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Know

Take a moment and think about your family when you were a child. What were your relationships like with your primary caregivers, siblings, aunts, uncles, or grandparents? Think about the considerable impact your family had on you growing up. Conversely, think about the impact that you had on your family members. For example, when you were dealing with a stressful situation or major life change, how were the members of your family affected? These reflective thoughts help you consider the influence of family dynamics.

It may be natural to think about how the children you work closely with in your program are affected or shaped by their families. However, it is easy to forget that a family is a complex system that changes frequently, depending on each family members’ interests, development, and stage of life. Caregivers, siblings, aunts, uncles, or grandparents can all be affected by a child’s behaviors and experiences. Bowen’s family systems theory (1978) acknowledges the complexity of families and suggests that changes in any part of the family system have an impact on all other individuals in the family.

Let’s think about a family that consists of a mother, grandmother, and twins. The family plans for the grandmother to care for the twins at home until they are 3 years old, while the mother is at work. How will the family dynamics change when the twins enroll in a child care program? Perhaps the grandmother will be able to participate in hobbies and visit her friends, which could improve her well-being. Maybe the mother will be able to talk with the grandmother about various interests and ideas, instead of most conversations concerning caring for the twins. A change in one element of this family can have a significant impact on all other family members and change the family dynamic. Next, imagine that one of the twins begins exhibiting sexual behavior challenges in their new child care setting. How would this situation affect the mother or grandmother? Perhaps the mother or grandmother would need to go to more appointments or connect with community resources or agencies for support. The family would have to shift and adapt to meet the needs of the child.

The Importance of Rapport and Family Engagement

As a child care professional, a majority of your work is spent with the children in your program. It can be difficult to find time to connect with families; however, developing rapport with families is essential and it benefits the children in your care. Being friendly, asking questions, offering opportunities for engagement, and expressing interest are all ways to build strong relationships with families. Developing a strong relationship with families can be beneficial because if a sexual behavior challenge arises, you have already established a basic level of trust with the child’s family, thereby creating a more supportive environment. For more information on family engagement, please visit the �Թ��� Family Engagement course.

Communicating With Families

In Lesson Five, you had the opportunity to read how a staff member, Crystal, responded to a sexual behavior challenge in a school-age program. You learned how to respond in the moment and engage in the necessary follow-up procedures after the fact. Now that you have learned how to manage the immediate needs of children in the moment, you can turn your attention to supporting the family through this experience. Prior to communicating with a family about their child’s sexual behavior, you can prepare yourself for the conversation by doing the following:

Assess your own reactions and biases: In Lesson One, you learned the importance of reflecting on your own attitudes and assumptions that you hold toward this highly sensitive topic. Acknowledging your biases or discomfort around this topic prepares you to communicate with families about their children’s sexual behavior.

Start with empathy: Empathy is commonly described as being able to put yourself in someone else’s shoes and consider what they may be going through. Developing empathy for children and families coping with sexual behavior challenges is important because it can improve understanding, communication, and relationships. For parents or caregivers, caring for a child who exhibits sexual behavior challenges can be immensely stressful. It can be difficult to know how to respond or help their child. Furthermore, caregivers may feel like they are being judged by others for their child’s behaviors or that others will think of them as “bad” parents or caregivers, which adds an extra layer of complexity. Families with children who exhibit sexual behavior challenges may experience any of the following (NCTSN, 2009):

• Difficulty believing that the sexual behavior actually occurred
• Anger (toward their child, other children involved, at themselves, or at the world)
• Withdrawing from their child
• Sadness or depression
• Guilt and shame
• Isolation
• Disappointment (in child or self)
• Confusion and uncertainty, especially if it’s unclear as to why the child is acting out
• Nightmares or other traumatic stress reactions, particularly if the parent was sexually abused a child

Identify strengths: Prior to your difficult conversation with a family about their child’s sexual behavior challenges, take a moment to consider the strengths of the child or the family. What makes them unique? What makes them strong or resilient? A strengths-based approach empowers the family and encourages program staff to identify and leverage the incredible strengths of families.

Sharing Information With Families: Effective Communication

What you say, and the way you say it to families matters. When sexual behavior challenges occur, it’s likely that families will have questions about (1) what is considered normative or expected sexual behavior in children as opposed to sexual behavior challenges and (2) the sexual behavior challenge situation you observed.

Families do not expect or anticipate the need to support children with sexual behavior challenges and may not be familiar with the range of normative and challenging sexual behaviors or how to handle such a situation. It’s important to keep in mind that, based on their own experiences or cultures, not all families will have the same perceptions or expectations regarding their child’s behavior. When speaking about the topic with families, try to create an environment where questions and discussion about sexual development are welcomed and encouraged.

Each child is different, each situation is complex, and it can be difficult to answer questions about sexual development and behavior in the moment. For example, you may have families ask you if the sexual behavior they observe at home is “normal.” If a family member asks you a question about sexual development that you are unsure of, it’s OK to admit you are unsure. While admitting you don’t know can feel uncomfortable, it’s important not to make assumptions or guess. Instead, let the family know that you will find out more information after consulting with a member of your program leadership. You can say “I’m not sure, but I can find out more and ask my program administrator. One of us will follow-up with you as soon as possible.” This response shows transparency and can help strengthen your relationship with the family. It may also be useful to have resources readily available to consult or to use when discussing this topic with families. You may find it helpful to refer to the Normative Childhood Sexual Development & Behavior handout in the Apply section of Lesson Two.

In addition to discussing the range of normative and challenging sexual behaviors, families may also have questions for you about the instances of challenging sexual behavior you observed. When discussing sexual behaviors with families, here are some important considerations:

Ineffective Communication: What to Avoid

While there are plenty of effective communication strategies that you can use with families, it’s important to be aware of ineffective communication, or statements that may make a family feel uncomfortable or defensive. Below are some examples to avoid.

Avoid labels or diagnoses: When speaking with families about their child’s sexual behavior challenges avoid making assumptions or generalizations. Behavior is complex and children’s behavior is a form of communication that can be interpreted. Because behaviors can be interpreted, we may speculate about what a child is attempting to communicate through a behavior; however, it’s important not to jump to conclusions by diagnosing or labeling a child. Only specialists, who as part of their scope of practice can diagnose or suggest diagnoses, should introduce discussion about specific diagnoses with families. For example, a child care professional can say, “I have observed Jacob repeatedly using unsafe touch,” but should not make statements such as, “I think your child has a sexual behavior disorder.” If you are unsure of what you should say, refer to your professional guidelines and consult with a coach, trainer, or administrator.

Avoid judgment or criticism: Remember that children’s sexual behavior challenges can be a tremendous shock to the family. Think back to the many ways families may experience or react to these behaviors and use empathy when working with them. If families feel judged or criticized, it’s possible they will shut down and withdraw from working cooperatively with program staff. For example, a comment like “If you were more involved with your daughter she wouldn’t be exhibiting these behaviors” can be offensive for families to hear and would likely make them feel attacked and defensive.

Don’t compare one child to another: Avoid comparing the behaviors or actions of one child to another child in your program. For example, a statement like “none of the other children in my room have had issues like this” can hurt the feelings of the family you’re working with and damage the relationship you’ve developed with them.

�Թ���ing Families Through Their Child’s Sexual Behavior Challenges

Depending on the sexual behavior concern, you may work with a family whose child exhibits the behavior, or a family whose child has experienced the behavior. Think back to the case study in Lesson Five about Cameron and Makayla. The families of both Cameron, the child that exhibited the sexual behavior challenge, and Makayla, the child that experienced the sexual behavior need support.

As you’ve already learned, one way to be immediately supportive of these families is to utilize your effective communication skills with them regarding the sexual behavior incidents. In addition to the way you share information with them, it can be helpful to connect them with mental health or other community resources.

It’s important to note that, for some, there may be stigma around mental health services. Keeping this in mind, the way you introduce mental health services matters. Instead of saying “You need counseling” and handing them a phone number, opening up a conversation about counseling and its benefits could be more productive. You could ask the family if they would be open to consider counseling and describe that it can be a source of support in dealing with challenging sexual behaviors in children. If the family expresses interest during this conversation, offer to help them set up the appointment or anything else they may need. This shows your support. Taking the first steps to enroll in mental health services can be extremely difficult. You can support families by highlighting the benefits of counseling services, providing detailed information regarding local resources, and offering to be of assistance with setting up the first appointment. The decision to enroll in counseling services is up to the family, so it’s important that you respect their decision either way. Don’t pressure them to make a decision in that moment. To help support a family in crisis, simply express that you are there to help connect them if that’s what they choose at any time.

See

Initiating conversations with families about sexual development and behavior can feel uncomfortable for everyone involved, especially if you have limited knowledge and experience discussing this topic. Watch as two experts share recommendations for respectful ways to communicate with families.

Do

As you’ve learned, discussing sexual behavior challenges with families can be a difficult conversation for all adults involved. So far, you’ve explored ways that you can use effective communication skills to support families in crisis, now let’s turn your attention to programs. It’s important to examine program policies, procedures, and available community resources that can help support families who are dealing with their child’s sexual behavior challenges.

Take a few moments and consider the following questions regarding your program:

• Are you aware of local mental health community resources?
• Are you aware of when referrals to services may be appropriate?
• Are community mental health resources readily available at your site? Where is this information? Is it in a place that families can see? How is this information presented? Is the information offered in the native languages of the families in your program?

While considering how information is displayed and readily available for staff and families is important, building strong partnerships with local agencies can also be beneficial. By connecting with local mental health resources, coaches, trainers, and administrators can create a seamless transition to needed services. For example, getting to know the point person for scheduling intake appointments for families, allowing families to have their first meeting with a counselor at your site, or inviting staff from community agencies in to lead discussion groups or speak with parents can work to reduce stigma around mental health and make it more approachable for families.

To better support families dealing with sexual behavior challenges, consider how your program can create stronger connections to community resources or how your site can work to reduce the stigma around mental health services.