In 1983, child psychiatrist Roland Summit outlined what he termed the "Child Sexual Abuse Accommodation Syndrome." (Summitt, R. 1993). In a manner similar to the "battered- child syndrome," Summit described five characteristics he claimed were commonly observed in sexually abused children:
1. Secrecy-- The child has been programmed by a perpetrator of sexual abuse to keep the abuse a secret.
2. Helplessness-- The child is overwhelmed with feelings of helplessness in contending with the abuse.
3. Entrapment and accommodation -- Feeling overwhelmed with helplessness, the child "accommodates"--or complies with--the perpetrator's expectations.
4. Delayed, conflicted, and unconvincing disclosure-- Feelings of helplessness, and the related history of accommodation, leave the child very ambivalent about disclosing abuse. As a result, the child's disclosure is delayed, conflicted, and/or unconvincing.
5. Retraction-- Having disclosed past sexual abuse, children will then retract their disclosure in response to pressure from the perpetrator and other adults attempting to protect the perpetrator.
The accommodation syndrome cannot be used as a diagnostic procedure equivalent to the battered- child syndrome (Myers, J. E., Bays, J., Becker, J., Berliner, L., Corwin, D. L. & Saywitz, K. 1999). Rather than detect sexual abuse, the accommodation syndrome assumes that abuse has occurred and explains the child's reactions to it. In cases of battered child syndrome, one proceeds from the characteristics of the injury to conclusions regarding the cause of the injury. Therefore, battered child syndrome can be indicative of physical abuse. With the accommodation syndrome, however, one reasons from the assumption of sexual abuse, to explaining the child's reactions to this assumed event. Thus, the accommodation syndrome is not a sexual abuse version of the battered child syndrome.
Symptomatic behavior is seen as a survival strategy, either communicating the pain of the child to those who would hear the message, or helping the child cope with a deeply embedded pain....................
