Protecting children from harmful sexual behaviour

Introduction

What is harmful sexual behaviour?

Harmful sexual behaviour (HSB) is developmentally inappropriate sexual behaviour which is displayed by children and young people and which may be harmful or abusive (derived from Hackett, 2014). It may also be referred to as sexually harmful behaviour or sexualised behaviour.

HSB encompasses a range of behaviour, which can be displayed towards younger children, peers, older children or adults. It is harmful to the children and young people who display it, as well as the people it is directed towards.

Technology assisted HSB

Technology assisted HSB (TA-HSB) is sexualised behaviour which children or young people engage in using the internet or technology such as mobile phones. This might include:

viewing pornography (including extreme pornography or viewing indecent images of children)
sexting

(Hollis and Belton, 2017).

> Find out more about sexting

Resources for health practitioners and schools

We have a range of resources specially created for professionals working in health and educational settings.

Watch: the role of health in recognising HSB

> View our resources on harmful sexual behaviour for the health sector

Managing sexualised behaviour in schools

> Listen to our episode on responding to harmful sexual behaviour in educational settings

> Tune into our episode on assessing sexualised behaviour

> Find out more about our online training courses about harmful sexual behaviour in schools

> Read our CASPAR briefing on the guidance for schools and colleges in England on sexual violence and sexual harassment between children

Recognising

Recognising harmful sexual behaviour

Signs and indicators

Children and young people demonstrate a range of sexual behaviours as they grow up, and this is not always harmful.

Sexualised behaviour sits on a continuum with five stages:

appropriate – the type of sexual behaviour that is considered 'appropriate' for a particular child depends on their age and level of development
inappropriate – this may be displayed in isolated incidents, but is generally consensual and acceptable within a peer group
problematic – this may be socially unexpected, developmentally unusual, and impulsive, but have no element of victimisation
abusive – this often involves manipulation, coercion, or lack of consent
violent – this is very intrusive and may have an element of sadism

(Hackett, 2010).

A child's behaviour can change depending on the circumstances they are in, and sexual behaviour can move in either direction along the continuum. So it's important not to label all of a child's behaviour as belonging to one category.

Deciding if behaviours are healthy or age-appropriate

It’s not always easy to distinguish whether a behaviour is healthy or age-appropriate.

> Find out more about developmentally healthy stages of sexual behaviour

We’ve produced some guidance to help professionals decide what kind of sexualised behaviour a child or young person might be displaying.

Although this is aimed at health practitioners, it will be helpful for people in any sector.

> View our guidance about HSB for health practitioners

Risks and vulnerability factors

Experience of abuse and neglect

Many children and young people who display HSB have experienced abuse or trauma (Hackett et al, 2013).

Children who have been sexually abused may not know that what has happened to them is wrong. This can lead to them displaying harmful sexual behaviours towards others (Ringrose et al, 2012).

Complex needs

Children and young people who display HSB may have complex needs and may display other behavioural problems alongside their HSB (Hollis, 2017).

For example, children who display harmful sexual behaviour may:

have poor self-regulation and coping skills
experience social anxiety and a sense of social inadequacy
have poorly internalised rules for social behaviour
have a poorly developed sense of morality
lack secure and confident attachments to others
have limited self-control and act out emotional experiences through negative or otherwise inappropriate behaviour
have little insight into the feelings and needs of others or their own mental states
place their own needs and feelings ahead of the needs and feelings of others
show a poorly defined sense of personal boundaries
have developed strong and not easily corrected cognitive distortions about others, themselves, and the world they share
have deficits in social skills and in social competence overall

(Rich, 2011).

> Find out more about the characteristics of young people who display HSB in our statistics briefing

> Tune into our episode to find out why it's important educational institutions are aware of HSB

Responding

Responding to harmful sexual behaviour

If a child's sexual behaviour is not healthy or age-appropriate, it's important to respond quickly before the behaviour becomes harmful to that child or other children.

> Take our online training on harmful sexual behaviour in schools

> Read our CASPAR briefing on the guidance for schools and colleges in England on sexual violence and sexual harassment between children

Reporting

If you think a child is in immediate danger, contact the police on 999. If you're worried about a child but they are not in immediate danger, you should share your concerns.

Follow your organisational child protection procedures. Organisations that work with children and families must have safeguarding policies and procedures in place.
Contact the NSPCC Helpline on 0808 800 5000 or by emailing help@nspcc.org.uk. Our trained professionals will talk through your concerns with you and give you expert advice.
Contact your local child protection services. Their contact details can be found on the website for the local authority the child lives in.
Refer the child or young person for therapeutic support. For example, from our Turn the Page service.
Direct children and young people to Childline if they would benefit from confidential advice and support. Calls to 0800 1111 are free and children can also contact Childline online or get information and advice on the Childline website. You can download or order Childline posters and wallet cards to keep on display and give to children and young people.

> See our information about recognising and responding to abuse

Assessment

Professionals working with children and young people who display HSB should use a mix of both specialist risk assessment tools for HSB and more generic assessment models. They should consider each child's developmental history, family background and any broader child protection concerns (Hackett, Branigan and Holmes, 2019).

> Listen to our episode on assessing sexualised behaviour

Framework for a multi-agency approach

The Harmful sexual behaviour framework aims to support multi-agency local work with children and young people who have displayed HSB.

The framework was developed by the NSPCC, Research in Practice and Professor Simon Hackett, with input from a large number of national organisations, local authorities and subject experts.

The framework uses a joint local approach, involving:

staff with a strategic role in coordinating child protection and local HSB responses
commissioners of local child protection and HSB services
those with a wider safeguarding remit and audit responsibility, such as chairs and members of Local Safeguarding Children Boards (LSCBs) and local safeguarding partners.

Support in using the framework

We’ve developed a support package to complement the framework and audit tools. If you’d like more information please email HSBFramework@NSPCC.org.uk.

> Find out more about the Harmful sexual behaviour framework

Prevention

Preventing harmful sexual behaviour

Teaching children about healthy relationships

Society and culture have a big impact on what children think about sex and sexuality. What they see and read on television, the internet and in other media can reinforce these ideas and can contribute to children and young people becoming sexualised early on in their lives – or may normalise non-consensual sexual activities.

Schools have an important role in challenging these ideas and teaching children about healthy relationships and behaviours (Champion, 2016; House of Commons Women and Equalities Committee, 2016).

> Find out more about promoting healthy relationships

> Read our guidance on having difficult conversations with children and young people

Giving children a voice

It’s vital to build safe and trusting relationships with children so they can speak out about any problems they are experiencing. This involves teaching children what abuse is and how they can get help.

Our Speak out Stay safe service for schools helps children understand abuse in all its forms and encourages them to seek help if they need to.

> Find out more about Speak Out Stay Safe

Direct work

Direct work with children affected by harmful sexual behaviour

Tailoring support to the needs of the child

It’s important that professionals working with children and young people who display HSB take a holistic approach, using a range of responses tailored to each child. Consider:

the child's age
the child’s stage of development
the level of risk and need

(Hackett, Branigan and Holmes, 2019).

For example, some children and young people's needs can be met through parental monitoring and work on positive social behaviour, while others need therapeutic support and specialist services (Hackett, Branigan and Holmes, 2019).

It's important to promote stable and supportive relationships, self-awareness, self-management and a healthy lifestyle.

Interventions for HSB should be:

strengths-based - building on the skills and ability the child or young person has
supportive - creating an environment where young people feel safe to talk
multi-modal - addressing issues within the whole context of the young person’s life as well as working individually with them
focused on resilience - with an emphasis on identifying factors that improve a young person's strengths and enabling them to understand what influences their behaviours
collaborative - using professional networks to make best use of different people’s expertise

(Hackett, Branigan and Holmes, 2019).

> Find out more about harmful sexual behaviour in schools

Considering both 'offline' and online behaviours

It's important to consider both 'offline' and online behaviours when assessing children and young people who display HSB, rather than treating these behaviours separately (Hollis and Belton, 2017).

Strategies for direct work

Some useful strategies in direct work include:

narrative techniques to allow children who display HSB to create space between themselves and the problem, and evaluate their position (Walker and Laugharne, 2016)
metaphor/visual techniques to help children understand complex ideas relating to sex and sexuality while minimising feelings of shame and embarrassment (Mickshik and Sam, 2016)
practical strategies to help children and young people to manage their behaviour (Belton, 2017)
social skills development: to teach children and young people how to apply the concepts of socially acceptable behaviour in practice - for example learning when it is appropriate to have physical contact by hugging someone (Rogers, 2016).

Working with parents

Parents and carers need support alongside the therapeutic service for children and young people (Belton, 2017).

Forming a therapeutic relationship as a family can help develop problem solving and communication skills to help restructure and unite families (Yoder and Ruch, 2016).

Post-programme support

Having post-programme support in place will help young people who display HSB to continue the techniques they have been taught after their therapeutic support ends (Belton, 2017).

Services to help children

Our Turn the Page service helps children and young people understand and manage their own harmful sexual behaviour. The service focuses on strengths, to help children and young people feel better about themselves and learn to handle problems positively. It also includes families in the therapeutic process, to encourage moving on from the harmful sexual behaviour together.

> Find out more about Turn the Page

Our National Clinical Assessment and Treatment Service (NCATS) is a national service that provides consultations, assessments and a range of specialist interventions for children and young people displaying HSB. We can also provide tailored training to social care.

> Find out more about NCATS

Legislation and guidance

Key guidance

England, Northern Ireland, Scotland and Wales each have their own legislation and guidance about how professionals must respond to child abuse and protect children from harm. These include key messages for practice for professionals working to safeguard children at risk of harmful sexual behaviour.

Guidance for the education sector

In England, Keeping children safe in education (Department for Education, 2020) advises professionals in the education sector on how best to respond to harmful sexual behaviour (referred to in the guidance as peer on peer sexual abuse).

The Department for Education (DfE) has also provided advice for schools and colleges on how to prevent and respond to reports of sexual violence and harassment between children (DfE, 2018).

In Northern Ireland, Safeguarding and child protection in schools: a guide for schools contains information on children who display harmful sexualised behaviour (Department of Education, 2019).

Guidance for other sectors

In England, Harmful sexual behaviour among children and young people (National Institute for Health and Care Excellence (NICE), 2016) provides guidance for professionals on responding to children and young people who display harmful sexual behaviour, including those on remand or serving community or custodial sentences. It aims to ensure these problems don't escalate and possibly lead to them being charged with a sexual offence. It also aims to ensure no-one is unnecessarily referred to specialist services.

In England and Wales the Home Office provides guidance for police and practitioners on Part 2 of the Sexual Offences Act 2003. This includes the requirements for children and young people who have been convicted of sexual offences to keep agencies informed of their whereabouts (the notification requirements) (Home Office, 2018).

In Northern Ireland, Co-operating to safeguard children and young people in Northern Ireland has sections on peer abuse and harmful sexual behaviour (Department of Health, Social Services and Public Safety, 2017).

In Scotland, the National guidance for child protection in Scotland (Scottish Government, 2014) includes sections on responding to children and young people who display harmful or problematic sexual behaviour, and underage sexual activity. The National guidance - under-age sexual activity: meeting the needs of children and young people and identifying child protection concerns (Scottish Government, 2010) is designed to be used alongside the National guidance in Scotland.

The All Wales Protocol: The management of young people engaged in sexually harmful behaviour (PDF) (All Wales Child Protection Procedures Review Group, 2012) sets out the co-ordinated multi agency, collaborative approach between child welfare and criminal justice agencies. It recognises that children and young people engaged in sexually harmful behaviour are likely to have considerable needs themselves, and also may pose significant risk of harm to others.

Sexting

Creating or sharing explicit images of a child is illegal, even if the person doing it is a child. However national guidance highlights the need to prioritise safeguarding issues rather than criminalising young people.

As of January 2016 in England and Wales, if a young person is found creating or sharing images, the police can choose to record that a crime has been committed but that taking formal action isn't in the public interest.

> Read our advice for professionals on how to respond to sexting incidents

References and resources

All Wales Child Protection Procedures Review Group (2012) All Wales Protocol: The management of young people engaged in sexually harmful behaviour (PDF) [Accessed 29/08/18].

Belton, E. (2017) Turn the Page: manualised treatment programme: final evaluation report. [London]: NSPCC.

Champion, S. (2016) National action plan for preventing child abuse and violence in teenage relationships (PDF). [London]: Sarah Champion MP.

Department for Education (DfE) (2020) Keeping children safe in education. London: Department for Education.

Department for Education (DfE) (2018) Sexual violence and sexual harassment between children in schools and colleges. London: DfE.

Department of Education (2019) Safeguarding and child protection in schools: a guide for schools. Belfast: Department of Education.

Department of Health, Social Services and Public Safety (2017) Co-operating to safeguard children and young people in Northern Ireland. Belfast: Department of Health.

Hackett, S (2014). Children and young people with harmful sexual behaviours. London: Research in Practice.

Hackett, S (2010). Children, young people and sexual violence. In Barter, C and Berridge, D (eds) Children behaving badly? exploring peer violence between children and young people. London: Blackwell Wiley.

Hackett, S. et al (2013) Individual, family and abuse characteristics of 700 British child and adolescent sexual abusers. Child Abuse Review, 22 (4): 232–245.

Hackett, S., Branigan, P. and Holmes, D. (2019) Operational framework for children and young people displaying harmful sexual behaviours. Second Edition. London: NSPCC.

Hollis, V. (2017) The profile of the children and young people accessing an NSPCC service for harmful sexual behaviour: summary report. [London]: NSPCC.

Hollis, V. and Belton, E. (2017) Children and young people who engage in technology-assisted harmful sexual behaviour; a study of their behaviours, backgrounds and characteristics. [London]: NSPCC.

Home Office (2018) Guidance on part 2 of the Sexual Offences Act 2003. London: Home Office.

House of Commons Women and Equalities Committee (2016) Sexual harassment and sexual violence in schools: third report of session 2016–17 (PDF). [London]: House of Commons.

Mickshik, J. and Sam, H. (2016) The gift: a guide to treating children and young people with problematic sexual behaviour. NOTA news, 78: 11-12.

National Institute for Health and Care Excellence (NICE) (2016) Harmful sexual behaviour among children and young people. [London]: National Institute for Health and Care Excellence (NICE).

Rich, P. (2011) Understanding, assessing and rehabilitating juvenile sexual offenders. 2nd edn. New Jersey: Wiley.

Ringrose, J. et al (2012) A qualitative study of children, young people and 'sexting': a report prepared for the NSPCC (PDF). London: NSPCC.

Rogers, E. (2016) A serene setting to address harmful sexual behaviour. Children and young people now, 19 July-1 August: 20-22.

Scottish Government (2010) National guidance - under-age sexual activity (PDF). Edinburgh: The Scottish Government.

Scottish Government (2014) National guidance for child protection in Scotland. Edinburgh: The Scottish Government.

Walker, L. and Laugharne, C. (2016) Helping children to learn about safer sexual behaviour: taking steps to safety: a guide book. London: Speechmark.

Yoder, J. and Ruch, D. (2016) A qualitative investigation of treatment components for families of youth who have sexually offended. Journal of Sexual Aggression, 22 (2): 192-205.