Legacy of abuse

Caring for young children who behave sexually
towards other children and adults is among the toughest tasks faced
by foster carers and other professionals. Ruth Winchester
reports.

Many adults find it uncomfortable to talk to
children about sex. And they get precious little advice or support.
But for foster carers responsible for children who behave sexually
as a result of abuse, support is even more necessary – and still
too rarely on offer.

Sexualised, or “sexually reactive” behaviour
in children provides carers with a particularly difficult
challenge. Examples of sexualised behaviour include “sexual acting
out or unusual sexual behaviour, including mock intercourse,
excessive masturbation, a sexual awareness which would not be
expected, flirtatiousness and sexually provocative behaviour, such
as rubbing up against an adult.”¹

The majority of children exhibiting this
behaviour have been abused, and many simply expect that they will
be related to sexually by adults or peers. They may have found that
some types of behaviour elicited affection or were a way to get
attention, or to gain power and control over a frightening or
threatening situation.

And it is not confined to older children –
even very young children can behave in a way that makes adults and
other children acutely uncomfortable. According to psychotherapist
and expert witness Sue Richardson: “All ages are affected. Children
under five, for instance, are very often sexually reactive because
they don’t always have the language to talk about what they feel or
want, and they might be literally re-enacting what has happened to
them in the past.”

Sexualised behaviour can be directed at anyone
– adults and children, strangers or family members. It can be
difficult for carers to distinguish from normal sexual exploration,
and there may be real safety issues for other children in the
household and outside the home.

Paula Telford is children’s services manager
for the Kaleidoscope Project which is run jointly by Barnardo’s and
the NSPCC and was set up to offer assessment and intervention for
children whose sexual behaviour is harmful to others: “These young
people have usually suffered some form of significant damage – not
always sexual, sometimes it is physical abuse or another form of
significant harm or event. But their behaviour often presents a
very serious risk to other children. It’s usually directed at
children whom they are in contact with, whether older or younger –
it’s very rare that it’s directed at a child they don’t know.”

Unfortunately, foster carers may not be
informed of the true picture even when such behaviour is known
about by professionals in advance. According to one source: “Too
often it seems there’s a conspiracy of silence – if people know a
child is sexually reactive they know that it’s very difficult to
get a carer for that child, so they keep quiet about it.”

Cherie Talbot was a foster carer for 15 years,
and has experience of “sexualised” children. She is training
manager for the Fostering Network which runs courses for foster
carers to help them to deal with all aspects of sex and
sexuality.

She says: “It’s very difficult caring for
children who are not born to you – you can do very ordinary things
and have very normal routines which, for children who have been
abused, are very threatening. They might see having a cuddle as a
precursor to sexual abuse – and because that has been the only love
and affection they get, they respond sexually.

“You have to look at what in your behaviour
might be construed as risky. For instance, for some children having
a story read to them in bed might be a trigger. When I was
fostering we would read bedtime stories to all the children
together in the living room before bed, and then if any of them
wanted a story in bed I would use a portable cassette player.”

“As a foster carer it’s a question of
developing strategies to deal with the symptoms while the
underlying problems get dealt with,” Talbot adds. “I remember one
little girl who had been abused. I had a rule that children were
not to answer the door, but one day she got to the door before I
could and by the time I got there she had her arms around this
man’s neck and her legs round his waist, rubbing away, with this
poor man looking terrified. So I put a hook and eye on the top of
the door so the older children with keys could come in and out, but
she couldn’t open the door alone.”

Talbot also believes that children need to be
actively shown what behaviour is acceptable. “I’m a firm believer
that if you take something – a way of coping – away from a child
then you have to replace it with something else. So you teach
children ‘we don’t sit on people’s laps like that in this house’
and you show them how to sit properly.”

Her own four children were raised alongside
foster children and Talbot had to set up some very firm ground
rules to ensure that everyone was safe. “We had a rule that
children did not go into each other’s bedrooms, and a house rule
that nobody keeps secrets. No one has the power to make you keep a
secret, and there are no sanctions against people who don’t keep
them.”

But she adds: “It can be very difficult to get
good professional help for children. It’s very difficult to get
psychotherapy because there can be the attitude that there’s no
point starting it until they are settled in their permanent home.
With children sometimes having long waits while permanent
placements are found, they can be deprived of vital, albeit
expensive psychotherapy.”

Treatment for sexualised behaviour varies.
Much can be achieved within a loving, patient and supportive home
environment, but for those with more enduring problems, treatment
may centre around working with the child to identify why they
behave in certain ways, and finding more appropriate alternatives
or breaking the cycle. But treatment of any sort pays off,
according to both Telford and Richardson, who say that the earlier
therapeutic work starts the better the outcome. Untreated,
sexualised behaviour can develop into long-term behavioural
difficulties, or worse.

According to Richardson: “It’s a big jump to
make, but I would say that untreated sexually reactive behaviour
can end up as paedophilia. Most adult paedophiles have had the
problem since adolescence. It’s very important that people who
recognise this behaviour should act as soon as possible.”

More awareness of this type of behaviour, and
a more enlightened approach from professionals and services would
also pay off – and may already be happening. “With hindsight we’ve
been seeing sexualised behaviour in children for years but it is
only recently that we started identifying it as such,” says
Richardson. “In the past we’ve had adolescent boys being done for
indecent exposure or low grade sexual assault – there has been
traditionally a very punitive approach to it taken by carers and
professionals, or at least one based on ignorance. That’s now
starting to change.” CC

– See S Hackett, Facing the Future: a
Guide for Parents of Young People who have Sexually Abused,
Russell House Publishing, 2001, £16.45. www.russellhouse.co.uk
 

¹ The Fostering Network,
Fostering a Child Who Has Been Sexually Abused, The
Fostering Network, 2001, 020 7620 6400.

Notes for carers

– Foster carers need to be aware, before the
placement, of the effects of having a child who has been sexually
abused in the household, particularly someone who may test the
family or seek comfort by displaying inappropriate sexual
behaviour.

– Children may need help learning how to
satisfy their sexual needs in an appropriate way. Other young
children in the household may also be vulnerable to a foster child
initiating sexualised contact with them because of their own
experience. They can be at risk both of false allegations and of
sexual advances which they do not have the understanding to deal
with.

– Foster carers need to be aware that children
who display inappropriate sexual behaviour can invoke feelings of
disgust. Foster carers may feel disgusted with the child because of
their behaviour, or if on the receiving end, they may feel
disgusted with themselves because they would appear to have
attracted it.

See reference above.