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Background Sexual behavior problems (SBP) in school-aged children is a social concern that draws increased attention amongst child protection services and practitioners. Past research that highlighted the variety in profiles and in behavioral manifestations of children with SBP emphasizes the importance of a well-informed and sensitive approach for appropriate intervention. However, studies validating the theoretically hypothesized vulnerability of children with SBP remains scarce. Objective This study aimed to further our understanding of the risk factors that influence the variety and severity of SBP. Participants and setting Eighty-eight child-adult dyads (35.2% girls, Mage = 9.1 years; SD = 2.2 years) referred for SBP by child protection services or public services between 2006 and 2010 participated in the study. Participants completed a series of questionnaires as part of their assessment in a specialized therapeutic center for SBP. Methods A theoretical model of risk factors was examined using multiple linear regression analysis. Results Amongst the factors identified, externalizing behavior problems were the most strongly associated with the variety (β = .50; p Conclusions This study outlines the high co-occurrence of SBP, externalizing behaviors and non-sexual victimization, which should raise concern for the assessment of the children and to further adapt treatment strategies and goals.

OBJECTIVES: The short-term outcomes of child sexual abuse (CSA) on academic, behavioral and social adaptation at school were examined in order to: (1) document the proportion of sexually abused (SA) girls struggling in school and define the nature of their difficulties, (2) explore whether different profiles of school adaptation could be identified, and (3) examine the different constellations of contextual, personal, and familial correlates of abuse for each profile. METHOD: The sample consisted of 100 French-speaking mother-daughter dyads. Girls (aged 7-12, M= 8.64) were administered cognitive functioning tests and completed self-report measures to assess symptomatology, perception of abuse, and support provided. Mothers and teachers completed questionnaires to assess child's emotional, social, behavioral, and academic functioning in school. RESULTS: Descriptive analyses showed that a substantial number of girls (54%) presented clinical school adaptation difficulties in at least one of the three domains evaluated. Cluster analysis revealed four distinctive school functioning profiles: (1) academic-specific, (2) acting out/withdrawn, (3) polyclinical, and (4) resilient. These were distinguished by degree of school functioning difficulties and number of domains affected. The profiles were further discriminated by elements of the CSA experience and contextual, familial, and personal factors. The number of spheres of functioning affected was proportional to the number of risk factors to which girls were exposed. DISCUSSION: Results suggest the need for a systematic and thorough assessment of SA child functioning at school and may guide mental health professionals in providing differential treatment on the basis of the emerged typology. PRACTICE IMPLICATIONS: Sexually abused children demonstrate a wide variability of responses, rendering the elaboration of a "one size fits all" treatment rather difficult. The emerged typology underscores the complex heterogeneity of school adjustment profiles and suggest that secondary effects of abuse on child's level of school functioning require specific assessment and close monitoring. This study raises practical questions as to whether such secondary effects could best be addressed as a primary treatment objective, or in addition to a trauma-focused approach, or as the sole treatment objective. Language: en