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Responding to Sexual Behavior Challenges

In this lesson, you will walk through a case study of a sexual behavior challenge in a child care program. You will read a detailed account of how staff members respond, collaborate, and communicate so all involved children, staff, and families have the necessary information needed to support the individuals involved and provide high-quality care.

Objectives
  • Know how to respond to sexual behavior challenges.
  • Review examples of how to communicate with staff and families about sexual behavior challenges.
  • Understand the importance of respecting the privacy of children with sexual behavior challenges.

Learn

Know

Just as it is when caring for children, consistency with routines and expectations is helpful for adults. When you observe a sexual behavior, your immediate actions to respond in the moment should be the same whether you recognize the behavior to be normative, or problematic, or if you are unsure. You first learned the Responding to Sexual Behavior steps in Lesson Two, and you can review these steps again here.

Responding to Sexual Behavior: In the Moment

  1. Pause
    • Remain calm
    • Collect your thoughts
  2. Redirect
    • Change the routine or environment
    • Suggest other activities
  3. Listen
    • Find out information
    • Understand from the child's viewpoint
  4. Teach
    • Communicate expectations and rules
    • Reinforce appropriate behavior

Responding to Sexual Behavior: After the Fact

  1. Reflect
    • Consider all known information
    • Determine the type of behavior
  2. Prepare
    • Know how to respond in the moment: pause, redirect, listen, and teach, in the future
  3. Communicate
    • Communicate with the teaching team
    • Determine communication with families

Sexual Behavior Challenge Case Study

Crystal is a school-age staff member, and you will read about her response to a sexual behavior challenge in her program. This case study illustrates Crystal’s use of best practice to support the children involved and the steps she and Sheila, her program administrator, took after the incident.

Crystal observes Makayla (7 years old) and Cameron (11), two children in the school-age program, having an argument about whose turn it is at the computer station. Makayla insists that another staff member told her she could have a turn next, and Cameron yells, “Ms. Crystal said I could have a turn!” Makayla ignores Cameron and moves forward sitting at the computer station. Cameron tells Makayla she is going to “get it on the bus tomorrow.” Cameron further threatens Makayla using sexually explicit language to describe how he is going to make her perform sex acts. As he is speaking, Cameron forcefully puts his hand down Makayla’s pants and touches her genital area. Makayla runs toward Crystal and is very upset.

Responding to Sexual Behavior Challenges: In the Moment

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Pause: Crystal feels very angry toward Cameron and recognizes that she needs to quickly intervene. She immediately calls to have an additional staff member assist with supervision and also requests that a member of the leadership team assist. Sheila, the program administrator, knows Makayla and her family well and will soon be able to join. This is not the first time there has been an incident of Cameron threatening other children. However, staff have never observed him using inappropriate sexual touch. Staff is already providing targeted support (Tier 2 of the Pyramid Model) for Cameron because he has repeatedly had challenges with handling typical, peer conflicts that occur in school-age children. Learn more about the Pyramid Model and targeted supports in the Focused Topics course, Supporting Children With Challenging Behaviors.

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Redirect: Crystal calmly redirects, “Cameron, sit here and wait,” as she gestures for him to sit in a seat she has pulled aside. When the additional staff member, Josh, arrives, Crystal asks him to closely supervise Cameron while she speaks with Makayla in private. Crystal asks Josh to let Sheila know where they are and to please join.

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Listen (Makayla): Once they are in a private area, Crystal checks in with Makayla, “Are you OK?” Makayla begins to cry as she explains that Cameron is always, “Cutting the computer line and taking longer than we are supposed to. He is a bully!” Crystal tries to comfort Makayla, saying that she understands why she is so upset. Crystal knows she needs to address the explicit language and inappropriate touching to make sure she knows exactly what happened, per Makayla’s account. Crystal waits for Sheila to arrive before asking Makayla questions about the incident. When Sheila joins, Crystal explains to Makayla, “When things like this happen we have to have two grown-ups available, so Ms. Sheila is going to sit with us while we talk.” Crystal asks Makayla, “Can you tell me exactly what happened to cause you to be so upset?” Makayla uses her own words to describe the incident, and Sheila makes sure to carefully document. Both know they must have detailed documentation, including staff observations, and those of the children involved.

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Teach (Makayla): Once Makayla has calmed down, Crystal assures Makayla that no one deserves to be threatened, bullied, or inappropriately touched. She praises Makayla for going to a staff member rather than arguing back or becoming confrontational with Cameron. Makayla is still very upset and wants to see her mom. Crystal suggests they see if Ms. Toni, a staff member Makayla is fond of, is OK with letting Makayla sit with her. Makayla is agreeable to this. Crystal shares with Toni that Makayla had an upsetting incident and wants to be with someone she feels close to. She is careful to continue to control her emotions and not to speak in detail about the situation while other children are around.

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Listen (Cameron): Crystal requests that Josh stay so she, Sheila, and Cameron can speak in private. Crystal explains to Cameron that another grown-up must be present and write some things down when there is a serious conflict with children in the program. Crystal uses open-ended questions to understand why Cameron engaged in this behavior. “You made a very serious threat and touched another person’s private parts. What was going through your mind when you did those things?” Cameron is upset but withdrawn, gesturing that he doesn’t know. Crystal keeps her cool, trying to minimize the anger she feels inside. She tells Cameron, “You are a good person, and I know you care about other people. How do you think Makayla felt when you threatened her and touched her private parts?” Cameron acknowledges that he made Makayla feel “sad” and “scared.” Cameron says, “I get so mad over stupid stuff,” as tears roll down his face.

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Teach (Cameron): Crystal does her best to comfort Cameron. She very calmly speaks about how threatening any kind of violent or sexual behavior is a form of bullying or harassment, and children are never to touch another person’s private parts. She tells Cameron, “I can tell that you are upset and angry right now, but it is never okay to threaten to hurt another person or to touch a person’s private parts. When you are upset or having a problem with another child, you can always come get help from an adult.” She shared with Cameron that if he ever feels like he isn’t sure of what he can do if he disagrees with someone or he is going to lose control of his anger, he should immediately come to her or another staff member. Normally, Crystal encourages children to talk out conflicts with each other, but she recognizes that Cameron does not have the skills to do this. Cameron is still upset, and Crystal recognizes that he needs direct supervision until his parent picks him up. Sheila arranges to ensure Cameron has one-to-one supervision.

Responding to Sexual Behavior Challenges: After the Fact

Sheila makes sure that both Makayla and Cameron have direct supervision and support. Crystal and Sheila go to a private area to work through the Responding after the Fact steps.

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Reflect: Crystal shares with Sheila her account of what happened. They make sure they are in agreement about what has been documented. They work through the Sexual Development and Behavior Factors handout and Sexual Behavior Reflection Tool together. You can see their completed forms in the Learn attachments.Problem Sexual Behavior (PSB) Non-Clinical Referral Tool Sheila and Crystal determine that Cameron’s behavior is non-normative because:

  • Cameron used advanced sexual knowledge and forcefully touched another child’s private parts.
  • Cameron’s pattern of threatening behavior has not improved with targeted support and redirection.
  • Overall behavior is interfering with his ability to have peer relations.
  • The incident occurred with a child with a two or more year age gap
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Prepare: Sheila praised Crystal for how she responded to this situation. Crystal followed the Responding in the Moment steps and recognized she needed the assistance of another staff member. Sheila and Crystal discussed that they need to provide more support and guidance around computer time. This is not the first issue to arise around this activity. Sheila suggests that staff clearly state to everyone the line-up for computer stations. The children who participate will do their part by writing their names on the board in the computer room in the correct order. Also, Crystal will provide all the children in the program a refresher on respect, safe touching, and bullying. Both agree that until they have a more concrete plan, Cameron needs direct supervision. Sheila will make arrangements to have a staff member available to supervise him until further plans are made to support Cameron.

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Communicate: 

PUBLICCrystal and Sheila go over other details such as what time the incident occurred and where. Additionally, Sheila has Crystal document all of the steps she took to support both children. They decide on the following communication plan:

  • PUBLICSheila will call Makayla’s parent and inform them of the incident, what staff did to support Makayla, and the program’s plan to provide additional supervision for the other child, and to share information about specialized support they can utilize if Makayla needs it. Sheila will follow up with them in one week and encourage the family to come to her if they need help with anything sooner.
  • PUBLICSheila will call Cameron’s parent and inform them of the incident, what staff did to support Cameron, plans for additional supervision of Cameron, and recommended next steps. Vanessa and Chris, Cameron’s parents, are aware that the program had been implementing targeted support for Cameron’s difficulty with peers. Sheila will inform them that when that support is unsuccessful or the child escalates behavior, it is best for the child to have more intensive intervention. She will communicate that the program staff need the guidance of a professional with more expertise to best support Cameron’s learning and development and offer to coordinate that help. Sheila will recommend that the family reach out to their school district too because it is a way for children to potentially receive support without cost to the family.
  • PUBLICTomorrow, before school-age children arrive, Sheila will share the incident with the school-age program staff. She will highlight Crystal’s responses so staff know what to do if this occurs again. Also, Sheila will make clear which staff member is responsible for direct supervision of Cameron, until they receive guidance from a specialized professional for intensive intervention. Additionally, Sheila will reinforce issues around confidentiality and the importance of using appropriate language to understand Cameron’s behavior and what Makayla experienced (e.g., “Cameron demonstrated a sexual behavior challenge” “Makayla was involved in another child’s sexual behavior challenge.”)
  • PUBLICWith Sheila’s support, Crystal will share the new procedures for the computer station with the school-age staff and the plan to do a refresher for all the children on respect, safe touching, and bullying.

See

Supportive responses to sexual behavior challenges help programs assess what happened, plan for the future, and guide the children and youth involved. Listen as experts discuss next steps and things to consider when sexual behaviors occur in your program.

Responding to Sexual Behavior Challenges

Experts explain how to respond to sexual behaviors.

Do

Respecting the Privacy of Children

In the case study above, there are key moments where Crystal and Sheila were careful to respect the privacy of the children involved. For example, when Josh came to assist Crystal, she did not give him details other than that Cameron needed direct supervision while Crystal spoke with Makayla in private. This happened immediately after the incident and before Crystal was able to gather all necessary information. She shared exactly what she knew and only what Josh needed to know to supervise Cameron. Did you notice other times when Crystal respected Makayla and Cameron’s privacy?

Review these general guidelines to respect the privacy of children with sexual behavior challenges.

  • Communicate and share support plan details only with staff who directly care for a child with sexual behavior challenges. For example, if you work in a preschool classroom, you should not discuss behavior plans, IEPs, or medical information about children with coworkers who are not responsible for their care.
  • Only discuss details about children’s sexual behavior in private, not in front of children or other families.
  • When a sexual behavior challenge involves another child, you must keep information about other children confidential. For example, when Sheila speaks with Makayla’s parent she will state that “another child” threatened and inappropriately touched Makayla. Though you cannot control what information children share with their families, it is important that you uphold confidential practices.
  • Make sure families and staff know who the point person is for communication, should there be questions from families of children involved, or from other families in the program. This will likely be the program administrator.
  • If families speak with you about concerns or questions regarding their child’s sexual development and behavior in their home environment, make sure you do not discuss details with other staff unless they need to know that information to care for children while in your program.

Explore

Select the toddler, preschool, or school-age case study that you read in Lesson Four, and brainstorm how you will respond to these children’s sexual behavior challenges.

Apply

Practice is key to achieving mastery of a new skill. You may have limited opportunities to practice responding to sexual behavior, but the steps to respond can be applied to other parts of your work with children and youth. Complete the Thoughtful Responses activity here to brainstorm ways you can respond to children’s behavior.

Glossary

Emotional Disturbance:
an educational disability category under IDEA (Individuals with Disabilities Education Act) for students with challenging behaviors that affect the children’s learning
Targeted Support (Tier 2):
Second tier of the Pyramid Model, a systematic approach to teaching social skills to have a remedial or preventive effect

Demonstrate

True or false? When responding to sexual behavior challenges in the moment, it is best to first pause and remain calm. And after the fact, it is best to first reflect and consider all known information before proceeding with a plan.
Toby, an 8-year-old, pulled 3-year-old Chris into a bathroom and forcibly removed his pants. Trish, the program manager, is working with Jarone, the staff member who first observed the incident. Together they have reviewed all of the documentation they have of the incident. Trish is now ready to communicate about this incident with Chris’ family. Select the phrase that best illustrates how Trish should describe the incident.
Preschool teacher Chyna has a student, Mia, who has a history of sexual behavior challenges. Chyna and the program manager, Kimberly, are working with a specialist who has provided a support plan with recommendations for the program staff. Select which scenario does not respect Mia’s privacy.
References & Resources

Bancroft, J. (Eds.). (2003). Sexual development in childhood. Bloomington, IN: Indiana University Press.

Chaffin, M., Berliner, L., Block, R., Cavanaugh Johnson, T., Friedrich, W., Garza Louis, D., . . Silovsky, J.F. (2006). Report on the task force on children with sexual behavior problems. Findings from the Association for the Treatment of Sexual Abusers. Report of the ATSA Task Force on Children With Sexual Behavior Problems. (apa.org)

Friedrich, W.N., Fisher, J., Broughton, D., Houston, M., Shafran, C.R. (1998). Normative sexual behavior in children: A contemporary sample. Pediatrics, 101(4), e9-e9.

Friedrich, W. N., Fisher, J. L., Dittner, C. A., Acton, R., Berliner, L., Butler, J., … Wright, J. (2001). Child Sexual Behavior Inventory: Normative, Psychiatric, and Sexual Abuse Comparisons. Child Maltreatment6(1), 37–49.

Kellog, N.D., Committee on Child Abuse and Neglect. (2009). Clinical report- The Evaluation of sexual behaviors in children. Pediatrics, 124(3), 992-8.

Lucier-Greer, M., Nichols, L. R., Peterson, C., Burke, B., Quichocho, D. & O’Neal, C.W. (2018). A brief guide to understanding and responding to normative and problematic sexual behaviors among children. Auburn, AL: Military REACH.

The National Child Traumatic Stress Network & National Center on Sexual Behavior of Youth. (2009). Sexual Development and behavior in children- information for parents and caregivers.  ttps://www.nctsn.org/sites/default/files/resources//sexual_development_and_behavior_in_children.pdf

The National Child Traumatic Stress Network & National Center on Sexual Behavior of Youth. (2009). Understanding and coping with sexual behavior problems in children. https://www.nctsn.org/sites/default/files/resources//understanding_coping_with_sexual_behavior_problems.pdf

Steinberg, S.B. (2017). Sharenting: Children’s Privacy in the age of social media. Emory Law Journal, 66, 839-884.

Swisher, L.M., Silovsky, J.F., Stuart, R.H., Pierce, K. (2008). Children with sexual behavior problems. Juvenile and Family Court Journal, 59(4), 49-69.