribed gender roles, women’s status, and patriarchal family and community structures. For example, in certain communities whereby gender roles are firmly fixed and mothers are fully assigned the role of child rearing, they are generally blamed for any disclosure of abuse (Lovett, 2004). This may prevent children from disclosing to in an effort to protect their mothers. In other cultures, the discussion of sexuality or sexual abuse is regarded as taboo and as a result, children have learned that it is not okay to ask for help in the face of abuse. Furthermore, cultures that emphasize honouring of elderly male members may hinder children from disclosing abuse, especially if the abuse is perpetrated by an elderly male individual who is respected in the community. Children may also hesitate to disclose abuse to prevent dishonouring the family name and inducing family shame. Finally, across cultures where children do not feel seen or heard, it is less likely that they will seek help when experiencing abuse or even if they do, they are not always met with an appropriate response (Alaggia, 2010; Chan, et al., 2011; Jensen, et al., 2005).

On the other hand, cultural insensitivity from the side of prevention and intervention to the needs of diverse communities can further impede children and their families from accessing the help needed (Aronson Fontes & Plummer, 2010). At the macro-level, institutional racism, unfair immigration laws, economic barriers, and inadequate access to protection services can hinder the effort to get help. At the micro-level, language barriers such as the lack of informational resources in the native languages of various cultural groups and the lack of linguistic services in the prevention/intervention process can prevent children and families from receiving help. Furthermore, being insensitive to cultural factors underlying decisions of disclosure can deter families from reaching out or increase mistrust of mainstream protection services (Gilligan & Ahkatar, 2006; Paine & Hansen, 2002).

Gender Factors

Gender differences have been identified in terms of the concerns children and youth expressed that impeded them from disclosing abuse and getting the help they needed (Alaggia, 2010; Alaggia, 2005; Alaggia & Millington, 2008; Paine & Hansen, 2002). In general, the messages received through mainstream media about gender roles and expectations can prevent males and females from reaching out for help. For example, Alaggia and Millington (2008) revealed that boys and men were hesitant to disclose abuse due to stereotypical expectations around masculinity such as the misconception that men are immune to victimization or that they are inadequate if victimized. Furthermore, when male victims have been abused by a same-sex perpetrator, they may hesitate to disclose due to the fear that their sexual orientation and masculinity would be questioned. On the other hand, girls and women in general hesitated to get help due to the belief that they were responsible for the abuse, to the concern of how disclosure would affect those around them, and to the fear of being blamed or not believed.  Finally, in a gender analysis study on disclosure of child sexual abuse, both males and females reported experiencing concerns with their sexuality and sexual orientation. Both genders also reported that another significant deterrent to the disclosure of abuse and getting help was the perception that they would not be heard or supported in the ways needed.

Non-verbal Indicators

Sometimes, disclosure of child maltreatment may not be verbal in nature (Alaggia, 2010; Jensen, et al., 2005; Katz, et al., 2012; Staller & Nelson-Gardell, 2005). Younger children may not have the cognitive or linguistic capacity to clearly communicate their experience of abuse and may sometimes express their distress non-verbally or indirectly. For example, Alaggia (2010) found temper tantrums to be a possible non-verbal indicator of abuse in younger children. Children may also express their distress around abuse by not wanting to visit the home of a perpetrator who is known to the family. Jensen and colleagues (2005) reported that some children did not fully disclose abuse until they were completely separated from the perpetrator. Non-verbal indicators in older children and adolescents may include angry outbursts, substance abuse, eating disorders, and/or running away from home. The fact that children may express their distress in indirect or non-verbal ways underscores the importance for adults to remain sensitive to these possible indicators and to follow up with children by asking them what is troubling them. On the other hand, it is also imperative to recognize that not all children display outward signs of distress and as a result, their distress may go unnoticed.  An important caveat to keep in mind when interpreting children and youth’s non-verbal behaviour is not to make premature assumptions about maltreatment, but rather to follow up for clarification in a sensitive and supportive way.

Children with Disabilities

Across a number of studies around the world, it has been found that children with disabilities experience significantly higher incidences of child maltreatment compared to their peers without disabilities (Child Welfare Information Gateway, 2012; Stalker & McArthur, 2012). Despite, higher incidence rates, underreporting is a prevalent issue. This is likely due to communication barriers these children may have that prevent them from getting the help they need. In fact, children with communication difficulties and behavioural disorders were found to be particularly at risk for maltreatment (Sullivan & Knutson, 2000). Another barrier to accessing support is physical or social isolation, which may limit access to protection services (Paine & Hansen, 2002). Also, due to communication difficulties, disclosures by children with disabilities may be viewed as being less credible and are thus minimized (Goldman, 1994). The barriers identified here do not represent a comprehensive list. Children with disabilities may generally be exposed to a greater number of caregivers across a number of environments, which increases the complexity around their access to help around abuse.

In general, younger children have been found to disclose incidences of abuse to adults whereas older children and adolescents turn to their peers for support (Kogan, 2004; Shackel, 2009; Ungar, et al., 2009). Older children and adolescents have also been found to disclose more often to professionals or to the police. As mentioned earlier, due to limitations in cognitive and verbal capacities, younger children may not always directly disclose and may express their distress indirectly or non-verbally (Alaggia, 2010). It is critical that adults remain sensitive to these cues and follow up with the children to facilitate the disclosure process. When older children and adolescents do disclose to their peers, it is usually about maltreatment experiences involving same-age peers and not necessarily about abuse perpetrated by adults. Regardless of the type of abuse shared with peers, it is imperative to emphasize the necessity of adult involvement. That is, it is not the responsibility of the peer to whom abuse is disclosed to intervene, but rather they should immediately get help from a trusted adult(s).  Educating older children and adolescents around how to help their peers by asking for support from adults is an important piece in any personal safety or prevention program.

The type of response children and youth receive upon disclosure is critically important to whether or not they will continue to disclose and get the help they need. Researchers have found children to be extremely sensitive to the responses they receive and they can quite accurately predict whether or not the response would be positive or negative (Hershkowitz, et al., 2007; Jensen, et al., 2005; Staller & Nelson-Gardell, 2005). When children predict responses to be negative, they were much less likely to disclose and get help. Some children may attempt to disclose via behavioural indicators and have reported giving up telling about abuse perpetrated against them when adults did not respond in a supportive way (Alaggia, 2004). These findings underscore the importance of the quality of support adults provide in facilitating the disclosure process. To ensure that a child does get the help they need, adults need to become informed about the factors that facilitate the disclosure process.

Regardless of whether disclosure occurs in childhood, adolescence, or adulthood, perceived positive support is associated with better outcomes (Jensen et al., 2005; Tener & Murphy, 2015). As mentioned earlier, one of the significant barriers to disclosure and getting help is the fear children and youth have of not being believed (Alaggia, 2010; Crisma, et al., 2004) Some children have also reported mistrust of adults and not believing that they would be adequately supported even if they did tell (Crisma, et al., 2004; Somer & Szwarcberg, 2001). Children and youth have reported that they were more likely to get help and/or disclose about experiences of abuse when a trusted adult in their lives took the time to ask them what was wrong, when adequate privacy was provided for the disclosure, when they did not feel rushed, and when they felt truly listened to without being judged. Furthermore, children have reported not disclosing or getting help due to uncertainties around what the disclosure process would entail. Adults need to take the time to reassure children that getting help is the right thing to do (Chan et al., 2011; Lovett, 2004; Ungar, et al., 2009).

Efforts must also be made to address the specific barriers described in the previous section. Below, recommendations for addressing each of these factors are addressed:

1. Unstable family environments and/or isolation from the surrounding community can impede children from getting the help they need in the face of child maltreatment ((Alaggia, 2010; Alaggia & Kirshenbaum, 2005; Crisma, et al., 2004; Kogan, 2004). Sometimes, the adults in a child’s immediate social environment (e.g. family, relatives, neighbours) may not be able to provide them with the support needed upon disclosure. Educators of prevention programs and other professionals working with children on issues of personal safety should provide children with resources on how to access help when in need (e.g., calling a kids helpline or identifying adults they can turn to in their community).
2. When working with children, youth, and their families from diverse cultural groups, it is imperative to be culturally responsive and to address concerns with an open, non-judgmental attitude (Aronson Fontes & Plummer, 2010). Whenever possible or when it is requested, services should be provided in the preferred language of the individuals concerned. Professionals working with children and their families must also be aware of their own preconceptions about various cultural groups to ensure they do not impede communication and access to needed services.
3. It is important to be mindful of the different concerns each gender may have about the disclosure process so that these concerns can be effectively addressed (Alaggia, 2010; Alaggia, 2005; Alaggia & Millington, 2008; Paine & Hansen, 2002). Although some are shared, boys and girls may also have different concerns around getting help such as those involving gender stereotypes, gender identity, and sexual orientation. Each individual and their circumstances should be approached uniquely to ensure their needs are met.
4. Children and youth may partially or indirectly disclose through behavioural indicators or indirect verbal communication (Alaggia, 2010; Jensen, et al., 2005; Katz, et al., 2012; Staller & Nelson-Gardell, 2005). Adults need to ensure they are sensitive to the cues expressed and follow up by asking children and youth what is troubling them in a supportive manner.
5. When working with children with disabilities, interventions that focus on improving relations with caregivers (both within and outside the family) and reducing caregiver stress may help to prevent or decrease the likelihood of further maltreatment (Stalker & McArthur, 2012). Efforts aimed at helping children with disabilities develop communication strategies as well as providing them with more information about personal safety should also be prioritized to ensure they have better access to the help they need (Child Welfare Information Gateway, 2012).