A Parent Guide to Children with Problematic Sexual Behavior

“I just found out that my child engaged in problematic sexualized behavior with another child. Now what?”

For parents who face this incredibly difficult situation, you may feel like your world is crumbling around you. You may feel isolated, fearful, and unsure where to turn for help and information. You may wonder if your family will ever be the same and if your child will have life-long problems.

This article will guide you through the specific steps to take when you learn that your child has sexualized behavior or has engaged in inappropriate sexual behavior with another child.

What Are Problematic Sexualized Behaviors in Children and Teens?

All children engage in exploratory sexual activity. This is how children learn about their bodies. This behavior is normal and not harmful. However, some behaviors do not fall in line with what is healthy and need to be addressed.

Here are warning signs that a behavior is outside the real of normal:

• Behavior occurs frequently.
• Takes place between children of very different ages or abilities.
• Is initiated by strong feelings (anger, sadness) rather than exploring with curiosity.
• Causes or potentially can cause harm to another child.
• Involves coercion, threats, bribes, force, aggression, or secrecy.

Here are some examples of behaviors that are not typical and need to be addressed:

• Touching private parts (their own or someone else’s) to the point of causing pain or physical harm.
• A child who continually attempts to look at someone without clothes on or shows themselves without clothing over private parts.
• Sexual interaction with other children that includes oral-genital contact or sexual intercourse.
• Any sexualized behavior that includes force, coercion or aggression.

After parenting children with abnormal sexual behavior and working with many families whose children have unhealthy sexual behavior, I encourage you to trust your instincts as a parent. If you believe the behavior your child is displaying is alarming, abnormal, unhealthy, manipulative, or abusive, you are probably right. Be assertive to seek treatment and help for your child.

Can Treatment Help Children Who Act Out Sexually?

Yes. Treatment is available and can help children with sexual problems. Here are some important facts about children with atypical sexualized behavior:

• Children and teens who receive treatment can be taught to have healthy sexual boundaries and behaviors. Treatment outcome statistics for children are much more positive than those of adults.
• Many children (40-80%) who have sexualized behavior were victims of sexual abuse, but not all. Do not assume that only children who are sexually abused themselves will act out sexually. This is especially true of children with attachment disorders (RAD) because they desire control and many do not have a healthy conscious.

When Your Child Acts Out Sexually: Step by Step What To Do for Parents

When you find out that your child has engaged in inappropriate sexual behavior, your thoughts are a swirl of emotion and you probably don’t know where to turn for help. While there is information available for when your child is a victim of sexual abuse, little information exists for what to do when your child has perpetrated the behavior.

Here is helpful guidance for what to do, step by step.

Step 1: Take care of yourself.

Don’t panic.

Stop, take a breath, and calm down. As much as it’s tempting to panic, remember that your calm guidance is needed to hold your family together. The problem didn’t develop in one day and it won’t be solved in one day, but know that healing and treatment are possible.

Remember that treatment for sexual problems in children has a much higher success rate that treatment for adults, so stay hopeful and positive.

Allow grief.

Allow yourself time and space to grieve. This is a devastating discovery that is hard to take in. Your life is not over, but it will change. You hurt for your child, yourself, and any children that were harmed by your child.

You may feel guilt that this happened on “your watch”. You wonder what you did wrong because your child engaged in this inappropriate behavior.

If the sexual abuse occurred between siblings, you may feel like you are in a real life version of the movie Sophie’s Choice, where you have to choose between your two children. This is an impossible situation for any parent and there are no easy answers.

While all these feelings are understandable and need to be grieved, harboring endless guilt, shame, or anger doesn’t help you or your child to move forward. Your calm presence will be important for healing and recovery.

Take time for yourself.

Take the time you need to care for yourself as you take the necessary steps to care for your child or children. You’ll have difficult times and the road can feel lonely. Talk with a friend, spouse, or counselor. Make time each day for self-care. Your child has the best chance of healing when you are doing well yourself.

Step 2: Report.

While it may be one of the most difficult things you will ever do, it’s important to report the situation to the proper authorities. Besides being the right thing to do, reporting may be necessary to get the necessary treatment and services for your family.

The following are options for reporting the situation. You may choose to report to one, two, or all three of the following.

Report to a professional.

The first step is tell what happened to a professional who is currently working with your family. This could be a therapist, school social worker, or pediatrician. These professionals are mandated reporters which means they are required by law to report what happened. They are also trained in how to handle this type of situation and next steps to take.

File a police report.

You have the right to file a police report and it may be requested that you do so. Call the police department (not 911) and request to meet with a police officer to file a report. They will come to your home or invite you to come to the police station to take a report. They will not take your child away or press charges against you at the time of taking the report. This is simply a formal reporting of what happened. This type of report may be necessary in order for your child to receive treatment.

Report to the Department of Human Services.

You have the option to call the Department of Human Services (in the county where you live or in the county where the situation occurred) and report what happened. Your child will not be immediately taken away or placed into foster care if you make a report.

If you know that a professional (such as a therapist or doctor) will be reporting the situation, it’s a good idea for you to call and report, too, so that you can clearly explain the details of the situation from your point of view. After reporting, you may receive a follow-up visit from a department worker right away, in a week or two, or there might not be any further follow-up at all.

Step 3: Assessment.

As mentioned above, because some sexual exploration is normal, it can be difficult for parents to determine what is within the realm of healthy child behavior and what is deviant or inappropriate.

If you believe a behavior is problematic or are unsure, the next step is an assessment.

Medical Evaluation

If you feel your child might have been harmed or if there is physical evidence to gather, take any children involved to the pediatrician or emergency room for an evaluation. (For ER care, go to a Children’s Hospital when possible since they are better equipped to deal with a child’s needs at this time.)

Even if you think the time for gathering evidence has passed, it’s a good idea to take a child for a medical evaluation just to be on the safe side.

Forensic Interview

A forensic interview is an interview completed by a professional to determine the facts of a situation. In the case of sexualized behavior or abuse, the social worker or doctor is trained in techniques to do the best job in determining what happened without asking leading questions.

A forensic interview may be done for the child who was abused and/or the child who perpetrated the behavior. Information from this type of interview is admissible in court. After the interview is complete, a social worker can guide you toward the resources your child or family needs, such as therapy or victim services.

If the situation just happened or you just learned about it, it may be best not to ask your child too many questions until the forensic interview is complete. (This is especially important for foster parents.)

Psychosexual Evaluation

A psychosexual evaluation is an in-depth evaluation of a person’s sexuality and includes information about the person’s history, mental health, sexual desires, and in the case of someone who has abused others, the likelihood they will do it again (risk of re-offence).

Psychosexual evaluations are completed for children, teens, and adults. Because this is an in-depth evaluation, it can be quite expensive so you will need to seek funds to cover it from insurance, the court system, the Department of Human Services, or a treatment program.

This type of evaluation may be necessary to get a child proper treatment, or can be helpful in determining if children can live safely within a family or community environment.

Step 4: Supervision.

Once you find out that a child has acted out sexually with another child, proper supervision is absolutely necessary.

Line of Sight Supervision

If the child remains in your home, he or she should not be left alone with other children or pets. Begin line of sight supervision, which means that the child is within an adult’s line of sight at all times. Children should not share a bedroom, use the restroom at the same time, or change clothes together. The child should not go into public bathrooms without adult supervision.

This level of supervision must continue until evaluation and treatment have been completed. While this type of supervision is very difficult in a home situation, it can be done.

Restraining Order

It’s possible that the court will order a restraining order between the child who perpetrated the behavior and the one who was a victim. If this is the case, the two children will not be allowed to live in the same home together or see each other (even if they are siblings) until the restraining order is lifted. Typically the restraining order is lifted once both children have completed treatment and the victim’s therapist gives approval.

Family Safety Plan

When children will continue to live together in the same home, creating a family safety plan helps to keep all members of the family safe during and after treatment.

Step 5: Treatment.

Here are some of the interventions that are available that are specifically designed to address the needs of children who act out sexually.

Boundaries Therapy

For children under the age of 12 and children who may not fully understand the ramifications of their actions (such as those with low IQ or autism), boundaries work may be the most appropriate treatment. This type of therapy teaches what is appropriate for sexualized behavior, touching other people’s bodies, and how to have a healthy sexuality that does not harm others.

Reconciliation and Reunification Therapy

For children who have perpetrated, hurt, or abused another child, part of their treatment will involve the reconciliation and, if appropriate, a reunification process.

Reconciliation is a type of therapy where the perpetrator of abuse is taught to take accountability for his or her behavior, express remorse, and have compassion for the victim. Often this type of therapy involves writing a letter or statement taking full responsibility for the abuse that occurred, stating an apology, and explaining steps that have been taken so that it will not happen again. This is also sometimes called the clarification process.

Reunification is when a victim and abuser come together in a healing way to discuss what happened and repair the relationship. This is typically done with a therapist or therapists present. This type of reunification can only occur when the victim is ready, on the victim’s time table, and if the situation is deemed safe for all involved.

Trauma Therapy – Children who have been the victim of sexual abuse need to engage in their own therapy. This may be TF-CBT (Trauma-Focused Cognitive Behavior Therapy) which includes calming and coping skills work, parent education, writing or drawing a trauma narrative, and ensuring future safety as children learn to speak up for their needs.

Problem Sexualized Behavior Treatment Programs

Specific treatment programs exist to help children who have deviant sexual behavior.

Treatment programs can be residential treatment or inpatient programs, or they can be outpatient treatment. Some programs offer intensive in-home or day treatment. These programs are sometimes called “boundaries” or “specialized” treatment programs.

Problematic Sexual Behavior – Cognitive Behavioral Therapy (PSB-CBT) – This type of treatment program is an evidence-based treatment model for children and youth ages 3-18 who have engaged in problematic sexual behavior (PSB). Click here for more information about finding sexual treatment programs for children near you.

While learning that your child has sexual issues can be hard for any parent to face, by following these 5 steps you can move into healing and progress for your child and whole family.

Do you have a question about treatment for children with deviant sexual behavior? Share in the comments below.

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