PSB-CY Child Information

Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

PROBLEMATIC SEXUAL BEHAVIOR IN CHILDREN AND YOUTH (PSB-CY) NON-CLINICAL REFERRAL TOOL (NCRT)
This PSB-CY NCRT is a referral tool, informed by current literature and related tools and resources. The PSB-CY NCRT is not an assessment or disposition tool,
information recorded on the PSB-CY NCRT can be sensitive in nature and should be handled according to your agency/program/service guidance. No PII
(Personally Identifying Information) should be included on the PSB-CY NCRT.
INSTRUCTIONS
The PSB-CY Non-Clinical Referral Tool (NCRT) was developed to assist personnel from the Department of Defense Education Activity (DoDEA) and Child
Development/Youth Programs (CD/YP) personnel in determining if a consult or referral to FAP is necessary and is designed to assist FAP personnel in
determining if a referred incident warrants engagement of the Multi-Disciplinary Team (MDT).
Individuals in supervisory roles or designated roles for making referrals of Problematic Sexual Behavior among Children and Youth (PSB-CY) in DoDEA (e.g.,
Administrator, Principal, School Counselor, School Psychologist, School Nurse) and CD/YP (e.g., CYS Director, CDC Director, Training and Curriculum
Specialist) will complete the PSB-CY NCRT with input from the direct referral source (e.g.,Teacher, Child Care Staff Member) who observed or have been made
aware of the behavior(s) exhibited to determine if a consult or referral to FAP is necessary. Individuals from FAP (e.g., Family Advocacy Program Manager,
Clinical Case Manager, Clinician) who receive the PSB-CY referral from DoDEA or CD/YP will review the PSB-CY NCRT, with input from the referral source, to
determine if engagement of the MDT should be engaged. FAP personnel will complete the PSB-CY NCRT when receiving PSB-CY referrals from non-DoDEA
and non-CD/YP sources, such as parents or law enforcement to determine if engagement of the MDT should begin.
There are two parts to the PSB-CY NCRT (i.e., Part 1 and Part 2). Part 1 is intended to assess where the exhibited behavior(s) falls on the Sexual Behaviors
Guide, how frequently the behavior or behaviors have been exhibited, and the developmental age range of the children or youth involved. After completing Part
1, follow the next steps listed in the gray answer key at the bottom of page 3. Instructions in Blue and Bolded are for DoDEA and CD/YP, and instructions in
Green and Underlined are for FAP personnel.
Within Part 2, there are two sections (i.e., Section 2A and 2B). You complete Section 2A, if more than one child or youth was involved in the incident (e.g., one
child exhibited and one child was impacted or two youth exhibited and three youth were impacted) in the behavior(s). You complete Section 2B, if the behavior(s)
exhibited by the child or youth did not involve another child or youth (i.e., one child exhibiting and no impacted children). After completing Part 2 Section 2A or
2B, follow the next steps listed in the gray answer key at the bottom of page 8 for Section 2A or at the bottom of page 9 for Section 2B. Instructions in Blue and
Bolded are for DoDEA and CD/YP, and instructions in Green and Underlined are for FAP personnel.
For assistance or questions related to the implementation of the PSB-CY Non-Clinical Referral Tool, please contact the Clearinghouse for Military
Family Readiness at Penn State by email at [email protected] or by phone at 1-877-382-9185 from 9:00 a.m. to 5:00 p.m. EST.

Part 1. PSB-CY NCRT
1. Directly below provide information on the sex, chronological age, and grade of child(ren) or youth involved (i.e., exhibiting and impacted) in the behavior. No
PII (Personally Identifiable Information) should be included on the PSB-CY NCRT, such as child(ren) or youth names or demographic information. For
DoDEA or CD/YP referrals, if known, please indicate if the child(ren) or youth involved have a known educational support plan (i.e., Individualized Education
Plan [IEP], Individualized Family Services Plan [IFSP], 504 plan, or Individualized Support Plan [ISP]):
a. Exhibiting child(ren) or youth information:
Sex (i.e., male, female, other, or unknown), chronological age, and grade of child(ren) or youth exhibiting the behavior. If no information is available or
provided on the exhibiting child(ren) or youth, please write “no information available” in the first space below:
Example: Male, age 7, 1st grade

Known educational support plan?

Yes

No

Unknown

1.

Known educational support plan?

Yes

No

Unknown

2.

Known educational support plan?

Yes

No

Unknown

3.

Known educational support plan?

Yes

No

Unknown

4.

Known educational support plan?

Yes

No

Unknown

5.

Known educational support plan?

Yes

No

Unknown

6.

Known educational support plan?

Yes

No

Unknown

7.

Known educational support plan?

Yes

No

Unknown

b. Impacted child(ren) or youth information:
If applicable, sex (i.e., male, female, other, or unknown), chronological age, and grade of child(ren) or youth impacted by the behavior. If no information is
available or provided on the impacted child(ren) or youth, please write “no information available” in the first space below:
Example: Male, age 7, 1st grade

Known educational support plan?

Yes

No

Unknown

1.

Known educational support plan?

Yes

No

Unknown

2.

Known educational support plan?

Yes

No

Unknown

3.

Known educational support plan?

Yes

No

Unknown

4.

Known educational support plan?

Yes

No

Unknown

5.

Known educational support plan?

Yes

No

Unknown

6.

Known educational support plan?

Yes

No

Unknown

7.

Known educational support plan?

Yes

No

Unknown

DD FORM 3179, JAN 2022

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

2. Description of exhibiting child(ren) or youth behavior(s). Include no PII on the child(ren) or youth involved:
a. Describe the behavior(s) exhibited (i.e., be as specific as possible and utilize anatomical terms when documenting body parts) and who
observed or was made aware of the behavior(s):

b. Describe where the behavior(s) occurred (e.g., on or off the military installation, DoDEA or non-DoDEA school, youth center, home):

c. Describe any adult redirection provided to the child(ren) or youth exhibiting the behavior(s):

d. Describe any noticeable reactions by the child(ren) or youth exhibiting or impacted by the behavior(s) such as using profanity,
physical aggression, crying, or somatic symptoms (e.g., stomach pain, headaches, weakness):

DD FORM 3179, JAN 2022

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

3. Frequency of exhibited behavior(s) by child(ren) or youth.
a. For DoDEA or CD/YP personnel in a supervisory or PSB-CY specific role (e.g., Administrator, Principal, School Nurse, School
Counselor, CYS Director, CDC Director), is this the first time the child’s/youth’s sexual behavior has been brought to your attention?
Yes

No

If No, how many (e.g., second time, third time)?

No information available or provided
b. Is this the first time the direct referral source (e.g., Teacher, Child Care Staff, Parent) has observed or been made aware of the child’s/
youth’s sexual behavior described above or other sexual behaviors?
Yes

No

If No, how many (e.g., 2 total occurrences, 3 times a week)?

No information available or provided
c. For FAP personnel, is this the first time the child’s/youth’s sexual behavior has been brought to your attention?
Yes

No

If No, how many (e.g., second time, third time)?

No information available or provided
4. Does the behavior(s) exhibited fall under the Normative Category for the child(ren) or youth’s chronological age on the Sexual Behaviors
Guide listed on pages 4-7?
Yes

No

5. If more than one child was involved (e.g., exhibited or impacted by) in the behavior(s), were the children at similar developmental ages
(cognitive, language, social, emotional, motor development) (e.g., one child was at a developmental age of 6 years old and the other was at
a developmental age of 7 years old)?
(CD/YP and DoDEA should confer with the proper personnel regarding the developmental ages of the children involved;
i. e., DoDEA should confer with one of the following: Inclusion Action Team, Student Support Team, or Case Study Committee. CD/
YP should confer with the Inclusion Action Team. FAP should defer to the referral source [i.e., DoDEA or CD/YP] as they will have the
necessary information on the developmental ages of the children involved.)
Yes

No

Not Applicable

** If “Yes” was selected for questions 3, 4, and 5 or if “Yes” was selected for questions 3, 4, and “Not Applicable” was selected for
question 5, the behavior should be considered Normative for the child(ren) involved. For further guidance, refer to Next Steps under When the
Behavior falls under the Normative Category on page 10 for DoDEA and CD/YP and page 12 for FAP.
** If “No” was selected for ANY or ALL of questions 3, 4, and 5, please move on to Part 2 of the NCRT on page 8.

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

SEXUAL BEHAVIORS GUIDE
AGES 2-4 YEARS
Normative “Common” Sexual Behaviors (X as applicable)
Masturbating or touching genitalia in public or private

Uses elimination words for bathroom and sexual functions (e.g., pee pee, poo poo)

Touching or looking at their own, familiar adults (e.g., parents, caregivers), or children’s (e.g.,
siblings, peers) genitalia, breasts, or buttocks

Plays doctor or nurse inspecting others’ body parts

Enjoys being nude

Explores differences between males and females

Displaying genitalia area and/or buttocks to others

Interested but does not seek ways to watch people going to the bathroom

Stands too close or displays poor physical boundaries

Wanting to learn about genitals, intercourse, babies

Has erections
Cautionary “Less Common” Sexual Behaviors (X as applicable)
Continues to masturbate, in public or private, or touch genitals after adult redirection and beyond
developmental expectations
Continues to touch adults (e.g., parents, caregivers), or other children’s (e.g., siblings, peers)
genitalia, breasts, or buttocks after adult redirection and beyond developmental expectations
Rubs their genitalia and/or buttocks against others
Attempts to kiss others using tongue

Has frequent erections
Asks adults or children to take their clothes off
Continues to ask questions related to genital differences and/or sexual content when all questions
have been answered
Seeks ways to watch people going to the bathroom after adult redirection and beyond
developmental expectations

Undresses in public after adult redirection and beyond developmental expectations
Problematic “Uncommon” Sexual Behaviors (X as applicable)
Penetration of self or others with an object to genitals or rectum

Asks adults or other children to engage in specific sexual acts

Inserts objects or fingers into genitalia or rectum

Asks unfamiliar adults sexual questions

Touches unfamiliar adults, peers, and/or animal’s genitalia

Uses physical force on other children to engage in sexual acts (e.g., restraining the child while
engaging in sexual play/games)

Tries to engage in intercourse with an adult or another child

Has advanced knowledge about sexual acts

Has mouth to genitalia contact with children or adults

Engages repeatedly in a variety of sexual acts or behaviors

Exhibits fear or emotional distress of having an erection

Uses emotional coercion to get others to engage in sexual acts (e.g., will offer the child a bribe
such as candy or a toy to take clothes off and play doctor)

Imitates adult sexual behavior

Asks to watch sexually explicit material on television or the internet

Pretends toys are having intercourse or performing sexual acts

Accesses sexual material online or offline (i.e., access is accidental or child is exposed to it
deliberately by an adult)

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

SEXUAL BEHAVIORS GUIDE
AGES 5-9 YEARS
Normative “Common” Sexual Behaviors (X as applicable)
Occasionally self-touches and masturbates in private

Playing doctor or nurse inspecting others’ body parts

Awareness of privacy about bodies

Conversations about genitalia, breasts, or buttocks with peers

Kissing or holding hands

Interested in watching/peeping at people who are nude or going to the bathroom

Kisses/hugs familiar adults and children

Wanting to learn about genitals, intercourse, babies

Has erections

Interest in breeding behavior of animals

Uses profanity for bathroom and sexual functions

Draws genitals on human figures for artistic expression or because figure is portrayed in the nude

Telling inappropriate jokes and/or uses sexually explicit gestures

Looks at nude pictures on the internet, videos, magazines, etc.

Plays games with peers related to sex and sexuality (e.g., show me yours, I’ll show you mine
behavior)
Cautionary “Less Common” Sexual Behaviors (X as applicable)

Accidentally accesses pornography online or offline

Masturbates, touches/rubs, or exposes genitalia in public

Frequently uses sexual language that makes other children uncomfortable

Kisses/hugs unfamiliar adults and children

Engages in foreplay with dolls or peers with clothes on

Touches other children’s or animals’ genitalia, breasts, or buttocks, clothed or unclothed

Engages in sexually explicit conversations with peers

Occasional incidents of looking at others’ genitalia, breasts, or buttocks; showing their own
genitalia, breasts, or buttocks; or rubbing their own genitalia, breasts, or buttocks on others, after
adult redirection and beyond developmental age expectations

Draws genitals that are disproportionate on nude or clothed figures

Wants to play games related to sex and sexuality with children 2+ years younger or older in
chronological age (special attention paid to 2+ age differences and any developmental or power
differential differences)

Sends or asks to receive pictures of genitalia, breasts, or buttocks
Shows interest in and/or seeks out pornography (e.g., non-accidental, finds ways to watch
pornography)

Problematic “Uncommon” Sexual Behaviors (X as applicable)

Repeatedly touches others’ genitalia, breasts, or buttocks

Initiates or participates in sexually explicit conversations with another child(ren) 2+ years younger
or older in chronological age (special attention paid to 2+ age differences and any developmental
or power differential differences)
Engages in sexually explicit conversations with peers after adult redirection and beyond
developmental age expectations
Using physical force on others to engage in sexual acts (e.g., restraining the child while engaging
in sexual play/games)
Uses emotional coercion to get others to engage in sexual acts (e.g., will threaten to exclude the
child or tell a secret if the child does not take clothes off and play doctor)

Has mouth to genitalia contact with other children

Has advanced knowledge about sexual acts

Repeatedly looks at others’ genitalia, breasts, or buttocks; shows their own genitalia, breasts, or
buttocks; or rubs their own genitalia, breasts, or buttocks against others, after adult redirection and
beyond developmental age expectations

Draws sexual images (e.g., intercourse, group sex, sex with animals, sadism, etc.) and/or genitals
stand out as most prominent feature
Taking and/or sharing nude sexual images of themselves or others with or without their knowledge
on social media, text, and/or internet

Engages in oral, anal, or vaginal penetration with another child

Meets friends met online face to face (risk of sexual assault)

Engages in sexually exploratory behaviors with another child who is 2+ years younger or older in
chronological age (special attention paid to 2+ age differences and any developmental or power
differential differences)

Asks to watch sexually explicit material on television or the internet

Painful erections or hurting self to stop erections

Intentionally accesses pornography and/or plays violent or sexual video games

Imitates sexual behavior (e.g., simulating intercourse with dolls, peers, or animals)

Sexual play or masturbation with an object that involves anal or vaginal penetration

Compulsive masturbation in private or public
Mutual masturbation with a peer or group
Masturbation that includes vaginal or anal penetration and/or the use of objects
Any genitalia injury or bleeding not explained by an accident

DD FORM 3179, JAN 2022

Accesses or shows pornography to others

Page 5 of 12

Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

SEXUAL BEHAVIORS GUIDE
AGES 10-12 YEARS
Normative “Common” Sexual Behaviors (X as applicable)
Masturbating or touching their own genitalia, breasts, or buttocks in private

Discussing genitals or reproduction

Wanting privacy

Plays games with same aged peers related to sex and sexuality (e.g., Show me yours, I’ll show
you mine behavior)

Kissing, holding hands, flirting

Increases in sexual thoughts and feelings

Occasional flashing or mooning

Observing sexual content through media (e.g., magazine or television)

Using profanity

Having own social media accounts that are supervised by parents/caregivers

Telling inappropriate jokes and/or uses sexually explicit gestures

Access to pornography

Cautionary “Less Common” Sexual Behaviors (X as applicable)
Masturbates, touches/rubs, or exposes genitalia in public

Discussing fear of getting pregnant or a sexually transmitted infection

Occasional incidents of looking at others’ genitalia, breasts, or buttocks; showing their own
genitalia, breasts, or buttocks; or rubbing their own genitalia, breasts, or buttocks on others, after
adult redirection and beyond developmental age expectations

Taking nude, sexual images of themselves

Attempts to expose other’s genitals

Secretive about using the internet/social media (risk of being groomed or exploited)

Simulating foreplay or intercourse with peers, clothed

Seeking out pornography (e.g., non-accidental, finds ways to watch pornography)

Voluntarily exchanges sexual content (text or images) via cell phone or internet

Problematic “Uncommon” Sexual Behaviors (X as applicable)
Compulsive masturbation in private or public

Forcing or coercing others to participate in any sexual behavior (e.g., physically holding the child
or threatening to exclude the child if they don’t undress or expose their genitals)

Sexual play or masturbation with an object that involves anal or vaginal penetration

Making written or verbal sexually explicit threats

Self-touch that causes harm or damage to genitalia, breasts, or buttocks
Mutual masturbation with a peer or group
Engages in unwanted touches of others’ genitalia, breasts, or buttocks

Degrading/humiliation of themselves or others using sexual themes (e.g., offensive jokes, name
calling, insults)
Taking and/or sharing nude sexual images of themselves or others without their knowledge on
social media, text, and/or internet
Bullied or coerced others to send sexual content (text or images) via cell phone or internet (e.g.,
exclude the child or threatens to share a secret if the child does not participate)

Penetration of dolls, other children, or animals

Repeatedly seeks out adult pornography (i.e., non-accidental, finds ways to watch pornography)

Engages in sexual behaviors with another child who is 2+ years younger or older in chronological
age (special attention paid to 2+ year age differences and any developmental or power differential
differences)

Interest in child pornography (e.g., looking at images, watching videos)

Simulating intercourse or foreplay with peers, unclothed

Meets friends met online face to face (risk of sexual assault)

Forces or coerces others to watch pornography (e.g., refusing to leave until the child watches
pornography or threatening to share a secret)

Repeatedly looks at others genitalia, breasts, or buttocks; shows their own genitalia, breasts, or
buttocks; or rubs their own genitalia, breasts, or buttocks against others, after adult redirection and
beyond developmental age expectations

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

SEXUAL BEHAVIORS GUIDE
AGES 13-18 YEARS
Normative “Common” Sexual Behaviors (X as applicable)
Masturbating in private

Telling inappropriate jokes

Need for privacy

Sexual teasing and flirting

Kissing, hugging, holding hands
Voluntarily shared engagement in sexual intercourse or sexual activity with a partner of similar
developmental age

Sending/receiving sexual images of others or sexual material (e.g., pornography, pictures, or
movie/television clips) with their knowledge
Viewing sexual content through media such as pornography, pictures, or television for arousal
(e.g., viewing movies with sexual content)

Participating in sexually explicit conversations or obscenities with peers
Cautionary “Less Common” Sexual Behaviors (X as applicable)
Masturbates, touches/rubs, or exposes genitalia in public

Attempts to expose others’ genitals

Engages in unsafe sexual behavior (e.g., multiple sexual partners)

Engages in frequent sexual relationships about which they feel uncomfortable

Preoccupied with or anxious about sex

Using themes or obscenities involving sexual aggression

Spying on others who are nude or engaged in sexual activity
Problematic “Uncommon” Sexual Behaviors (X as applicable)
Compulsive masturbation in private or public

Sexual contact with animals

Self-touch that causes harm or damage to genitalia, breasts, or buttocks

Making written/verbal sexually explicit threats

Engages in unwanted touching of others’ genitals, breasts, or buttocks

Making obscene sexual phone calls or texts

Forcing or coercing others to participate in any sexual behavior (e.g., physically holding the child/
youth, engages in unwanted sexual penetration, or threatening to exclude the child if they don’t
undress or expose genitals)

Displaying exhibitionism or voyeurism or sexually harassing others

Penetrating another person forcefully (e.g., causing pain or injury)

Taking sexual images of others to exploit them, with or without their knowledge
Taking and/or sharing nude sexual images of themselves or others without their knowledge on
social media, text, and/or internet

Engages in sexual behaviors with another child/youth who is much younger or older in
chronological age (special attention paid to 2–5 year age differences and any developmental or
power differential differences)

Bullied or coerced others to send sexual content (text, videos, or images) via cell phone or internet

Repeatedly looks at others’ genitals, breasts, or buttocks; shows their own genitals, breasts, or
buttocks; or rubs their own genitals, breasts, or buttocks against others, after adult redirection and
beyond developmental expectations

Accesses sexually aggressive/violent pornography and/or child pornography

DD FORM 3179, JAN 2022

Having nude images of others without their knowledge

Forces or coerces others to watch pornography (e.g., refusing to leave until the child/youth
watches pornography or threatening to share a secret)

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

Part 2. PSB-CY NCRT
If more than one child or youth was involved (e.g., one exhibited and one impacted child) in the behavior exhibited, complete Section 2A found
directly below. If the behavior exhibited by the child or youth did not involve another child or youth, please complete section 2B on page 9.
Section 2A. Answer questions 1-8 if more than one child or youth was involved in the behavior
Yes

No

No

Don't
Know
or N/A

1) Does the behavior(s) fall under the Cautionary Sexual Behaviors Guide for the exhibiting child’s chronological age listed
on pages 4-7?
2) Does the behavior(s) fall under the Problematic Sexual Behaviors Guide for the exhibiting child’s chronological age listed
on pages 4-7?

Yes
3) If “No” was selected for Question 5 in Part 1, did the developmental gap cause a potential power differential
where an impacted child was taken advantage of? For example, although both children involved are at a
chronological age of 14 years, the child exhibiting the behavior has no developmental delays and the
impacted child has cognitive and/or social, emotional delay(s). If no developmental gap was identified in
Question 5 in Part 1, select “Don’t Know or N/A”.
4) Did the behavior persist after adult redirection despite what you would normally expect for the developmental age
of the child exhibiting the behavior?
5) If redirected, did the child exhibiting the behavior display anger or irritation (e.g., yelling, using profanity, physical
aggression)?
6) Was physical aggression, coercion, intimidation, or force used (e.g., pushing, slapping, holding, grabbing,
causing pain or injury) towards the impacted child(ren)?
7) Was emotional coercion or intimidation used (e.g., making threats to share a secret or exclude the child if he or
she did not participate) towards the impacted child(ren)?
8) Did the child(ren) impacted display emotional distress and/or somatic symptoms (e.g., crying, stomach pain,
headaches, changes in sleep patterns, decreased appetite) after the incident?

** If “Yes” was selected for any of the questions with a Red box (i.e., question 2, 5, 6, 7, or 8),
For CD/YP or DoDEA, a referral to FAP should be made. FAP will review the information contained on the NCRT and provide
information on FAP next steps for engagement of the MDT. Refer to Next Steps for CD/YP and DoDEA: When the Behavior falls under
the Problematic Category on page 10 for further guidance.
For FAP personnel, follow Service FAP procedures on notifying the FAP Supervisor or Manager and engaging the MDT. Refer to Next Steps
for FAP Personnel: When the Behavior falls under the Problematic Category on page 12 for further guidance.
** If “Yes” was selected for any of the questions with a Yellow box (i.e., question 1, 3, or 4),
For CD/YP or DoDEA, confer with FAP regarding the incident and a determination of engagement of the MDT will be decided with
your input and participation. Refer to Next Steps for CD/YP and DoDEA: When the Behavior falls under the Cautionary Category on
page 10 for further guidance.
For FAP personnel, review the information contained on the NCRT with input from the referral source. Make a determination for engagement of
MDT with referral source input and participation. Follow Service FAP procedures for conferring with FAP Supervisor or Manager. Refer to Next
Steps for FAP: When the Behavior falls under the Cautionary Category on page 12 for further guidance.
** If “No” was selected for questions 1-8, the behavior should be considered Normative for the child(ren). Follow internal process and
procedures for follow-up action. If applicable, provide caregivers with information for available resources on Normative Sexual Behaviors.

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

Section 2B. Answer questions 1-4 if the behavior exhibited by the child did not involve another child
Yes

No

No

Don't
Know
or N/A

1) Does the behavior(s) fall under the Cautionary Sexual Behaviors Guide for the exhibiting child’s chronological age listed
on pages 4-7?
2) Does the behavior(s) fall under the Problematic Sexual Behaviors Guide for the exhibiting child’s chronological age listed
on pages 4-7?

Yes
3) Did the behavior persist after adult redirection despite what you would normally expect for the developmental age
of the child exhibiting the behavior?
4) If redirected, did the child exhibiting the behavior display anger or irritation (e.g., yelling, using profanity, physical
aggression)?

** If “Yes” was selected for any of the questions with a Red box (i.e., question 2 or 4),
For CD/YP or DoDEA, a referral to FAP should be made. FAP will review the information with the referral source contained on the
NCRT and provide information on FAP next steps for engagement of the MDT. Refer to Next Steps for CD/YP and DoDEA: When the
Behavior falls under the Problematic Category on page 10 for further guidance.
For FAP personnel, follow Service FAP procedures on notifying the FAP Supervisor or Manager and engaging the MDT. Refer to Next Steps
for FAP Personnel: When the Behavior falls under the Problematic Category on page 12 for further guidance.
** If “Yes” was selected for any of the questions with a Yellow box (i.e., question 1 or 3),
For CD/YP or DoDEA, confer with FAP regarding the incident and a determination of engagement of the MDT will be decided with
your input and participation. Refer to Next Steps for CD/YP and DoDEA: When the Behavior falls under the Cautionary Category on
page 10 for further guidance.
For FAP personnel, review the information contained on the NCRT with input from the referral source. Make a determination of engagement of
MDT with referral source input and participation. Follow Service FAP procedures for conferring with FAP Supervisor or Manager. Refer to Next
Steps for FAP: When the Behavior falls under the Cautionary Category on page 12 for further guidance.
** If “No” was selected for questions 1-4, the behavior should be considered Normative for the child. Follow internal process and procedures
for follow-up action. If applicable, provide caregivers with information for available resources on Normative Sexual Behaviors.
**The PSB-CY NCRT is not designed to determine if a child’s or youth’s behavior is illegal. The servicing legal office and the Military Criminal
Investigative Office (MCIO) are the appropriate agencies for determining if a behavior is illegal. The laws in each state define illegal sexual acts
for which these acts are considered to be illegal.

**At all times, prevention, outreach, and response will reflect and accommodate diversity in cultural norms, ethnicity, religion,
socioeconomic status, disability, gender, gender identity and expression, and sexual orientation.

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

PSB-CY NCRT Next Steps
CD/YP and DoDEA Personnel NEXT STEPS
When Behavior falls under the Normative Category
Follow internal process and procedures for notification of parents/caregivers and follow-up action
Normative behaviors may be inappropriate for your setting, follow your organization's internal guidance for responding to these behaviors
If applicable, provide parents/caregivers with information for available resources on Normative Sexual Behaviors
When Behavior falls under the Cautionary Category
Follow internal processes and procedures for addressing immediate safety concerns for all children involved
Gather and complete information on page 11 in preparation for conferring with FAP
Provide copy of NCRT to the FAP POC
Confer with FAP
Review the information contained on the NCRT with the FAP POC and FAP will make a determination for engagement of the MDT
Confer with the FAP POC and your Supervisor or Principal to discuss strategies for addressing the behavior (e.g., close observation, supervision,
redirection)
Follow internal processes and procedures for notification of parents/caregivers and follow-up action
Keep communication open with the parents/caregivers and provide anticipatory guidance and support, as appropriate
When Behavior falls under the Problematic Category
Follow internal processes and procedures for addressing immediate safety concerns for all children involved
Gather and complete information on page 11 in preparation for referring behavior(s) to FAP
Follow internal CD/YP and DoDEA procedures for reporting PSB-CY incidents to the FAP
Provide copy of NCRT to the FAP POC
Confer with the FAP POC and your Supervisor or Principal to discuss strategies for addressing the behavior (e.g., close observation, supervision, redirection)
while FAP engages the MDT
Follow internal process and procedures for notification of parents/caregivers and follow-up action
Keep communication open with the parents/caregivers and provide anticipatory guidance and support, as appropriate

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

CD/YP and DoDEA Personnel Next Steps Cont.
Date:

1. Name, agency, and contact information of person completing the NCRT:

2. Were immediate safety concerns addressed for all child(ren) involved?
Yes

No

If No, please explain:

3. What was the outcome of the NCRT for the exhibited behavior(s)?
Normative, no referral to FAP

Cautionary, consult with FAP

Problematic, referral to FAP

4. If consult/referral to FAP was made, please provide date of contact and by whom:

5. Name and contact information of FAP Personnel receiving consult/referral:

6. Was the parent(s) or caregiver(s) of the child(ren) or youth exhibiting the behavior(s) notified?
Yes

No

If Yes, please provide date of contact and by whom:

7. Was the parent(s) or caregiver(s) of the child(ren) or youth impacted by the behavior(s) notified?
Yes

No

If Yes, please provide date of contact and by whom:

8. Was law enforcement notified?
Yes

No

If Yes, please provide date of contact and the contact information for the law enforcement personnel notified:

DoDEA and CD/YP Section Ends

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Prescribed by: DoDI 6400.01, SEC 549B; FY19 NDAA, Sec 1089

FAP Personnel NEXT STEPS
When Behavior falls under the Normative Category
Provide referral source with information on relevant educational resources, and if needed, strategies for addressing the behavior
Normative behaviors may be inappropriate for your setting, follow your organization's internal guidance for responding to these behaviors
Document the referral source’s next steps for addressing and monitoring the behavior
When Behavior falls under the Cautionary Category
Follow internal processes and procedures for addressing immediate safety concerns for all children involved
Review the information contained on the NCRT with input from CD/YP or DoDEA personnel or other referral source
Make a determination for engagement of the MDT (Consult with the FAP Supervisor or Manager, as needed)
If MDT is engaged, follow internal processes for convening the MDT when the behavior falls under the Cautionary category
If MDT is not engaged, provide referral source with relevant educational resources and if needed, strategies for addressing the behavior
In coordination with CD/YP, DoDEA or other referral source, keep communication open with parents/caregivers and provide anticipatory guidance and
support, as appropriate
When a parent/child/youth self-refers a sexual behavior concern to a behavioral health provider for treatment and there are no other impacted children
identified, no concerns about co-occurring child abuse or neglect, or no duty to warn requirements, follow guidelines for behavioral health referrals
When Behavior falls under the Problematic Category
Follow internal processes and procedures for addressing immediate safety concerns for all children involved
In coordination with CD/YP, DoDEA or other referral source, keep communication open with parents/caregivers and provide anticipatory guidance and
support, as appropriate
Follow Service FAP procedures for reporting PSB-CY referrals to the FAP Supervisor or Manager
Provide the referral source with guidance on addressing and monitoring the behavior, as needed, while FAP engages the MDT
FAP Manager will engage the MDT by contacting the core MDT members (i.e., DoDEA or CD/YP, and NCIO/LEA within the required timeframe)
When a parent/child/youth self-refers a sexual behavior concern to a behavioral health provider for treatment and there are no other impacted children
identified, no concerns about co-occurring child abuse or neglect, or no duty to warn requirements, follow guidelines for behavioral health referrals

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