Many teens are having sex. (54% of teens have had sex at least once.) Many teens have multiple sex partners. (About 1/3 of 18 and 19 year olds have had 2 –5 partners.) About 3 million teens get STDs each year. Only 60% of sexually active teens are using condoms.
Infants and toddlers are learning about their bodies and the world around them, and spend a large amount of time learning and practicing names of things. They are interested in how their bodies work, and that interest includes their breast areas and genitals. Especially during toilet training, a good deal of a toddler’s time and energy is spent focusing on how to control bladder and bowel function. As a result, they may talk about their genitals regularly. Infants and toddlers also explore their bodies. Just as they move their arms and legs and poke their fingers into their eyes, they may touch their penis or clitoris or vaginal area to see what happens. Some infants and toddlers learn quickly that touching the genitals feels good, and so may masturbate. Infants and toddlers need physical affection. Providing hugs and cuddling infants and toddlers is a regular part of working with children of this age. A few adults worry so much about their actions being misinterpreted as sexual abuse that they are reluctant to hug children. Hugging and cuddling should not be misinterpreted as sexual abuse.
Set the tone that sexuality is normal Infants and toddlers are not ready for “sex education” or direct instruction about sexuality-related issues. The primary responsibility of adults working with children this age is to set a tone that sexuality is a normal part of being a healthy human being. The best way to do this is to be calm and matter-of-fact. Specific ways to support sexual development in infants and toddlers are outlined below. Teach them correct names for body parts, including genitalia. Children need to know the correct names for their genitalia. Calling genitals by “cutesy” names sends a message that there is something offensive or silly or different about those parts of their bodies. Calmly using the appropriate names sends the message that these are parts of the body, just as the elbow or knee are body parts. Children also need to know the appropriate names of their genitals in order to communicate better. A boy who has an infection in his penis will not be able to explain that to an adult if he has learned to call it by some cute name such as “monkey”. “Penis”, “vagina”, and “clitoris” are among the terms that are appropriate to teach a young child. React calmly to self-touching. Infants and toddlers explore all parts of their bodies, including their genitalia. Both boys and girls explore their genitals, but self-touch is most common in boys, especially during bathing and diaper changes. When a child strokes his/her genitals, adults can gently redirect the child’s hand, and redirect him/her to another activity. It’s important not to get upset and attach sexual meaning to the action. An adult who slaps the child’s hand away and reprimands him/her sends a negative message. Remember that self-touch is very common and typical in infants and toddlers. They are curious about their bodies, and learn quickly that touching their genitals feels good. Provide appropriate physical care. Changing diapers is a part of being an infant or toddler caregiver. Some caregivers are so concerned about allegations of sexual abuse that they are not careful about cleaning a child’s genitals during diaper changes. Make sure you do not caress a child’s genitals or touch in a way that other adults could interpret as inappropriate. But touching an infant’s or toddler’s genital area is a regular part of providing quality care for him/her. Hug and cuddle them. Some providers worry that any touch will be misinterpreted as sexual abuse. Hugging and cuddling children this age is an appropriate and important way to demonstrate affection and to build relationships. Don’t hesitate to offer hugs!
Three- and 4-year-olds have more completely developed language skills, and have learned how to ask questions in order to learn new information. Many 3- and 4-year-olds will ask anything that is on their minds, including questions that adults would consider inappropriate. Children this age do not have a sophisticated understanding of the pragmatics of asking questions; they do not realize that some questions are better asked in private. Children who ask, “Where do babies come from?” may not actually be asking about sexual intercourse. They may want to know something more basic, such as where they were born. Children do not need long, complicated, in-depth answers to their questions at this age. The most basic information is often enough to answer their questions. “Playing doctor” is the term many adults use to describe young children’s tendency to remove their clothes and examine each other’s bodies. “Playing doctor” is more common among mixed-sex pairs or groups, because children realize that boys’ and girls’ bodies are different, and are curious about the differences. Although not all children “play doctor,” it is common and normal in children this age, and does not have a sexual meaning. Masturbation continues to be common in young children, especially at naptime or when they are upset. Masturbation is usually used as a self-soothing mechanism. Many young children do not understand that it is considered inappropriate to touch their genitals in public, and so may masturbate in front of others unless taught not to do so. Adults tend to attach sexual meaning to young children’s actions when it does not exist. Three- and 4-year-olds do not have the cognitive or social/emotional skills to understand sexuality as adults do. Even when they masturbate or engage in other sexual-like behaviors, those behaviors do not have the eroticism associated with adult sexuality.
Set the tone that sexuality is normal Like infants and toddlers, 3- and 4-year-olds do not have an adult understanding of sexuality and are not ready for “sex education” or direct instruction about sexuality-related issues. The primary responsibility of adults working with children this age is to continue to set a tone that sexuality is a normal part of being a healthy human being. The best way to do this is to be calm and matter-of-fact. Specific ways to support sexual development in 3- and 4-year-olds are outlined below. Answer their questions in simple terms Young children are looking for basic answers to their questions, including questions such as “Where do babies come from?” The best approach to such questions is to ask the child open-ended questions in response, in order to gauge how much he/she understands already and exactly what question he/she is actually asking. A child who asks “Where do babies come from?” might be interested in how moms and dads make babies, or she might want to know where she was born, or she might wonder whether she can go to the store and buy a baby. Asking questions allows adults to tailor their answers to the specific questions a child is asking. Don’t attach adult meaning to their actions When young children masturbate or “play doctor”, they do not understand these as sexual activities. They are exploring because they are curious, or are repeating an action because they have learned it feels good. Provide appropriate guidance Three- and 4-year-olds have the cognitive and social-emotional maturity to begin learning that there are appropriate and inappropriate times and places for certain activities. A child who is masturbating can be redirected with an explanation that touching one’s genitals is an activity that is appropriate at home when you are alone, not at school with other people. Children who are “playing doctor” can be taught that everyone wears clothes at school, except when going to the bathroom or changing clothes for swimming. Encourage children to make choices Children build good decision-making skills over time and with practice. Children who are encouraged to make simple choices in early childhood will begin learning the skills that can be applied to later decisions about sex and other risky behaviors. As they get older, children can take responsibility for more complex decisions. Continue to show affection through hugging and cuddling Some providers worry that any touch will be misinterpreted as sexual abuse. Hugging and cuddling children this age is still an appropriate and important way to demonstrate affection and to build relationships. Don’t hesitate to offer hugs. Follow the child’s lead, however; if he/she is reluctant to be hugged, find other ways to express affection, such as giving compliments.
Concrete thinkers Children in early elementary school think in very concrete terms. They are not able to easily understand abstract concepts like “love” and “sex” except as they relate directly to their own experiences. This is one reason why children think that hugging and kissing transmit AIDS – because their understanding of sexuality includes only behaviors they have observed. Keep in mind that children this age will have an incomplete understanding of sexual intercourse because it is an activity that is outside their immediate experiences. Don’t connect intercourse and pregnancy Many elementary children have had the “facts of life” explained to them. They understand the basics of what sexual intercourse is. They have also had many opportunities to observe pregnancy, and understand the basics of a baby growing inside its mother. Most children this age do not understand that intercourse is what causes pregnancy, and that a woman who is pregnant has had intercourse. May be afraid of HIV/AIDS Many children this age have heard of HIV/AIDS. They know it is a serious disease that can kill people. Because they have an incomplete understanding of intercourse, they believe that behaviors such as hugging and kissing are ways that AIDS can be spread. They also may not realize that most people are not infected with HIV/AIDS. As a result, they may be afraid that being hugged or kissed by anyone will give them AIDS. More need for privacy in bathroom and dressing Many young children are comfortable using the bathroom and changing clothes in front of others, including members of the opposite sex. By the time they enter elementary school, most children have begun to realize that toileting and dressing are activities that most people do in private, and that there are parts of the body that are not typically shown to others.
Set a tone of “askability” The most important way to teach school-agers about sexuality is to communicate your willingness to answer their questions. Let children know that you are willing to talk about whatever topics interest them. Children who believe that adults are open and honest are more willing to ask questions, and are less likely to go to their friends for information. “Askability” also includes non-verbal information such as body language and facial expression. It is especially important to teach parents of school-agers to be approachable and “askable.” Answer questions matter-of-factly Children learn as much about sexuality from the tone of your response as from the actual words. A child who hears embarrassment or shame or discomfort from an adult will learn that sexuality is shameful or embarrassing or uncomfortable, and may not ask any more questions. Remember that children this age are very literal, and think very concretely. They do not need detailed information about all aspects of sexuality. Ask questions to find out how much they know and what they want to know, and shape your answers around what they say. Be sure to encourage children to talk to their parents about these issues. Discuss and relieve fears about AIDS If you hear children who are afraid of getting AIDS from hugging or kissing, let them know that it’s actually very difficult for a child to get AIDS. Make sure they understand that AIDS is not transmitted through hugging or kissing or sharing drinking glasses or any other everyday contact. Allow privacy if requested Children’s requests for privacy in the bathroom and when dressing should be honored. Adults need to be nearby in order to provide guidance and help if needed, but allowing children this age to dress and use the bathroom alone sends a message that you respect their independence and their feelings about their body. Teach decision-making skills Before children become adolescents, they need to learn the skills to make healthy decisions and communicate those decisions to others. Give children opportunities to evaluate different ideas, discuss ways to solve problems, talk about moral dilemmas, and make decisions about ambiguous issues. Model healthy relationships Children need to know that sex is healthiest when it happens in the context of a loving, committed relationship. Be a role model of healthy relationships (including intimate relationships, relationships with coworkers, and relationships with children’s parents). Model good communication, healthy resolution of disagreements, and genuine affection for others. Children learn a great deal about relationships by observing adults.
Healthy sexual development is very different from sexual abuse The preceding slides include milestones and behaviors of typical sexual development. Don’t confuse typical sexual development with sexual abuse. Children who are being sexually abused may show very different behaviors. Sexual abuse disrupts normal sexual development, unless the abused child receives intensive intervention to help him/her deal with the abuse. Sexual abuse happens. Unfortunately, some children (including young children) are abused sexually by adults or teens. Know the signs of sexual abuse! The next slide and the list-making activity in the curriculum outline will discuss signs of sexual abuse. Document, document, document If you observe something that makes you suspect that a child might be being sexually abused, your first and most important step is to document exactly what you observe. Be as specific as possible. Include what physical signs you saw, what was said, how the child reacted, etc. Keep track of exact dates and times when things happened. Report suspected abuse All early childhood professionals in Georgia are mandated reporters of suspected abuse. This means that you are required by law to report any suspected abuse to your local DFCS office. If you work in a center, begin by reporting your suspicions to your director or administrator, and sharing your documentation. You and your director can then decide who should make the report. The law does not require that you have absolute proof of the abuse in order to report a suspected case.
This list should be used as a summary of the ideas generated in the list-making activity from the curriculum outline. Regarding inappropriate sexual knowledge or behavior, remember that even very young children are sexually aware (as discussed in the previous slides). Inappropriate knowledge would involve a child talking about or demonstrating a sexual activity that children of that age would not typically encounter. One example of inappropriate knowledge would be a child who described oral sex, or demonstrated oral sex on a doll or stuffed animal. It is also important for early childhood professionals to know that most of these signs (especially nightmares, bedwetting, and appetite changes) could also be attributed to other issues besides sexual abuse. A caregiver should be more concerned if he/she observes several of these signs in the same child, or if he/she observes the signs repeatedly over a period of time.
Masturbation Remember that masturbation is common, especially in boys, starting in infancy. It is fine to redirect a child who is masturbating, and to teach a preschooler or school-ager that it’s not appropriate to touch one’s genitals except in private. “ Where do babies come from?” Most young children are not asking about sex when they ask this question. Start by asking an open-ended question such as “Where do you think they come from?” Playing doctor Children are curious about each other’s bodies. Beginning at age 2 or 3, children can be taught that they need to leave their clothes on at school, except when they are changing clothes or using the bathroom. Redirect children to another activity. Frank discussions about body parts These discussions are very common in 3- to 5-year-olds because they have the language to express what they are thinking, but not the social experience to know that genitals are not a topic that most people discuss openly. You may want to simply listen to these conversations; you may learn important information about how your children think and what they understand about sexuality. Discourage any talk that is insulting or negative. You can also gently encourage children to understand that there are times and places (e.g., at the grocery store) when it is not appropriate to discuss the genitals. Questions about homosexuality Most young children do not understand sexuality, and thus do not understand the sexual implications of a same-sex relationship (just as they do not understand the sexual implications of an opposite-sex relationship). Young children may have observed same-sex couples and may be curious. If a child in the class has same-sex parents, it is important to send the message to all children that there are many different kinds of families, and that all families are equally okay. Children who express negative stereotypes about homosexuality, or use “gay” as a derogatory term, are most likely to have learned these stereotypes from adults. Treat “gay” insults in the same way you would handle any other name-calling. Gender stereotypes 3-, 4- and 5-year-olds are learning who they are. One part of establishing that identity is identifying themselves as male or female, and adopting roles and behaviors and preferences based on that identification. Many young children have very rigid gender stereotypes (e.g., “That’s a girl toy” or “Only boys can play football.”) Challenge gender stereotypes whenever possible by providing real-world examples of adults in counter-stereotyped roles (e.g., male nurses, female truck drivers). Make it clear that all toys and activities in your program are open to both boys and girls, and that it’s all right for both boys and girls to like many different kinds of activities.
This is a common issue among parents. Some fathers, in particular, are concerned that doing “girly” things will make their sons gay. Reassure parents who raise this concern that there is absolutely no research evidence that connects what toys children play with, what games or sports they play, or what clothing they wear in childhood with the likelihood of being gay. Boys who wear dresses in the dress-up area are no more or less likely to be gay than boys who refuse to dress up, or who only wear suit coats and ties. In fact, research has shown that children raised by same-sex parents are no more likely to be gay than children raised by opposite-sex parents. As early childhood professionals, it is crucial to remember the important role that parents play in young children’s ideas and attitudes about sexuality. Sexuality education is first and foremost the responsibility of the children’s parents. At the same time, many parents are uncomfortable handling sexuality issues and questions with their young children, and may come to their children’s teachers for ideas and advice. Teachers may have to help parents figure out how to answer their children’s questions, and locate resources to support parents in their role as sexuality educators. The information in this class and the web sites on slide #26 are good starting places for teachers and parents who need more information about sexuality education in early childhood. You might probe participants’ own understanding of the issue a little further by asking, “Would your response be different if the child were a girl and the request involved dump trucks? If so, how?”
Youth Risk Behavior Surveillance System Centers for Disease Control and Prevention. (2005). The Youth Risk Behavior Surveillance System – 2005: National, state, and local data. Atlanta: Centers for Disease Control and Prevention. http://www.cdc.gov/HealthyYouth/yrbs/index.htm Add Health Study Resnik, M. D., et. al. (1997). Protecting adolescents from harm. Findings from the National Longitudinal Study on Adolescent Health. Journal of the American Medical Association, 278, 823–832. http://www.nichd.nih.gov/health/topics/add_health_study.cfm Kaiser Family Foundation Survey Hoff, T., Greene, L., & Davis, J. (2003). National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences . Menlo Park, CA: Henry Kaiser Family Foundation. http://www.kff.org/youthhivstds/3218-index.cfm
It's Never Too Early to Set the Tone
It’s Never Too Early to Set the Tone Handling Sexuality Issues and Questions in Early Childhood Diane W. Bales UGA Cooperative Extension
How Would You React? <ul><li>What do you think is happening here? </li></ul><ul><li>How would you feel about handling this issue? </li></ul><ul><li>What’s the first thing you would say or do? </li></ul><ul><li>What do you think children would learn about sexuality from your reaction? </li></ul><ul><li>What would you tell the child’s parents when they come to pick up their child? </li></ul>
Sexuality in Early Childhood? <ul><li>The development of healthy sexuality begins in infancy. </li></ul><ul><li>Sexual abuse disrupts normal sexual development. </li></ul><ul><li>Many adults feel uncomfortable with the idea of sexuality in young children. </li></ul><ul><li>Teachers can help parents teach healthy attitudes about sexuality. </li></ul>
Today’s Agenda <ul><li>Why should early childhood professionals care about sexuality? </li></ul><ul><li>The adult’s role in young children’s sexual development </li></ul><ul><li>Uncomfortable issues and questions </li></ul>
Session Objectives <ul><li>Participants will: </li></ul><ul><li>Describe typical sexual development in children. </li></ul><ul><li>List ways that adults can promote healthy sexuality in young children. </li></ul><ul><li>List signs of sexual abuse in young children. </li></ul><ul><li>Brainstorm ways to handle common sexual behaviors and questions in young children. </li></ul>
Why Does Sexuality Matter for Early Childhood Professionals? <ul><li>Children’s attitudes about sexuality begin forming early. </li></ul><ul><li>Attitudes learned in early childhood affect teen sexual behavior. </li></ul><ul><li>Young children learn about sexuality from adults around them. </li></ul>
Setting the Tone in Early Childhood <ul><li>Many teens are misinformed about sexuality. </li></ul><ul><ul><li>Many teens have multiple sex partners. </li></ul></ul><ul><ul><li>About 3 million teens get STDs each year. </li></ul></ul><ul><ul><li>Only 60% of sexually active teens are using condoms. </li></ul></ul><ul><li>Teaching about sexuality begins in early childhood, not in adolescence. </li></ul>
An Important Role for Early Childhood Professionals <ul><li>Young children who learn positive messages about sexuality are less likely to engage in risky sexual behavior later. </li></ul><ul><li>You can influence children’s attitudes about sexuality. </li></ul><ul><li>It’s never too early to set the tone! </li></ul>
Sexuality and Early Childhood <ul><li>Children begin learning about sexuality very early. </li></ul><ul><li>Young children are curious about their bodies. </li></ul><ul><li>You may have to face sexual behaviors and questions in young children. </li></ul><ul><li>Children pick up adults’ attitudes about sexuality (both positive and negative). </li></ul>
Sexual Development in Infants and Toddlers <ul><li>Interest in all body parts and functions </li></ul><ul><li>Focus on genitals during toilet training </li></ul><ul><li>Learn names of body parts, including genitals </li></ul><ul><li>Learn that self-touch feels good </li></ul><ul><li>Need physical affection </li></ul>
How To Teach Infants and Toddlers about Sexuality <ul><li>Set the tone that sexuality is normal </li></ul><ul><li>Teach them correct names for body parts, including genitalia </li></ul><ul><li>React calmly to self-touching </li></ul><ul><li>Provide appropriate physical care </li></ul><ul><li>Hug and cuddle them </li></ul>
Sexual Development in 3- and 4-year-olds <ul><li>Learn by asking questions and by experimenting </li></ul><ul><li>May ask “Where do babies come from?” </li></ul><ul><li>May “play doctor” </li></ul><ul><li>May touch genitals to soothe themselves </li></ul><ul><li>DON’T understand adult sexuality </li></ul>
How To Teach 3- and 4-year-olds about Sexuality <ul><li>Set the tone that sexuality is normal </li></ul><ul><li>Answer their questions in simple terms </li></ul><ul><li>Don’t attach adult meaning to their actions </li></ul><ul><li>Provide appropriate guidance </li></ul><ul><li>Encourage children to make choices </li></ul><ul><li>Continue to show affection </li></ul>
Sexual Development in School-agers (ages 5 – 8) <ul><li>Concrete thinkers </li></ul><ul><li>Don’t connect intercourse and pregnancy </li></ul><ul><li>May be afraid of HIV/AIDS </li></ul><ul><li>More need for privacy in bathroom and dressing </li></ul>
How To Teach School-agers about Sexuality <ul><li>Set a tone of “askability” </li></ul><ul><li>Answer questions matter-of-factly </li></ul><ul><li>Discuss and relieve fears about AIDS </li></ul><ul><li>Allow privacy if requested </li></ul><ul><li>Teach decision-making skills </li></ul><ul><li>Model healthy relationships </li></ul>
A Brief Caution about Sexual Abuse <ul><li>Healthy sexual development is very different from sexual abuse </li></ul><ul><li>Sexual abuse happens. </li></ul><ul><li>Know the signs of sexual abuse! </li></ul><ul><li>Document, document, document </li></ul><ul><li>Report suspected abuse </li></ul>
Possible Signs of Sexual Abuse <ul><li>Bruises or scratches on groin or inner thighs </li></ul><ul><li>Stained underclothes </li></ul><ul><li>Discomfort sitting or walking </li></ul><ul><li>Inappropriate sexual knowledge or behavior </li></ul><ul><li>Fear of a particular person </li></ul><ul><li>Nightmares and bedwetting </li></ul><ul><li>Sudden changes in appetite </li></ul><ul><li>Reports of being sexually abused </li></ul>
Ways to Feel More Comfortable with Sexuality Issues <ul><li>Know what’s typical. </li></ul><ul><li>Listen more than you talk. </li></ul><ul><li>Ask open-ended questions. </li></ul><ul><li>Empower parents to teach sexuality. </li></ul><ul><li>Use gentle guidance to shape behavior. </li></ul><ul><li>Remember that young children don’t understand adult sexuality! </li></ul>
Uncomfortable or Challenging Issues with Young Children <ul><li>Masturbation </li></ul><ul><li>“Where do babies come from?” </li></ul><ul><li>Playing doctor </li></ul><ul><li>Frank discussions about body parts </li></ul><ul><li>Questions about homosexuality </li></ul><ul><li>Gender stereotypes </li></ul>
Parents Matter Too! <ul><li>“ Don’t let my son wear the tutus in the dress-up area. I don’t want to turn him gay!” </li></ul><ul><ul><li>What’s behind this comment? </li></ul></ul><ul><ul><li>How would you handle this request? </li></ul></ul><ul><li>Take-home message: Parents’ attitudes matter! </li></ul><ul><li>Support parents as sexuality educators for their children. </li></ul>
For More Information <ul><li>UGA Cooperative Extension </li></ul><ul><li>www.fcs.uga.edu/ext </li></ul><ul><li>Sexuality Information and Education Council of the United States (SIECUS) </li></ul><ul><li>www.siecus.org </li></ul><ul><li>American Academy of Pediatrics </li></ul><ul><li>www.aap.org/healthtopics/sexuality.cfm </li></ul>
Sources of Statistics <ul><li>Youth Risk Behavior Surveillance System (YRBSS), Centers for Disease Control and Prevention </li></ul><ul><li>National Adolescent Health Longitudinal Study (Add Health), National Institute for Child Health and Human Development </li></ul><ul><li>National Survey of Adolescents and Young Adults: Sexual Health Knowledge, Attitudes, and Experiences, Kaiser Family Foundation </li></ul>