Key findings 

• Of the 198 children or young people who took part in the service between March 2013 and August 2015:
  • 28 were female;
  • 69 were males aged 11 and under with no learning difficulty;
  • 101 were males with a learning difficulty (not all formally diagnosed).
• In more than 85% of cases, the harmful sexual behviour (HSB) displayed by these children or young people was directed towards one specific person.
• Compared with adolescent boys (as identified in the study by Hackett et al, 2013), children or young people in these groups more often displayed HSB towards family members and less often towards children younger than themselves.
• Compared with the girls and younger boys in our study, boys with a learning difficulty were most likely to have abused someone outside of their family and were less likely to have abused a family member.
• Compared with the younger boys and boys with a learning difficulty in our study, girls were most likely to behave in a sexually harmful way towards multiple people, and have varying relationships to them (such as both family and nonfamily members).
• Research exploring the trauma, wellbeing, behaviour and wider sexual behaviours of a sub-sample of 74 children or young people found they had a range of emotional, behavioural and peer-related difficulties alongside their HSB. As such, it is worth considering that the child’s HSB represents another form of externalising behavioural difficulties, and that their externalising (“acting out”) and internalising (such as anxiety and depression) difficulties may stem from the same issue, such as their own trauma and/or abuse.
• Many of the children or young people indicated experiencing some level of trauma. A flexible service delivery model may, therefore, be required so that assessment and intervention can focus on the child’s own trauma and associated symptoms alongside their HSB.
• A holistic approach to assessment is needed to incorporate the views and experiences of children or young people, their parents and carers, people and professionals within their wider network, and to gain information from standardised measures. This will allow practitioners to formulate interventions focused on the child's or young person’s wide-ranging needs associated with their HSB.
• A holistic, multi-agency approach to intervention is needed, acknowledging and addressing the range of emotional, behavioural and peer-related difficulties faced by these children or young people. It may also need to be tailored specifically for younger children and children or young people with a learning difficulty.