Harmful sexual behaviour by children and young people: Expert Group report

Chapter 6: Theories and Practice of Prevention

The examination and understanding of HSB involving children and young people is a large and developing practice base. It is a contested area with sometimes competing definitions and perspectives.

Most prevention strategies around HSB (as with strategies around other societal concerns) are premised on particular theoretical standpoints. It is therefore important to be clear on the underlying premise of strategies and to appreciate that there are inevitable tensions when it comes to the prioritisation and resourcing of these.

Scotland uses a three-pronged approach. No single approach is deemed 'better' than the others; the combination is widely recognised as being needed in order to provide successful outcomes at individual and societal levels.

• Public Health - the emphasis is on the health, safety and wellbeing of populations as a whole. There is a focus on intervention with individuals as necessary, but also a focus on prevention and ascertaining underlying risk factors that increase the likelihood that individuals will experience HSB or display HSB if the risk factors are not addressed. More recently, ACEs have been identified as risk factors and in need of preventative measures.
• Gendered Analysis - the emphasis is on gender equality. Sexually-abusive behaviour is viewed as an individual manifestation of a structural problem with social-cultural dimensions. The approach to prevention emphasises the changing of culture, wider social attitudes, and norms, thereby disrupting the drivers of abuse.
• Psychological - the emphasis is on disruption or dysfunction in psychological processes at an individual level, with a focus on intervention.

The following diagram^[111] suggests a potential range of preventative responses for consideration at primary, secondary and tertiary level.^[112] When considering the annotations on the diagram it should be noted that the term 'Sex Education' is not a term used in Early Learning or in school settings in Scotland. Rather than being referred to in isolation, it is part of 'Relationships, Sexual Health and Parenthood (RSHP)'^[113], reflecting the importance of building trusting relationships, as well as sexual health.

Infographic:

Infographic text:

All children

Few children

Primary

• Sex education
• Child sexual abuse prevention education

Secondary

• Early intervention for children displaying lower-level problematic sexual behaviours or attitudes

Tertiary

• HSB assessment
• Parent education
• General therapeutic help
• Specialist therapeutic help
• Criminal justice response

Primary Prevention

Primary prevention is the largest area of preventative work, because it covers all children and young people.

"In the public health framework, primary prevention means reducing the number of new instances of intimate partner and sexual violence by addressing the factors that make the first-time perpetration of such violence more likely to occur. Primary prevention therefore relies on identifying the 'upstream' determinants and then taking action to address these."^[114]

"Primary prevention is about preventing violence before it occurs. Our approach focuses on changing behaviour, building the knowledge and skills of individuals, and ultimately delivering a progressive shift in the structural, cultural and societal contexts in which violence occurs. This is complemented by our ambitions in achieving gender equality and eradicating poverty, which will make a critical contribution to ultimately preventing and eradicating violence against women and girls for good. Adopting this approach challenges the notion that violence against women and girls is inevitable and suggests an approach which can contribute to realizing our ultimate vision. It aims to change societal attitudes, values and the structures which produce inequality. In particular, it requires a step change in the attitudes which condone and excuse violence against women and girls, which enable perpetrators to deny the reality of what they are doing and place the blame on their victims. It raises fundamental questions about the way our society is currently organized."^[115]

Primary prevention entails universal access to sets of generic materials and engagement opportunities. It requires to be age, capacity, and gender-appropriate, as well as providing signposting to where individuals could seek further support, as required.

Primary preventative tools are needed for:

• Children and young people
• Parents and carers
• Professionals involved in delivering services around safety, health and wellbeing for children and young people, including:
  • Staff in early learning and childcare settings, primary and secondary schools
  • Staff in further and higher education
  • Health care professionals
  • Police
  • SCRA
  • Prosecutors
  • Social workers, support workers and youth workers, including people working in statutory and third sector organisations with children and young people.

The knowledge and expertise of some specific professionals will always be required to support the very small numbers of children and young people who become involved in the most serious HSB.

However, all children and young people have groupings of adults who come into contact with them frequently throughout their childhood and adolescence, including adult family members, Early Learning and child care providers, teachers and staff in primary and secondary schools. This can continue through to Apprenticeships, College and University.

Role of Family in Prevention

Families come in all shapes and sizes. Parents and carers have a key role in preventing many forms of harm which may threaten their children, including those that might be caused by sexual behaviours of other children and young people, as well as those that may be caused by self-harming sexual behaviours of their own child.

Prevention includes making sure that children are aware of what to do if they feel uncomfortable or threatened by the behaviour of others. Parents and carers need to know how to access information and support their children to do that; and how to seek early interventions to support children and young people affected by HSB. This ranges from promoting resilience and relationships skills, through to more specific interventions such as education about consent and supervision, and obtaining support and monitoring to ensure recovery if HSB has occurred.

There is a wealth of information available online regarding internet risks and safety, about healthy personal relationships and what might cause concern about a child or young person's behaviours, or about the general social environment around children and young people, for a parent or carer. However, the volume of material available can be overwhelming.^[116]

It is not always clear which information or advice available online is relevant to a Scottish context, or has been evaluated as being reliable.

Role of Professional Educators in Prevention

The universal services (Health, Education, Justice, and Child Protection) are all recognised as having a role in prevention and early intervention to avoid harm to children, but it is in early years, primary and secondary school settings that the majority of children come into contact with professional adults most frequently.

Early learning and childcare settings, primary and secondary schools have a clear role in prevention through providing a rich environment for proactive intervention, promoting resilience and providing positive role models, creating a culture where respectful attitudes and behaviour are the norm. Examples include helping children develop the skills to make and maintain friendships, and learning and implementing coping strategies for life, such as assertiveness skills.

At all levels, effective prevention means that attention needs to be paid to an individual child's wider needs, as outlined within GIRFEC. Seeing the child as being integrated in and across multiple systems that have direct and non-direct influences on them and their behaviour offers opportunities for learning to be more meaningful through their everyday life.

Interventions will not be labelled 'HSB therapy' and will not necessarily relate solely to sexual behaviours. They can be of multiple types and include one-to-one work, skills training, educative inputs, and mentoring, etc. Within this approach, schools in particular can have a significant role for children who have engaged in or been affected by HSB. Gilligan (2000) captured the important place schools and teachers can have in children's lives including as ally, capacity builder and secure base.

The benefits of working with a child's family are well recognised.^[117] Engaging effectively requires a particular sensitivity and understanding of how these issues impact on families' functioning and subsequent responses to agencies.

Contribution to Primary Prevention in Early Learning and Childcare Provision, Primary and Secondary School

Early learning and childcare settings, primary and secondary schools are places where almost all children and young people come into contact with educational professionals. School is the biggest interface with a statutory authority for Scotland's children and young people. Adults who teach children and young people play a significant part in creating safe learning environments, providing pastoral care as well as academic engagement.

Primary prevention needs to engage boys and girls (and other genders) as active agents in changing culture, and is likely to be most effective in settings where there is a strong ethos of children's rights and participation. The children and young people's consultation for the Equally Safe delivery plan identified a range of priorities for tackling gender inequality and social attitudes including for the education system to work alongside children and young people to address gender inequality and gender-based violence, and for all teachers to be trained on gender equality from nursery to university, from qualification and throughout continuing professional development.^[118] Examples of primary prevention programmes currently used in schools in Scotland is highlighted in Annex G.

Curriculum for Excellence

Curriculum for Excellence^[119] (CfE) is intended to help children and young people gain the knowledge, skills and attributes needed for life in the 21st century, including skills for learning, life and work. Its purpose is often summed up as helping children and young people to become successful learners, confident individuals, responsible citizens, and effective contributors.

Learning delivered in the Health and Wellbeing (HWB) parts of CfE aims to ensure that children and young people develop the knowledge and understanding, skills, capabilities and attributes which they need for mental, emotional, social and physical wellbeing now and in the future.

Within HWB, 6 specific topics are referred to as 'organisers'. Three of the organisers are most relevant for prevention of HSB:

• Mental, emotional, social and physical wellbeing
• Planning for choices and changes
• Relationships, sexual health and parenthood

Those highlighted in bold are categorised in the guidance as 'Responsibility of All'. This means that engaging in learning with children in these areas is the responsibility of all teachers registered with the General Teaching Council of Scotland, and that the teachers are required to evaluate the progress of each child based on 'Experiences and Outcomes' within Responsibility of All. In addition, practitioners delivering Personal and Social Education (PSE) should assess progress at each level for the other organisers within HWB. Benchmarks have recently been published to support practitioners' understanding of what children should know and be able to do at the end of each level.^[120]

As part of the Scottish Government's Mental Health Strategy 2017-2027^[121], a review into PSE in schools was carried out during 2018. The review included looking at pastoral care and counselling services. The final report from the review^[122] (published in January 2019) included 16 recommendations linked to improving learning experiences in PSE, ensuring that the experiences are of a consistently high standard and updated to reflect guidance and key messages around issues such as healthy relationships and consent.

In addition, a resource co-created with teachers and third sector organisations is currently being developed. The RSHP.scot website will provide up-to-date, age-appropriate learning and teaching resources for children and young people from Early Learning to the 4th level of CfE in areas such as consent, abuse and relationships, social media, and pornography, including support for sharing learning with parents and carers. There will be separate resources for parents, carers and those working with children and people with additional needs. This was formally launched in September 2019.

Discussions about sexual health and relationships can contribute to primary prevention by exploring gender roles and stereotypes with young people and their relationship to sexual violence - in particular discussions around cultural influences that are negative in nature and associate masculinity with dominant and aggressive sexual behaviour (conveyed particularly through pornography) and femininity with a more subordinate role. Young people can instead be supported to navigate relationships based on consent, empathy, mutual pleasure and equality.

Discussions around gender can be conducted in a way that includes and engages boys as well and girls, inviting them to be part of the solution in tackling gendered violence, and addressing the negative impacts of such violence on boys as well as girls and people of other genders. Where scenarios are used in educational settings, these can include abuse of boys and men as well as girls and women, explore specific impacts and ensure clear signposting to inclusive services. Scenarios and examples should include LGBTI people and those in same sex relationships, as well as other factors which can influence power dynamics within relationships, such as disability and ethnicity.

Practitioners can help to tackle some of the underlying social attitudes which excuse or condone sexual violence by giving clear messages that young people are never responsible, in whole or in part, for sexual violence that they experience. It is important to make sure that discussions of risk do not obscure the fact that the main message remains that young people are entitled to expect appropriate behaviour from others, and not that they have to restrict their own appropriate life choices because of the potential of inappropriate behaviours of any other person.

Role of Third Sector Organisations and Primary Prevention in Schools

Many schools make use of additional inputs from a variety of Third Sector specialists such as Barnardos, Scottish Women's Aid, and Rape Crisis Scotland. Feedback from these additional inputs is generally very positive from teachers and pupils.

Provision tends to be in secondary schools only, although this is not routinely available across Scotland. In addition, there is a lack of consistent access to inputs from different providers. Where inputs are available that have been designed specifically for delivery at different points throughout a pupil's secondary education, these are often received only at one point and not progressively throughout a child and young person's education, rather than originally planned for.

Rape Crisis Scotland currently receives funding from Scottish Government to offer a National Sexual Violence Prevention Programme with seven topic areas aimed at four secondary school age groups.^[123]

This particular programme is delivered to schools in all local authority areas by 14 Rape Crisis Centres.^[124] It is one of the few primary prevention interventions offered by a Third Sector organisation that has been independently evaluated following a pilot project that took place in 9 schools.

Feedback from pupils and teachers about the project was evaluated as showing that the sessions had improved knowledge and attitudes around healthy sexual and relationship behaviours. Input from that programme is received by approximately 18,000 young people across 150 secondary schools, with a programme that usually ranges from one to three workshops planned in liaison with schools, most often including the topic of 'Consent', 'What is Sexual Violence', and 'Sexualisation'.

Guidance for teachers on the conduct of teaching relationships, sexual health and parenthood education within the Curriculum for Excellence, published in 2014, is currently being updated to reflect changes in light of the effects of societal changes such as social and digital media.

Internet Safety Contributions to Primary Prevention

The 2018 Ofcom report^[125] into children's media use and attitudes highlights:

• Social media can bring a combination of social pressures and positive influences. Children are still being exposed to unwanted experiences online, but almost all recall being taught how to use the internet safely;
• There has been an increase in parents of 12-15 year-olds and of 12-15 year olds themselves saying that controlling screen time has become harder; however most young people aged 12-15 consider they have a struck a good balance between this and doing other things;
• Parental concerns about the internet are rising, although parents are, in some areas, becoming less likely to moderate their child's activities.

Young people aged 12-15 who use social media or messaging sites / apps are aware of some of the social pressures and negative associations with this use, with 78% feeling pressure to look popular and 90% saying that people are mean to each other on social media, at least 'sometimes'. These pressures are particularly felt among girls.

Going online can expose children and young people to unwanted experiences. One in eight 12-15 year-olds said they had been bullied either face to face or on social media. 9% said they had been bullied through messaging apps or by text, an increase from 5% in 2017.

The Ofcom study found that 16% of children aged 8-11 who go online have seen something online that they found worrying or nasty, but at 31%, 12-15s are nearly twice as likely to have experienced this.

Controls around internet providers are not devolved to the Scottish Government but reserved to the UK Government. Both work closely together, and with the other devolved administrations, on issues around internet use.

Under the Digital Economy Act 2017, all online commercial pornography services accessible from the UK are required to carry age-verification controls to prevent children from seeing content that is not appropriate for them. These services mainly take the form of websites and apps, and should not carry extreme pornography.

The UK Government has appointed the British Board of Film Classification^[126] as the Age-verification Regulator because of its long and proven experience in classifying films, videos, websites and more, and its knowledge of online regulation. The age-verification requirements are designed to ensure that if a child stumbles across a pornographic website, they will not be able see any unsuitable content.

While development and enforcement of such prohibitive technologies have a role in preventing children and young people from exposure to inappropriate content on specific websites, these technologies will not address the type of internet-enabled harm that occurs as a result of digital technology being used for HSB by children and young people communicating with other children and young people, or access to some of the most extreme and illegal content.

The following diagram (taken from the Ofcom report) provides a snapshot of how our children and young people use and interact with media devices and services, according to age.

Infographic:

Infographic text:

3-4s

• 1% have their own smartphone, 19% have their own tablet
• 96% watch TV on a TV set, for 14h a week
• 30% watch TV on other devices, mostly on a tablet
• 36% play games, for nearly 6 1/4h a week
• 52% go online, for nearly 9h a week
• 69% of these mostly use a tablet to go online
• 32% watch TV programmes via OTT services (like Netflix, Now TV or Amazon Prime Video)
• 45% use YouTube, 80% of these say they use it to watch cartoons while 40% say funny videos or pranks
• 1% have a social media profile

5-7s

• 5% have their own smartphone, 42% have their own tablet
• 97% watch TV on a TV set, for around 13 1/4h a week
• 44% watch TV on other devices, mostly on a tablet
• 63% play games, for around 7 1/2h a week
• 82% go online, for around 9 1/2h a week
• 67% of these mostly use a tablet to go online
• 44% watch TV programmes via OTT services (like Netflix, Now TV or Amazon Prime Video)
• 70% use YouTube, 65% of these say they use it to watch cartoons while 61% say funny videos or pranks
• 4% have a social media profile

8-11s

• 35% have their own smartphone, 47% have their own tablet
• 94% watch TV on a TV set, for nearly 13h a week
• 43% watch TV on other devices, mostly on a tablet
• 74% play games, for around 10h a week
• 93% go online, for around 13 1/2h a week
• 45% of these mostly use a tablet to go online, with 24% mostly using a mobile
• 43% watch TV programmes via OTT services (like Netflix, Now TV or Amazon Prime Video)
• 77% use YouTube, 75% of these say they use it to watch funny videos or pranks while 58% say music videos
• 18% have a social media profile
• 40% who own a mobile are allowed to take it to bed with them, it’s 28% among tablet owners

12-15s

• 83% have their own smartphone, 50% have their own tablet
• 90% watch TV on a TV set, for around 13 1/4h a week
• 62% watch TV on other devices, mostly on a tablet or mobile
• 76% play games, for around 13 3/4h a week
• 99% go online, for 20 1/2h a week
• 53% of these mostly use a mobile to go online, with 23% mostly using a tablet
• 58% watch TV programmes via OTT services (like Netflix, Now TV or Amazon Prime Video)
• 89% use YouTube, 74% of these say they use it to watch funny videos or pranks with same proportion saying music videos
• 69% have a social media profile
• 71% who own a mobile are allowed to take it to bed with them, it’s 61% among tablet owners

Scotland's National Action Plan on Internet Safety for Children and Young People

The Scottish Government is planning to publish a progress update on the Scottish National Action Plan during 2019, which will highlight actions being delivered to support children and young people, parents and carers and professionals in building their own resilience online.

The Police Scotland Web Constables programme was established in January 2015. This is a national network of more than 400 'Web Constables' including Local Policing officers who are equipped to deliver localised online safety messaging. They support Local Ambassadors who can pass on internet knowledge and skills in local communities.

The Be Smart Peer Mentoring Internet Safety Programme was developed to further enhance the effectiveness and reach of the Web Constables/Ambassadors programmes by Police Scotland's Safer Communities department in consultation with Trend Micro (Global online security experts). Its interactive format encourages young people to talk openly about online matters and aims to promote the positives of the virtual world whilst encouraging young people to consider the risks and consequences of their online behaviour. Some schools, youth organisations and colleges are using the programme to raise awareness, and enhance protection and prevent cyber related crime.

Use of Social Marketing as a Method of Messaging

Positive messaging is recognised as a way to encourage uptake of preventative actions. Any prevention work, including awareness raising, specific programmes in education or elsewhere and the work that individual professionals contribute toward prevention in their day-to-day work, should take into the account "the big mistake". That is where the use of descriptive norms (such as "lots of people do X") can inadvertently reinforce an undesirable behaviour. For example, a campaign to reduce fraud provided people with information that such behaviour was possible and how they might personally benefit from fraud.^[127]

Behaviour change and social norms theory suggests that trying to shock people with daunting figures about the scale of a problem can also fail or backfire simply because of the suggestion that the unwanted behaviour is commonplace. This means that the behaviour is perceived as being more normal and less wrong, and also acts as a "magnet", whereby people are more likely to decide to engage in that behaviour.^[128]

One example of this comes from widely shared statements of concern about how common it is for children and young people to 'share' intimate images. The 2010 EU Kids online survey found that 4% of 11-16 year olds had sent or posted sexually explicit messages and 12% had received them; higher proportions have been found in surveys asking about friends rather than their own behaviours.^[129] Where messaging describes image sharing as common behaviour by children and young people it may be both encouraging this behaviour and making it harder for children and young people affected to seek help.

The No Knives, Better Lives prevention work in Scotland developed four Rs to describe messaging strategies that did not fall into the big mistake:

• Risks and consequences - legal risks, but also personal (e.g. impact on self and family if caught);
• Resilience - what we know about why children and young people act a particular way (e.g. fear, status, norm) and how to address these;
• Reassurance - supporting healthy norms (e.g. challenging perception that everyone does this behaviour); and
• Responsibility - empowering children and young people to be agents of change, partners in protection.

The experience of No Knives, Better Lives also identified the importance of giving children and young people the opportunity to rehearse behaviours, to practice and develop skills, as well as unpick attitudes.

The use of marketing approaches, more commonly used for encouraging consumers to purchase commercial products, has been used over several years in Scotland and elsewhere to bring about voluntary behaviour change in a target audience on public health issues. This is described as 'social' marketing and is used within the NHS in Scotland. For example recent campaigns on self-checking for signs of breast cancer, and children worried about parents dying of smoking related diseases have made use of many types of media vehicles to engage with the public in a variety of ways.

A social marketing approach within a framework of health improvement was used to promote positive sexual health for young people in NHS Tayside in 2016. The approach recognised that cultural changes in a rapidly developing environment of new media meant that professionals may not always have a good enough understanding of young people's current lived experience. Targeted message delivery around sexual health was achieved, using social marketing methods, to meet the needs of children and young people and the professionals who engage with them in health and youth work settings.^[130]

A messaging vehicle that is available to all schools is the secure GLOW Network. The GLOW Network can host information in audio and video, as well as documents. It has the capacity to curate materials so that they are only accessed by children and young people of certain ages .The network is open to school staff, and to parents and carers, and could act as a valuable channel for sharing primary prevention messages. It is already used for materials that Police Scotland created for school pupils.

Social media and traditional methods of sharing messages (on public transport, TV, radio programmes and newspapers) and providing advice on where to access further information (and support) need to be used to ensure that as many parents and carers as possible see, hear and understand the messages, know what to do to keep children and young people safe and how to obtain help when that is needed.

The Scale of the Prevention Messaging Required

To plan effectively for implementation of any preventative programme it is essential to know the size and different segments of the population that the messages are to be designed for.

The most up to date statistics on the number of children and young people in Scotland^[131], and best available information on the numbers of professionals engaging with them^[132], highlight the scale of the preventative messaging required and are shown in the following tables/graphs:

Children and Young People in Scotland
Aged 15 and under	917,442
Aged 16 to 24	593,361
Total	1,510,803

Infographic text:

693,251 pupils in 2502 Local Authority schools

• 400,276 in Primary Schools
• 286,152 in Secondary Schools
• 6,823 pupils in Special Schools

Early Learning and Childcare Provision

• 96,549 registrations
• 2544 centres

Independent Schools

• 29,495 pupils
• 74 schools

Teaching Workforce
Publicly-funded schools	51,959
Independent schools	3,689
Total	55,648

Nursing Workforce
Qualified nursing staff	47,203
Qualified midwifery staff	2,954
Total	50,157

Note: There will also be a range of individuals working in Third Sector delivery, Crown Office and Procurator Fiscal Service, Scottish Children's Reporter Administration and courts.

Interventions for Secondary and Tertiary Behaviours: Effective Response and Prevention

As shown in the earlier inverted triangle diagram, illustrating behaviours and the potential range of preventative responses, secondary and tertiary levels of behaviour include more specialised interventions. The more serious behaviours may require referral of the child or young person to the Reporter to the Children's Panel on offence grounds, or to COPFS for consideration of court proceedings.

Secondary and Tertiary Behaviours

While secondary and tertiary categories relate to a very small number of children and young people compared with the population as a whole, they exhibit behaviours of increasing concern.

It is important for public safety for appropriate and timely interventions to be made, and that efforts are directed towards avoiding repetition of harmful behaviour as well as towards improving that child or young person's own life chances.

The fact that the child or young person exhibiting the HSB is in the same school as a child or young person they may have harmed is a particularly difficult scenario for education staff. The issues faced in upholding the rights of all the children and young people involved, those harmed and those causing harm, can be extremely challenging. This will not be helped by the speed with which rumour and innuendo can be shared among children, young people, parents and carers by social media while professionals are trying to investigate the position and make the best arrangements to safeguard all involved.

The need for clear messages regarding who does what when responding to behaviours at secondary and tertiary level is vital.

There are numerous factors that can contribute to children presenting with HSB, and early professional consideration should be given to whether the child is in need of protection. The assessment of, and intervention to work with parents is essential. It is important to generate and explore hypotheses in relation to potential origins of behaviour.

The impact of learning of a child's HSB upon parents and carers should not be minimised. The shock of finding out about the behaviour and subsequent investigation can have a profound impact on family functioning. Many parents report feelings of guilt, failure, shock, embarrassment and humiliation.^[133]

The benefits of working with the child's family are well recognised.^[134] Engaging effectively requires a particular sensitivity and understanding of how these issues impact on a family's functioning, and subsequent responses to agencies.

Interventions do not come as a single fix, labelled 'HSB therapy', and will not necessarily be described as relating solely to sexual behaviours. They can be of multiple types and include one-to-one work, skills training, educative inputs, and mentoring, etc. Within this approach, schools in particular can have a significant role for children who have engaged in or been affected by HSB. Gilligan (2000) captures the important place schools and teachers can have in children's lives including as an ally, capacity builder and secure base.

Secondary Prevention

Secondary prevention may be necessary where there has been behaviour of concern, or an environment combined with other factors signals high risk of potential harmful behaviours. It involves a child's plan^[135] and supports for the child and the family. The plan will prompt screening or assessments. Screening is necessary to assess whether the sexual behaviour is normative or harmful.

If screening suggests that the behaviour is inappropriate or problematic (rather than abusive or violent, which would require tertiary responses) then a brief assessment would be appropriate. That would involve an interview with parents/carers, limited engagement with the child, and a review of collateral sources of information.^[136]

Once all of the sources of information are analysed, decision-making and action about managing and reducing risk should be made. These decisions need to be proportionate to the level of risk presented, taking into account the developmental stage of the child.

There are few specific assessment tools designed for pre-adolescents displaying HSB. Approaches that promote the child's wellbeing and address any adverse childhood experiences or social difficulties will be important. GIRFEC wellbeing indicators can be used to aid any assessment, but the process of getting it right is key: setting up a plan to support the child, ensuring they have the right support at the right time from the right people.

Interventions with children where behaviours are at secondary level will most likely be single agency. Schools, social work or health services are best placed to identify risk factors and to deliver secondary, child-focused interventions.

Steps also need to be taken where no HSB has been reported by the child or young person, but other circumstances suggest that there are risk factors which make it highly likely they and their family require support, such as where a child is exposed to domestic violence in the home and it is suspected that this may also include sexual violence.

Tertiary Prevention

Tertiary prevention describes interventions that are necessary when a child or young person displays HSBs which are violent or abusive. The purpose of responses at this level is to prevent such behaviour escalating or being repeated.

There are a range of tertiary level responses currently in place in Scotland, including proceedings within the criminal justice system, referral to the Children's Reporter, and specific interventions by specialist practitioners.

In most instances behaviours at this level will have been reported to the Police and in turn reported to SCRA and/or COPFS.

The involvement of specialist services can be (and often is) linked to the decisions taken by the Reporter; or by a court as a result of COPFS raising prosecution proceedings.

Interventions by the Reporter to the Children's Panel, Prosecutors and Courts

Legislation on Sexual Crimes

In Scotland at 16 a young person can get married, give consent for sexual intercourse, and vote in local elections. At the age of 17 a young person can obtain a driving license, and at 18 they can vote in a General Election and buy alcohol. These ages are all set by Acts of Parliament.

The Expert Group considered the current position in Scotland with that in other jurisdictions and explored the differing ages when ability to consent to sexual activity is recognised. The PhD thesis of Dr Isla Callander^[137] and fact finding by the Secretariat were helpful to the Expert Group in this.

A considerable amount of legislation in Scotland makes certain sexual behaviour criminal depending on the ages of the people involved. Much was primarily intended to protect children and young people from harmful sexual behaviour by adults. However, the same legislation criminalises consensual sharing of sexual images of a person under 18 as well as many physical contact sexual activities by children and young people, regardless of whether both parties are freely willing to engage.

Further detail of the legislation that is often involved applies to complainers or accused under certain ages is set out in Annex B.

Children's Hearing System and Criminal Justice System Responses

There are a number of ways that the most serious types of HSB by children and young people can be addressed by action within the legal system in Scotland:

(i) the child is referred to SCRA for a Reporter to consider whether a children's hearing is necessary;

(ii) the child is reported to COPFS for a prosecutor to decide if the child should be prosecuted in a criminal court; or

(iii) a report on the child is submitted to both SCRA and COPFS

What happens in practice depends mainly on two factors: the age of the child, and the seriousness of the behaviour.

When the Expert Group commenced work in terms of section 41 of the Criminal Procedure (Scotland) Act 1995, the age of criminal responsibility was 8. That meant that no child under the age of 8 could be guilty of an offence, no matter the seriousness of their behaviour.^[138] Section 41A states that a person may not be prosecuted in respect of any offence committed at a time when they were under 12 years of age. Children between 8 and 12 who were suspected of committing an offence could still be referred to the Reporter.

The Age of Criminal Responsibility (Scotland) Act 2019 changes that so that no child under 12 can be guilty of an offence.

Consequently the only formal action for any child under 12 will be initiated by referring to the Reporter.^[139]

For children aged 12 and above (but under 18) there are a variety of routes through the formal SCRA or criminal justice system, depending on the seriousness of the behaviour and, if over 16, whether they are able to be referred to SCRA

Referrals to the Children's Reporter

Most allegations of criminal behaviour by someone over the age of 8 and under 16 years are not prosecuted or sentenced within the adult court system. These allegations are dealt with by the Children's Reporter, who makes a decision about whether a children's hearing is required based principally on issues to do with the child's welfare.

Irrespective of whether the case is considered within the Children's Hearing System or the criminal justice system, it will have to be proved that the behaviour took place, or that the child has accepted that they behaved in that way, before the Children's Hearing or Court set out what will happen to address the harmful behaviour.

Referrals to SCRA for HSB come principally from the police where a young person has been charged with an offence, but may also come from other agencies. In cases referred to the Reporter, the statutory threshold is derived from sections 60 and 61 of the Children's Hearings (Scotland) Act 2011, which in effect state that a referral must be made by the local authority or Police Scotland where they consider:

(a) that a child is in need of protection, guidance, treatment or control, and

(b) that it might be necessary for a Compulsory Supervision Order (CSO) to be made in relation to the child.

Any referral to the Reporter must be made on the basis of a clear understanding and appropriate application of the statutory criteria. "Guidance on Referral to the Reporter - Guidance for Partners" was produced by the Children's Hearing Improvement Partnership for use by referring agencies.^[140]

Where a child is referred, section 66(2) of the Children's Hearings (Scotland) Act 2011 states that the reporter must determine:

(a) whether the Principal Reporter considers that a section 67 ground applies in relation to the child, and

(b) if so, whether the Principal Reporter considers that it is necessary for a compulsory supervision order to be made in respect of the child.

If the answer to both of these is affirmative, then the Reporter must arrange a Children's Hearing to consider the child's case.

The question of whether a section 67 ground applies is one of sufficiency of evidence. If the ground is that the child has committed an offence then the Reporter must be satisfied that there is corroborated evidence that can be argued to show, beyond reasonable doubt, that the child committed an offence. Evidentially, this is identical to that required for a prosecution.

In answering whether a CSO is necessary, the Reporter's approach is based on an assessment framework^[141] that considers (i) the child's development, (ii) parenting, and (iii) family and environmental factors.

What then becomes critical is the quality and extent of the information made available to the Reporter by the referrer. Chief among this is the assessment report, which is compiled by the local authority. The Expert Group heard that issues raised by Reporters about the quality of these reports from local authorities included that some do not have a "basic" assessment on the risk of re-offending, far less a specialist risk assessment tailored for sexual offences.^[142]

Joint Reporting to the Children's Reporter and Crown Office and the Procurator Fiscal Service

There are a number of categories of offence which require to be jointly reported to SCRA and COPFS.^[143] Insofar as the offending concerns HSB, it will require to be jointly reported where either the person who committed it is aged between 12 and 15 years of age and the behaviour is so serious that it would normally be tried before a jury; or the young person is 16 or 17 and either (i) subject to a CSO or (ii) they have a case that is already with the Reporter because a referral was received before they turned 16 and a decision has not been made.

All other cases of HSB by a young person aged 16 or 17 will be reported only to COPFS, and referral to SCRA is not an option.

Where a case is jointly reported, SCRA and COPFS will discuss the case and share information and views regarding the most appropriate decision. The final decision rests with COPFS.

In relation to HSB falling within the first category (serious offending by a child aged between 12 and 15 years old), there is a presumption that the child will be referred to the Children's Reporter. The presumption may be overridden where COPFS has regard to certain factors set out in the Joint Agreement between COPFS and SCRA regarding decision making in cases of children who are jointly reported. These factors include:

• the gravity of the offence, which must be such that prosecution before Sheriff and Jury is required;
• whether there is a pattern of serious offending;
• whether SCRA is currently working to address the child's offending or, if not, whether a suitable service within the Children's Hearing System could become involved to address the offending or offending related needs;
• whether any possible decision by the Reporter could suitably address the needs and behaviour of the child and any risk they present;
• whether prosecution might have an adverse effect on the victim; and
• whether the child has any health or development issues that might indicate that their needs and behavior would be best dealt within the Children's Hearing System.

In relation to HSB falling within the second category (offending by a 16 or 17 year old subject to a CSO or with a live referral before the Reporter), from June 2019 there is a presumption that all children jointly reported - including those aged 16 or over and on a CSO - will be dealt with by the Reporter.

Where the Procurator Fiscal initially considering a jointly reported case of HSB thinks that prosecution should occur, they require the instructions of Crown Counsel to prosecute where the child is under 16.

While COPFS and SCRA are obliged to make contact in such cases at the earliest stage of proceedings to share the necessary information required and the Reporter will provide information required within 5 working days of a request by COPFS, a final decision can take time. This is often due to the nature of the evidence in sexual offence cases where forensic evidence or evidence recovered from devices may play a significant role, or where the interviewing of vulnerable witnesses takes time and may require more than one interview. Carrying out the required analysis and assessing the whole evidence will inevitably take time in many cases.

There can be instances where particularly long periods of time elapse between the date of the alleged offence and a final decision being made on the best way to deal with the case. Sometimes the decision is made to refer it back to the Reporter for a decision on the need for a CSO although the Joint Agreement between COPFS and SCRA clarifies that, before doing so, the Procurator Fiscal must obtain the Reporter's view on whether, taking into account any delay, the needs and behaviour of the child can be addressed by the Children's Hearing System more appropriately and effectively than in the criminal justice system. In such cases, no attempt will have been made to have any discussion with a young person about their behaviour for many months, sometimes for over a year.

Research on the impact of interventions shows that where a young person has engaged in HSB that the sooner intervention commences, the more likely it is that intervention will achieve a positive outcome. From the point of view of those who have been harmed by the behaviour, and who may require to give evidence, it is also desirable that their involvement in any legal process starts and ends as quickly as possible.

For these reasons it is important that decisions about whether a young person's case is dealt with by COPFS or by SCRA are taken as quickly as possible, and if the case is to proceed through the adult court system every effort should be made to reach a conclusion as quickly as possible to allow rehabilitative work to start with all children and young people involved.

Criminal Proceedings in the Adult Court Systems

Alongside increases in the reporting of HSB by children and young people over the past decade, there have been parallel increases in the number of children and young people in the criminal justice system and where risk management regimes are primarily designed for adults.

Charging and prosecuting a child over 12 is sometimes absolutely necessary for public safety^[144], but use of these criminal justice avenues can hinder the recovery of all the children involved.^[145]

UN guidelines indicate that children and young people under 18 years should not be processed in the same systems as adult offenders. Children and young people who are subject to court processes, due to the nature of their offending, are a source of tension between welfare and control. Regardless of this, some young people are dealt with by the adult system and may be subject to Multi Agency Public Protection Arrangements (MAPPA) .^[146]

Her Majesty's Inspector of Prosecution in Scotland^[147] found that in cases of sexual crime where children and young people were tried in adult courts, most of the victims of the most serious sexual offences had vulnerabilities, as did the children and young people causing the harm.

Research into children and young people who cause harm by their HSB provides clear evidence that they are often vulnerable. This does not prevent their entry into the adult justice system and detention in police station, court and large scale prison facilities designed for adults.

Rigby et al^[148] examined how some young people with HSB are dealt with by the criminal justice system and MAPPA in Scotland, as opposed to the Children's Hearing System. They highlighted that the welfare outcomes for children and young people can be impaired when they go through the adult court process (where they are subject to MAPPA and the sex offenders register). The researchers recommended that children and young people could have their needs better met within the Children's Hearing System, because the adult systems are not designed to meet the developmental needs of children and young people.

There are a wide range of procedures which follow reports of children and young people causing harm to other children and young people by their sexual behaviours. These procedures differ significantly depending on whether the circumstances are dealt with through the Children's Hearings System or the Adult Court System.

At present there is no ability to impose bail orders in proceedings in the Children's Hearings System relating to a child or young person accused of offences involving HSB.

For those under 18 who are dealt with in the adult criminal justice system, a court can impose bail conditions designed to prevent the accused from approaching or interfering with any witness, including - crucially - the alleged victim.

Commonly, this can take the form of prohibiting an accused from going within certain distances of where the alleged victim resides, works or attends for education or recreational purposes.

There are also requirements imposed on COPFS to keep alleged victims informed of the conditions of bail that have been imposed by the court, and information on progress of the case through the court system including the outcome.

If a victim is approached by the accused person face-to-face, through others, or via social media, then they know from the information provided by the prosecutor that they can contact the police. If that is reported by the police, then the court will consider whether there has been a breach of the bail conditions. That may result in a further restriction of liberty for the accused, including being taken into custody while awaiting trial.

None of this applies to those who are reported directly to the Children's Reporter, and if a case has commenced in the adult court system but it is decided that it would be best suited to proceed in the Reporter's system, any bail conditions imposed by the court fall as soon as the case is closed in the adult court system.

Potential changes to allow for the Children's Reporter to deal with cases of young people under 18 that otherwise currently have no option but to be dealt with by the adult criminal justice system are being examined as part of the Child Protection Improvement Plan, and involve the Justice Board and the National Child Protection Leadership Group.

If there are to be future legislative changes to allow cases involving accused under 18 to be proceeded against within the Reporter's system, then these issues will need to be fully addressed to ensure victim and public confidence in any new approach.

Recognition of the harm that criminal justice processes can cause children, despite the more victim-focussed approach to obtaining and leading evidence since 2004^[149], has led to further proposals in Scotland to explore the value of a Barnahus approach such as those in Sweden, Norway and Finland. Instead of using police offices and adult court buildings, these countries provide networks of designated buildings for children where professionals (from social services, police, the public prosecutor, forensic examiners, paediatricians, and child and adolescent psychology and psychiatry), can confer and collaborate to establish the best approach for the individual child witness to obtain their evidence and to assist their recovery.

The approach is set out in the Barnahus 'Promise' Standards:^[150]

• Safety: Processes are careful yet robust, promoting the safety of those involved by discovering the truth within the most harmful circumstances.
• Wellbeing: the wellbeing of the child is the lens through which all decisions and actions are taken.
• Preparation: processes include early discussion between the lead agencies, co-ordination and partnership with those responsible for the child's care.
• Understanding: each stage and any change or decision is explained in a way that makes sense to each child and those responsible for their safe care.
• Support: support is provided for children and families involved in these processes.
• Skill: professionals involved are afforded the training and supervision that ensures a co-ordinated and child centred process.
• Pace: preparation and pace of exploration is patient and attuned to the impact of trauma upon the needs and feelings of each child.
• Place: investigative processes are conducted in an environment which is child friendly and amenable to those attending for the child's support.
• Rights: the child's present feelings and future rights are respected and protected at every stage.
• Improvement: feedback is sought and systemic processes are evaluated and improved to ensure adherence to standards.

As with GIRFEC^[151] although initially designed with victims of HSB in mind, these principles may have generic value when considering a child or young person who has demonstrated HSB. These children and young people will often require similar approaches if they are to be successful in moving towards non-harmful behaviours, allowing them to participate fully in society, and in many instances to recover from the impact of relevant ACEs and trauma while improving the chances of their rehabilitation.

It may be helpful to apply these general approaches to investigative processes involving a child or young person accused of HSB.

Proportionality of response

Correct and swift responses to a child or young person's HSB by parents, carers and professionals are key.

The Expert Group found that responses by those who are not confident in dealing with this kind of behaviour can be overly restrictive around children who exhibit inappropriate and problematic, but not abusive or violent behaviour. Conversely, overly-restrictive responses prevent the development of skills that actually serve to mitigate against escalation in behaviours. For example, restricting toilet access to times outwith the presence of other children and always to be in the company of a supervisory adult, restricting play and peer-related activities, or restricting access to clubs reduces opportunities for socialisation and the development of healthy relationship skills.

Insufficient or late responses fail to provide supportive intervention to the child causing harm and/or properly safeguard other children and young people.

For professionals working with individuals with intellectual disability (ID), it is common to encounter families and carers who see children and young people with ID as essentially asexual. In addition, families and carers may actively discourage sexual education or sexual expression by individuals with intellectual disability.^[152] These approaches can hamper efforts to address inappropriate sexual behaviour, when these are displayed, with parents and carers perhaps being less likely to report concerning sexual behaviours.

HSB can result in severe legal repercussions for children and young people, with consequences that last into adulthood. For instance, information about offending behaviour (whether resulting from a court conviction, disposal by a Children's Hearing, or information retained by the police) can remain part of a person's record into adulthood. This means that it may be disclosed as part of a criminal record certificate obtained under the Police Act 1997 or on a PVG scheme record. As well as forming part of the disclosure system, the Protection of Vulnerable Groups Scheme^[153], is a system of ongoing monitoring of individuals who wish to do 'regulated work' with children or protected adults, including voluntary work. That means that information held in police records about HSB committed by a person when they were under 18 may be disclosed in certain circumstances years^[154] later and prevent them from being able to take up opportunities e.g. a job in a school or as a volunteer coach to a junior community sports team.

All of the this demonstrates why professionals, parents and carers need to be confident in recognising, and consistent and competent in responding to risk at this higher level.

Interventions by Specialist Services

The Safer Lives intervention for children and young people is a modular intervention programme developed by G-Map in Manchester for adolescents who display HSB. It is a programme for individual work with children and young people under the age of 18 who demonstrate HSB, building on the strengths-based Good Lives Model. The Scottish Government funded a roll out of this programme in 2008. The Centre for Youth and Criminal Justice (CYCJ) supports trainers and delivers training on request. Additional intervention programmes are detailed in Appendix D.

Whilst interventions by this kind of specialist service may be sufficient to prevent further HSB, for some individuals this will not be the case. Some children and young people will require specialist mental health intervention, detention or treatment under the Mental Health Act, or psychopharmacological treatment.

These needs can normally be met through the Child and Adolescent Mental Health Service (CAMHS) although one particular challenge noted by the Expert Group was the difficulty engaging with expert professionals who are typically aligned with CAMHS. CAMHS professionals require expertise in normal and abnormal development, gender development, sexual development and the impact of neurodevelopmental difficulties on the onset and development of HSB (e.g. a child with Autistic Spectrum Disorder whose new special interest is pornography, or a child who engages in hypersexual behaviours for sensory reasons), as well as highly specialist psychological skills necessary for treating problematic behaviours.

Discussions are at initial and tentative stages about establishing a West of Scotland adolescent medium secure managed clinical network, and a West of Scotland community regional Forensic CAMHS. This would provide an inpatient forensic service for children whose mental disorder is specifically linked to their risk of harm to others, for example a child who suffers from schizophrenia experiencing auditory hallucinations telling them to harm someone sexually.

Most children will not meet the diagnostic criteria for a mental disorder and so will not be able to access CAMHS or the medium secure facility, despite having mental health problems such as attachment difficulties and complex developmental trauma that are linked to their HSB.

The Interventions for Vulnerable Youth (IVY) Project which provides a specialist psychological and social work approach to risk practice for children (12-18 years) who present with complex psychological needs and a risk of serious harm to others, was developed to meet this gap in service.

IVY has been widely welcomed as a significant resource by front line practitioners who wish to access expert discussion of the most difficult cases. Although there is still work to be done with front line practitioners to ensure consistent application of referral thresholds and provision of all relevant background information to IVY at the time a request is submitted for support, expansion of this service at the tertiary prevention level would meet the needs of children who do not, at the time of initial referral, appear to merit CAMHS, psychiatric, pharmacological or other treatment under the Mental Health Act.

One of the drivers for establishing IVY was to offer community-based risk management support to avoid the unnecessary use of secure care and to support better transitions from secure care (informed by the Securing Our Future Initiative).^[155] At least 71% of the children supported by IVY are looked after children, with around 61% having experienced domestic violence. A high number had previously undiagnosed learning difficulties.^[156] Referrals have been taken from 31 of the 32 local authority areas and the majority of these (73%) have been from social work services.^[157]

A joint psychosocial/social work model was considered the most appropriate approach for understanding and managing these children but where there is co-occurring mental disorder and/or pharmacological input is considered appropriate, there is scope for joint working with CAMHS psychiatrists. However, the young people referred to IVY are not the same population that would require secure forensic mental health inpatient care or meet other CAMHS criteria. The IVY population is a wide group of children in crisis and distress, whose route to violence/HSB has usually been linked to complex trauma, the impact of psychological injuries and their poor emotional and mental well-being (to emphasise, this is not the same as a diagnosed mental disorder/mental illness that requires inpatient treatment in NHS settings).

It is important to recognise the role that improving how a family functions can have in reducing HSB. The Scottish Government commitment to preventing ACEs, and, where they have occurred, supporting children, families and adults to build resilience and overcome adversity will promote this, as will the development of an adversity and trauma-informed workforce. The National Trauma Training Framework will deliver the principles of trauma-informed practice for statutory authorities' workforce.^[158]

The plan to develop a trauma-informed workforce will assist with the reduction of HSB involving children and young people, as vulnerable children and young people are better able to be identified and supported.

Risk assessment

Risk assessment is about targeting and intervening with high risk groups as well as creating a culture, expectation and skills to enable young people to engage in healthy sexual and relationship behaviour.

As mentioned in Chapter 1, the Framework for Risk Assessment, Management and Evaluation (FRAME) and the Care and Risk Management (CARM)^[159] process provide a framework for professionals in relation to the management of risk for young people who present a risk of harm.

FRAME highlights that a structured professional judgement approach should be taken in relation to the risk of further offending behaviour, and that this should be informed by reflecting that children are children, and offending is often a result of unmet needs. The CARM process intends to ensure a transparent, proportionate and rights-based approach, placing a child or young person at the centre of decision-making, holistically considering any risks and needs. The process is underpinned by GIRFEC and ensures that decisions about risk inform the Child's Plan in a meaningful way.

When applied to secondary and tertiary level cases, risk assessment is the process by which criteria that provide a structure for successful intervention are considered in relation to a particular child or young person for the purposes of reaching an opinion about: (1) whether they will continue to engage in such behaviour or not, and (2) what intervention strategies should be implemented in order to mitigate the risk and promote the best possible future for them.

Scotland has access to excellent resources and guidelines relating to the risk assessment and response to young people who demonstrate HSB, which provide a clear rationale and set of practice guidelines. The Risk Management Authority's RATED resource highlights which risk assessments tools should be used in Scotland.^[160]

Research on adolescents who are at risk of, or who carry out sexual offences, indicates that the seriousness of any actual or planned sexual offence does not determine future risk. This needs to be balanced against the fact that retrospective research indicates that those whose behaviour regresses typically have an early onset of problematic behaviour that can escalate and diversify over time.

This is why risk assessment and response needs to be delivered by qualified experts following best practice in a way that targets and delivers support to where it is needed.

Research consistently highlights that individuals engaging in HSB often live with parents or carers who have high levels of mental health issues, substance misuse, offending, and exposure to domestic violence. The effect that these have on their own parenting capacity needs to be considered as part of a wider systemic approach to assessment and intervention.

A 2016 report from the Care Inspectorate into Significant Case Reviews (SCRs)^[161] indicated that high quality assessment and planning are fundamental to creating safety for children and young people. The report highlighted a need for improvement in the following areas:

• The extent to which information is shared and used to enhance the understanding of risk and needs.
• The need for better use of chronologies to inform assessment and decision making.
• The arrangements for children who are in transition within and between services.
• Better consideration of the vulnerability of older young people with risk taking behaviour.

The report highlighted that decisions about increasing intervention need clear collective responsibility in keeping children safe, when there are accumulating or increased concerns about a child's circumstances.

Young people who present a risk of HSB to others are currently a disadvantaged and disempowered group. They constitute a population that can fall between service thresholds and who can find it difficult or impossible to access resources. Access to services equipped to assess, understand and manage the very complex and diverse needs of young people who offend can be a significant challenge.

The nature of the challenges include but are not limited to:

(1) the fact that young people may not exhibit impairment of a nature or degree to enable access to local CAMHS services - they may not meet referral criteria. Early indicators of mental disorder, psychological disturbance or very rare forms of psychopathology may therefore go undetected, with the young person excluded from services that would assist and lower risk;

(2) high level skills being required to meaningfully assess, formulate and intervene with high risk youth who have both mental health difficulties and a risk of violence. These skills are not equitably spread across the country;

(3) typical models of assessment and intervention used to assess child and adolescent mental health problems are not always successful with this group. Young people may or may not engage, and this group can effectively opt-out. An assertive outreach is often necessary, as is patience, since the young people tend to take a long time to engage and build rapport with professional staff;

(4) the young person live between local authorities, which challenges access to psychological therapies based on NHS Board boundaries and organisational barriers, especially with short-term placements;

(5) the young peoples' needs can be complex psychological, emotional and behavioural.

Lead professionals and statutory authorities can find it difficult to access the right resource. Currently in Scotland, there is a perceived lack of specialist services and dedicated youth justice teams to deal with these behaviours.^[162]

The paradox is that young people in the community often do not have the access to adequate resources. It is only when their psychological or mental disturbance and violence risk escalates to a level requiring secure care that they receive access to specialist child forensic mental health services. Not all children will require secure care, and best practice suggests that children should remain in community settings wherever possible, since outcomes for children placed in secure care are typically poor. In addition, removing children from their communities, schools and peers could remove their protective factors and compound their difficulties.

If risk assessments and risk responses are to be meaningful and effective, tertiary level cases need to be assessed and managed by multi-agency teams (under CARM protocol) who have access to the right level of expertise for identifying and understanding risk from a biopsychosocial^[163] model. Such teams require professionals who can identify where there are serious psychological disturbances (e.g. personality difficulties) and mental disorders (e.g. neurodevelopmental disorder, major mental illness).

There should be consistency in the availability and quality of specialist assessments and the range of services available across local authority areas. The Expert Group was advised that significant variation across the country in relation to both assessment and services is reflected in the experience of Reporters to Children's Panels.

When a Reporter arranges a hearing for a young person, a Children's Hearing considers what services are required to address a child's needs or behaviour. This is not something a Reporter should consider when making their decision. In practice, however, the Reporter's decision may be influenced by the child's engagement with specialist services available within the community

In one example shared with the Expert Group, the recommendation made (and followed by the Reporter) as part of an assessment was that a child who had committed a very serious sexual offence and who had already started engagement with specialist services, should not be brought to a hearing but should instead be referred to the local authority on a non-statutory basis, and for ongoing engagement with specialist resources to continue. While this recommendation was made on the basis of genuine acceptance on the part of the child that they had behaved as alleged, it was clear that the availability of specialist services who could provide an appropriate level of support was key in that recommendation.

All local authorities are offered training in the Safer Lives intervention programme and specialist risk assessment tools from CYCJ. Those who undertake this training are further supported by regular risk formulation forums. Lack of awareness that this training is available, and about which risk assessment tools to use, may be an issue so far as lack of confidence in front-line staff is concerned. Glasgow City Council has its own specialist team working in this area, HALT, as well as the only forensic CAMHS service in Scotland. IVY provides support for the whole of Scotland by way of a psychology and social work service for the most serious behaviours, but its future is uncertain. Greater understanding of the support available to front line practitioners to provide them with appropriate interventions and access to specialists, would help to avoid some of the current inconsistencies of availability of services and responses.

The Scottish Prison Service gathers information from young people in HMYOI Polmont by way of an annual survey. Results from the 2018 survey highlighted the often challenging and traumatic childhoods of young people who committed crimes leading to custodial sentences.^[164]

In terms of what can be done to rehabilitate a young person in custody, if a young person is accused and denied bail and therefore remanded in custody until the date of trial, they are unable to engage in any restorative work. Another issue is that on many occasions by the time a trial has taken place, if the young person is found guilty, then the period they were awaiting trial is often taken into account by the court resulting in a very short period of detention or liberation from court. These issues limit the ability of staff within HMYOI Polmont and other establishments to work with young people to try and prevent further offending.

While there are many opportunities to engage with staff for those serving sentences in HMYOI Polmont it is still the case, as with availability of interventions outwith prison settings, that many of the current assessments and interventions available are for adult offenders.

Contextual Approaches

The following diagram^[165] shows the Abuse triangle, which shows that three things are required in order for abuse to take place: the abuser, the victim, and a relevant setting. If one of the three is absent, then abuse cannot take place.

New approaches have been developed over the last decade suggesting the need to consider a wider context than the individual child or young person displaying HSB.

Kelly (2017) discusses the role of context in shaping and enabling violence against women in that harmful behaviours towards women and children are fostered in contexts where male violence is tolerated, excused or naturalised, or perpetrators not held accountable and victims blamed.

Smallbone (2016) examines place, perpetrator and victim. His view is that individuals, organisations and professions engaged in trying to prevent HSB should think less about risky people and more about risky contexts.

Firmin (2017) examined experiences in the home, in conjunction with experiences in peer groups and school environments that reinforce and legitimise powerful men's dominant position in a community or society, justifying their subordination of women and other men in the population. She explored how individual psychological factors contribute to why some children from a group of similar backgrounds emerged as victims and others as perpetrators. She also explored how context could be the major influence in attacks occurring if incidents were treated in isolation, rather than recognising the contextual risk around places and cultures such as housing estates, schools and particular places where young people gathered.

Expert Group Findings and Conclusions

Prevention of HSB is achieved through responses to secondary and tertiary HSB as well as through primary prevention activity.

There needs to be assurance that current approaches are delivering what is required for Scotland's children and young people, both in terms of those who are harmed and those who are harming (or who are at risk of doing so).

Consistent and proportionate responses are required at each of the three levels of intervention.

Improved evidence is required regarding the issues, including the extent and scale of problems.

Significant numbers of websites host information about primary prevention, but the volume of materials available make it difficult for many professionals, parents, carers, and children and young people seeking information on primary prevention to access the best information.

Promotion of a small number of reliable websites providing information that has been identified as the most effective in a Scottish context could assist professionals, parents, carers, children and young people.

Scotland has introduced interventions that accord with those seen in many other jurisdictions, but few of these have been evaluated.

Evidence suggests that early commencement of work with professionals delivering tailored interventions results in earlier recovery for both those who cause harm, and those who are harmed.

There is anecdotal evidence of success, with no repeat of HSB by children and young people who have engaged with interventions delivered by professionals.

Anecdotal evidence suggests that the time taken to reach a decision when behaviour is referred to the adult criminal justice system can create a barrier to successful engagement, even in those cases that do not ultimately end up being handled by the adult criminal justice system.

Appropriate assessments are not always available to those making decisions on whether proceedings should be taken through the Children's Hearing or adult court system.

Trauma-informed approaches are best practice.

Consistency of thresholds for referral and access to qualified professionals are essential.

Assessment requires to take account of developmental and learning needs, including consideration of learning disabilities and communication needs.

There needs to be consistent use of appropriate assessment and risk assessment tools.

CARM was designed specifically to be used in respect of under 18s, but does not appear to be consistently followed.

Expert Group Proposals

The Relationships, Sexual Health and Parenting (RSHP) web source, created by the recent review on PSE should be promoted as the 'go-to' place where professionals can seek out relevant resources. This should also be promoted to parents and carers, to enable them to access what their children and young people are being taught at school, and view additional primary prevention materials that are designed to help them discuss the topics with their children.

The GLOW network is a valuable conduit for primary prevention materials and consideration should be given to it being promoted as one of the main 'go-to' places for children and young people.

A matrix should be developed (similar to those available in other public health scenarios) to guide all front line practitioners regarding evaluated services available for children and young people, and how to access qualified professionals who can facilitate contact for early assessment and referral to suitable services.

Decisions on how to proceed in respect of a child or young person accused of harming another child or young person by reason of their HSB should be informed by appropriate assessments.

A national expert resource (such as IVY) should be available to local services who provide assessment- and interventions-and need support with respect to more challenging presentations.

The majority of the Expert Group support the proposition currently being considered by the Justice Board and the Child Protection Leadership Group that there should be an extension of the Children's Hearing System to allow all under 18s over 16 and not subject to a compulsory supervision order to be considered for referral to the Reporter rather than automatically processed in the adult criminal justice system

CARM should be used to manage the risk of HSB consistently across Scotland. The Expert Group welcomes Scottish Government's consideration around CARM and the introduction of CARM within youth justice standards.