National Center on Sexual Behavior of Youth Fact Sheet

National Center on Sexual Behavior of Youth Fact Sheet

Sexual Development and Sexual Behavior Problems in Children Ages 2-12
This Fact Sheet provides basic information about sexual development and problematic sexual behavior in children ages 2-12. This information is important for parents and professionals who work with or provide services to children such as teachers, physicians, child welfare personnel, daycare providers, and mental health professionals. Understanding children’s typical sexual development, knowledge, and behavior is necessary to accurately identify sexual behavior problems in children. Guidelines to distinguish typical sexual behaviors from problematic sexual behaviors are described below.

Research on sexual behavior of children ages 2 to 12 has documented that:

  • sexual responses are present from birth; 1
  • a wide range of sexual behaviors for this age range are normal and non-problematic; 1, 2
  • increasing numbers of school age children are being identified with inappropriate or aggressive sexual behavior;3 it is not clear if this increase reflects an increase in the actual number of cases or an increase in identification and reporting;
  • several treatment interventions have been found to be effective in reducing problematic sexual behavior in children, such as cognitive behavioral group treatment;4, 5 and
  • sexual development and behavior are influenced by social, familial, and cultural factors, as well as genetics and biology.7

Typical sexual knowledge of children age 2 to 6 years old:

  • understand that boys and girls have different private parts;
  • know labels for sexual body parts, but use slang words such as weenie for penis; and
  • have limited information about pregnancy and childbirth.

Typical sexual knowledge of children ages 7 to 12 years old:

  •  learn the correct names for the genitals but use slang terms;
  •  have increased knowledge about masturbation, intercourse, and pregnancy; and
  •  understand the physical aspects of puberty by age 10.

Common vs. Infrequent Sexual Behaviors in Children

In the last decade, research has described typical sexual behaviors in boys and girls ages 2-12.2 The table below lists sexual behaviors that are commonly observed or reported by parents of pre-school and school age children.

COMMON SEXUAL BEHAVIORS
AGES 2-6

  • Do not have a strong sense of modesty, enjoys own nudity
  • Use elimination words with peers
  • May explore body differences between girls and boys
  • Curious about sexual and genital parts
  • Touch their private parts, even in public
  • Exhibit sex play with peers and siblings; playing “doctor”
  • Experience pleasure from touching their genitals

COMMON SEXUAL BEHAVIORS
AGES 7-12

Sexual play with children they know, such as playing “doctor”
Interested in sexual content in media (TV, movies, radio)
Touch own genitals at home, in private
Look at nude pictures
Interested in the opposite sex
Shy about undressing
Shy around strange men

Research has also described infrequent and uncommon sexual behaviors in boys and girls ages 2-12. 2

The table below lists sexual behaviors that are reported by parents of pre-school and school age children to be infrequent or highly unusual.

INFREQUENT SEXUAL BEHAVIORS AGES 2 – 12
Puts mouth on sex parts
Asks to engage in sex acts
Puts objects in rectum or vagina
Imitates intercourse
Masturbates with objects
Undresses other people
Touches others’ sex parts after being told not to
Asks to watch sexually explicit television
Touches adults’ sex parts
Makes sexual sounds

Sexual Play vs. Problematic Sexual Behavior

Professionals in the field have developed a continuum of sexual behaviors that range from common sexual play to problematic sexual behavior.10 These are described below.

Sexual play

  •  is exploratory and spontaneous;
  •  occurs intermittently and by mutual agreement;
  •  occurs with children of similar age, size, or developmental level, such as siblings, cousins, or peers;
  •  is not associated with high levels of fear, anger, or anxiety;
  • decreases when told by caregivers to stop; and
  • can be controlled by increased supervision.

Problematic sexual behavior

  •  is a frequent, repeated behavior, such as compulsive masturbation;
    • Example: A six-year-old repeatedly masturbates at school or in other public places.
  • occurs between children who do not know each other well;
    • Example: An eight-year-old girl shows her private parts to a new child during an after school program.
  • occurs with high frequency and interferes with normal childhood activities;
    • Example: A seven-year-old girl has been removed from the soccer team because she continues to touch other children’s private parts.
  • is between children of different ages, size, and development level;
    • Example: An eleven-year-old boy is “playing doctor” with a three-year-old girl.
  • is aggressive, forced, or coerced;
    • Example: A ten-year-old threatens his six-year-old cousin and makes him touch his penis.
  • does not decrease after the child is told to stop the behavior;
    • Example: A nine-year-old child continues to engage other children in mutual touching after being told the behavior is not allowed and having consequences, such as being grounded.
  • causes harm to the child or others.
    • Example: A child causes physical injury, such as bruising, redness, or abrasions on themselves or another child, or causes another child to be highly upset or fearful.9

Children With Sexual Behavior Problems

Children with sexual behavior problems (SBPs) are children 12 years and under who demonstrate developmentally inappropriate or aggressive sexual behavior. This definition includes self-focused sexual behavior, such as frequent public masturbation, and intrusive or aggressive sexual behavior towards others that may include coercion or force. Although the term “sexual” is used, the children’s intentions and motivations for these behaviors may be unrelated to sexual gratification.

Some children who have been sexually abused have inappropriate sexual behaviors and others have aggressive or highly problematic sexual behavior.8 However, it should be noted that the majority of children who have been sexually abused do not have subsequent inappropriate or aggressive sexual behaviors.

Although only a small number of children develop problematic sexual behavior, professionals and parents may have concerns about (1) whether the behavior is problematic, (2) whether a child should be referred for mental health services, and (3) when an incident should be reported to the proper authorities.

Suggestions for professionals and parents are listed below:

  •  Do not overreact as most sexual behaviors in children are within the typical or expected range.
  •  Inappropriate or problematic sexual behavior in children is not a clear indicator that a child has been sexually abused.
  •  Most children will stop the behavior if they are told the rules, mildly restricted, well supervised, and praised for appropriate behavior.
  •  If the sexual behavior is problematic as defined above, referral for mental health services is recommended.
  •  It is important to remember that children with problematic sexual behavior are significantly different from adolescent and adult sex offenders.
  •  A report to Child Protective Services (CPS) and/or law enforcement may be required by law for certain behaviors such as aggressive or forced sexual behavior.

Additional information about adolescent sex offenders and children with sexual behavior problems is available from the National Center on Sexual Behavior of Youth, http://www.ncsby.org.

Reference:
1. Gordon, B. N., & Schroeder, C. S. (1995). Sexuality: A developmental approach to problems. New York: Plenum Press.
2. Friedrich, W. N., Grambsch, P., Broughton, D., Kuiper, J., & Beilke, R. L. (1991). Normative sexual behavior in children. Pediatrics, 88, 456-464.
3. Araji, S. K. (1997). Sexually aggressive children: Coming to understand them. Thousand Oaks, CA: Sage.
4. Bonner, B. L., Walker, C. E., & Berliner, L. (1999). Children with sexual behavior problems: Assessment and treatment (Final Report, Grant No. 90-CA-1469). Washington, DC: Administration of Children, Youth, and Families, Department of Health and Human Services.
5. Pithers, W. D., Gray, A., Busconi, A., & Houchens, P. (1998). Children with sexual behavior problems: Identification of five distinct child type and related treatment considerations. Child Maltreatment, 3, 384-406.
6. DeLamater, J., & Friedrich, W. N. (2002). Human sexual development. The Journal of Sex Research, 39, 10-14.
7. Silovsky, J. F., & Bonner, B. L. (2003). Children with sexual behavior problems. In T.H. Ollendick, & C.S. Schroeder (Eds.), Encyclopedia of Clinical Child and Pediatric Psychology (pp.589-591). New York: Kluwer Press.
8. Kendall-Tackett, K. A., Williams, L. M., & Finkelhor, D. (1993). Impact of sexual abuse on children: A review and synthesis of recent empirical studies. Psychological Bulletin, 113, 164-180.
9. Hall, D. H., Matthews, F., Pearce, J., Sarlo-McGarvey, N., & Gavin, D. (1996). The development of sexual behavior problems in children and youth. Ontario, Canada: Central Toronto Youth Services.
10. Johnson, T. C. (1998). Understanding children’s sexual behaviors: What is natural and healthy. Order information http://www.TcavJohn.com.

The University of Oklahoma is an equal opportunity institution.

Opinions in this document are those of the authors and do not necessarily represent the official positions or policies of the US. Department of Justice/Office of Juvenile Justice and Delinquency Prevention.

This Fact Sheet was prepared through the National Center on Sexual Behavior of Youth at the Center on Child Abuse and Neglect, University of Oklahoma Health Sciences Center and was authored by Jane F. Silovsky, PhD and Barbara L. Bonner, PhD. This project is funded by grant number 01-JR-BX-K002 from the Office of Juvenile Justice and Delinquency Prevention (OJJDP), US Department of Justice.

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Ethics and Confidentiality

The success of the advocate/victim relationship is based upon the development of the victims’ trust that they may confide sensitive and intimate information fully and freely to their counselors. Confidentiality is essential for effective advocacy because without an assurance of confidentiality, victims may avoid help altogether or may withhold certain personal feelings and thoughts because they fear disclosure.

 

We have ethical obligations to:

  • · Survivors with whom we work (and their children)
  • · Our coworkers
  • · Our agency and its reputation
  • · Professional affiliations (NASW, etc.)

 

Ethical Guidelines for working with survivors

  • · Respect and maintain confidentiality
  • · Offer support, information, safety options, and advocacy.
  • · Identify and reinforce strengths and respect current survival methods.
  • · Do not offer personal opinion.
  • · If you cannot help, find another resource that can.
  • · Accept and reinforce right to make own decision.
  • · Don’t discriminate. For any reason.

 

Relationships that must never happen between an advocate and client:

  • · Good friend/confidante
  • · Romantic/sexual/intimate
  • · Financial (lending or borrowing money)
  • · Business (hiring or being hired by; purchasing from)

 

Why Confidentiality between Survivor and Our Programs is Important

  • · Privacy allows survivors to confide sensitive and intimate information that is necessary to the counseling or advocacy relationship.
  • · Without the assurance of confidentiality, many survivors would not seek our services.
  • · There is an expectation from the survivor and the community that our services are confidential.

 

The harm of disclosure to those seeking counseling or shelter is palpable: many counselors agree that when told that the private information revealed during counseling sessions may be used in court, there is a drastic change in the dynamics of the counseling relationship. For survivors of domestic and/or sexual violence, confidentiality may be more than just an issue of privacy; it may be one of life and death.

 

The YWCA’s Confidentiality Policy is located in the first section of the manual.

Several Michigan laws protect survivor confidentiality in certain circumstances: domestic violence/sexual assault counselor, social worker, licensed professional counselor, medical personnel, and psychologists.

Exceptions to General Confidentiality:  suspected child abuse, duty to warn.

Confidentiality Policy

Confidentiality Notice

Staff and volunteers at the YWCA of Greater Flint Domestic Violence and Sexual Assault Services (DVSAS) will keep confidential all information communicated to them by survivors of domestic violence and sexual assault utilizing YWCA services. This means that:

  1. We will not disclose to any other person or entity whether we have had contact with you or provided services to you, or whether or not you are residing in our shelter.
  2. We will not disclose to any other person or entity information or materials that you have disclosed or given to us or that we have disclosed or given to you.
  3. We will oppose any subpoena or other legal effort to obtain this information from us, when you have not authorized the release of this information.

There are some exceptions to this. The information that you give us may not be kept confidential if:

  1. We learn or have reason to suspect that a minor child is being abused or neglected. In such a case, we will contact Child Protective Services;
  2. We witness through sight or hearing an actual or imminent physical assault or other unlawful and dangerous act upon you by another person. In such case, we may contact law enforcement for assistance;
  3. We learn or have reason to believe that you intend to harm yourself. In such case, we may notify law enforcement and/or emergency medical personnel to seek assistance for you;
  4. We learn or have reason to believe that you intend to harm another person and have the means and ability to do so. In such case we may contact law enforcement and/or may warn the person who you intend to harm.

If you give us written or verbal permission to release information to others, we will do so in accordance with the terms of that permission. You have the right to revoke that permission at any time.

In order to further protect the confidentiality of survivors of domestic violence, we ask that you not share the names, identities, or any other information about anyone you believe to be receiving services from YWCA of Greater Flint.

Client’s Rights and Grievance (Complaint) Procedure

We welcome your thoughts, suggestions, and concerns regarding our services. Please share them either with the person you are working with or with their supervisor. You can find out who someone’s supervisor is by calling our Crisis Line (810) 238-7233.

You have the right to a fair hearing if services to you are denied, reduced, or ended, or if we fail to act upon your request for service within a reasonable period of time. You have the right to start a formal grievance process. This is how:

Filing a Recipient’s Rights Grievance:

  1. Address your issue directly with the staff member involved. If you feel that this is not safe or that the resolution is unlikely, proceed to step #2.
  2. Contact the staff person’s direct supervisor to discuss your issue.
  3. If the matter cannot be resolved by the supervisor, submit your written grievance within 6 days to the Program Director. You may ask for assistance in writing your statement. Please include the following information so that your concerns can be addressed as quickly as possible:
  • Statement explaining your grievance.
  • What right(s) you feel have been violated.
  • What you think will resolve your grievance.

Within five business days of receiving your grievance, the Program Director will contact you and the staff involved. If necessary, a meeting may be set up between the Program Director, you, and staff.

A letter with solutions and/or outcomes will be sent to you within five business days of all discussions and meetings.

  1. If your grievance has not been resolved by step #3, you may submit another written statement within five business days to the Program Director which will be forwarded to the CEO within two business days.

Within five business days, the CEO will send you and the Quality Assurance Committee a letter informing you of actions taken to resolve the grievance. The QA Committee will use information from the grievance procedure to consider changes in agency practices. The timelines are for your guidance; every effort will be made to resolve your grievance in a timely manner.

I, ______________________________________, understand the YWCA Flint DVSAS Policy of:

  • Confidentiality as explained to me by a staff member. I have received a copy of this policy.
  • I understand that DVSAS will report to Child Protective Services any known or suspected child abuse or neglect. I also understand that DVSAS will contact law enforcement if we have reason to believe that you will harm yourself and/or another person.
  • Further, I agree not to disclose any identifying information about anyone that I encounter during my interaction with YWCA Flint or YWCA DVSAS. This includes saying whether or not someone is staying at or receiving services from YWCA DVSAS.
  • This is to acknowledge that the client rights and grievance procedure has been explained to me on this date, and I fully understand what has to be done to file a grievance if it becomes necessary.

I have received a copy of the YWCA of Greater Flint DVSAS Confidentiality Notice and Client’s Grievance Procedure.

Client Signature:_________________________________________________Date:_____________

Witness:_______________________________________________________ Date:_____________