Harmful Sexual Behaviour

'Sexual behaviours expressed by children and young people under the age of 18 years old that are developmentally inappropriate, may be harmful towards self or others, or be abusive towards another child, young person or adult'. (Hackett 2014 Children and Young People with Harmful Sexual Behaviours).

The current definition of Sexual Abuse in Working Together to Safeguard Children is also relevant as it recognises that abuse can be perpetrated by children as well as adults.

It is widely accepted that HSB sits on a continuum – with behaviours ranging from healthy and developmentally appropriate, to problematic and harmful/abusive. It is therefore helpful to distinguish between problematic and harmful / abusive.
Most healthy / developmentally appropriate 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.

Inappropriate behaviour:

• Single instances of developmentally inappropriate sexual behaviour;
• Behaviour that is socially acceptable within a peer group;
• Generally consensual and reciprocal;
• May involve an inappropriate context for behaviour that would otherwise be considered normal.

Problematic behaviour:

• Developmentally unusual and socially unexpected behaviour;
• May be compulsive;
• Consent may be unclear and the behaviour may not be reciprocal;
• May involve an imbalance of power;
• Doesn’t have an overt element of victimisation.

Abusive behaviour:

• Intrusive behaviour;
• May involve a misuse of power;
• May have an element of victimisation;
• May use coercion and force;
• May include elements of expressive violence;
• Informed consent has not been given (or the victim was not able to consent freely).

Violent Behaviour:

• Physically violent sexual abuse;
• Highly intrusive;
• May involve instrumental violence which is physiologically and/or sexually arousing to the perpetrator;
• May involve sadism.

These categories and descriptions are taken from the NSPCC guide - Responding to children who display sexualised behaviour.

Practitioners should be aware that sexualised behaviour may be an indicator that the child or young person is suffering, or has suffered in the past, from abuse or neglect, particularly sexual abuse, and this should always form part of any assessment. As with all areas of child protection, language used is very important in ensuring that practitioners do not lose sight of the fact that the child or young person’s behaviour is likely to be the result of trauma experienced or being experienced themselves. For example the term 'a child / or young person who displays harmful sexual behaviour' is more appropriate and accurate, as it emphasises the child or young person's developmental status first and foremost whilst acknowledging the behaviours that are causing concern. Terms such as 'young sex offender' or 'young abuser' are not appropriate and ‘sexualised behaviour’ does not describe the nature of the behaviour.

Peer exploitation is where one young person befriends and grooms a young person into a 'relationship' and then coerces or forces them into sexual activity with others. In this context, harmful sexual behaviour may be related to child sexual exploitation or child criminal exploitation. Again, consideration should also be given to the fact that the young person who is deemed to be sexually exploiting another child, may themselves  be a victim of child sexual exploitation, or criminal exploitation themselves.

The link between online 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. Online 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. Visit NSPCC research and resources for further information.

An Ofsted thematic review (Review of Sexual Abuse in Schools and Colleges (Ofsted)) detailed concerns around sexual peer-on-peer abuse. This abuse included:

• Sexual violence, such as rape, assault by penetration and sexual assault;
• Sexual harassment, such as sexual comments, remarks, jokes and online sexual harassment, which may be stand-alone or part of a broader pattern of abuse;
• Upskirting, which typically involves taking a picture under a person's clothing without them knowing, with the intention of viewing their genitals or buttocks to obtain sexual gratification, or to cause the victim humiliation, distress or alarm;
• Sexting (also known as 'youth-produced sexual imagery').

See A continuum of children and young people's sexual behaviours (Hackett, S (2010)).

At least a third of all sexual offences against children in the UK involve other children as the perpetrators (Hackett et al., 2016). Since much abuse is unreported or unrecognised, official statistics are only able to reveal a small proportion of actual incidence but evidence suggests that children and young people who are sexually abusive towards others are likely to have experienced considerable disruption in their own lives (AIM Project). They may have been exposed to domestic violence, have witnessed or been subjected to physical or sexual assault, have problems with their educational development and are likely to be involved in a range of offending behaviours and pro-criminal networks. While it is fair to say that most children and young people who abuse or are abused do not go on to become adult abusers, many adult abusers when interviewed, claim to have started their abusive behaviours in childhood.

The impact of childhood sexual abuse is known to lead to costly (both in the human and financial sense) long term mental health difficulties including anxiety, depression, post-traumatic stress disorder, psychosis, substance abuse, eating disorders, self-harm and suicide (Briere &Runtz 1988; Polusny & Follette 1995; McGee et al 2002; Spataro et al 2004). There are also adverse health effects from childhood sexual abuse, including higher rates of health risk behaviours such as smoking, alcohol and drug misuse, risky sexual behaviour (including prostitution), sexually transmitted infection and gynaecological problems (Nurse et al 2005).

What has been acknowledged (Working Together to Safeguarding) is that children and young people who have been involved in harmful sexual behaviour require a multi-disciplinary and multi-agency co-ordinated response to identify the problem, assess risk and put in place an effective management plan.

The causes of child/adolescent harmful sexual behaviours are multi-factorial involving socio-cultural, environmental, familial, interpersonal and developmental factors. These are unique in every case. Where a concern exists about sexualised behaviour in children or young people it is important that this is looked at within a holistic context and that staff are able to access appropriate case discussion from a specialist worker, and if necessary assessment interventions, quickly and efficiently. This includes the need to actively consider whether the child or young person displaying the behaviour needs safeguarding themselves.

When exploring harmful sexual behaviour risks it is important to consider that:

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; - Alternatively:
• Most pre-adolescent children displaying harmful sexual behaviour have themselves been sexually abused or experienced other kinds of trauma or neglect.
• All children, including the instigator of the behaviour, need to be viewed as victims;
• Children have greater access to information about sex through technology and this has had an impact on their attitudes to sex and sexual behaviour;
• Children with harmful sexual behaviours who receive adequate treatment are less likely to go on to commit abuse as an adult 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 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.

Harmful sexual behaviour is characterised by a range of behaviours that can include:

• Sexual name-calling;
• Sexual harassment;
• Online sexual bullying;
• Sexual image sharing;
• Sexual assault;
• Rape.

In considering the question of harm, practitioners must also consider harm to the child or young person displaying the behaviour themselves as well as to the alleged/perceived “victim”. If there is felt to be a significant risk to the child or young person themselves from their own behaviour then consideration must be given to Local Safeguarding Board Procedures.

There are no diagnostic indicators in personal or family functioning that indicate a predisposition towards sexual offending although the following characteristics have been found in the background of some young people who sexually offend:

• Attachment disorders - poor nurturing and parental guidance;
• Domestic abuse;
• Previous sexual victimisation - a younger age at the onset of the abuse is more likely to lead to sexualised behaviour;
• Social rejection and loneliness;
• Poor empathy skills.

Many of these factors exist alongside typical family environments where other forms of abuse are present and children will often have experienced some form of trauma.

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. 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.

See Further Information for a range of resources and organisations that will support professionals to identify sexual behaviours from inappropriate to problematic to abusive and respond appropriately.

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.

Keeping Children Safe in Education (DfE) reflects that all staff working with children are advised to maintain an attitude of 'it could happen here' and that it can occur between two children of any age and sex, from primary through to secondary stage and into colleges. A friend may make a report or a member of school or college staff may overhear a conversation that suggests a child has been harmed or a child's own behaviour might indicate that something is wrong and these should be acted upon.

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 referred to Children's 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 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 Justice 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.

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.

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.

See also: Addressing Child-on-Child Abuse: a Resource for Schools and Colleges (Farrer and Co.). This is intended to be used as a resource and reference document for practitioners – to consult as and when required and to the extent needed, and to help them navigate whichever area(s) of child-on-child abuse they are dealing with.

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. 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 program 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:

1. Motivation to sexually abuse – this can arise from a number of sources which vary with the individual;
2. Overcoming internal inhibitions – most young people who sexually abuse are aware of the taboos against this behaviour, yet because of their experiences or a specific set of circumstances, they can overcome these;
3. Overcoming external inhibitions – this can include grooming the victim and involve creating the physical opportunity to commit the offence;
4. Overcoming the resistance of the child – the offender will employ a variety of methods to commit the offence and equally important keep the victim quiet. These may include bribery, threats or other forms of coercion.

Exploring behaviour using this model may help open up discussion and avoid the pitfalls of falling into asking too many "why" questions. Instead, open questions should be used such as "tell me", "explain to me", "describe to me."

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 provision that the victim and specific incidents are not discussed.

Legislation, Statutory Guidance and Government Non-Statutory Guidance

Keeping Children Safe in Education Part Five: Child on Child Sexual Violence and Sexual Harassment

Safeguarding Children as Victims and Witnesses (Crown Prosecution Service)

Pre-Trial Therapy (inc Annex A: Specific Considerations for Children)  (Crown Prosecution Service)

Useful Websites

Key messages from research on children and young people who display harmful sexual behaviour

Harmful Sexual Behaviour Framework: An Evidence-informed Operational Framework for Children and Young People Displaying Harmful Sexual Behaviours (Research in Practice)

Children and Young People Presenting with Harmful Sexual Behaviours: a Toolkit for Professionals (The Children's Society)

Children and Young People who Engage in Technology-assisted Harmful Sexual Behaviour (NSPCC)

Addressing Child-on-Child Abuse: a Resource for Schools and Colleges (Farrer and Co.)

Harmful Sexual Behaviour - NSPCC research and resources

Beyond Referrals: Harmful Sexual Behaviour

Tackling Child Exploitation Resources on Harmful Sexual Behaviour (Contextual Safeguarding Network)

Helping education settings identify and respond to concerns (csacentre.org.uk) - when they have concerns of child sexual abuse or behaviour.

Sibling sexual behaviour: A guide to responding to inappropriate, problematic and abusive behaviour (csacentre.org.uk)

Child Protection Resources from Stop It Now - includes a range of publications on preventing abuse among children & young people including online

Brook Traffic Light Tool Training - Please note: The Traffic Light Tool and training has undergone extensive review and development in 2020. Brook no longer supports previous versions of the Tool

The Northamptonshire Tackling Child Sexual Exploitation Toolkit

The Northamptonshire Safeguarding Children Partnership's Child Sexual Exploitation (CSE) Assessment Form

Northamptonshire RISE Team