Body Safety Training Workbook (BST)

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
Medium
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Body Safety Training Workbook (BST) has been rated by the CEBC in the area of: Prevention of Child Abuse and Neglect (Primary) Programs.

Target Population: Children ages 3-8 years old and their parents and teachers

For children/adolescents ages: 3 – 8

Brief Description

The Body Safety Training (BST) Workbook is a behaviorally based and developmentally appropriate curriculum for parents and teachers to instruct young children about personal safety. There are two versions of the BST Workbook; one for parents to use at home and one for teachers to use in a classroom setting. The two versions can be used separately or in combination. The BST Workbook contains ten lessons; the first half of the workbook covers general safety (e.g., fire, gun, pedestrian, poison) and the second half covers body safety (e.g., teaching children the body-safety skills of recognizing, resisting, and reporting inappropriate touching).

Program Goals:

The goal of the Body Safety Training (BST) Workbook is:

  • Helping children learn the 5 "R"s of body safety by:
    • Helping children recognize potentially abusive situations or potential abusers
    • Encouraging children to refuse sexual requests by saying 'No'
    • Teaching children to resist by getting away from the perpetrator
    • Encouraging children to report previous or ongoing abuse to a trusted authority figure
    • Reassuring children that secret or inappropriate touch is never the child's responsibility
    • Emphasizing the importance of protecting their bodies and keeping their bodies safe from a variety of dangers
    • Enhancing self-appreciation through reminding children how special they are, and that their bodies, including the private parts, are special too
    • Improving teacher/parent knowledge about child sexual abuse, including ways to prevent (primary prevention) and ways of handling disclosures (secondary prevention)

Essential Components

The essential components of Body Safety Training (BST) Workbook include:

  • The BST Workbook includes background information on how to use the workbook, the rationale for teaching children this information, and the research base of the workbook.
  • Using the script, children are taught 10 body-safety lessons:
    • Lesson 1 covers Boss of Body (being in charge of their bodies); Body Information (name, address, phone number); and Body Safety (there are rules at home and school to keep your bodies safe).
    • Lesson 2 covers Poison Safety; Fire Safety; and Gun Safety.
    • Lesson 3 covers Home Alone; Water Safety; and Lost in a Store.
    • Lesson 4 covers Seat Belt Safety and Pedestrian Safety.
    • Lesson 5 teaches three rules when interacting with others, including strangers: 1) always ask first before accepting a gift, a ride, or offering to help an adult; 2) never go with a stranger, and always tell an adult where they are going; and 3) always try to go with a buddy.
    • Lessons 6-10 shift the focus from keeping the body safety from poisons, guns, cars, and strangers, to touching safety.
    • Lesson 6 teaches children names and location of their private parts, and encourages the parents to teach their children the anatomically correct terms for the genitals.
    • Lesson 7 teaches the Body Safety Rule and helps children recognize and distinguish between appropriate and inappropriate touching/viewing situations (OK and Not OK situations).
    • Lesson 8 teaches self-protection skills (say no, try to get away, tell someone) if Not OK touching requests occur.
    • Lesson 9 reviews the “No, Go, Tell” skills, and teaches children the skill of reporting and emphasizes that it’s never a child’s fault if “Not OK” touching of private parts occurs.
    • Lesson 10 serves as a review and practice of all skills.
  • The workbook contains short stories accompanied by pictures.
  • Throughout the script, there are prompts to ask child(ren) questions and practice the skills.
  • Instructors are prompted to use language of encouragement throughout the program (samples provided)
  • Children’s progress is monitored using the Token Time chart, which lists all concepts and skills taught
  • The parent version of the workbook can be used with individual children, and the teacher version can be used with small groups of children (varying in size depending on age/attentional abilities of the group participants, usually maximum of 12).

Child/Adolescent Services

Body Safety Training Workbook (BST) directly provides services to children/adolescents and addresses the following:

  • Lack of knowledge of how to protect oneself from abuse
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Parents and teachers are the educators and indirectly learn about child sexual abuse and injury prevention by teaching the curriculum.

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • School

Homework

Body Safety Training Workbook (BST) includes a homework component:

If taught by parents, the entire workbook can be considered as homework. Parents are encouraged to generate examples of safety rules children need to follow both in and out of home.

Languages

Body Safety Training Workbook (BST) has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Workbook and adequate space to instruct child(ren)

Minimum Provider Qualifications

The only requirement is to be able to read the script included in the workbook. However, training in early childhood education would be useful when teaching small groups of children.

Education and Training Resources

There is a manual that describes how to implement this program; but there is not training available for this program.

Implementation Information

Since Body Safety Training Workbook (BST) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Body Safety Training Workbook (BST).

Formal Support for Implementation

There is formal support available for implementation of Body Safety Training Workbook (BST) as listed below:

Program staff is available for implementation support via phone, email, and Skype consults.

Fidelity Measures

There are no fidelity measures for Body Safety Training Workbook (BST).

Implementation Guides or Manuals

There are implementation guides or manuals for Body Safety Training Workbook (BST) as listed below:

The introduction to the BST explains how to use the program.

Research on How to Implement the Program

Research has been conducted on how to implement Body Safety Training Workbook (BST) as listed below:

  • Wurtele, Kast, Miller-Perrin, & Kondrick (1989). A comparison of programs for teaching personal safety skills to preschoolers. Journal of Consulting and Clinical Psychology, 57, 505-511.
  • Wurtele, Gillispie, Currier, & Franklin (1992). A comparison of teachers vs. parents as instructors of a personal safety program for preschoolers. Child Abuse & Neglect, 16, 127-137.
  • Wurtele, Kast, & Melzer (1992). Sexual abuse prevention education for young children: A comparison of teachers and parents as instructors. Child Abuse & Neglect, 16, 865-876.

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Safety

Show relevant research...

Wurtele, S. K., Kast, L. C., Miller-Perrin, C. L., & Kondrick, P. A. (1989). A comparison of programs for teaching personal safety skills to preschoolers. Journal of Consulting and Clinical Psychology, 57, 505-511.

Type of Study: Randomized controlled trial
Number of Participants: 100

Population:

  • Age — Mean=5 years
  • Race/Ethnicity — 92% White; 7% American Indian, and 1% Hispanic
  • Gender — 51% Female and 49% Male
  • Status — Participants were students at two Head Start preschools serving a low-income, predominantly White population.

Location/Institution: Northwestern community of 50,000 people

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of this study was to determine the effectiveness of two educational approaches for teaching personal safety skills with preschoolers in a classroom setting. Participants were randomly assigned subjects within a classroom to one of three prevention programs: the Behavioral Skills Training Program (now called the Body Safety Training [BST] Workbook), the Feelings Program, or an attention control group. Measures utilized include the “What If” Situation Test, the Personal Safety Questionnaire, Fear Assessment Thermometer Scale (FATS), Teacher's Perceptions Questionnaire, Program Enjoyment Rating Scale, and the Parent's Perceptions Questionnaire (PPQ). Children's abilities to discriminate between appropriate-touch and inappropriate-touch requests, their prevention skills, and levels of emotional distress were assessed before, immediately, and one month after program participation. Parents and teachers were surveyed regarding children's reactions. Results indicate that compared to the control group, both BST and the Feelings Program were effective in enhancing children's knowledge and prevention skills without making them fearful, suggesting that preschool children can benefit from such programs. However, children in the Feelings Program had difficulty recognizing the appropriateness of certain touch requests, suggesting that this approach may have limited utility with preschool-age children. Limitations include the small sample size, issues with the measures used, and generalizability of results to other racial/ethnic populations.

Length of postintervention follow-up: One month.

Wurtele, S. K. (1990). Teaching personal safety skills to four-year-old children: A behavioral approach. Behavior Therapy, 21, 25-32.

Type of Study: Randomized controlled trial
Number of Participants: 24

Population:

  • Age — 4 years; Mean=4.2 years
  • Race/Ethnicity — 92% White
  • Gender — 71% Male and 29% Female
  • Status — Participants were children attending a YMCA preschool.

Location/Institution: Colorado

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of this study was to determine the effectiveness of a behavioral approach for teaching children personal safety in a classroom setting. Preschoolers were randomly assigned to either the Behavioral Skills Training Program (now called the Body Safety Training [BST] Workbook) or an attention control program. Measures utilized include the “What If” Situation Test, the Personal Safety Questionnaire, the Teachers' Perceptions Questionnaire, and the Parents' Perceptions Questionnaire. Results indicate that preschoolers who had participated in the BST program demonstrated greater knowledge about sexual abuse and higher levels of personal safety skills compared to controls, and these gains were maintained at the one-month follow-up. No program-related increases in problematic behaviors were reported by teachers or parents, nor were the children in the BST group perceived by their parents as more fearful subsequent to participation. Limitations include small sample size, reliance on self-reported measures, and generalizability of results to other racial/ethnic groups.

Length of postintervention follow-up: One month.

Wurtele, S. K., Currier, L. L., Gillispie, E. I., & Franklin, C. F. (1991). The efficacy of a parent implemented program for teaching preschoolers personal safety skills. Behavior Therapy, 22, 69-83.

Type of Study: Randomized controlled trial
Number of Participants: 52

Population:

  • Age — 3.5 to 4.5 years; Mean=49.3 months
  • Race/Ethnicity — 94% White and 6% Hispanic
  • Gender — 56% Male
  • Status — Participants were children at a YMCA preschool.

Location/Institution: Colorado

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of this study was to determine whether preschool-age children can learn personal safety skills when taught by their parents. Preschoolers were randomly assigned to either a home-based version of the Behavioral Skills Training program (BST; now called the Body Safety Training [BST] Workbook) or a waitlist control group. Children's abilities to discriminate between appropriate-touch and inappropriate-touch requests, their prevention skills, and levels of emotional distress were assessed. Measures utilized include the “What If” Situation Test (WIST), the Personal Safety Questionnaire, Program Enjoyment/Private Parts Rating Scale, Background Information Questionnaire (BIQ), and Parent’s Perceptions Questionnaire (PPQ). Results indicate that following BST participation, children demonstrated greater knowledge about sexual abuse and higher levels of personal safety skills compared to controls, and these gains were maintained at the two-month follow-up. No program-related increases in negative behaviors were reported by parents, nor were children in the BST group seen as more fearful subsequent to participation. Limitations include validity of assessment measures, small sample size and generalizability of results to other parents and children.

Length of postintervention follow-up: 2 months.

Wurtele, S. K., Gillispie, E. I., Currier, L. L., & Franklin, C. F. (1992). A comparison of teachers vs. parents as instructors of a personal safety program for preschoolers. Child Abuse & Neglect, 16, 127-137.

Type of Study: Randomized controlled trial
Number of Participants: 61

Population:

  • Age — Mean=57 month (4.75 years)
  • Race/Ethnicity — 46% White, 31% Hispanic, 16% Black, 2% Asian, 2% Native American, and 3% other
  • Gender — 54% Male
  • Status — Participants were children enrolled in Head Start program.

Location/Institution: Colorado

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of this study was to compare the effectiveness of parents and teachers as instructors of a personal safety program. Low-income preschool children were randomly assigned to either a home-based version of the Behavioral Skills Training program (BST; now called Body Safety Training [BST] Workbook), a school-based version of the Behavioral Skills Training program (BST; also now called Body Safety Training [BST] Workbook), or a control program. Measures utilized include the “What If” Situation Test (WIST), the Personal Safety Questionnaire, Program Enjoyment/Private Parts Rating Scale, Parent's Perceptions Questionnaire (PPQ), and the Teacher Perception Questionnaire (TPQ). Children were posttested on knowledge and skill gains. Results indicate that no significant differences were found between BST groups of children taught by teachers or parents, and children in both of these groups demonstrated greater knowledge about sexual abuse and higher levels of personal safety skills compared with those in the control group. Knowledge and skill gains were maintained at the two-month follow-up. No program-related increases in negative behaviors were reported by teachers, nor were they perceived by the parents of children in the BST groups. Limitations include small sample size and generalizability of results to other families.

Length of postintervention follow-up: 2 months.

Wurtele, S. K., Kast, L. C., & Melzer, A. M. (1992). Sexual abuse prevention education for young children: A comparison of teachers and parents as instructors. Child Abuse & Neglect, 16, 865-876.

Type of Study: Randomized controlled trial
Number of Participants: 172

Population:

  • Age — Mean=55.4 months (4.62 years)
  • Race/Ethnicity — 53% White, 23% Hispanic, 23% Black, and 1% Asian
  • Gender — 58% Female
  • Status — Participants were children enrolled in a Head Start program.

Location/Institution: Colorado

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of this study was to compare teachers and parents as instructors of a personal safety program. Head Start preschoolers were randomly assigned to one of four groups: 1) Behavioral Skills Training program (BST; now called Body Safety Training [BST] Workbook) taught by their teachers, 2) BST taught by their parents, 3) BST taught by both teachers and parents, or 4) a control program. Measures utilized include the “What If” Situation Test (WIST), the Personal Safety Questionnaire, Parent's Perceptions Questionnaire (PPQ), and the Teacher Perception Questionnaire (TPQ). Results indicate that following program participation, children in any of the BST groups demonstrated greater knowledge about sexual abuse and higher levels of personal safety skills compared with those in the control group. Gains in knowledge and skills were maintained at the 5-month follow up. Children taught by their parents showed greater improvements in recognizing inappropriate-touch requests and in their personal safety skills compared with children taught by their teachers, and children who received the program both from teachers and parents were better able to recognize appropriate-touch requests and to demonstrate higher levels of personal safety skills compared with children taught only by teachers. The emotional costs associated with participating in the program were minimal, and both parents and children rated the program positively. Limitations include small sample size and generalizability of results to other families who do not receive the same level of support for the intervention.

Length of postintervention follow-up: 5 months.

Currier, L. L., & Wurtele, S. K. (1996). A pilot study of previously abused and non-sexually abused children's responses to a personal safety program. Journal of Child Sexual Abuse, 5(1), 71.

Type of Study: Nonrandomized controlled trial using matched groups
Number of Participants: 26

Population:

  • Age — 3-7 years
  • Race/Ethnicity — 92% White, 4% Hispanic, and 4% African-American
  • Gender — 62% Female
  • Status — Participants were children who have experienced sexual abuse.

Location/Institution: Colorado

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The current project evaluated the effectiveness of the Behavioral Skills Training Program (now called Body Safety Training [BST] Workbook) in children with a history of sexual abuse. Measures utilized include the “What If” Situation Test, the Child Sexual Behavior Inventory, and the Personal Safety Questionnaire. Sexually abused children and children with no history of sexual abuse were matched and then taught a personal safety program by their parents (or caretakers). Results indicate that both groups of children demonstrated significant increases in skills and knowledge scores following the program. No negative reactions to the program were observed by parents, and sexually abused children exhibited fewer inappropriate sexual behaviors following program participation. Limitations include small sample size, use of therapy with some subjects, use of parent-reported outcomes from the parent who delivered the intervention, and concerns about generalizability of results to other families.

Length of postintervention follow-up: One month.

Sarno, J. A., & Wurtele, S. K. (1997). Effects of a personal safety program on preschoolers' knowledge, skills, and perceptions of child sexual abuse. Child Maltreatment, 2, 35-45.

Type of Study: Randomized controlled trial
Number of Participants: 75

Population:

  • Age — 42-65 months, Mean=55.09 months (4.59 years)
  • Race/Ethnicity — 65% White, 17% Black, 7% Hispanic, and 1% American Indian
  • Gender — 52% Female and 48% Male
  • Status — Participants were children enrolled in a Head Start program.

Location/Institution: Colorado

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study was to examine preschoolers’ knowledge, skills, and perceptions of child sexual abuse. Preschoolers were randomly assigned to participate in either the Behavioral Skills Training program (BST; now called Body Safety Training [BST] Workbook) or a general safety control program. Measures utilized include the “What If” Situation Test (WIST) and the Children’s Perception Questionnaire (TPQ). Results indicate that BST participants improved significantly in potential abusive situations (say “no” get away), report secret touching, and remember key concepts (e.g., that abuse is never a child’s fault). BST did not, however, affect participant’s perceptions of the age and gender of perpetrators or the gender of the victim, the relationship between victims and perpetrators, or the possibility of abuse reoccurrence. Limitations include lack of follow-up, small sample size and generalizability of results to other children.

Length of postintervention follow-up: None.

Wurtele, S. K., & Owens, J. S. (1997). Teaching personal safety skills to young children: An investigation of age and gender across five studies. Child Abuse & Neglect, 21, 805-814.

Type of Study: Reanalyses of data from five randomized clinical trials
Number of Participants: 406

Population:

  • Age — 41-68 months; Mean=54.7 months (4.56 years)
  • Race/Ethnicity — 63% White and 37% Nonwhite
  • Gender — 51% Female and 49% Male
  • Status — Participants were children who have experienced sexual abuse.

Location/Institution: Not Specified

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study used data from Sarno & Wurtele, 1997; Wurtele, 1990; Wurtele, Currier, Gillispie, & Franklin,1991; and Wurtele, Kast, & Melzer, 1992. The current project evaluated the effectiveness of the Behavioral Skills Training Program (BST; now called Body Safety Training [BST] Workbook by using data compiled from five previous studies. Measures utilized include the “What If” Situation Test and the Personal Safety Questionnaire. Results indicate preschoolers who had participated in the BST program demonstrated greater knowledge and higher levels of personal safety skills compared with the control group. Boys and girls reacted similarly to the program, as did children from younger and older age groups. Limitations include length of follow-up and generalizability of results to other children and families.

Length of postintervention follow-up: Varies.

Lee, Y. K., & Tang, C. S. (1998). Evaluation of a sexual abuse prevention program for female Chinese adolescents with mild mental retardation. American Journal on Mental Retardation, 103(2), 105-116.

Type of Study: Randomized controlled trial
Number of Participants: 77

Population:

  • Age — 11-15 years
  • Race/Ethnicity — 100% Chinese
  • Gender — 100% Female
  • Status — Participants were female adolescents with mild mental retardation.

Location/Institution: Hong Kong, China

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The current project evaluated the effectiveness of the Behavioral Skills Training Program (BST; now called Body Safety Training [BST] Workbook) among female Chinese adolescents with mild mental retardation. Measures utilized include the Raven’s Standard Progressive Matrices, the “What If” Situation Test, the Personal Safety Questionnaire, and the Fear Assessment Thermometer Scale. Results indicate BST group improvement in their knowledge about sexual abuse and self-protection skills subsequent to participating in a sexual abuse prevention program. Results also indicate the BST participants showed a significant increase in their recognition of appropriate touch requests after joining the prevention program and did not over generalize the recognition of inappropriate touch requests to appropriate touch of private part for hygiene or medical reasons. However, the recognition of appropriate touch requests was not maintained after 2 months. Limitations include small sample size, reliance on self-report measures, and generalizability of results beyond adolescents with mild mental retardation.

Length of postintervention follow-up: 2 months.

Zhang, W., Chen, J., Feng, Y., Li, J., Liu, C., & Zhao, X. (2014). Evaluation of a sexual abuse prevention education for Chinese preschoolers. Research on Social Work Practice, 24(4), 428-436.

Type of Study: Randomized controlled trial (randomization at the classroom level)
Number of Participants: 150

Population:

  • Age — 2-5 years
  • Race/Ethnicity — 100% Chinese
  • Gender — 50% Boys
  • Status — Participants were preschool children.

Location/Institution: Urban areas of Beijing city, China

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The study evaluated the effectiveness of the Body Safe Training (BST) Workbook (called BST Program in article) in a sample of Chinese preschool children. Participating children were randomly assigned to either the BST group or the wait-list control group by class. Measures utilized include the “What If’’ Situations Test (WIST) and the Personal Safety Questionnaire (PSQ). Results indicate following program participation, preschool children in the BST group demonstrated greater knowledge about sexual abuse prevention and higher levels of self-protection skills compared with children in the waitlist control group. Limitations included concerns about generalizability to other populations, reliability of the PSQ, the use of classroom level randomization, and lack of follow-up.

Length of postintervention follow-up: None.

References

Kenny, M. C., & Wurtele, S. K. (2010). Child sexual abuse prevention: Choosing, implementing, and evaluating a personal safety program for young children. In K. L. Kaufman (Ed.), The prevention of sexual violence: A practitioner’s sourcebook (pp. 303-317). Holyoke, MA: NEARI Press.

Contact Information

Name: Sandy K. Wurtele, PhD
Agency/Affiliation: University of Colorado, Colorado Springs
Email:
Phone: (719) 255-4150
Fax: (719) 255-4166

Date Research Evidence Last Reviewed by CEBC: December 2014

Date Program Content Last Reviewed by Program Staff: October 2016

Date Program Originally Loaded onto CEBC: April 2015