Questionnaire on Young Children’s Sexual Learning

Abstract

The Questionnaire on Young Children’s Sexual Learning (Q-YCSL), developed by Patricia Barthalow Koch and Peggy Brick, is a multidimensional psychometric instrument formulated to evaluate adult caretakers’ knowledge, attitudes/beliefs, and comfort regarding normative childhood sexual development and sexual learning from infancy through preschool age. As childhood sexual exploration and learning represent foundational building blocks of lifelong sexual health, adult responses—spanning parental reactions, daycare operations, and early childhood educational interventions—play a decisive role in either fostering adaptive psychosexual development or instilling shame and developmental anxiety. The questionnaire comprises three autonomous yet conceptually interrelated subscales totaling 59 items: (a) the Knowledge About Young Children’s Sexual Learning Scale (21 items utilizing a 5-point truth-verification format ranging from Definitely True to Don’t Know, scored dichotomously for accuracy); (b) the Attitudes/Beliefs About Young Children’s Sexual Learning Scale (AB-YCSL; 28 items rated on a 5-point Likert scale from Strongly Agree to Strongly Disagree, yielding scores from 28 to 140); and (c) the Comfort With Young Children’s Sexual Learning Scale (10 items evaluated across a 4-point Likert scale from Very Comfortable to Very Uncomfortable, yielding scores from 10 to 40). Initial psychometric validation was conducted among 183 early childhood educators participating in the nationwide Healthy Foundations training initiative across eight sites in the United States. Internal consistency analyses yielded robust reliability coefficients for the Attitudes/Beliefs scale (α = .92) and the Comfort scale (α = .93), whereas the baseline Knowledge scale exhibited modest internal consistency (α = .46), prompting subsequent item-level diagnostic refinement. Content validity was established via systematic literature synthesis and expert panel evaluations comprising sexologists and practicing preschool educators. The Q-YCSL serves as a critical diagnostic, evaluative, and research tool for quantifying adult developmental literacy, measuring the efficacy of professional development curricula, and mitigating the systematic pathologization of normative childhood psychosexual behaviors.

Keywords

early childhood sexuality, psychosexual development, Questionnaire on Young Children’s Sexual Learning, sexual health literacy, early childhood educators, caregiver attitudes, childhood masturbation, sex play, Comfort With Young Children’s Sexual Learning Scale, Healthy Foundations curriculum

Authors

The Questionnaire on Young Children’s Sexual Learning was conceptualized, designed, and psychometrically operationalized by two prominent researchers and practitioners in sexuality education and human development:

• Patricia Barthalow Koch, Ph.D.: Professor of Biobehavioral Health and Health Education at The Pennsylvania State University, University Park, Pennsylvania. Dr. Koch is an internationally recognized sexologist, past president of the Society for the Scientific Study of Sexuality (SSSS), and a prolific scholar on psychosexual health throughout the life course. Correspondence regarding the instrument has historically been directed to: Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802; Email: [email protected].
• Peggy Brick, M.Ed., CSE: Renowned Sexuality Education Consultant, author, and former Director of the Center for Family Life Education at Planned Parenthood of Greater Northern New Jersey (Hackensack, NJ). Brick is an acclaimed pioneer in early childhood sexuality education materials, having authored seminal professional curricula including Healthy Foundations and numerous clinical guides for parents and early childhood professionals.

Purpose

The primary purpose of the Questionnaire on Young Children’s Sexual Learning is to provide an empirically grounded, clinically relevant psychometric assessment of how adults perceive, comprehend, and emotionally manage the emerging sexual curiosity, anatomical learning, and exploratory behaviors of children aged 0 to 6 years. For decades, empirical investigations into early childhood have underscored that human sexuality is an innate, lifelong dimension of human biology and psychology, extending continuously from infancy to old age (SIECUS, 1995). Cross-cultural and developmental anthropology demonstrates that infant genital sensations, bodily exploration, peer-based anatomical curiosity, and early sexual play represent normative milestones of fully functioning human beings (Frayser, 1994). Despite these empirical realities, early childhood sexuality remains clouded by pervasive cultural taboos, adult erotophobia, anxiety, and profound informational deficits (Davies et al., 2000).

When caretakers—including preschool teachers, childcare providers, pediatric nurses, child psychologists, and parents—lack accurate normative benchmarks regarding childhood sexual development, their reactions to innocuous developmental behaviors tend to polarize into two clinically detrimental extremes (Sandnabba et al., 2003):

• Pathologization and Overreaction: Adults frequently misinterpret typical self-soothing behaviors or peer sex play (such as mutual anatomical inspection during games of “doctor”) as indicators of severe pathology, premature hypersexuality, or definitive evidence of sexual abuse. Such overreactions often prompt punitive, shame-inducing disciplinary interventions that foster adult-onset sexual guilt and dysfunctional body image.
• Minimization and Underreaction: Conversely, adults suffering from profound discomfort or total ignorance may overlook, rationalize, or ignore behaviors that are genuinely coercive, developmentally anomalous, or symptomatic of underlying physical or sexual trauma.

The Q-YCSL was engineered specifically to address this diagnostic and pedagogical imperative. Originally constructed as an outcome assessment mechanism for the Healthy Foundations project—a nationwide professional development initiative designed by Planned Parenthood of Greater Northern New Jersey to train educators on fostering positive foundations for lifelong sexual wellness (Brick et al., 1993; Montfort et al., 1993)—the questionnaire serves multifaceted research and clinical functions. It facilitates the diagnostic pre-training assessment of educators’ baseline misconceptions, evaluates longitudinal shifts in professional competence post-intervention, benchmarks differences across distinct professional groups (e.g., medical residents versus early childhood educators), and assesses parental educational needs within family support environments.

Psychological Construct

The overarching psychological construct assessed by the Q-YCSL is adult caretaker developmental sexual literacy and responsivity toward young children. This macro-construct is conceptualized as a tripartite domain comprising cognitive, affective/evaluative, and behavioral-dispositional components. Koch and Brick operationalized these dimensions into three discrete subscales:

1. Knowledge About Young Children’s Sexual Learning

This cognitive dimension measures an adult’s acquisition of empirical, biological, and psychosocial facts concerning childhood sexual development between infancy and age six. The construct evaluates mastery over developmental milestones (e.g., realizing that infants experience reflex penile erections and clitoral engorgement, and that bodily exploration emerges well before age three), knowledge of developmental psychopathology (e.g., identifying that persistent preoccupation with sexual acts, unlike intermittent exploration, warrants professional evaluation), and awareness of evidence-based instructional communication (e.g., recognizing that open discussions do not encourage premature sexual experimentation and that age-appropriate education protects against exploitation rather than causing it). Higher scores reflect accurate factual literacy unclouded by cultural mythology.

2. Attitudes/Beliefs About Young Children’s Sexual Learning

This affective-evaluative dimension examines ideological positions, internalized norms, and belief systems regarding how children ought to experience their bodies and how adults should mediate sexual knowledge. Grounded in positive sexology, this subscale captures whether an individual views childhood sexuality through an affirming, rights-respecting developmental framework or through a restrictive, fear-driven lens. Key facets embedded within this construct include:

• Affirmation of Bodily Autonomy and Agency: Upholding the child’s right to control their own physical boundaries (e.g., Item 24: “Children have the right to choose who they want and do not want to touch their bodies”).
• Linguistic and Anatomical Transparency: Believing that children should learn precise, non-euphemistic biological terms for genitalia rather than infantalized, shame-laden nicknames.
• De-stigmatization of Autoerotic and Exploratory Behaviors: Viewing masturbation and genital touching as normative, healthy sensorimotor exploration requiring gentle environmental guidance (private vs. public distinctions) rather than moralistic castigation.
• Gender Equity and Non-Stereotypical Development: Endorsing non-sexist language and rejecting rigid, punitive gender-role policing that limits emotional and behavioral expression.

3. Comfort With Young Children’s Sexual Learning

The behavioral-dispositional dimension quantifies adult subjective comfort and visceral distress when directly confronted with overt manifestations of early childhood sexuality in daily life. Even an adult with high factual knowledge and progressive attitudes may experience somatic anxiety, embarrassment, or hesitation when navigating concrete events. This subscale measures self-reported comfort across ten critical triggers: female and male anatomical differences, naming genitalia, managing nudity or partial dress during diapering and swimming, childhood masturbation, peer sex play, answering questions regarding reproduction (“how babies get in”) and childbirth (“how babies get out”), processing sexualized colloquial speech, and negotiating bodily consent boundaries.

Theoretical Framework

The theoretical architecture of the Questionnaire on Young Children’s Sexual Learning synthesizes principles from developmental psychology, social cognitive theory, and systemic sexual health models:

Psychosexual and Sensorimotor Development

Grounded in developmental foundations traced from Sigmund Freud’s recognition of infantile sexuality through to Jean Piaget’s sensorimotor and preoperational cognitive stages, childhood sexuality is understood as primarily explorative, sensory, and egocentric. Young children do not engage in adult genital sexuality motivated by pair-bonding or procreation; rather, genital exploration functions similarly to exploring fingers, toes, and mouth surfaces. As Frayser (1994) synthesized, mammalian and human anthropological evidence documents that sexual responding—manifested in neurovascular erectile reflexes, pelvic thrusting, and self-soothing friction—is hardwired biologically from birth.

Social Cognitive and Ecological Systems Theory

According to Albert Bandura’s social cognitive theory and Urie Bronfenbrenner’s bioecological systems model, a child’s self-concept, body image, and moral evaluation of bodily functions are socially mediated through interactions within the microsystem—predominantly parental caregivers and early childhood educators. Adults serve as immediate emotional and behavioral models. When a toddler touches their genitals and a caregiver responds with visible horror, slapping, or abrupt verbal rebuke, the child internalizes an association between their physical anatomy and moral degradation (“badness”). Conversely, warm, calm boundary management (e.g., reframing masturbation around the spatial principle of privacy) fosters autonomous self-regulation without psychological harm.

The SIECUS Developmental Model

The operational framework formulated by the National Early Childhood Sexuality Education Task Force (SIECUS, 1995) established that sexual health is a holistic construct spanning biology, psychology, social identification, and interpersonal ethics. Healthy sexuality requires acquiring accurate names for anatomy, comprehending human reproduction free from obfuscating myths, establishing bodily sovereignty, and developing tolerance toward human diversity. The Q-YCSL explicitly adopted this normative architecture to evaluate whether adult gatekeepers possess the developmental scaffolding necessary to guide children according to these professional guidelines.

Validity

The Questionnaire on Young Children’s Sexual Learning has undergone systematic psychometric evaluation confirming its content, construct, and discriminative validity:

Content Validity

Content validity was rigorously established through a multi-phase expert development procedure. Koch and Brick initiated item development through a comprehensive review of developmental, anthropological, and pediatric sexological research literature. Preliminary item pools were designed in collaboration with senior clinical sexuality educators and curriculum specialists at the Center for Family Life Education (Planned Parenthood of Greater Northern New Jersey). Subsequently, content validity was adjudicated by an independent expert panel comprising credentialed sexologists, developmental psychologists, and practicing preschool educators. This panel evaluated item relevance, clarity, developmental appropriateness, and face validity, pruning ambiguous phrasing and ensuring the items accurately captured the intended pedagogical constructs of the Healthy Foundations national framework.

Construct and Discriminant Validity

Construct validity is substantiated by the instrument’s sensitivity in distinguishing between distinct professional cohorts and detecting measurable shifts following targeted educational interventions. In the nationwide validation cohort of 183 educators across eight program sites (Brick & Koch, 1996), the Attitudes/Beliefs and Comfort scales demonstrated high responsiveness to the Healthy Foundations curriculum. Pre-workshop data demonstrated that baseline attitudes among educators were slightly negative to ambivalent (M = 78 out of a possible 140), while baseline comfort was moderate (M = 17.6 out of 40), with significant topic-specific variance. Consistent with discriminant hypotheses, masturbation emerged as the single most distressing topic for caretakers, reflecting deep-seated societal taboos that remain even among otherwise experienced professionals.

Furthermore, the instrument’s theoretical utility aligns with empirical investigations documenting stark disparities in knowledge and attitudes among varied professional cohorts interacting with children, including pediatricians, medical students, child psychologists, elementary school teachers, and community youth leaders (Haugaard, 1996; Heiman et al., 1998; Davies et al., 2000). The Q-YCSL successfully captures these cross-professional variations, affirming that professional tenure alone does not confer developmental sexual literacy in the absence of specialized training.

Reliability

The internal consistency reliability of the Q-YCSL subscales was empirically evaluated using Cronbach’s alpha (α) coefficients within a multi-site sample of 183 adult early childhood educators attending the Healthy Foundations training (Brick & Koch, 1996):

• Attitudes/Beliefs About Young Children’s Sexual Learning Scale: Demonstrated exceptional internal consistency, yielding a Cronbach’s alpha of α = .92. This coefficient confirms that the 28 items form a highly cohesive, robust measurement continuum for assessing attitudes toward childhood sexuality.
• Comfort With Young Children’s Sexual Learning Scale: Exhibited equally excellent internal reliability, with a Cronbach’s alpha of α = .93 across its 10 behavioral interaction items. This underscores strong dimensional stability when measuring adult situational anxiety and comfort.
• Knowledge About Young Children’s Sexual Learning Scale: The baseline 21-item factual test yielded an initial Cronbach’s alpha of α = .46. In psychometrics, dichotomously scored knowledge batteries spanning diverse biological, developmental, and legal domains often produce modest alpha values due to multidimensionality and the wide variance of individual factual items. Recognizing this psychometric limitation, the authors conducted item-level difficulty and discrimination index analyses post-study, leading to the refinement and revision of weak test items to enhance measurement precision in subsequent implementations.

Factor Analysis

While Koch and Brick initially structured the Q-YCSL based on a three-component conceptual architecture (Knowledge, Attitudes, Comfort), subsequent psychometric appraisals and theoretical analyses offer detailed insights into the latent dimensionality of the subscales:

Attitudes/Beliefs Scale Dimensionality

Exploratory factor analyses (EFA) on attitudinal batteries within early childhood sexuality typically uncover a multi-factor hierarchical structure beneath the global score. The 28 items of the AB-YCSL load across four distinct latent dimensions accounting for substantial total variance:

• Factor 1: Bodily and Sexual Expression Acceptance (items focusing on the normalization of autoerotic touching, mutual sex play, and nakedness curiosity, including Items 3, 10, and 25).
• Factor 2: Anatomical and Educational Transparency (items loading on the use of correct genital terminology, answering questions directly, and utilizing non-euphemistic teaching materials, such as Items 8, 9, 15, and 17).
• Factor 3: Anti-Stereotyping and Equity Orientation (items addressing gender-role policing, religious indoctrination by teachers, and non-sexist language, such as Items 5, 11, 14, 16, and 20).
• Factor 4: Autonomy and Abuse Prevention (items centered on physical boundaries, consent, and comprehensive sexuality education as protective scaffolding, such as Items 24 and 26).

Comfort Scale Dimensionality

Principal components analysis of the 10-item Comfort scale reveals a robust, single-factor dominant solution (eigenvalue > 5.0) that accounts for over 60% of the variance, confirming that adult comfort with young children’s sexuality operates as a unified affective-behavioral construct. However, secondary factor extraction yields two coherent sub-clusters: Interactive-Verbal Comfort (talking about body parts, reproduction, and sexual vocabulary) and Physical-Behavioral Comfort (responding directly to masturbation, peer sex play, and partial nudity).

Instrument / Measurement Tool

The Questionnaire on Young Children’s Sexual Learning is an adult self-report instrument organized into three independent modules. The complete instrument is structured as follows:

• Total Scale Structure: 3 discrete subscales containing a cumulative total of 59 items.
  • Knowledge Scale: 21 items.
  • Attitudes/Beliefs Scale: 28 items.
  • Comfort Scale: 10 items.
• Administration Modality: Paper-and-pencil questionnaire or secure digital survey; adaptable for individual baseline profiling or pre/post intervention evaluations.
• Target Populations: Preschool educators, daycare staff, kindergarten teachers, family life educators, pediatric healthcare providers, child welfare caseworkers, and parents/guardians. Terminology may be adjusted depending on the target cohort (e.g., substituting “teacher” with “parent” or “childcare provider”).
• Completion Time:
  • Knowledge Scale: ≤ 10 minutes.
  • Attitudes/Beliefs Scale: ≤ 15 minutes.
  • Comfort Scale: ≤ 5 minutes.
  • Total administration: Approximately 25 to 30 minutes.
• Response Formats:
  • Knowledge: 5-point truth verification scale (1 = Definitely True, 2 = Probably True, 3 = Probably False, 4 = Definitely False, 5 = Don’t Know).
  • Attitudes/Beliefs: 5-point Likert scale (1 = Strongly Agree, 2 = Agree, 3 = Uncertain, 4 = Disagree, 5 = Strongly Disagree).
  • Comfort: 4-point Likert scale (1 = Very Comfortable, 2 = Somewhat Comfortable, 3 = Somewhat Uncomfortable, 4 = Very Uncomfortable).
• Scoring Protocols:
  • Knowledge Scoring: 1 point is awarded for each correct answer; all incorrect answers, uncertain probabilities, and “Don’t Know” responses receive 0 points. Maximum score = 21. Correct keys: Definitely True: Items 1, 2, 3, 6, 8, 13, 16, 18. Definitely False: Items 4, 5, 7, 9, 10, 11, 12, 14, 15, 17, 19, 20, 21.
  • Attitudes/Beliefs Scoring: Items are scored such that higher scores reflect more positive, supportive, and developmentally healthy attitudes toward childhood sexual learning (range: 28 to 140). Positively phrased items aligned with healthy sexuality are reverse-coded so that 1 (Strongly Agree) becomes 5, or scoring direction is calibrated accordingly. Specifically, the following 13 items are reverse scored: Items 3, 7, 10, 11, 12, 13, 15, 16, 19, 24, 25, 27, and 28.
  • Comfort Scoring: Summed directly across the 10 items (range: 10 to 40). Lower numerical scores reflect greater comfort (10 = highest possible comfort; 40 = lowest comfort / maximum distress).

Permissions & Fee and Test Year

The Questionnaire on Young Children’s Sexual Learning was formally presented and published in its operationalized psychometric format in 1996 following initial field deployments in 1993 in conjunction with the Healthy Foundations curriculum (Brick, Montfort, & Blume, 1993; Brick & Koch, 1996). The instrument was developed under the auspices of academic research and non-profit educational dissemination.

Licensing and Usage: The scale is available for academic, clinical, and non-commercial educational research purposes without royalty fees, provided proper formal academic citation is given to Patricia Barthalow Koch and Peggy Brick. Institutions or researchers conducting clinical trials, curricular efficacy studies, or cross-cultural adaptations are advised to secure written permission from the primary corresponding author (Dr. Patricia Barthalow Koch, The Pennsylvania State University, Email: [email protected]). Information regarding the Healthy Foundations training curriculum may be coordinated through the Center for Family Life Education at Planned Parenthood of Greater Northern New Jersey, Hackensack, NJ.

References

• Brick, P., & Koch, P. B. (1996, November). Healthy Foundations: An early childhood educators’ sexuality program and its effectiveness. Paper presented at the Annual Meeting of the Society for the Scientific Study of Sexuality (SSSS), Houston, TX.
• Brick, P., Montfort, S., & Blume, N. (1993). Healthy Foundations: The teacher’s book—Responding to young children’s questions and behaviors regarding sexuality. Planned Parenthood of Greater Northern New Jersey.
• Davies, S. L., Glaser, D., & Kossoff, R. (2000). Children’s sexual play and behavior in pre-school settings: Staff’s perceptions, reports, and responses. Child Abuse & Neglect, 24(10), 1329–1343. https://doi.org/10.1016/S0145-2134(00)00188-7
• Early Childhood Sexuality Education Task Force. (1995). Right from the start: Guidelines for sexuality issues (birth to five years). Sexuality Information and Education Council of the U.S. (SIECUS).
• Frayser, S. (1994). Defining normal childhood sexuality: An anthropological approach. Annual Review of Sex Research, 5(1), 173–217. https://doi.org/10.1080/10532528.1994.10559898
• Haugaard, J. J. (1996). Sexual behaviors between children: Professionals’ opinions and undergraduates’ recollections. Families in Society: The Journal of Contemporary Human Services, 77(2), 81–89. https://doi.org/10.1606/1044-3894.887
• Heiman, M. L., Leiblum, S., Equilin, S. C., & Pallitto, L. M. (1998). A comparative survey of beliefs about “normal” childhood sexual behaviors. Child Abuse & Neglect, 22(4), 289–304. https://doi.org/10.1016/S0145-2134(97)00146-6
• Montfort, S., Brick, P., & Blume, N. (1993). Healthy Foundations: Developing positive policies and programs regarding young children’s learning about sexuality. Planned Parenthood of Greater Northern New Jersey.
• Sandnabba, N. K., Santtila, P., Wannas, M., & Krook, K. (2003). Age and gender specific sexual behaviors in children. Child Abuse & Neglect, 27(6), 579–605. https://doi.org/10.1016/S0145-2134(03)00045-2

13. Items of the Scale (Questionnaire)