MONDAY, Jan. 6, 2014 (HealthDay News) -- More than 20 percent of at-risk seventh graders have "sexted" and those middle schoolers were much more likely to also have engaged in some type of sexual behavior, a new study finds.
Sexting is when someone sends sexually explicit messages and/or pictures by cellphone. Seventeen percent of the children surveyed said they had sent a sexually explicit message during the past six months. Five percent of the seventh graders admitted to sending sexual photos via cellphone.
Teens who sexted were almost three times more likely to have oral sex and more than twice as likely to have vaginal sex, according to the study.
"Sexting behavior was not uncommon among middle school youth and co-occurred with sexual behavior. These data suggest that phone behaviors, even flirtatious messages, may be an indicator of risk. Clinicians, parents and health programs should discuss sexting with early adolescents," the study authors wrote.
The findings were published online Jan. 6 in the journal Pediatrics.
Many of today's teens and preteens have access to the Internet and mobile devices, and this is changing the way kids communicate. Seventy-one percent of 12- to 13-year-olds had access to a cellphone, 68 percent had their own cellphone and 23 percent had a smartphone, according to the study.
While teens may be more savvy with technology than their parents are, young teens still lack the maturity to fully understand the consequences of their actions, the researchers said.
In the study, 410 seventh graders from five urban public middle schools in Rhode Island completed surveys between 2009 and 2012. All of the children had been identified by school counselors, nurses or administrators as having behavioral or emotional difficulties.
The students completed written surveys about their sexting behaviors, sexual risk behaviors and sexual activity. They were also given written tests to assess their emotional competency.
Seventeen percent of the teens said they had sent sexual text messages in the past six months, while 5 percent said they had sent sexual photos by cellphone in the previous six months. Nine percent of the teens said they had sent sexual messages via the Internet, and 2 percent said they had sent sexual photos that way.
Those who engaged in sexting were more likely to have greater physical maturity than their peers. Hispanic teens were more likely than other groups to send sexual photos via text message, according to the study. Girls were far more likely than boys to send sexual photos by text message.
Teens who sexted struggled more with emotional competence, and they had less emotional awareness than their peers, the study indicated. Teens who sexted also were more likely to report intentions to engage in sexual activity and they were more likely to feel that their peers, family and the media approved of this behavior.
Teens who sexted were twice as likely to touch genitals over clothing, 2.7 times more likely to have oral sex and 2.2 times more likely to have vaginal sex than their non-sexting peers, the findings showed.
One expert said the age at which this behavior is occurring is probably surprising to many.
"Parents probably don't think about sexual behavior as much in 12- or 13-year-olds," said Dr. Hina Talib, an attending physician in the division of adolescent medicine at The Children's Hospital at Montefiore in New York City. "This study highlights that middle school-aged teens can be vulnerable, and that doctors and parents should be screening for these behaviors and talking about media safety. This group is at risk by the way they make decisions. They think they're invincible."
Talib said she suspected the rate of sexting would likely be lower in middle school students who didn't have emotional or behavioral difficulties, but she said it's still important for parents to talk with their children about sexting.
"Sexting is almost normalized by their environment. Parents can denormalize it and teach their kids that it's not normal, it's not safe and it has ramifications and consequences that they probably haven't considered. A discussion about sexting can be a way to start talking about how healthy relationships should be," Talib said.
She suggested that parents could begin a discussion by saying something like, "'I hear that some people get text messages with sexual pictures. Have you heard about that? Do you know that you can get in trouble for that?'"
Dr. Victor Fornari is director of the division of child and adolescent psychiatry at North Shore-LIJ Health System in New Hyde Park, N.Y. He said: "The prevalence of sexting behavior among this high-risk group was one in five, including both messages and photos. The significant prevalence of this behavior identifies a new opportunity for prevention and intervention."
But, Fornari added, "How to discuss sexting with young people without increasing the likelihood of the behavior is a new question. As we have learned from other studies about efforts at reducing risk-taking behaviors, youth are more likely to listen to their peers than they are to the adults in the school. Effective interventions need to be developed that can educate youth about the risks of sexting behavior."
Learn more about how to talk to kids about sexting from CommonSenseMedia.org.
SOURCES: Hina Talib, M.D., attending physician, division of adolescent medicine, The Children's Hospital at Montefiore, New York City; Victor Fornari, M.D., director, division of child and adolescent psychiatry, North Shore-LIJ Health System, New Hyde Park, N.Y.; February 2014, Pediatrics