When the child is in care

• The child’s behaviour is often their primary language.
• They may internalise or externalise their feelings.
• Boys who have been sexually abused may demonstrate overt ‘toughness’ as a strategy, and develop a hyper-masculine shield to counteract feelings of powerlessness.
• Girls may internalise their distress, becoming withdrawn, anxious and depressed – which can lead to their distress and needs being overlooked.
• However, many children do not fit either of these ‘gendered scripts’. Look at the whole child, rather than using sex-based assumptions to predict how their distress may show up. Your response must be to the behaviour demonstrated, not an assumption based on gender stereotypes.

Children who have suffered child sexual abuse, possibly alongside other forms of complex trauma, may require care that is not just safe but actively therapeutic. The child's history of abuse and subsequent removal creates a fundamental sense of unpredictability and insecurity. It’s important to:

• minimise how often the child moves home, wherever possible
• recognise the role the carer plays in providing reparative care
• adopt a trauma informed approach to care, which will help the carer understand the child’s behaviour as communication of unmet need
• consider how you can build a safe and consistent network of adults around the child
• ensure the child’s care plan states clearly whether siblings (including step-siblings) are placed together or apart, and the rationale for this based on a formal sibling assessment.

Children who have been sexually abused often exhibit behavioural changes upon entering care. They may become emotionally dysregulated, struggling to manage their feelings and responses to everyday situations. If this happens, it’s important to:

• consider how the child will be supported to emotionally regulate, build healthy relationships, and reduce their feelings of shame by understanding their behaviour as a trauma response 
• provide safe and predictable responses which support the child in being able to trust again
• support carers to build trust by being transparent, honest and reliable, keeping promises within appropriate boundaries.

Children who have been sexually abused are not a homogeneous group; they have different needs, vulnerabilities, and different ways of expressing their trauma.

• Children with physical or learning disabilities face unique vulnerabilities that increase their risk of abuse. They are at greater risk of sexual abuse and may struggle to communicate their needs.
• Children with speech, language or communication needs may find it difficult or impossible to report harm using traditional methods. This may also limit their capacity to process and express their emotions in a safe care setting.
• Some languages do not have the words to talk about their abuse. If a child’s first language is not English, be mindful that this may inhibit their ability to discuss body parts, intimacy or the sexual abuse that has happened.
• When considering the vulnerabilities of neurodivergent children in care who have been sexually abused, it is necessary to consider the intersection of neurological differences, the impact of trauma, and the systemic challenges of the care environment.

Finding the right carer for a child with a history of sexual abuse requires a nuanced assessment which meets the child’s complex needs. The carer will need specific emotional and psychological competencies that go beyond general caregiving, including an understanding of:

• how sexual abuse impacts a child’s brain and behaviour
• how to respond to sexualised behaviour in a trauma informed way, reducing the impact of shame.

When considering whether a carer may be suitable, consider too:

• the household composition
• their ability to offer long-term stable care
• what support they may need to effectively meet the child’s needs
• their capacity to manage contact (if necessary)
• whether they too have experienced sexual abuse, as this may affect their response.

A significant challenge occurs when the Family Court does not find facts about child sexual abuse, but does find facts about physical or emotional abuse or neglect. In that case, children’s social care will need to navigate the space between the legal outcome and any ongoing safeguarding duty. There may also be implications for finding a suitable carer. 

• If the social worker underplays sexual abuse concerns to make a child appear ‘easier to place’, they inadvertently set the care arrangement up for failure.
• Where facts have not been found but the social worker’s concerns remain, these should be documented as ‘shadow risks’ in the safety plan
• The social worker and other practitioners working with the child should advise potential carers that the child may only start to tell or exhibit sexualised behaviours after they feel safe in their new home.

Bear in mind that, when a history of sexual abuse is not formally acknowledged in the care plan, the child may feel ‘unheard’ by the system – and this is likely to reduce their trust in the adults around them.

Many children who have been sexually abused find it difficult to settle into a new care setting. Even an experienced and attuned carer may struggle to build a relationship with them. 

• The child may experience heightened feelings of mistrust, fear and anxiety – which may show as a reluctance to engage, difficulty forming attachments, or even withdrawal from those around them.
• Establishing trust can be a slow and complex process.
• Monitoring the placement closely and remaining vigilant to the child’s behaviour is essential.
• Building a therapeutic and trusting relationship requires a collaborative approach involving not only the carer but also other practitioners, and potentially the child’s trusted adults.

As the child’s social worker, you should be mindful of presuming safety too quickly.

• Safeguarding reviews have illustrated that children who have been removed from abusive or neglectful homes remain highly vulnerable to subsequent harm.
• Monitoring the care placement, especially for a child with complex needs, requires a heightened and nuanced approach. Be mindful of potential risks within and around the placement.
• Distressed behaviour may signify both the process of healing from past trauma and/or the presence of current, new or ongoing abuse.
• Remember that people who sexually abuse children come from all walks of life and may seek positions of trust and authority near vulnerable children for the purpose of abusing or exploiting them.
• Make the child an active participant in their safety and stability, and ensure their voice is heard, without placing the responsibility for their safety on them.

The child may display behaviours that appear sexual in nature and are developmentally inappropriate or occur with a frequency and intensity that is unusual for the child’s age. Sexually abused children often use these behaviours as a sensory, self-soothing method to cope with anxiety or counteract trauma-induced dissociation.

The child’s carer(s) should be educated to adopt a trauma-informed approach when responding to sexualised behaviours: avoid pathologising language, provide safe sensory alternatives, maintain routine and predictability, and offer non-judgemental affirmation.

Where a sexually abused child displays harmful sexual behaviour, you will need to consider carefully who they live with and spend time with. Remember your responsibility to safeguard other vulnerable children and adults, as well as the child themselves. 

• Risk and needs assessments should look beyond the specific sexual behaviour to the child's broader social ecology, including their family dynamics, school environment, peer relationships, and use of social media and technology in general.
• The home safety plan should focus on the carer's role in supervision, managing family dynamics (including with siblings and any other children in the home) and controlling the digital environment.
• Safety plans in the home and the school should address the environmental risks, supervision structures and privacy needs in each location – but responses to incidents of harmful sexual behaviour should be consistent across settings.
• Consider whether generic assessment frameworks are adequate, and whether some specialist assessment may be beneficial – but carry out a consultation before commissioning this.

It’s important to recognise that the child may pose a risk to others but is vulnerable themselves. Children with learning disabilities are more vulnerable both to being sexual abused and to displaying inappropriate or problematic sexual behaviour.

Technology is playing an increased role in daily life, and the development of artificial intelligence creates an additional element of risk to vulnerable children. As digital platforms and online interactions continue to evolve, new risks emerge for children and vulnerable adults. Assessments, support and safety plans should consider:

• the role of technology in any harmful behaviour experienced or displayed by the child
• the risks posed by AI companions, especially for vulnerable and socially isolated children
• how to respond to and monitor technology-assisted harms
• the support that carers might need to develop their skills in the fast-changing digital landscape.