Response and interventions into harmful sexual behaviour in schools

Scoping Review of the Definitions Used to Describe and Understand Harmful Sexual Behaviors in Children and Young People

There is a growing body of evidence that adolescents, and other children, are responsible for a significant proportion of sexual abuse against children. However, there are substantial differences in how this phenomenon is defined and conceptualized between and within sectors. This scoping review explored the current definitions of harmful sexual behaviors (HSB), and other similar terms, used across a range of stakeholder groups. In all, 141 papers were reviewed from both empirical and gray literature sources, including key policy and practice documents. Included papers needed to list a clear definition for the behavior of interest. There was disagreement and inconsistency across the included papers in their conceptualization of harmful, abusive, or problematic sexual behavior (PSB) in children and adolescents. Although the term HSB has been adopted as an umbrella term or continuum in many policy, practice, and research settings, there is a large variance in behaviors, treatment needs, etiology, and harms present across different types of sexual behavior. Relying solely on one term to describe a wide range of sexual behaviors in children and young people may limit the understanding of this issue and imply similarities between groups that are not present. We suggest that clearly defined subsets of HSB, such as sexual abuse, technology-assisted HSB, and PSB, may give more context to the behavior of concern and may be helpful in informing further research, prevention, and best practice approaches.

Young Love "Locked Down": Adolescent and Young Adult Perspectives on Sexting During the Covid-19 Pandemic in England

There were limited opportunities for in-person social, intimate, and sexual interactions in England during 2020-2021, due to restrictions imposed by the UK government in response to the Covid-19 pandemic. While previous studies examined the effects of lockdown on intimate relationships, there is less qualitative research regarding young people's perspectives on and experiences of digitally mediated intimacy (sexting) during the period. This paper discusses findings from focus groups with 80 adolescents and interviews with 38 young adults that explored the topic. Analysis identified a normalization of non-consensual distribution of intimate images within adolescent peer culture and a reluctance to report or intervene in response to incidents of non-consensual distribution that are witnessed or experienced. The adolescent girls and young adult women also described other forms of unwanted and invasive image-sharing and requests for images. Young adults held various perspectives on sexting during lockdown, with some describing sexting as unfulfilling and/or "risky" and others sharing experiences of using sexting to generate intimacy and, among some, engaging in unwanted sexting with partners. By considering both adolescent and young adult perspectives obtained through focus groups and interviews, the study highlighted how group-level norms and meanings surrounding the risks and rewards of sexting may be reproduced or reworked as individuals transition from adolescence to young adulthood. The study underscores the need to support adolescents and young adults in cultivating healthy digital sexual cultures and interpersonal relationships.

A descriptive analysis of children seeking medical attention for problematic sexualized behavior

Introduction

Problematic Sexualized Behavior (PSB) in children is an increasingly prevalent and often misunderstood issue that impacts the well-being of children. Quantifying the numbers of affected children is challenging due to inconsistencies in how these children are identified, as well as misperceptions surrounding the issue and lack of a coordinated community response.

Methods

In this single-center retrospective case review, we attempt to report data on child demographics and case characteristics for children presenting to one Child Protection Program (CPP) medical specialty team for concern of PSB.

Results

A total of 224 children were identified as having engaged in PSB during the study period. 110 (49%) of these children were referred to the CPP for medical evaluation and medically triaged by the team. The remaining 114 children (51%) were identified through the medical triage of the presenting cases as having engaged in PSB with the index children, but were not referred to CPP for medical care themselves. The majority of children who were referred (69%) were the recipient of the PSB, compared to being the displayer of the behavior (20%). Of the recipient cases, the child displaying PSB was also referred to the CPP only 14.5% of the time.

Discussion

These results highlight that the number of children presenting for medical evaluation with concern of PSB is a significant underestimation of the prevalence of PSB in the community. This notable gap in identification of children engaging in PSB prevents service delivery for these children, including medical evaluation. The results also demonstrate that children displaying PSB were disproportionately missing from care and represent a specific area of missed opportunity for intervention and support by medical professionals.

Strengthening Schools' Responses to Students' Harmful Sexual Behaviors: A Scoping Review

Research into harmful sexual behavior (HSB) by children and young people under the age of 18 has grown in recent years. A key concern emerging is the high prevalence of HSB in school settings. Although teachers are increasingly aware of HSB, their provision of effective responses has remained a major challenge. While progress has been made by providing teachers with best practice models and tools, little is known about what facilitates and hinders their application of these in practice. This scoping review sought to address the question: "What are the barriers and enablers for teachers in responding effectively to HSB?" Eight international databases and one search engine were employed to identify relevant academic and gray literature. The inclusion criteria comprised all study types, published in the past two decades, and focused on teachers' knowledge, experiences, and responses to HSB. Twenty-five publications met the inclusion criteria. Thematic analysis identified that minimization of HSB, harmful social norms, and inadequate support from external agencies were major barriers. These barriers could be mitigated by adopting a whole-school approach and establishing proactive partnerships with parents and external agencise, along with offering alternative pathways to safety. The findings of this review highlighted the importance of addressing the full continuum of HSB through early, secondary, or tertiary interventions, and sharpening the focus of respectful relationships education to transform gender relations in classrooms and the workplace. Further research is needed to explore schools' responses to specific populations, including those with disabilities and females.

Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis

BACKGROUND

Exposure to sexual content, such as online pornography or live sexual content, has been posited in the literature as a risk factor for problematic sexual behaviors (PSBs) in children and adolescents, and has been identified as an important avenue for research and intervention, particularly given the ubiquitous access to technology among children.

OBJECTIVE

To examine the association between live/violent and non-violent sexual content exposure and PSB among children and adolescents. Objectives also include informing future research on sexual content exposure as a risk factor for PSB, and providing clinical recommendations related to prevention and intervention.

PARTICIPANTS AND SETTING

Results are based on 16,200 participants (28.65 % female; Mage = 14.26; range = 4.74-17.92) and 27 studies conducted in North America, Europe, Asia, and Africa.

METHODS

A systematic review was conducted of available literature published up to September 2021. Abstract and full-text review were conducted to assess whether studies met inclusion criteria. Random-effects meta-analyses were conducted on included studies.

RESULTS

Significant associations were found between exposure to non-violent sexual content and likelihood of engaging in PSB (OR = 1.82; p < .001; 95 % CI: 1.50-2.21), and between exposure to violent/live sexual content and PSB (OR = 2.52; p < .001; 95 % CI: 1.75-3.61). Sex emerged as a moderator of the association between exposure to non-violent sexual content and PSB, such that the association was stronger in studies with a greater proportion of females.

CONCLUSIONS

Results support the need for future research on risk factors and mechanisms implicated in PSB. Prevention and intervention programs for children with PSB and their families could benefit from incorporating education on sexual content exposure.

Frontline Workers' Response to Harmful Sexual Behavior: Building Blocks For Promising Practice

Frontline workers, including educators and health practitioners, play an important role in identifying and responding to harmful sexual behavior (HSB) carried out by children and young people. Despite this, there have been no reviews of the evidence about promising practice for how frontline workers could best manage this behavior. This article presents a scoping review of evidence exploring the research question: How can frontline professionals be trained and supported to better manage HSB carried out by children and young people? Multiple databases were searched in July 2020. Inclusion criteria included a focus on professional development or practice relating to children and young people displaying inappropriate sexual behavior or HSB; a population of frontline workers (teachers, health practitioners, coaches, childcare workers); and all study types, including gray literature. Two reviewers screened the articles, and findings from included papers were synthesized according to the method of thematic synthesis. Thirty-one papers were included in the review. Five themes were identified in response to the research question: process of identification and response, knowledge required to identify and respond, skills needed to identify and respond, organization-level supports, and system-level supports. The authors propose the "building blocks" for a promising practice model, which sets out the process of identification and response to HSB, and the knowledge required by frontline workers to support that process. Further, the model identifies the skills required by frontline workers to undertake the process of identification and response, as well as the organization-level and system-level scaffolding needed for good practice.

Preventing harmful sexual behavior in primary schools: Barriers and solutions

BACKGROUND

Schools are recognized as crucial stakeholders in preventing and combating public health problems such as sexual violence and abuse. While prevention efforts have often focused on safeguarding children from adult perpetrators, less attention has been dedicated to safeguarding against harmful sexual behavior (HSB) displayed by children and young people at school. As little is known about teachers' understanding of and responses to HSB in primary school more research is needed.

OBJECTIVE

The objective of the study is to explore and identify barriers to the prevention of HSB in primary school. Possible solutions to these identified barriers are pursued through a transformative lens.

PARTICIPANTS AND SETTING

Nineteen informants from six schools participated in focus-group interviews at their respective schools in the south-eastern region of Norway in May and June 2019. Fifteen of the informants were primary school teachers, three were school principals and one was a social worker.

METHODS

The focus-group interviews were transcribed verbatim, and the transcripts and field notes were analyzed using thematic analysis.

FINDINGS

Primary school teachers report a lack of HSB competence and limited multi-agency cooperation or coordinated practice. Under these circumstances, the teachers perceive the prevention of HSB as an overwhelming individual professional responsibility.

CONCLUSIONS

The study suggests that the following three policy initiatives need to be prioritized.