Harmful Sexual Behaviour

1. Definition

'Sexual behaviours expressed by children and young people under the age of 18 years old that are developmentally inappropriate, may be harmful towards self or others, or be abusive towards another child, young person or adult'. (Hackett 2014 Children and Young People with Harmful Sexual Behaviours)

The current definition of Sexual Abuse in Working Together to Safeguard Children is also relevant as it recognises that abuse can be perpetrated by children as well as adults.

An Ofsted thematic review (Review of Sexual Abuse in Schools and Colleges (Ofsted)) detailed concerns around sexual child-on-child abuse. This abuse included:

Sexual violence, such as rape, assault by penetration and sexual assault;
Sexual harassment, such as sexual comments, remarks, jokes and online sexual harassment, which may be stand-alone or part of a broader pattern of abuse;
Upskirting, which typically involves taking a picture under a person's clothing without them knowing, with the intention of viewing their genitals or buttocks to obtain sexual gratification, or to cause the victim humiliation, distress or alarm;
Sexting (also known as 'youth-produced sexual imagery').

See A continuum of children and young people's sexual behaviours (Hackett, S (2010)).

2. Risks

Two thirds of contact sexual abuse is committed by peers;
History of abuse, especially sexual abuse, can contribute to a child displaying harmful sexual behaviour;
All children, including the instigator of the behaviour, need to be viewed as victims;
Children have greater access to information about sex through technology and this has had an impact on their attitudes to sex and sexual behaviour;
Children with harmful sexual behaviours who receive adequate treatment are less likely to go on to commit abuse as an adult compared to children who receive no support;
Incidents of harmful sexual behaviour should be dealt with under the specific child protection procedures which recognise the child protection and potentially criminal element to the behaviour. There should be a coordinated approach between the agencies;
The needs of the children and young people should be considered separately from the needs of their victims;
An assessment should recognise that areas of unmet developmental needs, attachment problems, special educational needs and disabilities may all be relevant in understanding the onset and development of abusive behaviour;
The family context is also relevant in understanding behaviour and assessing risk.

There are no diagnostic indicators in personal or family functioning that indicate a pre-disposition towards sexual offending although the following characteristics have been found in the background of some young people who sexually offend:

Attachment disorders - poor nurturing and parental guidance;
Domestic violence and abuse;
Previous sexual victimisation - a younger age at the onset of the abuse is more likely to lead to sexualised behaviour;
Social rejection and loneliness;
Poor empathy skills.

3. AIM3 Assessment Framework

The AIM3 assessment framework and procedures are designed to assist professionals in assessing children and young people who have committed a sexual assault or undertaken harmful sexual behaviour.

The framework adopts a partnership approach, which is essential for the development of effective practice. It incorporates the concepts of the Assessment Framework used by Children's Social Care and other agencies, as well as the 'Asset' framework used by Youth Offending Teams. Its use is intended to fit within the timescales agreed by the criminal justice and child welfare systems.

The AIM3 Initial Assessment model is the first stage in gathering and analysing information, which will assist practitioners to consider what further assessments and interventions might be required to support the young person and their parents or carers. It recognises the importance of parents and family support for the child or young person throughout, therefore adopts a holistic approach to assessing the young person and their family.

The framework provides a model to assist all professionals within Children Social Care, Youth Offending Teams and other agencies or services, who have contact with children and young people, to conduct an initial assessment in order to:

Identify potential risk of re-offending;
In child protection terms identify risk to either the young person or their actual or potential victim(s);
Identify the young person's needs;
Assess the young person's motivation and capacity to engage in services and plans;
Identify the capacity of the parents or carers to support the young person;
Suggest priorities for initial response;
Consider referral into the public protection system.

In assessing the distinction between behaviour that is experimental in nature and behaviour that is abusive, the notions of consent, power, equality and authority need to be considered by the assessors.

It may be that the child or young person cannot remain living with their family during the assessment or treatment process as they may be considered a risk to other children in the household. The AIM3 model recognises the importance of parents and family for the child or young person throughout, therefore adopts a holistic approach to assessment.

The model does not make decisions for assessors but will support decision-making by focusing on strengths and concerns.

Please refer to AIM3 Assessment Guidance documents for further information.

Note that if a child or young person is subject to family court proceedings, the permission of the court should be obtained before undertaking an AIM3 assessment.

Where a male child or young person (10 years or over) admits an offence of harmful sexual behaviour, he and his parents will be informed by the Police Officer that an AIM3 assessment will be undertaken. AIM3 Process is not applied to young women and girls.

The investigating Police Officer will refer the child or young person to the Youth Offending Team. This will trigger the AIM3 Assessment process, for which the Youth Offending Team Worker will take lead responsibility.

The completed AIM3 assessment report must be shared with the investigating Police Officer within 20 working days of the Strategy Meeting.

The AIM3 Assessment report will make a recommendation to the Police regarding an appropriate disposal for the child or young person. However, the Police maintain the right to make a final decision in consultation with the Crown Prosecution Service, having fully considered the recommendations and any other relevant information which has been collated.

An AIM3 assessment must be completed on all young people before being sentenced. If necessary an adjournment must be requested in order to carry out the assessment, which will inform the pre-sentence report.

The AIM3 model can assist practitioners from Children's Social Care, Youth Offending Service, Child and Adolescent Mental Health Team and other agencies to:

Assess the child's needs including their motivation and capacity to engage in services and plans;
Identify the capacity of the parents/carers to support the child including specific needs in relation to the behaviour;
Identify potential risk factors and the likelihood of re-offending.

4. Indicators

There are no diagnostic indicators in personal or family functioning that indicate a pre-disposition towards sexual offending although the following characteristics have been found in the background of some young people who sexually offend:

Attachment disorders - poor nurturing and parental guidance;
Domestic violence and abuse;
Previous sexual victimisation - a younger age at the onset of the abuse is more likely to lead to sexualised behaviour;
Social rejection and loneliness;
Poor empathy skills.

Many of these factors exist alongside typical family environments where other forms of abuse are present.

There is a significant minority of young people who display this behaviour who have a level of learning need - up to 40% in some studies. Their needs must be carefully assessed as some assessment tools are not suitable. Also, the intervention may need to be extended and involve a high degree of coordination between agencies.

It can be useful to think of sexual behaviour as a range or continuum from those behaviours that are developmentally and socially accepted to those that are violently abusive (see Children and Young People with Harmful Sexual Behaviours).

Most healthy sexual behaviour can be characterised by:

Mutuality (Children of a similar developmental and chronological age);
Absence of coercion in any form (bullying, emotional blackmail, fear of the consequences);
Absence of emotional distress.

Additionally, sexual behaviour which seems compulsive, is repeated in secrecy and continues after interventions from parents or carers, is a cause for concern.

5. Protection and Action to be Taken

Incidents of harmful sexual behaviour come to light, either through discovery or disclosure, which may be third-party or second-hand information. The details provided should be accurately recorded by the person receiving the initial account. Concerns about the behaviour and the welfare and safety of the child/ren should be referred to Children social care as set out in the Referrals Procedure.

Children's social care will undertake an assessment and there will be an interagency strategy meeting if the concerns are that a child has suffered or a child or children is/are likely to suffer, significant harm. The Strategy Discussion/Meeting is a forum for analysing risk, sharing background information on the young people and planning further action. In addition to police and children's social care, schools, Youth Offending services or any other agency with significant contact to any of the young people should also be invited to the meeting where appropriate.

The strategy meeting should consider:

Issues of child and public protection, including a clear understanding and description of any alleged incident;
An assessment of the child/young person's needs, and the need for further specialist assessment;
The roles and responsibilities of child welfare and criminal justice agencies;
Any on-going safety issues for all the young people involved;
Child welfare concerns for the young person;
The safety of potential victims including siblings;
Risk management at home, in school and in the wider community;
Future living arrangements for the young person;
School attendance and related education issues;
Support for the young person and their family;
The needs of the young person;
Relevant victim issues;
Intervention/treatment issues/identification;
Outline roles, tasks and expectations for different professionals/agencies;
Whether there should be a referral into the public protection system (MAPPA arrangements).

The context of the behaviour and background of the young people and their family are important factors in determining next steps. Where there is no requirement to hold a formal strategy meeting, it is still good and useful practice to hold a multi-agency planning meeting to consider the needs of the children or young people involved.

Strategy meetings will make contingency plans for future actions following further assessment and investigation of the incident. The option of reconvening the strategy meeting post the investigation may be useful in some cases.

Specialist opinion may be required to inform the assessment from those providing specialist treatment services for young people who sexually harm others.

Where there are concerns that the alleged abuser is also a victim of abuse consideration should be given to convening a Child Protection Conference if the young person is deemed to have suffered, or is likely to suffer, significant harm.

Where a child protection conference is convened the multi-agency meeting could be incorporated into it in order to avoid repeat meetings. The child protection conference will therefore need to address the needs of the child/young person both as an abuser and as a victim, and this should be made clear at the outset.

In cases where the threshold is met, a meeting should be convened under the Multi-Agency Public Protection Arrangements (MAPPA) to consider public protection matters and safety. Under Category 1 MAPPA all those (adults and young people) recorded on the sex offender register need to be referred to MAPPA.

Following the investigation, if the decision is made to engage the young person in further work, it is important that these discussions take place as soon after the investigation as possible. Successful engagement of families significantly diminishes if there is a time delay in arranging specialist intervention.

The Review of Sexual Abuse in Schools and Colleges (Ofsted) identified that most children would not report incidents (for a variety of reasons) and many educational establishments were 'unaware' of the significant level of sexual harassment and sexual violence.

Keeping Children Safe in Education (DfE) reflects that all staff working with children are advised to maintain an attitude of 'it could happen here' and that it can occur between two children of any age and sex, from primary through to secondary stage and into colleges. A friend may make a report or a member of school or college staff may overhear a conversation that suggests a child has been harmed or a child's own behaviour might indicate that something is wrong and these should be acted upon.

6. Issues

Young people may be in denial about having a problem with their sexual behaviour and this may be supported by parents who do not want to confront reality of their child behaving in this way. There is often no legal requirement for the child or family to accept help and it may be easier to ignore the problem than confront it. This is a common response to this issue, practitioners will need to be familiar with the proposed intervention if they are to encourage anyone to accept it. The offer of further work may be helpfully framed as an opportunity to understand how the young person came to be in a position where they behaved in a way considered to be abusive.

Support of parents and carers is extremely helpful in promoting engagements and successful outcomes. Parents need to be informed about the program to the extent that they are aware that sexually explicit conversations will take place, also they may be asked to speak to their child about sexual issues. They may also be asked to model appropriate and respectful sexual attitudes and language.

Evidence suggests that young people 'take on' and internalise labels, and therefore to describe a young person only as a 'sex offender' or 'young abuser' may impact on their motivation and responsiveness in both assessment and treatment, leaving them feeling they cannot change.

Why anyone offends sexually is a complex question. One popular model which seeks to organise thinking around this topic is known as Finkelhor's Four Pre-conditions to Sexual Abuse, which suggests that four pre-conditions should be in place before an abusive act takes place. Interruption at any stage may prevent abuse taking place.

The stages are:

Motivation to sexually abuse - this can arise from a number of sources which vary with the individual;
Overcoming internal inhibitions - most young people who sexually abuse are aware of the taboos against this behaviour, yet because of their experiences or a specific set of circumstances, they can overcome these;
Overcoming external inhibitions - this can include grooming the victim and involve creating the physical opportunity to commit the offence;
Overcoming the resistance of the child - the offender will employ a variety of methods to commit the offence and equally important keep the victim quiet. These may include bribery, threats or other forms of coercion.

Exploring behaviour using this model may help open up discussion and avoid the pitfalls of falling into asking too many "why" questions. Instead, open questions should be used such as "tell me", "explain to me", "describe to me."

Delays in completing criminal investigations need not necessarily delay referral for specialist help; there is often a significant delay between completing enquiries and a decision being made about whether to prosecute. A programme of work can be agreed with police and Crown Prosecution Service, usually with the proviso that the victim and specific incidents are not discussed.