Le viol des bébés, repérage et prise en charge

If sexual violence perpetrated against children currently seems to be better recognized and treated, there is one type of act and one age category that are totally disregarded: babies and very young children, many of pre-verbal age, (0–3 years) who are victims of rape. However there are adults (and even minors) who are regularly convicted of being perpetrators. Our professional experience has led us for years to treat very young children who are victims of rape without the specificity of this violence being discussed in scientific articles. There is a real taboo concerning the rape of babies, and this unspeakable act leads the interveners to not even imagine that such an act can exist and, therefore, not to consider its reality, even though the resulting disorders are obvious. Admittedly, this is extreme abuse, given the vulnerability of the victims. It is nevertheless very real and the absence of publications on this subject can only make us wonder, because it probably results in a resounding silence about many situations. Perpetrators who rape a baby might kill the child as a result of the acts committed [1], they can continue to abuse the child even when they grow up, but they may also stop the abuse as soon as the child becomes able to speak for fear of being reported. As no quantitative study has ever been carried out on this subject, we can only transmit the reality of the field based on our work as psychotherapists and experts. When a very young child is subjected to rape that is not detected, and when he or she survives, and that violence stops when they begin to speak, it does not mean that the violence suffered will not be expressed in other ways, especially by violence against oneself or others. Rape leaves physical and psychological ramifications and it is often inappropriate sexual behavior that will alert adults (relatives, teachers). But the young child does not have sufficient memory capacity to remember what they have experienced and suffered, and they are unable to denounce their aggressor. Since the expressiveness of post-traumatic stress disorder is not linear, it is common that the child's attitude will be noticed by adults only years after the assaults have been committed. And the consequences of rape suffered in early childhood can be innumerable (multiple post-traumatic disorders, disorders in the construction of childhood sexuality, learning disorders, disorders in the establishment of social bonds, etc.). At a time of full psychosexual, psychoaffective and cognitive development, this extreme violence can have a lasting effect on the child's future. Furthermore, the fact that externalized disorders (which are clearly visible and worrying) can appear on a delayed basis remains largely unknown, including by professionals. This can be a source of all kinds of misunderstandings, particularly due to the lack of training of those involved who believe that if the disorders manifest themselves it is because the abuse has just been committed and they are convinced that the child is able to name the perpetrator. Children who have been raped as a baby do not have this ability to defend themselves when they are assaulted and to denounce their perpetrator at the time when the abuse took place. It is therefore essential to identify these situations as early as possible in order to limit the effects of such violence. The main objective of this article is to describe the specificity of rape committed on toddlers in order to better identify the signs likely to alert health professionals to the reality of this type of violence to which very young children are submitted so that the earliest possible treatment can be undertaken. The audience of our publication is that of babies and children under the age of three, that is, an age group where the child's dependence on an adult is very strong, and the capacity for verbal expression is nil or very limited. The memory of recent events is still in the child's infancy and is best expressed by a behavior of interpretation that is not always obvious. This article is informed by our clinical experience and qualitative data collected throughout our years of experience. This work has allowed us to conduct an analysis of these different criteria, and to propose, through a synthetic table, fundamental elements of identification when working with very young children. If the rapes suffered by very young children result in obvious marks on the child's body, they are also at the origin of invisible psychological suffering that can result in disorders endangering not only the child (dangerous behavior, addictions, suicide attempts, suicide), but can also effect his or her entourage (sexual violence, physical aggression). The conclusion of this reflection is the necessity of recognizing the importance of training stakeholders to step away from the frequent denial of the reality of this violence. Daring to talk about this subject in order to reverse this unspeakable clinical situation, makes it possible to envisage appropriate care and to reduce the number of child victims who remain alone in their suffering, with all the concurrent dangerous consequences that this can entail.