Defining Child Sexual Abuse:

Child Sexual abuse (CSA) is a preventable public health crisis with devastating personal, social, and economic consequences. While prevention is possible, CSA requires a unique approach compared to physical abuse and neglect prevention. For instance, CSA has a hidden nature and most perpetrators are known to the victim.

Why Prevention Matters

• Child sexual abuse costs the U.S. $9.3 billion annually in health care, lost productivity, child welfare, violent crime, special education, and suicide-related costs [1]
• Survivors face lasting harm: 34% lower adult income, almost double the rate of welfare dependence, higher disability rates, unplanned pregnancies, and incomplete education [2,3]
• Gold standard child sexual abuse prevention programs create high impact and cost-savings, but require minimal time investment and minimize teacher burden.

Research Findings

• CSA is different than physical abuse and neglect. Most perpetrators are trusted individuals. General abuse prevention programs are not sufficient.
• Evidence-based prevention works. Multi-sector programs have the potential to improve the efficiency of child protective service operations.

Additional Findings

Additional benefits include reduced ER visits, increased school readiness, better mental health, and stronger workforce outcomes.

Schools are key — programs like Safe Touches [5]:

• Cost $43/student (less when scaled).
• Can be delivered in under an hour by trained Child Advocacy Center staff.
• Increase children’s knowledge about recognizing and reporting abuse, with long-term retention.
• 92% of schools voluntarily participated when high-quality programming is offered
• Using trained, qualified facilitators (not teachers) reduces burden and mitigates concerns about disclosures during training.

Policy Examples from Other States:

• Multiple states have advanced legislation mandating child sexual abuse (CSA) prevention education in schools, with varying approaches to curriculum and implementation.
• Erin’s Law has been adopted in 37 states (with 13 still pending) and requires schools to provide age-appropriate CSA prevention education. Early
  versions, such as the original Illinois statute, took a streamlined approach by mandating instruction but leaving flexibility in delivery.
• For the strongest outcomes, any CSA prevention statute could provide curricula that aligns with evidence-based practices or research-informed programs, ensuring states implement approaches proven to reduce abuse and increase system efficiency.

1. Letourneau, E. J., Brown, D. S., Fang, X., Hassan, A., & Mercy, J. A. (2018). The economic burden of child sexual abuse in the United States. Child Abuse & Neglect, 79, 413–422. https://doi.org/10.1016/j.chiabu.2018.02.020
2. Mersky, J. P., & Topitzes, J. (2010). Comparing early adult outcomes of maltreated and non-maltreated children: A prospective longitudinal investigation. Children and Youth Services Review, 32(8), 1086–1096. https://doi.org/10.1016/j.childyouth.2009.10.018
3. Fergusson, D. M., McLeod, G. F. H., & Horwood, L. J. (2013). Childhood sexual abuse and adult developmental outcomes: Findings from a 30-year longitudinal study in New Zealand. Child Abuse & Neglect, 37(9), 664–674. https://doi.org/10.1016/j.chiabu.2013.03.013
4. Noll, J. G., Felt, J., Russotti, J., Guastaferro, K., Day, S., & Fisher, Z. (2025). Rates of Population-Level Child Sexual Abuse After a Community-Wide Preventive Intervention. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2024.6824
5. Pulido, M. L., Dauber, S., Tully, B. A., Hamilton, P., Smith, M. J., & Freeman, K. (2015). Knowledge Gains Following a Child Sexual Abuse Prevention Program Among Urban Students: A Cluster-Randomized Evaluation. American Journal of Public Health, 105(7), 1344–1350.
   https://doi.org/10.2105/AJPH.2015.302594
6. Radakin, F., Scholes, A., Solomon, K., Thomas-Lacroix, C., & Davies, A. (2025). The economic and social cost of contact child sexual abuse. UK Home Office. https://www.gov.uk/government/publications/the-economic-and-social-cost-of-contact-child-sexual-abuse