NICE issues new guidelines on sexting in teens

Behind the Headlines

Tuesday September 20 2016

While teens have always looked at porn, some content today can be very extreme

Some children can get coerced into sexting

"An NHS watchdog has issued advice about sexting to help professionals spot the difference between 'normal' sexual experimentation and harmful sexual behaviour among children and teens," BBC News reports.

The National Institute for Health and Care Excellence (NICE) has issued new guidelines on what is known as harmful sexual behaviour. As well as sexting (sending sexually explicit pictures or messages via smartphone) it also includes other age inappropriate sexual behaviour such as watching extreme pornography or making inappropriate remarks.

The NICE guidance, published online today, focuses on children and young people who are the sole offenders of harmful sexual activities, directed either towards themselves or others, rather than child sexual exploitation, peer-on-peer or gang-related sexual violence.

NICE suggests inappropriate sexual behaviour, including sexting, is often an expression of other underlying problems and should be addressed early.


Need for Guidelines

The guidelines have arisen from a need to ensure problems related to harmful sexual behaviour do not escalate and lead to children being charged with sexual offences. It also aims to ensure children do not get referred to specialist services unnecessarily.

Not much is known about children and young people who display harmful sexual behaviour that has not reached a level regarded as criminal. The response to these behaviours is difficult as there is a lack of understanding about where in the social care system these children should be directed, making effective responses challenging.

Evidence suggests that for children or young people, displaying sexualised behaviour can be an expression of other underlying problems. Early assessments without involving specialist harmful sexual behaviour services can help, however there is limited evidence of effective approaches to combat harmful sexual behaviour.

The guidelines are targeted at a range of people, including social workers, child and adolescent mental health services, youth offending teams, schools, primary care workers and people committing harmful sexual behaviour, their families and the public.



NICE guidelines recommend that schools have a named safeguarding lead and that there is more support and collaboration between services. Key people such as teachers, social workers and doctors should judge how appropriate the sexual behaviour is for the age of the child or young person.

Indicators of possible problems include: using sexualised language such as adult slang words to talk about sex, sexualised behaviour such as sexting or sending sexual images using online or mobile technology, or viewing pornography inappropriate for age or developmental status.

Inappropriate behaviour can be identified using tools such as the Brook Sexual Behaviours Traffic Light Tool, which helps identify the seriousness of the behaviour using a traffic light system. Early assessment is then recommended to see if the child has any unmet needs that can be addressed with universal services, such as at school, health visitors or the GPs. They also recommend considering involving the child's family before referral or any intervention.

If harmful sexual behaviour is displayed, the guidelines recommend referring children to harmful sexual behaviour services, child protection services and the criminal justice system, if necessary.

On referral, a single lead point of contact should be identified to make sure there are no unnecessary assessments or repetitions in services. The lead role should be agreed by the multi-agency team and could be from the child and adolescent mental health service, children's social services or the voluntary sector such as Barnardo's or the NSPCC.

If you are concerned that a child in your care may be engaging in harmful sexual behaviour a useful first step would be to talk to a health or social care professional who has been in contact with the child, such as their teacher, social worker or GP. 

Analysis by Bazian. Edited by NHS Choices. Follow NHS Choices on TwitterJoin the Healthy Evidence forum.

Analysis by Bazian

Edited by NHS Choices

Links to the headlines

NHS watchdog issues sexting advice. BBC News, September 20 2016

Sexting: treating children as 'mini sex offenders' could make things worse. The Daily Telegraph, September 20 2016

Children caught sexting should be sent to social workers and psychiatrists, say health chiefs. Mail Online, September 20 2016

Don't ignore child sexting, teachers told. The Times, September 20 2016

Further reading

National Institute for Health and Care Excellence. Harmful sexual behaviour among children and young people. September 20 2016


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Find out the risks of sexting, and what could happen to sexual images and messages posted online.

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