CNN reported on a story this week regarding 4-5 year old children performing sex acts on each other at a preschool in California. While I’m not in a position to comment on that story, I would like to take the occasion to discuss some parenting implications.
Where does one draw the line between normative and troubling behaviors?
Kids are naturally curious about their bodies and the bodies of other children. For them to comment about such, make jokes, “play doctor” and engage in other expressions of curiosity is normative. Some elements that would make this troubling would be as follows:
√ One of the children is significantly older than the other one. A difference of three years is often used, though there are exceptions (e.g., in Pennsylvania the legislature has set a cutoff of four years between teens who have sex).
√ One of the children is forced to do something that s/he doesn’t want to do.
√ An adult is present.
√ Someone gets hurt, either physically or mentally.
√ Someone gets penetrated.
What might cause a child to abuse a peer?
Research and my clinical experience suggest three causes that are more likely 
than others (of course there may be more than one cause and this list is not comprehensive):
• The perpetrator has himself or herself been the victim of sexual abuse or sexual over-stimulation. The act of sexual acting out can be a child’s way of trying to cope with the trauma of having been a victim himself or herself.
• The child is suffering from juvenile onset bipolar disorder. Hypersexuality is one of the symptoms of bipolar disorder when it has an onset in childhood (which is not the same thing as saying that all children with bipolar disorder are hypersexual).
• The child has a serious case of childhood onset conduct disorder. Children with serious variants of this disorder organize their inner world around aggressive and violent themes. In these instances the sex act is a way of being violent towards and/or dominating another child.
What are the signs that a child has been sexually abused?
It isn’t really possible to be comprehensive as kids are too variable both in the ways they become symptomatic and the degree of trauma it takes for them to become symptomatic. That said, these are some of the more common symptoms:
√ Sudden onset of disturbance in regulatory habits (e.g., sleep, appetite). This can also be manifested by the undoing of previously accomplished developmental milestones (e.g., a child starts wetting the bed).
√ Exaggerated startle responses; this refers to jumping or acting startled upon experiencing routine or casual touches.
√ Intense fear expressed when it comes to approaching situations or people that are reminiscent of the abuse.
√ Sexual acting out.
√ Suddenly and persistently acting like the undead (i.e., having flat affect and disengaging from life).
√ Sudden and persistent mood disturbance (i.e., sadness, anxiety and anger).
Can you share six strategies that parents can use to prevent sexual abuse?
1. I believe the top prophylactic strategy is the maintenance of a good and 
consistent sex education program in the home. This should begin as young as your child can have a conversation with you. Obviously, you’re going to pace yourself on what you share when. The overall goal is to be the first one to cover a given topic (e.g., I don’t want a song or a peer to be the first one to introduce and define a sexual behavior or issue to my child). This is a blog entry with related content: Communicating with Teens about STDs
2. Make sure children are appropriately monitored when they come together. I discuss this extensively in Chapter Three of my parenting book, Working Parents Thriving Families (WPTF). Related content can also be found in these blog entries:
Teens Are Going to Have Sex and Drink, You Can’t Control That…Not!
10 Tips for Parenting Your Progeny’s Online Life
Recent Research: Teens Need Parents to Monitor Them
3. This is somewhat redundant with the first recommendation, but establish what good and bad touches are, what your child should do if approached for such and what your child should do if s/he experiences such. Part of this could be creating various vignettes for your child and asking him or her what s/he would do in those situations.
4. Ask the appropriate school administrator how they handle bathroom trips and 
activities. Partner with them on making sure that the monitoring and access are effectively managed. (You’d also want to ensure that there are not other occasions for children to be unmonitored for an extended period of time.)
5. Ensure that your child is appropriately monitored when not in school and in your home (I cover this extensively in the chapter I mentioned above).
6. Do “special time” each week with your child. This keeps the communication channels open. I discuss this extensively in Chapter One in WPTF. For a handout on doing special time click here.
What do I do if my child has suffered sexual abuse?
Get an evaluation done by an appropriately experienced mental health professional ASAP. For instance, Children’s Advocacy Centers are spread across our country. To find one near you, click here.
Dr. David Palmiter's Blog for Hectic Parents 