For children, problematic sexual behaviors (PSB) are not always related to sexual stimulation. Often, children who exhibit PSB do so out of curiosity, anxiety, lack of accurate information about their bodies, as part of self-calming or attention-seeking strategies, or imitation. Imitation may stem from exposure to mature adult sexual behaviors.

Additionally, research shows that many of these behaviors can come from trauma. A majority of children with PSB have experienced physical, sexual, and/or emotional abuse. Many others have been exposed to domestic or community violence. Other risk factors include inadequate family boundaries around sexuality and nudity, as well as early exposure to pornography.

Educators, healthcare providers, and professionals working in youth-serving organizations are often the first to be aware of children engaging in PSB. This can happen either through disclosure or by witnessing the behaviors. The following steps can help guide you through this discovery and what you to do next.

Step 1: Determine if You Have Mandated Reporting Obligations 

If you are a mandated reporter, you are required to report any situation which causes you, in your professional capacity, to reasonably believe that a child has experienced, or is at substantial risk of experiencing, abuse or neglect. That information is communicated to DCF (Department of Children and Families) through a “51A” report. 

If you are a mandated reporter, you should report PSB incidents if you have reasonable cause to believe one or more of the children involved has experienced, or is at substantial risk of experiencing, abuse or neglect which causes harm or substantial risk of harm to their health or welfare. 

For more information about what constitutes problematic sexual behavior, visit the National Center on the Sexual Behavior of Youth website.

When it comes to sexual behavior among adolescent peers, note the following:

• Any sexual behaviors or activity between a caregiver and a child should be reported to DCF regardless of the child’s age or the caregiver’s age. The built-in power dynamic between the caregiver and the child likely reaches the reasonable cause to believe threshold. Remember that babysitters, camp counselors, and teachers are all caregivers.
• Age-appropriate consensual sexual behaviors, even if they require some intervention by personnel, do not reach the threshold of reasonable cause to believe that a child has experienced, or is at substantial risk of experiencing, sexual abuse—unless there are other facts, circumstances, or red flags. 

It can be difficult to know if a relationship is consensual, even if the people in the relationship say that it is consensual. In the end, whether to file a 51A report when children engage in sexual behaviors depends on your knowledge and understanding of the situation. When in doubt, consult with your organization’s legal counsel or call DCF for further guidance.

For more information on mandated reporting and sexual activity between children, visit the Office of the Child Advocate’s Mandated Reporter Training platform. 

Mandated reporters must report child abuse and neglect when they learn of it in their professional capacity, but anyone can report child abuse and neglect. Anyone seeking to report suspected child abuse or neglect should contact DCF’s Child-at-Risk-Hotline at 800-792-5200.

Step 2: Think of THE Child’s Safety

Remember that many children who exhibit PSB have experienced trauma and/or are victims themselves. 

• Approach conversations with calm and focus on explaining appropriate boundaries. 
• Use words that label actions and behaviors, not children. Labels negatively affect how children see themselves and how adults respond to their behaviors. Use terms such as “children/adolescent with problematic sexual behaviors” or “youth with harmful sexual behaviors.” Avoid labeling children as “sex offenders” or “sexual abuse perpetrators”, as these terms come from the adult justice system and are often not appropriate for children.

Consider the entirety of the child’s and their family’s needs. Children with PSB and their families may have multiple needs.

• If you are involved in case planning, collaborate with other professionals working with the child. Consider establishing or participating in regular interdisciplinary meetings, which help promote successful outcomes for all. their safety.
• If you are planning for supports or making referrals, think about the child’s educational, therapeutic, and medical needs. 
• Consider services parents and siblings might need during this time of crisis. Effective interventions directly involve parents and caregivers. 

Promote healthy and prosocial development. Interventions should strike the right balance between community safety and child wellbeing. For instance:

• If you are developing a safety plan, consider the developmental needs of the child. Systematically excluding them from social interactions with their peers can worsen the situation.
• If you are involved in case management, include opportunities for the child to understand and establish healthy boundaries. Encourage prosocial activities that safely promote skill building, connection, and collaboration with peers.

Step 3: Find Resources Online and in Your Community

Resources in Your Community

MASOC Resource Directory can help you easily identify PSB treatment providers in your area. 

MASOC can help you with case consultation, including how to find support from experienced clinicians, how to access additional assessments, and how to leverage best practices for case management or safety planning. Contact MASOC at info@masoc.net or call (413) 344-0367.

Massachusetts Children’s Alliance’s Service Navigator can help CAC staff and community-based providers connect children statewide with PSB-CBT trained clinicians. The Service Navigator assists in referrals directly from CAC staff, linkage partner agencies, community-based organizations, and/or private practice clinicians seeking further support for their client. Contact them at info@machildrensalliance.org.

Your local Child Advocacy Center can provide you with comprehensive services to support your family, including expert assessments and access or referrals to evidence-based treatment, parenting support and education, and coordination with other professionals working with your child.

Online Resources

MASOC Recorded Webinars: MASOC regularly hosts and co-sponsors webinars for clinicians serving children engaging in PSB. You can find recorded webinars on topics such as prevention, sexual wellbeing, the role of gaming in PSB, and sibling sexual abuse. https://masoc.net/resources/recorded-webinars/ 

T

The Sibling Aggression and Abuse Research and Advocacy (SARAA) Initiative resource page for professionals and practitioners provides a number of resources to help guide professionals through managing sibling sexual abuse situations. It also provides information about their experts who are available to speak at conferences, provide webinars and in-person training, and offer consultation to professionals and organizations. 

The Pennsylvania Coalition to Advance Respect’s Promoting Healthy Sexual Development includes three 10-minute webinars by experts in sex education for children and PSB prevention. These resources can help professionals talk with children and adolescents about consent, ways to talk about sex and bodies, and healthy masculinity. 

Stop it Now! Tip sheet on how to talk with parents about their child’s behaviors can help professionals prepare for conversations about sexual behaviors that can feel awkward and even scary. 

The National Center on the Sexual Behavior of Youth (NCSBY) webpage for professionals presents an overview of the latest research findings and best practices for professionals working with youth with PSB.  

The NCSBY, along side the Youth Partnership Board, also created “Working with Adolescents with Problematic or Illegal Sexual Behavior Advice from Youth” (Spanish version here)”. This is a five-page document that discusses denial, building trust, confidentiality, and disclosure. 

Resources for Social Workers and Child Welfare Staff

Resources to navigate sibling sexual abuse cases:

The Sibling Sexual Behaviour Mapping Tool, developed by the University of Birmingham (UK), can help social workers’ individual thinking and planning when working with children who have engaged in sibling sexual abuse. The linked website also includes a 17-minute video to help professionals understand and respond to sibling sexual abuse.

The Sibling Aggression and Abuse Research and Advocacy (SARAA) Initiative provides information on sibling sexual abuse, including fact sheets, guidance on how to promote positive sibling relationships, and the latest information on SSA. In addition to resources for caregivers, the website includes information for siblings themselves. 

MASOC provides training on using the Massachusetts Child and Adolescent Assessment Protocol (M-CAAP), a comprehensive assessment tool that can assist providers in gaining and understanding of a youth’s unique risk and protective factors and to formulate appropriate case management or treatment decisions. Contact MASOC at info@masoc.net or call (413) 344-0367.

Resources for Juvenile Justice Professionals

Impact Justice’s Juvenile-Specific Treatment for Problematic Sexual Behaviors developed a 20-page document summarizing research on youth who sexually offend. Although originally developed for two counties in California, the document includes research and considerations for risk-needs assessment, case planning, family engagement, and reentry that is broadly relevant for juvenile justice system professionals.

---

Does the child you work with have an intellectual or developmental disability? 

While much of the information and resources about problematic sexual behaviors (PSB) are applicable to all children, children with intellectual or developmental disabilities may have unique reasons for engaging in PSB and require unique approaches to treatment. To read tailored guidance on PSB in children with developmental or intellectual disabilities, click here.