What do 3–6-year-old children in Finland know about sexuality? A child interview study in early education

Figures & data

Table 1. Drawing-assisted interview studies of non-abused children’s sexual knowledge*.

Authors, year, country	Subjects: age, number (boys/girls), recruited from, sample characterisation (if any)	Design	Topics studied with drawings	Findings	Differences in children’s knowledge by age, sex and demographic background
Gordon, Schroeder, and Abrams (1990). USA	2–7- year-olds, n = 130 (74/56). From a private paediatric practice and a public health clinic. Majority upper-class families.	20 black and white drawings adapted from SE materials designed for this age group. Structured protocol, 7 interviewers. Recorded in an interview transcript. The parent present when needed.	Gender identity and sex (GI) Sexual Body parts/Genital naming (GN) and functions Non-sexual body parts (NB) Pregnancy and birth (PB) Safety skills (SS) Adult sexual activity (AS)	GI: 94% identified own gender. Only few of younger and>50% of 6–7-year-olds identified their gender on genital basis. GN: 68% knew right or slang term for penis and 52% for vagina. Most knew urinating function; seven other as ‘babies come out of there’, ‘to play with’. NB: Well known in all age groups. PB: 15% knew of sperm or egg. 6 children knew of penis in vagina. 58% baby in uterus. 30% genital delivery or Caesarean section. SS: 64% named penis, 58% vagina and 60% anus as a private part. 55% knew to tell someone about inappropriate touch, but answers as ‘say no’, ‘get away’ were not awarded. AS: 0% knew much but 8 children some as ‘making love, trying to have a baby, doing a nasty’.	Knowledge increased with age. e.g. 4-year-olds: 30% named penis, 27% breasts, only 10% vagina. No gender differences. Lower-class children knew significantly less about GN, SS and total knowledge than middle- and upper-class children about. Lower-income parents had a more restrictive attitude towards sexuality and taught their children less than higher-income parents.
Volbert and Homburg (1996). Germany	2–6-year-olds, n = 147 (84/63). From kindergartens/preschools in Berlin and 2 smaller cities. 60% of parents refused because the child was too young. Most parents had an average level of education.	15 black and white drawings. Individually interviewed in their kindergarten. Structured protocol, specific questions such as does the baby come out from the bottom, the navel or the [child’s word for vulva].	GI GN and functions PB AS Child/child intimacy (CCI) Child/adult intimacy (CAI)	GI: 89% identified own gender; 99% identified sex in pictures. GN: 96% named penis, 90% named vulva. 5% used right terms. PB: 10% knew of sperm or egg or coitus, 2 detailed. Some said: ‘Mom bays her babies’, ‘The baby is picked up at the hospital’. 75% baby in uterus. 40% genital delivery or caesarean section. AS: No knowledge (3 something as ‘they make a baby with seed’.) CCI: 13% indicated forbiddance ‘He musn’t do that’. CAI: no abuse-related comments.	Knowledge increased by age. No differences between genders or municipals. The level of sexuality education reported by parents had a significant impact on children’s knowledge.
Brilleslijper‐Kater and Baartman (2000). Netherlands	2–7-year-olds, n = 63 (31/32). From one kindergarten, one preschool, one after-school kindergarten in Amsterdam area. Parents mainly high educated, not religious, native Dutch. Children tested IQ > average and vocabulary > average.	15 drawings, developed by Volbert and Homburg (1996). Individually interviewed about 30 min in their kindergarten/school. Video-recorded.	GI GN and functions PB AS CCI CAI	GI: 97% identified own gender; 79% identified sex in pictures. GN: 95% named penis and 78% vagina, also child’s own words were accepted. Urination function 85% penis, 68% vagina. Some other as: ‘One can stroke it’, ‘Three holes: for pee, poop and a baby’ PB: 11% mentioned seed or egg and 6% something related to intercourse. No-one knew where the baby comes out. AS: 38% turned the picture up. 2% knew of intercourse, 3% something such as they make a baby, 10% gave a sexual meaning as ‘they are fucking’, without naming penis in the vagina. CCI: answers simple and descriptive. CAI: answers simple and descriptive.	Knowledge increased by age. No gender differences. 52% of parents provided sexuality education only if the child asked.
Brilleslijper-Kater (2005). Netherlands	3–7-year-olds, n = 99 (48/51) From 3 kindergartens and 2 after-school centres in Amsterdam area. Parents average or high job classification, 68% not religious. Children tested 83% IQ > average and 100% good receptive vocabulary.	14 drawings, developed by Volbert and Homburg (1996). Individually interviewed about 30 min in their kindergarten/school. Video-Recorded.	GI GN and functions PB AS CCI CAI Children’s non-verbal reactions (NV)	GI: own gender well identified, 25% genital basis. GN: 99% named penis and 84% vagina, when also child’s own words were accepted. Most knew urinating function; 10% birth function (vagina), one 6yo: ‘To have intercourse’ (penis). PB: 12% mentioned seed or egg; 5% related to intercourse. 23% genital delivery or caesarean section, 31% did not know where baby comes out. AS: 8% intercourse, 16% something sexual. CCI: 11% neutral touch, 54% sexual description. CAI: 60% neutral touch, 0% sexual description. NV: open, natural, unsuspicious reactions.	Knowledge increased by age. No gender differences.
van Ham et al. (2021). Netherlands	3–9-year-olds, n = 90 (45/45). The aim to get 100 children failed. From pre- and primary schools around country. 99% children born in Netherlands, 10% had second language. No visual or cognitive impairment, psychiatric or behavioural disorder, earlier picture-assisted interview.	15 drawings, based on Volbert and Homburg (1996). Specially trained interviewers. Video-Recorded.	GI GN and functions AS CCI CAI NV	GI: 90% identified own gender; 99% identified sex in pictures. GN: 98% (of all) named penis and 74% vagina (62% Bs, 85% Gs). Most knew urinating function; one knew sexual function. AS: 38% making love (31% Bs, 44% Gs) CCI: 80% descriptive. CAI: 53–93% descriptive. NV: Pictures of naked children or adults, love making, and children’s play elicited most reactions as giggling.	3-year-olds knew least, 4–9-year-olds equally. Girls gave more correct answers than boys in all topics, but girls median age was higher.

*Studies that used only drawings of the body to study the naming of body parts, have been excluded.

Figure 1. Scoring of the pictures.

Table 2. Age, sex, number and the percentage of all participants.

Background variables
	Sex	Boys	Girls	Total
Age (years)
3		13 (10.2%)	10 (7.6%)	23 (17.4%)
4		12 (9.1%)	14 (10.6%)	26 (19.7%)
5		30 (22.7%)	19 (14.4%)	49 (37.1%)
6		15 (11.4%)	19 (14.4%)	34 (25.8%)
Total		70 (53%)	62 (47%)	132 (100%)

Table 3. Percentage of incorrect (does not know), partially correct, and correct answers.

	No correct information	Partially correct	Correct information
Picture 1
Names vulva	44.7	3.8	51.5
Names penis	34.1	4.5	61.4
Picture 2
Knows how a baby gets into the tummy	97.0	3.0	0.0
Knows how a baby gets out of the tummy	60.6	17.4	22.0
Picture 3
Identifies the situation as unwanted	11.4	15.2	73.5
Suggests safety skills*	41.7	56.1	2.3
Picture 4
Knows what to do if encounters bad things in media**	62.8	36.3	0.9
Picture 5
Identifies the situation as sexual	84.8	15.2	0.0

Note: Values are percentage points. n = 132, unless otherwise specified. * n = 130, ** n = 113 (follow-up questions).

Table 4. Pearson correlation coefficients between items.

Variable
	1.	2.	3.	4.	5.	6.	7.
1. Names vulva
2. Names penis	.60
3. Knows how the baby gets into the tummy	.08	.03
4. Knows how the baby gets out of the tummy	.32	.38	.17
5. Identifies the situation as unwanted	.29	.33	−.06	.20
6. Suggests safety skills	.28	.25	.04	.11	.46
7. Knows what to do on encountering bad things in media	.22	.24	.04	.10	.26	.34
8. Identifies the situation as sexual	.10	.08	−.09	.17	.08	.12	.11

Values presented with bold font are statistically significant (p < .05). Responses are coded as 0=does not know, 1=partially correct, 2=correct.

Table 5. Associations of age and sex with sexuality-related knowledge level variables.

Variable
	Sex		Age
	OR	95% Cl	OR	95% Cl
1. Names vulva	1.61	0.80–3.23	1.71	1.21–2.43
2. Names penis	0.47	0.23–0.97	1.73	1.21–2.46
3. Knows how the baby gets into the tummy	2.44	0.43–13.94	0.69	0.32–1.51
4. Knows how the baby gets out of the tummy	1.05	0.52–2.10	1.73	1.21–2.49
5. Identifies the situation as unwanted	0.81	0.37–1.77	1.70	1.17–2.48
6. Suggests safety skills	1.09	0.52–2.27	2.14	1.48–3.11
7. Knows what to do on encountering bad things in media	1.34	0.60–2.98	2.70	1.68–4.32
8. Identifies the situation as sexual	1.81	0.68–4.81	1.48	0.89–2.44
9. Summed variable: Conception and childbirth	1.14	0.57–2.28	1.68	1.18–2.40
10. Summed variable: Genital naming	0.91	0.47–1.74	1.74	1.26–2.41
11. Summed variable: Safety skills	0.91	0.47–1.76	1.92	1.38–2.66
12. Summed variable: General level of knowledge	1.23	0.67–2.25	2.28	1.66–3.13

Odds ratios (OR) and their 95% confidence intervals (CI) are from ordinal logistic regression models fitted separately for each outcome variable, and predicted by children’s sex and age. ORs higher than 1.00 indicate positive associations, ORs lower than 1.00 indicate negative associations. Sex was coded as 0=girl and 1=boy. Associations presented in bold are statistically significant (p < .05).

Gordon, B., C. Schroeder, and J. Abrams. 1990. “Age and Social-Class Differences in Children’s Knowledge of Sexuality.” Journal of Clinical Child Psychology 19 (1): 33–43. doi:10.1207/s15374424jccp1901_5.

 Web of Science ®Google Scholar

Volbert, R., and A. Homburg. 1996. ““Was wissen zwei-bis sechsjährige Kinder über Sexualität?.” [What do children aged 2–6 know about sexuality].” Zeitschrift fur Entwicklungspsychologie und Pädagogische Psychologie 28: 210–227.

 Web of Science ®Google Scholar

Brilleslijper‐Kater, S., and H. Baartman. 2000. “What Do Young Children Know About Sex? Research on the Sexual Knowledge of Children Between the Ages of 2 and 6 Years.” Child Abuse Review 9 (3): 166–182. doi:10.1002/1099-0852(200005/06)9:3<166:AID-CAR588>3.0.CO;2-3.

 Google Scholar

Brilleslijper-Kater, S. 2005. “Sexual Knowledge in Sexually Abused and Non-Abused 3- to 7-Year-Old Children.” Beyond Words: Between-Group Differences in the Ways Sexually Abused and Nonabused Preschool Children Reveal Sexual Knowledge. PhD diss., Vrije Universiteit Amsterdam.

 Google Scholar

van Ham, K. S., S. van Delft, R. Brilleslijper-Kater, J. van Rijn, J. van Goudoever, J. H. van der Lee, and A. Teeuw. 2021. “Reactions of Non-Abused Children Aged 3–9 Years to the Sexual Knowledge Picture Instrument: An Interview-Based Study.” BMJ Paediatrics Open 5: 1. doi:10.1136/bmjpo-2021-001128.

 Google Scholar