According to a new review of studies,School-based sexual abuse prevention programs can teach children to recognize mistreatment and might increase self-protective behaviors.

However, the programs have a downside: they could heighten anxieties, making children more fearful of strangers, the review cautions.

It was a concern that anxiety may be increased as we found in the review, but we were pleased that there was an increase in knowledge, said lead reviewer Karen Zwi of Sydney Childrens Hospital in Australia. The important issue is whether in a real life situation a child could utilize this knowledge.

The aim of the systematic review was to determine whether school-based sexual abuse prevention and education programs are effective, if they protect children and if they might cause unintentional harm.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The Cochrane reviewers analyzed 15 studies that included school-age pupils and high school students living in Canada and the United States. The education programs covered topics such as how to identify potential abuse, good touch vs. bad touch concepts and who to tell if abuse occurs.

The studies employed a variety of teaching strategies to educate the children, from films and lectures to puppet shows and role-playing.

One study found that children who participated in an education program were less likely to go with a simulated abductor than children who had not (21.5 percent vs. 47.6 percent).

Nine studies found that children who received sexual abuse prevention education demonstrated greater kno
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