Minnesota study gives hope for children with sexual behavior problems

It's common to feel many emotions when faced with the prospect of children as victims, or perpetrators, of sexual violence: Horror. Grief. Anger. Shame.

One emotion we rarely dare to feel is hope.

But findings from a new, myth-busting study by the Minnesota Coalition Against Sexual Assault (MNCASA) give us hope in abundance for these children, their families and society.

The project, funded by Raliance, a nonprofit that distributes funds from the National Football League, examined how Minnesota identifies and treats children with sexual behavior problems, as well as how our state might better train those who work with them.

Among eye-opening findings is a correction to the widely held belief that children who are victims of sexual assault will become adult perpetrators, thus perpetuating an insidious cycle.

In fact, when children receive appropriate and timely treatment for sexual behavior problems (preferably brief and family-focused), they are at no greater risk than the general population of becoming adult sex offenders.

Also, for children exhibiting sexual behavior problems, it is essential that we treat the whole child, and avoid further stigmatizing him or her with terms such as "sex offender."

"I have spoken to many, many parents over the years about the shame they feel when they talk about how their child has sexually harmed another child," said Joan Tabachnick, a national expert on child sex abuse prevention who served as an adviser to the study.

What they want more than anything, she said, "is to know that their child can grow up and live a safe and healthy life."

That sunny, and attainable, outcome is what drove the study, said project lead Yvonne Cournoyer, who recently retired from the coalition.

"Anecdotally, we were hearing stories, particularly of children falling through the cracks after being identified for acting out in concerning ways," she said. "Child-care providers know how to respond to hitting. They don't question themselves."

With sexual behaviors, however, they're not so confident, she said. In fact, two-thirds of professionals who work with children said they were interested in training on how to recognize and respond to these behaviors.

"A lot of providers wondered, 'How do I talk to a parent about this? If I say I'm seeing this, is that parent going to be upset? Will he or she pull the child from my care because they're afraid of what it means?'

"We really wanted to do the report to make this a more common conversation," Cournoyer said. "There doesn't need to be all this stigma. It gets in the way of us responding."

MNCASA (mncasa.org) collected data from August 2016 to June 2017, drawing from previous studies, personal stories and interviews with professionals working in child care, Head Start, social services, mental health services, public health services and early childhood education.

The objective was to try to improve early identification, increase access to services for children and their families and, ultimately, reduce the likelihood of children engaging in problematic sexual behaviors.

The first, and by no means small, challenge was to determine what, exactly, a problematic sexual behavior looks like.

Despite the reluctance by adults to see them as sexual beings, children "display a wide range of sexual behaviors," the report noted. A 2009 study, for example, found that 42 to 73 percent of children have experienced some sort of sexual activity by the time they are 13. That might mean trying to view another person's genitals and breasts, standing too close to another person or touching their own genitals, all of which are considered developmentally appropriate.

Younger children might self-stimulate, play doctor or imitate adult sexual behaviors. Such behaviors tend to peak by about age 5, when children pick up on social cues that it's best to keep such actions private.

Behaviors that are worrisome tend to occur with frequency, often between two children of widely different ages or abilities, and may be driven by anger or anxiety. Such behaviors tend to continue, despite adult intervention or corrective efforts.

Even in these cases, it is important not to assign "adult" meanings and motivations to a child's actions. The National Center on the Sexual Behavior of Youth (ncsby.org) notes that while adults who sexually abuse children may be driven by deviant sexual arousal, it is very different for a child who, more likely, "feels anxious or angry, is reacting to a traumatic experience, is overly curious after seeing sexual materials, seeks attention, is trying to imitate others, or is merely trying to calm him or herself."

That's why it's best to refer to them as "children with sexual behavior problems," instead of sex offenders or perpetrators.

Dr. Tim Wright, who has worked with youth sexuality for nearly 30 years, is heartened by changes he is seeing, even the most subtle.

"When I get calls from teachers and adoptive parents, instead of saying, 'I have a boy who is perpetrating on other kids,' they say, 'I have a child here who wants to touch other children on the bottom.' "

It's a child-first approach.

"We know these kids need to be treated as individuals," said Wright, director of outpatient programming at Minnesota's Village Ranch, which offers a continuum of family services, including outpatient therapy and residential care for teen boys.

"We need to tell parents, 'Calm down. Let's understand this.' And, also, let's work together to get this fixed. When you're working with children with sexual behavior problems, less is best," he said.

"Focus on family-based interventions, with rules and the development of the child's assets, and they're in and out the door in 16 weeks.

"Their identity," he said, "isn't formed around 'I am a bad kid.' "