1. Carol Carson copyright Carol Carson Associates Ltd 2015

2. Key Messages 1.Children cannot change their behaviour on their own; you need to work with their families and key people in their network 2.Engaging with families is essential if a child remains at home. Make contact quickly and try to empathise and seek the family views. 3. This is multi-agency work, referrals can come in from any part of a child’s network and to get children back onto healthy developmental pathways everyone they are in contact with needs to give consistent, persistent messages for the child. 4. Continuum of sexual behaviours HealthyProblematic Harmful copyright Carol Carson Associates Ltd 2015

3. Healthy Sexual Development 0 – 4 years Family, culture/faith and community main influences Exploratory behaviours, through touch, taste etc Sensual stage – intimacy, hugs and kisses, attachments, relationship blueprints Emotional regulation – learning to comfort themselves, soothing rather than sexual Toileting – if abused, cross wiring of different emotions and bodily sensations

4. copyright Carol Carson Associates Ltd 2015 Healthy Sexual Development 5 – 7 years old Family, culture/faith and community still the most influential Concept of ‘rude’ - bums and willies! Comparisons and questions Desire for privacy Gender socialisation

5. copyright Carol Carson Associates Ltd 2015 Healthy Sexual Development 8 – 12 years old Peers and Media now the most influential Informed Questioning Stage – increase in cognitive ability Puberty happening for some Mimicking relationship behaviours Sexual identity and sexual attractiveness

6. Children Under the Age of 12 Years Old Children can trick, bribe, manipulate and force other children into sexual acts Sexual pleasure can be a major reinforcing factor Infants and small children – more likely to be associated with comfort seeking and regulation of arousal Other behavioural/mental health problems 96% Kellogg study, 76% conduct disorders, 40% ADHD, 27% ODD Arson and cruelty to animals Influence of family environment on sexual development Access to other children more limited. copyright Carol Carson Associates Ltd 2015

7. copyright 2015 Carol Carson Associates Ltd Working with Girls Stronger relationship between girls being sexually abused and becoming abusive 1:4 of violent girls were sexually abused compared to 1:10 of violent boys Maternal depression/ negativity and life stress and conflict in the mother/daughter dyad affect girls becoming aggressive more than boys. Aggressive females more likely to live in conflictual/neurotic families. Mental health issues such as self harm/ eating disorders Societal views of females as nurturers Overlap with child sexual exploitation

8. Causes of Problematic/Harmful Sexual Behaviours The younger the child, with more serious sexual behaviours, the more likely that they have witnessed or experienced highly sexualised environments or actual sexual abuse Disrupted sexual development where a child’s emotional and physical space is routinely violated leaving a residue of distress related to sex Adult sexual activity has overwhelmed their cognitive ability to understand creating tension, confusion and anxiety Unstable or unpredictable environments which leave children with high levels of emotional anxiety. If the environments are also very sexual the confusion and anxiety may be expressed in a sexual way Environments which are violent and/or sex is used as an exchange commodity for attention, love or money copyright Carol Carson Associates Ltd 2015

9. Pathways into Sexual Behaviours 1.Child has been sexually abused 2.Child lives in a highly sexualised environment 3.Exposure to sexual information through media, social networking, older siblings etc They have either experienced it, witnessed it or lived with it. It has got to have come from somewhere

10. Age Appropriate Work 0 -4 Years -Most of the work directed at care givers -Need to unlearn old behaviours and learn new healthy ones -Consistent, persistent, concrete messages -Redirection of their behaviour -Distraction to something more interesting/healthy -Role modelling healthy ways to get attention, affection etc. copyright Carol Carson Associates Ltd 2015

11. 5 – 7 Years Most of the work still directed at care givers – consistent persistent concrete messages Child should be able to engage on some work around their behaviours and worries.  Use of metaphorical stories  Use of puppets, symbolic objects  Use of third person stories Emotional responses from carers to sexual behaviours to help the child re-learn how to ask for emotional nurturance copyright Carol Carson Associates Ltd 2015

12. 8 – 12 Years -Work directed at child and family -More able to engage in discussion around their behaviours and their worries -They can manage abstract concepts and have more ability to reason logically and order their thoughts coherently -They have a clearer view of morality – right and wrong -Cognitive Behavioural techniques -Third person stories -Games, quizzes, pen and paper exercises -Cartoons -Role plays -Situation cards -“Stop and Think” – Butler and Elliott 2006 copyright Carol Carson Associates Ltd 2015

13. Work with the family Addressing Parents own victim issues if relevant Education about healthy and harmful sexual behaviours Parenting skills Boundary setting – re privacy; appropriate and inappropriate physical touch (including sexual ) within the family Able to talk about the sexual behaviour in a non punitive, non judgemental way Emotional expressiveness within the family No secrets – scaffolding the family - Kerplunk theory! copyright Carol Carson Associates Ltd 2015

14. Characteristics of Healthy Sexual Behaviours Mutual consensual, choice, exploratory, no intent to cause harm, fun, humorous, no power differentials

15. copyright Carol Carson Associates Ltd 2015 Characteristics of Problematic Sexual Behaviours not age appropriate one off incidents or low key such as touching over clothing, particularly if there is peer pressure self directed eg. masturbation balancing factors, eg lack of intent to cause harm; level of understanding; acceptance of responsibility other children irritated or uncomfortable but not scared, they feel free to tell someone other factors such as parents/carers are concerned and supportive.

16. copyright Carol Carson Associates Ltd 2015 Characteristics of Harmful Sexual Behaviours Not age appropriate Elements of planning, secrecy, force or coercion Power differentials eg. age, size, status, strength The response of others eg fear, anxiety, discomfort The response of the child eg. fear, anger, aggression, blames others, takes no responsibility Frequent incidents or increasing in frequency and disproportionate to other aspects of their lives Not easily distracted, compulsive despite intervention Other difficult behaviours, conduct disorders, anger, poor peer relationships etc.