One group in Fargo, N.D., developed a series of coloring books, role-playing games and educational videos designed to teach children when they are experiencing "bad touch."
The group, called Red Flag Green Flag Resources, was started by social workers and counselors unhappy with the prevention programs in their communities. Those programs mainly focused on the dangers of strangers, said Carmen Sauer, the group's public education coordinator.
But the greatest threat to children actually is from people they know, even their own parents, Sauer said. So the group created a new set of methods to help children understand when adults, even a parent, is crossing the line.
Deborah Malberg, a social worker with Hagerstown Catholic Charities, said coloring books are good tools to help children understand "good touch" and "bad touch." Good touch, for example, would be holding hands and hugging, while bad touch includes fondling of private parts.
Such books teach children that they don't have to obey adults who make them uncomfortable with "bad touch," even if it the adult is a parent or uncle or cousin.
Malberg cautioned that the concepts of good and bad touch can be confusing and that parents and other adults need to spend time making sure children understand.
Donna Swope, who counsels adult victims of child abuse, said her patients were victims of repeated abuse because the predator, usually a family member or neighbor, convinced them to keep the abuse a secret.
"Many children today would not be alive if they had not kept the secret, which is one of the dilemmas we face," she said. "In most cases, the predator is someone they know and love," who threatens to burn down the child's house, or kill their dog, cat or even parents.
Swope said it is essential for adults to listen to what kids are saying, particularly if they claim to have a "special relationship" or share a "secret" or play a "secret game" with an adult or adolescent. If you hear these words, "ask a few more questions," she said.
Marilyn Smith, who studies child sexual abuse at West Virginia University, said parents and caregivers should teach children the real names for body parts.
Kids giggle and get embarrassed when they are first taught words like penis and vagina, Smith said.
"But they eventually get it," she said.
Using the right words encourage children to talk about experiences with those body parts, Smith said. Kids become freer to complain about vaginal pain, or tell on someone trying to cause them vaginal pain, just as they would describe a sore throat or hurt foot.
Smith cautioned adults against giving kids the impression that private parts are bad, or dirty. Such messages encourage them to keep dangerous "secrets" of abuse to themselves.
Protecting children involves more than just teaching them to say "no," Smith said. Children should understand that sex is positive in a loving relationship. Then the concept of saying "no" to people wishing to do them harm will make sense, she said.
Marilou Barratt, a local licensed social worker, echoed Smith's warning. She said the concepts of good and bad touch need to be updated as children grow older and more capable of understanding touch in a sexual context.
Red Flag Green Flag materials, while they encourage parents to teach sexuality to children, don't attempt to do it for them, Sauer said.
"We don't get into teaching sex education or sexuality. We teach that private parts are the parts of the body covered by our swimsuit or underwear," Sauer said.
Red Flag Green Flag has sold more than one million publications to schools, social service agencies and parents throughout the world, Sauer said.
The materials teach basic concepts of touch that do not differentiate between a nose, a foot and private parts, Sauer said.
"We teach you can control your body and the space around your body," Sauer said.