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    Objectives
    • Identify ways to respond to staff members' diverse beliefs on sexual development.
    • Explore how to support direct care professionals’ responses to children’s sexual behavior.
    • Demonstrate how to support a whole program in implementing best practice.

    Learn

    Learn

    Teach

    Responding to Staff Members’ Diverse Beliefs About Sexual Development

    As you learned in Lesson One, most child care professionals, even those with many years of experience and advanced education, have had little or no professional development or formal education on sexual development and behavior. Due to a lack of opportunity to learn about this topic, program staff may need more extensive support.

    Perhaps you have observed how the lack of opportunity to learn affects staff members’ beliefs and how they view their role in supporting sexual development. You may have heard staff make the following comments:

    • “Children don’t need to learn about this until they reach puberty.”
    • “That behavior is so inappropriate; the family needs to handle this.”
    • “I’m not a sex-education teacher, so I’m not qualified.”
    • “These are private issues that we shouldn’t be discussing with children.”
    • “That’s not my job; the social worker needs to take care of this issue.”

    While these feelings may be common, it is important that staff understand that their primary roles are to keep children safe and to support their learning and development, including sexual development. When you discuss staff’s feelings and beliefs on sexual development, during the My Knowledge and Beliefs of Childhood Sexual Development activity in Lesson One, it is important to acknowledge the staff members feelings while emphasizing that they play an important role in teaching children about boundaries and appropriate touch and in responding appropriately to sexual behaviors when they occur. For example, you may acknowledge that a staff member might feel uncomfortable or unqualified to discuss sexual development and behavior with children and youth while also explaining the many ways that they can promote healthy sexual development in the program by using appropriate vocabulary, teaching what is “safe” versus “unsafe” touch, teaching children about boundaries (physical and verbal), and pointing out others cues and responses to touch. If you encounter beliefs from program staff similar to those mentioned  above, you can do the following:

    Acknowledge

    When staff members indicate that they feel uncomfortable with children’s sexual behavior, or seem overwhelmed when asked to use specific strategies, acknowledge their feelings. Staff members may ignore sexual behavior or become angry when asked to provide support to children when they are not sure what they should do or feel uncomfortable.

    Coach: “You seem unsure of what to do when school-age children make jokes of a sexual nature. What can I do to support you?”

    Relate

    Show the staff member you relate to how they feel by sharing about a time when you felt uncomfortable with a work responsibility or task. You could talk about what you felt before you formally learned about sexual development and behavior. Let them know you recognize that stepping outside of one’s comfort zone can be difficult.

    Coach: “Supporting sexual behavior is sometimes uncomfortable for me, too. I’m a very private person who doesn’t usually discuss things like this. But I also know that this is an important part of children’s development that I can’t ignore.”

    Take action

    While it is important that staff have the opportunity to speak with someone about the challenges in their work, coaches will want to take action to evolve thinking and behavior. Collaborate with staff by asking them to develop an action step. For example, they could complete a lesson or observe another staff member implement a strategy, but make sure they have input in deciding on the action step.

    Coach: “I’m hearing you say you disagree that you should model asking for permission to touch children. Tell me more about this and what we can do to help you feel more comfortable in doing so.”

    Supporting Direct Care Staff

    Remember that several factors affect children and youth’s sexual development and behavior:

    • Culture and family norms
    • Development
    • Function of the Behavior
    • Frequency and participation
    • Environment
    • Effect on others
    • Response to redirection

    Though you will consider all of these factors, direct care staff may need the most help from you when analyzing children’s development and functions for sexual behaviors. You will likely need to be part of the process when staff complete the Sexual Behavior Reflection Tool, Sexual Development Definition and Factors, and other forms. Even when a more seasoned teaching team completes these forms without you, you should review their documentation to ensure best practice.

    Development

    Typical or age-appropriate behavior, especially during the early childhood years, is variable. As more children with disabilities or delays are cared for in inclusive programs, it is valuable to think about development based on children’s individual abilities rather than chronological age or program placement. This can be difficult for direct care staff, particularly when they identify strongly as a caregiver for a specific age group. For example, a caregiver may say: “I’m a school-age staff member, and school-age children should know to cover their private parts.” While this statement is generally true, this staff member may care for a 7-year-old child who is developmentally similar to a 4-year-old.

    When staff members encounter sexual behavior, help them think about development by asking them the following questions:

    • What behavior occurred?
    • What do we want to happen?
    • What can the child do?

    Review the example below about a child named Kari. Notice that we do not have information about Kari’s age because the focus of this exercise is for staff to think about developmental abilities.

    What behavior occurred?

    Kari walks out of the bathroom with her private parts exposed.

    What do we want to happen?

    Kari will pull her pants up before leaving the bathroom.

    What can the child do?
    • Recognize when it is time to go to the bathroom
    • Can independently pull down pants and underwear but can’t yet pull up
    • Needs help with clothing fasteners
    • Does not yet feel bashful about exposing private parts
    • Learning about public versus private

    A developmental frame helps staff determine ways they can support the strategy, “What do we want to happen” with Kari. Staff may decide to give her a reminder cue before she enters the bathroom like, “tell me if you need help pulling up your pants.” A staff member will stay near the bathroom so they can hear if Kari requests help. They can also teach her what private means by explaining, “Our private parts stay covered in the classroom” or “Pants get pulled up before we leave the bathroom.”

    Function of the Behavior

    All behavior occurs for a reason or has some function and determining the function of sexual behaviors requires careful thought about children’s cognitive abilities. You may need to coach direct care staff when trying to determine this. Some children may be able to tell you why they engaged in a behavior, “I did it to be funny.” But many children, especially children preschool-age and younger, will not understand why they engage in sexual behaviors or unsafe touch. In these instances, you need to think carefully about the child’s environment and development to determine if the intention behind the behavior is a reaction or a more thought-out occurrence.

    A reaction to the environment is a response to what a child experiences. The child was not thinking about what they were going to do beforehand. Instead, they reacted to their environment. A planned occurrence involves thinking about what one will do ahead of time and the effect that action will have on others. This requires advanced cognitive skills including logical reasoning, self-awareness, and social awareness. Lesson Five of the VLS Focused Topic course, Supporting Children with Challenging Behaviors provides additional information on the function of behavior.

    Supporting Direct Care Staff with Follow-up Questions

    In this example, a school-age team hears about a sexual behavior involving Neil, a 9-year-old child with autism. Other children report that when Neil is in the bathroom, he will walk up to them while they are using the urinal and attempt to look at their genitals. After hearing of this behavior, the team completed the Sexual Behavior Reflection Tool below. Use the toggle feature to read the follow-up questions that Ashley, a training and curriculum specialist, asks the teaching team. 

    Is the behavior random or infrequent?
    No. Two children report that Neil has tried to watch them while using the urinal at different times.
    Is the behavior typical for the child’s age and developmental ability?
    No. A 9-year-old should know that it is inappropriate to violate someone’s privacy this way.
    Is the behavior driven by curiosity, exploration, and playfulness?
    No. Neil has a lot of problem behaviors and usually hangs out by himself.
    If other children are involved, is it mutual and good-humored?
    No. The other children were annoyed.
    If other children are involved, do they know each other well and are they of a similar age and development (<2 years)?
    Yes. The children are around Neil’s age and they all attend the after-school program together.
    Is the behavior easily redirected?
    Staff haven’t had the chance to redirect Neil. One of the other children said they told Neil to “back off.”
    Normative Sexual Behavior?
    No. Neil should know that it is inappropriate to watch others in the bathroom.

    Ashley's follow-up questions for the team help them decide that although Neil’s sexual behavior is inappropriate for 9-year-olds, it is not unexpected given Neil’s development. They develop a plan to make a picture schedule for Neil’s bathroom routine. Also, Neil is to have direct supervision while in the bathroom. Ashley and the team plan to implement this prevention plan for two weeks before reassessing the behavior. The coach will communicate the plan to Neil’s family, in addition to calling the families of the two children who reported the incident. She will confidentially share what was reported and that the program has a prevention plan in place to address the behavior. If there are still concerns after two weeks, program leadership will consult withPUBLIC a specialist. You may wonder why Ashley or the program administrator chose to wait to contactPUBLIC a specialist. Program leadership assessed Neil’s behavior to be consistent with his developmental abilities; therefore, they were confident in deciding that this sexual behavior is normative for Neil and can be easily prevented using universal and targeted strategies (supervision and picture schedule).

    Assessing Program-Wide Needs

    It is helpful to have a baseline for the knowledge and comfort level of program staff regarding sexual development and behavior. You can collect data to assess this by asking staff to complete the My Knowledge and Beliefs self-assessment tool in the Apply section of Lesson One. This is one way to measure individual staff members and your program as a whole. If you find that most of your program staff report limited knowledge on sexual development and behavior or feel uncomfortable with this topic collaborate with your program administrator to plan a professional development opportunity. You and the program administrator can support program-wide learning in the following ways:

    • Lead a presentation or discussion to orient staff to sexual development.
    • Invite a specialist with expertise in this area to give staff a presentation.
    • Set an internal goal such as, “By the end of the calendar year, all lead staff members will have completed the Sexual Development & Behavior in Children and Youth Focused Topics Course.”
    • Provide group case study opportunities. For example, you could lead a small-group discussion and practice using tools such as the Sexual Behavior Reflection Tool and Sexual Behavior: Definition and Factors worksheets.

    These opportunities support staff members’ knowledge and communicate that everyone, not just leadership and specialists, have a role in promoting healthy sexual development and preventing sexual behavior challenges.

    Model

    Normalize Communicating About Sexual Development

    There is a tendency for child care staff to only discuss children’s sexual behavior with each other and with families when there is a concern. Even when sexual behavior is normative, staff may feel hesitant to ask questions or talk with their teaching team and families. You can help program staff gain confidence by allowing them to practice with you. During role-playing, you can model how you would talk about sexual behaviors and preventive strategies and also have staff practice what they would say to a coworker or family. Read the examples showing how a coach models communicating about sexual behavior.

    Coach: “I’ve noticed that Lola asks a lot of questions about where babies come from, and I do my best to provide developmentally appropriate responses. She recently asked, “Do mommies poop out the babies?” I let Lola know that when babies are born, they come out through the mother’s private parts or a doctor uses special tools to help the mother birth the baby another way. These kinds of questions are very typical for children this age and show that Lola is learning about how the body works and the human life cycle. What questions do you have?”

    Coach: “I’ve observed Demarcus talking about his genitals in the bathroom, a very typical behavior. He uses the term, “pee pee” and I model the word “penis” for him when he brings up the topic. I teach children the correct names for all body parts, including private parts, because it educates them about their bodies. Also, this is a strategy that experts recommend to prevent sexual abuse. If a child says, for example, that someone touched their “pee pee,” it can be unclear what that means. But if a child says that someone touched their penis, it is very clear what happened. What questions or thoughts do you have about this?”

    How Leadership Can Support Families with Children with Sexual Behavior Challenges

    As discussed in Lesson Six, families with children with sexual behavior challenges may have additional life stressors as a result of their child’s needs. Review the specific ways program leadership can support families:

    • For children who attend intervention appointments in the middle of the day, offer to help the staff and family by getting the child ready to leave. The family member can then quickly pick up their child. This is especially helpful for family members who take time off work for appointments.
    • Keep all paperwork you receive for the child, such as support plans or evaluation reports, organized and readily available. If a family misplaces their documents, offer to make a copy for them.
    • If a child leaves your program to attend intensive treatment for sexual behavior challenges, you or your program administrator can reach out to the family via a phone call to let them know you are thinking of them. Be available to listen if they would like to share updates, but it’s OK if the conversation ends with you sharing your thoughtful message.
    • It is not uncommon for children with sexual behavior challenges to also display normative sexual behaviors. When children and youth have sexual behavior challenges, work withPUBLIC a specialist to communicate the range of behaviors observed, so families understand that some sexual behaviors are typical. This can help families with children with sexual behavior challenges feel less stigmatized and learn more about sexual development.

    How PUBLICMultidisciplinary Teams Support Children with Sexual Behavior Challenges

    Direct care staff will have the support of program leadership,PUBLIC a specialist, and the family when they implement a support plan for children with sexual behavior challenges. While a team approach is best, it is important that everyone involved have clearly defined roles. Review the example below to see how programs may choose to designate specific responsibilities.

    PUBLICSpecialists
    • Complete evaluation and create support plan for child care programs.
    • Recommend and coordinate external intervention (outside of child care program) with family.
    • Coordinate conferences and team communication.
    Program Leadership (Administrator and Training & Curriculum Specialist)
    • Assist direct care professionals when completing the Sexual Behavior Reflection Tool and other program tools.
    • Review all internal documentation of sexual behaviors.
    • Be present when staff member speaks with children or youth after a sexual behavior incident has occurred; ensure documentation procedures are followed.
    • Put temporary support plans in place while awaiting recommendations fromPUBLIC a specialist.
    • Serve as point of contact forPUBLICspecialists and families regarding questions or updates.
    • Serve as a point of contact for program staff regarding questions or updates.
    • Ensure that support plans and other documents are placed in child’s file.
    • Ensure that support plan can be implemented (staffing needs, etc.).
    • Model recommended strategies for direct care staff.
    • Observe and provide feedback to direct care staff.
    Direct Care Staff
    • May work with program leadership or in some cases with teaching team, to complete documentation of sexual behaviors.
    • Inform and receive feedback from program leadership on all sexual behavior documentation.
    • Carry out support plan recommendations and strategies.
    • Bring questions and concerns about support plan implementation and behavior to program leadership.
    • Share relevant communication from family with program leadership.
    • Continue to communicate with family using best practice.

    If there is a teaching team in your program that cares for a child or youth with sexual behavior challenges, that team will likely need more than typical support from you. They may be asked to carry out strategies that are new to them or possibly even have an additional staff member added to their team to provide closer supervision for the child with sexual behavior challenges. This can be challenging and stressful for staff. Be sensitive to the fact that they are caring for a child who has needs beyond what is typical for most children.

    Observe

    Jane Silovsky, Ph.D., Professor of Pediatrics at the University of Oklahoma Health Sciences Center, discusses ways coaches can support staff in promoting healthy sexual development and behavior. As you listen to this video, think about the recommendations made and if you are already doing some of these things. Are there new practices you would like to begin in your work as a coach, trainer, or administrator?

    Coaching Staff to Support Children’s Sexual Development

    Listen to an expert discuss ways coaches can support staff in promoting healthy sexual development.

    You will create a program environment where staff are able to reflect on their practices around children’s sexual development and behavior. As you read each scenario that follows, think about how you might respond. Then read suggested ways you might approach the situation with each staff member. 

    Coaching and Creating Programs that Support Sexual Development Scenarios

     

    Scenario

    You Observe:

    Carmen uses slang terms to refer to children’s private parts.

    You Say:

    Say to the staff member:

    • “What do you know about using correct terms for children’s private parts?”
    • “Have you ever observed a staff member or family member using correct terms for children’s private parts? Why do you think they do that?”

    You Do:

    Take Action

    • Set up a time for Carmen to observe you, or another staff who uses correct terms, during diaper changes or when helping children in the bathroom.
    • Provide Carmen with a list of correct terms for parts of the body.

    Scenario

    You Observe:

    • Terry frequently tells children “stop touching” when preschoolers interact with one another.

    You Say:

    Say to the staff member:

    • “I noticed that the children need to be reminded about touch a lot. What can we do so they learn this rule better?”
    • “How do the children respond when asked to stop touching one another?”

    You Do:

    Take Action

    • Model using positive guidance to communicate what children should do versus what they should not do.
    • Reflect on other ways you can teach children to ask permission to touch.

    Scenario

    You Observe:

    • You overhear Diane and Shanae discussing Nicholas, a child with a history of sexual behavior challenges. You hear them refer to him as a “sexual predator” and make judgmental statements about Nicholas’s family.

    You Say:

    Say to the staff member:

    Individually discuss with these staff members what you heard them say.

    • “I heard you use some strong language when discussing Nicholas and his family. Tell me a bit more about how you are supporting them?”
    • What do you know about why children develop sexual behavior challenges?”

    You Do:

    Take Action

    • Coach Diane and Shanae to understand how inappropriately labeling children can further stigmatize, affect children’s behavior, and affect children’s view of themselves. Use lesson content to support this conversation.
    • Encourage Diane and Shanae to learn risk factors for sexual behavior challenges.

    Scenario

    You Observe:

    • Tiffany comes to you complaining about Mason, a program child receiving intervention for sexual behavior challenges. The family’s specialist has recommended that Tiffany discuss safe and unsafe touch with the entire class. Tiffany doesn’t think it’s her job to teach Mason these rules and feels it’s unnecessary to do whole group teaching when only one child has the issue.

    You Say:

    Say to the staff member:

    • “How do you think having peers that know about safe and unsafe touch will affect Mason?”
    • “Tell me more about why you feel it’s not your role to teach children this skill?”

    You Do:

    Take Action

    • Provide Tiffany the opportunity to reflect on her beliefs. Consider requesting she complete the first lessons of this course.
    • Provide Tiffany the opportunity to observe you or another staff member teaching children about safe and unsafe touch.

    Explore

    Explore

    Complete the Determining Children's Intentions activity to brainstorm whether the described behaviors were reactions or planned occurrences. Reflect on your responses with a colleague.

    Apply

    Apply

     Review the Coaching Conversation: Reflecting on Staff Beliefs attachment to see an example of how a coach helps a staff member expand their thinking on their role in supporting children’s sexual development.

    Glossary

    TermDescription
    Chronological AgeAge of person measured from date of birth
    Logical ReasoningAbility to connect two or more ideas and think about future consequences
    StigmatizeAttribute a belief of shame or disgrace

    Demonstrate

    Demonstrate
    Assessment

    Q1

    When talking about children and youths’ challenging sexual behavior, several factors affect their behavior. Which two factors will direct care staff likely need the most help from you on?

    Q2

    True or false? When a child or youth displays sexual behaviors, the following three questions help guide staff members as they think about the child or youth’s developmental abilities: What behavior occurred? What do we want to happen? What can the child do?

    Q3

    Trinka is a coach at a child care program and has been receiving a lot of questions from direct care staff about sexual behaviors. Which strategy should Trinka use to best support the program staff?

    References & Resources

    Counterman, L. & Kirkwood, D. (2013). Understanding health sexuality and development in young children. Voices of Practitioners (8)2, 1-13.

    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 healthy supervision of infants, children, and adolescents (3rd ed.) (pp.169-176). Elk Grove Village, IL: American Academy of Pediatrics.

    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. Retrieved from https://www.nctsn.org/sites/default/files/resources/sexual_development_and_behavior_in_children.pdf