Harmful sexual behaviours (including peer-instigated abuse)
A study of sexual abuse and assault among a US nationally representative sample of over 13,000 youth aged 0-17 years found that the majority of offences were at the hands of other juveniles (76.7% for males and 70.1% for females) (Gewirtz-Meydan & Finkelhor, 2019).
One-third of all child sexual offences are committed by teens, usually boys between the ages of 12 and 15. Offences by juveniles often involve close relationships and opportunity – perhaps a sibling or close family friend. On average, juvenile offenders are three or four years older than their victims. And there is a steep drop-off in incidents as children approach their later teen years and learn about boundaries and healthy sexual behaviour. Teen offenders do not often go on to become adult offenders: the likelihood that a child convicted of a sexual offence will ever be convicted of a second offence is just 2 – 3%. Additionally, less than 10% of adults who commit acts of child sexual abuse were offenders as juveniles (Der Bedrosian, 2018).
In Australia, youth aged 10 – 17 years account for approximately 12.5% of all recorded offences. Of these, youth account for approximately 16% of all individuals with a principal sexual offence (ABS 2020, cited in Molnar, McKillop, Allard, Rynne & Adams, 2021).
In Queensland, approximately 23% of youth who have been proceeded against by police for a sexual offence are Aboriginal and/or Torres Strait Islander (c.f. less than 5% of general youth population) (ABS, 2017, 2020; Queensland Police Service, 2017; cited in Molnar et al., 2021).
Sexual abuse involving child siblings is thought to be the most common form of intra-familial child sexual abuse, perhaps up to three times as common as sexual abuse of a child by a parent (Krienert and Walsh, 2011; Stroebel et al, 2013; cited in Yates & Allardyce, 2021).
A review of research studies on sibling sexual abuse found that, on average, victims in cases of sibling sexual abuse were around 4.5 years younger than the perpetrator, and that for over 75% of cases, the abuse lasted for more than one year. For around one-third of victims, the sibling sexual abuse happened regularly (e.g., weekly). Alongside an early onset and extended duration and frequency, studies of sibling sexual abuse showed a particularly high intensity of abuse, for example through involvement of coercion, force, and manipulation (Bertele & Talmon, 2023).
A recent Australian study found that 45% of harmful sexual behaviour incidents reported to statutory child protection were from schools (Spangaro, Kor, Payne, Hanley, Allan, et al., 2021).
In a scoping review of sexually harmful behaviours in residential care in Australia, it was reported that, ‘in approximately 35% of cases of sexual abuse where victims were 0–18 years, perpetration was carried out by other children & young people, and for cases with victims 0–12 years, this rose to 50%’ (McKibbin, 2017, p. 373).
Risk factors for harmful sexual behaviour
A medical chart review study of child initiators of interpersonal problem sexual behaviours found that most initiators were male (83%) and related to the child they engaged in sexual behaviour (75%). The average age of children initiating problem sexual behaviours was 10 years (range 4-17 years). More than half (58%) reported viewing sexually explicit media, and 47% had experienced sexual abuse (DeLago, Schroeder, Cooper, et al., 2020).
An Australian study of over 5,000 children reported to statutory child protection for problematic and harmful sexual behaviour found that the largest cohort of those reported were aged 10-13 inclusive. Overall, females were a significant minority decreasing in prevalence as they aged, from 36% under 10 years of age to 15% between 16 and 17 years of age. This contrasted sharply with males, increasing in prevalence as they aged, from 63% under 10s to 84% between 16 and 17 years of age (Spangaro et al., 2021).
According to data from the Federal Bureau of Investigation’s National Incident-Based Reporting System (NIBRS), just over 13,000 cases of sibling sexual violence were reported to the police between 2000 and 2007. Most of the victims were girls under 13 years old; offenders were most often older brothers, with a mean age difference between victim and offender of 5.5 years (cited in McDonald & Martinez, 2017).
A meta-analysis exploring associations between sexual content exposure and sexual problem behaviour among children and adolescents found a significant association between exposure to non-violent sexual content and likelihood of engaging in sexual problem behaviour, and a stronger association between exposure to violent or live sexual content and sexual problem behaviour. Specifically, children and adolescents exposed to non-violent sexual material were over one and a half times as likely to engage in sexual problem behaviours than those not exposed, and children and adolescents exposed to violent sexual material or live content were about two and a half times as likely to engage in sexual problem behaviours than those who were not exposed (Mori, Park, Racine, et al., 2023).
A systematic review of the characteristics of young people who exhibit sexually abusive behaviour found that poor parent-child attachment plays a role in sexual offending behaviour, in that children who suffer from disrupted attachment with their parents, coupled with experiences of placement instability, can have difficulties in forming healthy attachments with caregivers and peers. Additionally, the prevalence of various types and abuse neglect among adolescents who sexually offend was also highlighted, suggesting that experience of maltreatment in general may be important in the development of sexual offending behaviour (Malvaso, Proeve, Delfabbro & Cale, 2019).
An Israeli study conducted with 30 children aged 6-10 years who were victims of problem sexualised behaviours from a peer found that all of the children who perpetrated the behaviours were minors in the age range of 6–12 years, including 11 girls and 19 boys. The age gap between the offenders and the victims was no greater than 2 years. This study also found that all of the offenders were termed “friends” by their victims, and they were either in the same class, the same extracurricular activities, and/or lived in the same neighbourhood. The majority of the children (80%) described the abuse as part of routine play, while 20% provided narratives that described more of an abuser–victim dynamic, including strategies such as isolating the victim from the normal routine or context, using threats to ensure silence and prevent disclosure, and using force and violence (Katz, 2020).
Risk factors for sexual behaviour problems have been shown to exist at multiple levels of the child’s environment, with a child’s aggressive behaviours and post-traumatic stress symptoms, the caregiver’s psychological difficulties and children’s perceptions of family health, and the child’s experience of sexual and/or physical abuse being shown to predict a child’s sexual behaviour problems at age eight (Wamser-Nanney & Campbell, 2019).
A study of 254 children who had been sexually abused found that levels of post-traumatic symptoms were more predictive of interpersonal problem sexual behaviour than were other characteristics of the sexual abuse experienced. Specific risk factors for the development of interpersonal problem sexual behaviour among sexually abused youth included being male, greater sexual abuse severity, and higher levels of post-traumatic stress symptoms (Wamser-Nanney & Campbell, 2020).
Research with Canadian children assessed at a specialised therapeutic centre for problem sexual behaviour found that externalising behaviour problems were strongly associated with both the variety and severity of problem sexual behaviours the child presented with. This research also found that nonsexual victimisation experiences (e.g., exposure to family violence) were also associated with a greater variety and severity of problem sexual behaviours, while sexual abuse alone was not (Tremblay, Daignault, Fontaine, Boisvert & Tourigny, 2020).
Australian Bureau of Statistics recorded crime data suggests that children and young people aged 10-19 years were the alleged offenders in 20% of sexual offences committed in Australia in 201920 (Australian Bureau of Statistics, 2021).
Using police data from all Australian states and territories, Bromfield and colleagues (2017) found that the majority of child sexual abuse allegations to police occurring within an institutional location involved a minor as the person of interest (ranging from 32% of cases in the Australian Capital Territory to 93% in Queensland). In a follow up using case data from New South Wales and Western Australia, it was found that the persons responsible were primarily males aged 10-17 years who attended the same school as the victim (Parkinson, Lewig, Malvaso, Arney, Katz, & Newton, 2017).
A small study conducted with 107 educators in Australian schools and out-of-school care settings found that 41% had observed children displaying harmful sexual behaviour in those settings (Ey & McInnes, 2018).
Hackett and colleagues (2013) reviewed the cases of 700 young people in the UK who displayed harmful sexual behaviour problems. The large majority (97%) of the sample were male, and 38% had some degree of learning difficulty. Two-thirds (66%) of the sample had themselves experienced abuse (e.g., physical, or emotional abuse) and up to 40% may have been sexually abused. The young people in Hackett et al.’s (2013) sample displayed serious behaviours – 80% had attempted inappropriate touching of other young people or children, and just over half had attempted to non-consensually penetrate another child or young person. About one in five had used violence in the context of non-consensual sexual activity. The young people in Hackett et al.’s (2013) study most commonly offended against children under 10, although 45% of the sample harmed other young people 11–17 years of age and about a fifth committed offences against adults. Male and female children appeared to be equally likely to be offended against (Hackett et al., 2013).
An exploratory study of the sexual behaviour problems of 111 young men referred (at an average age of 14 years) to harmful sexual behaviour services across England and Wales found that the majority of young people offended against were children aged 10 years or under, with offending consisting of a wide range of contact and non-contact offences. Exposure was the most common non-contact behaviour, noted in 14 cases (13%). Thirty-seven (33%) of the young people had either sexually touched a child, or got the child to sexually touch them, and 26 cases (23%) described instances of penetrative or attempted penetrative activity. While in some cases the abusive behaviours were single or infrequent instances, in 22 of the cases harmful sexual behaviours lasted a considerable amount of time – with 8 cases (7%) noting that abuse lasted at least 10 months (Balfe, Hackett, Masson & Phillips, 2021).
Juveniles account for more than one-third (36%) of those known to police to have committed sex offences against minors. As a proportion of the total, 38% are between the ages of 12 and 14, and 46% are between ages 15 and 17. The vast majority (93%) are male (Finkelhor, Ormrod & Chaffin, 2009).
A study conducted with juveniles who have sexually offended found support for a link between psychological abuse by a male caregiver and subsequent problematic sexual thoughts and behaviours (Davis & Knight, 2019).
A study of subtypes of juveniles who have sexually offended in Switzerland found four mutually exclusive offender subtypes: a child-offender subtype (those who offended against children aged under 12 years, or at least 3 years younger than the offender), and three distinct categories of offenders with adolescent or adult victims – a verbal/online offender, a touch offender, and a severe peer/adult offender. The juvenile sexual offenders of the severe peer/adult offender subtype were found to be at increased risk of sexual and nonsexual criminal recidivism, and this subtype along with the child victim subtype showed greater levels of behavioural and social problems, psychosocial adversity and adverse childhood experiences than the verbal/online offenders and touch offenders (Barra, Mokros, Landolt, Bessler & Aebi, 2021).
A review of the research on protective factors for perpetration of sexual violence among high school and college students found eleven factors that were significantly associated with reduced sexual violence perpetration, including empathy, impulse control, knowledge of sexual consent, social support, parental factors, peers, church attendance or religiosity, and school connections (O’Connor, Smith, Woerner, & Khan, 2023).
Interventions for harmful sexual behaviour
Based on research into what works and matters when working with children that demonstrate harmful sexual behaviour, Hackett and colleagues (2016) concluded that interventions must be: evidence-based, holistic, multi-modal, strengths-based, supportive, proportionate, tiered, resilience-focused, and with a multi-agency approach.
A systematic review examining components of harmful sexual behaviour interventions viewed as useful by young people and their families identified five key themes including the key role of the relationship between the young person and practitioner, the significance of the role of parents and carers, the importance of considering the wider context in which the abuse has occurred, the role of disclosure in interventions, and the need to equip young people with skills as well as knowledge (Campbell, Booth, Hackett & Sutton, 2020).
Behaviour management for parent/carers is an important treatment component – St Amand and colleagues, in a meta-analysis of program studies which targeted sexual behaviour in children, stated that a “primary agent of change for sexual behaviour problems appears to be parent or caregiver involvement. Treatments for sexual behaviour that do not include caregiver involvement are not supported by these results” (St Amand et al., 2008, p. 161)
There is a growing body of research on appropriate and effective treatment methods for juvenile offenders, or youth who present with harmful sexual behaviour. At present, the evidence suggests that multi-systemic therapy (MST) programs, which are less commonly used for juvenile offenders than CBT programmes, show more significant effects on recidivism (Radford, Richardson Foster, Barter & Stanley, 2017). For example, a randomised clinical trial of MST with juvenile offenders, using an 8.9-year follow-up of rearrest and incarceration data, showed that MST participants had lower recidivism rates than did participants of usual community services, for both sexual (8% vs. 46%, respectively) and nonsexual (29% vs. 58%, respectively) crimes (Bordin, Schaeffer & Heiblum, 2009).
McKibbin et al. (2019) describe a secondary prevention program called Respecting Sexual Safety, which provides an early intervention response to harmful sexual behaviour for children and young people living in residential care. Three prevention strategies were identified as important, including whole-of-house respectful relationships and sexuality education, missing from home strategy, and sexual safety response. Evaluation results showed increases in young people’s knowledge, skills, and attitudes about sexual health and safety, and increases in workers’ self-efficacy in responding to harmful sexual behaviour and child sexual exploitation.
Australian Bureau of Statistics (2021). Recorded Crime – Offenders, 2019-20. Canberra, ABS.
Balfe, M., Hackett, S., Masson, H., & Phillips, J. (2021). Young men with harmful sexual behaviour problems: a qualitative exploration of the nature and characteristics of their violence. Journal of Sexual Aggression, 27(2), 139-152.
Barra, S., Mokros, A., Landolt, M.A., Bessler, C., & Aebi, M. (2021). Criminal recidivism and psychosocial adversity in offense-related subtypes of sexually abusive adolescents. Journal of Sexual Aggression, 27(2), 185-203.
Bertele, N., & Talmon, A. (2023). Sibling sexual abuse: A review of empirical studies in the field. Trauma, Violence, and Abuse, 24(2), 420-428.
Bordin, C.M., Schaeffer, C.M., & Heiblum, N. (2009). A randomized clinical trial of Multisystemic Therapy with juvenile sexual offenders: Effects on youth social ecology and criminal activity. Journal of Consulting and Clinical Psychology, 77, 26-37.
Bromfield, L., Hirte, C., Octoman, O., & Katz, I. (2017). Child sexual abuse in Australian institutional contexts 2008-13: Findings from administrative data. Sydney, Australia: Royal Commission into Institutional Responses to Child Sexual Abuse.
Campbell, F., Booth, A., Hackett, S., & Sutton, A. (2020). Young people who display harmful sexual behaviors and their families: A qualitative systematic review of their experiences of professional interventions. Trauma, Violence & Abuse, 21(3) 456-469.
Davis, K.A., & Knight, R.A. (2019). The relation of childhood abuse experiences to problematic sexual behaviors in male youths who have sexually offended. Archives of Sexual Behavior, 48, 2149-2169.
DeLago, C., Schroeder, C.M., Cooper, B., Deblinger, E., Dudek, E., et al. (2020). Children who engaged in interpersonal problematic sexual behaviors. Child Abuse & Neglect, doi: org/10.1016/j.chiabu.2019.104260.
Der Bedrosian, J. (2018). When the abuser is a child, too. John Hopkins Magazine, Spring 2018. Retrieved from: https://hub.jhu.edu/magazine/2018/spring/children-who-are-child-sexual-abusers/
Ey, L., & McInnes, E. (2018). Educators’ observations of children’s display of problematic sexual behaviours in educational settings. Journal of Child Sexual Abuse, 27, 88-105.
Finkelhor, D., Ormrod, R., & Chaffin, M. (2009). Juveniles who commit sex offences against minors. Washington, DC: Office of Juvenile Justice and Delinquency Prevention, U.S. Department of Justice.
Gewirtz-Meydan, A., & Finkelhor, D. (2019). Sexual abuse and assault in a large national sample of children and adolescents. Child Maltreatment, DOI: 10.1177/1077559519873975.
Hackett, S., Masson, H., Balfe, M., & Phillips, J. (2013). Individual, family and abuse characteristics of 700 British child and adolescent sexual abusers. Child Abuse Review, 22(4), 232–245. doi: 10.1002/car.2246
Hackett, S., Holmes, D., & Branigan, P. (2016). Operational framework for children and young people displaying harmful sexual behaviors. London: NSPCC.
Katz, C. (2020). “What do you mean the perpetrator? You mean my friend??” Spotlighting the narratives of young children who are victims of sexual abuse by their peers. Psychology of Violence, 10(1), 30–37.
Malvaso, C.G., Proeve, M., Delfabbro, P., & Cale, J. (2019). Characteristics of children with problem sexual behaviour and adolescent perpetrators of sexual abuse: A systematic review. Journal of Sexual Aggression, doi: 10.1080/13552600.2019.1651914
McDonald, C. & Martinez, K. (2017). Victims’ retrospective explanations of sibling sexual violence. Journal of Child Sexual Abuse, 26(7), 874-888.
McKibbin, G., Halfpenny, N., & Humphreys, C. (2019). Respecting sexual safety: A program to prevent sexual exploitation and harmful sexual behaviour in out-of-home care. Australian Social Work. doi: 10.1080/0312407X.2019.1597910.
McKibbin, G. (2017). Preventing harmful sexual behaviour and child sexual exploitation for children and young people living in residential care: A scoping review in the Australian context. Children and Youth Services Review, 82, 373–382.
Molnar, T., McKillop. N., Allard, T., Rynne, J., & Adams, D. (2021). Patterns of rearrest for Aboriginal and/or Torres Strait Islander and non-Indigenous youth who have sexually harmed. Journal of Sexual Aggression, 27(2), 167-184.
Mori, C., Park, J., Racine, N., Ganshorn, H., Hartwick, C., & Madigan, S. (2023). Exposure to sexual content and problematic sexual behaviors in children and adolescents: A systematic review and meta-analysis. Child Abuse & Neglect, 143, doi: 10.1016/j.chiabu.2023.106255
O’Connor, J., Smith, L., Woerner, J., & Khan, A. (2023). Protective factors for sexual violence perpetration among high school and college students: A systematic review. Trauma, Violence & Abuse, doi: 10.1177/15248380231171189
Parkinson, S., Lewig, K., Malvaso, C., Arney, F., Katz, I., & Newton, B.J. (2017). Child sexual abuse in Australian institutional contexts: The reliability of police data, nature of allegations reported to police, and factors driving reporting rates. Sydney; Royal Commission into Institutional Responses to Child Sexual Abuse.
Radford, L., Richardson Foster, H., Barter, C., & Stanley, N. (2017). Rapid Evidence Assessment: What can be learnt from other jurisdictions about preventing and responding to child sexual abuse. Connect Centre for International Research on Interpersonal Violence School of Social Work, Care & Community, University of Central Lancashire.
Spangaro, J., Kor, K., Payne, J., Hanley, N., Allan, J/, Finlay, S., Simpson, H., & Fabrianesi, B. (2021). Access and engagement with services for sexual safety for children and young people with problematic and harmful sexual behaviour (AccESS Study). School of Health and Society, University of Wollongong.
St Amand, A., Bard, D.E., & Silovsky, J.F. (2008). Meta-analysis of treatment for child sexual behavior problems: Practice elements and outcomes. Child Maltreatment, 13, 145–166.
Tremblay, M., Daignault, I.V., Fontaine, N.M.G., Boisvert, I., Tourigny, M. (2020). School-aged children with sexual behavior problems: Untangling the relationship between externalizing behavior problems and nonsexual victimization on the variety and severity of sexual behaviors. Child Abuse & Neglect, 107, doi: 10.1016/j.chiabu.2020.104490
Wamser-Nanney, R., & Campbell, C.L. (2020). Childhood sexual abuse characteristics. abuse stress, and PTS: Ties to sexual behavior problems. Child Abuse & Neglect, 105, doi: 10.1016/j.chiabu.2019.104290
Wamser-Nanney, R., & Campbell, C.L. (2019). Children’s sexual behavior problems: An ecological model using the LONGSCAN data. Child Abuse & Neglect, doi: 10.1016/j.chiabu.2019.104085.
Yates, P. & Allardyce, S. (2021). Sibling sexual abuse: A knowledge and practice overview. Essex: Centre of Expertise on Child Sexual Abuse.