Parents should not worry when their young children touch themselves, seem interested in nudity or sit a little too close to others, as long as the behavior does not occur all that often and the child can be distracted from it, according to a new report by the American Academy of Pediatrics.
On the other hand, children who openly imitate intimate sexual acts, engage in sexualized play with peers who are much younger or older, or act out sexually may need further assessment or intervention, according to the report, published this week in the journal Pediatrics.
The full report, including a table of “normal, common” behaviors, “less common normal” ones, “uncommon” ones and “rarely normal” behaviors, became available Monday at the journal’s Web site. Carole Jenny, head of the academy’s committee on child abuse and neglect, which issued the report, said it was an attempt to help doctors respond to questions from parents and caregivers.
“There are behaviors that are clearly normal and there are others that raise more concern,” Jenny said. “The question is to sort that out and help the pediatrician figure out which issues are normal and which require follow-up. Pediatricians have been wanting direction, and this in an effort to provide some direction.”
The report focuses primarily on children between ages 2 and 6.
“Some behaviors that are reported as problematic by the parent may be normal for the child,” the report says, and the pediatrician can offer the parent “reassurance and guidance regarding appropriate responses.” On the other hand, “If sexual behaviors are escalating, frequent, or intrusive, a more comprehensive assessment and treatment may be needed.”
For instance, the report says it would be entirely normal for young children to be interested in seeing siblings, peers or even adults naked. It is also normal for children of this age group to want to show off and touch their own naked bodies.
Preschool-aged children are naturally inquisitive and undergo periods of enhanced awareness of their environments,” according to the report. “Recognition of gender differences occurs during this time and contributes to inquisitive viewing and touching of other children’s genitals. This curiosity-seeking behavior tends to occur within the context of other similar, nonsexual explorations.” As a result, parents and caregivers should not be worried about this behavior and can either distract their child or discourage the behavior.
On the other hand, children who participate in sexual behaviors with children four or more years older or younger, or who display a variety of sexual behaviors on a daily basis and who become angry if they are distracted fall into the “rarely normal” category and should be further examined to see what may be happening in their homes or elsewhere in their lives.
Sexual behavior problems in children are significantly related to living in homes in which there is disruption because of poor health, criminal activity, or violence,” the report notes. “The greater the number of life stresses… the greater the number and frequency of sexual behaviors observed in children.”
Between these two extremes, Jenny said, are a “reasonable range of behaviors” that do not signify sexual problems or abuse, and how parents or caregivers respond tends to depend on their attitudes. “Some families are much more uptight about these things. It really varies from family to family,” she said.
The report also says that “the variety and frequency of sexual behaviors” increase in young children up to the age of 5 and then decreases gradually after that.
However, it notes that parents may simply be watching their children more closely before age 5 and that “younger children are less aware of breaches in personal space and how their behavior may be construed as sexual or inappropriate.”