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Tuesday, June 27, 2017
Identifying Child Abuse
I am a preschool teacher for Migrant Headstart (so I have not been around the children in my class for too long, and their families will be leaving soon). We have caught a few of the boys engaging in advanced sexual "play". One of these boys is temperamental and does not listen to the teachers very well. He becomes very upset, and often violent, when told to stop doing something. And this is probably insignificant, but interesting nonetheless: when we wanted to have a professional observation done on the child (because of his classroom behavior) by a mental health professional, his father objected, saying we were accusing his son of being crazy. Do we have something to be concerned about here?
It is often difficult to differentiate normal exploratory behavior from abnormal sexual activities in children. Normal sexual behaviors begin shortly after birth. Children learn to identify themselves as girls or boys at age 2 or 3 years and enjoy displaying their nude body parts at that age. Between ages 3-6 years children commonly display sexual behaviors, and masturbation (in both girls and boys) is very common. Sex play with peers is also common and usually involves some degree of undressing and mutual touching. By age 6-7 years, overt sexual behaviors diminish, and these children are typically more modest than the younger child. These points may also help to differentiate normal behavior from abnormal sexual activities: Normal play during childhood involves consenting and developmentally appropriate behavior between peers. The behavior should be mutually motivated by curiosity and pleasure. It should not be coerced or pressured or involve children of different cognitive levels or ages. Here is a reference: Friedrich WN, Grambsch P, Broughton D, et al. Normative sexual behavior in children. Pediatrics 1991;88:456-464.
Kathi L Makoroff, MD
Assistant Professor of Pediatrics
College of Medicine
University of Cincinnati