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Sexual behaviors in children are common, occurring in 42 to 73 percent of children by the time they reach 13 years of age.

Developmentally appropriate behavior that is common and frequently observed in children includes trying to view another person's genitals or breasts, standing too close to other persons, and touching their own genitals.

Sexual behaviors become less common, less frequent, or more covert after five years of age.

Such behaviors should be evaluated within the context of other emotional and behavior disorders, socialization difficulties, and family dysfunction, including violence, abuse, and neglect.Although many children with sexual behavior problems have a history of sexual abuse, most children who have been sexually abused do not develop sexual behavior problems.Children who have been sexually abused at a younger age, who have been abused by a family member, or whose abuse involved penetration are at greater risk of developing sexual behavior problems.Although age-appropriate behaviors are managed primarily through reassurance and education of the parent about appropriate behavior redirection, sexual behavior problems often require further assessment and may necessitate a referral to child protective services for suspected abuse or neglect.When parents present to a physician's office because of concerns about their child's sexual behavior, several issues typically arise: parent anxiety, the extent to which the behavior is disruptive in the home or school setting, the origin of the behavior, and effective management of the behavior.

Sexual behaviors in children are common, occurring in 42 to 73 percent of children by the time they reach 13 years of age.1A detailed history, including family stressors and changes, the child's access to sexual materials or acts, violence between the parents, and risk factors for abuse and neglect, assists in determining management and safety strategies for children with sexual behavior problems.A = consistent, good-quality patient-oriented evidence; B = inconsistent or limited-quality patient-oriented evidence; C = consensus, disease-oriented evidence, usual practice, expert opinion, or case series.For information about the SORT evidence rating system, go to A detailed history, including family stressors and changes, the child's access to sexual materials or acts, violence between the parents, and risk factors for abuse and neglect, assists in determining management and safety strategies for children with sexual behavior problems.Sexual behaviors can be prompted or modified by several factors: normal development, parent reaction to the behavior, changes in family stressors, and access to sexual material.For example, recent technology, such as the Internet, chat rooms, and texting, has expanded the way children are exposed to sexually explicit information.