“My child touches himself every chance he gets! At daycare, the mall, church — anywhere!”
There is no single parental anxiety I hear voiced more often than a variation on the above statement — concern that a child is exhibiting sexual behaviors. These behaviors can vary from touching one’s self to touching someone else, exposing one’s self to others to drawing or discussing body parts. It isn’t surprising that these behaviors should spark such concern in a caregiver. It wasn’t that long ago that sexual behaviors were thought to be a strong indicator that a child had been sexually abused. We now know this is generally not the case.
The reality is that sexual behaviors are incredibly common in children. It is estimated more than half of children will engage in some type of sexualized behavior during childhood, and these behaviors are often a normal part of childhood development. If discovered, the child certainly may be embarrassed, but rarely does the child experience deep anger, shame or fear.
While it is normal for parents to be anxious, it is important to calmly redirect the behavior when seen and provide education to the child about body parts and body safety. When handled this way, normal behaviors tend to diminish, if not disappear altogether. All of these behaviors, of course, are influenced by what the child experiences in the home. You can imagine how the birth of a sibling, viewing a family member in the restroom or witnessing a mother breastfeeding an infant could each provoke a child to ask about or imitate what they are seeing.
When to Seek a Consultation About a Child’s Sexual Behavior
So when should a caregiver be concerned? A few general “red flags” for me include:
Situations when the children involved in sexualized behaviors are of different developmental levels or different ages (4 or more years difference as a guideline)
Situations where the children involved do not have an ongoing mutual play relationship
Behaviors that involve force or aggression
Behaviors that are intrusive (genital-genital contact, genital or anal penetration)
Behaviors that result in significant distress or pain.
Seeing a child engage in some type of sexual behavior scares many of us as parents. because it is difficult for us to separate our knowledge and attitudes about sex from what our children know and believe. I encourage parents to talk to each other about their children’s behavior — sexual or otherwise. Sometimes hearing from trusted friends that you aren’t alone as a parent and that your child’s behavior isn’t abnormal is incredibly reassuring. Likewise, realizing that a child’s behaviors are different from his or her peers will prompt the caregiver to seek further help.
I recommend to anyone interested in learning more about this topic to read Dr. Nancy Kellogg’s clinical report on “The Evaluation of Sexual Behaviors in Children.”
Jonathan D. Thackeray, MD is the former chief of the Division of Child and Family Advocacy at Nationwide Children’s Hospital and associate professor of clinical pediatrics at The Ohio State University College of Medicine.
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