Protecting children from harmful sexual behaviour

Last updated: 04 Sep 2018
Introduction

Harmful sexual behaviour (HSB) is developmentally inappropriate sexual behaviour which is displayed by children and young people. It may also be referred to as sexually harmful behaviour or sexualised behaviour. It can be displayed towards younger children, peers, older children or adults, and 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. As with 'offline' HSB, TA-HSB encompasses a range of behaviours including:

  • viewing pornography (including extreme pornography or viewing indecent images of children)
  • sexting (Hollis and Belton, 2017).
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 is often seen as 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, Holmes and Branigan, 2016).

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.

A tool for considering if behaviours are healthy or age-appropriate
If you're unsure whether a behaviour is healthy or age-appropriate, Brook provides a helpful, easy to use tool that can be used by professionals as well as parents.

Brook’s traffic light system is used to describe healthy (green) sexual behaviours, potentially unhealthy (amber) sexual behaviours and unhealthy (red) sexual behaviours. It also suggests what kind of attention and response you should give to each type of behaviour and what kind of help might be necessary to ensure the child's safety (Brook, 2018).

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), including:

Children who have been sexually abused may not know that what has happened to them is wrong. This can lead to normalisation of 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).
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.

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. 
  • Contact the police.

Services will risk assess the situation and take action to protect the child as appropriate either through statutory involvement or other support. This may include making a referral to the local authority.

> See our information about recognising and responding to abuse

Assessment

Professionals should use a mix of both specialist risk assessment tools for HSB and more generic assessment models to consider each child's developmental history, family background and any broader child protection concerns (Hackett, Holmes and Branigan, 2016).

Framework for a multi-agency approach

The Harmful sexual behaviour framework aims to support 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.

How is the framework organised?

The framework covers five essential domains of developing and delivering an integrated and effective HSB service for children, young people and their families:

  • a continuum of responses to children and young people displaying HSB
  • prevention, identification and early assessment
  • effective assessment and referral pathways
  • interventions
  • workforce development.

Each domain includes:

  • a summary of the latest evidence to support practice and local decision making 
  • an audit tool to help local areas assess the current state of their HSB offer and service responses
  • key principles to consider when focusing on delivery, with practical examples.

The framework should be used alongside the NICE guidelines on harmful sexual behaviour among young people (National Institute for Health and Care Excellence, 2016).

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

National Clinical Assessment and Treatment Service (NCATS)

The National Clinical Assessment and Treatment Service (NCATS), offered by the NSPCC in partnership with Oxleas NHS Foundation Trust, 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 and health agencies, universities or at events across the UK.

We work with boys and girls up to the age of 21. They may have emotional and behavioural disorders, developmental disorders, or learning disabilities.

We have a multi-disciplinary team that includes:

  • four social workers
  • a consultant clinical psychologist
  • a consultant child and adolescent psychiatrist
  • a systemic family therapist
  • a probation professional.

You may wish to refer young people to us:

  • when there is historical and/or persistent harmful sexual behaviour
  • if you require detailed guidance about case management or treatment of HSB cases.

NCATS is based in north London but is available nationwide.

> For more information about NCATS visit the NSPCC website

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) – such as through the personal, social, health and economic education (PSHE) curriculum.

We’ve worked with the PSHE Association to create lesson plans for young people aged 10-16 on personal safety and healthy relationships.

AGENDA is a free online toolkit developed with young people, for young people. It supports them in how they can safely and creatively challenge gender inequalities and oppressive gender norms.

> Find out more about AGENDA

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 know how to protect themselves.

> 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, and use a range of responses tailored to each child, considering:

  • the child's age
  • the child’s stage of development
  • the level of risk and need (Hackett, Holmes and Branigan, 2016).

For example, some children and young people's needs can be met through parental monitoring and work on positive social behaviour, while others need limited therapeutic support. Some children will benefit from more specialist services (Hackett, Holmes and Branigan, 2016).

Interventions for HSB should aim to promote stable and supportive relationships, helping young people develop self-awareness, self-management and a healthy lifestyle. 

Interventions should also 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, Holmes and Branigan, 2016).

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 can help children understand complex ideas relating to sex and sexuality while minimising feelings of shame and embarrassment (Mickshik and Sam, 2016)
  • practical strategies can help children and young people to manage their behaviour (Belton, 2017)
  • social skill development: some children may need to be taught 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

It's also important that support is given to parents and carers 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 is for children and young people aged 5 to 18 and helps them 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.

We’ve evaluated Turn the Page and found:

  • participants saw improvements to their self-esteem, emotional loneliness and sense of mastery over their life
  • the programme helped build an effective relationship between young people and practitioners, which promoted constructive discussions about HSB
    (Belton, 2017).

One young person who participated in the programme told our evaluators:

"The work helped me out a lot. I know rights and wrongs now. It helped explain things so it’s a lot easier now. I know not to touch people unless they want to, that’s why I came here. It changed my life now ‘cos I could have carried on like that."

(Belton, 2017)

 > Find out more about Turn the Page on the NSPCC website

Guidance

Guidance

Key guidance

England, Northern Ireland, Scotland and Wales each have their own guidance for 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, 2018a) and Sexual violence and sexual harassment between children in schools and colleges (Department for Education, 2018b) advise professionals in the education sector on how best to respond to harmful sexual behaviour.

In Northern Ireland, Safeguarding and child protection in schools: a guide for schools (PDF) contains information on children who display harmful sexualised behaviour (Department of Education, 2017).

Guidance for other sectors

In England, Harmful sexual behaviour among children and young people (National Institute for Health and Care Excellence, 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

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].

Barnardo's (2016) Now I know it was wrong: report of the parliamentary inquiry into support and sanctions for children who display harmful sexual behaviour (PDF). Barkingside, Essex: Barnardo's.

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

Brook (2018) The sexual behaviours traffic light tool. [Accessed 13/08/2018].

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

Department for Education (DfE) (2018a) Keeping children safe in education: statutory guidance for schools and colleges (PDF). London: Department for Education.

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

Department of Education (2017) Safeguarding and child protection in schools: a guide for schools (PDF). 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.

Erooga, M. and Masson, H. (2006) Children and young people with sexually harmful or abusive behaviours: underpinning knowledge, principles, approaches and service provision. In: Erooga, M. and Masson, H. (eds.) Children and young people who sexually abuse others: current developments and practice responses. 2nd ed. London: Routledge.

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., Holmes, D. and Branigan, P. (2016) Harmful sexual behaviour framework: an evidence-informed operational framework for children and young people displaying harmful sexual behaviours (PDF). 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.

Welsh Assembly Government (2007) Safeguarding children: working together under the Children Act 2004 (PDF). Cardiff: Welsh Assembly Government.

Welsh Government (2018) Social Services and Wellbeing (Wales) Act 2014: codes of practice and statutory guidance. [Accessed 10/08/18].

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.

Elearning

Our elearning courses can help develop your understanding of how to protect children from abuse.

Managing sexualised behaviour in schools

Support for children and young people

Childline provides information and advice for young people about healthy and unhealthy relationships.

Further reading

Read our learning from case reviews briefing about harmful sexual behaviour.

For further reading about harmful sexual behaviour, search the NSPCC Library catalogue using the keyword "harmful sexual behaviour".

If you need more specific information, please contact our Information Service.

Related NSPCC resources

Read our research briefing about harmful sexual behaviour

Read our report about the profile of the children and young people accessing an NSPCC service for harmful sexual behaviour.

Read our report about sexually harmful behaviour in young children and the link to maltreatment in early childhood.

Read our report about provision for young people who have displayed harmful sexual behaviour.

Read our harmful sexual behaviour framework 

Read our review of the research on children and young people who display harmful sexual behaviour online

Read our report about children and young people who engage in technology-assisted harmful sexual behaviour.

Read our research about children, young people and sexting