Sexually Reactive Children

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Sexually Reactive Children
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What is a sexually reactive child

• A child under the age of 12 that acts sexually
  towards another child.
• Same age child that exhibits excessive
  masturbation.
• Same age child that uses force or coercion to
  initiate sexual acts with another child

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Characteristic of a sexually reactive child

• Impulsive, ADHD type
• Lack of secure attachment to caregiver
• Poor boundaries
• Lack of warmth/empathy
• Restricted range of emotion
• Poor internalization of right from wrong
• Hopelessness/Depression
• Blames others/denial of responsibility

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Characteristic of Caregiver and Environment

• Neglect and/or physical and/or verbal abuse
• Frequent moves
• Insecure attachment
• Domestic violence
• Poor modeling of aggression/sexuality
• Poor boundaries between caregiver and child
• Role reversal
• Poor monitoring of the child

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Caregiver Characteristics Contd

• Maternal depression
• Fear by caregiver
• Rejection by caregiver
• Child was sexually abused
• Mother was sexually abused
• Access/Exposure to pornography

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Normal Sexualized Behaviors

• Playing doctor
• Masturbation
• Having a sense of modesty, enjoys own nudity
• Using elimination words with peers
• Curious about genitals
• Touch their private parts in public
• Look at nude pictures
• Interested in sexual content in media

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Problematic Sexualized Behaviors

• Puts mouth on sex parts
• Puts objects in vagina or rectum
• Masturbates with objects
• Touches others sex parts after being told no
• Touches adults sex parts

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Problems Continued

• Asks to engage in sex acts
• Imitates intercourse
• Undresses other people
• Asks to watch sexually explicit television
• Makes sexual sounds

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• Problematic sexual behavior is a frequent,
  repeated behavior vs. sexual play that is
  exploratory and spontaneous

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Contributing Factors

• According to Friedrich (2007) the contributing
  factors that cause a child to act out sexually on
  another child are largely due to four factors.

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Four Factors

• Cumulative stress (total stress load not
  individual stressors)
• Modeling of coercion
• Tendency toward externalizing behaviors (i.e.,
  biological and attachment)
• Disturbed sexual relating

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• For a child to act out sexually his/her
  cumulative stress must be combined with insecure
  attachment and repeated experiences of abuse
  and/or observing adults abuse each other.
• Friedrich, W (2007). Children with Sexual
  Behavior Problems, WW Norton, New York.

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• Additionally, children that experience this
  cumulative stress early in life are less able to
  manage their emotions and behaviors making it
  almost impossible for them to soothe themselves
  (self regulate) when upset. Add to that the fact
  that these children are mostly impulsive, ADHD
  children and you find that what started as self
  stimulation to soothe leads to touching others.

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Need for Service

• Jacobi Medical Centers Family Advocacy Program
  (FAP) who provides services to child victims of
  sexual and physical abuse realized the need for
  specialized services to address the unique needs
  of the families of these children.

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Need For Service, Cont

• We are the only program in the Bronx working
  specifically to address sexually reactive
  behaviors.
• Most treatment programs provide services to
  adolescents, and even those are scarce. There are
  very few in all of NYC that work with children
  under the age of 12.

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• With the generous support of the Childhood World
  Foundation, FAP was able to realize their goal.

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Treatment Model

• Child Centered Relational Family Therapy based
  on the Ackerman Institutes Relational Family
  Therapy. The Ackerman Institute is a highly
  regarded Family Therapy training and treatment
  program in NYC. With the generous support of the
  World Childhood Foundation, the Ackerman
  Institute provides monthly individualized
  training and consultation

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• The model is a unique family therapy model
  that incorporates individual and family therapy
  into the treatment. The purpose of the model is
  to allow open dialogue between child and
  caregiver.