Understanding Children’s Sexual Signals and Behavior

Abstract

Increasingly children come to professional attention because they use ‘sexually harmful behaviour’. Such children are treated as dangerous to others rather than as neglected or abandoned children who use sexualized behavior to fast-track connection to protective adults. We present case examples, arranged developmentally from infancy to puberty. All had standardized video-recorded assessments of attachment that reliable and blinded coders coded. In addition, we have information about the parents’ history that helps to explain their behavior. We also review neurology to understand how smell and touch affect sexualized behavior. We conclude that children’s sexualized behavior is not usually motivated by sexual desire. Instead, it appears to serve attachment functions for children whose needs for adult protection and comfort have not been met - by their parents or by the professionals who placed them in care. We close with recommendations for research and for professional practice.

1. Introduction

Our work with troubled families has revealed many sexualized signals and behaviors used by and with children. Such behavior is noticed increasingly often in school-aged and adolescent children and is sometimes labeled ‘sexually harmful behavior’, with teams being set up to manage such children. This led us to worry about a recurrence of the over-reaction to ‘discovering’ sexual abuse in the 1980s and 1990s. Avoiding the parallel of the daycare abuse scandals and false recovered memory of sexual abuse syndrome seems important. In the case of children’s sexualized behavior, we worry that the clinical response may have gotten ahead of the functional understanding of the behavior. Our goal is to identify such behavior and explore its meaning, rather than assuming that it indicates harm or dismissing it as irrelevant. Finding new meanings requires verifying the presence of the behavior (that is, not considering it false or overlooking it) while remaining open about discovering its interpersonal function (that is, not assuming that it is harmfully sexual).

To explore our concern, we reviewed our archive of attachment data, seeking cases in which children participated in sexualized interactions with adults, usually their parents. Ordinarily such behavior would lead to questions about sexual abuse, but when we reviewed the family context, other explanations seemed more likely. In this chapter, we describe this behavior and place it in its family context to demonstrate that it can serve important attachment functions. We also suggest how professionals can assist family members to meet their attachment needs without resorting to sexual behavior.

Once we changed our perspective from a deficit model of knowing that sexualized behavior with and by children was culturally unacceptable, religiously prohibited, ethically wrong and sometimes criminally proscribed to asking if it served any useful function in desperate circumstances, we found new understandings for the behavior. Our emerging strengths model identified sexual signs and behavior as being used when relationships were at risk of failing and for the purpose of protecting the self when relationship were necessary for survival. Put another way, we concluded that precocious and inappropriate sexuality involving children served an attachment function under desperate circumstances.

Normally, we would first review the relevant literature, but the literature was focused exclusively on the problems created by inappropriate sexual behavior and did not address the functions that we observed. Consequently, we first describe this behavior as a series of developmentally ordered cases; we use the cases to develop clinically meaningful hypotheses about the function of sexual behavior used with and by children, first case by case, then more generally [1]. We then discuss recent studies on the contribution of touch and smell to sexuality. Finally, we offer recommendations about how child protection personnel and other mental health professionals might respond so as to promote the well-being of children and their families.

This topic is important because children’s sexualized behavior is receiving more attention and can result in the child being labeled pejoratively and sometimes being socially excluded or placed in a foster home. The understanding articulated in this chapter might help professionals to respond in more helpful ways.

We divide our discussion into five parts: (1) attachment and reproduction, (2) a developmentally ordered series of case studies that highlight the functions of sexualized behavior, (3) the scientific evidence-base for smell and touch as tied to sexuality and attachment, (4) four general hypotheses about sexuality, attachment, and survival, and (5) recommendations for professional response when children show sexual signs and behavior. A fuller account of these ideas can be found in Crittenden and Landini [2].

2. Attachment and reproduction

All children (except those in institutions) attach to their caregivers; this promotes their survival because the caregivers protect and comfort the children when they are endangered and, over the course of childhood, help children to learn how to protect and comfort themselves. The primary means of being safe and feeling secure as one grows up is having close relationships with other people: parents and other family members, then best friends, romantic partners, and finally committed partners (spouses) with whom one will raise a family. These attachment relationships all touch sexuality in some way: babies are the outcome of sexual behavior, young children learn to use the affectionate behaviors that become part of the sexual repertoire after puberty, adolescents experience sexual desire and direct it toward a peer, and committed sexual partners use sexual behavior to seal the exclusivity and intimacy of their relationship and to produce the next generation. It is clear that children’s attachment to parents is protective, but that is also true for same-aged best friends (in children’s social interactions), romantic partners, and committed life partners; in each case individuals with a special partner are safer, healthier, and develop more optimally than excluded children, rejected adolescents, or single adults.

Strikingly, both attachment and sexuality involve signaling that attracts another person and ties them to oneself with an emotional bond. Moreover, attachment and sexual behaviors are almost identical, differing only by the greater intensity of sexual behavior and the addition of interpersonal genital contact to sexual behavior. See Figure 1.

Figure 1.

Overlapping behavioral systems (Crittenden, [3], used with permission).

The overlap of attachment and sexual behavior creates a nearly failsafe survival system of interlocking neural and behavioral components [4], in which growing children do not have to learn a new communication system at puberty; instead, they repurpose the affectionate behavior that they know and add genital contact to it.

An important difference between attachment and sexuality is the speed with which bonds are formed. Attachment takes at least several months, but it endures for years, even lifetimes. Sexual attraction can be immediate, even if it is not necessarily enduring. When the fast-track sexual bond holds long enough to permit an attachment to form, its protective function is doubly fulfilled.

3. Developmental differences in sexual signals and behavior

All the cases that we describe have been viewed, in courses that we teach, by many mental health professionals including child protection workers, clinical psychologists, and psychiatrists. One of the most striking aspects of our teaching is that most of the professionals did not at first mention the sexualized behavior. When it was pointed out, they often explained it away by referring to cultural differences. A few of the cases have full Family Functional Formulations [5] that give us a much fuller understanding of the family context in which children become sexualized. Our goals are to guide readers to notice consciously behaviors that they respond to preconsciously and, having noticed, to seek explanations that yield a clearer understanding of the functioning of the child. When that functioning involves risk, we offer ways to reduce the risk.

To enable readers to ‘see’ what we write about, we use evocative imaged language. This includes giving each child or parent a memorable moniker and using everyday, colloquial language.

3.1 Infancy and the preschool years: receiving adults’ sexualized behavior

The way parents (or other caregivers) touch infants’ and young children’s bodies has implications for children’s current development and for their relationships at older ages. Needless to say, parents must touch children’s genitalia daily in infancy and frequently in toddlerhood. Lack of touch, such as experienced by some institutionalized children, is very detrimental. When such touch is sexualized, it can reflect relationship needs of parents and adversely shape the development of young children.

3.1.1 Confusing babies with men in dangerous circumstances

A standardized 3-minute video-recorded play interaction (CARE-Index, [6, 7]) was taken when ‘Little Man’ was 3 months old. His mother was changing his diaper and did so in a sexually stimulating way. She powdered him heavily, then rubbed his genitals vigorously. She smiled and sang brightly the whole time; her son, on the other hand, was silent, had a blank face, waved a plastic bottle between himself and her, and extended his legs, without force, as if to push her away. In response to her stimulation, he had an erection – which she inadvertently hit as she reached across his body. By that time, his face had a sad empty look. His mother seemed unaware of Little Man’s signals of inhibited distress. Flipping Little Man on his back, and still singing brightly, she opened his knees and kissed his penis.

When we showed this video to our classes, our professional viewers cringed, but when describing the video, they did not mention the sexual behavior. When asked about that, they attributed it to respecting cultural differences (the mother was Asian and living with her European husband in his country) and were hesitant to judge it adversely. Nevertheless, the developmental outcomes to Little Man were severe. By a year of age, he no longer expressed pain, even when he was injured; it seemed that inhibition of negative affect during genital touch had expanded to inhibition of all negative affect. Not feeling pain puts survival at risk because the child neither protects himself, nor signals with crying for others to protect him.

The backstory was that the mother was abandoned when she was 13 years old to earn her living as a prostitute; that is, she learned to use false sexual interest with men for survival. Later she used this strategy to attract and marry a lonely man who paid for sex. Then, living in a foreign country where she did not know anyone else and did not speak the language, she used this strategy on her son, treating him as a little man. Put another way, both parents used sexual strategies to initiate and speed attachment when they felt unsafe and alone. Neither recognized the inappropriateness of sexualized contact with an infant.

Our learning points were that (a) the mother had learned to use false sexual behavior to protect herself when she was abandoned, used it to gain a husband, and applied it to her son, because it had protected her and (b) respect for cultural differences should not blind observers to the universal realities of all human babies and their parents.

3.1.2 Irresolvable dilemmas vs. psychiatric diagnoses

At 14 months, ‘Toy Truck’ should have been learning to walk and talk; instead, in a Strange Situation Procedure [8], he crab-crawled awkwardly and made only odd guttural sounds. Repeatedly, he seemed to approach his mother, then turned away. He put his spread-open hand between himself and his mother, thus blocking his view. She smiled brightly and spoke informatively, but kept her feet, ankles, and knees closed and her hands between her thighs; later she covered her genitals with her hands. When he played with the toy truck, one arm swished the truck back-and-forth repetitively, but the other arm was frozen. Both Toy Truck and his mother used mixed signals of approach and avoidance. An unfamiliar woman, the Stranger, came in and his mother brightened, engaging in pleasant small talk. When his mother left the room (as required by the Strange Situation), Toy Truck pulled himself up on a chest and rocked back-and-forth. Suddenly he slipped and fell, hitting his face. He did not make a sound, only looking up with a worried face. The Stranger touched him comfortingly; he did not respond. When his mother returned, she resumed her closed position in her chair. The Stranger left, then his mother left, touching him gently on the head; Toy Truck almost fell over. He was fine while he was alone, but when the Stranger returned again and touched him gently, he slowly fell over backwards – without any protective falling reflex. Lying on his back, he drove his toy truck back-and-forth over his genital area, as if masturbating. As he did so, his eyes closed, he began making rhythmic guttural moans, and his legs extended and contracted in a pelvic rock. He seemed to be in a trance, then he jerked alert. After his mother returned, he approached her chair, pulling up-and-back as if he could not decide whether or how to get in her lap. She picked him up awkwardly, being sure not to embrace him – and his legs pushed forward, preventing being pulled against her body. His eyes were sad and empty. Toy Truck and his mother struggled in painfully contorted ways, never able to settle until his mother found his toes and, together, they watched his motionless foot.

When the Strange Situation was over, the mother asked how she had done, saying she was worried that her post-natal depression might have affected her son. The clinicians thought Toy Truck had autism. We thought both Toy Truck and his mother faced irresolvable conflicts: he that he must approach, but knew he must not, and she that she loved and wanted to care for him, but could not bear to touch him. We though that both ‘post-natal depression’ and ‘autism’ referred, in this case, to these dilemmas, with Toy Truck’s ‘masturbation’ functioning as self-comfort to protect them both from his need for closeness.

3.1.3 A mother’s need to be mothered herself

‘Give Me Sugar’ and her 18-month-old son were video-recorded during foster care contact. Despite Give Me Sugar holding her son tenderly, he looked away. She whispered and cooed; in response, he just stilled without looking at her. She raised him high in the air, then dropped him close to her face in a nuzzling game. He gave no response, but his eyes grew big and fearful.

She murmured softly “Give me sugar”, to no avail. When she play-bit his arm, then kissed the ‘wound’, he let her so without protest and a distant gaze, even when he attempted a faint smile.

Give Me Sugar’s backstory had a series of serious dangers: maternal abandonment when she was a child, sexual abuse by her father and his buddies, and five fostered children by different fathers. These suggested the improbability of her ever raising a child of her own. Instead, that happened when she had her sixth baby with a man who lived with his mother and she moved with them. The man eventually left, but Give Me Sugar had found a mother who protected and comforted her, helping her to raise her child safely. Meeting mothers’ basic needs can free their children from their mothers’ need to use sexuality to create attachment. Again, the backstory was key to our understanding, while compassion for the troubled young woman enabled the grandmother to apply the solution.

3.1.4 Learning to use sexual signals for protection

‘Sexy Arms’ dressed like a toddler in a black romper with shorts and a bib, but her blouse had sexy slit sleeves laced to the shoulder. Bare legs and black combat boots completed her blatantly sexual outfit. She was video recorded with her 24-month-old daughter in a Toddler CARE-Index (TCI, [9]). The TCI has three minutes of play, one minute of frustration, and closes with one minute of repair. During the play, the daughter played with a cardboard tube while Sexy Arms watched. On the signal to frustrate her daughter, Sexy Arms grabbed the tube away. The girl exploded into a screaming tantrum, then instantly fell backward silently onto the mat with arms and legs splayed open. She pulled her skirt up revealing her undergarments. Her body was totally vulnerable to attack, including to her genital area. Sexy Arms laughed and poked the tube in the tender area of her daughter’s spread upper thighs. For the repair, Sexy Arms returned the tube. Her daughter immediately accepted it with no residual signs of the tantrum, submission, or attack that had occurred moments before.

Like the infants described above, Sexy Arm’s daughter turned affect on and off suddenly, splitting (dis-associating) her mind from her body. More than that, she also actively participated in her mother’s strategy of sexualized dominance and submission. The mother’s backstory included physical and sexual abuse, severe neglect, and a diagnosis of borderline personality disorder. At just two years of age, her daughter was learning an extreme and dangerously sexualized strategy [10] for blocking out her own feelings and maintaining life-preserving submissive attachment to her emotionally volatile mother. The central learning points were recognition of dis-association as sudden onset and offset of intense behavior and the need for service providers to protect endangered mothers.

3.1.5 Rejection combined with sexual intimacy

At four-and-a-half years ‘Green Tent’ (see the Family Functional Formulation of this family in [11]) had mastered the use of sexual signaling that Sexy Arms’ daughter was learning. In a TCI, Green Tent’s mother spooked him from behind by suddenly popping her face into his; he crawled into a green play tent as if to escape. As she tried to lure him out, she made an ‘Ewww’ sound and flapped her hand in front of her nose as if to waft away the air coming from the tent’s opening. Was she disgusted by his smell? By him? Later she wrapped her arms around him from behind and walked him toward the floor-to-ceiling window – 20 stories above the ground. She pushed him forward, holding him tightly to her. Being near the window felt threatening – in one’s stomach. Green Tent ran behind her and pushed her hard toward the window. They laughed very loudly - at their threats of murder?

Green Tent lifted his mother’s clothing, exposing her bare skin; she pulled it down. To frustrate him, she sat in a chair and pulled Green Tent onto her lap, with his legs around her. He braced his palms on her breasts, then played with the pendant that hung between her breasts. Green Tent’s father, who was watching, coughed. Was this a male-on-male territorial dispute?

In the TCI with his father, Green Tent ignored his father and moved toward the tent, giving big disarming, open-mouthed smiles, speaking in a high babyish voice and caressing his father’s hair. His father followed on hands and knees. Green Tent brought his face intimately close to his father’s, then pulled him in for a hug; they both squealed loudly. Then his father restrained him and seemed to mount him, while kissing him and squealing.

Green Tent and his father struggled, yipping and chasing each other. They wrestled and growled. The father shrieked as Green Tent squeezed his father’s cheeks and brought his face in very close. The father threw his head back into a surrender position while his father looked at him threateningly.

On the frustration signal, he released Green Tent who moved away and looked out the window silently. On the repair signal, his father grabbed him. Green Tent resisted with his hands, then his father pulled him between his legs and close to his face. Green Tent’s knees pressed on his father’s genitals (while his father screamed loudly); then he pinched his father’s cheeks hard enough that he yelped in pain. They pulled each other’s hair. As the TCI ended, Green Tent mounted his father who assumed the surrender position.

The family was reluctant to let the therapist play with their son, but once he engaged with Green Tent, the interaction was quite normal.

For this family, we also have a Parents Interview [12] with Green Tent’s mother and father. The parents sat with a table between them; the mother was stiff and still; the father worked on his computer and two cell phones. They spoke in monotones, saying all the right things, but ignoring each other.

The mother’s backstory, as told in her Adult Attachment Interview (AAI [13]), involved repeated separations, ending up in a girls’ boarding school where her father strongly admonished her to stay away from boys. Nothing is known about the father’s childhood because he refused the AAI.

In the genogram, the family is shown as closed to outsiders; the therapist is the green triangle beside a tiny opening in the family’s structure. The parents (a dark blue square and pink circle) seemed blocked from direct communication with each other and instead struggled with each other through their ‘spousified’ son (the light blue square). See Figure 2.

Figure 2.

Green Tent’s family genogram. (used with permission, Crittenden, Landini& Zhang, [11]).

Green Tent’s desperation about his parents was enacted with his extreme sexualized behavior and aggressive behavior in his TCIs; his parents’ defeat showed in the absence of spousal connection in the Parents Interview. Compared to the two-year-old daughter of Sexy Arms, Green Tent is far more competent at sexualized seduction and submission as he tried to navigate a safe pathway between his alienated and strikingly asexual parents. Of course, it was Green Tent, and not his parents, who was diagnosed (with autism), even though the assessments suggest that the hidden spousal discord was the problem.

Although one might be alarmed by the family relationships, especially the boy’s sexualization, a fuller understanding can yield optimism. The parents sought treatment for their son, showing how much they cared for him, but neither they nor the therapist recognized that his symptoms indicated a spousal and family problem.

This case is informative and precious because, after a half century of intense effort advocated by parents of children diagnosed with autism, there are almost no data on their families. This case suggests that parental endangerment and spousal problems might precede autistic behavior, that the child might feel rejected and used sexually in an impossible to win battle between the parents. If that were somewhat true for other families with a child diagnosed with autism, treatment might best be directed toward the families. But this should be done very carefully to prevent parental distress and shame and consequent family break-up [14].

3.1.6 Early childhood development of sexual signaling

Considering these five children, it seems reasonable to propose that when parents fear abandonment, they sometimes use intense sexual signaling and behavior to tie their children tightly to them. This can initiate a developmental process of children’s learning to use sexual signaling and behavior in their own self-protective relationships. In early infancy, the babies could only inhibit their negative feelings, thus dis-associating their bodies and minds. Later they learned to show false positive affect while inhibiting true negative affect. At about two years of age, children could show brief, but intense, negative affect while still relying on inhibition and sexualized submission to stay safe. As they approached five years old, however, children whose parents used sexualized signals and behavior became able to themselves use sexualized aggression and submission in flexible ways to protect themselves.

All of this was happening while the brain was using contextual input to organize its own structure and development [15, 16]. This promotes individual and species survival, but, in cases of early sexualization of babies and young children, the neural networks conflate attachment and sexuality; this can be expected both to have long-term consequences and also to resist change even when maturation makes conscious awareness and choice possible.

Strikingly, almost none of the professionals who contributed these five cases articulated concerns about sexuality. Instead, the concerns were language development, foster care, autism, and family violence. We conclude that much more information is needed about families and mothers’ roles in generating sexualized child behavior. We note, clinically, that professionals are generally reticent to ask about or even note their observations regarding sexuality.

3.2 The school years and peer-to-peer sexuality

Once a child who uses sexualized strategies goes to school, it might become possible for adults to see the child as the initiator of sexually inappropriate or harmful behavior. For example, in the UK, 10-year-old children can be considered criminally responsible for sexual behavior. We think the family origins of such behavior need to be assessed.

Children from troubled families, particularly those with problems involving staying connected, are likely to feel vulnerable when they go to school, because school involves daily separations from parents. If protection, comfort, or connection are problems, anxious children might apply their sexualized self-protective strategies to other children or teachers. If they do, they might be identified as using ‘sexually harmful behavior’. Such labeling might exacerbate their need for comfort and connection or, conversely, initiate a pathway toward isolation.

3.2.1 Spousification of a son

‘Ms Luston’ was facing child care proceedings because of her drug use, sexually violent relations with men and unstable housing. A Family Functional Formulation was used to find ways to prevent her 6-year-old son from being placed in foster care. She cooperated with the male social worker who carried out the TCI and Parents Interview. Ms. Luston’s son was identified as using a self-protective strategy of sexualized caregiving of his mother; Ms. Luston used sexual signaling toward the social worker. He did not notice the blatant sexualized behavior of either mother or son. We wondered why, because resolving Ms. Luston’s difficulties and keeping her son in her care needed to account for her use of sexuality to solve the problem of abandonment in adolescence. Drug use, sexual violence, and instability followed as she tried to find safety through sexual relationships, including prostitution, with men.

The important take-away points for intervention are (1) noticing that Ms. Luston used sexual signaling whenever she felt unsafe, including when threatened by professionals with removal of her son, (2) using her backstory to understand her need for acceptance and stability, (3) assisting her to meet her own attachment and sexual needs, to enable her to release her son from a spousified attachment with her, and (4) helping professionals to notice sexuality and find its meaning in the need for stable and protective relationships.

3.2.2 When being male and masculine elicits maternal rejection

‘Bad Boy’ engaged in predelinquent behavior and enjoyed looking at submissive males in homosexual pornography. At 14 years old, he already acted like his 16-year-old brother who had been kicked out of the home for petty criminal acts. Now the brother wanted to return. Instead, Bad Boy’s 22-year-old sister had successfully started her own family. The next youngest was 10-year-old ‘Susan’ who had transitioned from being a boy to a girl named ‘Susan’ when (s)he was 7 years old. The youngest sibling was a 6-year-old boy. All the biological males had diagnoses of ADHD and were on the autism spectrum. All professional concern was for Bad Boy. We noticed that only the female sibling developed normally, whereas all the biological males had problems and two of them did not accept traditional male roles. It appeared that ‘Susan’ was on a developmental pathway of sacrificing sex to preserve attachment. We wondered if the mother feared sexually mature males and if both Bad Boy and ‘Susan’ had discovered ways to reduce the threat of their masculinity. Only knowledge of the mother’s history could address these questions.

Another previously published case [17, 18] shows how gender identity can be used to prevent parental rejection. ‘Graeme’ was the son of a separated couple with ongoing conflict. He was a problem at school and at 18 was diagnosed with autism. When living with his mother who feared his father, he was hyperfeminine; when living with father, he was hypermasculine. The point is that mothers sometimes fear masculinity and that can affect their sons’ development.

3.2.3 Loneliness and love

‘Loney’ had exhausted many foster placements, resided in an institution, and finally been returned to her last foster family (for a fuller discussion, see [3] pp. 8–9). By her 20s, she was in a mental hospital diagnosed with borderline personality disorder. In her AAI she described going to the park as a young girl to meet an old man who brought her lunch and bread to feed the ducks. She said he was the only person who cared about her. Loney said that her social worker told her that he was ‘grooming’ her and had ‘sexually abused’ her. The coding of her AAI suggested that she had been attached to him. The jarring disconnect between her experience of ‘love’ and the social worker’s notion of ‘grooming’ had made it hard for her to trust professionals, even into the present. She told her AAI interviewer that she had never mentioned the old man again to anyone – until now. Nevertheless, she had made hundreds of nearly identical figurines, one of which she gave to the interviewer. See Figure 3.

Figure 3.

Figurine representing Loney’s relationship with an old man feeding ducks. (used with permission of Patricia M. Crittenden).

We wonder if the figurines tell – and retell and retell – positive aspects of a story that the social worker’s misunderstanding and pejorative language had made ‘unspeakable’. Reducing Loney’s experience of a desperate affection to the term “sexual abuse” also precluded knowing exactly what sexual behavior occurred. Because such terminology substitutes a moral evaluative interpretation for accurate information about the event, it can make personal information less available for later reflection and integration, even in the context of therapy.

It is striking that Loney did not include herself in the sculpture and the old man looked sad and lonely. Again, we are forced to consider the role of sexual behavior in quickly establishing and maintaining attachment for both a lonely adolescent and a lonely old man. If the social worker had listened, rather than reacting, she might have understood Loney’s loneliness and been able to protect her. Instead, silence carried the harm forward.

3.2.4 Soothing rejection with sexualized comfort

Ten-year-old ‘Don Juan’ lived in a foster home with several other foster children who came and departed unpredictably. Don Juan himself had been in many foster homes. Don Juan knew his biological mother – and knew that she had a new partner with whom she shared two young children. He was not wanted in that family and, although he would see his mother from time to time, he knew he would not rejoin her. Don Juan came to attention because he hugged, kissed, and reached under his schoolmates’ clothes to touch their underwear. Although he did not use violent or coercive behavior, most of the children did not like it and some told their parents. Eventually, the police were brought in; Don Juan was treated as a sexual offender and placed in a supervised institution.

We had six years of assessments of attachment; these revealed Don Juan’s intense distress and desire for comfort from his foster mothers, including attempts to cuddle with them in bed. These incidents had ended several foster placements, especially as he approached puberty and was perceived as threatening by the foster mothers. The record did not mention Don Juan’s need for comfort, nor had any effort been made to help him to feel loved and accepted. To the contrary, he was thought to be over-sexed and placed in increasingly restrictive homes where he had less contact with mothering women.

The clinically important point is that children need comfort and some use sexualized behavior to achieve it. The failure of professionals to understand this might have led to interventions that exacerbated Don Juan’s need for comfort and harmed him.

It is our observation that sexual approaches by children to other children, especially their own siblings, occur most frequently when the children have not been able to form attachments with adults either because the parents were very neglectful or because the children were moved from one caregiver to another very frequently.

3.2.5 The smell of closeness

An extreme example of the same misunderstanding is ‘Sneak Thief’. Because of his ethnicity, a foster home could not be found and he was placed in an institution at age six. By eight years old, he was sneaking girls’ soiled panties out of the laundry and hiding them under his pillow where he could sniff them. During a workshop, his care team offered his situation as an example of sexualized behavior that was not related to attachment or desire for comfort. Given that panties are very personal and intimate and that smell is strongly associated with intimate relationships [19], we think that Sneak Thief was not seeking to be close to the girls or to harm them; instead, we think that he was desperately lonely and sought a powerful sensory signal of closeness to a woman/mother. Strikingly, he already knew that his need for comfort had to be hidden. Again, the professional response, based on attributing sexual motivation to a young boy, was harmful in that Sneak Thief both found himself labeled a sexual offender and had his freedom of movement limited. More importantly, he was not helped to understand his behavior and to find appropriate ways to experience comfort in relationships.

3.3 Pre-puberty and puberty

Stressed girls enter puberty earlier than non-stressed girls [20]. Foster care is stressful, especially when there have been multiple placements. Fostered girls might be expected to show sexual behavior to meet attachment needs more often than home-raised girls.

3.3.1 Sexual signals of desire for comfort and stability

After many foster placements and an adoption that failed suddenly and without explanation, ‘Restless Nellie’ was adopted at 10 years of age by an older childless couple. Her adoptive mother worked and her father was a stay-at-home dad. When she was 13, Restless Nellie ran away to a friend’s home where the friend’s mother overheard her talking. The mother concluded that Nellie had been sexually abused by her adoptive father. Investigation revealed that Nellie had been very anxious and that this showed in her intense tantrums (her adoptive mother sometimes had to wrestle her to the floor) and her inability to sleep alone (her parents alternated nights lying on her bed while she fell asleep). This escalated to sexual behavior with her adoptive father (who was later convicted of child sexual abuse and sent to prison). Nellie was placed in foster care. In her video-recorded Parents Interview, Nellie was observed flirting with the new foster father. He did not respond to these bids. We were left wondering if her desperate need for a home had led to sexualized behavior, serving an attachment function, that had possibly destroyed two adoptions and put a well-intentioned but misguided man in jail. Support for the notion that he was well-intentioned was his choice of pleading guilty instead of requiring his daughter to appear in court to testify against him. Carried a bit further, this suggests that, if sexual signals had sped the process of attachment, by the time the sexual abuse was discovered, he was attached to Restless Nellie and sought her best interest over his own. We cannot say that this interpretation is accurate for this, or any other case. We do, however, think that if professionals understood the possible function of sexuality to speed the process of attachment, they might choose placements for children more carefully or alert families to the possibility of sexualized behavior as a signal of the child’s need to feel secure, especially when the child is biologically unrelated.

We doubt that Nellie, her adoptive father or the professionals thought about the tendency of children with multiple placements to use sexualized behavior to create bonds more rapidly than can attachment. Nevertheless, this acceleration might be especially advantageous to children when the adults do not have a biological relation with a child.

3.3.2 Sexuality as the language of love

In a final example, 13-year-old ‘Bessy’ described behavior that her teacher thought was sexually abusive. After the teacher’s required report, Bessy and her four siblings were picked up without warning from their schools and put in foster homes. Bessy’s older sister refused to corroborate the charges and Bessy denied them. Investigation identified chronic neglect of the children, chronic maternal depression, and the father functioning as a homemaker and child carer; his wife was mostly confined by depression to her bedroom. In foster care, the older daughter ran away, the younger boys developed severe behavior problems, and, against a court order, the father kept sneaking back into the home. An infant was born 10 months later. The court and the professionals did not know how to stop the escalating problems.

Again, a backstory can help. Based on the parents’ AAIs, both had grown up in emotionally and physically neglectful families. Because of her own mother’s chronic severe depression, Bessy’s mother had been shunted among relatives for her whole childhood. Bessy’s father was raised by a depressed mother and an alcoholic father. His only brother had died in gang violence. Both parents expressed a very strong desire to have a large and loving family in which there was no violence. The bleakness of their histories and their spare style of speaking was overpowering.

After assessment, it seemed likely that the father did use sexualized affection with his daughters; indeed, it seemed that the only affection he himself had ever experienced was the sexual relationship with his wife. The children were born at two-year intervals, attesting to the couple’s sexual activity. Based on the assessments, it was concluded that the dad probably used a reversal parenting strategy [3, 21] to undo the neglect he had experienced, but having not experienced parental affection, he substituted sexualized affection with his daughters. It was recommended that the children be returned home, the father be taught how to show affection to children of different ages and genders, and the couple receive help with depression. Again, the central point is that sexual behavior, in both adults and children, can serve attachment functions. When that happens, attachment-based solutions may be needed.

4. Scientific underpinnings for the perspective offered here

We have developed these ideas over two decades [3, 4, 21, 22], but without strong scientific evidence. That is beginning to change and to do so quite rapidly with regard to smell and touch.

4.1 Smell and human bonds

Smell has long been known to influence fear-based protective behavior and sexual-based reproductive behavior very rapidly because of its single-synapse connection to the limbic system [23]. Smell has been implicated in immediate responses of sexual attraction [24, 25], fear [26], and disgust [27]. Some of our cases, for example, Little Man (genital intimacy), Green Tent (disgust), and Sneak Thief (genital intimacy) suggest how these universally human processes might function when children’s need for protection and comfort is threatened, especially when children need a rapid bonding process.

4.2 Touch and protection

Very recent work suggests a dynamical systems perspective on touch. Understanding touch is important for two reasons. One is its privileged neurological pathway from genetic predisposition to sensory stimulation to neurology (including dopamine and oxytocin release) to psychological feelings to behavioral pair bonding (both protective and reproductive attachment). These components of the pathway have most often been studied in isolation, but the most recent studies make connections across levels of representation. This facilitates understanding complex dynamic processes and their diverse range of outcomes. See Figure 4.

Figure 4.

A hierarchy of influences on behavior and development. (used with permission of Patricia M. Crittenden).

The second reason for the importance of understanding touch is that touch elicits very strong responses from professionals. We have proposed that in most cases sexual touch between children and adults is intended to protect and comfort the child by rapidly establishing an emotional bond. Without an understanding of the physiological processes and interpersonal needs of the individuals, professionals’ protective responses, that often involve separating children from caregiving adults, can have unexpected and harmful effects on both children and parents [28].

Research indicates that all mammals have genes for specific skin cells (that produce hair) that respond to stimulation with release of dopamine and consequent feelings of pleasure and sexual availability [29]. Slow stroking (i.e., soothing touch) releases oxytocin, that is experienced as affection and reduces anxiety and pain, whereas deprivation of touch produces feelings of loneliness and depression [30]. Further, this response is limited to intimate relationships and not social relationships. Additionally, there are individual differences in the need for touch [31]. Abdus-Saboor noted the evolutionary advantage for both attachment and reproduction of these privileged processes (Abdus-Saboor, as quoted in [32]).

This review suggests expanding the range of possible professional responses from constraining children, separating them from caregiving adults, and trying to change their behavior to considering whether they need protection from rejection, isolation, and abandonment.

5. New hypotheses about sexuality, relational bonds, and survival of individuals and the human species

Based on our cases, we offer four hypotheses regarding sexual signals and behavior in children:

1. Interpersonal behavior that appears sexual can function to speed the process of forming attachment and preserve endangered attachment relationships.

2. Strategies that contain sexualized behavior become increasingly complex as children develop, with the children taking an increasingly active role in the sexualization of attachment relationships.

3. Knowing the backstory can show how sexualized behavior is - or was - adaptive in particular family contexts.

4. Treatment that is individualized to meet unique person- and family-specific needs for protection and comfort will be more effective than treatment aimed at inhibiting sexualized behavior or separating children and parents.

6. Clinical implications for professionals

Professional guidelines require a proper evidence base that is currently unavailable on this topic. However, as cases like these are part of normal daily practice, we think the implications of our discussion, together with the principle of “first do no harm”, suggest three basic principles:

1. Obtain a detailed description of the sexual behaviors (so that functional attributions are possible) and the backstory before intervening, ensuring at least a three-generational perspective.

2. Provide for both parents’ and children’s attachment and survival needs (rather than trying to extinguish sexual behavior that signals unfulfilled needs).

3. Avoid child-parent separation if at all possible [28] because separation will increase children’s use of sexualized behavior.

6.1 The importance of backstories

The arousing effects of sexuality often lead professionals to omit the standard practice of obtaining a full family history. The focus on the inappropriateness of sexual behavior obscures its function when the legal-based labels prompt immediate action (e.g., “sexual abuse” or “sexual harm”, [3], p. 8).

Past separations might affect a family in the present in non-evident ways. An assessment of adverse life events, past and present, for all family members can help to reveal the possible attachment functions of sexual behavior.

6.2 Providing for parents’ and children’s basic attachment and survival needs

Intervention should address the causes of problematic behaviors, rather than suppressing them (etiologic versus symptom treatment). Developmentally, sexualized patterns of behavior can range from sexualized caregiving by the parent of an infant or a toddler, to enacted sexual approaches by an older child. Being developmentally precise about the behavior patterns can facilitate finding nuanced meanings for the behavior, directing to possible causes with more precision. Often the causes are anxiety about safety and comfort; this can be addressed by making the context safer and more predictable. Such things as safe housing in safe neighborhoods, sufficient food and clothing, dedicated and long-term attachment figures for the parents often result in more change than psychological services. For example, using para-professionals to structure the day with predictable routines (including especially regular meal times, outdoor time, and bedtimes) and the space (including keeping the house tidy and clothing clean and appropriate for the weather and activities). Once these things are orderly, the home will feel safer and work on relationships will be more productive.

Parents are often admonished to prioritize their children’s needs, and foster care is sometimes used as a threat to enforce this injunction. This only adds to parents’ need to protect themselves from loss, thus exacerbating the presenting problems. The opposite approach, of assisting parents to get in safer and comfortable situations, can facilitate management of problems. We see parents as children’s most effective protectors. Consequently, our thinking is that promoting parents’ safety and comfort will enable them to provide for their children.

6.3 Avoiding separation of children from parents or foster parents

When children are placed in care for their safety, the psychological trauma they suffer can never be fully repaired [28]. Moreover, foster or adoptive families should not always be assumed to be safer than biological families [33, 34]. Therefore, the attachment history of all caregivers should be explored carefully. In addition, children’s contribution should be considered: children’s sexualized strategies can harm not only the children, but also the adults trying to care for them (for example, Restless Nellie’s father). When parents have not been able to protect themselves, the professional community should avoid punitive or moralistic stances and try other approaches.

6.4 The danger of sexual behavior toward and by children

The idea that sexual behavior toward and by children is mostly an attempt to achieve protection and comfort should not be misunderstood to mean that such behavior is safe or unimportant. To the contrary, in all our case examples, sexualized attachment behavior occurred when children and often their parents as well were at very severe risk and unprotected. Therefore, these symptoms should be given high priority and redefined to bring them out of a specialized “sex-based” treatment, and be given full assessment and personalized intervention instead. Our cases suggest that compared to other presentations of distressed family relationships, those with sexualized symptoms tend to be more severe.

6.5 Limitations

When building theory on case studies, the lack of information about the prevalence of the considered conditions can skew ideas substantially [1]. Therefore, the theory we offer might be only relevant to a few cases. However, we did not exclude any cases that were inconsistent with the ideas offered.

6.6 Conclusion

The model we offer is based on observation and describes functional processes, pointing to new and hopefully more effective approaches to clinical intervention. As always, excitement and controversy are at interface between the known and unknown. We hope that redefining the function of sexualized behavior with children as being part of strategies to maintain protective child-parent relationships will encourage empathic attention to the needs of parents, reframe sexualized behavior with children as a sign of an intense need for safety and comfort, and reduce the designation of children as sexual perpetrators or offenders. We hope that professionals who use these ideas will be released from judgmental ‘police’ duty and freed to focus on their core motivation: helping people to live safer and more satisfying lives.

Acknowledgments

The authors appreciate the suggestions of Clark Baim, Mike Blows, Susan Spieker, and Simon Wilkinson.