DuBOIS - Despite the stereotypes of a stranger in a trench coat hanging around the playground, in more than 90 percent of sexual abuse cases, the child and the child's family know and trust the abuser. "What we see and statistically what has been proven, is most of your perpetrators are someone the family or the child knows. They're somebody that knows your habits - who knows when you're not going to be home and when you're going to be home - so they can take advantage," Billie Jo Weyant, director of Citizens Against Physical, Sexual and Emotional Abuse, said. "That's why a lot of times kids are so afraid to tell. Even adults can be afraid to tell. You don't know what that person has threatened those children, young adults and adults."Since most children seek approval from adults, they are vulnerable to abuse."The use of physical force is rarely necessary to draw a child into sexual activity. Offenders know this and take advantage of children in this way," Diane Kuntz, executive director of Prevention and Service for Sexual Assault through Guidance, Empowerment and Support, said. "They often groom children for sexual assault. The grooming process includes building trust, bestowing favors, alienating others, demanding secrecy and violating boundaries. Usually, sexual abuse begins gradually and then increases over time. It is rarely a one-time incident and often continues for years."PASSAGES and CAPSEA have differing perspectives regarding the increase of services provided to child victims of sexual assault and their families.PASSAGES was founded in 1980 as The Rape Crisis Center, and is dedicated to the provision of free and confidential services to the survivors of sexual assault throughout Clarion, Clearfield and Jefferson counties.Kuntz said since 1995, the number of children seen at PASSAGES has nearly doubled, along with the number of service hours provided. "In the past year, PASSAGES has provided 560 hours of services to 93 children," Kuntz said. "According to the Pennsylvania Coalition Against Rape, there were 4,562 substantiated cases of child sexual assaults in Pennsylvania in the 2005-06 fiscal year. In addition, sexual violence centers throughout the Commonwealth served 37,353 individuals. Of those served, 10,147 were child victims."Even though these numbers may seem staggering, Kuntz said 88 percent of child sexual abuse is never reported to authorities and sexual assault is the violent crime least reported to law enforcement.CAPSEA is committed to providing confidential service to victims of physical, sexual and emotional abuse in Elk and Cameron counties as well as to victims of all other serious crimes in Elk County.Weyant said of the 1,708 new victims the organization provided assistance, accompaniment and transportation to between 2007 and 2008, the number involving child sexual assault fluctuates. "Sexual violence and child sexual assault - this is something that is not going to go away in the next 10 years. On a positive note, me being here almost 19 years, I have seen many strides in the legal system, victims services," Weyant said. "Prevention is key. Adults have to educate themselves and children need to be made aware from day one with age appropriate information." Weyant said when victims services, law enforcement, the judicial system and other agencies work together and share information, abuse is more likely to be noticed and more victims can be helped. She stressed that when agencies share information, they are not disclosing private information, but talking about the issues and how to help victims."There was a time when I first started when you said 'sexual assault' and people said 'that doesn't happen around here.' People wanted to just hide," Weyant said.Kuntz agreed the "taboo" surrounding sexual assault is being progressively combated by increased awareness and education."Since 1995, the number of prevention/education programs provided in our service area has dramatically increased. In fiscal year 1994-95, PASSAGES provided 138 programs to 3,927 participants. In the 2007-08 fiscal year, Passages provided 785 programs to 15,438 of our area's youth," Kuntz said. "Talking about it is preventing it while assisting victims in coming forward. The more that people understand how common the problem really is, the easier it is to talk about. Thus, allowing victims to heal and helping to prevent sexual violence by raising awareness." Weyant said in her 19 years of working in victims services, she has also seen an improvement in the way details surrounding child sexual abuse are reported by the media. As an example, she recalled a high profile case in the early 1990s."So much detail was given (in the local newspapers) - the little girl's name, street address, the mother's name was in it. It was horrible because those people no longer had a safe haven," Weyant said. "I think the press has improved greatly." She said because of the press coverage, that trial had to be moved to another county in the eastern portion of the state. As a result, the family had to find their own means for travel, food and lodging. In comparison, psychologist and Project Point of Light Director William Allenbaugh II said if too much detail about the crime is published, it has the potential to hurt the victim."From a victim's perspective, the concern I have with the graphic depictions are the problems it can create for victims. If victims are in grade school, middle school, high school, even though they aren't named, people quickly put two and two together," Allenbaugh said. "I think it creates another obstacle for them to overcome. Victims can survive, but it is a process, and it gets more complicated when other people are aware of what went on." Project Point of Light was developed in 1986 as a joint effort of Clearfield and Jefferson counties' adult probation offices and the State Board of Parole in Altoona and Butler. It is an outcome-based program which targets adults and adolescents who experience difficulty as a result of inappropriate sexual behavior. Services are also available to victims and non-offending parents.From a perpetrator's perspective, Allenbaugh said he doesn't know how the details of a crime would serve any purpose, especially since they are already provided by affidavit to those who are working with the offender."I would have concern with the vividness more so for the victim than the perp," Allenbaugh said.The average age at which children are sexually abused is between 7 and 13. Allenbaugh said the youngest children he has worked with in the past year were 5 year olds."Look for a major change in where they (a child) are at. We see kids a lot of times who are sexually abused who experiment with siblings, such as trying to perform oral sex on their sisters - beyond what should be known," Allenbaugh said. "It could also be that they are seeing porn at home, which in my opinion is another form of sexual abuse."Sexual abuse is defined as any sexual act between an adult and a minor or between two minors where one exerts power over the other. Sexual abuse of children can include forcing, coercing or persuading a child to engage in sexual activity or to participate in non-contact acts like exhibitionism, exposure to pornography, voyeurism or talking sexually by phone or Internet.Weyant said there are victim crisis centers in every county in Pennsylvania.Once a victim discloses, he or she can call CAPSEA and a trained volunteer or staff member is available 24 hours for immediate crisis intervention. One of the first concerns of the CAPSEA representative is to make sure the individual is safe and to assist in getting them medical attention or referrals to meet their other needs. CAPSEA volunteers and staff can also serve as accompaniment and support to the victim."We don't do anything that victim or survivor doesn't want us to do. We let that person take the lead," Weyant said. "Also, people who initially call us don't have to disclose their name. We can assist an anonymous call, and all of our services are free of charge." Once the first response is handled, CAPSEA can also provide ongoing crisis, options and empowerment counseling and make referrals to other organizations and services. PASSAGES also has a 24-hour hotline. The organization offers individual and group counseling, medical accompaniment, legal advocacy through the entire legal process, and other information, referral and educational programs.Weyant has been involved in sexual assault education for many years. "I tell people anytime someone discloses that they have been victimized, it is never the fault of the victim. Do not act shocked or act like you don't believe that person. If people don't know what to do or where to turn, please call us. That is what we're here for," Weyant said. "It is a horrendous thing to go through, but when that person is in need of help and can find there are people who aren't going to judge them and are going to be in their corner with them, I think that is such a boost to helping that healing process start."When sexual assault occurs, if it is not dealt with, it can be like a contagion that plagues other areas in that victim's life and of society as a whole.Weyant and Allenbaugh said many cases of sexual assault start when victims are children and go on into adulthood. Allenbaugh works with victims through victim witness, Children & Youth Services and self referral."I work with a lot of victims in their 50s who are now trying to deal with what happened to them as kids and never reported it because back in those days it was just something you didn't talk about," Allenbaugh said. "Women have come a long way, but we still have a long way to go."An information packet from PASSAGES said early sexual victimization can result in life-long problems. The degree of trauma depends on age and personality of the child, the nature of the relationship between the child and offender, the nature and duration of the abuse, and the way disclosure is handled, especially the degree of support a family offers. Allenbaugh added that with older adults who have been sexually abused, some of the signs may be substance abuse, becoming obese as a way to avoid becoming close with people, lack of trust, depersonalization and lack of self esteem. Prostitution, delinquency, suicide, depression and sexual fears and dysfunction are also often associated with early and long-term abuse.A pattern of victimization can continue into future generations. Women abused as children sometimes marry men who will abuse their children. Men abused as children may continue the cycle of victimization as abusers."There is no simple checklist I know of (to be able to realize someone is being sexually abused). You have to look at the individual because there are so many different variables that can occur," Allenbaugh said. "The younger you catch it, the better."