Harmful sexual behaviours

Harmful sexual behaviour is the overarching term for any sexual behaviour by a child outside the ‘normal’ range for their age and level of development. Children are responsible for nearly 14% of all child sexual abuse in Australia and this rate appears to be increasing (Mathews et al. (b)).

Most harmful sexual behaviour involves children who are well known to each other with many cases involving siblings or close relatives such as cousins (Yates and Allardyce).

Each child who engages in harmful sexual behaviours has experienced a unique pathway and combination of factors contributing to their behaviour. 

Child sexual development

It is typical for children to engage in a range of sexual behaviours throughout their childhood. These behaviours become harmful when they move beyond curiosity and healthy development into behaviours that cause disruption, harm or risk to the child or other children. 

Understanding behaviours of concern

Sexual behaviour by children is commonly conceptualised as either developmentally expected, or harmful. To be considered harmful, the sexual behaviours must be concerning, problematic or abusive within the context they occurred. 

Look beyond an initial categorisation of the specific behaviour and extend the focus to opportunities for early intervention. 

If the focus is only given to deciding the categorisation of the behaviour, the following practice errors can occur:

• labelling or stigmatising the child based on their behaviour, without appropriate consideration of the child’s context, increasing risk of future sexual abuse or exploitation
• contextual risk factors and the potential for changes in the child’s behaviours over time can be overlooked 
• misinterpretations or conflicting perspectives amongst professionals about the level of risk due to reliance on categorisation without specific behaviours and their context identified for consideration.

Seek to understand the nature, context, and extent of reported behaviours to accurately determine the level of concern, harm and risk. Do this by exploring: 

• potential behavioural drivers and pathways for the child 
• the level of risk indicated by the behavioural history 
• the child’s developmentally expected behaviours 
• whether the behaviours are concerning, problematic, or harmful
• the responses which have already occurred.

Even behaviours which are developmentally expected should receive an empathetic and proportionate response from a safe adult caregiver.

Plan responses which uphold the child’s dignity and worth, while providing them care, connection and compassionate accountability. Ground responses using the following primary considerations:

• Early intervention provides the best opportunity for preventing escalation.
• Recognise the potential negative impact the behaviours displayed have on the social and emotional development of each child involved. 
• The safety of all children is paramount, but the safety and wellbeing of any child who has been harmed by another child must be prioritised in the immediate period. 
• Recognise the diversity of children regarding the nature of the behaviour, the social context of their lives and their uniquely experienced strengths, challenges, and needs.
• The developmental stage of the child who has engaged in harmful sexual behaviours determines their level of responsibility and required interventions.
• The principles of family inclusion (rather than an individualistic focus on the child’s behaviour) to structure effective intervention.
• How to support a child’s healing and recovery in the context of their relationships with significant others.
• Provide guidance to support the child to develop healthy and respectful understandings of sexual behaviour and development.
• Collaborate by partnering with families, schools, therapeutic supports and other relevant services.

(Thompson et al.)

Language guide

‘Language is not neutral; it is loaded with meaning. It communicates to others how we as individuals, and as representatives of an organisation, interpret, evaluate, and make sense. Being aware of the language we choose and the way in which we use it can be critical in determining whose view of ‘reality’ we are accepting, what power relations we wish to reinforce, what kind of world we wish to adopt, and the type of social work we wish to create.’ (Hawkins et al.)

Children engaging in sexual behaviours can be challenging and confronting for adults. The ways adults respond to children and how they understand a child’s sexual behaviour is influenced by personal values, understanding of sexual abuse and family opinions. The language used by professionals, family and media can influence how parents and caregivers respond to a child. This may result in inaccurate or biased documentation and disproportionate decision-making that fails to account for the full context and needs of children involved. 

When a child is given a label, these often infiltrate into their identity and they behave in ways to match. 

Highlight and promote other, healthy aspects of the child’s identity in conversations with the child, their family and other professionals. 

Why a child may engage in harmful sexual behaviour 

For intervention to prevent a child engaging in harmful sexual behaviour, use an ‘unmet need’ approach. Consider the challenging behaviour as a means of fulfilling the child’s need, as depicted in this iceberg diagram. 

Children who experience unmet needs or developmental disruption may experience a series of drivers which set them on a pathway to harmful sexual behaviours. Research identifies the following common drivers:

• experiences of domestic violence
• exposure to pornography
• disrupted attachments
• experiencing child sexual abuse
• hypermasculinity
• sexual arousal
• antisociality
• experiences of emotional or physical abuse
• inadequate sexual boundaries
• sexual attraction to children (McKibbon et al.).

Not all children with these experiences will develop harmful sexual behaviours and these experiences do not cause harmful sexual behaviours. However, when they intersect with other psychosocial vulnerabilities and situational risk factors, they can increase the risk harmful sexual behaviour may occur. 

Children with disabilities or neurodiverse conditions  

Children with a disability or neurodiverse condition are more vulnerable, increasing their risk when associated with harmful sexual behaviours. These children often: 

• lack support and education about sexual development and relationships
• face social isolation or exclusion from same-aged peers, increasing their contact with younger children
• may misinterpret or social cues, creating barriers to understanding consent.

Often, a child may seek out online resources to answer their questions, inadvertently increasing their risk of encountering pornography that is harmful or unsafe for their developmental capability. (Refer to the practice kit Disability.) 

Sibling harmful sexual behaviour

Sibling harmful sexual behaviour is the most common form of intra-familial sexual abuse (Yates and Allardyce). Female siblings under 10 are the most common victims of sibling harmful sexual behaviour (Pratt et al.). 

Like all other forms of harmful sexual behaviour, sibling harmful sexual behaviour can:

• be as harmful as sexual abuse by an adult
• have both short and long-term consequences for the child’s physical and mental health 
• lead to relationship difficulties throughout their lifetime with the impact be hidden until adulthood. 

Sibling harmful sexual behaviour is commonly a symptom of a fundamentally dysfunctional family system, and often occurs in those homes where the children are experiencing other forms of adversity. Research suggests the following experiences, characteristics and family environments increase vulnerability to sibling harmful sexual behaviour:

• intergenerational trauma
• family instability
• domestic and family violence
• power imbalances between children
• previous sexual victimisation of the children involved
• neglect, particularly lack of supervision
• parental experiences of childhood maltreatment
• inadequate sexual education
• parental mental illness or substance use.

Assess safety and risk

Assessing safety and risk when harmful sexual behaviours have occurred requires a comprehensive and holistic approach. Look at the incidents and identify patterns of behaviour, and the full context and circumstances around the behaviours that occurred. 

Use the following questions to guide gathering of contextual and holistic information:

Safety planning and harmful sexual behaviours 

Safety planning when a child has engaged in harmful sexual behaviours relies on having adequate measures to ensure supervision, privacy, boundaries and consent exist to reduce opportunities for future harmful sexual behaviours to occur. 

Safety and support plans must account for the nature of harm that has occurred and consider the emotional and psychological wellbeing of the children involved. Ensuring safety requires a clear and planned approach to communication and information sharing with children and between those involved in the care, therapeutic support and case management of each of the children. 

Use the following prompts to guide information gathering when determining if a child who has engaged in harmful sexual behaviours should remain at home during the assessment period.

The child who has engaged in harmful sexual behaviours is:

• currently safe from abuse (physical, emotional, sexual) and neglect
• able to understand and follow the safe family rules
• able to understand why the safety and support plan has been put in place
• receiving appropriate therapeutic treatment and support to change behaviour 
• not intimidating or causing fear to the child who was sexually abused or their parents.

The child who was sexually abused:

• is currently safe from abuse (physical, emotional, sexual) and neglect
• is not fearful of the child who engaged in harmful sexual behaviours
• has had their experience of abuse believed and validated by the adults providing them care
• understands what behaviours cause harm to themselves or others 
• understands the safety and support plan and the reasons it has been created 
• can identify their emotions and signs they are not safe
• demonstrates trust that the adults providing them care, and other members of their safety and support network, will follow the safety and support plan 
• can identify members of the safety and support network whom they will tell if they feel worried or unsafe, and who they are confident will believe them and take action.

The parents, along with the safety and support network:

• accept and acknowledge the harmful sexual behaviours
• accept and acknowledge the likely impact the sexual abuse has on the victim
• are not abusing, neglecting, or causing harm to other children 
• can provide an environment free from harmful sexual behaviours and any known triggers. For example, domestic violence, sexualised language or acts, access to drugs or alcohol, or pornography
• are not fearful of the child who engaged in harmful sexual behaviours and demonstrate limits applied to manage the child’s (non-sexual) behaviour where necessary
• demonstrate ability and willingness to implement the safety plan
• demonstrate effective supervision for the child who has engaged in harmful sexual behaviours
• can maintain connection to the child who was sexually abused and notice and respond appropriately to their cues of distress
• can maintain connection to the child who engaged in harmful sexual behaviours.

Supervision

Supervision is the active process of observing, guiding, and ensuring the safety and wellbeing of a child in your care. Determine the specific supervision required for a child who has displayed harmful sexual behaviours based on the level of risk, circumstances, triggers, and context for the individual child’s circumstance. 

Supervision may often be required to extend outside of the home, for example during outings, transport and at school. Plan which capable adult can provide this supervision considering each of the environments where the child may engage in harmful sexual behaviours. 

As the child who has engaged in harmful sexual behaviours develops new skills and demonstrates internalised control, the level of supervision can be adjusted. When changes to the level of supervision are being considered, involve the child, their care team and other professionals as participants to this decision making process. 

The supervision of a child who has engaged in harmful sexual behaviours should seek to achieve three key purposes set out in the following table:

Safe household roles

A key component of safety planning in the harmful sexual behaviour context is the creation and enforcement safe household rules – a set of agreements between those living in the home about how they will behave, interact and relate to each other. The development of these rules must involve all children and caregivers and must consider the realistic capability children and adults in the home have to follow the rules. The plan must also include clear agreements for what will happen if the rules are not followed.

Safe household rules need to consider the nature and context of harmful sexual behaviours that have occurred, and high-risk situations identified through assessment of patterns of behaviour. (Refer to Safe household rules.)

Communication strategy

Clear expectations for communication and agreements about roles and responsibilities should be established and documented to facilitate review of the safety and support plan and inform an ongoing assessment of risk. A crucial component of communication in the context of harmful sexual behaviours is ensuring all stakeholders have a shared understanding of the behaviour and risk to establish clear goals and ways of working together.

Make decisions about care arrangements

When deciding care arrangements for a child who has engaged in harmful sexual behaviours, consider the risk factors identified at that time, using the available knowledge. This process should consider the child’s views and involve consultation with other relevant professionals.

Regularly review the care arrangement and re-assess the risk modifying safety and support plans, arrangements, placement agreements and case plans as required. Review any decision for a child not to live with other children at least every 3 months, and whenever there is any other significant change in their circumstance.  

Care arrangements for children who have engaged in harmful sexual behaviours need to consider a range of complex factors including the safety and wellbeing of the child, potential risks to other children, the capacity of caregivers to protect and care for all relevant children, and management of any other environmental factors that may contribute to risk. Also consider what supports the care arrangement needs to ensure carers have the skills and knowledge to provide necessary care and supervision for children in the home.

Decision-making needs to balance the need to mitigate risks associated with harmful sexual behaviours alongside the rights of the children and promoting their wellbeing needs. 

Support the child’s right to connection and belonging

Research suggests secure, enduring attachments to family and pro-social networks can mitigate against the risk of a child engaging in further harmful sexual behaviours. Secure relationships across all domains (at the individual, family, school, peers and community levels) foster honest and respectful attitudes and care and concern for others (Quadara et al. (b)). Living with other children can provide opportunities for healing, connection and empathy that can contribute to reducing risk factors associated with persistent or recurring harmful sexual behaviours. 

Separation from siblings is reported by children with care experiences as one of the most significant losses they experience, characterised by trauma and grief. The impacts of this separation often have lasting detrimental effects into adulthood, including anxiety, depression and relational ambivalence. As such, siblings living together should be promoted whenever safe and possible.

Balance safety and connection

Balancing children’s needs for safety, protection and connection requires careful assessment and planning. Research indicates that the safety of children in residential care was most often compromised by other children in the care arrangement, however, children reported feeling most safe when they were with positive peers and felt some sense of belonging (Moore et al.). 

The Royal Commission found significant risks of possible sexual abuse exist when children who have engaged in harmful sexual behaviours are placed with other children who have experienced abuse. The risk of sexual abuse was found to be exacerbated by children lacking knowledge about appropriate relationships and sexual behaviour, and staff having a lack of awareness of age-appropriate behaviour.

The Royal Commission highlighted the need for residential care to offer a safe, supportive and therapeutic environment, staffed by care workers with skills relevant to preventing and addressing abuse. It also highlighted that particular care should be shown when determining appropriate care arrangement for children with harmful sexual behaviours. Institutional responses to child sexual abuse in out-of-home care found to often be compromised by a failure to address systemic risks, incomplete assessment and management of risks, failure to create a culture that supports disclosures, poor responses to child sexual abuse disclosures, and failure to share information.

In assessing the suitability of a care arrangement environment for a child with harmful sexual behaviours, consider:

• the characteristics and needs of each of the children
• the behavioural history of the child with harmful sexual behaviour 
• suitability of the care arrangement
• environmental care arrangement factors.

Characteristics and needs of each of the children

Making decisions about care arrangements for children who have engaged in harmful sexual behaviours requires a thorough assessment of the individual and interpersonal vulnerabilities of each of the children. Some experiences and characteristics may create additional vulnerabilities for children living in a home with a child who has engaged in harmful sexual behaviours. 

Behavioural history

In assessing the care arrangement needs of children who have engaged in harmful sexual behaviours, consideration should be given to the nature and context of the child’s history of behaviour. Assessment of these factors will include behavioural factors both related to, and distinct from, the child’s sexually harmful behaviour. 

Consider seeking a comprehensive assessment by a suitably qualified professional to develop an understanding of the risk factors contributing to the young person's harmful sexual behaviours, including the risk behaviours and potential triggers or high-risk factors for the child. This assessment can be considered when deciding whether the child can live with other children.

Suitability of the care arrangement 

Considering whether a child who has engaged in harmful sexual behaviours can live with other children requires an assessment of their individual care needs and the capability of the adult providing care. 

A key component of healing is the creation of positive environments for their social, emotional and cultural wellbeing. Enhancing connection and relationships is integral to any effective intervention with children with harmful sexual behaviours (Rich). 

Supporting the child to maintain and develop connections should be viewed as an urgent priority. This includes providing opportunities for children with harmful sexual behaviours to live with their siblings or other children when safe and possible. While supporting a child’s need for connection and belonging should always be a priority, arrangements for their time with siblings, family and peers must account for the identified risk factors.

For Aboriginal and Torres Strait Islander children, research for the Royal Commission found being strong in culture is protective as a source of resilience and healing. 

Environmental care arrangement factors

Situational factors, such as the institutional context of residential care arrangements, are often more influential in shaping decision-making around harmful sexual behaviours than the individual attributes of the child (O’Brien). These factors can create both opportunities for offending and triggers for existing vulnerabilities. 

Since harmful sexual behaviours are more likely to be impulsive than compulsive (Chaffin et al.), the care environment must focus on identifying and preventing situations that may lead to impulsive behaviours.

Review living arrangements for a child who has engaged in harmful sexual behaviours

If it is decided a child who has engaged in harmful sexual behaviours is not to reside with other children, or they are to be separated from a child who they were living with, consider the impact this may have on their wellbeing, specifically, their emotional and psychological support needs during this time.

Immediate consideration should be given to the change in circumstances required for the child to be safely placed with other children in future. According to the Australian Childhood Foundation, children who engage in harmful sexual behaviours have most often experienced relational trauma and betrayal of trust. Practitioners should respond with this in mind when developing plans that address their unique therapeutic needs. 

Ongoing assessment and review of care arrangements should occur and must consider and document of how the child, their care team and other professionals perceive the following factors:

• the child’s current understanding of their sexually harmful behaviour, including any secretive, coercive, threatening or forceful behaviours they may have used to facilitate the behaviour
• the understanding each child proposed to live together has about protective behaviours
• the child who has engaged in harmful sexual behaviours willingness to desist from future harmful sexual behaviours
• the presence of other risk factors for the child who has engaged in harmful sexual behaviours, including violence, impulsivity, antisocial behaviour, use of pornography, sexual exploitation and substance use
• the child who has engaged in harmful sexual behaviours attitudes about gender, sex, power and violence
• the vulnerabilities of any other child proposed to live in the home
• the capacity of the carers to support the children following safe household rules
• the capacity of the carers to identify and suitably respond to behaviours of concern including harmful sexual behaviours and other forms of abusive behaviour
• the capacity of the carer to identify and intervene in any concerning patterns of interaction between children
• the capacity of the carers to provide therapeutic responses to all children proposed to live in the care arrangement
• existing and required supports to assist the carer managing safety in the home
• the suitability of the physical care environment.

Once the care team has developed a shared understanding of factors creating an unacceptable level of risk, a shared plan should be developed with clear actions and responsibilities to address identified high-risk factors. 

Reducing risk

It is increasingly recognised that responses to harmful sexual behaviours should include a focus on the behaviours of concern, supported by attention to enhancing the child’s broader life skills, addressing social isolation, increasing access to education, addressing family problems and improving the young person’s relationships with caregivers (Hackett). 

Positive long-term relationships are crucial in assisting children with desistence from harmful sexual behaviours. Interventions for children who have engaged in harmful sexual behaviours should be tailored to the specific needs of the child and family.

Rehabilitative approaches should be used to enhance protective factors, promote stable and supportive relationships, and help children develop personal competence and healthy lifestyles. In reducing risk and building resilience, it is important that children are not labelled and stigmatised unnecessarily.