The study's purpose was to develop alternative explanations for sexualized behavior if sexual abuse was not confirmed or suspected. Other possible explanations explored were the presence of frequent disruptions to family life, previous unresolved exposure to sexual abuse, or contact with a sexualized child. Data were collected on 81 cases of sexualized behavior referred to a specialist child protection assessment unit over a 7-year period. The findings show that in very few cases was sexual abuse considered as an explanation for the sexualized behavior. Of the remaining cases, a substantial number showed evidence of family disruption, which could lead to sexualized behavior that develops as a comforting response for the child. Also, a number of children had experienced sexual abuse in the past, which might have been unresolved for the child; others had contact with a sexualized child, which might also have accounted for their sexualized behavior. Apparently, many of the children were facing difficulties in their lives and could benefit from therapeutic intervention, even though sexual abuse might not have been the cause of their sexualized behavior. 1 table and 12 references