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

Chapter 7: Statutory Authorities Knowledge and Responses - The NSPCC Audit Tool

The Expert Group established a sub group to consider the NSPCC HSB Framework Audit Tool^[166] that has been used by Local Children's Safeguarding Boards (LCSBs^[167]), in England, Wales and Northern Ireland over the last three years. The sub group^[168] was tasked with assessing whether this audit tool could be used to map practice and processes across Scotland targeted at children and young people in order to prevent sexual abuse from happening or from re-occurring. The tool requires a local multi-agency group to gather evidence and to assess local practice, processes and leadership in five areas:

1. A continuum of responses to children and young people displaying HSB.

2. Prevention, identification and early assessment.

3. Effective assessment and referral pathways.

4. Interventions.

5. Workforce development.

To allow information to be gathered and analysed during the life time of the Expert Group, the subgroup undertook a lighter touch audit, surveying CPCs to enable it to map current service provision in relation to primary, secondary and tertiary prevention; and ask for views on what was working well in local authorities in Scotland and what improvements CPCs considered were needed to improve outcomes for children and young people.

An amended version of the self-evaluation tool was developed with the Child Protection Chairs Group and Chief Social Work Officers and issued to CPCs in October 2018.

27 out of Scotland's 32 local authorities provided responses to the survey, which were then analysed.

On average four professionals from the statutory authorities that constitute each CPC had contributed to the self-evaluation.^[169]

The subgroup noted that for a number of questions there was variation in the focus of the answers, implying respondents interpreted these questions differently. These two factors limit the conclusions that can be drawn from this survey.

Responses on Policy and Guidance

The survey asked whether there was a multi-agency protocol in place in the local CPC area for supporting children and young people who display inappropriate, problematic or abusive sexual behaviour.

All CPC responses indicated they have multi-agency protocols for supporting such children and young people.

Approximately 45% of responses reported their Child Protection procedures as the sole protocol, while another 45% indicated guidance and protocols specific to harmful sexual behaviour, in addition to their Child Protection procedures. The final 10% of responses did not provide further detail and as such it was unclear what their protocols were.

Eight of the CPC responses specifically referred to Child Sexual Exploitation (CSE) guidance, with one appearing to solely reference this guidance. The implication from these responses is HSB exhibited by children and young people signals they are potentially victims of CSE or sexual abuse. Although this is possible, and undoubtedly important to assess, this may indicate a lack of broader understanding of the possible underlying causes of such behaviour in children and young people. It also may be that there is some uncertainty about definitions and characteristics of CSE. This confusion between CSE and HSB was also identified as an issue in work done supporting the use of the NSPCC HSB audit tool with LCSBs in England and Wales.

Only 20% of CPCs said they received data about children and young people with concerning sexual behaviour. Such data primarily includes the age, sex, ethnicity and additional support needs of the children or young people.

Only 8% stated that they report on multi-agency meetings and outcome. This is surprising as the Scottish Government's 2014 CARM Guidance for local authorities on the assessment of young people who present a risk of harm through HSB outlines that quantitative and qualitative data should be collected annually in relation to multi-agency decision making concerning young people who present risks to the public because of their sexual behaviours.^[170]

38% of CPCs reported procedures and guidance specific to school setting (e.g. guidance on sexting). Guidance in relation to responding to concerning sexual behaviour was mostly noted as contained within other guidance (e.g. anti-bullying, CSE, communications and online safety) rather than stand-alone guidance.

Over 90% of responses noted that concerns about inappropriate, problematic or abusive sexual behaviour are recorded in schools. 67% noted that there is no set threshold about what should be recorded and decisions were based on professional judgement. 17% noted thresholds are set by Child Protection guidance or by a multi-agency protocol.

Most responses noted that when concerns were recorded, schools recorded brief, factual details of the incident and circumstances, actions taken and known outcomes.

Responses on Primary Prevention

The survey asked about initiatives in place within education to keep children and young people from becoming involved in any form of inappropriate, problematic or abusive sexual behaviour.

Over 95% of the responses indicated the Health and Wellbeing curriculum in schools included topics such as consent, power imbalance, HSB, healthy relationships, online safety, bullying, and CSE. The delivery and design of this varies between schools, because Curriculum for Excellence allows flexibility to adapt curriculums locally to reflect local needs. Responses also indicated schools have specific awareness or prevention programmes or sessions in addition to the curriculum. Many CPCs reported that schools use local services for specialist input on these topics.^[171]

The majority of these programmes were in secondary schools (83%), followed by primary schools (46%) and early years (4%).

The survey asked a series of questions about what supports were in place for staff in identifying and responding to inappropriate or problematic sexual behaviour and how they can support children and young people at an early stage who are victims of, or who display, concerning or worrying sexual behaviours.

63% of responses indicated they provided multi-agency training in relation to healthy, inappropriate, and problematic sexual behaviours in the context of training on CSE, risk assessment and management, or specifically on children and young people displaying HSB. This is mostly reported as not mandatory and available to staff across agencies; i.e. Social Work, Police, Health, Education, Third Sector, etc.

75% of responses noted the GIRFEC approach in schools in their areas has provision to deal with inappropriate or problematic sexual behaviour, for example through the curriculum, staff training or formal procedures (i.e. planning meetings, child protection). There were no references in the responses to supports for parents and carers of children with higher needs^[172] in relation to inappropriate and problematic sexual behaviour.

Opportunities for training and learning development relating to problematic sexual behaviour were stated as available to staff in schools and centres by 83% of responses. However, there was significant variation in the type of training, from generic child protection training to specific training regarding HSB, and which staff would have access, from all staff to only those who have been dealing with this behaviour. Furthermore, due to varied interpretation, it was unclear as to what access staff in all agencies might have to specialist consultation and advice, although 79% reported they do. This was primarily through social work or other child protection agency, with a minority noting specialist external agencies.

Responses on Tertiary Prevention

The survey asked a series of questions about supporting and rehabilitating those children and young people who display abusive or violent sexual behaviours. All responses indicated that where a child or young person displays abusive sexual behaviour they will have an identified lead professional and a single child's plan. Clear procedures, processes and protocols alongside good collaborative multi-agency working were reported as currently effective in supporting and rehabilitating these children and young people. A number of barriers were noted including the divergent thresholds in different professionals' and agencies' understanding of HSB, complexity of cases, lack of capacity across agencies, staff anxiety, lack of training, and inconsistent processes.

It may be that some areas have more developed processes and procedures which could be usefully adjusted to improve areas where these are less developed.

46% of responses noted they have quality assurance measures in place with respect to some of the processes relevant to supporting children and young people who display sexually abusive behaviour. Primarily this quality assurance relates to generic processes and procedures such as child protection, IRD (Inter-Agency Referral Discussions) and CARM.

58% of responses reported specialist service provision for children and young people who display abusive and violent sexual behaviour i.e. social work, Third sector or NHS.

The numbers of children and young people in the area requiring such support determine whether it is a necessary to have such a service, with one area stating the numbers were so low they decommissioned this service.

Again having clearer information about the numbers of children and young people displaying inappropriate, problematic or abusive sexual behaviour would help inform CPCs and others with regard to needs-led service provision and procurement.

75% indicated there are therapeutic recovery services available in their area for children and young people who have been sexually abused such as those delivered by social work, Third sector or NHS.

21% noted that specialist services for victims of HSB had closed in their area in the last five years, leading to a reduction in support available however most reported this has now been absorbed by statutory agencies.

71% of responses noted there are occupational groups in their areas trained in evidence-based interventions in relation to children and young people who display abusive sexual behaviour, including social work or equivalent, youth justice, CAMHS staff and educational psychologists.

Survey of Head Teachers and Safeguarding Leads in Schools in Scotland

The recent UK-wide survey of Head Teachers and Safeguarding Leads highlighted the issues faced in addressing problems caused by peer on peer abuse, not limited to but including HSB.^[173] In this instance Peer on Peer was taken to mean a child or young person under 18 involving another child or young person under 18.

There were 174 responses from head teachers and safeguarding leads in Scotland. Of those:

• 28% of respondents did not consider that there was sufficient guidance from government and their local authority.
• Fewer than half suggested that they have a policy covering online peer on peer abuse (47%).
• 29% of respondents suggested that all staff receive training around online peer on peer abuse; 37% suggested there is no training and 20% were unaware.
• Respondents considered that online peer on peer abuse is likely to begin before secondary school, and is most prevalent in Primary 7.
• The majority of education around online peer on peer abuse was delivered to pupils in Secondary 1, suggesting that more emphasis is required for to children in primary education.

The authors concluded "Given the potentially life changing impact of such abuse on both victim and abuser we are concerned that schools are being left to address these problems in such an ad hoc manner. We would like to see far more joined up thinking around these issues so schools are confident they are addressing the problems effectively and students are receiving accurate and informed education around online peer on peer abuse".

Expert Group Findings and Conclusions

There was wide variation in the focus, information and level of detail given across the responses from CPCs in relation to the NSPCC audit tool. This limits what can be concluded from the survey, but broadly, all areas reported having multi-agency protocols in place to support children and young people who display inappropriate, problematic or abusive sexual behaviour, whether in the context of wider child protection procedures, or specific protocols or procedures.

The majority of schools were also reported to have relevant procedures and protocols, within child protection procedures or others; i.e. anti-bullying, CSE, online safety etc.

However, the use of the CSE procedures for children and young people displaying HSB appeared in some responses to the audit tool to be combined, rather than taking into account the significant differences and needs of these two, often distinct, groups.

There is variation in what concerns are recorded by CPCs, how they are recorded and the thresholds for these. Furthermore, this information does not seem to be used in the majority of cases to inform service provision or development.

More than half of CPCs noted they had no guidance for education staff in relation to handling self-generated sexual images, despite guidance of this nature being available for schools in England and Wales for several years.^[174]

The amended Audit Tool was useful in gathering information for CPCs and other statutory authorities involved in responding to HSB involving children and young people.

All professionals who work with children and young people in Scotland need to recognise and know how to safely respond to incidents of HSB; and how to refer on to appropriate services for assessment and intervention where relevant.

Services who provide assessment and interventions need support with respect to more challenging presentations.^[175]

HSBs displayed by children and young people - especially online - create many challenges for practitioners, and there are overlaps between CSE and HSB. However the current National Child Protection Guidance does not adequately cover the similarities and differences between CSE and HSB and makes no reference to contextual safeguarding.

The view that social work or equivalent, youth justice, CAMHS staff and educational psychologists are trained in and will deliver evidence-based interventions to address HSB may not be entirely accurate. For example, CAMHS are unlikely to work with children or young people displaying HSB unless there is a diagnosed mental disorder linked to the HSB.

It appears that data about children and young people who display inappropriate, problematic or abusive sexual behaviour in schools or the community is not routinely or systematically collected or reported on. This makes it difficult for CPCs to gain a clear and full understanding of patterns, frequency, nature and severity of such behaviours, which would help them plan relevant supports. This also suggests that many local authorities would benefit from closer analysis of current service provision, procedures and policies, effectiveness of interventions (across primary, secondary and tertiary prevention), referral pathways, workforce development and leadership in this area of practice.

In relation to primary prevention, the majority of schools are reported to include topics such as consent, power imbalance and HSB as part of the CfE but there is variation in this, with schools and areas designing and delivering these topics themselves.

Training and development provided by CPCs and in schools in relation to children and young people displaying problematic or abusive sexual behaviour is widely varied and in most cases delivered to some rather than all of the relevant professionals in each statutory organisation's workforce.

Differences in professionals' and agencies' understanding of HSB in children and young people was identified in responses to the survey as a barrier to effective working in this area, as was professional anxiety. More consistent training or input to promote a shared understanding would seem to be essential to increase staff confidence, knowledge and skills in assessing and collaboratively managing such cases.

The Scottish Psychological Trauma and Adversity Training Plan^[176] provides a model of how to develop a strategic framework for individual and organisational learning that recognises that different professionals with different roles will require different levels and intensity of training and support.

Expert Group Proposals

CPCs should review the NSPCC Audit Tool in consultation with the NSPCC to agree on any adaptations necessary for its use across Scotland.

Data about children and young people who display inappropriate, problematic or abusive sexual behaviour in schools or the community should be systematically collected for consideration by CPCs and reported on, together with information about outcomes for the children and young people involved.

There should be a 'Scottish Positive Sexual Behaviours Training Plan' (modelled on the Scottish Psychological Trauma and Adversity Training Plan), outlining core training needs at different levels for practitioners directly involved with children and young people, and covering how organisations audit their own learning needs.

The current review of the National Child Protection Guidance should address the similarities and differences between CSE and HSB, and refer to contextual safeguarding. The section on 'Children and young people who display harmful or problematic sexual behaviour' should be updated, particularly with respect to technology-assisted HSB and use of CARM.