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1.4.6 Assessment of Harmful Sexual Behaviour in Children and Young People

SCOPE OF THIS CHAPTER

This guidance is intended to help workers identify sexual behaviours in children and young people which are a cause for concern. It should be read in conjunction with Abuse by Children and Young People who Display Sexually Harmful Behaviour (West Yorkshire Consortium Procedures Manual).


Contents

  1. Introduction
  2. How to use these Guidelines
  3. Part I - Deciding if there is a Cause for Concern and the Level of Seriousness
  4. Part II - If it is a Cause for Concern - Where to Next?
  5. Part III - Further Stages of Assessment


1. Introduction

The aim of this guidance is to help workers evaluate the information they have, in order to make a more informed judgement about whether a child/young person's sexual behaviour is a cause for concern.

Part I is divided along age lines because different issues apply due to the difference in development between pre-adolescent children and adolescents. Workers should refer to the section which most fits the child's developmental level rather than the child's age.


2. How to use these Guidelines

There are three sections:-

Part I - deciding if there is a cause for concern and the level of seriousness

  1. Pre-adolescent children
    • Introduction to the issues relating to pre-adolescents;
    • Criteria for assessing the context of the information;
    • Detailed checklist for gathering information;
    • References.
  2. Adolescents
    • Introduction to the issues relating to adolescents;
    • Criteria for assessing the context of the information;
    • Detailed checklist for gathering information;
    • References.

Part II - If it is a cause for concern - where to next?

  • Flow chart of where to go with the information;
  • Child protection procedures;
  • Consultation.

Part III - Further stages of assessment

  • Different types of assessment which follow the initial identification of a cause for concern;
  • Information required about the family context which is relevant to all assessments and age groups;
  • Information required for PSR reports.


3. Part I - Deciding if there is a Cause for Concern and the Level of Seriousness

Pre-Adolescent Children

Introduction

Identifying Sexually Inappropriate and Sexually Abusive Behaviour in Pre-Adolescent Children

A number of factors may make it more difficult to identify problematic behaviours in younger children.

  1. Society often views childhood as a time of innocence. Sexual issues and child sexuality in particular are rarely openly discussed. Professionals may well feel inhibited therefore in expressing their views about what is appropriate or inappropriate sexual behaviour;
  2. Inappropriate sexual behaviour encompasses a broad spectrum of behaviours. There may be general agreement on what constitutes healthy sexual development, at one end of the spectrum, and coercive aggressive sexual abuse at the other, but less certainty about the range of behaviours in between;
  3. Concern about labelling young children as 'abusers', can lead to minimising the problem;
  4. Lack of strategies to deal with problematic sexual behaviours may lead to our feeling disempowered and reluctant to flag up the problem in the first place.

What follows is not intended to provide all the answers, but hopefully will be of help in increasing workers' confidence in identifying sexually abusive and inappropriate behaviours in pre-adolescent children. Labelling the behaviour in this way, rather than the child, avoids damming the child.

What Causes Sexually Inappropriate and Sexually Abusive Behaviour in Young Children?

There is growing evidence that many pre-adolescent children who exhibit sexually abusive behaviour have experienced or witnessed sexual activity themselves, or live in a highly sexualised environment.

In general, the younger the child displaying sexually abusive behaviour, the greater the likelihood that the child has been sexually abused or lives in a highly sexualised environment. Therefore the initial investigation needs to be structured in such a way as to not only assess the risks the child poses to others, but also to assess the child as a vulnerable child in their right. A Child Protection Conference is particularly relevant when working with younger children who display abusive behaviour.

Whilst these findings from research are important, it is important to state that not all children in these situations or experiencing sexual abuse will develop problematic behaviours and abuse others. In addition not all children who initially display problematic sexual behaviour will develop an abusive career path. Research has shown that some children who displayed these behaviours when followed up at a later stage no longer displayed these behaviours, others appear to have certain behaviours stop and resurface again in adolescence while others continue through to adulthood.

There is less certainty about what makes some abused children go on to display abusive behaviours themselves, while others do not. Research has identified a number of risk factors which may make sexually abused children more likely to go on to abuse others, and factors which increase their chances of coping with abuse or adverse factors in their environment.

Risk factors associated with child's experience of sexual abuse

  • Nature of abuse - repeated, long duration, greater severity;
  • Perpetrator - close relatives, multiple perpetrators;
  • Age of child - impact is greater the younger the child;
  • Action following disclosure - rejection/blame by family and significant others.

Risk factors independent of own sexual abuse

  • Experience of persistent physical violence within the family as victim and/or witness;
  • Lack of attention to the children's emotional needs;
  • Separation from important attachment figures and rejection by the family;
  • Whether there are protective processes at work i.e. whether the children have had opportunities to learn how to cope with the effects of their sexual abuse;
  • Family characteristics - high rates of poverty, schedule I offenders in wider extended family, criminality, poor attachments between parents and children.

Factors associated with children coping with abuse or adverse factors in their environment

When carrying out an assessment, workers also need to consider protective or mitigating factors:

  • Secure relationships - positive, stable attachments;
  • Emotional expressiveness - the ability to convey/understand own and others emotions, develops from the long term positive relationships in families, peer groups and community settings;
  • Positive role models - connections to people who serve as confidants and positive models of conduct. Could be peers as well as adults;
  • Positive self identity - self esteem, as well as one's own culture/ethnic group.

Theoretical Models

These are some of the theoretical models writers have used to understand why children display sexually abusive behaviour.

1. Finkelhor and Brown's Traumagenic Model (1986)

Finkelhor and Brown suggest that sexual abuse traumatises children through four distinct mechanisms, which may account for the response the individual has to that abuse. Most relevant here is the concept of traumatic Sexualisation which is based on learning theory, and suggests that children learn to behave in sexually inappropriate ways through repeated conditioning with positive reinforcement (attention/affection in exchange for sex). Children who have been sexually abused become highly eroticised and the difference between sexual relationships and affection becomes blurred.

2. Post Traumatic Stress Disorder

This model applies to trauma generally, but applied to children who have been abused, their sexually aggressive behaviour is viewed as a response to their own previous trauma.

In order to process traumatic material, children re-enact their experiences through play or action. Their behaviour is seen as an attempt to recreate their own abuse in ways which allow them mastery and control over their feelings. This may be because children have fewer alternative coping strategies open to them and their cognitive abilities are more limited.

3. Projective Identification

This is a concept from psychoanalytic theory which describes as maladaptive defence mechanism. Applied to abused children, projective identification with the aggressor is a way of relieving feelings of helplessness, fear and shame associated with the original abuse. Aggressive sexual acting out (doing what was done to them) becomes the compulsive behaviour which replaces, if temporarily, the unbearable emotional pain with feelings of power and omnipotence. Sexually aggressive behaviour may become the child's way of resolving situations in the present which arouse feelings of anger, distress or anxiety.

Age Appropriate / Healthy Behaviours

"It is important to assert that children are sexual beings, capable of demonstrating a positive, healthy, creative and spirited interest in sexuality". (Gil)

"Two things about childhood sexuality can be said with certainty: (1) sexual curiosity, interest, experimentation, and behaviour is progressive over time and (2) sexual development is affected by a number of variables (Gil). Martinson (1991) describes these variables as "cultural norms and expectations, familial interactions and values, and the interpersonal experiences encountered"

The section below are sexual behaviours defined by Eliana Gil and Toni Cavanagh Johnson (1993) which could be expected at various ages and stages of development.

Pre -schoolers 0 - 4 years old

Children in this category have limited peer contact and tend to be involved in self exploration. They discover the fact that they can achieve pleasurable sensations by stimulating themselves. This behaviour is likely to happen randomly and sporadically.

They tend to be disinhibited and it can also be an exhibitionist stage, where they show their genitals to others or are interested in other's bodies. They begin to imitate life around them and this can lead to them "copying" adult behaviour either out of curiosity or because of the reactions they get from those around them. Games such as "mummies and daddies" and "doctors" are prevalent at this stage.

Young school-age children 5 - 7 years old

These children now have more access to peers and more inter-active sexual exploration can take place both with the same gender and opposite gender peers. This is the questioning stage and children will be fascinated with bodies and sexual behaviour. Overt displays of affection such as kissing can cause great hilarity and expressions of disgust. Children may also find great pleasure in the telling of "rude jokes", some of which they may not understand but they like the reactions particularly of the adults around them.

Self masturbation is less random now and there is more exploration around different ways of achieving these pleasurable sensations. This information may be shared with peers possibly of the same sex. Feelings about privacy and inhibitions about showing their bodies can begin to develop around this time.

Latency aged children 8 - 12 years old

At this stage most young people are entering puberty. Their bodies are changing and the active hormone changes create a range of physical and emotional sensations. They may become more absorbed with masturbatory activities and begin to experiment with other sexual behaviours. They may go through periods of inhibition and disinhibition.

More sharing of information, comparing of bodies and competing particularly with regard to masturbation begins with peers, usually on a single sex basis. Relationships and sexual experimentation with the same and opposite sex may begin.

Characteristics of Age Appropriate and Problematic Sexual Behaviours

a) Characteristics of age appropriate behaviours

Gil describes the dynamics of age appropriate sexual behaviours as including "spontaneity, joy, laughter, embarrassment and sporadic levels of inhibition and disinhibition".

Age appropriate behaviour is also about mutuality, consent, curiosity, with no intent to cause hurt. The children involved engage in the behaviour freely and can disengage when they choose.

b) Characteristics of problematic behaviours

Gil describes problematic sexual behaviours as having "themes of dominance, coercion, threats and force. Children seem agitated, anxious, fearful or intense. They have higher levels of arousal and the sexual activity. It is as though no other activity gives the same degree of pleasure, comfort, or reassurance, and it becomes the focus for the child's life. This behaviour is usually extremely unresponsive to any parental or caretaker limits or distractions.

Using the frameworks of Groth and Laredo (1981) and Sgrol and colleagues who studied adolescent sex offenders, Eliana Gil proposed a set of criteria for assessing whether the sex play between children is age-appropriate or a cause for concern.

However she warns "When making assessments, the professional cannot consider a single criterion, but must appraise the situation along several criteria before reaching a conclusion. Using a single criterion can lead to over or under-reacting". 

Criteria for assessment of problematic behaviours

Problematic Sexual Behaviours

Johnson (1999), offers the following characteristics of problematic sexual behaviour in children that will alert us to possible problems with their sexual development and merit further assessment. The characteristics at the beginning of the list are less worrying than those towards the end.

  • The children engaged in the sexual behaviours do not have an on-going mutual play relationship;
  • Sexual behaviours that are engaged in by children of different ages or developmental levels;
  • Sexual behaviours that are out of balance with other aspects of the child's life and interests;
  • Children who seem to have too much knowledge about sexuality and behave in ways more consistent with adult sexual expression;
  • Sexual behaviours that are significantly different than those of other same age children;
  • Sexual behaviours that continue despite consistent and clear messages to stop;
  • Children who appear unable to stop themselves participating in sexual activities;
  • Children's sexual behaviours that elicit complaints from other children and/or adversely affect other children;
  • Children's sexual behaviours that are directed at adults who feel uncomfortable receiving them;
  • Children (over 4 years) who do not understand their rights or the rights of others in relation to sexual contact;
  • Sexual behaviours that progress in frequency, intensity, or intrusiveness overtime;
  • When fear, anxiety, deep shame, or intense guilt is associated with the sexual behaviours;
  • Children who engage in extensive, persistent mutually agreed upon adult-type behaviours with other children;
  • Children who manually stimulate or have oral or genital contact with animals;
  • Children sexualise non-sexual things, or interactions with others, or relationships;
  • Sexual behaviours that cause physical and/or emotional pain or discomfort to self or others;
  • Children who use sex to hurt others;
  • When verbal and/or physical expressions of anger precede, follow, or accompany the sexual behaviour;
  • Children who use distorted logic to justify their sexual actions;
  • When coercion, force, bribery, manipulation, or threats are associated with sexual behaviours.

Johnson, (Gil and Johnson 1993, Chapter 3), identifies definable groups of children based on a continuum of the level of sexual disturbance. Each group includes a wide range of children, with some on the borderline between groups, or those who move between groups over a period of time.

In summary these groups are:

  • Group One - Normal Sexual Exploration;
  • Group Two - Children who are sexually reactive.

Children who are sexually reactive will display more sexual behaviour than children with healthy sexual development. Their focus on sexual behaviour is out of balance. Most of the children in this group will have been sexually, physically and/or emotionally abused and those who haven't been directly abused will have been exposed to sexually overwhelming environments. These children are likely to be confused and overwhelmed by sex and sexuality and this leads to more frequent and visible sexual behaviours, as they are unable to absorb or fit their experiences into their developing sexuality.

Behaviours that characterise this group of children are solitary sexual behaviour such as excessive masturbation and sexual behaviour with other children and sometimes adults. This behaviour is often not in the child's control. The child does not use coercion or force or attempt to maintain secrecy and any harm or discomfort to others is not intentional. The sexual behaviours of these children appear compulsive and are often linked with deep shame, guilt and a pervasive anxiety. Many children in this group may be suffering from Post traumatic Stress Disorder caused by their own abuse.

  • Group Three - Extensive Mutual Sexual Behaviours

Children in this group are typically children who have suffered physical, sexual and emotional abuse and neglect. Many will have been physically and emotionally abandoned and many will be in substitute care. They have learnt that adults hurt them and are distrustful of relationships with adults. They frequently associate sex with love and caring and they look to other children to help meet their emotional needs through sexual behaviour. These children do not use force or coercion but find other similarly lonely and abused children to engage in a full range of sexual behaviours with. The behaviour gives them, if only momentarily, a sense of being close to someone and to relieve their feelings of despair.

Children in this group do not show emotion about their sexual behaviour unlike the children in group two who feel shame and guilt and those in group four who show anger and aggression. They seem to have a matter of fact attitude towards acting sexually with other children. These children will have started in group two as sexually reactive children and have begun to use sex as a coping mechanism. They may move into group four.

  • Group Four - Children Who Molest

Children in this group show sexual behaviours, which are beyond developmentally appropriate behaviours. They may engage in a full range of adult type behaviours. In a similar way to children in group two, they are preoccupied with sex and sexual behaviour and there is an impulsive and aggressive quality to their behaviour. Anger, rage, loneliness and fear often characterise their feelings around sexual behaviour. These children sometimes use physical aggression towards their victims and will always use coercion and seek out children who are vulnerable to bribes, to being fooled or to force and threats. These children will always be in a position of power over their victims, whether through size, age, status, intellectual ability etc. These children often display behaviour problems, have few friends and few interests. They have difficulties with impulse control and few coping skills. Their sexual behaviours increase over time and form a pattern. They rarely if ever show any empathy for their victims.

Children who molest may have been sexually abused, virtually all will have sexual abuse in their families, will have suffered emotional and probably physical abuse and will have witnessed extreme physical violence between their primary caretakers. These children are at high risk for continuing and escalating their sexual behaviours.

Detailed Checklist for Referral, Initial Investigation and Establishing Cause for Concern with Younger Children

Checklist for under 10's

  1. What type of sexual activity has the child been engaging in?
  2. What is the frequency of the behaviour?
  3. How persistent is the child's behaviour?
  4. What is the relationship of the children involved in the sexual behaviour?
  5. What is the context that the sexual behaviour occurs in?
  6. What is the response of the other children?
  7. Can the child talk about these behaviours?
  8. What is the child's emotional response to the behaviour?
  9. Does the child take any responsibility for these behaviours?
  10. Is the child willing to work on managing their behaviour?

References

Bentouin., Williams. (1998) 'Children & Adolescents: Victims Who Become Perpetrators' in (APT (1998) Vol 4 Page 101)

Cavanagh Johnson, Toni. (1998) Treatment Exercises for Child Abuse Victims and Children who Sexually Abuse Others Sage Press

Cunningham, Carolyn., MacFalane, Kee. (1991) When Children Molest Children The Safer Society Press.

De, Carol., Print, Bobbie., (1992) ' Young children who exhibit sexually abusive behaviour'. In From Hearing to Healing. Ed. Anne Bannister. Longman Books.

Gil, Eliana., Cavanagh Johnson, Toni. (1993) Sexualised Children Launch Press.

Pither, William D., Gray, Alison., Cunningham, Caroline., Lane, S. (1993) From Trauma to Understanding. The Safer Society Press.

Ryan, G>D, Lane, S>L., (1991) eds. Juvenile Sexual Offending - Causes, Consequences and Corrections Lexington Books.

Adolescents

Identifying Sexually Inappropriate and Sexually Aggressive Behaviours in Adolescents

Adolescence is a term generally applied to the transitional period between childhood and adulthood and it is a period of significant physical and emotional sexual development. There have been profound changes in sexual behaviour since the 1960's and this has affected the adolescent population as much as any other group. Sex education is mandatory in schools but only the biological aspects are compulsory. Adolescents are exposed to a wide range of environmental influences, from peers, TV, internet, magazines etc., portraying messages about sex as well as those they receive from their family. Interest and curiosity in sexual activity is normal and healthy for adolescents - young people will want to experiment - but it must be remembered that most young people deal with this without abusing other people.

Because of the unique developmental aspects of adolescence it is important to differentiate between adolescents and:

  1. Those younger children who sexually act out but who research and clinical experience identifies as having different characteristics and needs;
  2. Adult offenders who are developmentally mature.

What causes inappropriate and sexually aggressive behaviour in adolescents?

Sexual behaviour is learned and shaped by many factors including environment, social learning, family, inter-personal relationships and experiences, psychological and biological influences, and these factors are unique in each case. There are no single factor explanations, and adolescent sexual abusers are not an homogenous group. Adolescent sexual abuse is reinforced by low self-esteem, poor social skills, distorted thinking, sexual fantasy and masturbation, and without intervention such behaviour is more likely to escalate than diminish.

Age Appropriate Sexual Behaviours

Because there are a wider variety of sexual behaviours within adolescence it is more difficult to determine what the 'norm' would be. However a useful checklist by O'Callaghan and Print is included below which has been adapted from Ryan and Lane (1991) (in Morrison et al 1994).

Normal behaviours

  • explicit sexual discussion amongst peers, use of swear words, obscene jokes;
  • interest in erotic material and its use in masturbation;
  • expression through sexual innuendo, flirtations and courtship behaviours;
  • mutual consenting non-coital sexual behaviour (kissing, fondling, etc);
  • mutual consenting masturbation;
  • mutual consenting sexual intercourse.

Behaviours that suggest monitoring, limited responses or assessment

  • sexual preoccupation/anxiety;
  • use of hard core pornography;
  • indiscriminate sexual activity/intercourse;
  • twinning of sexuality and aggression;
  • sexual graffiti relating to individuals or having disturbing content;
  • single occurrences of exposure, peeping, frottage or obscene telephone calls.

Behaviour that suggest assessment/intervention

  • compulsive masturbation if chronic or public;
  • persistent or aggressive attempts to expose others' genitals;
  • chronic use of pornography with sadistic or violent themes;
  • sexually explicit conversations with significantly younger children;
  • touching another's genitals without permission;
  • sexually explicit threats.

Behaviours that require a legal response, assessment and treatment

  • persistent obscene telephone calls, voyeurism, exhibitionism or frottage;
  • sexual contact with significantly younger children;
  • forced sexual assault or rape;
  • inflicting genital injury;
  • sexual contact with animals.

Assessment of concern

Adolescents are above the age of criminal responsibility i.e. 10 years old, and sexually aggressive behaviour is likely to constitute a criminal offence and involve a Police enquiry. This clearly indicates a cause for concern. In some circumstances the Police may not be involved but similar criteria might be applied in assessing whether the behaviour is appropriate. For this purpose the following definition of "the adolescent sex offender" is useful:

The adolescent sex offender has been defined as a minor who commits a sexual act with a person of any age:

  1. Against the victim's will;
  2. Without consent;
  3. In an aggressive, exploitative or threatening manner (Ryan and Lane 1991).

In assessing the distinction between acts that are experimental in nature and those that are exploitative the context of the behaviour needs to be considered and the notions of consent, equality and authority can be applied as assessment criteria.

Consent is seen as having four elements:

  1. Understanding the proposal;
  2. Knowing the standard of behaviour;
  3. Awareness of possible consequences;
  4. Respect for agreement or disagreement.

Equality can be thought of at a number of levels in relation to perceived differentials of power - which can be affected by: age, size, race, gender, power of peer popularity, strength often previously demonstrated in non-sexual behaviour, self-image difference, arbitrary labels such as leader/boss etc., and fantasy labels in the context of play such as Leeds United Captain (picking players for the team).

Authority is to do with control and coercion. Ryan (1991) identifies a continuum of control in sexual acts ranging from:

  • Normal - no coercion, activity done in fun;
  • Manipulation/peer pressure at a subtle non-physical level;
  • Coercion by threats and bribes;
  • Physical force, weapons and other direct threats.

Legal Process

Involvement in the legal process will bring the young person into contact with other agencies. The possibility of a pending prosecution is likely to enhance any denial (often on the advice of a solicitor) thus making some aspects of assessment difficult. Liaison with Youth Justice Services is important, particularly if some formal assessment work is needed to inform a Pre-Sentence Report.

Detailed Checklist for Referral, Initial Investigation and Establishing Cause for Concern with Adolescents

  1. Why has the young person's behaviour caused concern and to whom?
  2. Was the behaviour appropriate to the age, intellectual, emotional and social functioning of the young person?

    Does the activity involve sexual knowledge on the part of the young person over and above what would be considered age appropriate?
  3. In what context did the behaviour occur?

    What preceded the behaviour? Was it planned or spontaneous?
  4. How frequently has the behaviour occurred?

    The more frequent the behaviour the more concern. Is there any evidence of escalating behaviour?
  5. What is the nature of the social relationship between those involved?

    Are they related? Is there a power imbalance in terms of size, power, ability and authority? Is one ore assertive? What is the age difference?
  6. Did the other person give informed consent?

    Was the other person precluded from this by age? Was there any evidence of protest, avoidance or physical resistance which suggested consent was not given? Did the young person attempt to ensure secrecy?
  7. What was the experience of the victim?

    How has the person who experienced the behaviours perceive them? Do they see them as abusive? Do they blame themselves? Are they able to consent to the activity even if they have expressed no concerns?
  8. Have those involved tried to ensure that the behaviour remains secretive?

    If so, how far have they done this and why? Is it because the abuser has threatened the victim? 
  9. What are the reactions of family members?

    Are they dismissive of the behaviour or attempting to minimise it?
  10. Has the child been confronted about his/her behaviour previously?

    Do any records contain information on sex education needs/therapeutic input?

References

Araji, S.K., (1997) Sexually Aggressive Children - Coming to Understand Them Sage Press

Calder, M.C., (1997) Juveniles and Children Who Sexually Abuse: A Guide to Risk Assessment Russell

Dale. F., (1997) 'Troubles of Sexuality' in Varma, V., Ed. Troubles of Children and Adolescents Kingsley

Gil, E., Cavanagh Johnson, T., (1993) Sexualised Children Sage Press

Hoghugi, M.S., (1997) Working with Sexually Abusive Adolescents Sage Press

Khan Timothy J., (1990) Pathways - A guide for parents of youths beginning treatment Safer Society Press

Morrison, T., Erooga, M., Beckett, R.C., (1994) Sexual Offending Against Children Routledge

Ryan, G.D., Lane, S.L., (1991) Juvenile Sexual Offending (Causes, Consequences and Corrections) Lexington Books

Terre, L., Burkhard, B., (1996) 'Problem Sexual Behaviours in Adolescence' in Bau, G.M., Gullotta, T.P., Adolescent Dysfunctional Behaviour Sage Press


4. Part II - If it is a Cause for Concern - Where to Next?

Where to Next Flowchart for Action

Useful Contacts

Useful Contacts for discussion/consultation

Advanced Practitioner

Area Youth Offending Team

Therapeutic Social Work Team - 2143301


5. Part III - Further Stages of Assessments

The purpose of this document is to provide information to aid workers carrying out the Child and Family Assessment. Full comprehensive risk assessments are the next stage of the process.

Following the identification of sexually inappropriate/aggressive/abusive behaviour a Child and Family Assessment will be undertaken. The following areas should be considered:

  1. What are the risks to other children in the same household or in the community – are immediate protection measures needed? i.e. is it safe for the child/young person to remain at home;
  2. Assessment of the child/young person's own needs both as a Perpetrator and as a vulnerable child, which is offence specific, looking at their risk to others and at risk to themselves;
  3. Assessments for Court which are offence specific and will be determined by any criminal proceedings and need further treatment. For details on what needs to be included in a Pre-Sentence Report on a young sex offender, please contact the Youth Offending Team.

Any further assessment undertaken has to be seen in the context of the child/young person's family as well as in the identification of sexually inappropriate/abusive behaviour.

Child and Family Assessment

1. Why do we need to assess families?

Because the family is so influential, and because for many children and young people their abusive behaviour will have happened whilst they are living within their families. It is vitally important, therefore, to understand the family setting and dynamics.

The assessment should help to give information about whether the family have participated either overtly or covertly in shaping the abusive behaviour of the child/young person. It will also inform an assessment of the family's acceptance of the need to change the child's behaviour and their awareness of the need for protection for the child and other siblings/children.

2. What needs to be included in the family assessment?

Child and Family Assessment should include:-

  1. Family members perceptions of the abusive behaviour - what happened, how, what should the consequences be any why, what are the levels of denial or minimisation shown by the family, who knows and who doesn't know about the behaviour?
  2. Reaction of family to disclosure - who do they support and why, are they taking adequate steps to support and protect the victim or potential victim, do they want help for the child/young person  who has displayed the problematic behaviour?
  3. Reaction of extended family or significant others - who do they support and why, what is the nature oft heir relationship with the child/young person and immediate family, what potential resources or unhealthy influences do they bring?

3. Using the Child and Family Assessment to evaluate risk and plan further intervention

The Child and Family Assessment will give a better understanding of the child and family's circumstances, the nature and scope of the problems in the family, the immediate risk factors and areas of future work with the family.

If the family are dismissive of or minimise the child's behaviour, blame the victim(s), refuse to participate in assessment or treatment, then the prognosis for change is poor.

If the family are appropriately concerned, would support the child/young person in receiving help and see themselves as an integral part of the process, then the prognosis is correspondingly more positive. If the child/young person remains at home it is vital that parents/carers are able and willing to provides sufficient supervision and external controls on the child/young person's behaviour, to create a safe environment in which work with the child/young person can begin.

Checklist for the Fuller Family Assessment

Child Developmental Needs

  1. What sexual material is available in the home to adults and children?
  2. How does the family discuss sexual issues? E.g. is there permission to discuss sex and is the information provided age appropriate for the children's level of understanding?
  3. Is there information given about privacy, right to their bodies, not to be touched?

Parenting Capacity

  1. What are the limits on behaviour which are set out and what methods of reprimanding are used?
  2. How are the rules of the family communicated and enforced?
  3. Are there age appropriate expectations of the children in terms of their role in the family generally?
  4. Is parenting handed over to the older children?
  5. What is the adults understanding of age appropriate sexual behaviour for children and how children conceptualise this?
  6. What boundaries are set for physical interaction between members of the family and between them and others?
  7. What is the family's view of protection issues and how they are put into practice?
  8. What are the family's attitude to jokes and teasing about sex and sexuality?

Family and Environment

  1. How are the interactions between children and siblings; and children and adults characterised? E.g. affectionate, aggressive, touching.
  2. What sort of language is used in the home? How do the family communicate with each other? E.g. warmly, positively, put downs etc. Is sexualised language used?
  3. How do the family show affection to each other?
  4. What is the family's belief system about children and sexuality? Is this in keeping with generally accepted beliefs within the family's cultural background?

Assessment of the Child/Young Person's own needs both as a Perpetrator and as a Vulnerable Child

For this type of assessment three elements need to be assessed - the offence itself, the risk the child/young person poses to others and the risks they are exposed to themselves.

Wenet & Clark's Juvenile Sexual Offender Decision Criteria (1986)

Evaluation

Low Risk

  • First documented offence, without evidence of a developing pattern;
  • Offender willing to explore offence in a non-defensive manner;
  • Offender acknowledges and understands the negative impact of the offence on victim (empathy);
  • Offender willing to accept responsibility for committing the offence without blaming others or circumstances;
  • Offender is guilty and remorseful because of the negative impact of offence on victim;
  • Offender understands the exploitative nature of the offence and reasons for its wrongfulness;
  • Offender admits to committing entire offence for which he/she was charged;
  • Parents/guardians acknowledge and understand the negative impact of the offence upon the victim;
  • Parents/guardians hold adolescent responsible for the offence without externalising blame onto others or circumstances;
  • Parents/guardians acknowledge adolescent committed entire offence for which he/she was charged;
  • Offender has healthy attitudes about sexuality;
  • Offender has no history of behaviour disorder involving physical aggression;
  • Offender's family unit is functional;
  • Family supportive of treatment and willing to become involved in therapy;
  • Family identifies problems within the family unit and among members other than the deviant sexual behaviour of offender;
  • Offender has adequate social adjustment, including presence of a peer support group and participation in peer group activities;
  • Offender has no history of behavioural and/or academic school problems.

Moderate Risk

  • Offender has committed two or more documented offences;
  • Discontinuation of offence behaviour if/when victim showed distress;
  • Offender resists describing and exploring offence in a non-defensive manner;
  • Offender does not understand the exploitative nature of the offence;
  • Offender minimises the negative impact of the offence on victim (little empathy);
  • Offender has little or no guilt or remorse because of the impact of the offence on victim;
  • Offender externalises blame for the offence onto others or extraneous circumstances;
  • Offender minimises extent of involvement in the offence, admitting to only part of the offence;
  • Offender resists participation in the evaluation without refusing;
  • Parents/guardians minimise the negative impact of the offence on the victim;
  • Parents/guardians externalise blame for the offence onto others or extraneous circumstances;
  • Parents/guardians minimise extent of offender's involvement in offence, holding him/her responsible for only part of the offence;
  • Parents/guardians resist participation in the evaluation without refusing altogether;
  • Offender has negative self-esteem;
  • Offender has depressive symptomatology;
  • Offender has unhealthy attitudes about sexuality;
  • Offender has been a victim of sexual or physical abuse, though this has not been a chronic or repetitive pattern;
  • Mother or father is a sexual offender;
  • Mother or father has been a victim of sexual and/or physical abuse;
  • Family unable to identify problems within family unit or among members other than the deviant sexual behaviour of offender;
  • Family is dysfunctional in response to transient situational factors, such as life cycle changes or other crises;
  • Offender has history of behaviour disorder involving physical aggression;
  • Offender shows poor social adjustment, including isolation from peers and few peer group activities;
  • Offender has history of behavioural and/or academic school problems.

High Risk

  • Offender has been treated for commission of a previous sexual offence;
  • Offence was predatory;
  • Offence was ritualistic;
  • Offence was sophisticated, involving precocious knowledge of sexual behaviour;
  • Offence resulted in physical injury to the victim;
  • Offence was associated with use of drugs or alcohol;
  • Offence involved violence, physical force, use of weapon, or threat to use weapon;
  • Continued offence behaviour despite victim's expressions of distress;
  • Evidence of progressive increase in the use of force used to commit repeated offences;
  • Offender completely refuses to participate in the evaluation;
  • Offender completely denies the referral offence;
  • Parents/guardians refuse to participate in the evaluation;
  • Parents/guardians deny that the offender committed the offence;
  • Parents/guardians deny that the offender has any psychosocial problems;
  • Offender engages in compulsive masturbatory fantasies involving deviant sexuality or offensive behaviour;
  • Evidence of thought disorder;
  • History of fire setting;
  • History of torturing animals;
  • History of chronic substance abuse;
  • Offender has been a victim of chronic and repetitive sexual and/or physical abuse;
  • Offender's family unit is chronically dysfunctional.

Code risk for re-offending: (1) low risk, (2) moderate risk, (3) high risk

Code prognosis/amenability of treatment outcome: (1) good, (2) fair/moderate, (3) poor

In addition to those factors identified by Wenet and Clark there are a number of other factors that re considered to be indicators of high risk:

  • Incest offenders;
  • Institutional history;
  • For rapists the first 12 months after treatment;
  • Assaults on both male and female;
  • History of truancy and/or absconding;
  • Unchanged cognitive distortions following treatment.

From Wenet & Clark (1988) in "Oregon Report on Juvenile Sex Offenders", Children Services Division, Dept of Human Resources State of Oregon, Salem OR97310

Assessment to Inform a Pre Sentence Report

Where a young person is being prosecuted for sexual offences and is admitting some culpability, it may be appropriate to carry out assessment work to inform the PSR. This may be undertaken by, or in conjunction with the Youth Offending Team, either in several individual sessions with the young person or by their attendance at a group. The assessment would determine the young person's:

  1. Sexual knowledge and attitudes to sexuality;
  2. General understanding of acceptable sexual behaviour and boundaries;
  3. Understanding of the nature of the offence and the reason for its wrongfulness;
  4. Willingness to accept responsibility;
  5. Level of victim empathy;
  6. Willingness to co-operate with a programme of work;
  7. Motivation to actively work towards changing abusive behaviour.

Additionally, there would be some evaluation of the level of support available from the young person's primary carers and their understanding, willingness and ability to co-operate with us.

End