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Understanding Normative Sexual Development & Behavior

In order to understand child and youth sexual behavior challenges (cautionary and problematic), you must first have foundational knowledge of normative sexual development and behavior. In this lesson you will review common examples of normative sexual behavior and learn how to respond in the moment and after the fact. Also, you will read suggestions for ways programs can promote healthy sexual development and prevent sexual behavior challenges.

Objectives
  • Familiarize yourself with examples of normative sexual behaviors.
  • Learn the steps to respond in the moment and after the fact to sexual behavior.
  • Learn strategies to promote healthy sexual development and prevent sexual behavior challenges.

Learn

One theme throughout this course is that sexual development and behavior is not black-and-white. As discussed in Lesson One, sexual development is made up of many parts, and many factors influence those parts. This makes it challenging to place behavior into a single category, including even normative behavior. Use the information you learn about normative sexual development and behavior as guidelines rather than hard and fast rules. Remember that normative sexual behavior in children is typical and follows a developmental sequence but also varies depending on the child.

Know

Normative Sexual Development and Behavior

Physical touch, exploration, and play are some of the ways humans learn to relate to others and themselves. Newborns are soothed by their caregivers’ touch. Being held, rocked, fed, and changed are examples of physical touch that help caregivers and infants bond. As they become more alert and their movements mature, infants learn to soothe themselves by bringing hands to mouth and will eventually explore their bodies by kicking, reaching, and rolling. Many infants will discover their genitals, and touching private parts is often one of the first sexual behaviors caregivers observe in children. The term “private parts” is used to refer to genitals, breasts, buttocks, or areas of the body usually covered by a swimsuit. While touching genitals is considered a sexual behavior because it involves a body part or topic we consider private, it is important that you think of behavior from the viewpoint of children. As children grow, so does their understanding of what is sexual, and we must remember not to sexualize, or place unnecessary sexual meaning, on behaviors we observe in children. An infant who touches their genitals learns that when they move and touch their body parts, they experience pleasurable sensations; this is an exploratory, normative sexual behavior. You may see normative sexual behavior referred to as “sex play,” due to the curious and innocent nature. Review the information below to learn other examples of normative sexual development and behavior for children at different developmental stages.

Birth to 6 Years
  • Males can have erections beginning at birth.
  • Newborn females may have a period-like vaginal discharge in the days following birth.
  • Explores and touches own genitals in public and private.
  • May enjoy being nude in public or private, lack of modesty.
  • Talks about body parts and bodily functions (bathroom talk).
  • Shows private parts to familiar people.
  • Stands very close to others, lack of personal space awareness.
  • Participates in pretend play involving touch (doctor, caring for baby).
  • Curious when family members are undressing, bathing, or toileting.
  • Touches adult breasts (especially mother’s).
5 to 8 years
  • Occasionally explores and touches own private parts when alone.
  • Develops modesty and understanding of private topics and activities.
  • Developing awareness of privacy about bodies.
  • Discusses private parts and bodily functions with children of similar age.
  • Playfully exposes or touches others’ private parts; may ask others to do the same (you show me yours, I’ll show you mine).
  • Kisses/hugs familiar adults and children.
  • Stands very close to others, lack of personal space awareness.
  • Participates in pretend play involving touch (doctor, caring for baby).
  • Curious about birth, life cycles, where babies come from.
  • Curious about bodies and nudity.
  • Imitates flirtatious or romantic behavior.
  • Uses foul language, or tells inappropriate jokes, or uses sexually explicit gestures.
6 to 12 years
  • Masturbates in private.
  • Wants privacy.
  • Females may begin menstruation (average onset in U.S. is 12 years).
  • May begin to develop secondary sex characteristics (pubic hair, enlarged breasts, facial hair, etc.).
  • Shows a growing knowledge of physical changes, reproduction, sexuality.
  • Plays games that may be of a sexual nature (truth or dare).
  • Finds humor in exposing private parts, may ask others to do the same (flashing or mooning).
  • Stands very close to others, lack of personal space awareness.
  • Uses foul language or tellsinappropriate jokes, or uses sexually explicit gestures.
  • Experiences exposure to and interest in sexually explicit language and media.
  • Begins to develop sexual attraction to peers.

What are your thoughts on the normative sexual behavior examples described above? Have you observed these behaviors when caring for children? Let’s take one of the listed examples, a toddler who enjoys being nude, and think about this from the lens of a child. Toddlers who take their clothes off likely enjoy the freedom of not being constrained by clothing. To sexualize this behavior, which you will want to avoid, would be to assume that the child takes their clothes off so others will look at their body. However, children at this developmental stage have a very limited understanding of how bodies are related to sex and attraction, instead this toddler’s normative behavior is related to exploring the sensation of being naked. Remember from Lesson One that you must think about many factors when you observe sexual behavior in children. Be aware that there are normative behaviors for some children not included in the information above.

The lines between expected ages for normative sexual behavior can be unclear and are influenced by children’s family experiences. For example, some mothers choose to extend breastfeeding well beyond infancy and toddlerhood. It may be normative for a child who breastfeeds through their preschool or early elementary years to continue to nestle with and touch their mother’s breasts beyond the age of 6. Another way that families’ affect sexual knowledge is through their children’s media exposure. It is common for some families to have the television or electronic devices on throughout the day, with varying levels of awareness and supervision regarding the content. Very young children who have viewed or heard adult media content may have somewhat more advanced knowledge of sex and adult relationships. You might see a toddler with such a family environment imitate “romantically” kissing and fondling a doll. This child may not understand the meaning of these behaviors, rather they simply mimic what they have seen at home.

Responding to Sexual Behavior: In the Moment

In Lesson One, you were able to reflect on any discomfort you may have about childhood sexual development and behavior. Remember, it can take time to learn information and implement new practices. Even for professionals with knowledge and experience with children’s sexual behavior, it is common to respond to children’s sexual behaviors by panicking or becoming flustered. Although sexual behavior is typical, and most of what you will likely observe in children is normative, it is still important to teach children boundaries and provide support. Review these guidelines for how to respond to children’s sexual behavior in the moment.

  1. Pause
    • Remain calm
    • Collect your thoughts
  2. Redirect
    • Change the routine or environment
    • Suggest other activities
  3. Listen
    • Find out information
    • Understand from the child's viewpoint
  4. Teach
    • Communicate expectations and rules
    • Reinforce appropriate behavior
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PAUSE:  The first part of a best practice response to an observed sexual behavior is to pause. This allows you to collect your thoughts and remain calm so you can take a few moments to think about the behavior you’ve observed. It’s OK if you need to step away from the situation, as long as you make sure children are unharmed and appropriately supervised. For example, you observe Abby touching Pablo’s genitals over clothing in a preschool classroom. While you see that this is innocent play and both children are laughing, pause and resist any urge you may have to yell, “Stop!” or “No touching there!”

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REDIRECT:  Redirect sexual behavior using positive guidance by providing other ways for children to engage. You might do this by suggesting activities or changing the routine or environment. It’s important to maintain a calm facial expression and tone of voice when redirecting. When redirecting in the situation above for example, you can redirect Abby and Pablo by saying, “Let’s finish playing dress-up and go over to the art station.” Showing a stronger response, such as anger or worry, can be upsetting to children and may create heightened reactions on their part. Be aware not to shame children’s sexual behaviors.

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LISTEN:  If the children involved are able to communicate their actions and intentions, you should follow up after the incident and ask what happened using open-ended questions and thoughtfully listen to their responses. Having another adult present for these conversations can be helpful so that they can document the conversation while you listen attentively to the child’s responses. Understanding what happened from children’s viewpoints helps to know their intentions. However, be aware that many children will not understand why they engage in sexual behaviors. This is especially true for children who are still learning what is public versus private and are developing an understanding of real versus pretend (preschool-age and younger). In the example above with Abby and Pablo, you can later ask each individual child, “What were you and (Abby or Pablo) playing in the dress up area?” Preschool and school-age children may be inclined to lie about what was going on, especially if they sense there was wrongdoing or know that their actions are taboo. While we don’t encourage children to lie, recognize that this shows they likely understand that their behavior is not socially appropriate. Infants, toddlers, and some children with developmental delays will not be able to communicate their viewpoint. Remember to think about the development and environment of these children to gain perspective on why they engage in sexual behavior.

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TEACH:  Use developmentally appropriate language and positive guidance to teach children rules and expectations. It may be appropriate to label behaviors using simple language so that children learn the vocabulary for the behaviors they engage in, especially for children with emerging receptive and expressive communication. For example, a 14-month-old lifts their shirt up and pokes at their nipple. You can teach by labeling, “That’s part of your chest. Your shirt covers your chest.” This helps the child learn in a positive way the name for the body part. In the previous example above, you can revisit safe touch and unsafe touch individually with Abby and Pablo and the entire class by discussing examples and having the children practice asking each other for high fives or other forms of safe touch.

Because culture and family norms will vary, there are likely behaviors that are acceptable for children to engage in at home but not in your program. It’s important to acknowledge when children may have different rules at home, and some children may argue with you, for example, that “Mommy lets me do it.” Be respectful of families’ choices around sexual knowledge and behavior (as long as these are not signs of abuse). Criticizing families’ decisions in front of children creates confusion for the children and may insult families.

Responding to Sexual Behavior: After the Fact

Once you have observed and responded to children’s sexual behavior in the moment, you will follow up with additional steps. Again, children’s sexual behavior is not black-and-white, and you may need time to process what happened and how you responded. Work with a coworker during these steps so you know you are moving forward in a manner that best supports the children involved.

  1. Reflect
    • Consider all known information
    • Determine the type of behavior
  2. Prepare
    • Know how to respond in the moment: pause, redirect, listen, and teach, in the future
  3. Communicate
    • Communicate with the teaching team
    • Determine communication with families
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REFLECT:  The first step in responding to sexual behavior after the fact is to reflect on your observation and determine if the behavior is normative. The Sexual Behavior Reflection Tool walks you through this process, though you may need a coach, trainer, or administrator to help you. If you answer yes to the six questions in the reflection tool, the sexual behavior is most likely normative. Remember that this is not black-and-white, and there will be times when you cannot confidently answer yes or no.Problem Sexual Behavior (PSB) Non-Clinical Referral Tool It may be helpful to complete the Sexual Development and Behavior Factors handout to help you gather all related information about the children involved and determine appropriate action steps. These documents can be found in the Apply section.

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PREPARE:  Be prepared in case you observe the same sexual behavior again. Remember that normative behavior is usually infrequent, so the children involved may not engage in the behavior again while in your care. But because normative sexual behaviors are common among children, you might observe the same behaviors in other children. Prepare with a coworker how, in the future, you will carry out the steps to respond in the moment: pause, redirect, listen, and teach. Use the Responding to Sexual Behavior handout in the Apply section as a quick reference to map out your plans.

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COMMUNICATE:  Collaborate with a coworker to determine whether you should communicate to families about sexual behavior. This should be decided on a case-by-case basis. In some instances, where for example you may have introduced a child to a new term, it is best to let the child’s family know that this has occurred and why. Other times, such as when a child demonstrates an isolated (no other children involved) and normative behavior, you and a coworker may determine that the situation is similar to any other time you would redirect and support a child. In this case, you may not feel the need to highlight the incident more than what you would typically communicate with the family. If a family asks you about a specific sexual behavior or development, you should of course be respectful, honest, and objective in providing feedback.

See

Though what is normative versus non-normative is not always clear, some sexual behaviors are commonly observed in children and youth. Listen as an expert describes normative sexual behaviors you can expect to see in children and youth at different developmental stages. Have you observed any of these behaviors in children or youth in your program?

Normative Sexual Behaviors

Listen as an expert describes examples of normative sexual behaviors.

Do

Promoting Healthy Sexual Development and Preventing Sexual Behavior Challenges

Promotion and prevention are terms you see throughout the Virtual Lab School, especially in the Supporting Children with Challenging Behavior Focused Topics course and Positive Guidance Foundational course. These same principles apply to sexual development and behavior. You can promote healthy sexual development and prevent sexual behavior challenges by empowering children with knowledge about their bodies, their rights, and safe behaviors. Review the suggestions below and reflect on how you may already be doing these things and whether there are new ideas you plan to implement.

Infants and Toddlers

  • Teach parts of the body using correct terminology (“private parts” and “bottom” are OK at this age).
  • Be responsive to children’s preferences about physical touch. Don’t force hugs, kisses, or holding hands (unless necessary for safety).
  • Label and teach “safe touch” (e.g., high fives, fist bumps, help with putting shoes on) and “unsafe touch” (hitting, pushing, biting, touching private parts).
  • Label children’s responses to touch using child-friendly language. “Bria looks sad when you push her.”
  • Use developmentally appropriate language when diapering and toilet training. “We wipe your bottom to keep it clean.”
  • Provide simple rules. “We keep our private parts covered.” “We don’t touch others’ private parts.”
  • Line-of-sight supervision.
  • Your body is special and it is yours.
  • Have readily available information on sexual development and behavior for families.

Preschoolers

  • Teach parts of the body using correct terminology.
  • Respond to questions about bodies and the life cycle with simple, developmentally appropriate answers. “The hole in your penis is your urethra.” “The lumps under my shirt are my breasts.” “Babies grow inside a mother.”
  • Our bodies change as we grow, and our bodies are all different.
  • Continue to teach and label “safe touch” and “unsafe touch.”
  • Teach children to ask permission, even when using safe touch. “Can I hold your hand?”
  • Teach children to read each other's cues and healthy ways to express emotions. “How did Leah feel when you put your hands on her legs?”
  • Teach children the characteristics of friendship and respect (beginning anti-bullying concepts).
  • Teach personal space using simple language, “bubble” or “Hula Hoop.”
  • Continue with simple rules, such as: “We keep our private parts covered,” or “We don’t touch others’ private parts,” or “No one should see your private parts unless you need help keeping your body clean,” or “No one should touch you in ways that make you feel sad or hurt.”
  • “Private” is when you are alone and “public” is when you are with other people.
  • Teach children to ask for permission before taking any pictures or video of others.
  • Teach children that they should give permission before others take pictures or video of them.
  • It is OK to touch your private parts when you are alone.
  • Line-of-sight supervision.
  • Your body is special and it is yours.
  • Have readily available information on sexual development and behavior for families.

School-Age

  • Provide accurate information about puberty, reproduction, and the life cycle.
  • Use accurate information to answer questions about sex and sexual health.
  • Teach children and youth to ask permission, even when using acceptable forms of touch.
  • Teach children and youth to read each other’s cues and respectfully disagree on opinions and preferences while maintaining relationships and friendships.
  • Reinforce ways to treat yourself and others with respect and dignity.
  • Inform children and youth that they can speak with a program staff member if they have private questions or concerns.
  • Create clear rules around personal space, privacy, dating and signs of affection, and use of technology.
  • Reinforce that children and youth should ask for permission before taking any pictures or video of others.
  • Reinforce that children and youth should give permission before others take any pictures or video of them.
  • Teach children and youth to prevent, recognize, and respond to bullying.
  • Introduce the concept of sexual harassment.
  • Teach children and youth about the various types of abuse.
  • Masturbation is normal and healthy but a private activity.
  • Line-of-sight supervision.
  • Have female hygiene products available (average onset of menstruation in the U.S. is 12 years).
  • Have readily available information on sexual development and sexual health for families, children, and youth.

Explore

You will now have the opportunity to revisit the case studies you read from Lesson One about Logan (toddler), Avery (preschool), and Devon and Kelly (school-age). Determine if you think their sexual behaviors are normative using the Sexual Behavior Reflection Tool, and brainstorm how you will respond in the moment and after the fact.

Apply

Use the following guides and tools to support your responses, communication, and preparedness when you observe sexual behavior in children in your care. You may consider making the Normative Childhood Sexual Development and Behavior handout available to families.

Glossary

Objective:
Factual information not influenced by person feelings or opinions
Private Parts:
Genitals, breasts, buttocks or areas covered by a swimsuit
Sexualize:
Place adult or advanced sexual meaning on a child’s behavior

Demonstrate

True or false? The best way to respond to instances of sexual behavior in children after they have happened is to follow these steps: communicate, reflect, and prepare.
Select which is not an example of normative sexual development and behavior.
When responding in the moment to children’s sexual behavior, the first step is to. . .
References & Resources

Bancroft, J. (Eds.). (2003). Sexual development in childhood. Bloomington, IN: Indiana University Press.

Chumlea, W. C., Schubet, C., Roche, A. F., Kulin, H. E., Lee, P. A., Himes, J. H., Shumei, S. S. (2003). Age at menarche and racial comparisons in US girls. Pediatrics, 11(1), 110-113.

Friedrich, W.N., Fisher, J., Broughton, D., Houston, M., Shafran, C.R. (1998). Normative sexual behavior in children: A contemporary sample. Pediatrics, 101(4), e9-e9.

Friedrich, W. N., Fisher, J. L., Dittner, C. A., Acton, R., Berliner, L., Butler, J., Wright, J. (2001). Child sexual behavior inventory: normative, psychiatric, and sexual abuse comparisons. Child Maltreatment6(1), 37–49.

Future of Sex Education Initiative. (2012). National sexuality education standards: Core content and skills, K-12 [a special publication of the Journal of School Health].

Hagan, J. F., Shaw, J. S., Duncan, P. (Eds.). (2008). Theme 8: Promoting healthy sexual development and sexuality. In Bright futures: Guidelines for health supervision of infants, children, and adolescents (3rd ed.) (pp.169-176). Elk Grove Village, IL: American Academy of Pediatrics.

Kellog, N.D., Committee on Child Abuse and Neglect. (2009). Clinical report- The evaluation of sexual behaviors in children. Pediatrics (124)3, 992-8.

Lucier-Greer, M., Nichols, L. R., Peterson, C., Burke, B., Quichocho, D. & O’Neal, C.W. (2018). A brief guide to understanding and responding to normative and problematic sexual behaviors among children. Auburn, AL: Military REACH.

The National Child Traumatic Stress Network & National Center on Sexual Behavior of Youth. (2009). Sexual development and behavior in children: Information for parents and caregivers. https://www.nctsn.org/sites/default/files/resources/sexual_development_and_behavior_in_children.pdf

The National Child Traumatic Stress Network & National Center on Sexual Behavior of Youth. (2009). Understanding and coping with sexual behavior problems in children. https://www.nctsn.org/sites/default/files/resources//understanding_coping_with_sexual_behavior_problems.pdf

Phipps-Yonas, S., Yonas, A., Turner. M., Kamper, M. (1993). Sexuality in early childhood: the observations and opinions of family daycare providers. CURA Reporter. (23) 1-5.

Smith, M. (1993). Pediatric Sexuality: Promoting Normal Sexual Development in Children. Nurse Practitioner, 18 (8), 37-44.

South Eastern Centre Against Sexual Assault and Family Violence. (2017). Age appropriate sexual behaviors in children and young people: Information for careers, professionals and the general public. East Bentleigh: SECASA. http://www.ncsby.org/sites/default/files/Age-appropriate-behaviours-book.pdf

Steinberg, S.B. (2017). Sharenting: Children’s privacy in the age of social media. Emory Law Journal, 66, 839-884.

Swisher, L.M., Silovsky, J.F., Stuart, R.H., Pierce, K. (2008). Children with sexual behavior problems. Juvenile and Family Court Journal, 59(4), 49-69.