Sexual Behavior in Children - PowerPoint Presentation

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Sexual Behavior in Children

Normal and ABnormalNaNCY Kellogg, M.d.- University of texas health science center

Sexual Abuse Trends

Since 1995, sexual abuse numbers are trending downApproximately 70,000 children per year in the U.S. are validated victims of sexual abuse

Media Influence

Children spending 6-8 hours a day exposed to some form of mediaTelevision: 8 sexual acts per hour (compared to <2/hr in 1976)Clothing (e.g. Abercrombie and Fitch): Clothes line for girls 7-14 include thong underwear with “Eye Candy” and “Wink Wink” near the crotch

A larger and younger generation of “sexual savvy” youth

Sex and Cell Phones

Study of 3477 law enforcement cases (2008-09)63% of sexual images transmitted by cell phoneAn adult was involved in 36%Telephone survey of 1560 youth ages 10-177% had received nude or nearly nude images of others1% appeared in or created nude images or videos

Types

Solitary Behaviors Behaviors involving othersPurpose:GratificationSelf-soothingCuriosityImitation

Attention-seeking

Normal sexual Behaviors

Developmentally appropriate and expectedNo risk factors for abuse are observedOther terms: “sexualized behavior” or “sexual play”

Normal: Ages 6-9

High frequency (14-40%) Touches genitals at home Tries to look at people when they are nude Stands/sits too close to others

Touches mother’s breast

Normal: Ages 6-9

Low Frequency (8-14%) Very interested in opposite sex Knows more about sexual topics Tries to look at pictures of nude people in books or T.V.

Talks about sexual topics

Dresses like opposite sex

Masturbates with hand

Normal: Ages 10-12

High Frequency (9-29%) Very interested in opposite sex Wants to watch/view nudity on television and other media

Knows more about sexual topics

Touches sex parts at home

Lower Frequency (5-8%)

Stands/sits too close

Tires to look at people when they are nude

Talks about sex acts

Talks flirtatiously

Dresses like opposite sex

Sexual Behavior Problems

Children 12 and younger who “Initiate behaviors involving sexual body parts (i.e., genitals, anus, buttocks or breasts) that are developmentally inappropriate or potentially harmful to themselves or others (Association for the Treatment of Sexual Abusers, 2006)Developmentally Inappropriate Occur at a greater frequency than seen in normative groups

Occur at a much earlier age than would be expected

Become a preoccupation for the child

Persist/reoccur after adult intervention

Potential Harm

Coercion or cause physical injury or emotional distress

Examples of SBP’s in Children

Any sexual behavior that involve children who are 4 or more years apartA variety of sexual behavior displayed on a daily basisSexual behavior that results in emotional distress or physical pain in at least one childCoercion or threats to another child to participatePersistent behaviors resistant to adult redirection and child becomes angry if distractedExplicit repetitive acts involving actual penetration or oral-genital contact

Asking an adult to perform a sexual act

American Academy of Family Physicians, 2010

Associated Disorders with SBP’s in Children

One study showed 96% of children with sexual behavior problems had an additional psychiatric diagnosis76% Conduct Disorder40% ADHD27% ODDExternalizing behavior problems strongly associated in childrenLower self-esteem and peer acceptance

Adolescent Sexual Behavior

Adult Response Required Sexual preoccupation/anxiety that interferes with daily functioning Pornographic interest Promiscuity/multiple sexual partners

Sexually aggressive themes or obscenities

Sexual graffiti that is chronic or affects others

Embarrassment of others with sexual themes

Violations of other’s body space, such as pulling down pants, pulling up shirt

Single occurrence of peeping, exposing or frottage (rubbing against others sexually)

Adolescent Sexual Behavior

Correction or Professional Intervention Compulsive masturbation Degradation/humiliation of self or others with sexual themes Chronic preoccupation with sexually aggressive pornography

Sexually explicit conversation with significantly younger children

Touching genitals without permission (“goosing” “tapping”)

Sexually explicit threats

Adolescent Sexual Behavior

Illegal Behavior requiring immediate intervention Obscene phone calls, voyeurism, exhibitionism, or frottage Sexual contact with someone of significant age or power difference Forced sexual contact

Forced penetration

Sexual contact with animals

Genital injury to others

FACT

If children receive a cognitive-behavioral therapy intervention, their risk of becoming a sex offender is no more than that of children with ADHD (Carpenter, Silovsky & Chafin, 2007)

Principles of Management for SBP’s

Gather information about the behavior from multiple sources Focus on what current factors are maintaining current behavior rather than the initial causes or past behavior Cognitive-behavioral and psycho-educational interventions involving the children, parents, and teachers are very effective (even short term therapy)

Do

Not push the sexual abuse agenda if a child does not disclose

abuse

Reporting Suspected Abuse

If Child gives a history that they have been sexually or physically abused If Child gives a history that they have had sexual contact with a child 4 or more years older or younger, or contact is otherwise abusive, or

If a child has injuries that are suspicious for sexual or physical abuse

Report neglect if a parent intentionally exposes child to harmful pornographic material or

Parent fails to modify environment to reduce the child’s access to sexually explicit material despite medical or mental health advice

FECC Assessment Tools

Child Sexual Behavior Inventory –CSBI Child Sexual Behaviors, 21 Problematic Characteristics –CSB21 Juvenile Sexual Offense Recidivism Risk Assessment Tool, 2nd

Edition –JSORRAT-II

Juvenile Culpability Assessment –JCA

Sexual Behavior and Attitude Interview

Trauma Symptoms Checklist for Children -TSCC

Trauma Symptoms Checklist for Young Children TSCYC