3.6 Harmful Sexual Behaviour: Procedure and Guidance

This procedure should be used in addition to the Neglect Guidance.

This procedure applies to all children and young people who display inappropriate or harmful sexual behaviours (HSB), including disabled children and young people. This may include, if appropriate, instances where a child or young person is assessed to be at risk of engaging in this type of behaviour. The procedure applies whether the victim is:

• outside of the child’s immediate household, or
• within her/his household, e.g. sibling abuse.

A coordinated response to children displaying HSB is required by all relevant agencies including Children Social Care, the police, the Youth Offending Service (YOS), and Child and Adolescent Harmful Behaviour Services (CAHBS). In line with NSPCC Guidance (2016), this response should recognise that children and young people displaying HSB are a varied and complex group with diverse needs that cannot be addressed by a ‘one size fits all’ model of service provision. The response should be needs led and based around the notion of a continuum of services responses across several levels.

The NSPCC Harmful Sexual Behaviour Framework (2016) provides a useful supporting document to this procedure. It provides an evidence based tool for a coordinated, multi-agency response to HSB.

The following definitions of HSB have been taken from the NSPCC Harmful Sexual Behaviour Framework.

Harmful sexual behaviour (HSB): Sexual behaviours expressed by children and young people under the age of 18 years old that are developmentally inappropriate, may be harmful towards self or others, or be abusive towards another child, young person or adult.

It is also useful to distinguish between problematic and abusive sexual behaviours.

• Problematic sexual behaviours: Problematic behaviours don’t include overt victimisation of others but are developmentally disruptive and can cause distress, rejection or increase victimisation of the child displaying the behaviour. Sexual behaviour problems are defined as behaviours involving sexual body parts that are developmentally inappropriate or potentially harmful to the child or others. They range from problematic self-stimulation and nonintrusive behaviours, to sexual interactions with other children that include more explicit behaviours than sex play, and aggressive sexual behaviours.
• Abusive sexual behaviours: Abusive behaviours involve an element of coercion or manipulation and a power imbalance that means the victim cannot give informed consent, and where the behaviour has potential to cause physical or emotional harm. Power imbalance may be due to age, intellectual ability, race or physical strength. Abusive sexual behaviour may or may not have resulted in a criminal conviction or prosecution. Such behaviours are more commonly associated with young people over the age of criminal responsibility or those in puberty.

As both problematic and abusive sexual behaviours are developmentally inappropriate and may cause developmental damage, a useful umbrella term is harmful sexual behaviours or HSB.

Physical abuse and bullying: Both physical abuse and bullying can include harmful sexual behaviour. If a child/young person has caused, or is at risk of causing, serious physical harm to another child/young person, a referral must be made to Children’s Social Care. In deciding whether an incident should be dealt with as a child protection matter, relevant considerations include the seriousness of the harm, the intention behind the assault and the difference in power between the victim and perpetrator (e.g. size, age, ability or development). Fighting between peers of equal standing or siblings would not therefore normally be subject to referral. See the BSCP guidance on Bullying. All agencies should refer to their own internal agency’s guidance on bullying including in regard to disabled children.

Children

Severe harm may be caused to children, including disabled children, by the abusive behaviour of other children. Such abuse must be taken as seriously as abuse perpetrated by an adult. The same signs and symptoms of abuse that pertain to the abuse of children by adults are applicable to the abuse of children by other children.

The effect on the victim of intimidation and peer pressure by their abuser may make it difficult for the victim to tell anyone what is happening.

Although a high proportion of young people do not continue to display HSB if they and their families are given the right support and input from services, professionals should also be alert to the fact that there is likely to be a risk to children other than the current victim.

Evidence suggests that children who display HSB may have suffered considerable disruption in their lives; have been exposed to violence within the family; have witnessed or been subject to physical or sexual abuse; have problems in their educational development; or may have committed other offences. Such children and young people are likely to be children in need, and some will, in addition, be suffering, or at risk of suffering, significant harm, and may themselves be in need of protection.

Professionals should, therefore, take a non-stigmatising approach to the presenting issue and be alert to the possibility that a child or young person who displays HSB may also be a victim. All relevant agencies must be aware of their responsibilities to both children, and this must be demonstrated in the multi-agency management of both cases. However, the priority is the protection of the identified victim and potential future victims.

A significant proportion of sexual offences are committed by teenagers, including learning disabled teenagers. However, HSB can be displayed by younger children and such cases must also be taken seriously. Even though they will not result in prosecution due to the child’s age, the behaviour should be considered alongside the wider context of school and home factors.

Adults

All agencies should be aware of the fact that HSB can be perpetrated against adults. In such cases, consideration should be given to notifying relevant agencies in order to promote early intervention and protect the welfare of the adult involved.

Where the victim is an adult with care or support needs, the Buckinghamshire Safeguarding Adults Board procedures for reporting safeguarding concerns should be followed.

Child Sexual Exploitation

Child sexual exploitation is a form of child sexual abuse. It occurs where an individual or group takes advantage of an imbalance of power to coerce, manipulate or deceive a child or young person under the age of 18 into sexual activity (a) in exchange for something the victim needs or wants, and/or (b) for the financial advantage or increased status of the perpetrator or facilitator. The victim may have been sexually exploited even if the sexual activity appears consensual. Child sexual exploitation does not always involve physical contact; it can also occur through the use of technology.

Some young people who display HSB are committing acts which would fit with the definition CSE. In particular, young people who sexually abuse other young people within the context of relationships (often described as ‘peer on peer’ abuse) fit both the definition of HSB as sexual behaviour which victimises others and CSE as exploitative, exchange-based abuse. Professionals should be aware that it is possible to see HSB and CSE as distinct but overlapping forms of sexual abuse, with both having elements of coercion, misuse of power, violence and lack of consent and choice. (NSPCC 2016). See also BSCP Child Sexual Exploitation Guidance.

Gang association

Over the past few years, research into serious youth violence has increasingly identified HSB within street gangs in the UK (e.g. Beckett et al, 2013; Firmin, 2011). In this context, sexually violent and abusive behaviours manifest in a range of ways including:

• Intra-gang exploitation where sex is exchanged for status, belonging, drugs and protection.
• Intra-gang violence where rape and sexual assault are used to control and humiliate, ensuring gang members adhere to the codes of the group, and that disloyalty is punished. Examples have also been found where predominantly boys and young men are required to sexually assault a young woman as part of an initiation process – as a means of demonstrating group loyalty.
• Inter-gang violence where rape and sexual assault are used to punish rivals, sometimes through attacks on the female siblings and girlfriends of gang members (for a full list of models see Beckett et al, 2013).

Professionals should be aware of these links and where appropriate ensure that any responses to gang activity make relevant referrals to services for young people displaying HSB. Without this collaborative approach “local services risk developing criminal justice responses to young people who harm in gangs, as opposed to therapeutic responses for those who need them.” (NSPCC 2016)

Professionals can sometimes struggle to identify which sexual behaviours are potentially harmful and which represent healthy sexual development. It is important that professionals are able to distinguish between behaviours that are normal and those that are abnormal regardless of culture, faith, beliefs, and their own experiences or values. Hackett et al (2010) proposed a helpful continuum model to assist with this process:

In addition, Brook has developed a Sexual Behaviours Traffic Light Tool to support professionals working with children and young people identify and respond appropriately to sexual behaviours. The tool uses a traffic light system to categorise the sexual behaviours of young people in order to help professionals make decisions about safeguarding, assess and respond to sexual behaviours appropriately, and better understand the differences between healthy sexual behaviour and HSB. The tool lists examples of presenting sexual behaviours within four age categories (0–5 years, 5–9 years, 9–13 years and 13–17 years) and grades them as either red (outside safe and healthy behaviour); amber (has potential to be outside safe and healthy behaviour); or green (safe and healthy sexual development).

For all cases where there are concerns about HSB, Children's Social Care and the police need to be informed. They will hold an initial strategy discussion/meeting within 24 hours. It is not always apparent at the outset whether a particular behaviour or incident is abusive, and a strategy meeting is an appropriate forum in which to share concerns before reaching an informed decision about the best way to proceed. The strategy discussion should involve the police, Children’s Social Care, Youth Offending Service and any other agencies playing a significant role (e.g. CABHS, education, GP).

It is important that a safeguarding response is considered for both the alleged victim and the child displaying HSB. This will ensure that appropriate steps are taken to protect the child displaying HSB in cases where they are also a victim of abuse or neglect.

The strategy discussion must consider the needs of all the children involved and consider whether there are other children potentially at risk (e.g. in the household, peer groups or community of the alleged abuser). It may be necessary to convene separate meetings to discuss the victim/s, and child/children displaying HSB.

At this meeting:

• information will be shared
• a decision will be made as to whether the threshold for social care to instigate child protection inquiries (Section 47) has been reached
• the police will decide whether a criminal offence is alleged and if the alleged abuser is over 10, it is the police who are responsible for making a decision about whether to carry out a criminal investigation (although in practice this decision may be made in partnership)
• a decision will be made as to whether advice from CAHBS should be sought if they have not already been included in discussions.

It will also be helpful to consider the following: 

• the relative chronological and developmental age of the children; this is of particular relevance when either child/young person is disabled
• a differential in power or authority, again of particular relevance when any of the children involved are disabled
• the behaviour involved (both physical and verbal), including whether the child/children are engaging in sexual activity which is inappropriate for their age or level of maturity, or which is illegal
• the number of children involved
• physical aggression, bullying or bribery
• the victim's experience and perception of the behaviour
• attempts to ensure secrecy
• any history of sexual abuse in the family
• duration and frequency of behaviour
• whether an assessment is required to inform decision making; where appropriate, assessment should include a recognised and established structured risk assessment tool (e.g. AIM2, JSOAPII).

If during the course of the discussion there are concerns about any risks to other children, a multi-agency meeting should be convened straight away in order to develop:

• a written risk management plan in relation to any child identified as at potential risk; including educational and accommodation arrangements both for the child displaying HSB and the potential victim(s)
• appropriate arrangement for the continuation of the assessment and the need for any specialist assessment
• how the services to be provided will be coordinated.

The strategy discussion will be used to agree how to proceed and this will include deciding whether or not child protection processes should be continued and/or whether criminal justice processes should be started.

If the young person displaying HSB is a Looked After Child, their social worker should undertake a risk assessment covering all vulnerable parties, including all other children living in the household. They should provide the carers with full information and disclose information to others on a need-to-know basis. This should be done with the advice/consultation and direct assistance if required of the CAHBS team.

Abuse has not taken place

Where the decision is reached that the alleged HSB does not appear to constitute abuse and there is no need for a Child Protection Inquiry, or criminal investigation:

• details of the referral and the reasons for the decision must be recorded
• when a child is found to be demonstrating problematic sexual behaviour that does not reach the threshold for harmful behaviour, a multi-agency child in need (CIN) planning process should be considered. Referral to CAHBS should be completed in order to gain additional support
• consideration should be given to the need for any further assessment or support services for any of the children involved (for example Early Help or specialist services).

Abuse has taken place

Where the decision is reached that the HSB appears to constitute abuse and the suspected abuser is a child:

• Children’s Social Care must plan the Child Protection enquiry/investigation under Section 47 of the Children Act 1989 with other agencies.
• If the police have decided that a criminal offence is alleged, there must be a joint investigation with the police in regard to the victim (see BSCP procedure for Child Protection Section 47 Enquiries).
• When the young people concerned are the responsibility of different local authorities, each authority must be represented, which will usually be convened and chaired by the authority in which the victim/s live/s
• It should be recognised that disclosure of HSB by a child/young person can be extremely distressing for parents and carers. The child/young person and their family should always be advised of their right to seek legal advice and be supported through the process.

A different social worker should be allocated for the victim/s and the abuser/s, even when they live in the same household, to ensure that both are supported through the process of the enquiry and that the needs of both are fully assessed.

The Section 47 Enquiry will be convened and chaired by Children’s Social Care and a record made. The following individuals should be invited to the meeting:

• social worker for the child alleged to have been abused
• social worker for the child against whom the allegations are made
• social workers’ line manager/s
• the police, including any police officer involved the reporting of an incident
• representative from CAHBS (possibly for advice at this stage if not already involved)
• YOS representative if the alleged abuser is aged 10 or over
• school representative/s (particularly if the concerns suggest that other children in the school setting may have been, or may be, at risk of being abused)
• other education staff as required
• school nurse or other health services staff, as required
• representatives of fostering or residential care, as applicable
• any specialist required, e.g. in regard to cultural information, or specific disability.

The discussion must plan in detail the respective roles of those involved in enquiries and ensure that:

• information relevant to the protection needs of the alleged victim is gathered
• if the police have not already begun a criminal investigation, there are clear decisions as to whether the police consider that a criminal investigation is required in regard to the suspected abuser, as this affects the investigation planning in regard to both victim/s and alleged abuser
• any information relevant to any abusive experiences and protection needs of the alleged perpetrator is obtained.

The police are responsible for any criminal investigation, and so decisions in relation to any criminal investigation rest with them.

In cases where the alleged perpetrator is below the age of criminal responsibility, the strategy discussion must agree whether police involvement is necessary.

During the Child Protection/Section 47 investigation, the following factors should be considered:

• the age of all children involved
• the seriousness of the alleged incident
• the effect on the victim and her/his own view of personal safety
• parental attitude, and their ability to protect their child (if victim or perpetrator)
• arrangements to protect the victim and other children, especially where the victim and alleged perpetrator are in the same household or school class
• whether there is suspicion that the alleged abuser has also been abused
• whether there is reason to suspect that adults are also involved.

When the alleged abuser is under 10 years old, and would be subject to a criminal investigation if over 10, there must be agreement about arrangements to carry out an assessment of risk, with a view to carrying out any further assessment or intervention as required. This would normally be under Section 47 as there is likelihood of significant harm to the development of the alleged abuser.

Where there is suspicion that the child is both an abuser and a victim of abuse, the strategy discussion must consider the order in which interviews will take place, bearing in mind that the police will make the decisions in regard to the criminal investigation.

Before interviewing the alleged abuser, it will be helpful to have obtained as much information as possible about the alleged offence. The interview with the victim and as much assessment as possible would usually precede the interview of the child/young person exhibiting the abusive behaviour.

If YOS have not previously become involved, they must be included at this point. The timing of the initial interview of the alleged abuser may depend on:

• the likelihood of ongoing abuse
• the possible loss of evidence or interference with witnesses
• the likelihood that the alleged abuser may abscond.

When a child is aged 10 or over and is alleged to have committed an offence, the first interview must be undertaken by the police under the provisions of the Police and Criminal Evidence Act 1984 (PACE). An appropriate adult is required – this should NOT be the social worker for the victim.

If it becomes clear during the PACE interview that the alleged abuser is also a victim of abuse, a further strategy discussion should be held to plan a separate interview and assessment under Section 47 of the Children Act 1989.

If the alleged abuser is not interviewed under PACE, arrangements must be made to carry out an assessment of risk, with a view to carrying out any further assessment or intervention as required.

If a child is to be interviewed as a victim of, or witness to, alleged abuse under the provisions of the Achieving Best Evidence in Criminal Proceedings guidance and the child admits offences, then separate interviews should be held. The police may decide that this should be held under PACE.

Throughout the enquiry, the immediate protection of the child/children must be ensured.

Outcome of enquiries

The position of the alleged victim and the alleged perpetrator must be considered separately.

If the information gathered in the course of enquiries suggests that the abuser is also a victim, or potential victim, of abuse, a Child Protection Conference must be convened.

In cases where a Child Protection Conference is held for a young person displaying HSB:

• A Youth Offending Service (YOS) representative must be invited to the conference where the child is age 10 or over
• YOS should be informed of the meeting in the case of younger children
• As well as carrying out all of its normal functions, the Child Protection Conference must take into consideration planning a response to the child’s needs as a possible abuser. This will include: developing a written risk management plan, including educational and accommodation arrangements; planning any future assessment; and coordinating services to be provided.

Where there are no grounds for a Child Protection Conference, but concerns remain regarding the child’s HSB, she/he must be considered as a child in need.

Risk is likely to remain unless the child/young person, parent and carer are willing and able to cooperate with professionals to ensure the child/young person’s future safety and wellbeing, and the risks that the child may pose are not denied by the child and family. If the family do not cooperate with the multi-agency intervention, a Child Protection Conference should be held.

Effective assessment should be multi-agency, child-focused and consider the unmet needs of the child, the underlying reasons or triggers for the behaviour, protective factors and strengths, and what can be done to reduce the HSB. This assessment will ensure the right level of response by services.

If the identified behaviour is not subject to prosecution (this may be the outcome in regard to learning disabled young people or where diversion therapy is offered), multi-agency assessment and planning with a view to appropriate treatment and placement remains essential as a preventive measure to both protect the young person themselves and to safeguard others. 

In cases which involved the justice system, a structured needs assessment should be carried out to ensure that the correct decision is made and effective intervention pathways are identified (e.g. CAHBS, YOS, other).

Some young people may need specialist input (residential educational / therapeutic).

Transition planning should be part of the assessment and intervention plan. For example, if a move in education, residential placement or even transition to adult services is required, this should be planned with the individual and services on offer.