Children in danger

(I am yielding this space today to  my wife Dr. Naomi Poca, pediatrician and child protection specialist,  to shed light on a disturbing reality, children sexually abusing children.)

Gleaned from the headlines of the CDN June 7, 2012 issue, “Children in trouble: girl raped by minors; no charges readied”, yes, these children are in danger. Danger from being misunderstood, mislabeled and mishandled.

Children’s behaviors are manifestations of: (1) what they have seen and heard (e.g., dad yelling at mom for not preparing a meal on time vs. dad helping mom cook food so the meal will be eaten on time), (2) how they are being treated (e.g., mom hitting child because he/she failed to pass a school exam vs. mom guiding and supporting  the child in studying for a school exam), (3) how they deal with conflict or stresses in their young lives (boy hits and yells at a girl or another boy because he needs to use their pencil vs. boy politely asking if he can borrow their pencil), or (4) the effects of maltreatment in the home or in the community (children who engaged in sexual intercourse between the ages of 14 and 16 years old were usually physically, sexually and/or emotionally abused early in their lives according to a study).

What about when boys or girls manifest behaviors that are sexual in nature? Are they ‘rapists’, too, like adult men (and a few women) who sexually molest another human being and, therefore, be treated with disgust?

Children 12 years and under, who demonstrate age or developmentally inappropriate or aggressive sexual behavior are called children with sexual behavior problems (CSBPs). This includes children with self-focused sexual behavior (e.g., excessive masturbation) and aggressive sexual behavior towards others that may include coercion or force. Although the word “sex” is used to describe the problematic behaviors of these children, the motivation  may be unrelated to sexual gratification. Children’s sexual behavior are considered problematic when the behavior (1) interferes with the child’s social or cognitive development, (2) occurs with coercion, intimidation or force, (3) occurs at a high frequency, (4) is associated with emotional distress, (5) occurs between children of significantly different ages or developmental abilities, and (6) repeated occurs in secrecy after adult intervention.

Sexual play among children is normal and not harmful, such as peering at private parts. However, these same behaviors can be become abnormal and harmful if done aggressively or intrusively.

Research has shown that the origins of sexual behavior problems in children are multiple: sexuality within the family, exposure to sexual materials, and exposure to familial violence and physical abuse among other negative childhood experiences. Sexualized behavior problems due to child sexual abuse is not very common. However, if such behaviors are seen in these victims, it is very likely related to sexual abuse that was repetitive and/or sadistic in nature.

Labeling and treating CSBPs as perpetrators or offenders is potentially psychologically damaging to their developing self-concept. Throughout childhood, children are developing an understanding of who they are. Adult responses that label or reinforce a belief that a child is deviant or perverted or pathological can hinder the child’s developing sense of self. The problematic behaviors of CSBPs do need to be corrected. The goals of intervention should be to reduce and eliminate inappropriate sexual behavior without negatively labeling the child.

CSBPs do not generally grow to become adolescent or adult sex offenders.

Teenagers who sexually offend, on the other hand, are not like CSBPs. These are adolescents aged 13 to 15 who commit illegal sexual behavior as defined by the law. Theories have been offered to explain the cause of deviant sexual behavior in adolescents toward younger children. The following have been found to be associated with a higher prevalence of adolescent sexual offending: (1) history of prior abuse, particularly physical abuse, although majority of those abused do not go on to become perpetrators, (2) impaired family functioning, (3) alcohol and substance abuse, (4) exposure to erotica, and (5) psychiatric disorders. Compared to non-sexual offending and non-delinquent adolescents, juveniles sexual offenders were found to have low self-esteem, few or weak social skills, minimal assertive skills and poor academic performance. The common psychological disorders found among these juveniles are conduct disorder, substance abuse disorders, adjustment disorders, attention-deficit/hyperactivity disorder with hyperactivity, learning disabilities, specific phobia, and mood disorders.

Juvenile sexual offenders are different from adult sexual offenders in that they have lower recidivism rates, engage in fewer aggressive behaviors over short periods of time, and have less sexual behavior. Sexual re-offending is low for juvenile sexual offenders who receive proper and adequate treatment.

The possible causes of sexual problematic behaviors in children and deviant sexual behavior in adolescents are diverse and complex. It is for this reason that a multi-disciplinary team that includes knowledgeable social workers and well-trained mental health professionals be involved in the thorough assessment of the individual, his/her family and the community. Interventions to reduce and/or eliminate the sexual behavior problem should focus not only on the child or adolescent but also on his/her family and the community he/she belongs to.

The processes that the identified CSBP or adolescent sexual offender will have to go through should not impact negatively on his/her development. He/she is not like the inveterate male predatory pedophile with a long history of abusive behaviors. He/she is a malleable being with the potential for change as long as properly understood and handled.