Heather Bacon and Sue Richardson
Prior to developments in the medical diagnosis of child sexual abuse, most strategies for intervention and treatment were based on the assumption that the child had moved or could be enabled to move to what Sgroi (1984:19) has termed 'purposeful disclosure'. This presupposed that the child was old enough to communicate and encountered the right conditions such as finding a sympathetic, believing adult. In other words, the responsibility was mainly with the child to take the initiative to begin the disclosure process. This rendered young, pre-verbal children particularly vulnerable.
In Cleveland in 1987, medical findings suggestive of child sexual abuse were the starting point of investigation for several children. In some cases there was a vigorous denial by both the young child and possible perpetrator. An assertion that the medical findings were erroneous prompted the explanation that the investigation had produced a 'false positive'. In other cases, children (again young) who were spontaneously able to give a recognisable account of sexual molestation could be seen as confirming the precisely similar medical findings. Children with medical findings suggesting the most serious forms of penetrative abuse were often unable to speak, or gave accounts which contradicted or did not confirm the medical findings.
At that time in Cleveland, such children were increasingly presenting for evaluation. Thirty-two of the 121 index cases reviewed by the Cleveland Inquiry were under the age of three. The youngest sexually abused child mentioned in the Report (Butler-Sloss 1988:146) was a baby of six weeks. The youngest caught up in the crisis was aged seven months. Gale (1988) in reviewing American studies, found that one-third or more of children in case samples were under the age of six years. A study by Hobbs and Wynne (1986) of thirty-five children in the UK found that twenty-four were aged five or under, with an age range starting at fourteen months. The Chair of the Cleveland Inquiry, Lord Justice Butler-Sloss described recognition of the sexual abuse of young children as a 'new phenomenon' for professionals, highlighting the fact