Harmful Sexual Behaviour

CONTEXT

Harmful sexual behaviour (HSB) is the term used for developmentally inappropriate sexual behaviour which is displayed by children and young people and which may be harmful or abusive. Sexual abuse perpetrated by children can be just as harmful as that perpetrated by an adult, so it is important to remember the impact on the victim of the abuse as well as to focus on addressing the needs of the child or young person exhibiting the harmful sexual behaviour. Practitioners also need to remain aware however of the negative effect of labelling children and young people as 'young sex offenders' or 'young abusers'.

Sexual abuse is defined in Working Together to Safeguard Children as:

"Involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening. The activities may involve physical contact, including assault by penetration (for example, rape or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing. They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual images, watching sexual activities, encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet). Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children".

Professor Simon Hackett's research review published by Research in Practice in 2014 showed that:

  • Children and young people account for about a quarter of all sexual abuse convictions against victims of all ages (Vizard, 2004) and a third of all sexual abuse coming to the attention of the professional system in the UK (Erooga and Masson, 2006);
  • In many cases, children and young people occupy dual identities as perpetrator of abuse and victim of harm;
  • The average age of children being referred for therapeutic interventions as a result of their sexual behaviour is dropping and a significant proportion of referrals concern children in their pre-adolescent years;
  • Increase in sexual behaviours online but young people with these behaviours may not share the backgrounds and risk profiles of those who commit contact sexual offences;
  • Young people with a disability are a particularly vulnerable group and young people with ASD are over represented in internet enabled sexual offences.

The purpose of this guidance is to provide an operational framework in respect of children and young people who display HSB and their alleged victims. Where possible this is in line with the NICE Guidance around Harmful Sexual Behaviour and also the NSPCC Protecting Children from Harmful Sexual Behaviour.

AMENDMENT

In August 2022, a link to the Children's commissioner report Talking to Your Child About Online Sexual Harassment was added in Further Information.

1. Definition

'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.

An Ofsted thematic review (Review of Sexual Abuse in Schools and Colleges (Ofsted)) detailed concerns around sexual child-on-child 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').

2. Risks

  • 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 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.

3. Indicators

There are no diagnostic indicators in personal or family functioning that indicate a pre-disposition 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 violence and abuse;
  • Previous sexual victimisation - a younger age at the onset of the abuse is more likely to lead to problematic 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.

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 How to Tell if a Child's Sexual Behaviour is Age Appropriate).

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.

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.

The Review of Sexual Abuse in Schools and Colleges (Ofsted) identified that most children would not report incidents (for a variety of reasons) and many educational establishments were 'unaware' of the significant level of sexual harassment and sexual violence.

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 Childrens Social Care which may require a referral and further assessment (see Referrals Procedure).

The Children's Services 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 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.

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.

5. Issues

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 proviso that the victim and specific incidents are not discussed.