Online-Initiated Contact and Child Sexual Abuse Severity: A Forensic Cross-Sectional Study

Background/Objectives: Digital technologies have created new pathways through which perpetrators can initiate contact with children, yet evidence directly comparing child sexual abuse (CSA) cases according to the mode of first contact between the victim and the perpetrator remains limited. This study compared CSA cases in which the victim first met the perpetrator online with cases in which first contact occurred face-to-face and examined whether online-initiated contact was associated with a higher prevalence of penetrative abuse. Methods: We retrospectively reviewed 1511 CSA cases evaluated at a tertiary-care Child Monitoring Center in Turkey (2017-2018). Cases were classified by mode of first contact as online-initiated (n = 91, 6.0%) or face-to-face (n = 1420, 94.0%); the face-to-face group served as a comparison group defined by mode of contact rather than a non-exposed control group. Groups were compared using chi-square tests with Bonferroni-adjusted post hoc analyses; effect sizes were expressed as Cramér's V and risk ratios (RRs). Results: Victims in the online-initiated group were predominantly female (89.0% vs. 79.4%; p = 0.027) and aged 12-18 years (79.2%). The perpetrator was most often described by the child as a friend or boyfriend (81.3% vs. 34.2%; p < 0.001), a pattern consistent with grooming dynamics. Penetrative abuse occurred in 54.9% of online-initiated versus 26.9% of face-to-face cases, an approximately twofold difference (RR = 2.04; p < 0.001). Conclusions: In this forensic sample, online-initiated contact was associated with a distinct case profile and more frequent penetrative abuse. Because the data derive from cases referred by judicial authorities for forensic evaluation rather than from adjudicated cases, the findings are associative and cannot be generalized to all CSA; nevertheless, they support the systematic documentation of online contact histories in forensic evaluation and child protection practice.