Kathleen Coulborn Faller Ph.D., James R. Marsh J.D., David L. Corwin M.D., and Joyanna Silberg Ph.D. present at the 2018 American Professional Society​ on the Abuse of Children​ Colloquium on characteristics of child pornography on the internet​, research related to child sexual abuse on the internet​, recent legislation and legal cases related to child sexual images on the internet​, evaluating survivors of child sexual abuse on​ the internet​, assessing damages for civil litigation involving child sexual abuse on the internet​, treatment approaches for victims, and​ future directions​.

1. Multidisciplinary Approach to Internet
Child Pornography: Impact on its
Victims
Kathleen Coulborn Faller, Ph.D.
Marion Elizabeth Blue Professor Emerita at the University of Michigan; Co-Director of the Family
Assessment Clinic at Catholic Social Services of Washtenaw County
James R. Marsh, J.D.
Marsh Law Firm
David L. Corwin, M.D.
Professor and Director of Forensic Services in the Pediatrics Department at University of Utah
Joyanna Silberg, Ph.D.
Senior Consultant, Child & Adolescent Trauma, Sheppard Pratt Health System

2. The American Professional Society
on the Abuse of Children
APSAC, now in partnership with The New York Foundling, was founded in 1987 and is a nonprofit, national
organization working to meet the needs of professionals engaged in all aspects of services for maltreated
children and their families, focusing on strengthening practice through knowledge.
In 2017, we launched the Center for Child Policy to translate research into usable resources that promote
evidence-informed policy-making and best practices for all professions involved in the field child
maltreatment.
Members receive discounts on conferences and training events, two peer reviewed journals, a peer-
reviewed magazine, newsletters, practice guidelines (and more!) and have the chance to participate in work
groups and committees with national impact!
Learn more at www.APSAC.org
Visit the registration desk to join NOW and receive a discount on membership!

3. Agenda
• Characteristics of child pornography on the internet
• Research related to child sexual abuse on the internet
• Recent legislation and legal cases related to child sexual images on the
internet
• Evaluating survivors of child sexual abuse on
the internet
• Assessing damages for civil litigation involving
child sexual abuse on the internet
• Treatment approaches for victims
• Challenges of working with these cases
• Future directions

4. APSAC Addresses Child Pornography and its
Impact on Victims
APSAC Amicus Brief (2014)
• Paroline v United States
http://bit.ly/APSAC-Brief
APSAC Position Paper (2013)
• APSAC Position Statement on Harm to Child Pornography Victims
http://bit.ly/APSAC-Paper

5. The Internet has made certain crimes
against children
[especially child pornography and
online child exploitation crimes]
easier to commit but harder to prevent

6. Why is this Kind of Crime Increasing?
• The more and more generalized access to Internet
• The number of users increases every year
• The price of the services is affordable
• The users remain anonymous
• The sale of pornography and other related material
through Internet is a lucrative trade which does not
require major investment
• The lack of appropriate legislation or governmental
policy to fight such a phenomenon

7. Characteristics of Internet Child Pornography
Victimization
• Most victims are sexually abused during the development of the child
pornography, resulting in trauma from the abuse
• Most perpetrators have a proximate relationship to their victims
• Most victims are admonished not to disclose using an array of threats to prevent
disclosure
• Victims may or may not be aware their victimization is being memorialized and
put on the Internet
• When victims become aware that their images are on the Internet and are being
accessed, they experience additional trauma
• Once law enforcement becomes involved, victims are notified when another
perpetrator accesses their images, resulting in additional trauma
• The trauma never ends because the images cannot be removed from the Internet

8. Canadian Centre on Child Protection: Child Sexual
Abuse Images on the Internet—Summary of Key
Findings—8 years of data; 152,000 images
• 78% of the images and videos assessed depicted very young, prepubescent
children under 12 years old
• 63% of those children under 12 years old appeared to be under 8 years of age
• 7% of those children under 8 years old appeared to be babies or toddlers
• 80% of the children were girls
• 77% of the children’s faces were visible in the images and videos
• 50% of the images and videos involved explicit sexual activity / assaults and
extreme sexual assaults
• 54% of the abuse acts against children under 12 years old involved explicit sexual
activity / assaults and extreme sexual assaults

9. More Key Findings
• 60% of the abuse acts against babies and toddlers involved explicit
sexual activity / assaults and extreme sexual assaults
• 69% of the images and videos appeared to be in a home setting, of
which 70% captured explicit sexual activity / assaults and extreme
sexual assaults
• 83% of the adults visible in the images and videos were males
• 97% of the content involved explicit sexual activity / assaults and
extreme sexual assaults when adult males were visible with the
children in the images and videos
http://protectchildren.ca/app/en/about

10. The Complex Experience of Child Pornography Survivors
Ateret Gewirtz-Meydana, Wendy Walsh, Janis Wolak, David Finkelhor, Child Abuse & Neglect, 80, 2018
• Convenience Sample: 133 adult victims who completed online survey
• Quantitative and Qualitative Data: open-ended questions used for
qualitative analysis
• Gender: 33 male; 64 female; 2 transgender or other
• Age Range: 18 to 75; 63% 35 or older
• Race: 87% non-Hispanic white
• Education: 64% college graduates; 26% post college degree
• Marital Status: 51% married or living with a partner;
33% single, never married

11. Characteristics of the Pornography Highlights
• Age when images first created: 22% 2 or younger; 23% 3 to 6; 27% 6 to 9
• Relationship to the perpetrator: 52% family member; 41% acquaintance
• Respondent was sexually abused during the crime: 93%
• How long the crime went on: 74% more than a year
• Images were illegally shared with others: 48% yes; 45% don’t know
• Crime was reported to police or child welfare: 23% yes; 61% no

12. Impact and Reactions to Being Sexually
Abused, Photographed, or Filmed
• Feeling ashamed, guilty, or humiliated: 74% all of the time
• Worrying that people would think you were a willing participant: 54% all of the time
• Feeling it was your fault the images were created: 51% all of the time
• Worrying that people would recognize you in public: 48% all of the time
• Worrying about friends or other people seeing the images: 48% all of the time
• Embarrassed about police, social workers, etc. seeing the images: 41% all of the time
• Refusing to talk to anyone about the images: 36% all of the time
• Refusing to talk to police or counselors about the images: 31% all of the time
• Refusing to be photographed or videoed by family or friends: 29% all of the time

13. LEGAL INTERVENTIONS
• Child pornography is like drug crimes: production,
distribution, trafficking, possession, plus facilitating,
advertising, and enticing
• Mandatory minimum sentences in the federal courts, most
state courts are much more lenient
• 2/3 of the criminal prosecutions are in state courts
• No federal “rape” statute – child pornography prosecutions
only address production of the images, not hands-on acts
• Federal restitution for victims and state crime victim funds
• Both federal and state civil remedies for victims

15. Amy, Vicki, Andy Act Update
• Intent of Congress that victims of child pornography be
compensated by every perpetrator who contributes to
their anguish (APSAC statement is also cited in the
Congressional findings)
• Restitution in “an amount that reflects the defendants
relative role in the causal process” (Paroline standard)
but no less than $3000
• Defined monetary assistance of $35,000 one-time
payment for trafficking victims only (not production)
• Defendant assessments to fund + $10 million set aside
• Victim right to evidence
• Progress report and fund report after 2 years

16. ASSESSMENT
TECHNIQUES
for Civil
Litigation
• Evaluation is focused around relevant questions
• Harm
• Standard of care
• Review of documents
• Should the evaluator view the pornography? (new victim
right under AVAA)
• Should the evaluator contact formal and informal network
members?
• Interviews with victims
• Interviews with supportive adults
• Psychological testing of victims and caregivers
• Having victims and supportive adults complete standardized
measures
• Assessment of economic impact

17. INTERVIEWS
• If the victim has supportive caregivers, they will be as
traumatized and sometimes more than the victims,
themselves
• This kind of victimization also affects other family members
• Because of the unique nature of internet pornography,
structured interviews are probably not advisable
• Semi-structured interviews
• The reason the person is there
• Details about the internet child pornography
• Its impact generally
• Follow-up with specific domains of impact

18. USE TESTS AND STANDARDIZED MEASURES
CONSISTENT WITH THE PRESENTING SYMPTOMS
• MMPI-A
• PAI (Personality Assessment Index)
• PSI (Parental Stress Index)
• PSS (Post-Traumatic Stress Disorder
Symptom Scale)
• OASIS (Overall Anxiety Severity and
Impairment Scale)
• PLC-S (Problems and Complaints
List—response to stress)
• Child Behavior Checklist
(completed by caregiver)
• Youth Self Report
(completed by child)
• Trauma Symptom Checklist for
Children (completed by child)
• Trauma Symptom Checklist for
Young Children
(completed by caregiver)
• Trauma Symptom Inventory

19. CASE STUDIES

20. Relevant People at the Time the Internet Child
Sex Abuse Images were Discovered
Family Composition
• Mother
• Stepfather
• K age 15 (victim)
• S-D age 15 (victim)
• Erin age 12 (victim)
• Fiona age 8 (victim)
• C age 1 (half sister)
Perpetrators
• Bio-father (RM)
• Car company executive (JB)

21. Description of the Criminal Acts
• RM had regular visitation with his 4 daughters, all of whom he victimized.
• During those visits, sometimes JB would be there.
• It appears Fiona and Erin were the most frequent targets for the pornography.
• Fiona would be drugged.
• Acts included fondling, cunnilingus, ejaculating on the victim, and intercourse.
• These acts were photographed and videotaped.
• They were uploaded onto the internet along with identifying information.
• There were images of other children, some apparently innocent.
• The images were downloaded from the internet.
• Mother stated in February 2015, there were about 150 cases involving
downloading.

22. LEGAL and CPS
INTERVENTION
• Federal case—violation of the pornography statutes
• State case—criminal prosecution for sexual abuse
• CPS involvement
• Mother initially assumed to be complicit
• Multiple workers
• Mother fearful that CPS would remove her children
• Termination of parental rights petition filed in the
Family Court
• RM released his rights
• Ongoing notification of new downloads

23. Impact on the Victims
Erin—16 in 2015
• She was the closest to her father and felt the most betrayed
• Multiple unprotected sexual relationships with boys she did
not want to have sex with
• Substance abuse
• Dropping out of school
• Suicidal thoughts and depression
• Hospitalized
• Defiant and aggressive behavior
• Sit on the front porch and smoke MJ
• Arrested and tried to kick the window of the police car

24. Excerpt from Erin’s Victim Impact Statement
• I used to be a normal girl, with a normal life, and normal parents.
• But that all changed, because of my father. I wish nothing had
changed and everything was back to normal. But so many
changes have happened, and it will never go back to the way it
was. I will never be able to go back to my old school, with the
people I grew up with, or even be friends with some of those
people. All because of these crimes. I don't get to have a normal
life anymore. I now have to live with the fact that my father is a
criminal. I don't get to have a Dad anymore. I don't have him to
walk me down the aisle, and be there for me when I need him.

25. Impact on the Victims
Fiona—15 in 2017
• She was drugged and therefore said she did not remember much about the abuse
• In her follow-up interview, she remembered more
• She was very close to Erin
• She emulated Erin
• Used drugs, but not as many as Erin
• Had sex with anyone
• Got into fights
• The move out of state has been good for her
• She stated she could have gone one of two ways, withdrawn and socially anxious or
sexual. She chose to be sexual
• She said she did not want to be like K, who has anxiety and no boyfriend

26. What kind of treatment helps victims of
Internet Child Pornography?
• Trauma-focused Cognitive Behavior Therapy with a supportive adult
may be indicated
• Treatment for Complex Trauma
• But the abuse is ongoing, which argues for ongoing treatment
• These victims feel so isolated and indeed they are at long distances
from other similarly victimized youth
• Virtual group treatment
• This could be a blog or a chat
• It could also be scheduled sessions orchestrated by an expert in internet sexual abuse
• Their caregivers and other family members need treatment too

27. Symptoms and Treatment History
of
70 Children

28. Results - Symptoms
0
5
10
15
20
25
30
35
40
45
50
NumberofCases
Symptom Categorization

29. What Happens to Children Exposed to Extreme
Abuse Pre-verbally or in Preschool Years?
• Blocks in cognitive, emotional, physical, verbal development
• Inability to integrate emotional information
• May look developmentally delayed, autistic, oppositional,
ADHD, hearing impaired…

30. Treatment Approach and Sequence
• Creating the Paradigm of Then and Now
• Helping find regulating and soothing activities and imagery
• Involvement of the parent as key co-therapist
• Interruption of Traumatic Play
• Educating about Parts and changing roles or tasks
• Assisting with nightmares and sleep issues and other symptoms
• Processing trauma in safe ways with parental soothing
• Changing Core Beliefs About Self
• Helping Family and Child Adjust to a Normal World

32. Added Trauma from Sexual Exploitation with
Photography (Quayle, Loofe and Palmer, 2008)
• Lack of control over the process of disclosure
• Lack of resolution since the images remain
• Shame and responsibility for having “let this happen”
implicit complicity
• Responsibility for involving others seen and unseen

33. Sometimes I have unreasonable fears that prevent me
from doing the normal things that other kids do. My
friend once asked me to go with her and her uncle to an
amusement park. I could not get it out of my head
that I would be abused. In the end I just couldn’t go.
I kept wondering if my friend’s uncle had seen my pictures.
Did he know me?
Did he know what I did?
Is that why he invited me to the amusement park?

34. The truth is, I am being exploited and used every day and every
night somewhere in the world by someone.
How can I ever get over this when the crime that is happening to
me will never end?
How can I get over this when the shameful abuse I suffered is out
there forever and being enjoyed by sick people?
I am horrified by the thought that other children will probably be
abused because of my pictures.
Will someone show my pictures to other kids, like my uncle did to
me, then tell them what to do?
Will they see me and think it’s okay for them to do the same thing?
Will some sick person see my picture and then get the idea to do
the same thing to another little girl?
These thoughts make me sad and scared.

35. I feel like I have always had to live a double life.
First I had to lie about what my uncle was doing to me.
Then I had to act like it didn’t happen because it was too
embarrassing.
Now I always know that there is another “little me” being
seen on the internet by other abusers.
I don’t want to be there, but I am.
I wish I could go back in time and stop my uncle from taking
those pictures, but I can’t.

36. I blame myself a lot for what happened.
I know I was so little, but why didn’t I know better?
Why didn’t I stop my uncle?
Maybe if I had stopped it there wouldn’t be so
many pictures out there that I can never take
back or erase.
I feel like now I have to live with it forever and that
it’s all my fault.
I feel like I am unworthy of anything and a failure.

37. What happened to me hasn’t gone away.
It will never go away.
I am a real victim of child pornography and
it affects me every day and everywhere I go.
Please think about me and think about my
life when you sentence this person to prison.
Why should this person, who is continuing
my abuse, be free when I am not free?

38. Questions?
Contact Information
• jamesmarsh@marsh.law
• david.corwin@hsc.utah.edu
• jlsilberg@aol.com
• kcfaller@umich.edu