- 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.
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:
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:
Supporting Direct Care Staff
Remember that several factors affect children and youth’s sexual development and behavior:
- Culture and family norms
- Function of the Behavior
- Frequency and participation
- 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.
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.
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.
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.
- 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.
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?
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.
Carmen uses slang terms to refer to children’s private parts.
Individually discuss with these staff members what you heard them say.
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.
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.
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