Based on the case study, punishing the child for normal masturbation led to sexual guilt and dysfunction in adulthood like not allowing intercourse. Negative reactions to normal childhood sexual behavior can have long lasting harmful effects. It is important that children are guided developmentally appropriately without shame, anxiety or trauma.

1. Learning is relatively permanent change in
behavior potential. There is no exemption for
sexual learning

3. Sexual Activity begins from the womb
and ends after 5 minutes of death.

4. No Exemption sexual behavior is learned in the
same manner such as other behavior is
learned
Birth-1yr Trust Mistrust
1-3 yrs Autonomy Shame
3-6yrs Initiate Guilt

5. Stages in Sexual Behavior
• Age-appropriate sexual behavior are seen
in children in various stages.

6. Pre-school children, age 0 to 4 years
• Shows, touches, or rubs own genitals, or
masturbates as a 'comfort' habit in public.
• Kisses and hugs others.
• Is curious about and looks at other's private
body parts; has limited understanding of
privacy needs.
• Talks about private body parts.
• .Plays 'house' or 'doctor' games.

7. Young children, approximate age 5 to
9 years
• Kisses and hugs others.
• Displays an interest in others' private body parts but is
aware of the need for privacy.
• Talks about and occasionally shows private body parts to
others.
• Uses words such as 'poo', 'bum' and 'willy' freely and
delights in being 'shocking'.
• Sometimes uses swear words and/or 'sex' words copied
from others.
• Plays 'house' or 'doctor' games.
• Sometimes touches or rubs own genitals, or masturbates as
a comfort habit.

8. Pre-adolescent children, approximate
age 10 to 12 years
• Kisses, hugs, and may 'date' others.
• Is interested in others' private body parts and
in the changes occurring in puberty, is aware
of the need for privacy.
• May ask questions about relationships and
sexual behaviour.
• May look at sexual pictures including internet
images.
• Masturbates in private

9. Adolescent children, approximate age
13 to 16 years
• Kisses, hugs, dates others, may have longer term
relationships.
• Is interested in and asks questions about body parts,
relationships and sexual behaviour. Is aware of the
need for privacy.
• Uses sexual language and talks about sexual acts with
peers.
• May look at sexual pictures including internet images.
• Masturbates in private.
• Experiments sexually with adolescents of similar age.

10. Sexual Behaviour in
Children

11. • Childhood sexual activity begins in infancy and early
childhood.
• Many children explore their genitals as infants and
some instances of childhood masturbation is also seen
• Children learn about sexuality as infants and continue
learning throughout their life.
• They begin to discover their bodies and take notice of
other's .
• Sexual activity like mouth to genital contact, some sort
of penetration with another child is involved rarely,
which are painful to the child.

12. Stress and Sexual Activity
• If sexual activity increases above original
level, it is an indication to the fact that the
child is stressed about some matter.
• They find the sexual activity comforting
during stress.

13. Normal Behaviour
• Touching/masturbating genitals in
public/private
• Viewing/touching peer or new sibling
genitals
• Showing genitals to peers
.

14. Normal Behaviour
• Standing/sitting too close
• Tries to view peer/adult nudity
• Behaviors are transient, few, and distractible
• This infactuation,discovery of pleasurable
feelings and desire for knowledge is
completely normal

15. Normal Behaviour
• The clearest example of sexuality during
childhood are genital fondling and sexual
play,although there are also subtler
indicators that many children are aware of
their own and others sexuality

16. Less common normal behaviors
• Rubbing body against others
• Trying to insert tongue in mouth while kissing
• Touching peer/adult genitals
• Crude mimic of movements associated with
sexual acts
• Sexual behaviors that are occasionally, but
persistently, disruptive to others
• Behaviors are transient and moderately
responsive to distraction

17. Uncommon behaviors in normal
children
• Asking peer/adult to engage in specific sexual
act(s)
• Inserting objects into genitals
• Explicit imitation of intercourse
• Touching animal genitals
• Sexual behaviors that are frequently disruptive to
others
• Behaviors are persistent and resistant to parental
distraction

18. Rarely normal
• Any sexual behaviors involving children who are 4 or
more years apart
• A variety of sexual behaviors displayed on a daily basis
• Sexual behavior that results in emotional distress or
physical pain
• Sexual behaviors associated with other physically
aggressive behavior
• Sexual behaviors that involve coercion
• Behaviors are persistent and child becomes angry if
distracted

19. Reaction Towards Normal Behaviour
1. Even in the case of normal behaviour Parents
or guardians react negatively to the thought
of their children engaging in any sexual
thinking or behaviour

20. Reaction Towards Normal Behaviour
2. Parents or guardians have a tremendous
impact on the sexual development of their
children, and should not take it lightly.

21. Reaction Towards Normal Behaviour
3. Many children receive typically negative
reactions from their parents when they are
found masturbating, but self-stimulation is
actually a natural form of self-exploration

22. What the Children should know
• Children should not be punished or
discouraged(as long as the social context is
appropriate),and taught that self-exploration
id dirty or bad, but rather that masturbation
is a private matter and should not be
performed in public. Negative responses Can
lead to likely increase in guilt and anxiety.

23. Punishment and Future
Effect
• Punishing the child during
masturbation will lead to
permanent sexual dysfunctions.
• If the parent control the sexual
activity it results in guilt.

24. Completion of Phallic Stage and its
Importance

25. • According to Freud's Psychosexual
Development, The Phallic Stage lasting from
3yrs to 6yrs is the stage when the primary
focus of the libido is on the genitals. At this
age, children also begin to discover the
differences between males and females.
• Completion of Phallic stage is necessary for
normal sexual behaviour

26. How to Manage
Child Masturbation

27. When and How to
• If the activity becomes
compulsive and interferes with
other normal activities or the child
cannot be distracted easily from
the masturbation
• If the child stimulates intercourse
with another child
.

28. • If any penetration with
another child is involved
• If the activity is intrusive or
painful to the child

29. • If the activity increases
much above the original
level indicating the child is
stressed about something
and is trying to comfort
themselves
• If there is mouth to genital
contact between one child
and another.

30. • If it seems to be accompanied by
the trauma to the area from
scratching or rubbing
• If the child performs masturbation
in a public place, request the child
to perform the activity in private
like urination and defecation.
• If the child uses any material such
as pencil, small toys parents or
caregivers have to interrupt

31. Consequences of Punishment
• Sexual Desire id controlled by a balance
between inhibitory and excitatory factors.
this is thought to be expressed via
neurotransmitters in selective brain area. A
decrease in sexual desire may be due to an
imbalance between neurotransmitters with
excitatory activity like dopamine and nor
epinephrine and neurotransmitters with
inhibitory activity like serotonin

32. • Punishing the child during
masturbation leads affect the
brain areas which leads to
sexual guilty and associated
personality disorder.

33. • Punishing may also lead to
masochism-It is nothing but classical
conditioning that mostly happens
when attaining initial sexual orgasm
is associated with pain, there is also
a chance when the future sexual
orgasms are also associated with
pain.

34. CASE STUDY
• Age:28yrs
• Gender: Female
• Brought to clinic by her parents and husband complaining of not
allowing to perform sexual intercourse.
• Physically well
• Not Diabetic
• Not Hypersensitive
• Hormone study normal
• No interpersonal problems with the spouse. There is tolerance as
and when the husband touches her private parts
• History: Mother repots that there was an incident of punishing the
patient as a child when the mother found the child masturbating,
then on continued to do so in private but the mother noticed her
behavior and manhandled the child for doing so.