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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.

Like message boards, chat rooms are popular spots for so-called flame wars in which two or more users enter into a tirade of insults sparked by a minor disagreement.

But these same factors can also work in your favor.

Another general rule for chat room safety is to avoid sharing any personal information in the context of a chat session.

Even if someone asks you directly, don't share information about where you live, your phone number, your real name or the names of family members.

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.

Chat rooms have always been popular spots for flirting with the opposite sex.

The anonymous nature of chat rooms tends to inspire exaggerated behavior in otherwise normal, respectful people.

One commentator calls chat rooms "safety valves" for strong emotions, opinions and urges that most people can't, or wouldn't want to express in real life [source: The Industry Standard].

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.

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