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Child maltreatment in sport: smashing the wall of silence: a narrative review of physical, sexual, psychological abuses and neglect
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  1. Kristine Fortier1,
  2. Sylvie Parent1,
  3. Geneviève Lessard2
  1. 1 Department of Physical Education, Université Laval, Québec, Québec, Canada
  2. 2 School of Social Work and Criminology, Laval University, Québec, Québec, Canada
  1. Correspondence to Sylvie Parent, Physical education, Université Laval, Québec, QC, Canada; Sylvie.parent{at}fse.ulaval.ca

Abstract

Child maltreatment in sport is an undeniable problem. High-profile cases of sexual abuse of child athletes are obvious examples of child maltreatment in this context. Young athletes also face physical and psychological maltreatment, as well as neglect, although these types of child maltreatment are understudied in sport and receive less public attention. Little is known as to how to define physical and psychological maltreatment and neglect in sport and their diverse manifestations. The aim of this paper is to propose concrete manifestations of each type of child maltreatment in sport. We aim to help practitioners better understand and researchers better measure this problem.

  • child
  • sport
  • violence
  • athlete
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Introduction

Child maltreatment in sport is a major and growing concern around the world. Cases such as those of Larry Nassar in the USA, the UK football sexual abuse scandal or the case of the ski coach Bertrand Charest in Canada1–3 shed light on the disturbing fact that young athletes are vulnerable to maltreatment. People in a position of authority over young athletes—coaches, parents, officials, administrators or members of the medical team—represent potential perpetrators.4–6

Young athletes are at risk of experiencing sexual maltreatment, physical maltreatment and psychological maltreatment in the context of practising their sport.7–13 Canadian veteran Olympic doctor and academic Dr Margo Mountjoy and colleagues14 argue that young athletes are particularly vulnerable to this form of violence due to the unique characteristics of the sport environment, such as the importance placed on the coach–athlete relationship, the intensity of youth sport, the demands of competition, the interest of the media in young athletes, time spent in distant training centres, recruitment procedures of young athletes, and the distance from home or school environment.14

We have noted that studies are limited by the lack of a consensus on the definition of maltreatment in sport.5 This means the term maltreatment is not uniformly used by researchers. Several other terms such as abuse, non-accidental violence, harassment and bullying are used in studies aimed at documenting child maltreatment despite the generally accepted consensus on the definition of this concept in the scientific community.15–17 Inconsistency in terminology can impair measurement of the problem and also make the sport community and the public confused about what really constitutes child maltreatment in sport.

Also, although some authors have suggested conceptual frameworks regarding maltreatment, violence or abuse in sport,5 14 18 none of them really operationalises clear manifestations of child maltreatment in sport, and some classification problems are present between forms of maltreatment. Here we propose concrete examples of each type of child maltreatment in sport. Our goal is to help practitioners better understand and researchers better measure the problem of child maltreatment in sport.

Child maltreatment in sport

We based our manifestations on the WHO definition, where child maltreatment is defined as:

All forms of physical and/or emotional abuse, sexual abuse, neglect or negligent treatment, or commercial or other exploitation, resulting in actual or potential harm to the child’s health, survival, development or dignity, in the context of a relationship of responsibility, trust or power.19

The manifestations proposed in this article (see table 1) have been developed in reference to the literature surrounding child maltreatment in sport, the limitations identified in this area of ​​research and some well-recognised work on child maltreatment in general.15 17 There are four different forms of maltreatment, namely physical, sexual, psychological and neglect. Here we present the various components and possible manifestations of each form of child maltreatment in sport.

Table 1

Manifestations of different forms of child maltreatment in sport

Physical maltreatment of children in sport

The majority of sport researchers favour a definition of physical maltreatment that emphasises actual or implied potential physical harm to the athlete (also referred to as physical abuse) rather than the purely physical nature of the aggression.5 7 20 In addition to documenting events that are generally considered physical maltreatment (pushing, biting, shoving, choking, hitting or punching), some authors have incorporated events that do not involve any physical contact in their definition of physical maltreatment, such as the imposition of excessive and intensive supplemental training,5 7 13 18 20 the forced pursuit of training and competition despite the presence of an injury or exhaustion,7 21 imposing the consumption of doping products,20 maintaining a very uncomfortable position,5 isolation of an athlete in a confined space,5 encouraging an athlete to initiate fighting and/or to wound the opponent,6 21 or the imposition of severe diets to lose weight.20 22

We argue that such a broad definition of physical maltreatment contributes to a substantial risk of confusion in classifying physical maltreatment and psychological maltreatment as it is very difficult to determine the consequences of a gesture, whether it be physical or psychological. Instead, we define physical maltreatment based purely on the physical nature of the aggression towards athletes rather than the consequences of these actions. In this way, we avoid the risk of confusion as to the distinction between physical maltreatment and psychological maltreatment, and we adhere to common guidelines concerning physical abuse outside the sport context.15 17 The choice of this definition involves a new classification of physical maltreatment in sport, where it manifests itself in five different ways (table 1).

Sexual maltreatment of children in sport

The criteria for defining sexual maltreatment are not uniform within the scientific community. Some definitions only consider acts that involve physical contact between the abuser and the victim (eg, penetration, touching, caressing),12 while others also encompass sexually suggestive acts that do not involve physical contact with the victim (eg, voyeurism, exhibitionism).5 7 13 Recent definitions of sexual maltreatment are increasingly broad, including gestures with and without physical contact.7 13 Sexual harassment can even be considered by some definitions to be sexual maltreatment.5

One of the main conceptual frameworks used by researchers to study sexual abuse in sport is Brackenridge’s sexual exploitation continuum,4 where sexual abuse is defined as stages on a continuum. The stages range from sexual discrimination and sexual harassment, to sexual abuse as the ultimate stage. According to Brackenridge,4 sexual harassment is different from sexual abuse in that it constitutes unwanted attention that can take the form of verbal or written threats, sexual jokes, sexual comments or insinuations, sexual or homophobic graffiti, sexually intimidating remarks, suggestive comments, invitations, or innuendos. Sexual abuse is described as forced physical contact or sexual acts carried out under manipulation or coercion.

For the purpose of this paper, sexual maltreatment of children in sport includes any activity that involves engaging a child in sexual activity, and is in line with the definitions proposed by Butchart and colleagues15 and Mathews and Collin-Vézina.23 Seven categories of behaviours are defined, either involving or not involving physical contact (table 1). Unlike Stirling’s5 framework, any sexual harassment behaviour that is not aimed at involving a child in sexual activity (jokes, degrading comments about appearance and so on) was excluded from the framework. This framework is therefore consistent with a Canadian non-sport-related work on the issue17 as well as the work of Brackenridge,4 which differentiate sexual harassment from sexual abuse.

Psychological maltreatment of children in sport

The work we present here offers new insights into the manifestations of psychological maltreatment of children in sport (see table 1). Several manifestations—classified by the majority of authors in sport as physical maltreatment—are part of our conceptualisation of psychological maltreatment. This form of maltreatment includes acts that have a high risk of harming a child’s mental health, safety or development.17

We make important additions to Stirling’s framework.5 For example, threats of violence intended to terrorise a young athlete, isolate and restrict the movements of a young athlete, and behaviours that promote corruption, exploitation, and the adoption of destructive, antisocial or unhealthy behaviours in young athletes represent categories of behaviours included in the psychological maltreatment category.17 The actions of forcing or asking an athlete (1) to perform excessive training beyond a reasonable point of exhaustion, (2) to train while injured despite contradictory medical advice, (3) to perform movements that are too difficult for his or her abilities and have or could have a negative impact on health or safety, (4) to adopt a self-destructive eating behaviour in order to achieve an ideal weight for the sport, (5) to use doping products or to use doping methods, or (6) to act violently in a competitive situation have all been classified as manifestations of psychological maltreatment.

Neglect of children in sport

Neglect, which occurs when ‘[…] the family environment or the person who is responsible for the child does not meet their basic needs in relation to health, education, emotional development, nutrition, accommodation and safety’,15 was not included in recent studies documenting child maltreatment in sport.7 13 Stirling5 and Mountjoy and colleagues14 extended the blanket definition of maltreatment in sport to include neglect. Indeed coaches and guardians of child athletes often have supervisory responsibilities that are sometimes equivalent to those of children’s parents, to entrust not only the development of the child but their safety as well, especially during outdoor tournaments or training and competitions abroad. The work of Stirling5 offered an important reflection on the categorisation of negligence in sport. As Stirling5 describes, neglect can be (1) physical (eg, allowing the use of alcohol and drugs, abandonment, being left injured), (2) educational (eg, preventing athletes from going to school), (3) emotional (eg, disregard of an athlete’s psychological health) and (4) social (eg, isolating athletes from friends, parents or romantic partners).

In a recent meta-analysis on child neglect,24 authors report three subtypes of neglect—physical, emotional and educational—and we adopted this approach too (table 1). Our choice of manifestations of child neglect in sport inside these subtypes was based on the suggestion of manifestations from Trocmé et al 17 and Stirling’s work.5 Manifestations of social neglect proposed by Stirling5 were incorporated in the emotional neglect and psychological maltreatment categories. So these items were not dismissed. For example, manifestations such as chronic exclusion of an athlete or discouraging athletes from having friends were retained. They however have been classified in manifestations of psychological maltreatment, based on the work of Trocmé et al,17 essentially because they do not constitute an omission or the absence of something (see definition of neglect) but rather a behaviour/an action from someone (here psychological maltreatment).

We included in our emotional neglect section a category called ‘permissive attitude towards the anti-social or criminal behavior of a child athlete’ (table 1), including manifestations such as letting a child athlete endure violent acts from another athlete without intervening or letting a child athlete consume doping products without intervening. However, we did not classify these manifestations in a social neglect category because of our choice of classification (Trocmé et al 17 and Stoltenborgh et al 24). It should be noted that manifestations of physical neglect related to food, clothing, proper living conditions and hygiene are responsibilities that are part of the family context rather than the sporting context, so they were not considered in our proposition.

What are the take-home messages for the sport community and researchers?

We believe this 2019 update will provide the sport community (athletes, coaches, clinicians, sport managers, decision-makers) with a better understanding of what child maltreatment is and the forms and concrete manifestations it could take in sport. This awareness-raising should minimise the risk that people—including young athletes themselves—consider it normal that authority figures in sport maltreat children. Many researchers point out that normalisation of violence towards athletes constitutes an important risk factor for victimisation (see Parent and Fortier25 for discussion). By naming these manifestations of child maltreatment in sport, we also hope to break down the wall of silence around these behaviours from authority figures in sport. There must be zero tolerance for child maltreatment. Child maltreatment is a problem of power imbalance and children are in a position of vulnerability.14 They need to receive due protection, including in sport.

Measurement is fundamental in research, and accurate measures of child maltreatment in sport are needed. Using our proposed categories and examples could help with consistent measurement. Many researchers have called for prevalence studies to measure the manifestations of child maltreatment in sport.14 26–28 This will contribute to reaching the first step of the public health approach,29 the monitoring of the problem, and will serve as a basis for intervention.

We appreciate there are limitations in what we have proposed. It may be interesting to consider adapting these manifestations to special athlete population, such as young athletes with physical and intellectual disabilities. We also consider that some elements of our proposal apply to adult athletes. However, special attention should be paid to some items less applicable to them, such as the concept of neglect, especially from parents. Finally, it could be very interesting to look at links between the types of child maltreatment in sport (comorbidity), especially because past research in child maltreatment showed that types of child maltreatment frequently coexist and that psychological maltreatment (or abuse) often occurs when the child experienced other forms of maltreatment (see Stoltenborgh et al 30 for a discussion on this).

What is already known

  • Athletes experience maltreatment in sport and child athletes are particularly vulnerable, and these experiences can have lifelong effects.

  • Child maltreatment in sport takes many forms, including physical, sexual and psychological maltreatment, as well as neglect.

  • There is confusion around the definitions and manifestations of psychological and physical maltreatment of child in sport that could impact on the comprehension of the problem and also on its measurement.

What are the new findings

  • As a result of reading this paper, the sport community (coaches, athletes, clinicians, sports managers, decision-makers) will be more aware of child maltreatment in sport and its varied manifestations.

  • We aim to reduce normalisation of child maltreatment in sport by raising awareness.

  • We contribute to smashing the wall of silence around child maltreatment by authority figures in sport.

  • Child maltreatment must not be tolerated.

References

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Footnotes

  • Contributors Each of the authors made substantial contributions. KF contributed to conception and study design, project management, and drafted the manuscript. SP contributed to conception and study design, project management, and writing and review of the paper. GL contributed to project management and reviewed the manuscript.

  • Funding This work was supported by the Social Sciences and Humanities Research Council of Canada under Grant 108560, and Ministère de l’Éducation et de l’Enseignement supérieur du Québec under Grant 104153.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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