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Risk assessment and decision making if a child has sexually reactive behaviours

This part helps practitioners gather information to further understand sexually reactive behaviours (SRB) to inform an appropriate response. It focuses on factors that may influence the reoccurrence of SRB.

Gather information to understand sexually reactive behaviours

Understanding sexually reactive behaviours (SRB) helps practitioners develop a more accurate assessment of the risk posed by the child with SRB, and what interventions might build safety for them and children around them who may be vulnerable. This information helps in the development of immediate safety plans and long term safety and support plans around the child with SRB as well as other children. 

Seek to understand characteristics of the child with SRB. Some characteristics of a child that are associated with repeated SRB include:

  • there are multiple instances of sexual abuse (this could include multiple incidences of abuse of one child or multiple incidences of abuse of multiple people)
  • the use of violence to sexually abuse other children, particularly where this violence was not necessary to sexually abuse the child
  • the use of penetration
  • the use of extensive planning and manipulation for opportunity to sexually abuse.

Attention

The presence of these risk factors does not mean that the child with SRB should be isolated from interactions with other children. It may mean that more intensive support and intensive safety planning is needed to help manage the SRB.

Questions to consider to assess risk

  • How did we find out about the SRB? For example, did the child tell someone?
  • Was the behaviour discovered by someone? Who? What did they do?
  • How long have the behaviours been occurring?
  • How many (known) times has the SRB occurred?
  • How many (known) victims are there?
  • Have the behaviours become more frequent or more serious? Indicators of severity may include:
    • penetration
    • greater levels of planning
    • greater use of force
    • greater levels of threats or intimidation.

Note

Where SRB have taken place over a number of years it is likely that the tactics used to sexually abuse the child have changed as both children have developed. Ensure an understanding of past and current behaviours in order to effectively respond to the behaviour.

  • Have the SRB stopped? If yes, how do we know they have stopped? Why did they stop? Did the child who was sexually abused tell someone? Were the SRB discovered? Did the child (with SRB) move away?
  • How did the child sexually abuse the other child? For example, did they use:
    • tricks, such as pretending the abuse was a game
    • manipulation, such as bribing the child with money or toys
    • threats, such as threatening to harm the child or others they love
    • force, such as punching, kicking, stabbing the child, causing the child injuries that need medical attention? If force was used, what type of force was used? Was the force used clearly beyond what was needed to sexually abuse the victim?
  • How were the SRB kept secret? For example, was the child:
    • threatened
    • physically assaulted
    • alienated from support
    • tricked into thinking that the behaviour was normal?
  • How much forethought, planning, or pre-meditation was involved in sexually abusing the victim? This includes coercive behaviour, and arranging the timing and location of the abuse.
  • Are there any obvious triggers for the behaviours? Some possible examples include:
    • jealousy
    • bullying
    • substance misuse
    • anger against the victim
    • domestic violence
    • shared rooms or sleeping environments
    • a lack of privacy in the home
    • pornography.
  • What was happening for the child who has displayed SRB at the time they occurred? For example:
    • Where was the child with SRB living?
    • Where was the child with SRB attending school?
    • Who was the child with SRB socialising with?
    • What was happening in the family environment?

Understand past responses to SRB

Gather information from parents and care providers about past responses to information that their child has displayed or may have displayed SRB. This information can help identify if there has been a shift in the parent’s response since the last episode of SRB. A parent who has denied or minimised a previous incident of SRB may respond with belief when another incident is discovered. This information assists in further assessing a parent’s ability to be an affective supervisor and participate in safety planning. Understanding previous interventions from Child Safety, care providers, education, child care, or the QPS is also important when deciding on the most effective approach.

Consider the following questions, including parental responses and the responses of care providers (for children in care):

  • How did the parents and care providers respond to the child who was abused and the child with SRB? For example:
    • Did they punish the child with SRB or the child who was abused? Did they remove privileges, lock the child in their room or verbally or physically hurt or threaten them?
    • Did they deny or minimise the behaviours?
    • Did they blame the child who was sexually abused?
  • How did they seek help, for example, did they discuss the behaviours with professionals?
  • Did they discuss the behaviours with extended family or community members?
  • How did they try to manage the behaviours? For example:
    • Did they put rules in place?
    • Did they increase supervision the child with SRB?
    • Did they put other limits in place?
  • How did the child with SRB respond to:
    • the child who was sexually abused
    • parents / other children in the home? For example, did they minimise or deny the behaviours, blame the child or show empathy for the child?
  • Were there any child protection or police responses to the previous SRB? What was helpful? What was unhelpful?
  • Were any protective measures put in place?
  • Were there any consequences for the child with SRB? What were they?
  • Is the child with SRB currently acknowledging the previous SRB?

For further information on assessing parents and caregivers as effective supervisors and safety planning, refer to Effective primary supervisors.

Understand current risk factors for the child with sexually reactive behaviours

Answering the questions below do not predict the risk of a child exhibiting sexually reactive behaviours (SRB) on their own. They help build a picture of risk and vulnerability, and provide an understanding of the types of interventions the child with SRB may need. While researchers and practitioners agree that long term separation of children with SRB is not recommended, a child who is experiencing multiple risk factors may need more complex and lengthy interventions before it is safe for them to return home.

Consider the following questions:

  • Does the child have frequent verbal, aggressive or angry outbursts? Where do these outbursts occur? For example, in multiple contexts, home, school or with peers?
  • Does the child have a history of harming animals or sexual behaviour with animals?
  • Does the child have a sexual abuse history? Did this abuse involve penetration or excessive force?

Note

While sexual abuse is a risk factor for SRB, most children who are sexually abused do not go on to sexually abuse other children.

  • Does the child have a history of bullying behaviour? Are they a victim of bullying behaviour?
  • Does the child have mental health issues that may lower their inhibitions, alter their mood or make it difficult not to act impulsively? For example, a history of conduct disorders, attention deficit hyperactivity disorder (ADHD), attention deficit disorder (ADD), Foetal Alcohol Spectrum Disorder (FASD), anxiety disorders, bipolar disorder or substance misuse.
  • Does the child have an intellectual impairment?

Note

While children with an intellectual disability are overrepresented in the cohort of children with SRB, they are also more likely to experience other risk factors for SRB such as abuse and neglect (including sexual abuse). Holistically assess the child with SRB and their exposure to other risk factors, rather than assuming that the intellectual disability is the cause of the SRB.

  • Is there evidence that the child is preoccupied with sexual urges or with meeting their own sexual needs? For example:
    • paraphilias (exposing, peeping, fetishes, etc.)
    • compulsive masturbation
    • chronic and compulsive use of pornography
    • frequent highly sexualised language and gestures
    • indiscriminate sexual activity with different partners out of the context of any relationship.
  • Is the child behaving in ways that are socially unacceptable, or harmful to themselves or others? (This behaviour does not have to involve criminal charges). For example:
    • vandalism and destruction to property
    • engaging in activities that are deliberately designed to cause distress
    • fighting and physical violence
    • owning or carrying a weapon
    • theft, robbery, burglary
    • reckless driving, driving under the influence of alcohol or other drugs.
    • use of violence.
  • Is the child experiencing behavioural problems at school? For example:
    • use of alcohol or other drugs at school
    • consistently coming to school late
    • suspension or expulsion
    • truancy.
  • Has the child been charged or arrested for any offence before the age of 16?
  • Is the child currently living in an unstable living environment? For example:
    • living in a family that is unstable, inconsistent or neglectful
    • at risk of homelessness
    • homeless
    • living in a youth refuge/hostel/temporary accommodation?

Practice prompt

Risk factors and protective factors can be seen as opposite sides of the same coin. Use the risk factors in this section to help identify protective factors for the child. For example, when assessing if there is any evidence that the child is behaving in an antisocial manner, look for evidence that the child has supportive friendships or is engaging in positive social activities such as extracurricular activities or sporting groups.

Understand risk factors for the family

The below factors are known to increase the risk of sexually reactive behaviours (SRB). These questions help practitioners understand the factors in the family environment that may have enabled or supported the SRB to occur. The questions also help practitioners assess the parent and family’s capacity to supervise the child with SRB and keep both children safe.

Be mindful of the parent’s emotions during the information gathering stage. Parents are likely to feel torn between the needs of each child and be experiencing emotions that are difficult to manage. Build rapport with the parent to assist in the level of information gathered to ensure a robust assessment and quality intervention.

Consider the following questions:
 

  • Have the children in the family experienced or are currently experiencing domestic and family violence?
  • Are the children in the family experiencing:
    • parental disability / illness or other issues that may impact on the parent’s capacity
    • parental alcohol and other drug use
    • poor supervision
    • abuse, neglect, emotional or physical violence?
  • How connected is the parent to the child with SRB? For example:
    • Is the child with SRB given roles and responsibilities that are not developmentally appropriate?
    • Does the parent appear to empathise with the child with SRB / child who was sexually abused / other children in the home?
    • Does the parent recognise and respond to emotional cues or distress experienced by the child with SRB?
  • Is the family environment highly sexualised? For example, exposure to pornography, explicit conversations about sex or witnessing sex between people in the family?
  • Is there secrecy about sex or a lack of knowledge about genitals, personal boundaries or what constitutes harmful behaviour?
  • Are there inappropriate parent-to-child sexual interactions? For example, prolonged kissing on lips or sexualised interactions?
  • Is there a lack of appropriate boundaries around nudity, privacy or sleeping arrangements? For example, are older children expected to shower without privacy?
  • Does the family have views about gender that may support SRB? For example, views such as:
    • being masculine means dominating women and children
    • women should meet a man’s needs for sex
    • women are objects for male sexual gratification.
  • Are some children given power or responsibility over other children in the family? For example, are:
    • older children in charge of disciplining their younger siblings?
    1. the children given adult responsibilities such as feeding, washing, dressing younger children?

Note

In some cultures, particularly for Aboriginal and Torres Strait Islander peoples, it is appropriate for older children to care for their younger siblings and family members. This is not a risk factor in isolation but relates to the dynamics of a child being in a position of power over younger siblings which can be a risk factor for SRB.

  • Are the parents able to effectively discipline their children or do they have a history of inconsistent, ineffective discipline or overly harsh discipline? For example, do the parents:
    • allow their children to ‘run’ the household and rarely impose limits on bedtimes, mealtimes, play activities?
    • impose different consequences for the same behaviour?
    • impose inappropriately harsh or harmful discipline?

Understand risk factors in the community

During adolescence, a child’s peers become critically important to their emerging sense of self and belonging. Adult community members play a critical role in supporting, encouraging and connecting with the child who was sexually abused and the child (with SRB). Approaches that connect both children to well-functioning peers and safe adult community members are a fundamental aspect of building safety.

 

The values and beliefs of peer groups and adult community members can also increase the risk of SRB. Risk factors for SRB are widespread across all communities, including Anglo-Saxon Australian communities. For example, access to pornography, and beliefs that encourage male sexual aggression or prioritise men’s rights to sex over women’s rights to consent.

Consider the following questions:

  • Does the peer group of the child with SRB condone or encourage sexually aggressive behaviour?
  • Does the peer group of the child with SRB engage in criminal or antisocial behaviour?
  • Is the child with SRB isolated from peers, with no close friends?
  • Do other adults who are involved with the child with SRB condone sexually aggressive behaviour?
  • Does the community have high levels of pornography use?
  • Does the community have high rates of violent crime or domestic violence?

Understand the experiences of the child who has been sexually abused

Consider the following questions in relation to the child who has experienced sexual abuse when assessing risk:

  • Are there other risk factors occurring for this child?
  • What is the child’s relationship to the siblings / other children in the home? For example:
    • Is the child liked?
    • How much power does the child have?
    • Is the child being bullied by siblings or other children in the home?
    • Is the child included in the games and activities of their siblings or other children in the home?
    • How do siblings or other children tend to respond when the child is distressed?
    • How do siblings or other children in the home view the sexually reactive behaviour?
    • Is the child fearful of any siblings or other children in the home?

Attention

If the child is in residential care, their relationships with their peers will form a critical part of your assessment. Talk with the CSO of the other children in the residential to ensure a robust assessment and to answer the above questions most accurately.
  • Is the child who has been sexually abused fearful of the child with sexually reactive behaviours? If yes, are there particular behaviours that have made them fearful?
  • How much does the child who was sexually abused understand about the SRB? Does the child who was sexually abused:
    • recognise that the behaviour was harmful
    • describe the harmful behaviour
    • describe any manipulative and coercive behaviour that was used by the child (with SRB)
    • know what a respectful sexual relationship looks like (consensual / equal / without coercion)?
  • What does the child who was sexually abused understand about protective behaviours (without over estimating a child’s ability to self-protect), including:
    • private parts
    • inappropriate touch
    • keeping secrets
    • what to do or say if someone touches their private parts
    • what to do or say if they are feeling unsafe or unsure.
  • Does the child who was sexually abused understand the safety plan and why it has been put in place?
  • Has a safety and support network been developed? Does it encourage the family to be have open communication? Are network members who don’t reside in the home aware of the concerns, and of their role to keep the child who was sexually abused, and other children, safe?
  • Can the child who was sexually abused recognise their emotions? Are they able to tell their parents / members of the safety and support network if they are feeling unsafe or unsure?
  • Has the child ever had therapeutic support to help manage their experiences of child sexual abuse?

Practice prompt

Determine whether the child would benefit from accessing specialist therapeutic support in addition to the work being undertaken with their family to address the sexually reactive behaviours. In addition, ensure the child receives sex education appropriate to their age and developmental stage.

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