Harmful Sexual Behaviour (HSB)

Harmful sexual behaviour involves one or more children engaging in sexual discussions or acts that are inappropriate for their age or stage of development. These can range from using sexually explicit words and phrases to full penetrative sex with other children or adults (Rich, 2011).

Harmful sexual behaviour (HSB) is developmentally inappropriate sexual behaviour which is displayed by children and young people and which may be harmful or abusive (derived from Hackett, 2014). It may also be referred to as sexually harmful behaviour or sexualised behaviour. It can be displayed towards younger children, peers, older children or adults, and is harmful to the children and young people who display it, as well as the people it is directed towards.

It is widely accepted that HSB sits on a continuum – with behaviours ranging from healthy and developmentally appropriate, to problematic and harmful/abusive. It is therefore helpful to distinguish between problematic and harmful / abusive.

Most healthy / developmentally appropriate 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.

Inappropriate behaviour:

• Single instances of developmentally inappropriate sexual behaviour;
• Behaviour that is socially acceptable within a peer group;
• Generally consensual and reciprocal;
• May involve an inappropriate context for behaviour that would otherwise be considered normal.

Problematic behaviour:

• Developmentally unusual and socially unexpected behaviour;
• May be compulsive;
• Consent may be unclear and the behaviour may not be reciprocal;
• May involve an imbalance of power;
• Doesn’t have an overt element of victimisation.

Abusive behaviour:

• Intrusive behaviour;
• May involve a misuse of power;
• May have an element of victimisation;
• May use coercion and force;
• May include elements of expressive violence;
• Informed consent has not been given (or the victim was not able to consent freely).

Violent Behaviour:

• Physically violent sexual abuse;
• Highly intrusive;
• May involve instrumental violence which is physiologically and/or sexually arousing to the perpetrator;
• May involve sadism.

These categories and descriptions are taken from the NSPCC guide - Responding to children who display sexualised behaviour (nspcc.org.uk)

Practitioners should be aware that sexualised behaviour may be an indicator that the child or young person is suffering, or has suffered in the past, from abuse or neglect, particularly sexual abuse, and this should always form part of any assessment. As with all areas of child protection, language used is very important in ensuring that practitioners do not lose sight of the fact that the child or young person’s behaviour is likely to be the result of trauma experienced or being experienced themselves. For example the term 'a child / or young person who displays harmful sexual behaviour' is more appropriate and accurate, as it emphasises the child or young person's developmental status first and foremost whilst acknowledging the behaviours that are causing concern. Terms such as 'young sex offender' or 'young abuser' are not appropriate.

Peer exploitation is where one young person befriends and grooms a young person into a 'relationship' and then coerces or forces them into sexual activity with others. In this context, harmful sexual behaviour may be related to child sexual exploitation or child criminal exploitation. Again, consideration should also be given to the fact that the young person who is deemed to be sexually exploiting another child, may themselves  be a victim of child sexual exploitation, or criminal exploitation themselves.

Abuse using Information and Communication Technology (ICT), such as the internet and mobile phones, falls within the scope of these procedures and will be managed in the same way. (See also Online Safety Guidance)

The use of ICT in HSB is often referred to as Technology Assisted harmful sexual behaviour. A wider used definition of TA-HSB developed by Belton and Hollis (2016) is ‘one or more children/ young people engaging in sexual discussions or acts using the internet and/ or any image -creating/ sharing or communication device which are considered inappropriate and /or harmful, to self and or other, given their age or stage of development’.

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

• Two thirds of contact sexual abuse is committed by peers (children under the age of 18 years);
• History of abuse, especially sexual abuse, and children who have witnessed domestic abuse within the household can contribute to a child displaying harmful sexual behaviour;
• Children have greater access to information about sex through technology and this can have an impact on their attitudes to sex and sexual behaviour;
• Children who display harmful sexual behaviours who do not receive adequate support are more likely to go on to commit abuse as an adult compared to children who receive support.

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 – Adverse Childhood Experiences (ACES), poor nurturing and parental guidance, neglect;
• 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, social and communication skills. This may be due to a developmental disorder or the impact of ACES as a young child.

Many of these factors exist alongside typical family environments where other forms of abuse are present and children will often have experienced some form of trauma.

There is a significant minority of young people who display harmful sexual  behaviour who have a level of learning need (children with Special Education Needs and Disabilities SEND, Learning Disability and Autism) - 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.

The link between on-line behaviour and harmful sexual behaviour may also be a cause for concern. Technology-assisted harmful sexual behaviour (TA-HSB) can range from developmentally inappropriate use of pornography (and exposing other children to this), through grooming and sexual harassment. On-line behaviour may be a trigger for sexual abuse and the long-term effect of exposure to pornography can affect the ability to build healthy sexual relationships (see NSPCC Research and Resources for further information).

Upskirting is a specific example of abusive behaviour that typically uses a mobile phone camera to capture an image under another person’s clothing. It is behaviour that has been linked to on-line bullying and grooming. Upskirting is a criminal offence and should be reported to the Police.

Concerns about children who display behaviour which may cause sexual harm to others (and in some cases to themselves as well) are some of the most challenging for professionals.

See Further Information for a range of resources and organisations that will support professionals to identify sexual behaviours from inappropriate to problematic to abusive and respond appropriately.

A multi-agency approach is needed at the earliest opportunity to identify, assess and intervene in cases of Harmful Sexual Behaviour.  This is to ensure that the child or young person gets appropriate support, or protection, and to reduce the likelihood of further Harmful Sexual Behaviour.

Where practitioners have concerns about a child/young person who is displaying harmful sexual behaviour they should consider this against the Harmful Sexual Behaviour continuum. This will help to identify the type of behaviour and the appropriate response.

Responding to children who display sexualised behaviour (nspcc.org.uk)

Advice should be sought from your organisations safeguarding lead to assist you with your assessment and identify the appropriate course of action. Consideration should be given to age and developmental function of the child / young person when making your assessment. The NSPCC provides helpful guidance on healthy sexual development of children and young people within their resources.  See links below

Harmful Sexual Behaviour - NSPCC research and resources – guidance on protecting children from harmful sexual behaviour

Healthy sexual development of children and young people | NSPCC Learning – guidance on stages of healthy sexual behaviour and responding to inappropriate sexual behaviour

As a guide, where behaviours are assessed as inappropriate or problematic a referral for early help/ targeted support should be made. Family Support Pathway (city) or Pathway to Provision (county). There may be circumstances where problematic behaviour is entrenched and a social work assessment is required.

If the sexualised behaviours of the child or young person causes a professional to believe or suspect that an another person has suffered significant harm, or is likely to suffer significant harm, or that the behaviour is the result of abuse or neglect then the index child, and any other children affected should be referred to CSC. Where the child lives in Nottingham City, referrals should be made using Children and Families Direct.

Where the child lives in Nottinghamshire County, referrals should be made to the MASH (Nottinghamshire Multi-Agency Safeguarding Hub).

Where there is an immediate risk of significant harm, follow interagency safeguarding children procedures and make an immediate referral to children’s social care or the Police. 

Children’s Social Care departments in Nottingham City and Nottinghamshire both have identified HSB leads, who can advise on further specialist assessment that may be required and whether the case should be presented to the local HSB panels. In Nottingham City this is called the ASHA Panel (Assessment of Sexual Harm Arrangements). In Nottinghamshire this is called the Harmful Sexual Behaviour (HSB) Panel. These should occur alongside the normal child protection processes if abuse or neglect is known or suspected. 

Local authority leads are:

Nottinghamshire: Child Protection Co-ordinator - lead for HSB

Nottingham City: Exploitation Coordinator – Harmful Sexual Behaviour Lead

Panels

The panels (ASHA and HSB panel) ensure that children and young people who display harmful sexual behaviour have their needs considered within a multi-agency meeting. The panels act in an advisory capacity to ensure that the child/young person is supported and their needs and the risks to themselves and others are properly considered.

Detailed practice guidance covering these specific procedures is available within Children's Social Care and the Youth Justice Service of both authorities.

The purpose of these meetings is to:

• Bring together the practitioners currently involved with the child or young person;
• Discuss the outcomes of assessments, with a view to agreeing on the level and type of risk which s/he may pose in different settings (e.g. at home, at school, in public places);
• Consider the holistic assessment, agree on how his/her needs are to be met in a service plan for him/her and the family and establish whether there is agreement to the service plan;
• Specific input within the service plan to help reduce the risk of a pattern of sexually abusive behaviour developing;
• Recommend actions to manage the risk of Sexual Abuse, bearing in mind any criminal justice action being taken.

The outcome of the meeting will vary depending on the needs of the child/young person. In most circumstances a plan will be agreed to be managed and reviewed under child in need procedures. Where a level of risk is identified it may be appropriate for a risk Strategy Meeting to be convened or the child/young person  to be considered under the Multi Agency Public Protection Arrangements (MAPPA) if the child is convicted of a criminal offence.

When a child/young person assessed as having sexually abused others they should be the subject of a Child Protection Conference if he or she is also considered personally to be at risk of continuing Significant Harm.

Note Schools should follow the statutory guidance: Keeping Children Safe in Education which came into force on 3rd September 2018.

See also: Addressing Child-on-child Abuse: a Resource for Schools and Colleges (Farrer and Co.). This is intended to be used as a resource and reference document for practitioners – to consult as and when required and to the extent needed, and to help them navigate whichever area(s) of child-on-child abuse they are dealing with.

Children and young people may not recognise that their sexual behaviour is problematic, and this may be supported by parents or carers. Unless the impact of their sexual behaviour reaches the threshold for referral to Children’s Social Care, or crosses a criminal threshold, 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. Denial is often used as a coping mechanism and is a normal response to a challenge specifically if it relates to something that is wrong or socially inacceptable. This is a common response to this issue and 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 child/young person came to be in a position where they behaved in a way that was considered to be problematic or abusive.

Support of parents and carers is extremely helpful in promoting engagement 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, and that 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.

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. Few young people are actually prosecuted for this behaviour, therefore the risk in waiting for a decision from CPS is that a decision not to prosecute may be interpreted as there being nothing to worry about. A programme of work can be agreed with police and CPS usually with the proviso that the victim and specific incidents are not discussed.

Legislation, Statutory Guidance and Government Non-Statutory Guidance

Keeping Children Safe in Education Part Five: Child on Child Sexual Violence and Sexual Harassment

Safeguarding Children as Victims and Witnesses (Crown Prosecution Service)

Pre-Trial Therapy (inc Annex A: Specific Considerations for Children)  (Crown Prosecution Service)

Useful Websites

Key messages from research on children and young people who display harmful sexual behaviour

Harmful Sexual Behaviour Framework: An Evidence-informed Operational Framework for Children and Young People Displaying Harmful Sexual Behaviours (Research in Practice)

Children and Young People Presenting with Harmful Sexual Behaviours: a Toolkit for Professionals (The Children's Society)

Children and Young People who Engage in Technology-assisted Harmful Sexual Behaviour (NSPCC)

Addressing Child-on-Child Abuse: a Resource for Schools and Colleges (Farrer and Co.)

Harmful Sexual Behaviour - NSPCC research and resources

Beyond Referrals: Harmful Sexual Behaviour

Tackling Child Exploitation Resources on Harmful Sexual Behaviour (Contextual Safeguarding Network)

Helping education settings identify and respond to concerns (CSA Centre) - when they have concerns of child sexual abuse or behaviour.

Child Protection Resources from Stop It Now - includes a range of publications on preventing abuse among children & young people including online

Brook Traffic Light Tool Training - Please note: The Traffic Light Tool and training has undergone extensive review and development in 2020. Brook no longer supports previous versions of the Tool