INTERAGENCY COOPERATION An early effort is imperative to prevent injury and provide help to vulnerable children struggling with problematic and harmful sexual behaviour. Such complex situations require a coordinated effort across professional groups. A well-established interagency relationship – with clear goals and defined roles – increases the chance of children getting the professional and social assistance they need – when they need it. Previous Next Innholdsfortegnelse Listen to a read-aloud version of the text on this page 1.4 Interagency Cooperation RVTS Mid 00:00 / 00:31

REPORT AND INVESTIGATE The sexual acts may be illegal and require police investigation, but the children still need much help in multiple areas. Several services and agencies then have to assist in the effort. If you are in doubt about filing a report you can contact Statens barnehus, the Child Welfare Service or the Police. Different ways to interpret problematic and harmful sexual behaviour (not exclusive) Reaction to own trauma Lack of social skills Impulsivity Loneliness, depression Difficulties regulating emotions Learning difficulties and neurological issues Difficulties forming connections Wanting attention Lacking in knowledge of sexuality, laws and regulations Curiosity and sexual arousal In need of supervision and safety Previous Next Innholdsfortegnelse Listen to a read-aloud version of the text on this page 5.7 Report and investigate RVTS Mid 00:00 / 00:58

CONSULTATION The Child Welfare Service is responsible for coordination in cases about harmful sexual behaviour, and will hold a Consultation. The Consultation is held shortly after the behaviour has occurred, so that all parties gain a common understanding of what is to happen next. Suitable agencies to include – excluding the school (contact teacher, guidance counsellor, principal) – are PPT, family protection services, BUP, the Police, Statens Barnehus, general psychologist, Bufetat. Guardians are allowed in during the last part of the meeting. The purpose of this meeting is to create a plan for the immediate future with everyone involved. Illustrasjon: Jens A. Larsen Aas Previous Next Innholdsfortegnelse Listen to a read-aloud version of the text on this page 6.2 Consultation RVTS Mid 00:00 / 00:47 Listen to a read-aloud version of the reflection 6.2 The origin of the Consultation – a reflection RVTS Mid 00:00 / 01:22 In this recording you will hear Helle Kleive, psychology specialist at Resource unit V27/Betanien Bergen, speak on the origin of the Consultation. V27 is a clinical resource unit for the BUP units in Helse Vest. It is connected to BUP at Betanien hospital. The target group of V27 is children and adolescents who display problematic or harmful sexual behaviour toward other children. The unit also offers training and guidance to professionals, authorities and agencies. Read a transcript of the audio recording Consultations were invented by me and a now retired colleague from E27, after half a year of working on the format. We were in Sweden in 2008, and they said: “we never start working a case like this without first calling a consultation”. There was an established routine where every authority was gathered, and then came up with a plan together. We didn’t have this in Norway, we had chaos, so me and my colleague based our idea on interprofessional team meetings, but changed it up a little. People were always talking over each other in those meetings, so we added a rigid structure and a clearly defined end product. This is how we made the Consultation, which is still in use today, I assume because of its effectiveness. The structure should work for more than just children and young people who have committed sexual violations, which is another reason I think it’s stuck around; it has a clearly defined structure, making it ideal for any number of situations.

THE SCHOOL’S RESPONSIBILITY The Education Act Section 9A-4 (Obligation to act in order to ensure pupils a good psychosocial environment), states: “Everyone working at the school must keep an eye on the pupils to ensure they have a good psychosocial school environment, and if possible, intervene against violations such as bullying, violence, discrimination and harassment. (…) Everyone working at the school must inform the head teacher if they suspect or find out that a pupil does not have a good psychosocial school environment”. THE OBLIGATION TO ACT CONSISTS OF FIVE SUBSECTIONS: Obligation to pay attention (Investigate and observe to gather information on what occurred.) Have conversations with the pupils involved to better understand what happened, and support everyone involved. Obligation to intervene Obligation to notify the school management (principal) Obligation to investigate (investigate and observe to gather information on what occurred.) Obligation to implement measures (make a plan of action) THE SCHOOL MUST CREATE A WRITTEN PLAN WHEN MEASURES ARE TO BE IMPLEMENTED IN A CASE. THE PLAN MUST DESCRIBE: a) What problem the measures are to solve b) What measures the school has planned c) When the measures will be implemented d) Who is responsible for implementation of the measures e) When the measures will be evaluated. The school must document what will be done to comply with the obligation to act. You MUST abide by The Education Act Chapter 9A if you receive information or suspect someone is exposed (by other pupils) to, or exposes other pupils to problematic or harmful sexual behaviour. Listen to a read-aloud version of the text on this page 4.5 The Schools responsibility RVTS Mid 00:00 / 01:57 «A need for observation and information gathering to ensure the correct actions are taken by adults.» - THE TRAFFIC LIGHT, P. 5 Previous Next Innholdsfortegnelse

THE TRIUNE BRAIN In order to function, the brain requires the different parts of itself to cooperate seamlessly. To simplify, we can say we have a survival brain, an emotional brain and a logical brain (MacLean, 1985). The survival brain is in control of functions like reflexes, breathing, heartbeat, blood pressure and body temperature. The emotional brain is central to emotional states like anger and fear, and controls memory functions and stress hormones. The logical brain provides us with language, awareness, the ability to reason and consciously controlled motor functions, among other things (Stien & Kendall, 2004). TWO MOTIVATIONAL SYSTEMS ARE IN CONTROL OF OUR ACTIONS The survival system (often called the alarm system) makes sure one is safe and out of harm’s way. The exploration system is characterized by curiosity and stimulates exploration, discovery and learning. The systems can’t be “on” at the same time, and the survival system always overrides the exploration system. Prior life experiences strongly affect how the systems cooperate with each other. When children have experienced something hurtful their survival system will, most of the time, be active, and the exploration system inactive. The children are occupied with scanning their surroundings for danger, which hinders their ability to learn. Even though we adults know the classroom is safe, the brains of these children are preparing for danger. To change this, the children need constant safe experiences in the classroom, until their brain has enough of them to realize it is, in fact, safe. The teacher’s understanding, predictability and perseverance can help the children’s brain to increasingly activate the exploration system. Doing this will improve the children’s learning ability, and the children get to experience the good of the world (Ringereide og Thorkildsen, 2019). LECTURER Kjersti Draugedalen has worked as a primary school teacher for over 10 years in Uganda, Groruddalen and Re municipality. She has further education in pedagogical guidance and sexual assault in the perspective of a lifespan. She is currently working on a public Ph.D. titled: “The opportunity teachers have to discover and implement measures for children and young people displaying harmful sexual behaviour in primary school”. Draugedalen is a proponent of inclusivity in schools, and especially the important role a teacher plays when meeting vulnerable children. RESOURCES Listen to a read-aloud version of the text 1.1 The triune brain RVTS Mid 00:00 / 00:50 Previous Next Innholdsfortegnelse As teachers we often meet pupils who challenge us in different ways, and this changes us as teachers. What maybe changes us most is meeting pupils who display problematic or harmful sexual behaviour. We adults usually panic and lose the calm needed to best approach the situation. However, new brain research may allow us to approach pupils struggling, especially with a sexualized behaviour, but also other kinds of disruptive behaviours. You see, the brain is divided into three parts: we have a survival brain, an emotional brain and a logical brain. The logical brain is activated when we are safe and calm, but the connection between the logical brain and the survival brain is shut down when we are worried and in a state of emergency preparedness, as we call it. This means that if us teachers are to educate pupils open to learning new things, we need the logical brain to be firmly activated. A very useful tool for explaining when children and adults have their logical brain “on”, is “the Window of Tolerance”. All humans have a window of tolerance, and while we are safe and open to learning within it, outside of it we enter “emergency preparedness”. Being in a state of emergency preparedness means the body is completely focused on how to avoid danger. For teachers, this means that we have to regulate children into their window of tolerance in order to educate, which, in turn, requires us adults to be calm and regulated ourselves. It is typical of us adults to go outside of our tolerance window when we are met with harmful sexual behaviour. It is therefore very important for us to be aware of our own triggers and reactions in order to approach children in the best possible way. We teachers use ourselves to teach, meaning our own self is the main tool we use in our profession. This fosters not only professional development, but a personal development, and means that when I, as a teacher, become triggered, I have to be very aware of what is happening to me personally, since I am the tool in the situation. Yes, relations and safety in school have been discussed for many years, but I think what is missing from the conversation is how we as teachers integrate ourselves when working on relations. Since, when we are safe and calm ourselves, we can make our pupils feel safe. We teachers need to stay calm upon meeting challenging behaviour. Being able to deal with pupils who behave in a way that triggers us, may be one of the most important things we do. You see, to be able to make change happen, we need to have a close relation with the pupil in question. In other words, us teachers are responsible for the relation and must invest in it from the first day of school, so that when hurtful and difficult situations occur, we can help regulate the pupil into their tolerance window. We can then encourage change via close dialogue and genuine guidance that does not feel constructed or fake. I believe attempting to correct pupils displaying any kind of challenging behaviour – but maybe especially sexualized behaviour – without having laid the ground work of building a relation, can result in the intervention going so badly you close the door on providing aid. This is why we emphasize building relations and safety first as part of the work of universal prevention in schools. Kjersti Draugedalen, Pedagog, Tønsberg kommune. Show transcript Duration: 5:14

DIFFERENT CAUSES FOR THE BEHAVIOUR It can be the result of unfortunate sexual experimentation, or maybe a reaction caused by emotional, physical or sexual assault or neglect. Some display this behaviour after having been shown or seen a lot of pornography, or after adults have had sexual intercourse in front of them. Others are more impulsive in their actions, with no apparent instigator or premeditative planning. The problematic or harmful sexual behaviour is often only one of several issues (behavioural issues, psychological or neurological problems) the adolescent is dealing with, and must be understood as such; in context, rather than as “its own thing”. There are, however, a significant percentage of adolescents not otherwise troubled, and whose cognitive and social functions fall within the normal part of the spectrum. Illustration: Jens A. Larsen Aas Listen to a read-aloud version of the text on this page 5.5 Different causes for the behaviour RVTS Mid 00:00 / 00:52 Previous Next Innholdsfortegnelse

CARING FOR THE VICTIM A child or young person who has been exposed to harmful sexual behaviour has lost a piece of themselves and needs help to reclaim their safety. Assure the child/adolescent by telling them you are there to care for and help them. Listen to the child and let them lead the conversation. Ask open questions and document questions and answers. Include a professional, e.g. the school nurse or BUP. Keep the child informed of what is happening. Listen to a read-aloud version of the text on this page 6.6 Caring for the victim RVTS Mid 00:00 / 00:32 Previous Next Innholdsfortegnelse

THE TRAFFIC LIGHT CAN HELP US DIFFERENTIATE – PART 2 LECTURER Birgit Hegge is a clinical social worker with a master’s degree in social subjects. She is also an educated specialist in sexological counselling, with approval from the Nordic Association for Clinical Sexology (NACS). She specializes in violence and sexual assault due to her many years of experience with mental health and child welfare. Hegge is a proponent of the prevention aspect of good sexual development and health. Previous Next Innholdsfortegnelse The Traffic Light is a framework for understanding sexuality, sexual development and how this is expressed in children and young people. In other words, the Traffic Light is meant to raise awareness of sexuality being an important part of children’s development – as important as language, for instance. It is also a tool to help us differentiate between healthy and problematic expressions of sexuality. Why is this important? In my experience, sexuality in children makes adults uncertain. We’re uncertain of what we see, what we should say, and how to react in the face of a child’s sexuality. We might just say nothing, reject or scold the child, resulting in the child not receiving the support and guidance they need. When it comes to sexuality, children need guidance and support just like in other aspects of life, and help to develop good sexual health as well as a healthy view of their own body. How does the Traffic Light help? Well, many adults report just reading it helps clarify what behaviours are acceptable. The Traffic Light is divided like the name indicates; in the colours green, yellow and red. The green light is the “go”-signal in traffic, and in this framework describes what a natural, healthy sexuality looks like. Now, if the child doesn’t show their sexuality, this is okay too. We are all different people, and not all children put their sexuality on display. At the green level, the child requires positive attention and support from you. The yellow light in traffic tells you to slow down or stop – or to get ready to drive. The same applies to yellow sexuality; you need to figure out what is happening. Are all the children fine? Do they find what’s happening acceptable? You have to find the answers to those questions; speak with the children, help them figure it out, ask them about their thoughts. Sometimes children need help with figuring out different ways to do things, and sexuality is no exception. Help them to adjust, find other ways, be more aware of everyone else’s boundaries. They need help with understanding and recognizing if they themselves are okay with what is occurring. If children don’t learn to recognize and enforce their own boundaries, they may have difficulties understanding how others can be uncomfortable. The red light means “stop”, both in traffic and in regard to sexuality. If the behaviour is red, you, the adult, must intervene immediately. This is why many people actively use the Traffic Light, either with fellow personnel or other acquaintances; they get to talk about it and read through the different categories, both colour and age group. The Traffic Light describes the different levels of age well, including what to expect and what sexuality in those ages looks like. However, such a framework can’t account for everything, and talking to other people reveals how humans are all different people with different boundaries. Adults are no exception, and we all react differently in the face of others’ sexuality – especially the sexuality of children. If you discuss it – preferably with your staff group – you can find out what this all means to you at your kindergarten/school/place of work, and how your institution should operate. You can together decide where the boundaries are, and why. What do you react to, and what don’t you react to? What keeps you from reacting in situations where you should have? If this has been discussed beforehand you can also create a strategy for how to act if a child expresses their sexuality in an unacceptable way. In addition, you can agree on a method of speaking to the child about sexuality. When we discuss the validity of our thoughts we become more assured, more open, and we appear more concise to children – and if we are clear and concise, children become assured as well. They receive the guidance, training and support they need to develop a healthy sexuality. This is the foundation of good sexual health; positive development, lots of joy, and healthy sexual common decency. Birgit Hegge, høgskolelektor VID, fakultet for helsefag. Vis teksten Spilletid: 7:15

5. HARMFUL SEXUAL BEHAVIOUR Harmful sexual behaviour is harmful both to the child exposed to it and the child inflicting it, and requires an immediate response from adults. Harmful sexual behaviour is an umbrella term for behaviour we classify as non-normative and non-acceptable sexual behaviour. It is usually characterized as being excessive, secretive, violating, forceful, regressive or threatening. In this chapter we give you insight into general statistics about harmful sexual behaviour, different causes of the behaviour, as well as suggestions on how to look after both affected parties. Previous Next Innholdsfortegnelse PAGES IN THIS CHAPTER CHARACTERISTICS OF HARMFUL SEXUAL BEHAVIOUR IN CHILDREN AND YOUNG PEOPLE WILL NOT REPEAT HARMFUL SEXUAL BEHAVIOUR BOTH BOYS AND GIRLS ALREADY KNOW EACH OTHER DIFFERENT CAUSES FOR THE BEHAVIOUR CARE FOR BOTH PARTIES INVOLVED REPORT AND INVESTIGATE HARMFUL SEXUAL BEHAVIOUR ONLINE

APPENDIX 1 EXAMPLE OF HOW TO MANAGE HARMFUL SEXUAL BEHAVIOUR IN PRIMARY SCHOOL Tom (12) was impulsive, disruptive and had a lot of trouble regulating himself. After a while girls from the class began telling of how Tom had slapped them on the butt and touched their breasts. During games and activities where the students were in close contact, he often became intense and persisted with pushing and touching, and did not stop when other pupils asked him to. He had on several occasions put his hands down others’ pants and touched their genitals. School staff viewed the behaviour as a result of having trouble with social skills and regulating emotions. The administration was contacted, and two adults who had a good relationship with Tom were, for a period, excused to follow him throughout the school day. They were also to hold conversations frequently, keep close supervision to prevent violations, as well as help Tom to regulate better and increase his social skills. Through conversations he had with adults at school, it emerged that Tom himself thought what he did was funny, that the other pupils thought so too, and nobody needed to bother with anything. The adults still felt uncertain and were worried new and more serious violations would occur, so they contacted the regional consultation team. The team shared their concerns and advised the school to make concrete plans for safety and increased mastery. The adults working closely with Tom spent a lot of time in dialogue with him, trying to give him insight into how the other pupils viewed his behaviour. The school arranged for his entire year to receive sex education on the topics of puberty, boundaries, “private areas” and what is, and is not, okay to do. Tom also had individual conversations on these topics, in addition to emotion recognition and regulation. An important part of these conversations became learning new strategies for managing different emotions. The school, in cooperation with Tom, drew up a safety plan. The plan described how an adult was to intervene and assist if situations occurred where Tom couldn’t regulate himself. The situations where the behaviour occurred were reviewed, and found to be transitional situations, recesses or typically unstructured lessons (e.g. physical education). Step 1 of the plan was for the teacher to say: “Tom, stop”. (The use of the name was Tom’s own idea, ensuring he knew whom the teacher was speaking to.) Step 2 was to be implemented if Tom did not stop after the reminder. The teacher would go over to him and put a hand on his shoulder (making sure Tom paid attention) before repeating the message. Step 3 was to be implemented if step 2 had no effect. Here Tom would be led/accompanied by the teacher to get away from the situation. If this turned difficult, the other students would be led away instead. Another part of the deal was for Tom to always be close enough he and the teacher could see each other, assuring Tom they were there to help if needed. It was imperative that Tom felt safe around and trusted the adult for this to work. The school management was actively involved with the process at all times, contributing with – among other things – extra resources for individual follow-ups and training for the entire staff on harmful sexual behaviour in children. Previous Next Innholdsfortegnelse Listen to a read-aloud version of the text on this page 7.2 Appendix 1 Example from primary school RVTS Mid 00:00 / 03:37 Illustration: Jens A. Larsen Aas

BEING MENTALLY AVAILABLE DURING CONVERSATIONS “Accommodating” children’s strong emotions and behavioural expressions requires us to stay calm and keep a lid on our own strong emotions and frustrations. This can prove difficult when children seem to reject and actively provoke you. The Window of Tolerance is a widely used metaphor which can help with resisting and regulating outbursts. Listen to a read-aloud version of the text on this page 4.2 Being mentallty available during conversations RVTS Mid 00:00 / 00:27 Previous Next Innholdsfortegnelse Dag Nordangers korte og enkle forklaring av toleransevinduet. Spilletid: 4:28

Prevention and management of problematic and harmful sexual behaviour in children and young people. Knappetekst kommer her Høyrejustert 2.5 Om voksne og deres rolle i forhold til barns seksualitet 00:00 / 01:40 Venstrejustert PREVENTION AND MANAGEMENT OF PROBLEMATIC AND HARMFUL SEXUAL BEHAVIOUR IN CHILDREN AND YOUNG PEOPLE This e-learning is developed by RVTS Mid-Norway along with REBESSA (Regional resource team on children and young people displaying problematic and harmful sexual behaviour) with the intention of raising the level of competence about healthy and normal sexuality in children and young people, as well as be a guide to managing cases with children and young people displaying problematic or harmful sexual behaviour. Knowledge about children’s sexuality can help lessen the risk of children developing sexually harmful behavioural patterns, in addition to ensure signs of violations and assault are discovered early, enabling the implementation of necessary measures. Many adults may harbour reservations about entering an arena where the child or young person’s sexuality is so clearly on display. This is exactly why it is important we provide concrete ways of understanding and managing such cases. Children and young people who display problematic and harmful sexual behaviours usually have quite tangled and complex motivations, and interagency cooperation is necessary for managing this successfully. There are several terms for sexual behaviour leading to concerns or injury. It is often appropriate to describe the behaviour or action as violating or abusive. What term should be used depends on the context and the purpose behind using it. In this guide the terms problematic and harmful sexual behaviour are mainly used about everything outside the realm of good and healthy sexuality in children. We still would like to encourage being conscious of your choice of words, both to nuance sexual actions between children and prevent stigmatization and unnecessary stress for those involved. We encourage using the guide actively and to set aside time in professional meetings for discussion and reflection around prevention and management of sexual offences. Every school should make their own guidelines with the names and addresses of their collaborators. The school management is especially responsible for this. INTENDED FOR: EVERYONE PRIOR KNOWLEDGE NEEDED: NONE ESTIMATED LENGTH: ABOUT 6 HOURS REQUIRED REGISTRATION: NO BEGIN PROJECT LEADERS The project leaders for this e-learning are RVTS Mid by Oddfrid Skorpe and Marita Sandvik. The school guide was developed in cooperation with Kjersti Draugedalen, Kristin Larsen and Rebessa (Resource team on problematic and harmful sexual behaviour in children). Oddfrid Skorpe Marita Sandvik Listen to a read-aloud version of the text Prevention and managment of problematic and harmful sexual behaviour in children and youth RVTS Mid 00:00 / 02:24 Begin course Innholdsfortegnelse