**24. What happened to Cleveland's children?**

The 121 children will now be between 33 and 48 years old. Their records were all destroyed by Social Services after the Inquiry, and it is impossible to know about any who came to the further attention of Social services or other agencies following their return home. We have some information about those children who remained in care and were followed up in the Child and Adolescent Mental Health Service (CAMHS) [41]. One, a group B child age 4 with medical findings of abuse, was protected as her older brothers were able to disclose. Once in care she was able to make a successful new attachment to her adoptive parents. Another girl removed from home at 4 years was successfully adopted, but continued to be troubled. Eventually at age 15, when given the

information about her early childhood along with therapeutic help, she made a good recovery. Another was returned home, but later asked to be taken back into care, and was fostered. Her own little daughter was later referred for help and was placed on the child protection register as the child was still at risk within the family in which her mother had herself been abused as a Cleveland child and returned home.

Over the years we have often been asked whether any of the other children can be traced or are likely to come forward to add their voices to the debate. The fact is that we simply do not know what has happened to them or if any have come forward in other settings. IICSA is hearing evidence from many other adult survivors who have previously been silent, disbelieved, or prevented for many reasons from accessing the justice system. So perhaps it is not surprising that the children who were so effectively silenced in Cleveland in 1987 have never spoken out publicly. If they were successfully protected – and despite the difficulties we have described, some were – they may well be getting on with their lives. If they were returned to their families only to experience further abuse, they are never likely to have trusted further attempts at intervention, and to have become casualties of the long-term effects on their mental and physical health. It is possible that some may even have taken the path of becoming perpetrators themselves. So a more apposite question is, why would they ever come forward? And what would they experience if they did?

## **25. Asking the right questions: what should we do now?**

We believe it is necessary to revisit areas of controversy, especially what the public expect professionals to do in respect of children whose bodies carry the hallmarks of abuse but who cannot disclose.

A renewed public and professional dialogue would need to go back to some fundamental unanswered questions and dilemmas. For Group B children, the need for protection might still be paramount to ensure a safe situation to be able to disclose. It's important to mobilise protective adults within the family and give them support and time to absorb what is happening.

It is clear that children who are trapped in silence need to be given time, listened to and also helped pro-actively. In 2015 the Children's Commissioner described precisely the same issues we were grappling with in Cleveland: 'There is a high level of commitment to tackling this issue among professionals working with children. However, statutory services are largely disclosure-led, with the burden of responsibility placed on the victim' ([21] p. 7). 'Some professionals are hesitant to seek information from a child for fear that such actions will be construed as 'leading the victim'. Victims are likely to exhibit some sign or indicator suggestive of sexual abuse, though in some instances this will not always be obvious or conclusive. Proactive enquiry is therefore necessary to substantiate concerns' (op.cit, Conclusions 4–5 p.9).

#### **26. Re-opening the medical window**

In 2018 paediatrician Chris Hobbs commented: 'Despite ongoing disputes and insufficient research, the physical signs of Cleveland stand largely undiminished in the eyes of the U.K. medical community. When present, they continue to provide evidence valued by professional and legal authorities charged with the protection of children' [42].

How would we now act in regard to the child if a medical diagnosis was made? If the medical window could be re-opened how would inter-agency planning aim to manage the disclosure process on behalf of the children?

Attaching greater relative forensic weight to the medical component of the jigsaw would assist Group B children, because 'While behavioural symptoms and disclosure are important in medical treatment and child protective services investigation, positive physical findings are associated with a finding of guilt (in the criminal court)' [43] p. 388.
