Working to prevent sexually harmful behaviour in children guidance

Working to prevent sexually harmful behaviour in children guidance

Working to Prevent

Harmful Sexual Behaviour involving Children and Young People

A PRACTICE GUIDE

For safeguarding children from

Sexual Abuse and Exploitation

This document contains sexually explicit language

Safeguarding Children from

Harmful Sexual Behaviour is Everybody’s Business

Written and produced by Tony Staunton.

Published by

Plymouth Safeguarding Children Board

November 2015.

For review in September 2016.

This document will be rendered out-of-date by October 2018.

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Harmful Sexual Behaviour

Quick View

As a parent, carer or practitioner working with children and young people, it's important that you have a good idea of what's normal sexual behaviour and can also spot the warning signs that something might not be quite right.

Here are some warning signs and examples:

sexualised behaviour which is significantly more advanced than you'd normally expect for a child of a particular age or which shows a lack of inhibition, could be a cause for concern

sexual interest in adults or children of very different ages to the child’s own age

forceful or aggressive sexual behaviour

compulsive habits

 reports from school that the child’s sexualised behaviour is affecting their progress and achievement

talking about or seeking-out pornography

a pre-school child who talks about sex acts or uses adult sexual language

a 12 year old who masturbates in public.

Online sexualised images:

research has shown that more children accidentally find online porn than deliberately search for it, so do not assume they are comfortable or feel safe:

graphic images and scenes can be very disturbing for children

28% of young people felt that pornography had changed the way they thought about relationships (NSPCC 2013)

image and performance is challenging more traditional understanding of intimacy

children and young people (and some adults) who watch online pornography can believe that it gives a true picture of sex and relationships which it doesn’t

d istribution of sexualised images, pictures of the “private parts” of a child under 18 years of age is illegal and can be used as part of bullying, coercion and exploitation.

Child Sexual Exploitation:

Sexual exploitation affects thousands of children and young people every year. By knowing the tell-tale signs, we can all play an important role in reducing that number. Coercion and power-relationships play a core part in preventing the victim from telling anyone. Look out for quite sudden and uncharacteristic changes in behaviour, including:

 unexplained gifts

 missing school

 changes in mood

 appearing wary or scared

 lack of interest in activities and hobbies

 going missing from home

 being secretive about where they are going

 loss of interest in activities and hobbies

Tools

The Brook Sexual behaviours Traffic Light Tool

1

helps identify and respond appropriately to sexual behaviours.

The NSPCC offers in-depth advice and guidance

2

Barnardos offers guidance and services to prevent child sexual exploitation

3

If you have any worries at all, even if you're not sure, then it's important that you act as soon as possible. Speak with your line manager, professional adviser or the Plymouth

Early Help Gateway. Early support to help children learn safe behaviour is vital.

1 http://www.brook.org.uk/our-work/category/sexual-behaviours-traffic-light-tool

2 http://www.nspcc.org.uk/preventing-abuse/keeping-children-safe/healthy-sexual-behaviour-children-young-people/

3 http://www.barnardos.org.uk/what_we_do/our_work/sexual_exploitation/about-cse/cse-spot-the-signs.htm

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Contents

Introduction

Part One

– Sexual Behaviour

Premature Sexualisation of Children

Harmful Sexual Behaviour in Children

4

5

8

Conceptual Framework for Sexual Harm and Abuse 10

Commercialisation and Sexual Imagery of Children 12

Universal Practice Requirements

Sexual Orientation

Part Two

– Elements of Child Sexual Abuse

Child Sexual Exploitation

13

14

17

Online Sexual Abuse

Sexting

Female Genital Mutilation

Part Three

– Practice Guidance

Definition of Child Sexual Abuse

Barriers to Action

Working with Children who exhibit HSB

Part Four

– Procedures

Enquiries

Assessment

Thresholds

Learning from Serious Case Reviews

Part Five

– Appendices

Services

Helpful websites: Working with HSB

18

19

21

24

25

26

27

29

30

31

34

36

39

42

Glossary of Terms 44

Further Reading 45

Using this Guidance: for quick reference, the core subject of each paragraph is highlighted in the first sentence, allowing fast scan reading of the document and quick reference to the information you require. We do encourage consideration of the full document to promote reflective practice, but do know just how busy you are!

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Introduction

The sexual abuse of children has been the subject of a great deal of public concern and media interest in recent years.

Everyone who works with children and families should be alert to the issues, and confident to take action where there are concerns that a child might be at risk, or a risk to others.

Whilst we are constantly alert to the potential threat from adults within or outside the family who seek out children to sexually abuse or exploit, we are now aware that about two-thirds of all sexual abuse of children is perpetrated by other children and young people.

Sexualised behaviours that are a cause for concern are seen in children as young as 3 and 4 years of age, and early identification and immediate help is essential to support the development of safe behaviours and understanding.

This Practice Guidance is offered to practitioners and their managers in Plymouth as a concise guide to the issues, definitions, assessment requirements and procedures where there is concern that a child may be exhibiting sexually harmful behaviour, or at risk of sexual abuse or exploitation.

We hope you find the contents useful.

Andy Bickley

Independent Chair

Plymouth Safeguarding Children Board November 2015

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PART ONE

There are many different terms that are used to describe acceptable and harmful sexual behaviours. This can cause confusion and lead to poor assessment. The definition of harmful sexual behaviour by children / young people is the same as for adults who sexually abuse and is often characterised by

 a lack of true consent

 the presence of power imbalance and

 exploitation.

Below are some brief explanations of the concepts used, and the professional terminology is explained further on

Page 10.

Premature Sexualisation of Children:

T

here are different views of what constitutes acceptable sexual behaviour in childhood. It is important to consider what constitutes healthy sexual behaviour and what are indications of more problematic behaviour that may require intervention. Indeed, overre

“Normal” childhood sexual play

acting to children’s sexual behaviour can have negative consequences and can lead them to feel ashamed and self-conscious about a natural healthy interest in their bodies and sexuality.

happens because the child is learning about themselves and others. Children explore visually and through touching each other

’s bodies, as well as trying-out gender roles and behaviour.

Children involved in such exploration are usually of similar age and size, boys and girls, friends rather than siblings, and participate on a voluntary basis. The typical feeling is light-hearted and spontaneous, and children may act silly or giggly. Although some children may feel some confusion or guilt about engaging in natural play,

The experience of sexual abuse can be analysed in terms of four trauma-causing factors:

traumatic sexualisation;

betrayal;

powerlessness; and

stigmatisation.

These are not necessarily unique to sexual abuse; they occur in other kinds of trauma. But the conjunction of these four dynamics in one set of circumstances is what makes the trauma of sexual abuse unique, different from such childhood traumas as physical abuse.”

Professor David Finklehor

they do not experience feelings of shame, fear or anxiety.

The sexual development of all children takes place along a continuum as they grow older and develop. It is false to suggest that children have no sexuality before puberty.

It is equally false to suggest that children share the same experiences and understanding of sexuality as adults. Childhood sexuality is not the same as adult sexuality. Children grow-up at different rates towards physical and emotional maturity, and harmful behaviours cannot be judged solely by what is considered to be ageappropriate. The premature involvement of children in the world of adult sexuality can distort development and disable for life.

Social and cultural factors and experiences, including abuse and peer pressure, can influence a child’s sexual development and can alter their ideas about sexual relationships. These ideas can lead to a child showing or engaging in harmful sexual behaviour which can be damaging to any children involved. C hildren of all ages and

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genders come to the attention of health and social care services, and criminal justice agencies, because they are displaying problematic sexual behaviour.

The experience of childhood includes risk taking and experimentation in order to develop understanding and resilience. Children will explore body parts, their genitalia, and seek to understand why and what things are for. They will be influenced by people close to them, and copy behaviours from family and friends, television and online games. Over time, their experiences will help develop personal standards for what is acceptable. The role modelling by close adults of attitudes and behaviours connected with gender and sexuality will be of major influence on the child’s future approach to sex.

Very young and preschool-aged children (four or younger) are naturally immodest, and may display open

– and occasionally startling – curiosity about other people’s bodies and bodily functions, such as touching women’s breasts, or wanting to watch when grown-ups go to the bathroom. Wanting to be naked (even if others are not) and showing or touching private parts while in public are also common in young children.

They are curious about their own bodies and may quickly discover that touching certain body parts feels nice. Parental guidance is required for the development of social skills and socially acceptable behaviour.

Puberty brings with it particular vulnerabilities.

Throughout the period of up to six or seven years of puberty (generally between 10 and 17 years of age) the child’s development towards adulthood produces significant changes to their physical and biological make-up, including the production of new hormones and the physical attributes of an adult. However, emotional development takes place at a much slower pace, leaving the teenager particularly vulnerable to abuse and exploitation. Teenagers can be far more vulnerable than they appear or act.

Pubescent adolescents experience major changes

– physical, intellectual, social, emotional and moral

– towards an emerging adulthood not fully formed before around 25 years of age.

Young people become capable and confident with abstract thought, experimenting with relationships, and highly influenced by their peers. They are working out the rules, experiencing a wide range of emotions, testing boundaries and struggling to develop a sense of “wholeness”. Teenagers are observed to be passionate, enthusiastic, rebellious, self-centred and materially minded. They may have significant challenges to fully comprehend implications and consequences of actions.

Children are not always able to apply informed choice.

A core concept to be considered here is the ability of the child or young person to make informed choice about what they do with their bodies as well as how they can understand the motives of other people and work-out their true feelings and intentions. Young people do not have a mature, tested and developed emotional intelligence. This means that children and young people may copy or become involved in, either consciously or unconsciously, activities that they cannot truly understand. They may not have

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developed the emotional intelligence to be able to feel in control of themselves, or may feel shameful about their own behaviour or that of others towards them.

Age development - a quick checklist:

Cognitively

Sexually

Socially

Child

Concrete thinking

Inquisitive

Family orientation

Play

Taking turns

Learning to negotiate

Egocentricity

Adolescent

Abstract thought

Experimentation

Egocentric

Masturbation increases

Changing anatomy

Peer orientation

Membership of groups

Friendships

Competition

Adult

Planning

Key relationships and sexual identity

Self-orientation

Interdependence

Acceptance

Social dance

Mutuality

Maturity

Emotionally

Morally

Mediated by others

Obeys to avoid consequence

– punishment and reward; parental responsibility and support

Lability (liable to constant change, error and instability) and range of emotions

Rebels

– testing approval and rules - rebels to show independence; peers versus parents and teachers - testing boundaries, developing personal moral code

Dynamic stability and support

Respects

– developed conscience and sense of rights; owns personal responsibility

In law, a child under 13 cannot consent to sexual activity in any form.

Sexual activity between 13 and 16 years of age remains illegal (Sexual Offences Act 2003), and at the same time teenagers at this age are exploring and experimenting with their growing sexuality. The response of adults requires judgement and understanding, including understanding the level of consent between peers. In terms of child development, even after thirteen years of age, the issues of informed choice and informed consent remains difficult and confusing.

Every child develops at a different rate with fluctuating levels of capacity and resilience. There can be no standardised response to sexual activity based on age alone. We have to understand and look for the attitudes and behaviours that suggest resilience and self-management. We can also identify the symptoms of distress and anxiety, secrecy and defensiveness which may be the result of unacceptable levels of risk-taking, grooming or coercion.

Behaviours, language and attitudes in childhood that portray or reflect adult sexual behaviours can be said to represent the premature sexualisation of a child who is not yet equipped to experience, manage or truly understand the world of adult sexual activities, interests or preferences. Research into harmful sexual behaviour in children suggests that neglect and maltreatment in early childhood, including sexual abuse, may predispose the onset of sexually harmful behaviour (Hackett, S &

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Masson, H). W hile it needs to be considered, it’s not correct to assume every child who displays problematic sexual behaviour has been sexually abused themselves.

Harmful Sexual Behaviour in children

There is a range of thinking about what constitutes harmful sexual behaviour in a child or young adult. We have a reasonable level of agreement about what is age

appropriate:

the things we see a child doing or thinking at a certain age that appear to be

usual and reasonably safe

– that is, do not produce deep upset or trauma.

The following chart offers some examples of what are called Green Light healthy and age-expected sexual behaviours:

Age

0-4 years

Curiosity and

Exploration

5-9 years

10-13 years

Green Light Behaviours

Healthy and age expected

holding or playing with own genitals

males may have erections

attempting to touch or curiosity about other children's genitals

attempting to touch or curiosity about breasts, bottoms or genitals of adults

games e.g. mummies and daddies, doctors and nurses

enjoying nakedness

interest in body parts and what they do and sensations

curiosity about the differences between boys and girls

asks very direct questions about sex and body variations

feeling and touching own genitals

curiosity about other children's genitals

curiosity about sex and relationships, e.g. differences between boys and girls, how sex happens, where babies come from, same-sex relationships

sense of privacy about bodies

telling stories or asking questions using swear and slang words for parts of the body

puberty starts for girls by age 10

solitary masturbation

puberty starts for boys

use of sexual language including swear and slang words

having girl/boyfriends who are of the same, opposite or any gender

interest in popular culture, e.g. fashion, music, media, online

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14-17 years games, chatting online

need for privacy

 consensual kissing, hugging, holding hands with peers

solitary masturbation

reaching sexual maturity (by 19 years)

sexually explicit conversations with peers

obscenities and jokes within the current cultural norm

interest in erotica/pornography

use of internet/e-media to chat online

having sexual or non-sexual relationships

sexual activity including hugging, kissing, holding hands

consenting oral and/or penetrative sex with others of the same or opposite gender who are of similar age and developmental ability

 choosing not to be sexually active

Taken from Brook Traffic Light (2014) and Toni Cavanagh

Summary of sexual development in adolescents 13-17 years old:

Characteristics Typical Sexual Behaviour

Hormonal changes

Menstruation in females

Development of secondary sex characteristics

More self-conscious about body / changes

Increased need for privacy around the body

Mood swings

Confusion about body changes

Confusion about self-identity

Fears about relationships

Doubts about sexuality

Fears about getting pregnant

Fears about being attractive and finding partners

Asks questions about relationships and sexual behaviour

Uses sexual language

Talks about sexual acts between each other

Masturbates in private

Experiments sexually with other teenagers of the same age

Consensual experimentation

Digital vaginal intercourse

Oral sex

Petting

Sometimes consensual sexual intercourse

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Conceptual framework for sexual harm and abuse

Healthy Development: Many expressions of sexual behaviour are part of healthy development and no cause for concern. However, when children or young people display sexual behaviour that increases their vulnerability or causes harm to someone else, adults have a responsibility to provide support and protection. It may be misleading to label behaviours displayed by young children in the birth to 5 category, or even the 5 to 9 category, as 'sexual'. A child who plays with his or her genitals may or may not be seeking sexual pleasure.

Adult perceptions, values and attitudes towards sexuality affect responses to children’s sexual behaviours. Adult understanding and experiences of mature sexual activities and sensations can be used to interpret children’s behaviours incorrectly. In fact, it is not clear how aware younger children are of sexual feeling, and behaviours are more likely to be seen as sexual because of the perception of the adult making the observation. Professionals are expected to use scientific understanding of child development when reflecting upon concerns.

There are a range of terms used by child care practitioners and services working with children and young people where there are concerns.

Serious sexual offences

include rape, sexual assault, sexual activity offences, abuse of children through prostitution or pornography, and trafficking for sexual exploitation.

Research into harmful sexual behaviour in children has evolved towards a general recognition that neglect and maltreatment in early childhood, including sexual abuse, may predispose the onset of sexually harmful behaviour.

However, while it needs to be considered, it’s not correct to assume every child who displays problematic sexual behaviour has been sexually abused themselves.

(Hackett, S and Masson, H).

Abusive Sexual Behaviour

refers to sexual behaviours that are initiated by a child or young person where there is an element of manipulation or coercion (Burton et al,

1998) or where the subject of the behaviour is unable to give informed consent.

Problematic sexual behaviour

is more often considered when referring to sexual activities that do not include an element of victimisation, but that may interfere with the development of the child demonstrating the behaviour, or which might provoke rejection, cause distress or increase the risk of victimisation of the child. Problematic behaviours may not necessarily be abusive (Hackett, 2004).

Both

‘abusive’ and ‘problematic’ sexual behaviours are developmentally inappropriate and may cause developmental damage to self or others.

Potentially harmful sexual behaviour includes any act that: is clearly beyond the child’s developmental stage, for example, a three-year-old attempting to kiss an adult’s genitals (this also requires understanding and accurate assessment of the child’s emotional stage of development, not just their calendar age);

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involves threats, force, or aggression;

involves children of widely different ages or abilities (such as a 12-year-old

“playing doctor” with a four-year-old);

provokes strong emotional reactions in the child

—such as anger or anxiety.

Sexual behaviour between children is harmful

if it involves aggressive contact with generally recognised “private” parts of the body, coercion, threats of violence, or one of the children being much older. Considerable diversity exists among both children and young people with harmful sexual behaviours. This diversity applies to their own backgrounds and experiences, the motivations for and meanings of their behaviours and their needs.

Contact Sexual Abuse: The NSPCC has identified that around two thirds of contact sexual abuse is committed by peers

– children of the same age-group. Davies (2012) suggested that there should be cause for concern if there is an age difference of more than two years or if one of the children is pre-pubertal and the other post-pubertal. In addition, Rich (2011) and Yates et al (2012) both stated that a young child can abuse an older child if the older one is

disempowered because of disability.

The most common case profiles of contact abuse involve boys aged 13 to 15 who primarily target pre-adolescent children with limited use of physical force. Rape occurs to a lesser degree. Statistically, these boys are more likely to get into trouble or be arrested for later non-sexual problematic behaviours than for sexual crimes. There is poor consideration that boys are sexually abused as well as girls, and that male perpetrators of abuse could also have been abused themselves.

There are a range of inter-related risks to children from premature involvement in adult sexual behaviours:

Annually, over 200,000 sexual offences committed by children are recorded in the UK (Cooper and Roe 2012), and research shows that not only is sexually abusive behaviour by children nearly twice as common as sexual abuse by adults (Radcliff

2012), but also that it is increasing in comparison with other types of young offending.

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Premature Sexualisation

Commercialisation of sexual imagery of children: Studies have suggested that increased sexual behaviour may be an indication that a child is, or has been, sexually abused. At the same time, children today are displaying more sexual behaviour and at younger ages, probably influenced by changes in social attitudes of parents, with increased access to internet-based pornography, online dating, and sexualised imagery in advertising and on TV.

Plymouth City Council statement:

Making a stand against

Access and exposure to

pornography affect children and young people’s sexual beliefs, according to the Office of the

Children’s Commissioner (2014). For example, pornography has been linked to unrealistic attitudes about sex; maladaptive attitudes about relationships; more sexually permissive attitudes; greater acceptance of casual sex; beliefs that women are sex objects; more frequent thoughts about sex; sexual uncertainty

(e.g. the extent to which children and young people are unclear about their sexual beliefs and values); and less progressive gender role attitudes

The Bailey Review: A six-month independent review into the commercialisation and sexualisation of childhood in 2012, called upon businesses and media to play their part in ending the drift towards an increasingly sexualised ‘wallpaper’ that surrounds children. Reg Bailey, Chief

Executive of Mothers’ Union, who led the independent review, talked to parents, unhappy with the increasingly

sexualised images in advertising

We are saying 'no' to sexualised images being used to advertise and promote products and services in locations across the city likely to be frequently seen by children and young people.

At Full Council in September 2013, cross-party agreement was gained to support campaigns which aim to protect children from exposure to inappropriate and unnecessary sexualised images in promotions, marketing and advertising.

We are working with partners to reduce the amount of on-street advertising containing sexualised imagery in locations where children are likely to see it. This is in-line with

Recommendation 2 of the Bailey Review* and the

Advertising Standards Authority's guidelines on sexual imagery in outdoor advertising.

The work aims to let children be children and reduce the pressure on them to grow up too quickly. In line with this, our Licensing Team is currently looking to incorporate this ethos into the renewal of all licensed premises to ensure that their signs and advertising are appropriate.

If you see any advertising or promotional material that you think is inappropriately sexual, you can report it to our customer services team by calling

01752 668000.

Depending on the content and where it is being displayed, issues are likely to be managed locally, but some may be referred to the national

Advertising Standards Authority, which has produced extremely useful guidance for parents called Advertising and Children . sexualised culture surrounding their children, which they felt they had no control over.

The Bailey Review has been criticised

as anecdotal, ideologically biased and without proof of the impact on children’s bio-psycho-social development. For practitioners and parents, it raises some key issues about social standards and values. For example, w hen assessing the significant influences on a child’s development, practitioners should consider the extent to which children are allowed to view 18-rated films and games on TV and the internet, and the level of parental guidance and supervision of their interface with commercial media and the Internet.

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Universal Practice Requirements

Knowing how to take a positive view and recognise healthy sexual behaviour in children and young people helps to support the development of healthy sexuality and protect children and young people from harm or abuse.

Prevention

of the development of harmful sexual behaviours requires carers and practitioners in universal services being able to recognise early signs and symptoms and share these concerns to allow effective support for the child and family.

The importance of Early Identification of HSB

has been recognised as a requirement for all carers and practitioners to understand and enact. The NSPCC continues to develop a multi-agency operational framework for working with children and young people where there is concern.

Early identification requires recognition of the criteria for sexually abusive behaviour:

1. The child has intentionally touched the sexual organs or other intimate parts of another person, or orchestrates other children into sexual behaviours;

2. The child’s problematic sexual behaviours have occurred across time and in different situations;

3. The child has demonstrated a continuing unwillingness to accept “no” when pressing another person to engage in sexual activity;

4. The child’s motivation for engaging in the sexual behaviour is to act out negative emotions toward the person with whom he or she engages in the sexual behaviour, to upset a third person (such as parent of a sibling), or to act out generalised negative emotions using sex as the vehicle;

5. The child uses force, fear, physical or emotional intimidation, manipulation, bribery, and/or trickery to coerce another person into sexual behaviour; and

6. The child’s problematic sexual behaviour is unresponsive to consistent adult intervention and supervision.

The Plymouth NSPCC supports children

, young people and their families/carers in addressing harmful sexual behaviours, and undertakes the formal assessment of children exhibiting HSB.

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Sexual Orientation

Everyone has a sexual orientation .

Sexual orientation is a combination of emotional, romantic, sexual or affectionate attraction to another person. It is about who you are attracted to, fall in love with and want to live your life with.

According to current scientific and professional

There are no proven theories as to how sexual orientation is determined. Many think that nature and nurture both play complex roles

– most people experience little or no sense of choice about their

understanding, the core attractions that form the basis for adult sexual orientation typically

sexual orientation.

The sense of self and emotionality associated with a growing consciousness of sexual orientation is particularly intense during puberty

– an already emotionally intense stage of life. Children and young

emerge between middle childhood and early adolescence. These patterns of emotional, romantic, and sexual attraction may arise without any prior sexual experience. People can be celibate and still know their sexual orientation

– be it lesbian, gay, bisexual, or heterosexual.

people can experience significant confusion, selfdoubt or even hatred, as well as character affirmation and newfound confidence. All deserve to be nurtured.

Sexual orientation is distinct from other components of sex and gender, including biological sex (the anatomical, physiological, and genetic characteristics associated with being male or female), gender identity

(the psychological sense of being male or female), and social gender role (the cultural norms that define feminine and masculine behaviour).

Prejudice and discrimination: Lesbian, gay, bisexual and transgender people in the United Kingdom encounter extensive prejudice, discrimination, and violence because of their sexual orientation. There are significant links between the experience of prejudice

– being on the receiving end of hatred

– and mental ill health. Practitioners are asked to think carefully about the use of language, and challenge discrimination to role-model acceptance and inclusion.

Gender identity is distinct from sexual orientation. Being a boy or a girl, for most children, is something that feels very natural. At birth, babies are assigned male or female based on physical characteristics. This refers to the "sex" of the child. When children are able to express themselves, they will declare themselves to be a boy or a girl (or sometimes something in between); this is their "gender identity" Which may be different from their sex assigned at birth. Some children, however, do not identify with either gender. They may feel like they are somewhere in between or have no gender.

Some children who are gender non-conforming in early childhood grow up to become transgender adults (persistently identifying with a gender that is different from their birth sex), some may identify with gay, lesbian or transgender orientation, and others will not.

Prevent gender role stereotyping :

Most children's gender identity aligns with their biological sex. However, for some, the match between biological sex and gender identity is not so clear. All children need the opportunity to explore different gender roles and different styles of play. We should ensure that the young child's environment reflects diversity in gender roles and encourages opportunities for everyone.

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PART TWO

ELEMENTS OF CHILD SEXUAL ABUSE

Child Sexual Exploitation

Child sexual exploitation distorts the usual sexual development of the child, and is child abuse.

Child sexual exploitation is when children and young people perform sexual acts, and/or have others involve them in sexual activities, and receive something (such as food, accommodation, drugs, alcohol, cigarettes, affection, gifts, or money) as a result, or are threatened if they do not take part.

Child sexual exploitation can occur through the use of the internet or mobile

phones. In all cases, those exploiting the child or young person have power over them because of their age, gender, intellect, physical strength and/or resources. For victims, the pain of their ordeal and fear that they will not be believed means they are too often scared to come forward to tell of the abuse and seek help.

Powerlessness is a key experience in CSE

, and refers to a condition where the child’s will, desires, and sense of worth are routinely disregarded. In cases of sexual abuse or exploitation, the child’s territory and body space are repeatedly invaded against the child’s will. This is made worse by imposed coercion and manipulation.

Powerlessness is then reinforced when children see their attempts to halt the abuse frustrated. It is increased when children feel fear, are unable to make adults understand or believe what is happening, or realize how conditions of dependency have trapped them in the situation.

An authoritarian abuser who continually

commands the child’s participation by threatening serious harm will probably instil more of a sense of powerlessness. But force and threat are not necessary.

A sense of powerlessness can happen:

in any kind of situation in which a child feels trapped, if only by the realisation of the consequences of disclosure; or

a situation in which a child tells and is not believed will also create a greater degree of powerlessness.

When children are able to bring the abuse to an end effectively, or at least exert some control, they may feel less disempowered.

Child sexual abuse, exploitation and trafficking cut across all cultures, class boundaries and occupations. There are elements common to most cases of sexual exploitation:

abuse of power

, grooming, coercion, targeting of vulnerable children, discrediting and silencing of victims, bribery, the use of gifts and/or threats, and the use of drugs or substances to subdue or encourage dependency;

feelings of worthlessness

, the sense of being somehow to blame and a feeling that they were treated as objects rather than people.

sex offenders treat children as objects for their own gratification rather than children or human beings, through a wide-range of abuse: from one-to-one, two

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adults/parents acting together, inter-generational family groups with multiple children, similar family groups with friends involved, religious groups, organised gangs and secretive cults.

like-minded individuals forming "networks" to deal in abusing children, making and distributing pornography, and procuring young people for prostitution and child abuse. Offenders

Signs of grooming and child sexual exploitation

will identify others in the community or through the internet who share their interests, enabling them to work together to entrap vulnerable youngsters. This may include people who have intentionally have clustered around a shared job-type or workplace to gain access to children and young people where they can exercise power, authority and/or trust relationships that offer opportunities to abuse.

Child Sexual Exploitation (CSE) is a type of sexual abuse in which children are sexually exploited for money, power or status.

Children or young people may be tricked into believing they're in a loving, consensual relationship. They might be invited to parties and given drugs and alcohol. They may also be groomed online. Some children and young people are trafficked into or within the UK for the purpose of sexual exploitation. Sexual

Signs of child sexual exploitation include the child or young person:

 going missing for periods of time or regularly returning home late

 skipping school or being disruptive in class

 appearing with unexplained gifts or possessions that can’t be accounted for

 experiencing health problems that may indicate a sexually transmitted infection

 having mood swings and changes in temperament

 using drugs and alcohol

 displaying inappropriate sexualised behaviours, such as over familiarity with strangers, dressing in a sexualised manner or sending sexualised images by mobile phone (‘sexting’)

 they may also show signs of exploitation can also happen to young people in gangs.

There are behavioural indicators that offer practitioners help in identifying children unexplained physical harm such as bruising and cigarette marks. vulnerable to or experiencing CSE. Plymouth uses the Risk Assessment Tool offered by the National Working Group for Tackling CSE, which can be found on the websites of Plymouth City Council or Plymouth Safeguarding Children Board .

Adults seeking to offer help and support need to understand the complex processes that lead to sexual exploitation. How we approach and work with these vulnerable children is crucial to successfully preventing their exploitation and holding the abusers to account.

Children and young people who become sexually exploited are often (but not always) from disrupted childhoods which have made them most vulnerable to being groomed. The power and control exerted by predatory adults usually forces the child to be compliant, and may involve the child becoming dependent upon the adult’s attention and support, at the same time as being afraid of repercussions if they try to escape or inform the Police or other authorities.

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Practitioners must promote positive values and attitudes that offer understanding and challenge negative judgements, labelling and blame of young people for their behaviours. The assessment of the child's vulnerability and ability to make fully informed choices in their relationships with others is essential.

Generally, the pubescent adolescent is at a developmentally vulnerable period of life requiring a level of support and guidance that is often unavailable to those most vulnerable to CSE. We do not accept labels of 'child prostitute',

'promiscuity' or the myth of the sexually provocative child. These notions come from an adult perspective of sexuality that denies the stages of child development and immature emotional intelligence.

Preventing Child Sexual Exploitation

The NSPCC offers advice on how to protect children. They advise:

helping children understand their bodies and sex in a way that is appropriate to their age

developing an open and trusting relationship so that they feel they can talk about anything

explaining the difference between safe secrets (such as a surprise party) and unsafe secrets (things that make them unhappy or uncomfortable)

teaching children to respect family boundaries such as privacy in sleeping, dressing and bathing

teaching them self-respect and how to say no

supervising internet and television use, including video gaming

ensuring early financial literacy and recognition of debt as a form of control

People of all backgrounds and ethnic groups, and of all ages are involved in sexually exploiting children. Although most are male, women may be perpetrators of sexual abuse. Criminals can be hard to identify because the victims are often only given nicknames rather than the real name of the abuser. Some children and young people are sexually exploited by criminal gangs which have been specifically set up for child sexual exploitation.

What to do if you suspect a child is being sexually exploited

If you suspect that a child or young person has been or is being sexually exploited, you should not confront the alleged abuser. Confronting them may place the child in greater physical danger and may give the abuser time to confuse or threaten them into silence.

Discuss your concerns with your professional manager local authority ch ildren’s services ( Plymouth Advice and Assessment Service ), the Police or an independent organisation such as the NSPCC. They may be able to provide advice on how to prevent further abuse and how to talk to your child to get an understanding of the situation.

If you know for certain that a child has been or is being sexually exploited report this directly to the police.

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Online Sexual Abuse

– inappropriate behaviour online

It has become common for children to experience sexual or offensive chat that makes them feel uncomfortable or are part of someone trying to meet up with them.

This can happen in online chat rooms, message boards, instant messenger or on social networking sites. It could be on a mobile phone, games console or computer. It could be messages, images or conversations over webcam. Where an adult is making sexual advances to children on the internet it should always be reported, to your local

Council’s child protection service, NSPCC, Childline, the Police or CEOP (the Child

Exploitation Online Protection service of the Police).

The Office of the Children’s Commissioner

(2014) found a significant number of children access adult pornography and that this influences their attitudes towards relationships and sex. It is linked to risky behaviour such as having sex at a younger age and there is a correlation between violent attitudes and accessing violent media.

Professionals from many agencies have reported particular concerns about the effects of pornography involving high levels of degradation, violence and humiliation, which is prevalent in material freely available online. Police case files have cited instances of boys and young men referring to pornography during discussion of sexual assaults (Berelowitz et al., 2012).

Children and young people's exposure to pornography occurs both on and offline but in recent years the most common method of access is via internet enabled technology. Exposure and access to pornography increases with age, although accidental exposure to pornography is more prevalent than deliberate access.

Any assessment of a child’s behaviour must include assessment of their online behaviours, and the role modelling of behaviours of other family members including parents, in order to understand the level of risk and need for safeguards. The

Plymouth Safeguarding Children Board has offered a useful diagram of examples for an online assessment checklist based upon the common conceptual framework:

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“Sexting”

Self-Generated Sexually Explicit Images & Videos Featuring Children or Young

People Online,

commonly known as

“Sexting”, is the act of sending sexually explicit messages, primarily between mobile phones but also using any form of webcam including on gaming consoles, tablets and laptops. Sexting also occurs online on social media websites for the public to view.

Sexting does not necessarily happen in isolation

.

It can be related to other online issues such as cyber bullying and draw from influences such as celebrity and pornography. Pornography is frequently viewed by 13-

14 year old boys, and while they acknowledge there is potential for harm, they do not feel they are affected

Professor Andy

Phippen of Plymouth

University undertook a study of the prevalence of sexting in Year 9 school themselves. Girls of this age will generally not look at pornography and view it as a negative influence.

A social danger with sexting is that personal and students and concluded that, of intimate material can be very easily and widely distributed, shared and stored on networks over which the originator has no knowledge or control.

Research by the Internet Watch Foundation in 2012, estimated that

88% of self-made explicit images are "stolen" from their original upload location (typically social networks) and teens aged 11 to 18 around 38% had received an "offensive or distressing" sexual image by text or email. made available on other websites, in particular porn sites collecting sexual images of children and young

Distress caused by offensive online behaviours, “Trolling”, people. The report highlighted the risk of severe depression for "sexters" who lose control of their online bullying and abuse have been images and videos.

The photos can also be used as blackmail, or sent to friends after a nasty breakup (or even while still in the relationship) as a method of revenge. This is a new risk associated with new media, as prior to cell phones and linked to significant increases in the incidence of selfharming by children and adolescents, low email it would be difficult to quickly distribute photos to acquaintances; with sexting, one can forward a photo in self-esteem and mental ill-health. a matter of seconds.

There are undoubtedly multiple risks when sending or receiving a sext, and these risks are something that often teens do not consider

– at least one third of teens do not consider or think of legal or other consequences of receiving or sending sexts.

Teenagers may simply text out of curiosity of sexual activity and it may increase as teenagers enter deeper into their teen years which can be problematic.

Sexting that involves children sending an explicit photograph of themselves to their peers has led to a legal grey area in the law against sexual images of children.

Some teenagers who have texted photographs of themselves, or of their friends or partners, have been charged with distribution of illegal images, as have those who have received the images. Specifically, any type of sexual message that both parties have not consented to can constitute sexual harassment, and sexting by a child under

16 remains a criminal act. From April 2015, socalled “vengeance porn” – the posting of intimate images of a person who has not consented to such publication on the

Internet

– was declared illegal in the UK.

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Harmful Sexual Behaviour Online

When working with young people who have engaged in harmful sexual behaviour on line it is important to consider:

motive - the personal needs the behaviour met for the young person and

that they are able to use the internet safely in the future.

Adolescents can be made vulnerable as they are exposed to incorrect information about human sexual behaviour and the encouragement of abusive sexual fantasies.

Online behaviour as a possible pathway into

sexually harmful behaviour. It is not known how many children and adolescents engage in sexual behaviour online or if there is a causal link between use of online pornography and sexually harmful behaviour. Case study analyses indicate a disinhibition effect of pornography on adolescent sexual behaviour, and that viewing highly abusive or violent images increases the risk at least for some adolescents (Jones V,

Protecting Children from Sexual Violence 2012).

There is professional concern where young people exhibiting sexually harmful behaviour are labelled as “sex offenders” with insufficient regard to the implications or the child’s rights. It is important to challenge children’s

Looking at abusive sexual material may act as a catalyst to engage in a sexually problematic way with another child or children, or may put a young person at risk of sexual exploitation by others, particularly adults. Children and adolescents may victimise other young people by accessing images of child abuse through

harmful sexual behaviour, but it is equally important not to equate it to that of adult sex offenders. Unlike most adults, children and pubescent adolescents are developmentally not

interactive technologies, or sexually soliciting others via social network sites.

The behaviour may include downloading, distributing and the production of child abuse images. There is guidance to assist practitioners working with young people whose internet

capable of the same kind of intellectual capacity for reasoning, planning and understanding the implications of their actions.

behaviour forms part of an overall concern regarding their harmful behaviours as well as those young people where this is the sole or main cause for concern.

The NSPCC

4

and AIM are together developing an internet based sexual offending assessment tool for adolescents. It is designed to be a stand-alone assessment tool which will assist in the formulation of risk of repeat behaviours/re-offence; identify likely causal factors and inform future therapeutic/treatment needs of the young person and the family/carers.

The

South West Grid

5

offers advice to practitioners on the assessment of online risktaking behaviours, and offers a helpline to professionals for advice on professional and personal concerns connected with online behaviours, profiles and behaviours.

4 http://www.nspcc.org.uk/services-and-resources/services-for-children-and-families/

5 http://swgfl.org.uk/products-services/esafety

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Female Genital Mutilation

In Britain, the definition of sexual abuse includes actions associated with female genital mutilation (FGM). From October 2015 it became mandatory to report known cases of Female Genital Mutilation (FGM) on girls under 18 to the police.

The physical and psychological impact of being subjected to FGM can influence the development of distorted

Female Genital Mutilation is

Classified into Four Major

understanding of sexual norms, sexual roles and behaviour, and result in trauma influencing sexual relationships throughout the victims out for non-medical reasons. It is usually carried out during childhood, from very young and to teenage girls. FGM is considered as an act of child sexual abuse, causing significant harm to the child’s sexual development and adult life.

women worldwide.

’ lifetime.

Female Genital Mutilation (FGM), also known as female circumcision or describes a range of procedures, often involving partial or total excision of the external female genitalia, that are carried

FGM thought to affect 100-140 million

FGM breaches international human rights law, in

“cutting”, particular the United Nations Convention on the Rights of the Child, and has been

Types:

I. 'Clitoridectomy which is the partial or total removal of the clitoris and, in rare cases, the prepuce (the fold of skin surrounding the clitoris);

II. Excision which is the partial or total removal of the clitoris and the labia minora, with or without excision of the labia majora (the labia are the ‘lips’ that surround the vagina); Type 1 and II account for 75% of all worldwide procedures;

III. Infibulation which is the narrowing of the vaginal opening through the creation of a covering seal. The seal is formed by cutting and repositioning the inner, and sometimes outer, labia, with or without removal of the clitoris; Type

III accounts for 25% of all worldwide procedure and is the most severe form of FGM;

All other types of harmful procedures criminalised in much of the world, including many African countries in which it is traditionally practised. The United

Kingdom is one of several Western countries that have enacted specific legislation in response to international migration. to the female genitalia for non-medical purposes, e.g. pricking, piercing, incising, scraping and cauterizing the genital area.

FGM is also included within the revised (2013) government definition of

Domestic Violence and Abuse. FGM is also known as Female Circumcision (FC) and Female Genital Cutting (FGC). The reason for these alternative definitions is that it is better received in the communities that practice it, who do not see themselves as engaging in mutilation.

FGM is practised around the world in various forms across all major faiths.

Muslim scholars have condemned the practice and are clear that FGM is an act of violence against women. Furthermore, scholars and clerics have stressed that Islam forbids people from inflicting harm on others and therefore most will teach that the practice of FGM is counter to the teachings of Islam. However, many communities continue to justify FGM on religious grounds. This is evident in the use of religious terms such as “sunnah” that refer to some forms of FGM (usually Type I).

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FGM is not practised amongst many Christian groups except for some Coptic

Christians of Egypt, Sudan, Eritrea and Ethiopia. The Bible does not support this practice nor is there any suggestion that FGM is a requirement or condoned by Christian teaching and beliefs. FGM has also been practiced amongst some Bedouin Jews and

Falashas (Ethiopian Jews) and again is not supported by Judaic teaching or custom. It should be noted that FGM is not purely an African issue, although there is greater prevalence there. In the UK FGM has been found among

Kurdish communities; Yeminis,

Indonesians and among the Borah.

Today it has been estimated that

migration which includes; Europe,

North America, Australia and New

There are substantial populations of

people in the UK from countries where under 16 who are at risk of type III procedure and a further 9,000 girls at

Immediate health problems:

Immediate physical problems;

Intense pain and/or haemorrhage that can lead to shock during and after the procedure;

Occasionally death;

Haemorrhage that can also lead to anaemia;

Wound infection, including tetanus.

Tetanus is fatal in 50 to 60 percent of all cases;

Urine retention from swelling and/or blockage of the urethra;

Injury to adjacent tissues;

Fracture or dislocation as a result of restraint;

Damage to other organs.

currently about three million girls, most of them under 15 years of age, undergo the procedure every year.

The majority of FGM takes place in 29

African and Middle Eastern countries, and also includes other parts of the world; Middle East, Asia, and in industrialised nations through

Zealand.

FGM is endemic, and this includes families living in Plymouth. It is estimated that there are around 74,000 women in the UK who have undergone the procedure, and about 24,000 girls risk of Type I and II.

FGM has no health benefits

, and it harms girls and women in many ways.

It involves removing and damaging

Long-term Health Implications

In the UK, girls and women affected by FGM will manifest some of these long term health complications. They may range from mild to severe or chronic.

Excessive damage to the reproductive system;

Uterine, vaginal and pelvic infections;

Infertility;

Cysts;

Complications with menstruation;

Psychological damage; including a number of mental health and psychosexual problems, e.g. depression, anxiety, post-traumatic stress, fear of sex. Many children exhibit behavioural changes after

FGM, but problems may not be evident until adulthood

Abscesses;

Sexual dysfunction;

Difficulty in passing urine;

Increased risk of HIV transmission/Hepatitis B/C

– using same instruments on several girls;

Increased risk of maternal and child morbidity and mortality due to obstructed labour. healthy and normal female genital tissue, and interferes with the natural functions of girls’ and women’s bodies. Many women appear to be unaware of the relationship between FGM and its health consequences; in particular the complications affecting sexual intercourse and childbirth which can occur many years after the mutilation has taken place.

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Health Impact Complications Are Common and Can Lead to Death.

The highest maternal and infant mortality rates are in FGM-practicing regions. The actual number of girls who die as a result of FGM is not known. However, in areas of Sudan where antibiotics are not available, it is estimated that one-third of the girls undergoing FGM will die.

Women who have undergone FGM are twice as likely to die during childbirth and are more likely to give birth to a stillborn child than other women. Obstructed labour can also cause brain damage to the infant and complications for the mother

(including fistula formation, an abnormal opening between the vagina and the bladder or the vagina and the rectum, which can lead to incontinence).

Indicators that FGM may soon take place, include:

Parents state that they or a relative will take the child out of the country for a prolonged period;

A child may talk about a long holiday (usually within the school summer holiday) to her country of origin or another country where the practice is prevalent;

A child may confide to a professional that she is to have a ‘special procedure’ or to attend a special occasion;

A professional hears reference to FGM in conversation, for example a child may tell other children about it;

Signs that FGM has taken place include:

Prolonged absence from school with noticeable behaviour changes on the girl's return;

Longer/frequent visits to the toilet particularly after a holiday abroad, or at any time;

Some girls may find it difficult to sit still and appear uncomfortable or may complain of pain between their legs;

Some girls may speak about ‘something somebody did to them, that they are not allowed to talk about'.

FGM is considered to be a form of child abuse (it is categorised under the headings of both Physical Abuse and Emotional Abuse). A local authority may exercise its powers under Section 47 of the Children Act 1989 if it has reason to believe that a child is likely to suffer or has suffered FGM. Under the Children Act

1989, local authorities can apply to the Courts for various Legal Orders to prevent a child being taken abroad for mutilation.

FGM is also an abuse of female adults, usually categorized under so-called

“honour based violence

” and domestic abuse definitions. Where a female adult is also defined as a Vulnerable Adult, additional support mechanisms would be available through local social care teams and adult safeguarding processes.

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PART THREE

Practice Guidance

If you are worried about the sexual behaviour a child, or sexual behaviours of others towards a child or young person, you must speak to your line manager or designated safeguarding co-ordinator, or trained child protection professional. If in doubt, contact the Local Authority’s statutory child protection service, the Police or NSPCC.

Where there is suspicion or an allegation

of a child or young person having been harmed in a sexual way by another child or young person, it should be

referred immediately

Consideration must be given to prevent any contamination of evidence.

to the children’s the child lives. Both the victim and the child who has allegedly displayed the harmful sexual behaviour

However, where there is cause for concern of sexual abuse within the family, guidance from

of social care referral team in the local authority where will need to be referred for assessment.

Concerns should usually be shared with the parent or carer of the child or young person. statutory services should be sought first, before informing carers or family members.

Disclosure: when receiving evidence of possible abuse

Stay calm.

Believe what you are being told.

Reassure the child/young person that they are doing the right thing in telling someone.

Give them time to say what they want to say.

Do not make comments, seem shocked or make judgments, other than to show sympathy and concern.

Keep questions to an absolute minimum and restrict them to those that help the child to talk freely. Use open-ended questions whenever possible, rather than those that only require a yes/no answer.

Clarify your understanding of the conversation using their own words if you do not understand (you may need an interpreter for those whose first language is not English).

Do not re-question the child/young person.

Be honest and tell them you cannot keep the conversation a secret, and you will need to inform other trusted people in order to help.

Explain to them what you are going to do next, and make sure you do it.

If the child needs immediate

Identifying signs and symptoms of sexual abuse is quite routine and should be considered as everybody’s business.

problematic sexual behaviour there are immediate practical issues of safeguarding, assessment and

medical attention call an ambulance, inform the paramedics of your concerns and make sure they

Working with these children is more complex

Where a young person has demonstrated

. know it is a child protection issue.

Contact your line manager as soon as possible for advice and guidance or Plymouth

Children’s

Social Care, the NSPCC or Police.

Record only what happened and was said as soon as possible after intervention to deal with. Alongside the child, the whole family is likely to be experiencing trauma. To achieve the best outcome for all, professionals need to fully understand the issues that can be present when a child engages in such behaviour. There is no simple, single solution.

Achieving Best Evidence

is the title used for the the child has disclosed.

Ensure maximum confidentiality and do not discuss with anyone except your line manager or

Children’s Social Care / NSPCC /

Police.

Do not question or contact

alleged perpetrators.

specialist method of formal interview used with children and young people who may be victims of sexual abuse, or perpetrators, and their families. It is designed to ensure the effective voice of those

It is advisable for all practitioners to have received regular child protection training, and to have

involved, without contamination of potential

rehearsed receiving a disclosure as a potential scenario.

evidence. Leading questions, putting ideas and words into the mind of the interviewee, or making assumptions and interpretation of

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responses are to be prevented. The atmosphere, location and ambience of the interview is vital to ensure the child feels safe enough and protected, comfortable and cared for, and that what is said is recorded clearly and accurately. Specifically trained interviewers know to establish rapport, allow a free narrative account from the interviewee, ensure open questions wherever possible, and take full account of the child’s emotional and cognitive intelligence including any learning difficulty or disability. Non-specialist practitioners should not attempt formal interviews of children exhibiting sexually harmful behaviour or who may have been sexually abused.

Definition of Child Sexual Abuse

“Sexual abuse involves forcing or enticing a child or young person to take part in sexual activities, not necessarily involving a high level of violence, whether or not the child is aware of what is happening.

The activities may involve physical contact, including assault by penetration

(e.g. rape, or oral sex) or non-penetrative acts such as masturbation, kissing, rubbing and touching outside of clothing, They may also include non-contact activities, such as involving children in looking at, or in the production of, sexual online images, watching sexual activities, or encouraging children to behave in sexually inappropriate ways, or grooming a child in preparation for abuse (including via the internet).

Sexual abuse is not solely perpetrated by adult males. Women can also commit acts of sexual abuse, as can other children”.

Working Together to Safeguard Children 2015, page 93

Remember, “Harmful Sexual Behaviour” (HSB)

includes:

 using sexually explicit words and phrases

 inappropriate touching

 using sexual violence or threats

 imposition of secrecy full penetrative sex with other children or adults.

Children and young people who develop harmful sexual behaviour may harm themselves and others. The issues of equality, true consent and coercion are key factors within the assessment of whether a child or young person’s behaviour is problematic or harmful and should be placed within the context of the incident(s) that have occurred.

Consent Issues: If a young person is under the age of 13 years old, they cannot legally consent to any form of sexual activity (Sexual Offences Act 2003).

Therefore a child protection referral is required in all such cases.

Action in relation to 13, 14 and 15 year olds:

The Sexual Offences Act 2003 reinforces that, whilst mutually agreed, non-exploitative sexual activity between teenagers does take place and that often no harm comes from it, the age of consent should still remain at 16. This acknowledges that this group of young people is still vulnerable, even when they do not view themselves as such.

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An assessment should take place of the young person’s competency to give consent and of the nature of the relationship. Consider any differences of age, maturity, level of development, functioning and experience and also the awareness of the potential consequences of their actions. A child protection referral or referral to the

Police is not mandatory in all cases of sexual activity involving a child under the age of

16 years of age, but an assessment (including whether the children are Gillick competent using Fraser guidelines

6

) must be undertaken.

Practitioner Confidence is recognisably low in the area of assessment of the sexual behaviour of children and young people. There is the additional cultural challenge to professionals of feeling able to talk openly about sex and sexual behaviours. Yet there is nothing more technical about signs and symptoms of sexual harm than those related to chronic neglect or physical abuse. Identification of harmful sexual behaviour or child sexual abuse is not a specialist area to be left to “experts”.

For the development of professional confidence, HSB training is essential.

Barriers to taking action on sexual abuse:

NSPCC research indicates that sexual abuse is under reported and that children and young people rarely disclose their experiences

.

Some commonalities in the experience of the victims do exist. Adults can find it difficult to report sexual abuse for reasons that are often similar to those which prevent children and young people from speaking up.

These include:

feeling worried that nobody will listen

not knowing who to tell

fe eling concerned that they won’t be believed

a lack of confidence in the abuse stopping and so believing there is no point telling anyone

internalising the abuse as somehow being their fault and because of this feeling embarrassed and ashamed

a reluctance to burden others with a disclosure

having ambivalent feelings and worries about getting the perpetrator of the abuse into trouble. Outside of the abuse this person may be likeable and supportive

being threatened by the perpetrator to stay silent and intimidated by the abuser about the possible consequences of telling anybody

being groomed by the perpetrator

sometimes information about their abuse is the one thing over which children feel they retain control; giving away that control can be frightening

confusion around whether what is happening to them is abusive and not understanding that they don’t just have to cope with it.

“It is strange because the reasons why young people find it hard to say they are being abused are often the same reasons that adults have for being reticent to help

. It’s so difficult for everyone involved.”

NSPCC helpline counsellor

7

6 http://www.nspcc.org.uk/preventing-abuse/child-protection-system/legal-definition-child-rights-law/gillickcompetency-fraser-guidelines/

7 http://www.nspcc.org.uk/globalassets/documents/helpline-highlights/helpline-highlight-report-sexual-abuse.pdf

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Working with Children who display sexually harmful behaviour:

Each child needs a unique and specific approach and support, with some key considerations:

1. Do not assume the behaviour is sexually motivated.

2. There may be more than one influencing factor- Insecure attachment, anxiety and low self-esteem, general neglect, underdeveloped impulse control, early exposure to sexual behaviour/material, family conflict, learned behaviour, to name but a few.

3.

Recognise that a child’s development is fluid and that this behaviour is likely to be responsive to intervention and can ultimately cease.

4. There may be other unreported or undetected problematic behaviour

– not just this allegation or presenting behaviour.

5. Parents and carers may not fully understand or be able to safeguard in the early stages of disclosure: despite what they have been told they may struggle to absorb the information.

6. Young people who target children are most likely to abuse both male and female victims.

7. Developmental differences are important: Although sexually troubled and sexually abusive behaviour in children can look remarkably like their adolescent counterparts, there are major age and ability-related developmental differences.

8. One significant difference is that older children (pubescent or post-

pubescent) are likely to be gaining sexual pleasure rather than asserting power or acting-out learnt behaviour. Sexual pleasure reinforces the behaviour.

The issues become more complex when trying to work with an adolescent who wants and needs to have sexual expression and relationships, but where they struggle to achieve this in a healthy way.

9. Shame and deception: adolescents are more likely to have a clearer understanding that the behaviour is wrong and be more closed to talking about their problem. One study found 80% of juvenile offenders were frequently deceptive to assessors when describing aspects of their offence prior to treatment (Burkhart et al, 2008). It is crucial to help this group overcome feelings of shame and to talk about their thoughts, feelings and behaviours.

10.

There’s no ‘one size fits all’ approach. Every instance in which a young person indicates sexually harmful behaviour will have unique circumstances and requires a unique response. Understanding the motivations and risk factors in young people who engage in sexually harmful behaviour

– and implementing balanced risk management strategies responsively

– underpins the potential to improve outcomes.

Recognition of Risk and Harm

Identification or Disclosure

of sexually inappropriate or harmful behaviour by a child can be extremely distressing not only for the children and young people involved, but also for parents, carers and other family members. They may react with disbelief and minimise the situation which could escalate concerns and it is therefore important that professionals help them through this process at an early stage so that they can support and where appropriate, protect their child.

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Hidden Abuse: There may also be attempts to hide the abuse by family or peers, including withholding of information or deception, known as “disguised compliance”, from both the perpetrator and the victim (who may be under threat or too shamed to disclose).

Disguised Compliance happens when parents or carers do not own the concern of the practitioner, or don’t admit their lack of commitment to the process and work

Respectful Curiosity:

The Inquiry by Lord

Laming into the death of

subversively to undermine it. The practitioner should maintain a focus upon the needs of the child, whilst being sensitive to the impact upon

Victoria Climbié identified barriers to the timely and

the family. Children or family members can accuse practitioners or become hostile, and this should not stop work with these families to uncover the reality of the child’s life.

Perpetrators as victims: It is also important to remember that not all children/young people

accurate identification of abuse, and recommended that practitioners need to maintain “respectful scepticism” when making enquiries.

displaying sexualised or harmful sexual behaviour have been sexually abused themselves. They may however have been living in an environment with few or inappropriate boundaries or been exposed to information or sexual activity which is beyond

The second Serious Case

Review examining Peter

Connelly’s death from severe neglect identified a catalogue of denials and

their level of development and understanding.

Hence in general the younger the child displaying sexualised or sexually harmful behaviour, the higher the likelihood of that child having been sexually abused or living in a sexualised environment.

false explanations by his mother and siblings, and said professionals must be “deeply sceptical of any explanations,

Sexually Problematic Behaviour: harmful sexual behaviour may also include children who exhibit a range of sexually problematic behaviour such as indecent exposure, obscene telephone calls, fetishism, downloading child abuse images from the internet, exhibiting

justifications or excuses you may hear in connection with the apparent maltreatment of children”.

harmful sexual behaviour against other children, masturbating in public and non-contact behaviour via any information technology they have access to

– in their home, in school, from a friend or in the community, e.g. Internet Cafés (computers, laptops, tablets, gaming consoles and mobile phones).

Risk-Taking Behaviour: whilst there is current evidence that young people are taking less risks than a decade ago, we are also aware that the traditionally recognised

“particularly vulnerable child” has become more vulnerable due to the commercialisation and accessibility of sexual imagery and suggestions. Children with emotional or cognitive difficulties will be particularly more vulnerable.

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PART FOUR: Procedures

Where there is concern that a child is exhibiting signs of harmful sexual behaviour,

the practitioner should immediately consult with their line manager and/or designated lead for child protection inside their agency.

When an allegation of sexual abuse has been made

, the Police are generally the first point of contact and it is critical for them to always consult with Children’s Social

Care regarding cases that come to their attention in order to ensure that there is an appropriate assessment of the victims needs and of the alleged perpetrator, including any risk factors within and outside the family home.

At all stages, event recording, and Information Sharing between practitioners, their managers, and partner agencies in contact with the child and/or family, must be ensured and maintained. See updated Government statutory guidelines 2015

8

.

1. Strategy Discussions

1.1. When a child / young person is suspected or alleged to have harmed

another in a sexual way, the Police and/or

Children’s Services must convene a strategy discussion or, in most cases, a strategy meeting within the required timescales. It is not always apparent at the outset whether a particular behaviour is abusive and a strategy meeting is an appropriate forum in which to share concerns before reaching a collective way forward. The potential complexities of these concerns usually require that the appropriate planning takes place in the form of a meeting.

1.2. On receipt of a referral, an initial strategy discussion must occur between

Children’s Social Care, the Police and Health professionals, and other appropriate practitioners in the team around the child and family, to share information and determine whether the threshold for section 47 enquiry (Children Act 1989) has been reached. The Police should be involved in the decision making process even if the child is under ten years of age and therefore below the age of criminal prosecution as they may, for example, have information about the child’s family which is relevant to the enquiries.

1.3. When the child or young person concerned resides in a different local authority

, it is expected that the strategy meeting is convened and chaired by the authority in which the potentially harmful behaviour occurred. In most cases a combined strategy meeting will be convened to share information in respect of the alleged victim and the child/young person who is suspected of displaying harmful sexual behaviour. The primary aim of any intervention should remain focussed on the protection of the victim, the protection of any other potential victims and the avoidance of repetition of the harmful sexual behaviour.

1.4.

Strategy meetings will be convened and chaired by Children’s Social Care

and a record of the meeting made. If the allegation involves a number of children, then

8 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/419628/Information_sharing_advic e_safeguarding_practitioners.pdf

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a Complex Strategy meeting should be held. It is important that appropriate representation is invited from relevant organisations working closely with the child and family, e.g. Designated Safeguarding Leads from the schools that all the children attend.

1.5. The strategy discussion or meeting must plan in detail the respective roles of participants at the meeting. It also must address ‘risk management’ measures that may be required within individual organisations, including voluntary and faith.

The discussion/meeting must take into account the immediate protection of all of the children involved and any others in contact with the child/young person who is suspected or alleged to have harmed others sexually.

If at this stage no further action is required, all agencies who have been involved should be informed of the outcome in writing. The parents or carers of the children will also be informed of the outcome of the meeting. Parents or carers should not be invited to, or receive minutes of, the strategy meeting(s).

2. Outcomes of Enquiries

2.1. Where the decision is reached within the strategy discussion that the alleged behaviour does not meet the threshold criteria for significant harm, the details of the referral and reasons for this decision must be clearly recorded. The outcome should also be appropriately shared with any professionals involved; if the referrer is not a professional, only limited information can be shared in accordance with inter-agency information sharing arrangements. The need for further assessment and support services to either child / young person should still be considered within a multi-agency framework.

2.2. A Social Work Assessment will normally be undertaken by CSC

. The exception to this is if it is apparent from the outset that behaviours are within the scope of healthy, ageappropriate development; at this stage Children’s Social Care may offer advice, refer the caller to other universal service provision, advise that an assessment under Early Help Offer be initiated, or conclude that no further action is required.

2.3. Where a section 47 enquiry is required

, a different social worker must be allocated for the victim and for the child / young person who is suspected or alleged to have harmed in a sexual way, even if they live in the same household, to ensure that both are supported through the assessment process and that their individual welfare and safety needs are being addressed.

2.4. The decision about initiating a child protection conference should be made following the outcome of the section 47 enquiry. A young person who is alleged or suspected to have displayed harmful sexual behaviour should only be the subject of an initial child protection conference if they are considered to be at risk of significant harm. The decision is taken between the child protection social work team manager and the child protection social worker who has completed the assessment.

2.5. If a child protection conference is not convened and there is an identified need for services to address the needs of the children concerned, a service plan

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should be drawn up in consultation with the young person, their parents / carers and professionals. The multi-agency service plan should be subject to review and include the child's need for any work to address their harmful sexual behaviour. Appropriate consideration should be given to maintaining care and education arrangements.

Regardless of whether the process followed is through an initial child protection conference or a multi-agency service planning meeting, it is important that children receive a level of intervention appropriate to their needs and risk factors.

2.6. Where abuse is inter-familial or where the child / young person who is alleged to have harmed sexually is in the same household, as other younger or more vulnerable children, the protection of any other potential victims must be addressed.

Consideration should be given for the need to remove the young person who may have caused the sexual harm from the household, at least in the short term.

2.7. In all cases requiring a social work assessment, lateral checks must be undertaken, and information about the concerns shared appropriately with organisations, such as schools, so they can manage the risks that a child may pose to others. Lateral checks should include information in regard to all the children involved.

Other organisations working closely with children and families may need to be consulted at this stage and risk management must be borne in mind when decisions around information sharing in these cases are made.

2.8. Plymouth schools/education settings may seek the support of the Education

Welfare Service in regards to completion of a Risk Management plan in relation to the child who may have demonstrated the harmful sexual behaviour.

2.9. If the threshold for undertaking a section 47 enquiry has not been met, the assessments completed by the social workers must indicate whether support needs to be offered to the children, young people and their families via a coordinated, multiagency, child in need service plan or Early Help Assessment or Early Help meeting.

It is important that all professionals who are involved must be invited to the meetings in order to share information and offer a coordinated, multi-agency approach that takes account of risk to other children and young people.

2.10. Where possible children and young people have a right to be consulted and involved in all matters and decisions that affect their lives and the use of interpreter services should be accessed if needed to achieve this. This right and respect extends to parents and carers and their active participation should be promoted.

3. Assessment

3.1. Work with children and young people who abuse others

, including those who sexually abuse/offend, should recognise that such children are likely to have considerable needs themselves, and that they may pose a significant risk of harm to other children. Evidence suggests that children who abuse others may have suffered considerable disruption in their lives, been exposed to violence within the family, may

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have witnessed or been subject to physical or sexual abuse, have problems in their educational development and 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. Children and young people who abuse others should be held responsible for their abusive behaviour, while being identified and responded to in a way that meets their needs as well as protecting others.

3.2. An assessment by professionals used to dealing with cases of suspected abuse or harmful sexual behaviour will be the best way forward, even if the child or young person has not directly revealed that something is wrong or if there's any other uncertainty on your part.

3.3. Assessment is required where there is an allegation of sexually harmful

behaviour concerning a child or young person or where there is sufficient professional concern in respect of a young person and possible sexually harmful behaviour. This applies even where the young person denies the behaviour. Denial is common in young people who sexually harm, as well as those who are the current victims of child sexual exploitation.

Multi-Agency Response:

no agency acting alone can appropriately manage children and young people who display sexually harmful behaviour.

3.4. Information Sharing: Assessment of Sexually Harmful Behaviour is a process of observation of behaviours over time.

Continuous and co-ordinated information sharing between agencies is essential in order to provide robust evidencebased assessment, planning, intervention and review. Ensure adherence to

Government guidelines 2015 .

Where a lead professional (LP) or a multi- agency group consider that the needs of a child or young person have become more complex and may need to be addressed through social work intervention they should refer to South West Child Protection

Procedures ( www.swcpp.org.uk ) and the Plymouth Assessment Framework guidelines (available at http://www.plymouth.gov.uk/framework_for_assessment_and_thresholds.pdf

4. Multi-Agency Procedures

4.1. There are multi-agency procedures for working with children and young people under the age of 18 years who are known to have engaged in sexually harmful behaviour towards another, whether or not they have entered the criminal justice system. The primary objective of all work with children and young people who display harmful sexual behaviour must be the protection of the victim and the prevention of a reoccurrence of the harmful sexual behaviour. It is therefore essential for there to be a coordinated, multi-disciplinary response in accordance with statutory guidance and these procedures.

4.2. The purpose of these procedures is to provide a clear operational framework in respect of children and young people who display harmful sexual behaviour and

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any alleged victims. It is important to note that professionals need to remain aware of the negative effect of labelling children and young people as young

‘sex offenders’ or ‘young abusers.’ The use of ‘children or young people who display

harmful sexual behaviour’ is considered to be more appropriate. This terminology acknowledges that their development as a child or young person is the first and foremost consideration and that they are displaying or enacting behaviour(s) that need to be appropriately addressed to work towards change.

4.3. All assessments should be co-worked between children’s social care or YOT, with the lead role being determined by the referral route. Professionals from other agencies such as education may also be involved in the assessment process.

5. Criminal Justice

5.1. The Police or the Court will notify the Youth Offending Team when they are aware that a child or young person over the age of 10 (age of criminal responsibility) is alleged to have engaged in sexually harmful behaviour and may have committed an offence. The notification will be made whether or not the child or young person has admitted to the offence.

5.2. The Youth Offending Team must immediately notify social care through the

Plymouth Advice & Assessment Service or the children’s social care referral team in the local authority where the child lives.

6. Social Care

If at any time, the case moves out of the criminal justice system, the social care route of assessment, planning, intervention and review should be followed under the child protection, looked after or child in need system.

6.1. Initial Review:

When children and young people are referred to Children’s Social

Care there should be an initial review within 24 hours to ensure that there are no immediate safeguarding issues. There must then be an initial strategy meeting held within 5 working days. The police, youth offending team, health and education must be invited to this meeting and consideration given to whether representatives from other agencies should also be invited to share any information. If a representative from the child or young person’s school does not attend, they will need to be kept informed of any outcome so that their own risk management plan for the school or educational setting can be implemented where appropriate.

6.2. AIM 2 Assessment: Whenever an assessment is being carried out with a child or young person who has displayed sexually harmful behaviour, consideration should be made for an AIM2 assessment. The Assessment, Intervention and Moving-on system

(AIM) was set up in January 2000 to improve the way professionals respond to the needs of young people, aged between 10 and 17 years, who display sexually harmful behaviour, and is now in its second format, hence AIM2.

Where the child or young person who has engaged in harmful sexual behaviour is already known to children’s social care and has an active referral, social care will

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identify a person to lead the AIM2, assessment, usually from the NSPCC, or in the case of a young person in the criminal justice system, the YOT will identify a lead.

Where the child or young person who has engaged in sexually harmful behaviour is not known to social care or does not have an active referral, the case will be allocated to a social worker who may refer to NSPCC to carry out the AIM2 assessment. If the victim has a social worker, s/he must not be directly involved in the AIM2 assessment of the young person who has engaged in the sexually harmful behaviour.

If a victim is also referred to social care, the social worker allocated to the victim must be different to the social worker allocated to the child or young person who has engaged in sexually harmful behaviour. Where practicable both cases should be supervised by the same team manager. However, where there are several victims from multiple households, this may not be possible but there should be close liaison between the team managers.

The child or young person and their parents / carers must consent and be willing to engage in the full AIM2 assessment. There must also be an admission of guilt.

7. Thresholds

7.1. A general guide to action based upon level of concern is offered here:

7.2. The Plymouth Assessment Framework offers a chart of possible cases scenarios as examples of the potential depth of concern associated b y a child’s behaviour or conditions. Practitioners are encouraged to consult the PAF and consider the guidance offered.

Examples related to Harmful Sexual Behaviour included in the Plymouth Assessment

Framework are offered on the next page:

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From the Plymouth Assessment Framework 2015:

Level 1

Support from

Universal services is sufficient

Age appropriate development re:

Fluency of speech and confidence

Willingness to communicate

Children not meeting their developmental milestones

Verbal and non-verbal comprehension

Language structure and vocabulary and articulation.

Milestones for cognitive development are met

Demonstrates a range of skills and interests.

Level 2

Targeted Support required (Single Agency)

Reluctant communicator

Not understanding ageappropriate instructions

Confused by non-verbal communication

Difficulty listening for an appropriate length of time

Immature structure of expressive language

Speech sounds immature.

Milestones for cognitive development are not met

Mild to moderate learning difficulties

Identified learning needs on

School Action of SEN Code of Practice.

Level 3

Targeted Support

(Integrated Targeted

Support and Lead

Professional)

Severe disorder and impairment in understanding spoken language

Communication difficulties have a severe impact on every-day life

Requires alternative or augmented means of communication.

Complex learning and/or disability needs

Serious development delay

Significant and repeated evidence of lack of comprehension of consequences of behaviour, e.g. repeated criminal or anti-social acts.

Gang-related criminal activities.

Level 4

Statutory Threshold met and intervention

required

Communication that is overtly inappropriate, e.g repeated overtly sexualised behaviour of a sophistication beyond the developmental age of the child and / or exhibiting power and control behaviour

(older child to younger).

Sets consistent and appropriate boundaries taking account of age/development of child/young person

Enables child to access appropriate activities and to experience success.

Parent provides inconsistent boundaries

Child or young person spends considerable time alone

Lack of response to concerns raised about child or young person

Parent does not support access to positive new experiences or social interaction.

No effective boundaries set

Parents unable to provide appropriate role model

Persistent condoned absence from school

Exposure to inappropriate or harmful material

Parents in conflict with statutory services

Evidence of prolonged social isolation.

PLEASE NOTE: Where there is concern for potentially harmful sexual behaviour exhibited by a child or young person under 18 years of age

,

early identification and an offer of early help to the family is crucial. This support to the family will be a core element of the early help offer from all universal services, and may not meet the threshold of concern for potential significant harm required to involve statutory child protection social work services.

Vulnerability to sexual exploitation

Sexualised behaviour of a sophistication beyond the developmental age of the child and / or exhibiting power and control behaviour (e.g. older child to younger).

Vulnerability of child under 18 to physical abuse or financial exploitation.

No effective and appropriate boundaries set

– child dangerously out-ofcontrol / offending despite appropriate intervention

Parent / carer passive/aggressive opposition to intervention and/or false compliance / misinformation / distraction tactics.

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Learning from Serious Case Reviews

A serious case review (SCR) takes place after a child dies or is seriously injured and abuse or neglect is thought to be involved. This includes cases of child sexual abuse where agencies have been involved with the family but the child has nevertheless suffered significant harm. The review looks at lessons that can help prevent similar incidents from happening in the future. The review considers how well the multiagency system and practice safeguarded the child at the time.

The Plymouth Safeguarding Children Board (PSCB) follows statutory guidance and works with the National Panel of independent experts, Ofsted and the Department for

Education towards the publication of Serious Case Reviews concerning children and young people in Plymouth. The Board may also conduct multi-agency reviews considering children where the threshold for an SCR has not been met but the child’s experience of the child protection system identifies cause for concern.

The PSCB has published a number of Reviews which highlight harmful sexual behaviour. All published reviews are available at the PSCB website: www.plymouthscb.org.uk

Little Teds Nursery

Early Years Practitioner, Vanessa George, was found to have a sexual interest in children, sharing images on the internet. The Review identified a wide range of issues with the nursery management, culture and physical environment that meant safeguarding risks were not minimised.

There was a weak governance framework at the private nursery with no clear lines of accountability. Factors that meant safeguarding risks were not minimised included the absence of safer recruitment procedures, an informal recruitment process and a lack of formal staff supervision within the nursery. Policies and procedures in relation to child protection had been lifted without adaptation to the setting from other documentation.

The environment enabled a culture to develop in which staff did not feel able to challenge some inappropriate behaviour by George. There appears to have been a complete lack of recognition of the seriousness of the boundary violation and a culture in which explicit sexual references about adults in conversation were the norm.

The report concludes that Little Ted's "provided an ideal environment within which

George could abuse."

Learning from the Review, the local authority Early Years Service strengthened advice and guidance to all early years settings, and the Board published comprehensive guidance and a tool kit

9

for all settings, detailing acceptable management procedures and best practice.

Child Q

A fifteen year old young man known as Child Q had been convicted of two serious sexual offences. The first offence against a fifteen year old female and a second offence against an eleven year old female had occurred whilst Child Q was on police

9 http://www.plymouth.gov.uk/pscbonlinesafetytoolkitearlyyears

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bail. Child Q received a custodial sentence His family was known to have had extensive involvement with agencies in Plymouth.

History of neglect, violence, aggressive and abusive family behaviours: Some of this behaviour involved Child Q assaulting others, on one occasion receiving a Final

Warning for Common Assault. Child Q had been excluded from school more than once prior to June 2012 due to aggressive and uncontrollable behaviour.

The review concluded that a number of systemic failings came together resulting in a repeat of a serious sexual offence whilst Child Q was on bail.

These factors were:

A failure over many years to adequately assess and address potential risks within Child Q’s family;

Delay in reporting the original offence and lack of proactive work by the social care out of hours team including risk assessment at the point that bail to the family home was agreed;

Insufficiently robust procedures in Plymouth regarding how to respond to a young person who may sexually harm others; and

Systems within the Youth Offending Team and Police that treated offences within the same family in isolation and did not easily promote a holistic approach to understanding risk.

Plymouth Safeguarding Children Board agreed to ensure that partner agencies assess their workforce competence in relation to sexual abuse and young people who sexually harm. This should include a review of their staff development strategy in order to identify and meet learning needs in relation to o early identification and response to childhood sexualised behaviour o signs and indicators of sexual abuse o risk factors associated with young people who sexually harm o an analysis of the impact of learning upon practice.

The publication of this Guidance booklet is an element of that action plan.

National lessons from Serious Case Reviews

The NSPCC national case review repository, in collaboration with the Association of

Independent LSCB Chairs. The repository provides a single place for published case reviews to make it easier to access and share learning at a local, regional and national level. The repository is accessible via the NSPCC library online , which has over 600 case reviews and inquiry reports.

This includes the 2015 review of the case of Child R

10

who was raped at the age of 15 whilst in foster care. Whilst in care, Child R had periods of going missing, highly disruptive behaviour, multiple placements and exclusions from school.

Issues identified included a lack of professional knowledge and understanding of Child

R's history and vulnerabilities and Child R's lack of engagement with and mistrust of professionals. It is clear that practitioner knowledge and confidence in working with issues of sexual abuse require improvement.

10 http://library.nspcc.org.uk/HeritageScripts/Hapi.dll/search2?searchTerm0=C5697

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PART FIVE: Services:

The

Plymouth Online Directory

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includes a number of support services for the early help, safeguarding and protection of children and young people vulnerable to harmful sexual behaviour or sexual abuse. It is routinely updated in a manner that this document cannot be, and readers are advised to refer to the POD frequently.

Barnardo’s BASE and Devon Spokes Project, Plymouth:

work with children and young people across Plymouth and Devon providing specialist sexual exploitation work. They work closely with sibling services across the country, and the service has been robustly reviewed showing consistently excellent practice.

Barnardo’s family support service works exclusively with families whose children are or have experiences CSE. This project works both with groups and provides 1-1 support including specialist support for foster carers. Plymouth Base works with young people aged 10-18 who are at high risk of, or experiencing Child Sexual Exploitation to provide, one to one intensive specialist support for children and young people, helping them to recognise and recover from CSE and move on in a positive way.

Contact e-mail: [email protected]

Service Manager

– Jeanie Lynch: 07824 301185

ChildLine

: is a private and confidential service for children and young people up to the age of nineteen. You can contact a ChildLine counsellor about anything

– no problem is too big or too small. Freephone Helpline 0800 1111

Care Leavers Service 18+ Plymouth City Council

: The Youth Service's 18+ Care

Leavers Team provides support and resources to young people aged 18 to 21 who have been in local authority care. This can be extended to age 25 in certain circumstances: call 01752 398200

Child and Adolescent Mental Health Services (CAMHS)

: The Child and Adolescent

Mental Health Service provides help for children and young people aged 5 -18 years, and their families, when the child or young person has a difficulty with their mental health. They provide high quality, multi-disciplinary mental health services to all children and young people with mental health difficulties and disorders to ensure effective assessment, treatment and therapeutic support for them and their families.

The CAMHS team consists of a range of qualified and experienced multidisciplinary clinician's covering a broad aspect of modalities including Nursing, Social Work,

Psychology and Psychiatry. Call: 01752 435125

Early Years Service Plymouth:

The Early Years Inclusion Service is part of the

Education, Learning and Family Support Department of Plymouth City Council. We support early years and childcare provision and children's centres in Plymouth. They include a safeguarding officer for advice and guidance. Call: 01752 307450

iAIM: The Internet Assessment, Intervention and Moving On (iAIM)

manual is primarily designed to provide social workers and youth justice practitioners with a framework for guiding their assessments and interventions with adolescent males

11 http://www.plymouthonlinedirectory.com/kb5/plymouth/fsd/family_results.page?familychannel=3&qt=&term =

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aged 12-18 years in mainstream education who have engaged in harmful sexual behaviors on-line using new technologies.

Infant Mental Health Team

: The Infant Mental Health Team are able to respond when a parent or carer is very distressed or anxious about their child, and where staff in universal services have been unable to help that parent to feel less anxious: Call

01752 434615

Lucy Faithful Foundation

is the leading child protection charity dedicated solely to reducing the risk of children being sexually abused. They work with families that have been affected by sexual abuse including: adult male and female sexual abusers; young people with inappropriate sexual behaviours; victims of abuse and other family members. LCF has developed a short, education based programme for young people with problematic on line behaviour, Inform YP, and also provide Internet Safety seminars for parents and schools.

Muslim Youth Helpline (MYH)

: Muslim Youth Helpline is a confidential listening service for young people; we offer emotional support and information for those going through a difficult time. Our helpline is culturally and religiously sensitive; however, our helpline workers do not discuss or impose their own political or philosophical views and are available to listen and support. 0808 808 2008

NSPCC Child Protection Helpline

A free 24 hour service which provides counselling, information and advice to anyone concerned about a child at risk of abuse. Staffed by qualified social work counsellors who will listen to callers' concerns and decide with them if action is required.

Public access: 0800 800 5000

The NSPCC has a service centre in Plymouth that offers programmes for children that have been affected by sexual abuse. The 3 programmes currently on offer are

‘Assessing the risk, protecting the child’, ‘Letting the Future in’ and ‘Turn the Page’.

The Plymouth Service Centre will be able to provide you with information on any more services they provide in the Plymouth area. They are based at Brunswick House,

1 Brunswick Road, Cattedown, Plymouth, PL4 0NP and can be contacted on 0844 892 0288.

Out Plymouth:

the support service for lesbian, gay, bisexual and transgender young people: Email: [email protected]

(Young people, teachers, parents, those who work with young people) Mob: 07774 336616 (Text or call).

UK Safer Internet Centre

provides support to professionals on all aspects of digital and online issues such as those which occur on social networking sites, cyber-bullying, sexting, online gaming and child protection online, and aims to resolve issues professionals face. Supported by the South west Grid for learning, the Centre develops new educational and awareness raising resources for children, parents and carers and teachers to meet emerging trends in the fastchanging online environment. Recent launches include resources focusing on early years , sexting , and 'how to' video guides on using parental controls on internet-connected devices . The centre also develops self-assessment tools for schools and other settings to evaluate their online safety provision, including policy development.

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Young Devon

: A service offering holistic support, information advice and guidance to young people. Areas include life skills, counselling, information on drugs and alcohol, general and sexual health advice, supportive accommodation, advice on housing and accommodation and personal life issues. Call 01752 691511

Youth Service Plymouth City Council:

Youth services work with young people in

Plymouth who are aged between 11 and 19 (up to 25 years old where there is a specific additional need or disability), including targeted support for people who feel unsafe, vulnerable or have additional needs that require one-to-one or more specialist support. Call 01752 306596

The Zone Sexual Health Service

: Confidential contraceptive and sexual health advice and free supplies for most methods of contraception; free condoms, pregnancy testing, chlamydia testing. Free emergency contraception. The nurse is available for contraceptive Pill, depot injection, emergency contraception, implant fitting, removal and advice, Termination of pregnancy advice and referral, other contraception advice, help and information. Drop in opening times; Monday,

Wednesday, Thursday 1:00pm - 5:00pm Tuesday: 3:00pm - 7:00pm Saturday:

10.30am - 4:00pm Phone: 01752 206626

Training

All agencies where people work with children, young people, parents or families should ensure in-house induction and routine training to ensure adherence to legal requirements for safeguarding and child protection. Child protection guidance should include reference to, and explanation of, the signs and symptoms of Harmful Sexual

Behaviour, as part of the underpinning knowledge for prevention of child sexual abuse.

In addition, multi-agency, inter-disciplinary training for practitioners and their managers involved in the assessment of risk and needs should be routinely accessed and regularly updated.

The Plymouth Safeguarding Children Board offers a range of child protection courses for practitioners and managers of all agencies working with children, young people and families in the City. One-day training courses on the specific issues of child sexual abuse, child sexual exploitation, and child online safety are currently available on our website training pages .

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Helpful websites: Working with HSB www.aimproject.org.uk

Provide assessment and intervention models, training and

supervision.

www.autism.org.uk

National Autistic Society. Provides information and support including information on the unique difficulties of a young person with autism in relation to sex and sexuality. Hold helpful conferences in this area.

Barnardo’s

Awareness, guidance, signposting and outreach on reducing risk taking and harmful behaviours. Focussing on sexual exploitation and sexually harmful behaviours, mental health, domestic and substance abuse, and homelessness.

www.BASHH.org

British Association for Sexual Health and HIV.

www.bild.org.uk

British Institute for Learning Disabilities offer useful resources for young

people with learning disabilities on social understanding and sexual

relationships.

www.brook.org.uk

Brook Advisory Service

www.childmentalhealthcentre.org

Useful resources on working therapeutically with children.

www.fpa.org.uk

Useful sexual health resources including information for young people with

learning disabilities

http://www.musc.edu/tfcbt

Offers online training for practitioners working with children who have significant psychological symptoms related to trauma

exposure. Developed by Cohen, Deblinger, Mannarino, CARES

Institute, USA.

NCATS

National Clinical Assessment and Treatment Service: A national centre of expertise on children and young people who show harmful sexual behaviour.

www.ncsby.org

The National Child Traumatic Stress Network. Useful resources on working with children and sexual development.

www.nota.co.uk

Organisation working to develop good practice across Britain and

Ireland with those working in the field of Sexual Aggression.

NSPCC Explaining Sexually Harmful Behaviour, National Society for the

Prevention of Cruelty to Children

– some very useful resources on the

HSB web pages.

www.nspcc.org.uk

Useful information, advice on sexual abuse and other safeguarding matters.

www.ncsby.org

National Centre for the Sexual Behaviour of Youth. Useful resources on working with children and sexual development, including a CBT

Programme for children and their parents/carers.

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www.NCTSN.org

The National Child Traumatic Stress Network. Includes useful information on Sexual Behaviour in Children including fact sheets for parents/carers.

www.parentsprotect.co.uk

A valuable website for parents developed by the Lucy Faithfull

Foundation on protecting children from abuse.

PSCB

Plymouth Safeguarding Children Board CSE pages, including the video, “Anna”.

www.signsofsafety.net

Useful resources for working with child abuse including denied child

abuse.

www.thinkuknow.co.uk

Advice and resources about safe internet use for 5 to 7s, 8 to 10s,

11 to 16s, and parents/carers, teachers and trainers.

www.workingwithmen.org

Useful sexual health and relationship resources for working with young people.

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Glossary of Terms

(not otherwise explained in the text)

Child Abuse and Neglect: Throughout this document, the recognised categories of maltreatment as set out in Working Together to Safeguard Children 2015. These are:

physical abuse

emotional abuse

sexual abuse

neglect

Child in Need:

Children who are defined as being ‘in need’ under section 17 of the

Children Act 1989 are those whose vulnerability is such that they are unlikely to reach or maintain a satisfactory level of health or development, or their health or development will be significantly impaired, without the provision of services, plus those who are disabled. Local authorities and other bodies have a duty to safeguard and promote the welfare of children in need.

Controlling behaviour is: a range of acts designed to make a person subordinate and/or dependent by isolating them from sources of support, exploiting their resources and capacities for personal gain, depriving them of the means needed for independence, resistance and escape and regulating their everyday behaviour.

Coercive behaviour is: an act or a pattern of acts of assault, threats, humiliation and intimidation or other abuse that is used to harm, punish, or frighten their victim.

Domestic Violence: Any incident or pattern of incidents of controlling, coercive or threatening behaviour, violence or abuse between those aged 16 or over who are or have been intimate partners or family members regardless of gender or sexuality. This can encompass, but is not limited to, the following types of abuse:

psychological

physical

sexual

financial

emotional

Forced Marriage: A forced marriage is a marriage in which one or both spouses do not (or, in the case of some adults with learning or physical disabilities, cannot) consent to the marriage and duress is involved. Duress can include physical, psychological, financial, sexual and emotional pressure.

Significant Harm: The Children Act 1989 introduced the concept of ‘significant harm’ as the threshold that justifies compulsory intervention in family life in the best interests of children and young people. Significant harm represents the impairment to the normal development that can be reasonably expected of the specific child or young person. It gives local authorities a duty to make enquiries to decide whether they should take action to safeguard or promote the welfare of a child who is suffering, or likely to suffer, significant harm. This was amended by the Adoption and Children Act

2002 to include, “for example, impairment suffered from seeing or hearing the illtreatment of another.

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Further Reading and Bibliography

Achieving Best Evidence in Child Sexual Abuse cases

– a Joint Inspection HMCPSI / HMIC

December 2014 [to access: http://www.justiceinspectorates.gov.uk/cjji/wpcontent/uploads/sites/2/2014/12/CJJI_ABE_Dec14_rpt.pdf

]

Bailey, R. (2012) Bailey Review of the Commercialisation and Sexualisation of Childhood ,

Beerthuizen, M. and Brugman, D. (2012)

Sexually abusive youths' moral reasoning on sex.

Journal of Sexual Aggression, 18(2): 123-135.

Brown, J., O'Donnell, T. and Erooga, M. (2011)

Sexual abuse: a public health challenge

. London:

NSPCC.

Davies, J. (2012) Working with sexually harmful behaviour [Article]. Counselling Children and

Young People, March 2012: 20-23.

Erooga, M. and Masson, H. (2006) Children and young people with sexually harmful or abusive

behaviours: underpinning knowledge, principles, approaches and service provision. In: Erooga,

M. and Masson, H. (eds.)

Female Genital Mutilation: Practice Guidance, November 2014. CAADA{to access: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/380125/MultiAgencyPrac ticeGuidelinesNov14.pdf

]

Finkelhor, D. and Browne, A. (1985)

The traumatic impact of child sexual abuse: a conceptualization (PDF).

American Journal of Orthopsychiatry, 55(4): 530-541.

Goodyear-Brown, P. (ed.) (2012) Handbook of child sexual abuse: identification, assessment, and

treatment. Hoboken, New Jersey: Wiley.

Hackett, S. (2006) Towards a resilience-based intervention model for young people with harmful

sexual behaviours. In: Erooga, M. and Masson, H. (eds.) Children and young people who sexually abuse others: current developments and practice responses. 2nd ed. London: Routledge.

Hawkes, C. (2009)

Sexually harmful behaviour in young children and the link to maltreatment in early childhood:

conclusions from a UK study of boys referred to the National Clinical Assessment and Treatment Service (NCATS), a specialist service for sexually harmful behaviour (PDF).

L

ondon:

NSPCC.

Horvath M, Alys L, Massey K, Pina A, Scally M and Adler J (2013).

Basically…Porn is Everywhere.

London. Office of the Children’s Commissioner

Phippen. A. (2012). Sexting: An Exploration of Practices, Attitudes and Influences.

London,

NSPCC / UKSIC

Pullman, L. and Seto, M. C. (2012)

Assessment and treatment of adolescent sexual offenders: implications of recent research on generalist versus specialist explanations.

Child Abuse and

Neglect, 36(3): 203-209.

Ringrose, J. (2012)

A qualitative study of children, young people and 'sexting': a report prepared for the NSPCC.

London: NSPCC.

Rogstad K and Johnston G. (2012)

Spotting the Signs: A national proforma for identifying risk of

child sexual exploitation in sexual health services London, Department of Health

Smith, S. (2012)

Study of Self-Generated Sexually Explicit Images & Videos Featuring Young

People.

London. Internet Watch Foundation

St. Amand, A., Bard, D. E. and Silovsky, J. F. (2008)

Meta-analysis of treatment for child sexual behaviour problems: practice elements and outcomes.

Child Maltreatment, Vol.13.2. pp 145--166.

Vizard, E. et al (2007)

Children and adolescents who present with sexually abusive behaviour: a

UK descriptive study (PDF).

Journal of Forensic Psychiatry and Psychology, 18(1): 59-73.

Yates, P., Allardyce, S. and MacQueen, S. (2012)

Children who display harmful sexual behaviour: assessing the risks of boys abusing at home, in the community or across both settings.

Journal of Sexual Aggression, 18(1): 23-35.

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Acknowledgements

Thanks are offered to the Plymouth multi-agency working group for the prevention of Harmful Sexual Behaviour (2014):

Belinda Allis, Plymouth Community Healthcare; Cleo Bolding, Education Welfare;

Claire Drummond, Action for Children; Maria Hollett, Early Years Service; Jeanie

Lynch, Barnardo’s; Dr Jessica Parffrey, Clinical Psychologist; Caroline Jones,

PSCB; Mark Beavan, Devon & Cornwall Police;, Julie Reynolds, Midwifery;

Richard Marsh, Headteacher; Sarah Allum, NSPCC; Elaine Shotton, Youth

Service; Tony Staunton, Plymouth City Council; Karl Sweeney, Schools Adviser;

Richard Yellop, Children’s Social Care.

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Safeguarding Children from

Harmful Sexual Behaviour is Everybody’s Business

Plymouth Safeguarding Children Board

Midland House

Notte Street

Plymouth

PL1 2EJ

01752 307535

[email protected]

First Edition

November 2015

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