Excerpted from Harmful Sexual Behaviour Framework, 2nd Ed. 2019, NSPCC, UK. https://www.icmec.

org/wp-content/uploads/2019/04/
harmful-sexual-behaviour-framework.pdf 14

It is helpful to distinguish between problematic

and abusive sexual behaviour:

Problematic •W
 hen this type of behaviour Such behaviours are more
• Problematic behaviours don’t appears to be trauma-related commonly associated with
include overt victimisation of – for example when symptoms young people over the age of
others may be disruptive to originate from sexual abuse criminal responsibility or those
the child’s development and the child has experienced in puberty.
can cause distress, rejection – the behaviour may be
or increase victimisation of the termed sexually reactive. As both problematic and
child displaying the behaviour. Sexually reactive and sexually abusive sexual behaviours are
They include behaviours problematic behaviours are developmentally inappropriate
involving sexual body parts more commonly associated and may cause developmental
that are developmentally with children in the damage, a useful umbrella
inappropriate or potentially pre-adolescent age range. term is ‘harmful sexual
harmful to the child or behaviour’ or HSB. This term
others. They range from Abusive has been adopted widely in the
problematic self-stimulation field, and is used throughout
• Abusive behaviours involve
and nonintrusive behaviours, to this framework.
an element of coercion or
sexual interactions with other manipulation and a power
children that include behaviours imbalance that means the
more explicit than sex play, and victim cannot give informed
aggressive sexual behaviours. consent, and where the
Sometimes, the term behaviour has potential to
‘problematic sexual behaviour’ cause physical or emotional
is used to describe behaviours harm. Power imbalance may
that may be developmentally be due to age, intellectual
appropriate but that are ability, disability or physical
expressed inappropriately strength. Abusive sexual
in a given context. behaviour may or may not
have resulted in a criminal
conviction or prosecution.
A continuum Hackett (2010) has proposed a continuum
15

1Responses

2
of behaviours model to demonstrate the range of sexual
It is vital for professionals to behaviours presented by children and
distinguish normal from abnormal young people, from those that are normal,
sexual behaviours. Chaffin, to those that are highly deviant:
Letourneau and Silovsky (2002,
p208) suggest a child’s sexual
behaviour should be considered Normal Inappropriate Problematic Abusive Violent
abnormal if it: • Developmentally • Single instances of • Problematic and • Victimising intent • Physically violent
Prevention
expected inappropriate sexual concerning or outcome sexual abuse

3
• occurs at a frequency behaviour behaviours
greater than would be • Socially acceptable • Includes misuse • Highly intrusive
developmentally expected • Socially acceptable • Developmentally of power
• Consensual, mutual, behaviour within unusual and socially • Instrumental
• interferes with the reciprocal peer group unexpected • Coercion and force violence which is
child’s development to ensure victim physiologically and/
• Shared decision • Context for • No overt elements compliance or sexually arousing
• occurs with coercion, making behaviour may be of victimisation to the perpetrator
intimidation, or force inappropriate • Intrusive Assessment

4
• Consent issues • Sadism
• is associated with • Generally may be unclear • Informed consent
emotional distress consensual lacking, or not able
and reciprocal • May lack reciprocity to be freely given
• occurs between children or equal power by victim
of divergent ages or
developmental abilities • May include levels • May include
of compulsivity elements of
• repeatedly recurs in secrecy expressive violence Interventions

5
after intervention by caregivers.

Developments
 16

A continuum of responses Assessing children and young Figure 2: Continuum of service intensity,
As identified in Hackett’s model, people and meeting their needs Morrison and colleagues (2001) adapted
in the context of the notion of a
above, children and young people
continuum of responses is the
from Ryan (1999)
with harmful sexual behaviours
are a varied and complex group subject of the third domain of this
with diverse needs that cannot be framework: effective assessment
and referral pathways. Many
addressed by a ‘one size fits all’
model of service provision. Assessment
In addition to the initial response
The diverse needs of these children and support offered to low level
and young people include the fact cases in frontline settings, several Parent education to help child
that many of them have hitherto levels of service response and
unrecognised learning difficulties, intensity are required in order to
specific educational needs, a range address various levels of need Extra educational input
of psychosocial risk factors and and concern, as highlighted in
co-occurring mental health the following model developed by
problems (Bladon et al, 2005). Morrison and colleagues (2001). Local therapeutic help

The wide range of harmful sexual Hence a small network of regional,

behaviours shown by children highly specialised assessment Specialist
and young people means their and treatment services may be provision
needs should be met in a variety required to meet some of the more
of different placement contexts. specialised needs shown by a
These range from their own homes smaller number of more complex
(most children and young people), cases. Few
general looked-after or care
settings (the more disadvantaged
and hard to manage young people
with moderate risk profiles), and
more specialist or secure provision
(young people who pose a high
risk of serious, significant harm
to others).