Caregiving for Children
with Sexual Behavior
Concerns
The Power of Partnership
The Alliance for Child Welfare Excellence is
Washington’s first comprehensive statewide
training partnership dedicated to developing
professional expertise for social workers and
enhancing the skills of foster parents and
caregivers working with vulnerable children and
families.
Acknowledgements
Parts of this training were used with permission and in
collaboration with the Child Welfare Training Institute at the
University of Southern Maine based in part on the training
Working with Children Exhibiting Sexual Behavior Problems.
Thank you! to the many Social Workers and Child Welfare
Professionals for their contributions.
For more information, please contact:
University of Southern Maine
Muskie School of Public Service
Child Welfare Training Institute
295 Water Street, Augusta, Maine 04330
Competencies
 CCW201-03 Understands the need to develop plans and procedures to
avoid DLR/CPS involvement; knows how to identify and seek services
and supports available in the event of a CPS allegation.
 CCW201-05 Has the knowledge to distinguish between urgent questions
or needs, critical incidents and emergencies and seek appropriate
assistance (CA, police, fire, ambulance).
 CCW202-02 Understand the value of effective communication and
engagement with the child welfare team.
 CCW204-03 Knows to listen and validate when a child discloses
information related to CA/N; understands the need to report information
to intake and social worker; knows to not conduct child interviews.
 CFAM231-03 Understands and recognizes effects of poverty, trauma,
and maltreatment and to identify resultant developmental delays.
 CFAM232-01 Understands the need to identify and seek services,
supports or training available to develop the skills needed to support and
help to heal the emotional trauma of children in care.
Competencies
 CFAM234-01 Knows how to encourage everyone in the home be
respectful; how to provide appropriate nurturing and empathy to
children.
 CFAM234-02 Understands how to provide structure and predictability for
a child who has been maltreated.
 CFAM234-05 Understands when children are emotionally distressed and
knows to respond with a focus of care, attention and skill building.
 CFAM234-07 Understands the importance of and need for a high level of
supervision in the caregiving home.
 CFAM234-09 Understands the skills necessary to address crisis/severe
behavior problems in the home: knows ways to de-escalate dangerous
situations and keep everyone in the home safe; follows agency policy on
nonphysical restraint of children in care.
 CFAM234-10 Knows and understands the influences/triggers on a child’s
behavior including: developmental challenges, behavioral emotional
challenges, past abuse, neglect, separation, and placement.
Competencies
 CFAM235-01 Understands the effect on the family of being a care
provider.
 CFAM239-02 Understands the skills necessary to provide care to children
who have special needs: developmentally delayed, or emotional
and/or behavioral issues.
 CFAM239-11 Knows how to help children and youth with the
development of a healthy sexual identity.
 CFAM239-12 Knows how to care for a child who is experiencing the
behavioral, emotional and/or developmental effects of sexual abuse.
 CSELF281-01 Understands the need to seek, receive and understand all
relevant placement information prior to accepting placement of a child
in the caregivers home.
Agenda
 Part 1: Exploring Family Values and Beliefs (Yours and
the child in your care)
 Part 2: Typical Sexual Development and “Red Flags”
 Part 3: Experiences that Can Lead to Sexual
Behavior Problems and Their Effects on Children and
Adolescents
 Part 4: Parent’s Role in Promoting Healthy Sexuality
 Part 5: Safe Family Living
 Part 6: Intervening with Sexual Behavior Problems
Housekeeping
MORE TRAINING
• Child Development
• Effects of Abuse and Neglect on Child Development
• Caregiving for Children with Physically Aggressive
Behavior Concerns
• Paper Trail: Documentation Training for Foster Parents
• Many more topics!
https://allianceforchildwelfare.org/
Part 1:
Exploring Family Values and Beliefs
(Yours and the child in your care)
• Guiding Principles
• Sentence Completion Exercise
• True-False Quiz
• Impact of Trauma, Abuse and Neglect on
Development
• Trauma Principles
• How Severely a Child is Impacted by
Sexual Abuse
• Selected Definitions
Part 1 Learning Objectives
Know your expectations and assumptions
Know your values and beliefs on issues
regarding sexuality
Learn characteristics of foster parents
effective in caring for children with sexual
behavior problems
MORE
Part 1 Learning Objectives
Know vocabulary and terms, including
legal terms, regarding sexual abuse
and sexual behavior
Know some statistics about child
maltreatment and child sexual abuse
Recognize the damaging effects of
labeling
Guiding Principles
Children are more than the sum of their
behaviors and history.
Every child is both vulnerable and resilient
and possesses strengths upon which
interventions are based.
Guiding Principles
 There are children whose sexual
behavior problems can be safely
managed in the foster home
setting.
Guiding Principles
 Foster parents are essential members of
the treatment team and are central to
decisions impacting the child.
Guiding Principles
Continuous open communication and
teamwork are the key to effective
therapeutic foster parenting.
Each child with sexual behavior problems is
unique and requires individualized
assessment, treatment, and intervention
strategies.
Talk to the child’s Social Service Specialist to
discuss all formal assessments
All children deserve emotional support
and nurturance.
Guiding Principles
Effective interventions and meaningful
relationships can lead to safe
management and resolution of sexual
behavior problems.
Children adapt and change, so foster
parents must adapt and change, as well.
Safety of children and the community is
CENTRAL to all decisions and interventions
of the treatment team.
Guidelines
Take responsibility:
To get what you need
To have a good learning experience
To take care of yourself
Openness, respectful, open-minded
listening
Confidentiality (See next slide)
Washington DSHS
Confidentiality Rule
WAC 388-148-0130
Information may only be shared with:
People directly involved in child’s case
plan
You may discuss ONLY with DCFS, DLR
staff and state fire marshal; child-placing
agency; GAL; others as directed by worker
When in doubt, ALWAYS check with your
child’s worker
Sentence Completion Activity
HANDOUT – Sentence Completion
Activity
True/False Quiz
What do we know about sexuality
and today’s youth?
9 Questions
If the answers surprise you, we can
provide you the citations so you can
read more!
True or False?
Approximately 1 in every 4 girls
and 1 in every 6 boys are
sexually abused before age 18.
Approximately 1 in every 4 girls
and 1 in every 6 boys are sexually
abused before age 18.
TRUE.
Nearly 70% of all reported sexual assaults
(including assaults on adults) occur to
children ages 17 and under.
An estimated 39 million survivors of
childhood sexual abuse live in America
today.
True or False?
Children are usually sexually
abused by a stranger.
Children are usually sexually
abused by a stranger.
FALSE.
30-40% of victims are abused by a family
member.
Another 50% are abused by someone
outside of the family whom they know and
trust.
Approximately 40% are abused by older or
larger children whom they know.
Only 10% are abused by strangers.
True or False?
Most children tell someone
about their abuse.
Most children tell someone
about their abuse.
FALSE.
Many children do not report that they have
been abused.
Evidence that a child has been sexually
abused is not always obvious.
Young victims may not recognize their
victimization as sexual abuse.
Almost 80% initially deny abuse.
Only about 1 in 200 reports of sexual abuse
made by children is a fabrication.
True or False?
Sexually abused children
primarily have emotional
reactions.
Sexually abused children
primarily have emotional
reactions.
 FALSE.
 Victims are more likely to have physical health
problems.
 Victims report more school problems.
 Victims are more likely to experience major depressive
disorders as adults.
 Young girls who are sexually abused are more likely to
development eating disorders as adolescents.
 Victims are 2.5 times more likely to develop alcohol
abuse issues.
True or False?
A child who is sexually
abused always proceeds to
abuse others.
A child who is sexually
abused always proceeds to
abuse others.
FALSE.
This is a widespread myth not supported by
any scientific evidence or research.
Studies have shown that the majority of sex
offending adults have NOT been sexually
abused as children.
Victims of childhood sexual abuse are NOT
more likely than non-victims to be arrested
for sex offenses.
True or False?
Online enticement of
children occurs about 10%
of the time.
Online enticement of
children occurs about 10%
of the time.
FALSE.
Based on a survey of 1,501 teens and preteens, 19% received unwanted online
requests to engage in sexual activities or to
provide intimate sexual information, within
the last year.
In 15% of those incidents, approximately 35
youth, solicitor attempted to contact the
youth in person, over the telephone, or by
mail.
True or False?
Most people who sexually
abuse have multiple victims.
Most people who sexually
abuse have multiple victims.
TRUE.
Nearly 70% of child sex offenders have
between 1 and 9 victims
At least 20% of child sex offenders have 10
to 40 victims.
True or False?
Growing up in a violent home
may lead to sexual behavior
problems, even if there was no
sexual abuse in the family.
Growing up in a violent home
may lead to sexual behavior
problems, even if there was no
sexual abuse in the family.
TRUE.
Additional risk factors include:
Incidents of trauma
Neglect
Exposure to domestic violence
Physical abuse
True or False?
Sexual offense rates are higher
than ever and continue to
climb.
Sexual offense rates are higher
than ever and continue to
climb.
FALSE.
Actual rate of reported sexual assault has
decreased slightly in recent years.
Rate of reported rape among women
decreased by 10% from 1990 to 1995
Arrest rates for all sexual offenses
dropped 16% between 1993 and 1998.
Definitions and Terms
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Trauma
Consent
Compliance
Cooperation
Sexually Abusive Behavior
Abuse Reactive Behavior
Juvenile Sex Offender
Enmeshed
Post Traumatic Stress
Disorder
• Developmentally
Appropriate Behaviors
•
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Handout
Sexual Misconduct
Coercion
Sexual Offender
Pedophile
Transference
Counter Transference
Ritualistic Abuse
Sexual Exploitation
Pornography
Sexualized Behaviors
Psychosexual
Assessment
Trauma
 “A single event or series of events
over time, which can tax or
overwhelm a person or community’s
resources and sense of wellbeing.”
How an individual responds
to trauma depends on:
The person (age, ethnicity, gender)
Event (when, where, with others,
number of occurrences, weapons,
threats)
Environment (where they live, support
systems in place, family and police
response, relationship to abuser)
How Trauma Appears
Feeling of
helplessness
Impacts sense of
safety
Changes in
Central Nervous
System
Sensory
Why did it
happen?
Attachments
PTSD (PostTraumatic Stress
Disorder)
Contagious
Shame-Based
Perspective
How Severely a Child is
Affected by Sexual Abuse
Abuse - Nature and Physical Contact
Abuser - Abuser’s age, relationship to
child, and how many abusers
Child - Age and developmental age
Consent
Agreement including ALL of these:
Understanding
Knowledge
Awareness
Assumption of equal respect
Voluntary, and
By a person who is mentally competent.
A child cannot give consent (by definition)
to sexual activity because of lack of
knowledge and maturity.
Compliance
Passive action, no apparent
resistance.
Compliance can occur WITHOUT
consent.
Cooperation
Participation regardless of beliefs
or desire.
Cooperation, like compliance,
may occur WITHOUT consent.
Sexually Abusive Behavior
Behaviors that involve coercion,
threats, aggression, secrecy, or
developmentally inappropriate sex
acts with or between children
Behaviors where one person has an
unequal power base
Abuse Reactive Behavior
Pattern of sexualized and/or
developmentally inappropriate sexual
behaviors
Occurs in reaction to past or current
abuse OR inappropriate exposure to
sexual situations
Juvenile Sex Offender
Describes youth who has engaged in an
offensive sexual act against victim’s will,
without consent
Often overused term, often used
incorrectly to describe a youth with
sexual behavior problems
May be adjudicated or non-adjudicated.
Enmeshed
Overly close relationship in which one
person is overly responsive to the
emotional life of another, outside of
developmental or cultural norms.
Post Traumatic Stress Disorder
Diagnostic label, applied to children and
adults, based on continuing reaction to
a traumatic event.
Symptoms might include flashbacks,
nightmare, dissociation, hyper-vigilance,
and reenacting trauma.
Developmentally Appropriate
Behaviors
Normal or typical behaviors within a
particular stage of development.
Sexual Misconduct
Behavioral act of engaging in sexually
offensive or abusive behaviors
Describes the behavior; does NOT label
the person.
Coercion
The act of forcing or compelling
someone to do something
Uses threats, intimidation, power
Sexual offender
Common label used to identify
someone who has engaged in sexually
offensive behaviors.
NOT a diagnosis
Pedophile
Diagnostic Label
Assigned to an adult (16 or older)
Person has primary or exclusive sexual
interest and arousal toward children
DOES NOT describe all sexual offenders
and is often misused
Transference
Having feelings awakened or triggered
by someone with whom you are
interacting
Based on past relationships with
someone significant
Counter-Transference
Emotional reactions or feelings of a
person in a therapeutic role toward
someone he or she is working with
Involves the therapist’s “own stuff”
Ritualistic Abuse
Bizarre, systematic, formalized,
repetitive abuse
Mentally, physically, and/or sexually
abusive
Ritualistic sexual abuse is usually painful,
sadistic, and humiliating
Sexual Exploitation
Purposefully manipulating or taking
advantage of another person to obtain
some sexual benefit or sexual
gratification.
Pornography
Writings, pictures, videos depicting
explicit or implied sexual behaviors
Sexualized Behaviors
Learned use of sexual behaviors to meet
basic nurturance needs.
Using sexual behaviors as a way to
relate to people.
Everyday behaviors and interactions
have a sexualized meaning.
Psychosexual Assessment
Specialized assessment
Psychologist, psychiatrist, neuropsychologist usually assesses
Assesses inappropriate sexual behaviors,
sexuality problems, or sexual abuse
concerns or allegations.
Part 2:
Normal Sexual Development
and Red Flags
What is “normal”
Red Flags
Part 2 Learning Objectives
Know the range of sexual behaviors
considered “normal.”
Know the ages and stages of “normal”
sexual development.
“What is Normal?”
Handout
Small group activity (5 mins)
Your group will be given a flip chart page
with an age range on it.
You are asked to come up with a list of
“normal” sexual behaviors you would see in
children of that age range.
Large Group Discussion (15 mins) and
review of Handout – Stages of Sexual
Development
Red Light, Green Light
Green Light Behavior: Healthy sexual
play for children 12 and under
Yellow Light Behavior: Concern/Possible
Intervention Needed
Red Light Behavior: Adult supervision
and confrontation needed - possibly
therapeutic intervention
Green Light Behavior
Exploration with children of similar age
and size; usually not siblings
Voluntary, spontaneous - usually not
shame, fear or anxiety
Sexual behavior balances with curiosity
about rest of their world
May still need limits or intervention (Just
because it’s normal doesn’t mean it’s OK)
Yellow Light Behavior
Cause for concern/possible intervention
needed
Preoccupation with sexual themes
Attempts to expose other’s genitals
Sexually explicit conversation, graffiti,
innuendo
Precocious sexual knowledge or language
Mutual/group masturbation
Simulated foreplay with dolls or peers
(clothed)
RED LIGHT BEHAVIOR
 Requires adult supervision, confrontation, and
therapeutic intervention
 Sexually explicit conversations with others of
significant age difference
 Touching genitals of others
 Degradation/humiliation of self or others with sexual
themes
 Forced exposure of others (hazing)
 Inducing fear/threats of force
 Sexually explicit proposals
MORE
RED LIGHT BEHAVIOR
 Repeated or chronic (or with younger children)
peeping, exposing, pornographic interest, rubbing
genitals against others or objects
 Compulsive masturbation (task interruption to
masturbate)
 Female masturbation that includes vaginal
penetration
 Simulated intercourse with dolls, peers, animals, or
clothed peers
 Oral, vaginal, anal penetration of dolls, children,
animals
 Forced touching of genitals
 Simulating intercourse with peers (nude)
Definite Need For
Therapeutic Intervention
Extensive preoccupation with sexual
themes
Angry, violent, forceful in sexual
behavior with others
Compulsive sexual behavior; not
necessarily enjoyable
Age-inappropriate sexual activity
Sexual activity with much younger or
much older child
Part 3:
Experiences That Can Lead To Sexual
Behavior Problems And Their Effects On
Children And Adolescents
 Family Risk Factors for Children Developing Sexual
Distress and Sexual Behavior Problems
 Impact on the Foster Family
 Impact on Development
 Impact of Fetal Alcohol Syndrome on a Child
 Effects of Sexual Abuse on Various Developmental
Domains
Part 3 Learning Objectives
Participants will recognize the nature of
experiences that can lead to sexual
behavior problems in children and
adolescents.
Participants will know the potential
effects of these experiences on
development.
Group Activity:
Brainstorm!!!
Why do children have sexual
behavior problems?
Sexual behavior problems
may result from:
 Sexualized anxiety, not pleasure-seeking
 Confuse affection with sexualized behavior
 Making sense of what happened to them
 Physiological arousal + sexuality = sexualized
behaviors
 May not know what is appropriate
 Masturbation reduces tension, loneliness,
fear, isolation, confusion, anxiety, etc.
Group Activity:
Brainstorm!!!
What are some family risk factors for
children developing sexual distress
and sexual behavior problems?
For example - sexual abuse, domestic
violence, and physical abuse are
common risk factors in children who later
develop sexual behavior problems
Can you think of others?
Additional Family Risk
Factors May Include:
 Exposure to adult sexual  Unclear family roles,
activity
unhealthy boundaries
and relationships
 Access to sexual
materials
 Extreme parental
dominance
 Extreme overprotectiveness
 Special privileges for
one child over another
 Family sexualizes routine
interactions
 Unequal roles, unequal
power
 Secrecy is a norm
MORE
Additional Family Risk
Factors May Include:
 Inappropriate adult roles
for children
 Parent is jealous of child
 Lack of consequences
for sexual behavior
problems
 Isolated from community  Covertly sexualized
atmosphere, seen in
and supports
attitudes toward
 Extreme reaction to sex
nudity, privacy,
education materials
toileting, bathing,
sexual teasing,
 Excessive use of alcohol
virginity, etc.
or drugs
 Intolerance of/denial
of/lack of empathy for
feelings
Impact on the Foster Family
LARGE GROUP DISCUSSION:
Keeping in mind the risk factors that a foster
child may have encountered while in their
birth family:
How will a child’s experiences in their birth
family, impact your family?
How will a child’s experiences in their birth
family impact how you parent that child?
Impact of Trauma on Development
Significant developmental
delays in one or more areas
Can be caused by genetics,
prenatal drug exposure,
environmental factors, or
abuse, neglect, and direct
trauma
Neurological Impacts
of Trauma
Maternal use of alcohol during
pregnancy may impact many
areas of a child’s development
and can result in neurological
disorders such as Fetal Alcohol
Spectrum Disorder
Neurological Impacts
of Trauma
Physical, cognitive, social & emotional
development
Intellectual Developmental Disorders (formerly
mental retardation)
Learning disabilities
Intrusive, poor judgment, overly talkative
Behavior problems
No understanding of cause and effect
Some children may behave in sexual ways
that could misinterpreted as “aggressive”
when they are more related to judgement
Neurological Impacts of
Trauma
Some children may behave in
sexual ways that could
misinterpreted as “aggressive”
when they are more related to
judgement.
Neurological Impacts
of Trauma
When it comes to behavior,
consider:
CAN’T vs WON’T
SKILL vs WILL
Effects of Sexual Abuse
Sexual Behaviors
Emotional
Social
Intellectual
Physical
Spiritual
Moral
Possible Effects: Sexual Behaviors
 public and/or excessive
masturbation
 seductive behavior
 promiscuous behavior
 sexual aggression toward 
children if unsupervised

 sexual gestures toward

peers that escalate
toward aggression

 lack of impulse control

 unusual interest in sex
and sex language
inappropriate to age

inappropriate touching
Exhibitionism
Peeping
sexual behavior with
animals/ toys
peeing in inappropriate
places
playing with feces
Possible Effects: Emotional
 nightmares
 fear of abandonment
 night terrors
 fear of appropriate intimacy
 depression
 fear of school or Y changing
rooms
 anger
 anxiety
 phobias
 hyper-vigilance
 lack of affect
 compulsive bathing
 shame & low self-esteem
 guilt / sexual guilt (guilt
derived from sexual pleasure)
 need for (too much) control
 obsessive/ compulsive
behavior
 lack of empathy
 bedwetting (enuresis)
 soiling (encopresis)
 loss of innocence
Possible Effects: Social
 lack of healthy boundaries with
strangers or in dating
 withdrawal from friends & family
 fear of certain gender
 charming/ flirtatious with adults
 controlling
 wearing many layers of clothing
regardless of weather
 fighting
 not bathing or compulsive bathing
 obsession with being powerful/
tough
 weight gain
 fascination with fire/ gore/
violence
 immaturity
 play with adults or younger
children vs. peers
 entrenched defenses
 cruelty to pets
 fire setting
 making self look unattractive
 promiscuity
 prostitution (95% of teenage
prostitutes have been sexually
abused)
 higher rates of juvenile
delinquency & sex offending
 difficulty with attachment & with
authority figures
Possible Effects: Intellectual
 School failure
 attention problems/ dissociation
 frequent absence or tardiness
(sometimes with excuses/notes from one
parent)
Possible Effects: Physical
 Injury
 eating disorders
 STD’s
 self-destructive
behavior
 Infections
 Pregnancy
 don’t trust body
sensations
 substance abuse (70 –
 high tolerance for pain
80% of sexual abuse
or accident prone
survivors report
excessive use of alcohol  psychosomatic or
& drugs)
stress-caused illness
Possible Effects: Spiritual
 Loss of hope
 higher suicide rate
 helplessness
 feeling abandoned/ betrayed by God and
world - alone and not worthy
 “hole in soul”/ emptiness
 vulnerable to fanatical or cult religions or gangs
 sometimes find sense of higher power and
hope through prayer
Use Your Best Judgement
Be careful not to be overzealous in
identifying children with some of these
indicators.
Any indicator alone does not necessarily
mean a child has been sexually abused.
These are GENERAL indicators of stress.
Severe, extreme and pervasive behaviors
may indicate sexual abuse.
Verbal disclosure is the best indicator.
Part 4:
Caregiver Roles in Promoting
Healthy Sexuality
Positive Messages to Children about Sex
and Sexuality
Suggestions for Prevention Education for
Children with Sexual Behavior Problems
Answering Children’s Questions About
Sex: “Can of worms”
Part 4 Learning Objectives
 Know the issues and messages that can
promote healthy sexuality in children.
 Be able to respond appropriately when children
and adolescents discuss their sexual
experiences.
 Explore reasons foster parents MUST talk about
sex and sexuality with children
 Explore ways foster parents can talk about sex
and sexuality with children
 Identify scenarios in which need to educate
children about sexuality and boundaries may
occur
 Define positive messages around sexuality
Personal Experiences
My parents taught me everything I needed
to know about sex.
My parents shared this information in a way
that was comfortable for me.
The messages I received from my parents
about sex were:
 a. That it is something special
 b. That it is very private and not to be discussed
 c. They were open and very matter-of-fact.
Personal Experiences
My parents encouraged me to ask
questions.
I felt comfortable asking questions.
Brainstorm
List negative messages children may
have received about sexuality from
sexual abuse, domestic violence, early
exposure to sexual activity, images and
language in homes with poor
boundaries, substance abuse, neglect,
television, internet access.
Additional Questions
Do children who have had early
exposure to sex know more than children
who have not?
What possible misinformation and gaps
in information might they have? Give
examples.
What might be the consequences of
such misinformation?
Correct Anatomical Terms
Vagina, penis, anus, breast, nipple,
buttock, urination, bowel movement,
defecation, feces, urine, masturbation,
orgasm, ejaculation, semen, sperm
Are you comfortable talking about this?
What is hard about it?
Wayne Duehn thoughts:
 “Yes, I know what the words ‘dick,’ ‘cock,’
‘rod,’ and ‘prick’ mean. I’ve heard them
before and at times may have used them
myself. But in this family, we will use the
appropriate sexual terms when talking about
what happened sexually to you and others. This
will let you know that I respect you, I am
listening to you, and I do care. The words ‘dick’
or ‘prick’ may be the only words you now know
and are most comfortable using. That’s OK. I
just wanted you to know the reasons why I will
use the word ‘penis.’ I want to show you
respect and make sure you feel safe.”
Handout
Positive Messages to Children
About Sex and Sexuality
Sex and sexuality is normal
Feelings, thoughts, and fantasies about
sex are a normal part of growing up, and
EVERYONE has these feelings
Touching yourself is a normal part of
sexual activity
Sexuality has responsibilities and
obligations, and carries ethical and
moral considerations
Prevention Education for Children
with Sexual Behavior Problems
Teach about Different Kinds of Touch
Role-Play, Set up a Safety Plan around
Touching Problems
Personal Space and Boundaries
Regular Sexuality Education
Birth Control Information
STD Prevention Information
Activity: Answering Children’s
Questions About Sex
You will be asked to participate
in a group activity regarding
how to respond to questions by
children about sex.
You will survive! (and be better
prepared)
First, let’s review some
guidelines
Guidelines for Responding to
Questions About Sex
 Answer all the child’s questions about sex and
sexuality (unless they are repetitive and you believe
the child is becoming over-stimulated by the
conversation)
 Try to understand what the child needs to know
and at what developmental level (make sure you
understand the question or confusion and look for
questions behind questions)
 Give just the information they are asking for or
demonstrating a need for and wait to see if they
want to know more.
Guidelines for Responding to
Questions About Sex
 Give the information honestly, accurately, simply
and directly (using correct names for body parts).
 Let them know by the way you respond that you
are open to these kinds of questions on an ongoing basis (even if you have some
embarrassment) and that sex is a good thing when
they are old enough and find someone special with
whom to share their intimate and sexual feelings!
 Your local Planned Parenthood Center has great
handouts and workshops about this and you can
call them for consultation.
Part 5:
Safe Family Living
House Rules
Preventing False Allegations of Sexual
Abuse Checklist
Part 5 Learning Objectives
Participants will identify and practice
limit-setting and expectations regarding
privacy and boundaries
Participants will understand the nature of
safety in the home, for the foster child
and the entire family
Participants will know the approaches for
reducing sexual behavior problems in the
home setting.
Handout
House Rules
Privacy
Respect, courtesy
Supervision
Bedrooms, bathrooms
Clothing, modesty
Horseplay, tickling, wrestling
Sexual talk, physical touch
Personal touch, personal space, pets
Allegation Prevention
Keep your behavior above reproach
Rule of three
Separate bedroom for foster child
No physical punishment
Clear house rules around privacy and
touching, wrestling, tickling, horseplay
Good documentation
Family and group therapy
Good relationship with caseworker
Part 6:
Intervening with Sexual Behavior
Problems
Understanding Different Types of Sexual
Behavior Problems
Toni C. Johnson’s Continuum of Sexual
Behavior Problems
Patricia Ryan’s 4 Step Model of
Intervention
Intervention Skill Building
Part 6 Learning Objectives
Participants will examine the nature of
sexual behaviors along the continuum
from normal to unhealthy
Participants will discuss and practice
appropriate parental responses to
inappropriate sexual behaviors
Participants will learn to set limits
effectively on problem sexual behavior in
ways that foster healthy boundaries
Understanding Different Types of
Sexual Behavior Problems
When a child experiences any trauma,
they may respond in a variety of ways:
No acting out at all
Acting out, but not sexually
Acting out sexually, from inappropriate to
molesting others
Acting out sexually AND other behavior
problems
Experts generally agree that sexual
behavior problems are best understood
and explained using a continuum of
behavior approach.
We have chosen to use the continuum
developed by Toni Cavanagh Johnson.
Toni Cavanagh Johnson’s
Continuum of Sexual Behavior
Problems
Group 1: Children who engage in natural
childhood sexual exploration.
Group 2: Children who are reacting to
sexual trauma or events.
Group 3: Children who are mutually
engaged in the full range of adult sexual
behaviors.
Group 4: Children who are sexually
aggressive toward other children.
Example Vignettes
Example 1
 Four-year-old Jenna climbs into the laps of men she
doesn’t know and snuggles up against them. She tries to
stick her tongue into the mouth of people who kiss her
and makes sexual sounds. She also spends hours sitting
on the couch masturbating against her stuffed animals.
Jenna is being raised in a very sexualized environment.
She lives in a one-bedroom apartment with her 18-yearold mother and her mother’s boyfriend. Her mother treats
her as a girlfriend, not as a daughter. Frequently, her
mother lets Jenna wear makeup and watch soap operas
all day long. She has no age appropriate toys in the
apartment and plays with no same-age friends. She
sleeps on the sofa bed that her mother and boyfriend
have sex on after they think Jenna’s asleep.
 GROUP ________?
Example Vignettes
Example 2
 Frank is an 11-year-old boy who is in residential care
and who often bribes younger children into sexual
activity, including oral sex and forced penetration of
a child’s vagina or anus with his fingers. He can turn
quite threatening with a vulnerable victim,
threatening to never talk to him again or hurt him
while he is sleeping some night. Once when he was
caught sodomizing a younger child, he angrily yelled
at the residential worker that he wasn’t doing
anything.
 GROUP ________?
Example Vignettes
Example 3
 The staff at an elementary school was thrown into a
frenzy when a teacher discovered three ten-year-old
boys playing together in the bathroom with their
pants down. The boys were attempting to identify
which of them could stand farthest from the toilet
bowl and still hit it with a stream of urine.
 GROUP ________?
Example Vignettes
Example 4
 Todd and Joey are 9-year-old boys who have been
in foster and residential care almost all their lives.
They are constantly trying to have mutual and willing
sex with each other. These behaviors include sexual
touching and oral sex. The group leader has to
provide constant supervision and separation of the
boys in order to stop the behavior. Even nighttime
hours need to be monitored because the boys will
sneak out of their bedrooms and climb into each
other’s beds.
 GROUP ________?
Handout
Patricia Ryan’s
4-Step Model of Intervention
STOP the behavior
Define the behavior, specifically and
clearly
State house rule or expectation about
the behavior
Redirect the child and/or enforce the
consequences
Practicing the 4-Step Model of
Intervention
HANDOUT – Intervention Skill Building
Real-Life Problems
 What sexual behavior problems have
you encountered or do you fear
about encountering with the children
in your home and/or care?
In Between Behavior Problems:
Support kids to succeed
Notice & reinforce appropriate, positive
behavior
If behavior persists, question whether it is
in response to particular situation - offer
therapeutic intervention
Are these part of a larger pattern of
generalized oppositional behavior?
CONGRATULATIONS!
Thank you for completing this training!
We hope you have learned more about
children struggling with sexual behaviors
as well as ways you can support the
children in your home, and yourself.
THANK YOU FOR CARING FOR THE
CHILDREN IN OUR SHARED COMMUNITY