Know

Consider your thoughts so far regarding sexual behavior challenges. Are you wondering what could have happened to a student to make them act out sexually in a problematic way? Or what futures look like for a student who is having sexual behavior challenges? How can you support them and their families? We explore these topics as we move through this lesson.

Variability of Causes for Sexual Behavior Challenges & Other Concerns

As you learned in Lesson Four, sexual behavior challenges can affect students for many different reasons. These behaviors can be a result of sexual abuse; however, this may not always be the case. If you suspect sexual abuse, or a student reports that they have been sexually abused, or if a student has been in contact with a known sexual abuser, it is important to make a mandatory report.

As educators, it is important to know the signs of sexual abuse in students, but it is also important to be aware of other potential risk factors for sexual behavior challenges. Students who have不是been sexually abused can also present with sexual behavior challenges. Consider a student with developmental delays who is struggling to learn personal space and may inappropriately touch themselves or others. Or maybe a student repeats the sexually explicit material seen on TV after an older sibling left the TV on. Students may also display sexual behavior challenges such as self-soothing through masturbation in response to traumatic events. These are all examples of paths to sexual behavior challenges that do not involve sexual abuse.

If a student experiences these challenges or needs, communicate your concerns with your school leadership. They will help decide next steps to take, including contactingPUBLICa specialistand communicating with the family about resources and supports. Communicating early and working as a team provides the family with options for support and can prevent a student with risk factors from developing sexual behavior challenges.

Potential Intervention Options

As educators, it is beyond our scope of practice to provide mental health services for students who present with sexual behavior challenges. However, you should be informed on intervention options for sexual behavior challenges available to students and their families. It is important to be aware that different programs and schools refer to these resources by various names. For example, mental health professionals can include counselors, psychologists, psychiatrists, or social workers. These professionals may provide counseling, therapy, intervention, or treatment. Certain settings may also include specialists, such as board-certified behavior analysts, occupational therapists, and intervention specialists. In learning about the various types of providers, you should be able to identify who the point persons in your school are for questions related to sexual behavior challenges. If you do not know, seek out this information.

家庭应收到关于性发展，童年和青少年发展的提供商的干预，以及基于研究的干预措施（NTCSN，2009）。心理健康专业人士将考虑差异诊断，并在儿童或青年期间看起来是全面的，考虑到他们的环境，育儿风格，家庭和社会因素。每项评估都是独一无二的，治疗决定是对逐个案例的旨在最小的限制性治疗选项​​（Martin，2019）。性行为挑战的两项基于研究的实践是创伤 - 认知性行为治疗（TF-CBT）和有问题的性行为 - 认知行为治疗（PSB-CBT）。

During the child or adolescent’s initial assessment, the mental health provider may ask that you, as the educator, contribute to your student’s assessment. Often, you will be provided with a questionnaire or checklist to complete. In addition to other assessment materials, your information helps the mental health professional make a recommendation for outpatient or more intensive therapy, such as inpatient or residential care, depending on the severity of the behaviors, the presence of additional mental health concerns, or previous unsuccessful treatment.

As intervention progresses, the mental health provider will work with the child or adolescent and with the family, possibly in individual or group and family therapy formats, to create a developmentally appropriate intervention plan. Often, counseling will consist of, but is not limited to, identifying and establishing healthy boundaries, self-regulation skills, and parent management training. Here are some examples of what intervention for sexual behavior challenges may look like based on the recommendations of a mental health professional:

• The student who mimicked sexually explicit acts when their older sibling left the TV on may be recommended to have weekly outpatient intervention that includes all the family members to help establish healthy boundaries and parent management.
• The student with developmental delays presenting with inappropriate touching may benefit from outpatient counseling two to three times a week to help parents and the child or adolescent establish healthy boundaries and self-regulations skills and to address other areas of need.
• 由于创伤事件而自我抚慰的学生可以在半天的门诊环境中供应，以学习应对他们的创伤压力响应以及何时何地探索其性行为的适当时间。如果在这种密集的门诊环境中，心理健康专业人员识别孩子或青少年的家庭生活是危险因素的更多，或创伤比最初诊断的更强烈，它们可以转移到住院患者或住宅护理设施中。根据设施，儿童或青少年可能与家人的互动有限，并增加每日结构，可以包括个人和团体咨询的定期治疗干预措施。虽然孩子或青少年的干预计划是保密的，但要意识到你作为教育者可以做些什么来帮助孩子或青少年，特别是在他们重新融入你的教室时，这是至关重要的。

Incorporating Intervention Strategies

对于具有性行为挑战的学生继续上学，除了收到干预外，可能会要求您遵循建议。其中一些建议可能是您作为课堂管理的一部分，以支持积极监督的一部分。心理健康专业人士可以要求您将策略纳入日常惯例，以加强学生在干预期间学到的内容。据手套，锡耶尔和锡洛夫斯基（2017年）介绍，讨论有关性行为的规则是一种可以防止性行为挑战的策略。在与学生讨论此类信息之前，与家庭进行沟通也是适合的，以便在提出信息后，如果在主页中出现问题或意见时，家庭不会被篡改。以平静的方式提出信息，有助于学生在讨论敏感主题时更加开放。

Schools are charged to keep all students safe. To address this concern, you may be asked to provide additional supervision for students receiving intervention for sexual behavior challenges. This may look like creating a supervision or safety plan with the students’ families and school administrators to ensure the safety of all students. This is especially important if the child or adolescent exhibited sexual behavior challenges toward other students. Also know that when a sexual behavior challenge has occurred, your school leadership will consulta specialist。根据专家，在制作转诊时可能存在滞后时间the specialistis able to consult or complete an evaluation of the student. In this instance your school’s leadership will put a temporary supervision plan in place until given further guidance.

Supervision plans can include:

• Line-of-sight supervision
• 支持ive shadowing (one-on-one)
• Line-of-sight supervision or supportive shadowing of the student upon arrival, during recess and lunch, and upon departure
• Supervision of the student during other times of the day that are less structured or have reduced supervision
• Designated play areas
• 监督学生使用洗手间
• Supervision for sports, including changing areas (e.g., for swimming)
• Procedures for the student to check in with a designated adult throughout the day
• A plan for responding to subsequent inappropriate sexual behavior, which may include a set of escalating consequences
• 具体行为管理策略，包括加强适当行为的计划
• A plan to involve the student in positive activities with peers
• A communication plan that specifies how and with whom information will be shared
• 指定的案例经理
• A scheduled review and update of the plan
• Clear communication of rules
• implementation of coping or calming skills, including those for the educator similar to CAPPD model inLesson Oneand the self-care strategies in the Focused Topics course, Trauma-Informed Care,Lesson Four

It is important that the safety or supervision plan is periodically reviewed as the student progresses in their intervention (Responding to Children’s Problem Sexual Behavior in Elementary Schools, 1999).

School Interventions

Schools can implement policies and preventive measures to address sexual behavior and be a supportive factor for students with sexual behavior challenges by:

• Reviewing policies regarding communication about sex education, promoting abuse prevention, and working with families affected by sexual behavior challenges.
• Offering sex education for families to incorporate the entire support system to engage in healthy communication about appropriate sexual development.
• Looking to school counselors or collaborate with clinical counselors to implement classroom lessons on healthy boundaries, self-regulation skills, and safe touch. School and clinical counselors can also help meet individually with students or with families to assist with supervision plans and discuss counseling referrals.

See

Interventions to address sexual behavior challenges are individualized and based on the specific needs of each student. When working in multidisciplinary teams, both within the school setting and when collaborating with professionals outside your school, you will contribute what you know about students’ strengths, challenges, and development so teams have in-depth information to inform the assessment and intervention plans. Listen as experts speaks about the assessment process and research-based interventions for students with sexual behavior challenges.

Assessing Students with Sexual Behavior Challenges

性行为挑战的干预措施

Do

As you think about your role as a professional working with students, reflect on what you can do to be a part of a supportive team. Reflect again on your personal biases of working with students experiencing sexual behavior challenges and how these biases have an impact on the support you provide. Consider these guidelines and standards of care for professionals working with children and adolescents who exhibit sexual behavior challenges provided by the National Center on the Sexual Behavior of Youth:

• Recognize the importance of your work for promoting community and family safety.
• Be aware of the potential for significant impact and life-altering consequences that your practices may have on youth and their families.
• Inform children, youth, and their families that professionals are mandated reporters of child abuse.
• Ensure that your student is fully informed, in developmentally and cognitively appropriate language.
• 随着家庭的同意，与外部专家和机构合作，因此学生的干预感觉就像团队努力。
• Follow relevant practice guidelines and ethical standards (e.g., Association for the Intervention of Sexual Abusers’ standards and guidelines, as well as those of your profession).