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Consider your thoughts so far regarding sexual behavior challenges. Are you wondering what could have happened to a student to make them act out sexually in a problematic way? Or what futures look like for a student who is having sexual behavior challenges? How can you support them and their families? We explore these topics as we move through this lesson.

Variability of Causes for Sexual Behavior Challenges & Other Concerns

As you learned in Lesson Four, sexual behavior challenges can affect students for many different reasons. These behaviors can be a result of sexual abuse; however, this may not always be the case. If you suspect sexual abuse, or a student reports that they have been sexually abused, or if a student has been in contact with a known sexual abuser, it is important to make a mandatory report.

作为教育工作者，重要的是要了解学生的性虐待迹象，但要意识到性行为挑战的其他潜在危险因素也很重要。有的学生不been sexually abused can also present with sexual behavior challenges. Consider a student with developmental delays who is struggling to learn personal space and may inappropriately touch themselves or others. Or maybe a student repeats the sexually explicit material seen on TV after an older sibling left the TV on. Students may also display sexual behavior challenges such as self-soothing through masturbation in response to traumatic events. These are all examples of paths to sexual behavior challenges that do not involve sexual abuse.

If a student experiences these challenges or needs, communicate your concerns with your school leadership. They will help decide next steps to take, including contactingPUBLICa specialistand communicating with the family about resources and supports. Communicating early and working as a team provides the family with options for support and can prevent a student with risk factors from developing sexual behavior challenges.

Potential Intervention Options

As educators, it is beyond our scope of practice to provide mental health services for students who present with sexual behavior challenges. However, you should be informed on intervention options for sexual behavior challenges available to students and their families. It is important to be aware that different programs and schools refer to these resources by various names. For example, mental health professionals can include counselors, psychologists, psychiatrists, or social workers. These professionals may provide counseling, therapy, intervention, or treatment. Certain settings may also include specialists, such as board-certified behavior analysts, occupational therapists, and intervention specialists. In learning about the various types of providers, you should be able to identify who the point persons in your school are for questions related to sexual behavior challenges. If you do not know, seek out this information.

家庭应该接受那些了解性发展、儿童和青少年发展以及研究性干预的提供者的干预（NTCSN，2009）。心理健康专业人员将考虑鉴别诊断，并将综合考虑儿童或青少年的环境、养育方式、家庭和社会因素。每项评估都是独特的，治疗决定是在个案的基础上作出的，旨在实现限制性最小的治疗选择（Martin，2019）。针对性行为挑战的两个研究性实践是以创伤为中心的认知行为治疗（TF–CBT）和问题性行为认知行为治疗（PSB–CBT）。

During the child or adolescent’s initial assessment, the mental health provider may ask that you, as the educator, contribute to your student’s assessment. Often, you will be provided with a questionnaire or checklist to complete. In addition to other assessment materials, your information helps the mental health professional make a recommendation for outpatient or more intensive therapy, such as inpatient or residential care, depending on the severity of the behaviors, the presence of additional mental health concerns, or previous unsuccessful treatment.

作为干预进展，心理健康提供者将与儿童或青少年和家庭合作，可能在个人或团体和家庭治疗格式中，以创造一个发展适当的干预计划。通常，咨询将包括，但不限于识别和建立健康的边界，自我监管技能和家长管理培训。以下是对性行为挑战的干预的一些例子可能根据心理健康专业人士的建议看起来像：

• The student who mimicked sexually explicit acts when their older sibling left the TV on may be recommended to have weekly outpatient intervention that includes all the family members to help establish healthy boundaries and parent management.
• 具有不适当的触摸的发展延误的学生可能会受益于每周两到三次的门诊咨询，以帮助父母和儿童或青少年建立健康的界限和自我规定技能，并解决其他需要的领域。
• 由于创伤事件而通过自慰自我安慰的学生可以在半天门诊中接受服务，以学习创伤应激反应的应对技能，以及探索性行为的适当时间和地点。如果在重症门诊环境中，心理健康专业人员发现儿童或青少年的家庭生活是一个更大的风险因素，或者创伤比最初诊断的更严重，他们可以被转移到住院或住院护理机构。根据设施的不同，儿童或青少年与家人的互动可能有限，日常生活结构也会增加，定期的治疗干预可以包括个人和团体咨询。尽管儿童或青少年的干预计划是保密的，但作为一名教育工作者，了解自己能为帮助儿童或青少年做些什么是至关重要的，尤其是当他们重返课堂时。

Incorporating Intervention Strategies

对于有性行为挑战的学生，如果继续就读于你的学校，除了接受干预外，你可能会被要求遵循建议。其中一些建议可能是你作为课堂管理的一部分已经在做的事情，以支持积极的监督。心理健康专家可能会要求你将策略融入日常生活，以强化学生在干预过程中所学的知识。根据Mitten、Sigel和Silovsky（2017）的研究，讨论性行为规则是一种可以防止性行为挑战的策略。在与学生讨论这类信息之前，还应与家庭进行沟通，以免家庭在信息呈现后出现问题或评论时措手不及。以平静的方式呈现信息有助于学生更开放地讨论敏感话题。

Schools are charged to keep all students safe. To address this concern, you may be asked to provide additional supervision for students receiving intervention for sexual behavior challenges. This may look like creating a supervision or safety plan with the students’ families and school administrators to ensure the safety of all students. This is especially important if the child or adolescent exhibited sexual behavior challenges toward other students. Also know that when a sexual behavior challenge has occurred, your school leadership will consulta specialist. 根据专家的不同，在进行转诊和the specialistis able to consult or complete an evaluation of the student. In this instance your school’s leadership will put a temporary supervision plan in place until given further guidance.

Supervision plans can include:

• 视线监督
• 支持ive shadowing (one-on-one)
• 在休息和午餐期间，在抵达时，学生的视线监督或支持性阴影，并在出发时
• Supervision of the student during other times of the day that are less structured or have reduced supervision
• 指定游戏区
• 监督学生使用洗手间
• Supervision for sports, including changing areas (e.g., for swimming)
• 学生的程序在全天内使用指定的成人进行办理登机手续
• A plan for responding to subsequent inappropriate sexual behavior, which may include a set of escalating consequences
• 具体的行为管理策略，包括加强适当行为的计划
• A plan to involve the student in positive activities with peers
• 一个通信计划，指定将如何以及与其共享的信息
• 指定的案件经理
• A scheduled review and update of the plan
• 明确沟通规则
• implementation of coping or calming skills, including those for the educator similar to CAPPD model in第一课and the self-care strategies in the Focused Topics course, Trauma-Informed Care,Lesson Four

It is important that the safety or supervision plan is periodically reviewed as the student progresses in their intervention (在小学中回应儿童的问题性行为，1999）。

School Interventions

Schools can implement policies and preventive measures to address sexual behavior and be a supportive factor for students with sexual behavior challenges by:

• Reviewing policies regarding communication about sex education, promoting abuse prevention, and working with families affected by sexual behavior challenges.
• Offering sex education for families to incorporate the entire support system to engage in healthy communication about appropriate sexual development.
• 期待学校顾问或与临床辅导员合作，以便在健康的边界，自我监管技能和安全触摸上实施课堂课程。学校和临床辅导员还可以帮助与学生或家庭一起单独与家人一起举行，以协助监督计划并讨论咨询推荐。

See

解决性行为挑战的干预是个性化，基于每个学生的具体需求。在多学科团队工作时，在学校设置内以及与学校外的专业人士合作时，您将贡献您对学生的优势，挑战和发展所知的贡献，因此团队有深入的信息，以通知评估和干预计划。由于专家们谈到了性行为挑战的学生的评估过程和基于研究的干预措施。

Assessing Students with Sexual Behavior Challenges

性行为挑战的干预措施

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As you think about your role as a professional working with students, reflect on what you can do to be a part of a supportive team. Reflect again on your personal biases of working with students experiencing sexual behavior challenges and how these biases have an impact on the support you provide. Consider these guidelines and standards of care for professionals working with children and adolescents who exhibit sexual behavior challenges provided by the National Center on the Sexual Behavior of Youth:

• 认识到您促进社区和家庭安全工作的重要性。
• Be aware of the potential for significant impact and life-altering consequences that your practices may have on youth and their families.
• 告知儿童，青年及其家人，专业人士是虐待儿童的任务记者。
• 确保您的学生以发育和认知的适当语言完全了解情况。
• 在征得家庭同意的情况下，与外部专家和机构合作，让学生的干预感觉像是团队的努力。
• 遵循相关的实践指南和道德标准（例如，性虐待者的介入协会的标准和指导方针以及您的职业的协会）。