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Reflections of an ACWA Conference Masterclass: Working with children who exhibit problematic sexual behaviour towards other children is In the Spotlight

by PeakCare Qld on 3rd November 2016

Home -> Articles -> 2016 -> November -> Reflections of an ACWA Conference Masterclass: Working with children who exhibit problematic sexual behaviour towards other children is In the Spotlight

At the 2016 Association of Children’s Welfare Agencies (ACWA) Conference, Pathways to Protection and Permanency: Getting it Right for Children, Young people and Families, Dale Tolliday presented a Masterclass on the topic: Is there an Accessible Framework and Roadmap for Prevention and Therapeutic Responses for Sexual Abuse that includes Children who Abuse?

Dale Tolliday is the Clinical Advisor at New Street Services, Sydney Children’s Hospitals Network and Office of Kids and Families, NSW Ministry of Health. He stated that prevention and recognising risk and occurrence of harm whilst developing appropriate responses are challenging requirements for the sector. His presentation explored each of these elements of providing safe care for children and suggested strategies for those caring for or responsible for the care of children in out of home care.

In defining child sexual abuse, Dale notes that it is a:

  • Lack of consent
  • Lack of equality and
  • Involves coercion

The prevalence of children and young people who sexually harm others in out of home care is difficult to ascertain as there is no stable data in Australia. The problem with data and studies includes the concern that the absence of data limits the reliability of studies. Existing studies are small and methodological issues are evident. Furthermore, children in out of home care are a vulnerable group. Another concern highlighted was that studies referring to child sexual abuse by children in care towards other children in care tend to refer to this as peer sexual abuse and this is an unreliable claim.

Sexual behaviour may be problematic for a number of reasons that include the behaviour as an indicator of past trauma experienced by the child. It may also denote potential risk of harm by others and harm to self. It interferes with broader development including identity and self-concept.

Dale is concerned about the labelling attributed to sexualised behaviours that don’t accurately depict the issue and invite a diminished view of a child or young person. Terms such as: perpetrator, paedophile, sexual offender and child on child are significantly problematic when aiming to work with children and young people who have behaved in sexually inappropriate ways with other children or young people.

Dale Holliday raised concerns about the term ‘child on child’ sexual abuse currently being used in various contexts including the Royal Commission. These concerns stem from the fact that children, including those in out of home care may have experienced trauma and are acting out abuse, not intentionally perpetrating it. He is concerned for all children and particularly concerned about children in distress, being labelled perpetrators. Furthermore, there may be complex dynamics at play in out of home care environments and abuse may not be an intent. Problematic or harmful sexual behaviour more accurately reflects the language required when discussing the issues being dealt with.

International research shows that there is a higher prevalence of child sexual abuse in out of home care compared with the general population, with highest rates evident in residential care. Children and young people who self-report denote significantly higher rates than those reported by the professionals working with them. Dale is clear that the sexual safety of children in out of home care is not limited to harm by other children given that emerging evidence is that children in residential care are at risk from both peers and staff in these settings.

In order to make sense of problematic childhood sexual behaviour it is necessary to consider: normative sexual development; safety, vulnerability and risk of harm; to distinguish normative from problematic behaviours and to have clarity with regards to harmful and abusive behaviours.

In assessing models of normative sexual development, caution is required as firstly, available models do not take into account social, cultural and religious differences. They do however provide a reference point. The Family Planning Queensland (now True Relationships) provide the traffic light example. When assessing concerns the dynamics of behaviour are an essential component, as is the recognition of personal attitudes and beliefs.

Overall, it is necessary to note that the models of normative sexual development generally give a ‘starting point’ which is not sufficient in itself. Family, cultural, social and religious factors also need to be taken into account. It is also important to consider that professionals in children’s services consistently hold different expectations for their own children compared with the expectations they have for clients. Furthermore, the dynamic and meaning of the behaviour are as significant as the behaviour itself.

In relation to children and young people aged 10-17 years, Dale asserts that we’ve historically imposed adult models to understand young people. We’re recognising now that this is inappropriate. Perceptions persist that this behaviour is located within young people and as a consequence, children and young people may be labelled ‘perpetrators’ and ‘sex offenders.’ There is growing recognition that young people who have sexually harmed have themselves generally experienced trauma or significant disadvantage.

Non normative sexualised behaviours develop through trauma experiences, imitation, exposure to explicit sexual information, self-regulation difficulties, boundary problems, lack of role definition and socio-cultural influences. Trauma history is a pertinent issue when assessing the needs of children and young people who exhibit sexualised behaviours. In relation to such behaviours that clearly fall outside of developmental expectation, the younger the child the more likely past or current harm. In older children (over 10 years) the majority have a trauma history, of which exposure to domestic and family violence is most common, closely followed by sexual abuse.

In terms of intervention with children and young people who exhibit harmful sexual behaviours towards others, the most positive outcomes include holistic family and associated care focussed on intervention. This produces the most significant outcomes with regard to ceasing problematic sexual behaviours. Ceasing such behaviours may not be immediate, especially for children with trauma experiences and self-regulation issues. Completing treatment is associated with the best outcomes.

There are increasing concerns and understandings that online influences impact the wellbeing of children and young people, in particular those who have demonstrated sexualised behaviours that may harm others. It is now broadly recognised that explicit online content is the most significant development in the area of sexual behaviours over the past decade. Online access to pornographic and explicit material has been shown to be associated with a younger age of sexual behaviours including sexual intercourse and such viewing substantially influences behaviours, expectations and choices of children, young people and adults.

In order to prevent and respond to sexual abuse in out of home care, Child Safe Organisations are needed. This requires attending to the issue as an organisation and ensuring structures, policy and procedure, rules and protocols, reporting, supervision and accountability are all centred on child safety. Organisations should also develop and articulate their ethos with respect to the sexual safety of children. This should include ethos regarding safety, sexuality, identity and sexual development.

Issues of supervision, sex education and the modification of inappropriate sexual behaviours are all relevant when supporting children who have demonstrated sexualised behaviours towards others. Therapeutic intervention is often required as is training for professionals and carers. Managing contact with family and others as well as child matching with regard to living arrangements is key.

Therapeutic responses require that the identification of the sexual behaviours be reported and recorded, the issues noted and responded to, the meaning and significance of the behaviours highlighted and the initial response and safety planning to be cognisant of the needs and vulnerabilities of all involved.

In considering specialist therapeutic responses it is important to avoid any therapeutic response which is not collaborative, holistic and developmentally focussed. Furthermore, it is also important to avoid placing unnecessary restrictions on a child.

A child safe organisation is an essential foundation to provide effective care for children. In relation to sexual safety much also hinges on the support and training of its workforce to respond in a coordinated way. The workforce will need continuous support through training and supervision and will be at its most effective when a child’s care team are working with a shared understanding of the relevant issues.

It is important to recognise that it is not agency protocols that resolve or address these matters. It is people who through relationships provide connection and healing for children.

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