This chapter was reviewed and updated in June 2019. Information was added with regard to Technology-assisted harmful sexual behaviour (TA-HSB) and Keeping Children Safe in Education (KCSIE) 2018. Further Information was reviewed and updated.
The definition of harmful sexual behaviours are those 'Sexual behaviours expressed by children and young people under the age of 18 years old that are developmentally inappropriate, that may be harmful towards self or others, or be abusive towards another child, young person or adult'. (Hackett: Children and Young People with Harmful Sexual Behaviours, 2014).
The current definition of Sexual Abuse in Working Together to Safeguard Children is also relevant as it recognises that abuse can be performed/commited/executed by children as well as adults.
- Two thirds of contact sexual abuse is committed by peers;
- History of abuse, especially sexual abuse, can contribute to a child displaying harmful sexual behaviour;
- All children, including the instigator of the behaviour, need to be viewed as young people needing support;
- Children have greater access to information about sex through technology and research indicates that this is likely to be having an impact on their attitudes to sex and sexual behaviour;
- Children with harmful sexual behaviours who receive adequate support and treatment are less likely to go on to commit further abuse compared to children who receive no support;
- Incidents of harmful sexual behaviour should be dealt with under the specific child protection procedures which recognise the child protection and potentially criminal element to the behaviour. There should be a coordinated approach between the agencies;
- The needs of the children and young people who are harming others should be considered separately from the needs of their victims;
- An assessment should recognise that areas of unmet developmental needs, attachment problems, special educational needs and disabilities may all be relevant in understanding the onset and development of abusive behaviour;
- The family context is also relevant in understanding behaviour and assessing risk.
There are no clear indicators in personal or family functioning that indicate an increased likelihood of sexually harming others although the following characteristics have been found in the background of some young people who show sexually harmful behaviour:
- Childhood neglect and relationship difficulties, which may include - poor nurturing and parental guidance;
- A history of Domestic violence and abuse;
- Previous sexual victimisation can be common - a younger age at the onset of the abuse is more likely to lead to sexualised behaviour as it is more likely that the individual's behaviour has become more entrenched and therefore continued sexual behaviour is displayed. There is no evidence that early onset of SHB leads to adult sexual offending, however studies of convicted adults suggest early onset of SHB has been a historical concern for some;
- Social rejection and loneliness, low self-esteem;
- Difficulty in getting on with or understanding others.
Many of these factors exist alongside typical family environments where other forms of difficulties are present.
There is a significant minority of young people who display this behaviour who have a level of learning need - up to 40% in some studies. Their needs must be carefully assessed as some assessment tools are not suitable. Also, the intervention may need to be extended and involve a high degree of coordination between agencies.
The link between on-line behaviour and harmful sexual behaviour may also be a cause for concern. Technology-assisted harmful sexual behaviour (TA-HSB) can range from developmentally inappropriate use of pornography (and exposing other children to this), through grooming and sexual harassment. On-line behaviour may be a trigger for sexual abuse and the long-term effect of exposure to pornography can affect the ability to build healthy sexual relationships (see NSPCC Research and Resources for further information).
It can be useful to think of sexual behaviour as a range or continuum from those behaviours that are developmentally and socially accepted to those that are violently abusive (see Children and Young People with Harmful Sexual Behaviours).
Most healthy sexual behaviour can be characterised by:
- Mutuality (Children of a similar developmental and chronological age);
- Absence of coercion in any form (bullying, emotional blackmail, fear of the consequences);
- Absence of emotional distress.
Additionally, sexual behaviour which seems compulsive, is repeated in secrecy and continues after interventions from parents or carers, is a cause for concern.
The Brook Traffic Light Tool may also be useful in distinguishing between 'normal' age-appropriate behaviour and behaviour which causes concern.
4. Protection and Action to be Taken
Incidents of harmful sexual behaviour come to light, either through discovery or disclosure, which may be third-party or second-hand information. The details provided should be accurately recorded by the person receiving the initial account. It is essential that all victims are reassured that their allegations are taken seriously, and they will be safeguarded. Where the disclosure is to a professional, a designated safeguarding lead should undertake and record an initial risk assessment and consider three factors:
- The victim, especially their protection and support;
- The alleged perpetrator; and
- The risk to any other children (and, if appropriate, adults).
Concerns about the behaviour and the welfare and safety of the child/ren should be discussed with Children Social Care which may require a referral and further assessment (see Referrals Procedure).
Children's Social Care will undertake an assessment and there will be an interagency strategy meeting if the concerns are that a child has suffered, or a child or children is/are likely to suffer, significant harm.
The Strategy Discussion/Meeting is a forum for analysing risk, sharing background information on the young people and planning further action. In addition to police and children's social care, schools, Youth Offending services or any other agency with significant contact to any of the young people should also be invited to the meeting where appropriate.
The strategy meeting should consider:
- Issues of child and public protection, including a clear understanding and description of any alleged incident;
- An assessment of the child/young person's needs, and the need for further specialist assessment;
- The roles and responsibilities of child welfare and criminal justice agencies;
- Any on-going safety issues for all of the young people involved;
- Seeking advice and consultation from the Child and Adolescent Harmful Behaviour service within oxford health CAMHS.
The context of the behaviour and background of the young people and their family are important factors in determining next steps. Where there is no requirement to hold a formal strategy meeting, it is still good and useful practice to hold a multi-agency planning meeting to consider the needs of the children or young people involved.
Strategy meetings will make contingency plans for future actions following further assessment and investigation of the incident. The option of reconvening the strategy meeting post the investigation may be useful in some cases.
Specialist opinion may be required to inform the assessment from those providing specialist treatment services for young people who sexually harm others. The Child and Adolescent Harmful Behaviour service offers specialist consultation in cases where a concern has been raised about a child's sexual behaviour.
Where there are concerns that the alleged abuser is also a victim of abuse consideration should be given to convening a Child Protection Conference if the young person is deemed to have suffered, or is likely to suffer, significant harm.
Where a child protection conference is convened the multi-agency meeting could be incorporated into it in order to avoid repeat meetings. The child protection conference will therefore need to address the needs of the child/young person both as an abuser and as a victim, and this should be made clear at the outset.
In cases where the threshold is met, a meeting should be convened under the Multi-Agency Public Protection Arrangements to consider public protection matters and safety.
Following the investigation, if the decision is made to engage the young person in further work, it is important that these discussions take place as soon after the investigation as possible. Successful engagement of families significantly diminishes if there is a time delay in arranging specialist intervention.
Note: Schools should follow the statutory guidance: Keeping Children Safe in Education which came into force on 3rd September 2018.
Young people may be in denial about having a problem with their sexual behaviour and this may be supported by parents who do not want to confront reality of their child behaving in this way. This can be an understandable reaction to an incident which often provokes shame and guilt in those involved. Many young people will hope that denial results in being left alone, and as such, denial itself should not be seen as a matter of concern in itself.
There is often no legal requirement for the child or family to accept help and it may be easier to ignore the problem than confront it. This is a common response to this issue, practitioners will need to be familiar with the proposed intervention if they are to encourage anyone to accept it. The offer of further work may be helpfully framed as an opportunity to understand how the young person came to be in a position where they behaved in a way considered to be abusive.
Support of parents and carers is extremely helpful in promoting engagements and successful outcomes. Parents need to be informed about the programme to the extent that they are aware that sexually explicit conversations will take place, also they may be asked to speak to their child about sexual issues. They may also be asked to model appropriate and respectful sexual attitudes and language.
Evidence suggests that young people 'take on' and internalise labels, and therefore to describe a young person only as a 'sex offender' or 'young abuser' may impact on their motivation and responsiveness in both assessment and treatment, leaving them feeling they cannot change.
Why anyone offends sexually is a complex question. One popular model which seeks to organise thinking around this topic is known as Finkelhor's Four Pre-conditions to Sexual Abuse, which suggests that four pre-conditions should be in place before an abusive act takes place. Interruption at any stage may prevent abuse taking place.
The stages are:
- Motivation – this can arise from a number of sources which vary with the individual and usually is due to a desire to have some sort of sexual activity;
- Overcoming internal inhibitions (giving permission) – some people who sexually abuse are aware of the taboos against this behaviour, yet because of their experiences or a specific set of circumstances, they may not see their behaviour as wrong;
- Overcoming external inhibitions (finding an opportunity) – this can include taking time to develop a relationship with the victim and / or involve creating the physical opportunity to carry out their behaviour;
- Overcoming the resistance (making it happen) –a variety of methods are used to make sexual activity occur These may include bribery,threats or other forms of coercion.
Delays in completing criminal investigations need not necessarily delay referral for specialist help; there is often a significant delay between completing enquiries and a decision being made about whether to prosecute. A programme of work can be agreed with police and Crown Prosecution Service, usually with the proviso that the victim and specific incidents are not discussed.
Children and Young People with Harmful Sexual Behaviours (Research in Practice) Hackett, S (2014): Children and young people with harmful sexual behaviours, published by Research in Practice.