Sexual Behaviours Traffic Light Tool (SBTLT)

1. Abstract

The Sexual Behaviours Traffic Light Tool (SBTLT) is a standardized, multi-agency assessment framework and clinical decision-support instrument designed to evaluate, categorize, and respond to psychosexual behaviors among children and adolescents aged 0 to 17 years (with extended clinical utility up to 25 years for neurodivergent or developmentally vulnerable populations). Originally developed in the United Kingdom by the young people’s sexual health and wellbeing charity Brook in 2011, and adapted from foundational work by True Relationships & Reproductive Health (formerly Family Planning Queensland, Australia), the instrument addresses a critical diagnostic and safeguarding need: systematically differentiating normative, healthy sexual development from concerning, problematic, or harmful sexual behaviors (HSB). The framework employs a tri-colored, developmentally stratified categorical rubric comprising Green (normative, exploratory, consensual, developmental), Amber (problematic, age-discordant, boundary-crossing, potential early-stage vulnerability or distress), and Red (harmful, abusive, coercive, exploitative, or severe legal/safeguarding transgressions) across four distinct but overlapping developmental age cohorts: 0–5 years, 5–9 years, 9–13 years, and 13–17 years. Unlike conventional psychometric self-report inventories, the SBTLT functions as a structured professional judgment (SPJ) tool and observational taxonomic guide, bridging clinical psychology, social pediatrics, educational safeguarding, and child protection services. Psychometric evaluations of the instrument emphasize content validity established via extensive Delphi-style multidisciplinary expert consensus, ecological validity across cross-sectoral institutional settings, and moderate-to-high inter-rater agreement when utilized by certified, calibrated practitioners. This article provides a comprehensive academic analysis of the SBTLT, including its psychometric architecture, foundational theoretical paradigms, construct operationalization, diagnostic validity, measurement reliability, and implementation considerations within institutional child safeguarding contexts.

2. Keywords

Sexual Behaviours Traffic Light Tool, SBTLT, Harmful Sexual Behaviour, child sexual development, structured professional judgment, child protection, safeguarding, psychosexual assessment, adolescent sexual health, developmental psychopathology, inter-rater reliability, multi-agency screening

3. Authors

The Sexual Behaviours Traffic Light Tool was conceptualized and formalized by Brook, the United Kingdom’s leading clinical charity dedicated to the sexual health, emotional wellbeing, and rights of young people. The operational development of the UK tool was spearheaded under the executive leadership of Simon Blake OBE (former Chief Executive of Brook), following collaborative clinical engagement with True Relationships & Reproductive Health (formerly known as Family Planning Queensland) in Brisbane, Australia. The developmental synthesis involved extensive multi-sector consultation with clinical child psychologists, designated safeguarding officers, pedagogical leaders, pediatricians, forensic social workers, and legal authorities specialized in youth justice and child sexual exploitation (CSE). While Brook maintains institutional authorship, copyright, and training governance over the contemporary British tool, True Relationships & Reproductive Health retains foundational developmental rights and governance over the Australian iterations of the traffic light framework.

4. Purpose

The primary purpose of the Sexual Behaviours Traffic Light Tool (SBTLT) is to provide an objective, standardized, and evidence-informed decision-making heuristic for practitioners tasked with safeguarding children and young people. In institutional, educational, clinical, and residential environments, professionals frequently encounter behaviors with sexual components, ranging from mutual physical exploration in early childhood to complex online interactions among adolescents. Historically, institutional responses to these behaviors have been characterized by substantial variance, oscillating between catastrophic over-reaction (pathologizing normative exploratory behaviors, leading to stigmatization, unnecessary social service referrals, or punitive disciplinary exclusion) and dangerous under-reaction (minimizing coercive, abusive, or sexually harmful behaviors as mere “phases” or “boys being boys,” leaving victims unprotected and perpetrators untreated). The SBTLT directly resolves this clinical dilemma by establishing shared, operationalized behavioral thresholds.

Clinically, the instrument serves three complementary operational objectives:

• Diagnostic Differentiation: To establish clear demarcation criteria between normative psychosexual developmental milestones, emerging problematic behaviors warranting targeted psychoeducation or monitoring, and clinically harmful sexual behaviors requiring immediate statutory child protection intervention or therapeutic forensic diversion.
• Harmonization of Multi-Agency Responses: To establish a shared linguistic and conceptual taxonomy across disparately trained professional groups, including teachers, general practitioners, pediatricians, mental health clinicians, social workers, foster carers, residential youth workers, and police officers. By using a uniform chromatic nomenclature (Green, Amber, Red), multi-agency safeguarding hubs (MASH) can calibrate proportionate, calibrated responses without linguistic ambiguity.
• Psychoeducational and Safeguarding Calibration: To operationalize actionable pathways tied directly to the observed behavioral category. Rather than functioning merely as an observational ledger, the SBTLT dictates concrete systemic workflows: Green behaviors prompt positive reinforcement, healthy relationship modeling, and developmental validation; Amber behaviors initiate targeted assessment, enhanced supervision, clear boundary setting, and contextual exploration of underlying stressors; Red behaviors trigger statutory safeguarding escalations, multidisciplinary risk management, forensic safeguarding assessments, and trauma-informed therapeutic interventions.

In empirical research contexts, the SBTLT is increasingly utilized as a classification taxonomy to establish epidemiological baselines of peer-on-peer sexual abuse, evaluate the efficacy of school-based relationship and sex education (RSE) curricula, and assess institutional compliance with statutory child welfare standards.

5. Psychological Construct

The central psychological construct operationalized by the SBTLT is the continuum of child and adolescent psychosexual behavior, conceptualized as a multi-layered spectrum ranging from developmentally normative sexual curiosity and play to severely deviant, coercive, and abusive acts. Child sexual development is not an instantaneous emergence at puberty; rather, it is a continuous, lifelong biopsychosocial process that manifests through distinct cognitive, physical, emotional, and social dimensions across differing chronological stages. The SBTLT deconstructs this overarching construct into three discrete qualitative tiers, calibrated across four progressive developmental bands:

The Tripartite Behavioral Severity Continuum

• Green (Normative / Developmental Behaviours): These behaviors reflect expected, age-appropriate manifestations of natural curiosity, anatomical exploration, identity formation, and peer socialization. Key psychological hallmarks include equal power dynamics between peers, mutuality, transparency, positive affect or mild neutral curiosity, absence of coercion, and immediate responsiveness to adult verbal guidance or boundary setting. In early childhood (0–5 years), this includes non-compulsive exploration of one’s own genitalia, playing “doctors and nurses” without force, and asking candid questions regarding biological differences. In adolescence (13–17 years), Green behaviors encompass consensual romantic exploration, reciprocal communication regarding personal boundaries, mutual affectionate behaviors, and private, non-compulsive solitary masturbation.
• Amber (Concerning / Problematic Behaviours): Behaviors categorized as Amber reside in an intermediate zone of developmental tension, developmental discordance, or emerging disinhibition. These actions deviate from expected social-normative thresholds based on the child’s developmental age, chronological maturity, or cognitive capacity. Psychological markers include subtle or moderate imbalances of power (such as age gaps, cognitive disparities, or social status differentials), repetitive or compulsive patterns of behavior that resist standard redirection, secrecy, distress, boundary-testing, or inappropriate sexual knowledge disproportionate to the child’s developmental stage. Amber behaviors often serve as behavioral indicators of emotional distress, exposure to adult media or pornography, disrupted attachment dynamics, domestic dysfunction, or early manifestations of trauma reenactment. Examples include persistent sexualized language directed at peers despite correction, peer-directed coercive exposure without overt physical violence, or sharing borderline sexually suggestive digital content under peer pressure.
• Red (Harmful / Abusive Behaviours): Red behaviors represent severe clinical pathology, significant safeguarding emergencies, or potential violations of criminal law. These behaviors cause direct physical, psychological, or emotional harm to others, or place the exhibiting child at grave risk of severe exploitation or victimization. Hallmarks of Red behaviors include overt coercion, physical force, threats, manipulation, severe power disparities (e.g., chronological age differences exceeding developmental norms, physical size dominance, cognitive exploitation), deliberate intent to harm or dominate, intense secrecy, grooming behaviors directed toward younger peers, or highly ritualized sexualized aggression. Red behaviors typically indicate severe environmental pathology, such as active or historical child sexual abuse (CSA), severe trauma, systemic neglect, or pervasive exposure to violent, non-consensual digital material. Manifestations include penetrative sexual assaults against peers, forcing younger children to engage in sexual acts, systematic sextortion, distribution of child sexual abuse material (CSAM), or participation in transactional sexual exploitation.

Developmental Stratification Across Cohorts

The construct explicitly acknowledges that identical behaviors carry radically divergent psychological and safeguarding meanings depending on the subject’s chronological age and developmental stage. The SBTLT structures the continuum across four overlapping cohorts:

• 0–5 Years: Sensory-motor exploration, somatic self-discovery, non-genital play, and pre-operational cognitive reasoning. Genital touch in this stage is largely accidental, sensory, or self-soothing.
• 5–9 Years: Early social awareness, peer grouping, latency-stage curiosity, and concrete operational cognition. Sexual curiosity is typically exploratory, intermittent, and easily redirected toward conventional recreational activities.
• 9–13 Years: Pubertal onset, identity development, expanding social-digital awareness, and early romantic idealization. Increased salience of peer social dynamics, technology use, and heightened physiological arousal coupled with developing prefrontal cognitive control.
• 13–17 Years (Extending to 25): Formal operational cognition, emerging adult sexual identity, romantic relationships, autonomous digital communication, and peer culture negotiation. Clear comprehension of consent, mutuality, and societal/legal boundaries is expected, with adjustments applied for individuals with neurodevelopmental or intellectual disabilities.

6. Theoretical Framework

The architecture of the SBTLT is anchored in the convergence of several prominent paradigms within clinical psychology, developmental psychopathology, and sociological safeguarding models.

Developmental Psychopathology and Continuum Models

The primary theoretical bedrock of the tool is the Continuum of Harmful Sexual Behaviour formalized by developmental psychopathology scholars, most notably Simon Hackett (2010). Hackett argued against the crude, dichotomous transfer of adult forensic psychosexual frameworks to pediatric and adolescent populations. In adult forensic psychology, sexual offenses are frequently conceptualized through stable paraphilic disorders, enduring predatory intent, and criminal deviance. In contrast, Hackett asserted that childhood and adolescent sexual behaviors exist on an elastic, developmental continuum ranging from normal-exploratory, through problematic, to sexually abusive. The SBTLT operationalizes Hackett’s continuum by grounding every behavioral assessment in normal developmental milestones, treating sexual curiosity as an inherent biological and psychological constant while evaluating the degree of distortion, coercion, and maladaptation introduced into the behavioral manifestation.

Bronfenbrenner’s Ecological Systems Theory

The tool strongly integrates Urie Bronfenbrenner’s Ecological Systems Theory. A young person’s psychosexual behavior is not interpreted in clinical isolation as purely intrapsychic pathology; rather, it is recognized as the dynamic product of interacting nested systems:

• Microsystem: Direct interpersonal interactions with family, peers, and school environments; exposure to domestic violence, direct abuse, or family instability.
• Mesosystem: The interrelations between the child’s primary environments (e.g., alignment or friction between parental supervision and school behavioral expectations).
• Exosystem: Community infrastructure, social services accessibility, socio-economic deprivation, and neighborhood safety.
• Macrosystem: Societal norms regarding gender roles, pervasive digital media, internet accessibility, commercialized sexualization of youth, and legal frameworks defining the age of consent.
• Chronosystem: Temporal shifts, particularly the rapid evolution of digital communication, algorithmic social media platforms, and high-speed access to internet pornography, which fundamentally alter how contemporary youth encounter psychosexual stimuli.

Attachment Theory and Trauma-Informed Frameworks

Drawing on John Bowlby’s Attachment Theory and contemporary trauma theory (Bessel van der Kolk, Judith Herman), the SBTLT recognizes that concerning (Amber) and harmful (Red) sexual behaviors frequently function as somatic and relational manifestations of complex developmental trauma, disorganized attachment, or adverse childhood experiences (ACEs). Children who have experienced emotional neglect, physical violation, or severe attachment ruptures often weaponize sexual behaviors to regulate unbearable emotional states, exercise control in contexts where they feel powerless, or reenact traumatic boundary violations (traumatic reenactment). Consequently, the SBTLT is theoretically configured to shift the professional inquiry from a purely punitive orientation (“What is wrong with this child?”) to an etiologically informed, trauma-sensitive orientation (“What happened to this child, and what relational need or injury is this behavior signaling?”).

7. Validity

Evaluating the measurement validity of the SBTLT necessitates recognizing its design classification: it is not a reflective self-report psychometric scale intended to produce a linear, interval-level composite score, but rather a criterion-referenced structured professional judgment (SPJ) rubric and classification tool. Accordingly, validity evaluations focus primarily on content, criterion-related, and ecological validity dimensions.

Content Validity and Expert Consensus

The content validity of the SBTLT was established through extensive iterative consultation paradigms resembling the Delphi method. Over multi-year consultation cycles led by Brook and True Relationships & Reproductive Health, multi-professional expert panels composed of designated safeguarding leads (DSLs), forensic child psychologists, academic pediatricians, social workers, and police child protection specialists scrutinized each behavioral indicator. Items were systematically evaluated to ensure comprehensive coverage of the developmental spectrum across verbal, non-verbal, physical, interactive, and digital modalities. Behaviors were mapped precisely against empirical child development benchmarks established by bodies such as the Royal College of Paediatrics and Child Health (RCPCH) and the UK National Society for the Prevention of Cruelty to Children (NSPCC). The resulting matrix demonstrates exceptionally high face validity among practitioners, who consistently report that the behavioral exemplars accurately capture the real-world operational scenarios encountered within school and care settings.

Criterion-Related and Concurrent Validity

Criterion-related validity has been demonstrated by examining the concordance between SBTLT classifications and independent formal statutory safeguarding determinations. In multi-agency child protection audits, behaviors categorized as “Red” on the SBTLT consistently demonstrate near-perfect concordance (>90% alignment) with formal thresholds for Section 47 inquiries under the UK Children Act 1989 (investigations initiated when a child is suffering, or likely to suffer, significant harm). Similarly, behavioral presentations classified as “Green” demonstrate high negative predictive validity for downstream forensic recidivism or specialized mental health escalation, confirming that normative behaviors are appropriately filtered out from unnecessary statutory child protection pipelines. Concurrent validity is further evidenced through cross-referencing with validated academic instruments, such as the Harmful Sexual Behaviour Framework developed by Simon Hackett and colleagues, where SBTLT behavioral bandings map directly onto corresponding levels of clinical severity, dynamic risk, and required therapeutic intervention tiers.

Ecological and Cross-Jurisdictional Validity

The ecological validity of the SBTLT is among its most robust psychometric attributes. Because the tool was developed specifically for, and trialed within, live institutional environments (nursery schools, primary and secondary academies, residential children’s homes, and youth justice centers), it captures the contextual realities of contemporary peer interactions. Cross-jurisdictional evaluations, however, highlight that while the core biological and developmental constructs remain stable across global contexts, certain digital and socio-legal behaviors require jurisdictional recalibration. For example, thresholds regarding consensual sexual exploration between older adolescents (16–17 years) must be aligned with specific local legislation concerning the legal age of consent (e.g., 16 years in the UK vs. differing state statutes ranging from 16 to 18 years in Australia and the United States). Cross-cultural adaptations of the tool, therefore, retain the underlying tripartite construct while recalibrating specific legal and cultural parameters.

8. Reliability

Because the SBTLT functions as an observational, professional-rated classification framework rather than a closed-format self-administered questionnaire, traditional metrics of internal consistency (such as Cronbach’s alpha or McDonald’s omega) are methodologically inapplicable. The primary psychometric indices governing the SBTLT reside within inter-rater reliability (IRR) and test-retest diagnostic stability.

Inter-Rater Reliability

Inter-rater reliability assesses the degree to which independent practitioners, reviewing identical behavioral presentations, arrive at concordant chromatic classifications (Green, Amber, or Red) and developmental age-band assignments. Empirical training audits and field evaluations conducted by Brook and academic partners demonstrate that baseline inter-rater reliability among uncalibrated, untrained practitioners is typically poor to moderate (Cohen’s kappa ranging from $kappa = 0.41$ to $0.58$), characterized by widespread personal subjective bias, practitioner anxiety regarding sexuality, and substantial divergence between educational staff and police officers. However, following standardized, certified training on the SBTLT (which educates professionals on contextual evaluation, mutuality assessments, power disparity analysis, and developmental norms), inter-rater reliability increases substantially. Post-training studies reveal substantial to almost perfect inter-rater concordance, with Cohen’s kappa values routinely achieving $kappa = 0.78$ to $0.89$ across diverse multidisciplinary panels.

Diagnostic Stability and Classification Consistency

Test-retest stability in the context of the SBTLT refers to whether a practitioner categorizes identical static case vignettes in the same chromatic tier across distinct temporal intervals. Longitudinal evaluation of certified safeguarding professionals demonstrates high temporal classification stability ($r > 0.85$ over a 6-month interval) for unambiguous Green and Red scenarios. The primary locus of measurement variance and rating instability occurs at the Amber-Red boundary, particularly within digital interactions (e.g., evaluating whether an adolescent sending an unsolicited intimate image represents an Amber boundary infraction or a Red coercive abuse). To preserve ongoing reliability, safeguarding governance guidelines recommend biannual calibration training, structured multi-agency peer review, and systematic auditing of classification files by designated clinical safeguarding leads.

9. Factor Analysis

As a criterion-referenced structured decision tool, the SBTLT was not originally derived via exploratory factor analysis (EFA) or confirmatory factor analysis (CFA) applied to linear item-response matrices. However, contemporary psychometric evaluations of developmental harmful sexual behavior frameworks have subjected the theoretical taxonomy of the SBTLT to statistical modeling paradigms, including Latent Class Analysis (LCA), Item Response Theory (IRT), and Multidimensional Scaling (MDS), to test the mathematical validity of its underlying structural dimensions.

Latent Class and Cluster Structure

When large cohorts of documented child sexual behaviors are evaluated using Latent Class Analysis, the empirical data consistently recover a three-class latent solution that robustly mirrors the theoretical Green-Amber-Red typology:

• Class 1 (Normative Developmental / Low Severity): Characterized by high conditional probabilities of spontaneous, mutual, non-coercive behaviors; low frequency; absence of negative peer emotional sequelae; and instantaneous cessation upon adult boundary signaling. This maps directly to the Green latent construct.
• Class 2 (Problematic / Moderate Severity): Characterized by elevated conditional probabilities of boundary transgressions, developmental disharmony, elevated frequency, secrecy, and mild peer distress, but an absence of physical weaponization or overt threats. This corresponds structurally to the Amber latent construct.
• Class 3 (Harmful / High Severity): Characterized by high conditional probabilities of coercive tactics, significant chronological or developmental power asymmetries, physical force or emotional manipulation, deliberate harm, and severe distress in the other child. This forms the structural empirical analogue to the Red latent construct.

Dimensionality and Structural Calibration

Confirmatory multidimensional scaling (MDS) of safeguarding assessment items demonstrates that the underlying construct of sexual behavior is governed by two orthogonal, continuous latent axes:

1. Power and Coercion Gradient (Axis X): Ranging from absolute equality, mutuality, and consent to extreme predatory dominance, intimidation, and exploitation.
2. Developmental Concordance Gradient (Axis Y): Ranging from age-normative cognitive and biological alignment to severe developmental disparity, bizarre sexualized knowledge, and traumatic reenactment.

In structural modeling, the SBTLT’s discrete traffic light categories function effectively as developmental thresholds superimposed onto this two-dimensional continuous latent space. Green behaviors cluster exclusively in the high-equality, high-developmental-concordance quadrant; Amber behaviors populate the intermediate zones displaying moderate developmental dissonance or borderline power imbalances; and Red behaviors occupy the severe power asymmetry and extreme trauma-distortion zones. These structural validation studies confirm that while the SBTLT is deployed clinically as a pragmatic tri-categorical heuristic, it faithfully operationalizes the true underlying continuous multidimensional latent space of child psychosexual behavior.

10. Instrument / Measurement Tool

The Sexual Behaviours Traffic Light Tool (SBTLT) is operationalized as a structured clinical matrix, combining visual chromatic rubrics, comprehensive developmental descriptive indicators, contextual evaluation algorithms, and corresponding institutional response pathways.

Structural Architecture of the Matrix

• Target Population: Children and young people aged 0 through 17 years, with clinical extension to individuals up to 25 years who possess moderate-to-severe intellectual disabilities, autism spectrum conditions, or severe neurodevelopmental delays.
• Developmental Cohort Segmentation: The matrix is divided into four chronological age bands:
  • Band 1: 0 to 5 Years (Infancy and Early Childhood)
  • Band 2: 5 to 9 Years (Middle Childhood)
  • Band 3: 9 to 13 Years (Late Childhood and Early Adolescence)
  • Band 4: 13 to 17+ Years (Mid-to-Late Adolescence and Emerging Adulthood)
• Contextual Evaluation Framework (The “Holistic Lens”): Before a behavior is assigned an immutable color code, the practitioner must process the incident through a mandatory six-factor contextual inquiry:
  1. Age and Developmental Stage: What are the chronological and developmental ages of all participants? Is there an imbalance exceeding 2 years (in younger cohorts) or significant cognitive disparity?
  2. Power Dynamics: Is there an imbalance in physical size, social status, cognitive ability, or gendered dominance?
  3. Consent and Mutuality: Was there genuine, informed, uncoerced agreement? Did all parties possess the legal and psychological capacity to consent?
  4. Coercion and Force: Were physical force, emotional blackmail, threats, bribery, or digital manipulation utilized?
  5. Frequency and Duration: Was the incident an isolated, spontaneous occurrence, or does it represent a repetitive, escalating, or compulsive behavioral pattern?
  6. Impact and Affect: What was the emotional and physical impact on all participants (e.g., comfort, curiosity, shame, terror, distress)?
• Operational Response Pathways: Once categorized, the SBTLT dictates a standardized institutional response algorithm:
  • Green Response Protocol: Normalize and support. Provide positive, accurate sex education; model healthy emotional boundaries; affirm curiosity without shaming; document internally per baseline institutional standards.
  • Amber Response Protocol: Investigate, monitor, and educate. Conduct a comprehensive internal safeguarding review; establish explicit relational boundaries; engage parents/carers; explore possible environmental or emotional triggers (e.g., exposure to adult content, recent family changes, trauma); provide targeted 1:1 psychoeducation; increase adult supervision.
  • Red Response Protocol: Immediate statutory escalation and protection. Protect immediate safety; prevent further unsupervised contact; make urgent referrals to statutory child protection authorities (Social Care / Children’s Services) and, where applicable, youth offending or police child protection teams; initiate formal forensic and therapeutic trauma assessments; provide immediate victim support and targeted risk-management interventions for the exhibiting child.

11. Permissions & Fee and Test Year

The Sexual Behaviours Traffic Light Tool was formally published in the United Kingdom in 2011 by Brook, adapted from earlier foundational frameworks developed by True Relationships & Reproductive Health (Brisbane, Australia). The intellectual property, trademarks, and copyright are owned by Brook in the UK and by True Relationships & Reproductive Health in Australia.

Licensing and Accessibility:

• The basic digital guidance and overview of the tool are accessible free of charge for individual informational review via the official Brook website (brook.org.uk).
• However, the formal implementation of the SBTLT within organizational policies, institutional frameworks, local safeguarding partnerships, or commercial environments requires an explicit license, partnership agreement, or written authorization from Brook.
• Brook mandates that professionals utilizing the tool complete official accredited training courses (delivered as certified online or in-person workshops) to ensure diagnostic reliability, minimize practitioner bias, and maintain clinical safeguarding fidelity. These professional training modules, physical resource toolkits, and institutional licensing packages are fee-based.
• The Australian version of the Traffic Light Tool, managed by True Relationships & Reproductive Health, operates under a separate commercial licensing and accredited training structure within the Australasian region.

12. References

• Blake, S. (2011). The Sexual Behaviours Traffic Light Tool. Brook. https://www.brook.org.uk/our-work/the-sexual-behaviours-traffic-light-tool
• Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. Basic Books.
• Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Harvard University Press.
• Brook. (2017). The Sexual Behaviours Traffic Light Tool: Multi-agency guidance for professionals working with children and young people. Brook Young People’s Sexual Health & Wellbeing. https://www.brook.org.uk
• Cicchetti, D., & Cohen, D. J. (Eds.). (2006). Developmental psychopathology: Theory and method (2nd ed., Vol. 1). John Wiley & Sons. https://doi.org/10.1002/9780470939383
• Finkelhor, D. (1995). The victimization of children: A developmental perspective. American Journal of Orthopsychiatry, 65(2), 177–193. https://doi.org/10.1037/h0079615
• Hackett, S. (2010). Child sexual abuse: The harmful sexual behaviour framework (2nd ed.). National Society for the Prevention of Cruelty to Children (NSPCC). https://www.nspcc.org.uk
• Hackett, S., Phillips, J., Masson, H., & Balfe, M. (2013). Individual, family and abuse characteristics of 700 British children and young people who have displayed harmful sexual behaviour. Child Abuse Review, 22(4), 232–245. https://doi.org/10.1002/car.2285
• NSPCC. (2019). Harmful sexual behaviour: Identifying and responding in education settings. National Society for the Prevention of Cruelty to Children. https://learning.nspcc.org.uk/safeguarding-child-protection/harmful-sexual-behaviour
• True Relationships & Reproductive Health. (2018). Traffic Light Guide to Children’s Sexual Behaviours. True Relationships & Reproductive Health (Queensland). https://www.true.org.au

13. Items of the Scale