�Թ���

Teach

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:

�Թ���ing Direct Care Staff

Remember that several factors affect children and youth’s sexual development and behavior:

• Culture and family norms
• Development
• Function of the Behavior
• Frequency and participation
• Environment
• 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 and Behavior 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.

Development

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.

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 �Թ��� Focused Topic course, �Թ���ing Children With Challenging Behaviors provides additional information on the function of behavior.

�Թ���ing 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 & Curriculum Specialist, asks the teaching team. 

 

Sexual Behavior Reflection Tool

 

Is the behavior random or infrequent?

No. Two children report that Neil has tried to watch them while using the urinal at different times.

 

Is the behavior typical for the child’s age and developmental ability?

No. A 9-year-old should know that it is inappropriate to violate someone’s privacy this way.

Follow-Up

“Though Neil is 9 years old, children with autism have delayed or atypical development. Privacy is a very abstract concept, an idea rather than something that can be tangibly experienced, which can be difficult for children with autism to understand.
Does Neil understand other abstract concepts?
Do you think he understands what privacy means?”

The team is in agreement that Neil has not developed abstract thinking and doesn’t understand privacy.

 

Is the behavior driven by curiosity, exploration, and playfulness?

No. Neil has a lot of problem behaviors and usually hangs out by himself.

Follow-Up

“I’d like for us to explore the intention of this behavior. I see that you documented that you don’t think it is driven by curiosity or exploration.
Why do you think Neil does this?
How does Neil usually initiate interactions with peers?”

The staff aren’t sure why Neil does this, but they agree that it is not a planned behavior. They don’t think Neil has developed that skill yet. The team also shared that although Neil doesn’t cooperatively play or communicate with peers, he does like to watch them.

 

If other children are involved, is it mutual and good-humored?

No. The other children were annoyed.

 

If other children are involved, do they know each other well and are they of a similar age and development (<2 years)?

Yes. The children are around Neil’s age and they all attend the after-school program together.

 

Is the behavior easily redirected?

Staff haven’t had the chance to redirect Neil. One of the other children said they told Neil to “back off.”

Follow-Up

“I know that you have not observed this behavior, but I’m wondering how Neil responds to redirection during other activities?”

The team shares that Neil sometimes responds to simple redirection. Neil’s parents have shared that when Neil has had difficulty learning routines at school, his classroom teacher makes a picture schedule. This has been very helpful at school, and the family uses a picture schedule to help Neil get ready in the morning at home.

 

Normative Sexual Behavior?

No. Neil should know that it is inappropriate to watch others in the bathroom.

Follow-Up

“I agree that we need to address this sexual behavior, but I also think it is the type of behavior that is developmentally typical for younger children. Although Neil’s chronological age is 9, his language and social skills are atypical and more like that of a toddler. You shared that he mostly plays by himself but likes to watch peers.
Do you think Neil understands that watching in the bathroom is any different from watching at other times?”

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 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 Development and Behavior 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.

Model

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.

How Leadership �Թ��� Families With Children Who Exhibit 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 �Թ��� 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.

PUBLICSpecialists

• 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.

Observe

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.