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Child Sexual Abuse Accommodation Syndrome is a model used by clinicians, courts and other institution to improve the understanding and acceptance of a child's position post sexual victimization. The syndrome is composed of five categories;(1) secrecy, (2) helplessness, (3) entrapment and accommodation, (4) delayed, unconvincing disclosure, and (5) retraction.

The syndrome featured heavily in the satanic rituals of the 1980s and 90s, because it purports to explain both delayed disclosures and withdrawals of false allegation of child sexual abuse.Child Sexual Abuse Accommodation Syndrome is used to justify any statement made by a child as an indication that sexual abuse had occurred—immediate disclosure was an indication of abuse, as are delayed disclosure, withdrawal and sustained denial.[2]

History of Child Sexual Abuse Accommodation Syndrome
Doctor Roland Summit was the first to propose the existence of child sexual abuse accommodation syndrome is 1983.

Doctor Roland Summit intended the proposal of child sexual abuse accommodation syndrome as a way to help psychologists understand the behavior of child that had already been abuse. It was not meant to diagnose children who exhibit these five behaviors who have not been abused. The correct way to implement child sexual abuse accommodation syndrome to explain the behavior from preceding abuse.

Secrecy
The act is usually committed when the child is alone with the adult, with intent of it to remain secret. The offending adult will use any tactics, logical or illogical, to appear to the child's sense of danger or fear. The tactics are a mix of threat and also a solution. If a child chooses to disclose the abuse after a significant time period, it may seem untruthful. Unless the sexually abused child can confide with a non-judgmental, trusting adult, they usually end up insecure and afraid of intimacy.

Helplessness
Children are taught not to speak with strangers or avoid their attention, but are usually taught to obey and trust related adults or adults put in charge of their care. This distracts attention from a more immediate risk, the betrayal of a relationship between a caregiver and a child. Surveys conducted estimate 10% of all females have been a victim of child sexual abuse, and almost 2% by their own father. The fact that the perpetrator is a trusted adult increases the sense of dread and helplessness.

A certain reaction when a child wakes up and finds an adult exploring their bodies with their hands or mouth, which is to physically resist or call for help. Most children fail this expectation. Because of this many children are ripped apart in court because they admit to failing to make any protest. Children are made to feel ashamed of their helplessness to communicate their feelings as most adults condemn anyone who submits easily to intimidation. For a child, it may be that the fear of losing family or love is much more threatening than the threat of violence. It is because of this offending adults quickly realize that dependent child are helpless to resist or complain.

Entrapment and Accommodation
Child sexual abuse does not usually occur once; it is very likely to be repeated several times especially when the child is in a dependent relationship with the offender. The offender may have feelings of guilt, fear and may consider terminating their behavior. It may be hard for the offender to stop their behaviors due to the simplicity of their offence it may become hard to avoid leading to addiction.

If the child does not seek help or medical attention; the child will soon begin to feel the need to live with the situation and to accommodate the fact that they are being sexually abused continuously. This leads to a conflict for the child, as the adult is seen as someone that is a loving and protective figure. Consequently, the child accepts the abuse.

The challenges the child faces in terms of survival will include: pathological dependence, self punishment, self mutilation, selective restructuring or reality and multiple personalities. It is crucial that the medical professional (therapist) dealing with the child not over look these symptoms that may lead the child to feel the development of another disorder.

Further on, it is essential that the child begins to develop some level of power and control. The need for a parent or guardian as a protective and authoritative figure must decrease in order to develop their confidence and level of acceptance.

The offender may be a parent in many situations. In this case, the parent most likely emotionally blackmails the child in terms of family welfare. For example, the parent may state “if you tell anyone, then Daddy will go to jail and you and your siblings will have to live in a shelter”. Making such statements the abusing parent gives the child demands and obliges them that they must follow or else. It can be seen as an explicit or implicit award. By using this method the child will not hesitate and will meet the abusing parent’s sexual demands. This puts the child in an authoritative position as they decide the family's welfare.

In the child’s mind, telling someone else the truth would seem to be a mistake (trouble causing) and keeping the abuse a secret would be the ultimate goal. Thus they are obliged to meet the parents demands.

The compliance leads to different symptoms in both female and male victims.

Female Victims
Female victims tend to exhibit behaviors such as : self-hate, self-mutilation, suicidal behavior, promiscuous sexual activity, and attempted runaways. The female victim may also try to manipulate the offender for extra advantages or allowances. The female victim tends to have hard feelings toward the mother, if the male parent is the offender. She may feel that the mother is not fulfilling her duties toward the father and may feel that the mother is the sole reason to blame for her abuse. The female victim may also feel that the mother is aware of the sexual abuse, but does not care for her and her well being. This will lead the female victim to develop feelings of low self worth. These factors lead to the mother daughter bond to weaken and several issues between the mother and daughter can arise in the future in terms of relationships.

Male Victims
A male victim of sexual abuse is will release his frustration out in the form of aggression and antisocial behavior. The male victim is more likely compared to a female victim to take benefit and manipulate the offender towards his own benefit. A number of symptoms may come into play such as depression, counter phobic violence and misogyny. Both genders are highly likely to turn to substance abuse as an option to escape the feelings of tension, depression and rage.

Delayed, Conflicted and Unconvincing Disclosure
The majority of child sexual abuse is never disclosed. Reported or investigated crimes are rare and are usually a product of unmanageable family conflict, accidental discovery or outreach from a community social service for child abuse instead of self reported. Since this is the case, many discoveries of abuse are not made until the child reaches adolescence when he/she becomes more capable of independence or defying authority.

Even if it is the victim him/herself that reveals this secret, chances are he/she is not believed. Unless specially trained, adults relate better to another parent trying to deal with their rebellious teen much easier than believing a child could tolerate incest without immediately telling someone.

Contrary to popular belief, most mothers do not know about the ongoing abuse. Most are not aware that their marriage partner could never do such a thing. When confronted, the mothers have to choose between a lying child or an unfaithful husband. With thoughts like "How could I not have known?" running through her head and logical arguments likes "How could I have done something like this all these years under your roof?" presented by her husband. Of the minority of mothers who believe their child, even a smaller percentage of cases are ever revealed outside the family.

If by chance a case reaches to court, one has to remember to be convicted of a crime the court has to requires proof "beyond a reasonable doubt." As all jurors must be adults, they can reasonable assume a child can have a fantastic imagination and most will not risk convicting a respectful adult and parent over what could be false claims.

Retraction
Family honor and welfare play critical roles in the last stage of Child Sexual Abuse Accommodation Syndrome. The abused child may change or alter their statement (retract from case in all). This is largely due to family pressures as the father will deny the child’s statements and charges. The mother will also not believe the statements, as she is unaware of the abuse. In this situation the child is put under a lot of pressure, as the child will be blamed for any inconveniences caused to the family, such as imprisonment of the offender, loss of income and home, dependency on welfare, absence of patriarch from home, intervention of children agency and affect on other siblings (put into foster care) and so on. The child can either escape the abuse or have the offender charged leading to family conflicts, or they can remain silent and live with the abuse.

In the majority of cases the abused child has retracted from their accusation or complains of abuse. The child will usually also state that their statements were a story they made up in an effort to get their parent in trouble as they were upset with them.

Research
Sexual abuse is a major societal issue that is faced by many countries, despite of developing or developed status. Despite this, the number of children that face sexual abuse is very difficult to determine. The reason why this data is underdeveloped is because figures are estimated and brought forward by Child protecton agencies. The second reason is that diagnosing a child as a victim of sexual abuse is a very difficult task, the accuracy of the diagnosis is questioned. This is because in the majority of cases that are brought forward there is insufficient medical and physical evidence that can lead to the conclusion of sexual abuse. Furthermore, there are many cases that are silenced and not brought forward at all. Due to the lack of this form of evidence, the child's statements about the abuse is the major form of evidence that is mainly used to determine if indeed sexual abuse has occurred or not.

As the child's statements are used to judge the concurrence of sexual abuse, it is crucial for professionals to interpret this information correctly and in the least damaging method as possible.

Several experts in this field have stated that a significant problem with depending on the statements provided by children victims of sexual abuse is that the majority of these children hesitate in coming forward with the truth and may keep the abuse a secret. The children may state that the abuse did not occur while it has in reality. They may also make several other statements in attempt to cover up the fact that they have been abused. The series of stages these children go though is referred to as the Child Sexual Abuse Accommodation Syndrome.

Hysteria
Childhood abuse hysteria syndrome is a useful tool in determining if a child is telling the truth in an abuse situation. The hysteria of the child does not refer to an uncontrollable outburst but instead refers to irrational fear or state of emotional shock and anxiety. In most cases child abuse accommodation syndrome is turned down, and the courts discount the reports as the child having hysteria. Hysteria is also used in other lengths with Child Sexual Abuse Accommodation Syndrome as well as Day care sex abuse hysteria which was the panic in the 1980's and 1990's. Hysteria is also seen in other scopes in closeness with Child Sexual Abuse Accommodation Syndrome by the family and friends of the victim. They are in so much shock and disbelief as what has taken place that in some situations, in most cases the female figures often turn hysterical.

Media
Child Sexual abuse continues to be discussed in schools and in communities to make members more aware of the issues associated with child sexual abuse. As this awareness is increasing, child sexual abuse victims are being analyzed and evaluated more for victimization. There are several categories that are assessed such as welfare, criminal, mental health, and medical. Thus several professionals are brought into the case to evaluate the victim. Some concerns are evaluation include confidentiality of information and inexperienced evaluators.

Popular Culture
There are millions of children who are sexual abused throughout the world, and are helpless with no one to tell and it is kept a secret for years. Notable individuals, famous celebrities and even athletes have gotten abused as children and have told no one until there early adult lives. Oprah Winfrey, Tyler Perry, Vanessa L. Williams are just a few notable celebrities that have been abused as children. Not only have individuals gotten abused, but media and television shows also demonstrate child abuse as well. Shows as Law and Order or Criminal Minds help demonstrate the abuse and follow by trying to catch the abuser and help the victim. There are also shows as Dr.Phil which help educate individuals and also help specific individuals with there situations. As society makes people educated by using popular culture as a medium, it will make people aware of not only the victims but also the coping devices and the steps needed as the Child Sexual Abuse Accommodation Syndrome to move on.

School Professionals
In the U.S, school professionals of all states have the same responsibility. The teachers and mental health professionals are required to report and notify an authority if they learn that child abuse is occurring. If the professional fails to report the abuse or does not report purposely then they will be held responsible in terms of a criminal liability.

Reporting and Investigation
Society has always seen the need to protect sexually abused and harassed children. In the 1800s several private agencies began to arise that designed programs to protect and serve abused children. These agencies have since made significant efforts to develop an efficient reporting and investigation method. According to the law, in certain states, a child protection agency is authorized to be involved if the victim has been abused by a family member or a caretaker. However, in certain states these agencies are authorized to intervene despite the nature of the case.

Witnesses
Children who are witnesses in a court cases can already be under emotional distress by the actionas occurring in their surroundings. In child sexual abuse cases it is even harder for the child to talk about what he or she saw in front of so many people. It is typical to delay talking about the incident and at times not talking about it at all. Children who have been sexual abused by a trusted family member or close friend are often faced by intimidation and keep the incident a secret. This can result in the courts understanding that the story was fabricated because she/he did not report it immediately, or retracted an accusation. The child sexual abuse accommodation syndrome is used in the court system to explain the child's behavior in the court and to establish the child's credibility. There has been many cases where the courts have allowed Child Sexual Abuse Accommodation Syndrome to be used, starting in the mid 1980's.Witnesses have also been asked to play with anatomically correct dolls. This allows not only the courts but also health physicians etc. to see if sexual abuse has in fact taken place. Dolls are also used in situations where children who are unable or unwilling to talk can act out what has happened to them. Expert testimony involving Child Sexual Abuse Accommodation Syndrome in criminal trials is controversial because syndrome evidence has been used as a scientific diagnostic tool or as a credibility bolster. The prosecution should only use expert testimony on the Child Sexual Abuse Accommodation Syndrome to explain seemingly inconsistent behavior or recantation by the child and to rebut the defense contention that the abuse never occurred because of the child's delayed and unconvincing disclosure, recantation, or other inconsistent behaviors. Used in this way, expert testimony explains how recantation or other behaviors can be understood by reasons other than deceit. The prosecution expert can explain the behavioral dynamics resulting from feelings of betrayal caused by the actions of the abuser and the rest of the family who failed to protect her or did not believe her eventual disclosure. Summit notes: The proper foundation for relevance of Child Sexual Abuse Accommodation Syndrome testimony is the inference raised by the defense that an inconsistent pattern of disclosures by the child is indicative of deceit. An abstract presentation of the Child Sexual Abuse Accommodation Syndrome by an expert who has never seen the child and knows virtually nothing about the case provides the jury with a demonstrably objective refection. There is no possibility that such an expert has couched the testimony to buttress the credibility of percipient witnesses. Ideally, the jury will be allowed to understand what is normal and real for child victims as a class, even if courts persist in seeing such conditions as pathological. where courts ruled that no expert gave their own opinions, instead discussed factors staying away from individual assessments. This can help the jury weigh with the victims testimony and was a positive case, because of the correct witness testimony.