Clinical update

Harmful sexual behaviour among children and young people

Your essential guide to harmful sexual behaviour among children and young people and how to prevent it

Your essential guide to harmful sexual behaviour among children and young people and how to prevent it

Essential facts

Harmful sexual behaviour is when children or young people engage in sexual discussions or acts that are inappropriate for their age or development. Many will naturally grow out of these behaviours, so while it is important they are not unnecessarily stigmatised, their actions should also not be ignored. 

What’s new

Harmful sexual behaviour in children and young people should not be ignored by nurses, according to new guidance from the National Institute for Health and Care Excellence (NICE). The guidance aims to ensure these problems do not escalate. For a small number of children and young people who commit sexual offences, there is evidence that shows early opportunities to recognise and address their behaviours were missed.

Signs and symptoms

Possible signs of problems include using sexualised language, such as adult slang, to talk about sex, and sexualised behaviour, such as sexting or sharing and sending sexual images using mobile or online technology. Viewing pornography that is inappropriate for age and developmental status; having sex; using sexual violence and inappropriate touching can all be signs. 

Causes and risk factors

Research suggests that two thirds of children and young people with harmful sexual behaviour have experienced some kind of abuse or trauma such as physical, emotional or sexual abuse, severe neglect, parental rejection, family breakdown, domestic violence, and parental drug and alcohol abuse. Around half had experienced sexual abuse.

How you can help your patient

Do not ignore inappropriate sexual behaviour. Treat each child and young person individually with an approach shaped to their circumstances and appropriate to their age. Involve family and support networks as action to change behaviour will only be effective if they understand there is an issue and are supportive. Use risk assessment tools that are suitable for the child or young person's developmental age and gender.

Expert comment

Maeve Murphy, clinical nurse specialist at forensic child and adolescent mental health services (CAMHS) for Greater Manchester West NHS Foundation Trust.

‘Inappropriate sexual behaviour has, up till now, been seen as a specialist area that nurses working in CAMHS and forensic services are most likely to encounter.

'But I hope these guidelines will show that nurses in all settings need to understand what it is and take action if there is concern, especially nurses in schools and health visitors.

'The Brook Sexual behaviours traffic light indicator is a really useful tool for nurses to use to see if a child or young person’s behaviour is causing concern for their age.

'If there are concerns, a nurse should start with speaking to their local safeguarding lead for advice.

'It is really important nurses do not treat children and young people who present with harmful sexual behaviour as mini sex offenders, but individually and as victims that need safeguarding in their own right.

'In the future, I hope that inappropriate sexual behavior will become part of all nurses safeguarding training.’

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