Silent Injuries, Inc. | Robert Emerick, M.Ed.

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The Silent Injuries Questionnaire (SQ) evolved from an earlier trauma inventory (Sexual Trauma Inventory - STI) developed to measure trauma symptomatology among primary child sexual abuse survivors (Emerick, 1993). The STI was modified to investigate the relationship between a child sexual abuse professional’s work related experiences and potential cognitive, emotional, social, and sexual injuries (Silent Injuries).

The data collected from anonymous respondents to The Silent Injuries Questionnaire (SQ) is used as a teaching aid to develop curriculum for child sexual abuse professionals attending Forensic Interview Training seminars sponsored by the Arizona Governor’s Office for Children. Seminar attendees include law enforcement officers, prosecuting attorneys, victim advocates, behavioral health clinicians, medical personnel, CPS workers, and support personnel.

SQ preliminary observations were based on anonymous responses collected from 250 seminar attendees. The questionnaire was posted at SilentInjuries.com and another 500 professionals anonymously contributed to the data pool. Data collection is ongoing and today the database includes over one thousand child sexual abuse professionals. The results are only available at professional conferences and updates to child abuse professionals’ membership organizations.

Respondents

Silent Injuries Questionnaire respondents were referred to the questionnaire to assist Robert Emerick develop curriculum for child sexual abuse professionals. The first 130 respondents completed the questionnaire as a paper and pencil protocol. The questionnaire was posted at a website (Letwilc.org) and respondents completed the questionnaire prior to attending seminars sponsored by Arizona’s Governor’s Office for Children and others completed the questionnaire per professional organization request. In January 2005, the questionnaire was posted at its’ permanent website address: SilentInjuries.com.

Respondent Demographics

Employer	Males	Females	Mean Age	Mean Age Career Onset	Mean Yrs. CA Responder
Law Enforcement	70	50	39.45	33.81	5.79
Prosecuting Attorney	19	57	43.09	33.22	10.17
Victim Counselor	9	76	40.83	31.42	9.40
Offender Counselor	34	36	46.6	35.41	11.19
Victim & Offender Counselor	22	45	46.1	32.67	13.77
Child Advocacy	7	110	41.32	34.21	7.07
Child Protection	22	95	38.92	31.07	7.85
Probation	9	4	42.61	31.69	10.92
SANE	0	33	45.54	37.13	8.41
Support Personnel	9	55	41.26	35.19	6.08
Total	201	561	41.88	33.39	8.56

The majority of respondents are female (73.6%). Significant age differences are observed between the professional groupings, with law enforcement and CPS professionals setting the youngest mean age and professionals treating offenders forming the eldest mean age.

Silent Injuries Questionnaire Psychometric Properties

The SQ is a 256-item measure comprising 218 Likert scale items on a 7-point scale (1 = strongly disagree; 7 = strongly agree) and 38 general health and demographic items. The 89-item Silent Injury Scale yields an acceptable internal consistency alpha (.9384). Respectable alphas are also observed for the four subscales: Cognitive Injuries (.9376), Sexual Response Cycle Injuries (.9190), Communication Injuries (.7857), and Toxin (.7360).

Silent Injuries Scales Psychometric Properties

Scale	Number Items	Cronbach’s Alpha
Toxin	6	0.7360
Communication Injuries	7	0.7857
Sexual Response Cycle Injuries	12	0.9190
Cognitive Injuries	29	0.9376
Silent Injuries	87	0.9384

Knowledge & Attitudes Regarding Child Sexual Abuse

General knowledge regarding offender dynamics and child victim trauma may inoculate child sexual abuse professionals from silent injuries during the first eighteen providing professional services (X2 = 5.458691, df = 2, p<.06). However, after responding to child abuse cases for more than eighteen months, this relationship no longer approaches significance.

Analysis of Variance was used to compare low, moderate, and high Silent Injury scale groups on the 13 items that query the professional’s knowledge and attitudes about child sexual abuse. This analysis yielded significant observations on four questions. Male child abuse professionals are more likely than female child abuse professionals to harbor potentially problematic attitudes about child sexual abuse (X2 = 4.656229, df = 1, p<.05). However, no gender bias is observed when males and females performing the same professional tasks are examined. PPA attitudes about child sexual abuse are unrelated to child sexual abuse history.

Employer	Factor One	Factor Two	Factor Three	Factor Four	PPA
Law Enforcement	41.8%	9.9%	21.5%	24.8%	23.1%
Prosecuting Attorney	43.4%	15.8%	17.1%	25.0%	19.7%
Victim Counselor	47.6%	3.7%	15.9%	32.9%	26.8%
Offender Counselor	60%	10.0%	22.9%	24.3%	37.1%
Victim & Offender Counselor	50.7%	7.5%	23.9%	16.4%	20.9%
Child Advocacy	43.6%	6.9%	11.2%	18.1%	17.2%
Child Protection	41.9%	6.0%	20.5%	22.2%	21.4%
Probation	53.8%	7.7%	30.8%	7.7%	38.5%
SANE	54.5%	6.1%	9.1%	12.1%	9.1%
Support Personnel	48.4%	11.1%	24.2%	32.3%	32.3%
Total	46.7%	8.4%	18.9%	23.2%	23.5%

Universal Toxin

Synonyms for universal are widespread, common, or worldwide. A toxin is a contaminant, poison, or pollutant. Collectively, a universal toxin is a poison, contaminant, or pollutant that causes a common adverse response. SQ data analysis reveals child sexual abuse cases expose professionals to a universal toxin. The toxin comprises three prongs that contribute individually and collectively to cognitive, emotional, social, and sexual challenges observed among child sexual abuse professionals. Among all professionals (N = 767), the risk to experience severe toxin exposure is related to profession and number of years responding to child sexual abuse cases.

Sex crimes investigators and prosecuting attorneys occupy a unique position among child sexual abuse professionals. Both professions experience severe toxin exposure earlier in their careers than other child sexual abuse professionals and both are more likely to experience severe toxin exposure. Among all professionals reporting 13 or more years responding to child sexual abuse cases (n = 180), 44% report severe toxin exposure.

Years Experience & Minimum Toxin Exposure

Profession	0 Experience & Min. Toxin	.1 – 1.5 years Experience & Min. Toxin	1.6 – 3.0 years Experience & Min. Toxin	3.1 – 8.0 years Experience & Min. Toxin	8.1 – 13 years Experience & Min. Toxin	13 plus years Experience & Min. Toxin	Overall Min. Toxin Exposure
Law Enforcement	0 – 3 0%	2 – 31 6.5%	0 – 24 00.0%	4 – 41 9.8%	0 – 9 0.0%	1 – 13 7.7%	7 – 122 5.7%
Prosecution	2 – 2 100%	2 – 12 16.7%	1 – 8 12.5%	4 – 16 25%	3 – 13 23.1%	2 – 25 8.0%	14 – 76 18.4%
Victim Counselor	0 - 0 0%	3 – 4 75%	8 – 18 44.4%	18 – 26 69.2%	8 – 14 57.1%	6 – 23 26.1%	43 – 85 50.6%
Offender Counselor	0 – 0 0%	5 – 7 71.4%	6 – 10 60%	6 – 17 35.3%	2 – 7 28.6%	7 – 29 24.1%	26 – 70 37.1%
Victim & Offender Counselor	1 – 1 100%	2 – 6 33.3%	3 – 4 75%	9 – 13 69.2%	6 – 13 46.2%	6 – 30 20.0%	27 – 67 40.3%
Victim Advocate	1 – 1 100%	8 – 17 47.1%	10 - 21 47.6%	16 – 42 38.1%	2 – 19 10.5%	7 – 17 41.2%	44 – 117 37.6%
Child Protective Services	0 – 3 0%	12 – 19 63.2%	8 – 20 40%	7 – 32 21.9%	7 – 19 36.8%	7 – 24 29.2%	41 – 117 35.0%
Probation	0 – 0 0%	0 – 0 0%	1 – 3 33.3%	1 – 3 33.3%	0 – 3 0%	2 – 4 50%	4 – 13 30.8%
SANE	0 – 0 0%	1 – 1 100%	2 – 4 50%	5 – 17 29.4%	2 – 5 40%	0 – 6 0.0%	10 – 33 30.3 %
Support Services	1 – 5 60%	9 – 15 60.0%	7 – 13 53.8%	4 – 16 25%	0 – 6 0%	1 – 9 11.1%	22 – 64 34.4%
Total	5 – 15 33.0%	44 – 112 39.3%	46 – 125 36.8%	74 – 223 33.2%	30 – 108 27.8%	39 – 180 21.7%	238 – 764 31.2%

Years Experience & Severe Toxin Exposure

Profession	0 Experience & Sev. Toxin	.1 – 1.5 yrs Experience & Sev. Toxin	1.6 – 3.0 yrs Experience & Sev. Toxin	3.1 – 8.0 yrs Experience & Sev. Toxin	8.1 – 13 yr Experience & Sev. Toxin	13 plus yrs. Experience & Sev. Toxin	Overall Sev. Toxin Exposure
Law Enforcement	1 – 3 33%	19 – 31 61.3%	14 – 24 58.3%	31 – 41 75.6%	6 – 9 66.7%	10 – 13 76.9%	81 – 122 66.4%
Prosecution	0 – 2 0%	3 – 12 25%	6 – 8 75%	7 – 16 43.8%	8 – 13 61.5%	18 – 25 72%	42 – 76 55.3%
Victim Counselor	0 - 0 0%	0 – 4 0%	2 – 18 11.1%	1 – 26 3.8%	1 – 14 7.1%	6 – 23 26.1%	10 – 85 11.8%
Offender Counselor	0 – 0 0%	0 – 7 0%	0 – 10 0%	2 – 17 11.8%	3 – 7 42.9%	10 – 29 34.5%	15 – 70 21.4%
Victim & Offender Counselor	0 – 1 0%	0 – 6 0%	0 – 4 0%	1 – 13 7.7%	4 – 13 30.8%	16 – 30 53.3%	21 – 67 31.3%
Victim Advocate	0 – 1 0%	3 – 17 17.6%	4 - 21 19%	11 – 42 26.2%	8 – 19 42.1%	5 – 17 29.4%	31 – 117 26.5%
Child Protective Services	0 – 3 0%	2 – 19 10.5%	4 – 20 20%	9 – 32 28.1%	5 – 19 26.3%	9 – 24 37.5%	29 – 117 24.8%
Probation	0 – 0 0%	0 – 0 0%	2 – 3 66.7%	0 – 3 0%	3 – 3 100%	0 – 4 0%	5 – 13 38.5%
SANE	0 – 0 0%	0 – 1 0%	1 – 4 25%	7 – 17 41.2%	2 – 5 40%	2 – 6 33.3%	12 – 33 36.4 %
Support Services	3 – 5 60%	4 – 15 26.7%	2 – 13 15.4%	4 – 16 25%	3 – 6 50%	3 – 9 33.3%	19 – 64 29.7%
Total	4 – 15 26.7%	31 – 112 27.7%	35 – 125 28%	73 – 223 32.7%	43 – 108 39.8%	79 – 180 43.9%	265 – 764 34.7%

Phone (623) 680 6624 s Email robertemerick@silentinjuries.com