Friday, April 13, 2018

Supporting policy to prevent harm: Identifying gaps to support children with sexual behavior problems

By Hannah Laniado (Prevention Program Manager, MNCASA at & Julie Patrick (National Partners Liaison, Raliance at
Recently, the Minnesota Coalition Against Sexual Assault (MNCASA) published, Children with Sexual Behavior Problems: Improving Minnesota’s ability to provide early identification and intervention services through policy and practice recommendations (June 2017), a comprehensive report outlining the data collection, literature review, and formation of recommendations for implementation. This is the first in-depth look at how one state can create change to improve intervention, prevention and response to children with sexual behavior problems.
The specific key recommendations are a model for how the system could improve for all children and families. Earlier identification and appropriate response require: specialized training for all professionals working with youth; consistent guidelines and protocols for tracking behavior; clear written policies professionals who work with children can access on how to respond – including when and what to communicate; as well as education and awareness raising to reduce stigma.
MNCASA looked at what’s working and not working in Minnesota’s current systems for identifying children (12 and under) with SBPs through funding from Raliance, a national partnership among leaders in the prevention of sexual harassment, misconduct, and abuse. With seed-funding from the National Football League, Raliance is dedicated to ending sexual violence in one generation and supports an impact grant program with a specific funding category to prevent primary perpetration. 
MNCASA utilized ATSA’s definition of SBPs: children ages 12 and younger who initiate behaviors involving sexual body parts (e.g. genitals, anus, buttocks, or breasts) that are developmentally inappropriate or potentially harmful to themselves or others (Chaffin et al., 2006).
This project collected information and data in multiple forms. To facilitate the process, a set of guiding questions were identified at the outset of the project and then five chosen data collection methods answered the guiding questions (for details refer to Report #1). Exploratory interviews with 19 key informants, a scan of the empirical literature (42 documents published in the last 10 years), a web-based survey of professionals who work with children (1,022 responses total), investigative interviews with professionals who work with children with SBPs, and story gathering were collected between August 2016 and May 2017.
Key Findings
The literature review examined the latest research on incidence, identification, assessment, treatment, and policies for children with SBPs to provided an empirical basis for work to better understand how well Minnesota is doing in effectively identifying and intervening with children showing signs of SBPs.
Per the survey of professionals who work with children, parents and colleagues view them as a resource on differentiating between developmentally expected sexual behaviors in youth and concerning or problematic ones. Many professionals expressed interest in training on how to interact with children and their parents about children’s sexual behaviors.
Interviews with key informants also showed the lack of a clear process or procedure for where to report a child who is engaging in concerning or harmful sexual behaviors. In fact, many different systems (including social services, law enforcement, medical providers, child protection, probation, and school staff) all come into contact with children with SBPs and yet here is no one system charged with responding to or even tracking reports of children with SBPs. This results in great variations, county by county, to reports of a child with possible SBPs. Professionals who work with children need guidelines for how to treat behaviors as serious, educate about treatment being available, help set up effective supervision, and create protective environments. Without these guidelines, there is a tendency to either over-react or under-react resulting in children not receiving the help they need. There are also disparities across the state in terms of access to effective treatment for children with SBPs. Not all providers have specific training on children with SBPs and not all use evidence based treatment methods. Not all parts of the state have easy access to professionals who specialize in working with children with SBPs.
The specific policy recommendations in detail
1.      Make specialized training on best practices for identifying and responding to children’s sexual behaviors readily available to all professionals who work with children and families. This training needs to address the myths about children’s sexual behaviors and share the message of hope that with treatment, children are at no greater risk to grow up to be sexually abusive. A key element of this training should be how to effectively engage parents in discussions of and treatment for their child’s SBPs. Ideally this training would be incorporated into the educational requirements for students as well as offered as part of ongoing professional development or as a requirement for licensure.
2.      Develop consistent guidelines and protocols for tracking and responding to children’s sexual behaviors, including sexual behaviors between children. Ideally, all children would receive an assessment by a qualified professional who would make recommendations to address any SBPs and any safety risks the child poses to others.
3.      Create written policies professionals who work with children can access on how to respond to a child showing concerning or problematic sexual behaviors, when and what to communicate to parents/caregivers, and how to refer a child for an assessment.
4.      Develop an educational campaign that can be used to raise awareness about children’s sexual development and SBPs. This could be done by providing resources during well-child doctor visits, sharing handouts at school open houses, etc. This effort would go a long way in reducing the stigma and fear that gets in the way of effective response to children showing early signs of SBPs.
Chaffin, M., Berliner, L., Block, R., Johnson, T. C., Friedrich, W., Louis, D.G., Lyon, T., Page, I., Prescott, D., Silovsky, J. (2006). Report of the ATSA Task Force on Children with Sexual Behavior Problems. Association for the Treatment of Sexual Abusers
With gratitude:
MNCASA would like to recognize Joan Tabachnick for her guidance throughout this project including reviewing multiple drafts of the literature review as well as Jane Silovsky and Jimmy Widdifield from the National Center on the Sexual Behavior of Youth (NCSBY), part of the Center on Child Abuse and Neglect (CCAN) in the Department of Pediatrics of the University of Oklahoma Health Sciences. Many ATSA members added value to this report.

No comments:

Post a Comment